A Visit to the ER

emergency roomEditor’s note: Professor Glenn Nielsen is on a partial sabbatical this year, maintaining his vicarage/internship responsibilities, but catching up on reading and writing occasional reflections on those readings. This is the first of these reflections.

When I flew to the conference in Atlanta a couple weeks ago, I knew I wasn’t feeling well.  I thought it was a little bug, but it turned out to be a significant infection caused by a nearly universal condition in aging men – enlarged prostate.  Put as delicately as I can, I could not urinate as the prostate had blocked off the urethra, causing infections in the whole urinary tract.

But I did not know that at the time.  I went to an urgent care center.  A culture was done on what little sample I could provide.  The result was a UTI diagnosis, common in women, not in men.  So I got a prescription for antibiotics and was told to drink lots of water.  I did, which, as you can imagine, only made matters much worse.  By the morning I was in such pain that I had the motel call 911 and off to the ER I went.  For the next five hours, I had blood work done, another urine sample, and then, a couple hours later, a CT scan.  By now I was in excruciating pain.  Finally, after all the lab work was done and the scan was read, the ER doctor did what should have been done hours before.  A catheter relieved (catch the pun?) the pain almost immediately.  More antibiotics were prescribed.  I was sent back to the motel.

I did not attend the conference.  I flew home and recovered for a few days.  I’m back at life again, without the catheter, a smaller prostate, and feeling much better.

I’m thankful for the medical care I received.  I’ve prayed that gratitude to our gracious God.  We have wonderful medicines, tests, and places to go to help us return to health.  Medical personnel are skilled.

But I wonder if those highly trained medical personnel are able to practice the art of medicine in the ER.  Why do I ask that?  Because during my visit to the ER (and the urgent care center), the only times I was physically touched was to start an IV, put on my wristband, take my blood pressure, and insert the catheter.  I was not physically examined, which may have made a difference as to when the needed procedure took place. Everything was done after technology had done its work: lab results, culture done, CT scan read.  But the human factor of diagnosing and moving forward seemed missing.

I mentioned this to a nurse I know, and she said that is what frustrates so many doctors.  They aren’t allowed to practice the medical art.  They have to punch into the computer the symptoms, lab results, etc, and then wait for the plan of action to be given to them.  I suppose that protects the hospital from law suits, human error, and the like.  But in my case, it kept me from the relief I needed, and I shudder to think what could have happened if the fluids had continued to build up in my bladder.  In my case, it appears to me that the doctor had become a technician rather than one who practiced the art of medicine.

I read somewhere that pilots are losing the ability to fly airplanes in difficult situations.  Why? Because the technology does so much of the actual flying now that those skills needed in extraordinary situations are atrophied.  How many can do what Captain “Sully” Sullenberger did when he landed the plane in the Hudson River a few years ago? I don’t know, and I didn’t do the research whether this is so or not.[1]

Why this TMI (too much information) about my visit to the ER? Well, at first I was going to reflect on a book I recently read about habitus, practical reasoning, and carrying out the ministry, exploring the difference between being a technician and the art of practical theology.  But that will need to wait until my next reflection.  You see, as I was reading during my recovery, I found a book review/article in Christianity Today that spoke about the medical field today and what Americans expect when they are ill or hurt.[2]  I will string together some quotations:

We had not realized how conditioned we were to see good health not as a gift, but as a right alongside liberty and the pursuit of happiness.

Instead of being grateful for the ability to stave off illness, we now demand fixes for any and all limitations, not just those caused by disease.  Cutillo says “Modern medicine looks increasingly more like the pursuit of happiness and control of the future than the cure of sickness and the care of health.”

[Medicine] is no longer a means to care for a person—body, soul, and spirit—but “a pseudoscience that reduces all of life to mechanical functions that can be measured and controlled,” says Cutillo.

Instead, Cutillo says, we must accept “the basic reality that we are dependent, frail and fragile.”  Not only are we weak, but our weakness is core to who we are.  “Our limitations are not out at the edge of our existence but at the center of our being.”  Accepting our limits is too difficult for most of us to simply choose.

Those words struck me to the core.  Now, I was incredibly blessed to have good health care in Atlanta and, despite the delay in treatment, I certainly appreciate the return to health (and good follow up with my urologist). But all it took was a small increase in the size of a small gland, and I realized how dependent, frail, and fragile I truly am.  It is at the center of my being…and yours too.  I also was reminded that it is nearly impossible to pray when you are doubled over in excruciating pain, trying to “go” while nothing is happening. Perhaps that agony is one of the times when the Spirit intercedes for us with groanings too deep for words.

But, finally, the heart of this reflection is to remind us that the gift of health is just that – a gift.  The medical care we receive is a gift too.  Yet our hope is not to be placed in a medical system that will fix us up and help us control life.  Rather, it is in a Savior, who can heal a leper and then turn our attention to the leper’s faith in the midst of thanksgiving.  Rob Moll ended his review with these words.

Not only will we get sick and suffer, but we will die.  We can appreciate and even be in awe of the wonders of medicine.  But our hope lies elsewhere.  As Paul wrote, “he who raised Jesus from the dead will also give life to your mortal bodies” (Rom. 8:11).  True health comes not from a fight to overcome the natural limits and vulnerabilities of our bodies, but from the hope we have in resurrected ones.

Indeed, give thanks for those who care for us in the medical field, but ultimately our hope is in Jesus, the Resurrected One.

Endnotes

[1] I did a quick Google search and found this joke that is said to be well known to pilots.

“What’s going to be in the cockpit of the future?”
“A dog and a pilot.”
“A dog? Why a dog?”
“Well, the dog is there to keep the pilot from touching anything.”
“Ummm, why have the pilot then?”
“Well, someone has to feed the dog!”

[2] Rob Moll, “Curing Our Misplaced Faith in Medicine,” Christianity Today (October 2016): 79-81.


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3 responses to “A Visit to the ER”

  1. Jim Rice Avatar
    Jim Rice

    Been there. Done that. Your analysis is right on. We owe a lot to those who have continued to improve medical technology and much more to our Lord Gog who sent His son to die on the cross so we are “relieved” of our sin. (Pun intended.)

  2. Esther Felsberg Avatar
    Esther Felsberg

    Being a recently retired nurse, I know where you are coming from. Frustrated by all the required cross checks, but aware of thankfulness at strides made in care. The Lord was always with me and my patients.

  3. Pastor Dave Poedel Avatar
    Pastor Dave Poedel

    As a former health care provider (physician assistant, before the profession existed) and now Pastor, and as one who recently had my prostate radically removed due to cancer, I relate to your experience in many ways.

    Between Calls I contemplated going back to school to get the needed degree for be a PA-C, my wife (a very seasoned RN) told me “you won’t like what happened to medicine”. By that she meant that emergency medicine specifically (my specialty) was very “hands on” for me as I practiced it and as I undoubtably told her over and over (I practiced before we met, so she had to rely on my possibly embellished memories) and that it was no longer that way.,

    Your explanation and excellent observations resonate with my fears that my wife was correct. Having separated one of my retinas I experienced the disjointed care in the Emergency Department of one of our local medical centers.

    I confess that my pastoral approach is very tactile and emotive at times. As a hands-on Pastor, I practice as I did in medicine: wholistically and very idealistically. Theologically sound? Absolutely! Christ-centered? YES! Lutheran? I pray so….but evangelical and catholic for sure.

    I thank you for your excellent observations. How will this change your teaching at the sem?

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