Denver Christian Docs

Define irony.

2011-07-22T14:53:00.000-07:00

Harvard Ethics student steals millions of papers.

I believe it was John Patrick, MD, who said "Ethics classes make you knowledgeable about ethics, but don't make you ethical."

New on line course on diseases of poverty

2011-07-22T14:36:00.000-07:00

by INMED. Here is the link.

How do we think about Aging in our culture?

2011-07-16T14:29:00.001-07:00

Gilbert Meilander is one of the leading thinkers on bioethics in our age. He wrote an article in April's First Things on Aging that is worth your consideration.

The Mystery Worshipper--consumer reports for churches

2011-07-16T11:03:00.001-07:00

There is an organization based out of England called "Ship of Fools" that has a crew of Mystery Worshippers that go out and "review" churches around the world. Great bunch. I reviewed a small church in New Orleans for them years ago, pre-Katrina, on a business trip.

They don't have a search function on the website that I see, but if you hit ctrl F on the browser it will substitute pretty well. Might be a good way to find a church in a new city.

Also what could be cool would be for someone searching to get registered as a Mystery Worshipper?

In His Image Family Medicine Residency

2011-07-16T10:32:00.000-07:00

It's in Tulsa, OK. Does that interest you? A residency in a Christian setting? Here is their link.

Pro-Life OB-GYN's. What a concept.

2011-07-16T09:52:00.000-07:00

There is an American Association of Pro-Life OB-GYN's. Interesting that the docs that DELIVER BABIES would need such an organization isn't it? Here is their site.

CMDA National Meeting in California this year

2011-02-10T12:17:00.001-08:00

The CMDA national meeting is a great time to meet up with like-minded physicians. When was your last medical conference, with CME, that included praise singing, devotionals, and world-class speakers? April 28-May 1; here is a link to the Christian Medical Dental Association's page for the meeting.

Marriage Enrichment Weekend in Denver for Lady Docs

2011-02-10T12:06:00.000-08:00

The first CMDA Marriage Enrichment Weekend especially for female docs is coming up in March. Here is a link to get you started. March 18-20, Loew's Denver Hotel. They still have a bit of room left.

Missionary Family Med Doc in Kenya!

2011-02-10T12:04:00.001-08:00

Matt Lewis, MD, our past President, is in Kenya doing missionary medicine. Here is his blog, reporting a day at a time. Pray for health for him, and a rich harvest for his mission.

Western Regional Report from Mike Mclaughlin

2011-02-10T12:00:00.000-08:00

Here is Mike's report for the most recent month. Please note:

Denver is doing well and we have two medical schools with active chapters.

Also note Ken Jones' entry near the bottom. Ken is a successful pastor and has a huge heart for doctors. He coaches us to do better in jobs, relationships, churches and has a vast experience to draw on. He does coaching using Skype, phone, etc. Seriously consider this resource for yourself; it certainly has helped me.

Medical Students starting back to their studies

2010-08-28T20:12:00.000-07:00

The medical students at Rocky Vista University and the University of Colorado are starting back to work. The CU students have the Christian Health fellowship, and begin meeting every other Thursday starting September 9th at 5:30 PM, ED2N 2101. They are also volunteering at the Denver Rescue Mission several nights a month.

The Rocky Vista students will be meeting on campus 2nd Tuesdays of every month, and at The Church at Parker the 4th Tuesday of each month. Weekly prayer meetings every Thursday at noon, room 223.

We have a BBQ at a local physician's home coming up September 4th; email me back at the address above to let me know if you want to come!

Then we also have an active Women in Medicine and Dentistry group (WIMD) that meets during the school year as well.

Send us an email at denvercmda at Hotmail dot Com and we'll get you hooked up.

Blessings! Jim

Gratitude and Thanks

2009-12-18T16:18:00.001-08:00

John Maxwell writes a blast Email on Leadership that I receive and sometimes actually read. Since I'm leading a study on Happiness at our church, and believe that Gratitude is one of the essential keys to happiness, this article caught my eye. Recommended reading!

Hepatitis C outbreak, sexually transmitted, in New York

2009-11-05T09:41:00.000-08:00

Just came across my Email that there is a new strain of Hepatitis C among gay men in New York City. As a pathologist I really dislike Hep C. It gets lab people all the time with needle sticks, etc. I'm a lot more afraid of Hep C than of HIV. And a new strain, efficiently sexually transmitted, with rapid liver damage?

Health Care Access Data

2009-10-21T13:43:00.001-07:00

Healthcare access data
Government and medical studies project that patients will experience a critical shortage
of physicians:
 65 million people lack adequate access to primary care physicians. They live in over
6,000 Primary Care Health Professional Shortage Areas, according to the U.S. Health
Resources and Services Administration (HRSA). It would take 16,585 practitioners to
meet their need for primary care providers.i

 50 medical studies have projected critical shortages of physicians.ii

o One study projects a shortage of 90,000 to 200,000 physicians by 2020 and
predicts that average wait times for medical specialties will increase
dramatically.iii

o “If physician supply and use patterns stay the same, the United States will
experience a shortage of 124,000 full-time physicians by 2025,” concludes a
report by the American Association of Medical Colleges.iv

 45% of doctors would consider quitting if Congress passes health care overhaul.v
Risking the loss of faith-based professionals by weakening conscience protections risks
access for millions of patients:
 One in eight hospitals in the U.S. is affiliated with the Catholic Church; they employ
more than 750,000 people and handle 16% of hospital admissions.vi

 Each year, one in six patients in the U.S. is cared for in a Catholic hospital.vii

 Pollingviii bodes ill for access if faith-based healthcare professionals lose conscience
protections:
o 95% of faith-based physicians agreed, "I would rather stop practicing medicine
altogether than be forced to violate my conscience."
o 32% of faith-based healthcare professionals report having "been pressured to refer
a patient for a procedure to which [they] had moral, ethical, or religious
objections."
o 20% of faith-based medical students say they are "not pursuing a career in
Obstetrics or Gynecology" because of perceived discrimination and coercion in
that field.

i “Shortage Designation: HPSAs, MUAs & MUPs,” HRSA web site http://bhpr.hrsa.gov/shortage/
ii “Recent Studies and Reports on Physician Shortages in the U.S.,” Association of American Medical Colleges,
April 2009. http://www.aamc.org/workforce/stateandspecialty/recentworkforcestudies.pdf
iii Merritt, J., J. Hawkins, et al. (2004). “Will the Last Physician In America Please Turn Off The Lights? A Look at
America's Looming Doctor Shortage.” Irving, TX, Practice Support Resources, Inc. For a summary of this study and
book, see
http://www.aameda.org/MemberServices/Exec/Bookreviews/spg05/Will_the_Last_Physician_in_America.pdf
iv “The Complexities of Physician Supply and Demand: Projections Through 2025,” AAMC report, October 2008.
https://services.aamc.org/publications/index.cfm?fuseaction=Product.displayForm&prd_id=244
v “45% Of Doctors Would Consider Quitting If Congress Passes Health Care Overhaul,” Investor's Business Daily,
Posted 09/15/2009 07:09 PM ET. http://www.investors.com/NewsAndAnalysis/Article.aspx?id=506199
vi “Health-Care Overhaul Creates Dilemma for Some Catholics,” Wall Street Journal, August 5, 2009.
vii Catholic Health Care in the U.S., January 2009 report of the Catholic Health Association.
http://www.chausa.org/NR/rdonlyres/68B7C0E5-F9AA-4106-B182-7DF0FC30A1CA/0/FACTSHEET.pdf
viii On behalf of the Christian Medical Association, The polling companyTM, inc./ WomanTrend conducted an
online survey of members of faith-based organizations, fielded March 31, 2009 to April 3, 2009. It was completed
by 2,865 faith-based healthcare professionals.
http://www.freedom2care.org/docLib/200905011_Pollingsummaryhandout.pdf

Health Care Access Crisis Looming

2009-09-28T14:18:00.000-07:00

All of us need access to healthcare. We Christian docs are called to provide care. But what happens if there just plain aren't enough of us?

Currently we are at an uneasy state with Physicians in the US. We already have fewer docs per population than other major developed countries (2.4 per thousand, vs 3.1 per thousand.) We are growing in numbers more slowly than our general population is. And in several states, and in several specialties, shortages are growing severe.

So that is the background. Now enter Federal Healthcare Reform.

Much of it sounds good. However, there is a fly in the ointment.

A recent IBD poll shows that as many as 45% of American Doctors will QUIT practicing if current proposals pass!

Is this a morally acceptable position? Each of us has to answer that for him/her self. Regardless of our positions, however, we will be working a lot harder.

Now, notice a new fly in the ointment. The Administration earlier this year announced that it would like to rescind the HHS regulations that recently went into effect to protect the conscience rights of healthcare providers. In brief, there have been a couple of Congressional actions (the Church amendments and the Hyde-Weldon amendment) that state that it is illegal to discriminate against a healthcare professional that refuses to do procedures that violate her conscience. Unfortunately (only a lawyer could come up with this) the amendments contain no enforcement provisions! So a person can break Federal law by forcing you to perform an abortion or quit, and there is no penalty.

The recent HHS regulations simply codify a set of enforcement provisions, that's all. The President wants to get rid of that enforcement. Let me ask you: if it was illegal to speed down I-25, but you knew there were no radar patrolmen, airplanes, speed traps, in fact that there was no way you could get any kind of citation, how fast would you really drive?

Now the Christian Medical and Dental Associations has 16000 members. This is certainly far fewer than the total number of doctors of Christian Faith in the United States. A recent scientific poll of 2865 members of various faith based organizations showed that 95% would quit practice rather than violate their conscience. I don't have data, but I'm highly suspicious that Christian and Catholic docs quitting would disproportiately hurt the poor and underserved. As a general rule, believing Christians of all stripes do more charity work on their own than do secular folks, and the least personally charitable are those on the Left. (There are about 800,000 physicians currently in practice in the US.)

Is conscience protection really a problem? 32% of docs surveyed said they had been pressured to refer a patient for a procedure that violated their conscience. 39% were pressured by faculty during training to do the same. This is not rare. I personally know an OB-GYN resident, at a CATHOLIC HOSPITAL, who reported such pressure. This is a real problem. Makes you wonder who is really "imposing their morality on others."

Another interesting fact: about 16% of beds in the US are in Catholic Hospitals. What if they shut down rather than bend to a US government mandate? How arrogant to think that a 2000 year old international religious group would reverse their opinion of abortion based on current political fashion in the US!

In summary, the poor and rural communities of the United States are about to be hammered. Write your congressman, senators, and the President.

Conscience Protection Website

2009-09-26T15:48:00.000-07:00

Your freedom to care for patients according to ethical standards is under attack. Go to this website for further information.

Center for Global Health at CU Denver

2009-08-23T08:47:00.000-07:00

There is a Center for Global Health at CU. Director is Cal Wilson, MD. It is a great local secret!

Physician assisten suicide is getting closer

2009-08-06T14:21:00.000-07:00

This shocked me. Two patients on Oregon's Medicaid (i.e., government) health plan received letters that the plan would not pay for their chemotherapy, but WOULD pay for barbiturates to end their life. Oregon is one of two states that have legalized Physician Assisted Suicide.

Go with me on this. If you believe that the government should run healthcare and that cost containment is important, what argument can you give in our secular public square that physician assisted suicide is not a great option? There are people out there who would save their dog before saving a human. Sedatives, less than a hundred bucks vs treatment of hundreds to thousands a month. "Care at the end of life costs way too much for too little benefit." So slip Granny a mickey and say goodbye. Oh, and also, that way she won't spend the kids inheritance on her long term care. Everybody wins (except granny, and after all she's had a good long life...)

"That would never happen in the United States." Tell that to the patients in Oregon. They had to go to the news to get treated.

Healthcare reform analysis

2009-07-25T09:32:00.001-07:00

Our own Dr. Walt Larimore has done some interesting analysis and points to some others. Here are some points. How often have you heard that the US:
1. Has 46 million uninsured;
2. Has the highest infant mortality rate in the developed world;
3. Insurers cover less costs today than they used to?

Here are some links. First, an analysis of the "uninsured" shows that the REAL number is probably between 10 and 35 million depending on your assumptions. If it's 10 million, should we really blow up the entire US healthcare system for 3% of the population? Wouldn't it be a LOT more efficient, kinder, better to figure out how to cover those few? If it's really only 3%, how about us docs stepping up and doing more charity care?

Second, an analysis of 9 circulating myths about US healthcare. Did you, for example, know that European countries don't count as many stillbirths etc as "infant mortality?" the US counts them all. No wonder we don't look as good.

Here's another myth: "We pay much more for health care, but our expected life span is shorter than Europeans." But an analysis has shown that if you subtract out automobile accidents (we drive a LOT more than Europeans) and homicide (you really can't blame the health system for 19 year old drug dealers shooting each other) we actually live LONGER than Europeans. Interesting, no?

How about this quote? (same source as above.)

"In countries with nationalized care, medical outcomes are often catastrophically worse. Take breast cancer. According to the Heritage Foundation, breast cancer mortality in Germany is 52% higher than in the U.S.; the U.K.'s rate is 88% higher. For prostate cancer, mortality is 604% higher in the U.K. and 457% higher in Norway. Colorectal cancer? Forty percent higher in the U.K."

We physicians need to recall one of our primary principles: Primum non nocere. First do no harm. If we nationalize our healthcare system, will we harm 90% or more of our patients?

Physician Assisted Suicide

2009-05-12T12:10:00.000-07:00

Here is an article from a Catholic news service on "euthanasia." Read it and weep. Years ago I predicted that economics was a partial driver of this misguided movement, and noted to some secretaries that the thought of giving Managed Care companies the idea that when care got too expensive they could off the patient scared me to death. I've not had time to pursue the Fox reference in the article about the man with prostate cancer who was told, "No chemo, but we will pay for the drugs for your assisted suicide."

Rabbi Telushkin on the questions God will ask...

2009-04-09T21:00:00.000-07:00

Youtube video on the four questions the Talmudic rabbis thought God would ask a new arrival in heaven--perhaps a bit like the old St. Peter at the gates jokes, but a serious look by a highly trained, committed, incredibly ethical man. His most recent book is "A Code of Jewish Ethics 2. Love your neighbor as yourself."

I watched this and quite frankly Christians have a lot to learn from this man.

JAMA article on Crucifixion, a classic

2009-04-09T08:00:00.000-07:00

In 1986 several physicians wrote an article on the medical aspects of crucifixion. I commend this article to you on this Easter Season. Mel Gibson was not so very far off in his movie on the Passion, unfortunately. It is worth reflecting that we humans have not "evolved" significantly since the Roman times.

Catholic Medical Association Meetings

2009-04-06T15:22:00.000-07:00

Here is a calendar of upcoming meetings of the Catholic Medical Association of Denver. Take a look! Next meeting is April 22nd, a "potpourri of medical ethics cases."

The subtle barrier of "God Talk"

2009-04-05T18:17:00.000-07:00

Perhaps I'm sensitive to this because of my background--the first thirty years of my life, I was totally unchurched, agnostic/atheist. As a result, perhaps my ear is better tuned to the culture we're in. But some years after my conversion a perceptive friend asked me what my reaction was to God Talk in church, and it still makes me a bit uncomfortable.

It's natural. Every group develops its own specialized vocabulary. We doctors are famous for producing unintelligible sentences for patients and families. Lawyers are just as bad. Accountants? Mix numbers and letters together! 401-k. 501-c-3. IRS 1099. You name it.

We do it in church, too. Sixty years ago in an essay to the Anglican Priesthood, CS Lewis wrote about the problem in terms that sound very familiar today. It's Essay 10, Chapter 10, Christian Apologetics, in the book God in the Dock. Here are some examples from 1945:

Creature. Means a brute or beast to the Modern, NOT a "created being."
Atonement. Not used by Moderns.
Charity. Means giving money or goods to others. Does not imply anything about Love or any link to Faith or Hope.
Dogma. Means unproven assertion enforced in an arrogant manner, not "truth."
Morality. Simply means "chastity" (or actually, boring lack of fun.) Usually associated with "sexual inhibition." Has lost
any implication of "doing what is right."

Last week we had Walt Larimore and Bill Peel deliver "The Saline Solution" to a group of docs, allied health, students, etc. One of the pages in the book talked about Red Flags that kill discussions of faith. Do any of these sound familiar to you? (I plead guilty to some of them...)

It's a proven fact that...
That's just the way it is...
There's no question that...
The Bible says...
You're not serious?

All of us need to relearn to continue conversations, to extend them. Did we not have training in this in school? It is disrespectful to lecture another of God's Creatures (see above.) Ask questions. Laugh. Avoid closing off conversations, avoid the killer phrases. Listen. People these days are fascinated by the spiritual and may be willing to hear your story if delivered gently.

Post on Conscience Abortion, and the Govt

2009-03-23T10:25:00.000-07:00

This is linked from the Susan B. Anthony list.

Archbishop Chaput speaks in Canada about politics

2009-03-03T09:45:00.000-08:00

Archbishop Chaput is a courageous man of God in Denver and we are blessed to have him here. He spoke recently in Canada on "Rendering unto Caesar". I've heard good things about his book with a similar title; haven't read it yet. But the talk is worth reading for all of us who call ourselves Christian.

Francis Collins speaks at Tulane on Faith and Science

2009-02-06T07:12:00.000-08:00

DenverDocDaughter2, the middle one, was chased out of New Orleans by a little storm called Katrina a few years back. She was attending Tulane University down there getting a Drama Degree. This choice did not surprise those of us who know her by the way! But ever since I have been getting Tulane news on my email. Since she graduated a while ago I usually don't read them, but the title caught my eye: Geneticist talks about faith and science. Dr. Collins was head of the Human Genome Project and wrote "The Language of God" (which is worth reading.)

A Doctor's Journey with Cancer

2008-12-31T21:12:00.000-08:00

Take a look at his website. A nonsmoker, he came down with lung cancer earlier this year. His website is a great witness.

Note: He was interviewed on Christian Doctor's Digest this month. It is a good story.

Porter Chaplain's Website

2008-12-31T20:43:00.000-08:00

Take a look. They call it "Words Worth Remembering".

The Expectation of Gratitude

2008-12-31T20:40:00.000-08:00

The Expectation of Gratitude

Luke 17:11, NIV.
Now on his way to Jerusalem, Jesus traveled along the border between Samaria and Galilee. 12As he was going into a village, ten men who had leprosy[a]met him. They stood at a distance 13and called out in a loud voice, "Jesus, Master, have pity on us!"
14When he saw them, he said, "Go, show yourselves to the priests." And as they went, they were cleansed.
15One of them, when he saw he was healed, came back, praising God in a loud voice. 16He threw himself at Jesus' feet and thanked him—and he was a Samaritan.
17Jesus asked, "Were not all ten cleansed? Where are the other nine? 18Was no one found to return and give praise to God except this foreigner?" 19Then he said to him, "Rise and go; your faith has made you well."

A 49 year old woman came in for biopsy of an ovarian cyst. The gynecologist sent me a portion for frozen section. I overcalled it as a malignancy, and she had a hysterectomy. The next day I realized my mistake and called the doc, who said that he would go tell the patient the good news. “She will be thrilled—she doesn’t have cancer!”

The way she showed me how thrilled she was, was to file suit for excessive surgery due to my error.

Most of us came to medicine to help others. We work long hours, gave much of our youth to studies rather than parties, sacrifice time with our own families. Of course we mostly do get paid well, but on the other hand we are on call and get called at all hours.

Is it too much to expect gratitude in return? Can’t we expect that people will understand how hard we work, how hard we try, how much we sacrifice, how much we worry over their conditions? Isn’t it wrong and unjust of people to not at least thank us?

And what do we often get? Complaints about bills. Complaints about waiting too long in the office. Complaints that recovery is taking too long. And of course complaints filed in court.

As I’ve matured, the realization has dawned that it is unwise to rely on expectations of undying gratitude and thanks from our patients. While gratitude and generosity are the absolute requirements for a happy and joyful life, for some reason many people choose ingratitude, thoughtlessness, or greed. Their choice is beyond my control, and should not dictate my satisfaction with my chosen calling as a pathologist. The scripture for the day reminds me that gratitude is a gift, not an obligation.

Luke 17 is a great story for young doctors and medical students. It teaches that even Jesus himself, performing miraculous cures that nobody else could have done, received only 10% gratitude. In fact, as I look back, I’ll bet my record is better than 10%. Our reward is doing a good job, taking the best care of people who have trusted their lives and health to our care and skills. The few times they come back to thank us are not their obligation, but a grand, generous, and unexpected gift from them to us, to be savored, enjoyed, and appreciated.

Lord, you of all of us most understand ingratitude from those you love. Your people constantly turn from your open arms and defy your loving instruction. We know you want to make us like you, like your Son. Teach us to serve without expectation, to excel in our work with your sons and daughters, to help them in their sufferings, and to rest content whether they think to thank us or not. Amen.

Bible knowledge can save your life!

2008-12-26T08:46:00.000-08:00

A woman had just returned to her home from an evening of church
services, when she was startled by an intruder. She caught the man in the
act of robbing her home of its valuables and yelled: 'Stop! Acts 2:38!'
(Repent and be Baptized, in the name of Jesus Christ, so that your sins
may be forgiven.)

The burglar stopped in his tracks. The woman calmly called the police and
explained what she had done.

As the officer cuffed the man to take him in, he asked the burglar: 'Why
did you just stand there? All the old lady did was yell a scripture to
you.'

'Scripture?' replied the burglar. 'She said she had an Ax and Two 38s!'

Merry Christmas!

Thanks, and then Giving!

2008-12-22T19:57:00.000-08:00

It is not an accident that Thanksgiving introduces the holiday season, beginning with Thanks. The other bookend is Giving. At Thanksgiving we talked about the vital importance of Gratitude, Thanks, to happiness and fulfillment. Just as vital to our mental and spiritual health is Giving, commemorated by Christmas and Hanukkah in the Judeo-Christian tradition.

The Bible encourages us to give.
Jewish Scriptures:
Give generously to him and do so without a grudging heart; then because of this the Lord your God will bless you in all your work and in everything you put your hand to. Deut 15:10.
The generous man will be prosperous, and he who waters will himself be watered. Prov 11:25.

Christian Scriptures:
It is more blessed to give than to receive. Acts 20:35
Give, and it shall be given to you. For whatever measure you deal out to others, it will be dealt to you in return. Luke 6:38
For God so loved the world that he GAVE his only Son, that whoever believes in him shall not perish but have eternal life. John 3:16.

How about other traditions?

Hindu wisdom says “They who give have all things; they who withhold have nothing.”

Dalai Lama: “If you wish to experience peace, provide peace for another.”

Arab proverb: “If you have much, give of your wealth; if you have little, give of your heart.”

Lao-Tzu: He who obtains has little. He who scatters has much.”

Pericles, Greece: What you leave behind is not what is engraved in stone monuments, but what is woven into the lives of others.

Seneca, Rome: There is no delight in owning anything unshared.

Churchill: We make a living by what we get, we make a life by what we give.

Albert Schweitzer: I don’t know what your destiny will be, but one thing I do know, the only ones among you who will be really happy are those who have sought and found how to serve.

C. S. Lewis: Nothing that you have not given away will ever be really yours.

Lord, thank you for making the world and giving it to us. Thank you for giving us life. Thank you for giving us your image, as a generous Giver. The wise of all times and places teach us to give to each other, and that in so doing we will become more truly ourselves. Amen.

Happy Thanksgiving--2008

2008-11-27T08:27:00.000-08:00

To Be Happy, Give Thanks—2008

The Bible tells us to be thankful:
Enter His gates with thanksgiving and his courts with praise; give thanks to Him and praise His name. For the Lord is good and His love endures forever; His faithfulness continues through all generations. Psalm 100:4-5, about 1000 BC

Thanks be to God for his indescribable gift. II Corinthians 9:15, about 50 AD

Why? Is this God’s ego trip? I don’t think so. I think it’s ultimately what’s best for me. Being thankful is the ultimate selfish act. I am happier and healthier when I’m grateful.

How about non-Biblical sources?

Buddhist Proverb: “Enough is a feast!”

Epictetus, Greek philosopher, 100 AD: “He is a wise man who does not grieve for the things he has not, but rejoices for those which he has.”

Cicero, Rome, 100 BC: “Gratitude is not only the greatest of virtues, but the parent of all others.”

Dale Carnegie, in How to Stop Worrying and Start Living, 1948:
Rule 4 in Seven Ways to Peace and Happiness: Count your blessings, not your troubles.
“The habit of looking on the best side of every event is worth more than a thousand pounds a year” –Dr. Samuel Johnson
“If you have all the fresh water you want to drink and all the food you want to eat, you ought never to complain about anything.” Captain Eddie Rickenbacker
“I had the blues because I had no shoes,
Until upon the street, I met a man who had no feet.”

Dennis Prager, in Happiness is a Serious Problem, 1990’s:
“Yes, there is a ‘secret to happiness’—and it is gratitude. All happy people are grateful, and ungrateful people cannot be happy. We tend to think that it is being unhappy that leads people to complain, but it is truer to say that it is complaining that leads to people becoming unhappy. Become grateful and you will become a much happier person.”

“Thus, it is in our self-interest to feel grateful because it helps enrich our own experience of life. Thanksgiving, in this view, should be every day of the year.” --Gregg Easterbrook

David Steindl-Rast, 2001: “Gratefulness makes us aware of the gift and makes us happy. As long as we take things for granted they don’t make us happy. Gratefulness is the key to happiness.”

Thank you for our many blessings. Thank you for the gift of love, that at times we don’t deserve. Thank you for our family, that we did not choose. Thank you that we happened to be born in the United States with its freedoms, opportunities, and second chances. We know that we did nothing to earn that blessing. Thank you for the wisdom of George Washington, who established Thanksgiving as a national holiday. He recognized the vital importance of gratitude. Thank you for the gift of life that makes all other gifts possible. And thank you for creation, and for your love, and for your help and guidance in making us better and happier people. Amen.

Snake bite deaths in the world

2008-11-04T13:40:00.000-08:00

Not certain why this struck me (pun not originally intended but I'll take credit) but here is an article about a huge problem in Asia, Africa, South America. Estimates are highly suspect, but 20,000 people a year may die from snakebite.

New Rand study links sexy TV shows to risky behavior

2008-11-03T14:46:00.000-08:00

Hot off press. Watching Friends etc., where people hop in and out of bed freely, seems to be associated with increased sexual activity and pregnancy among teens. What a surprise.

Israeli Archaeologists find old writing

2008-10-31T14:00:00.000-07:00

on a shard of pottery. Interesting!

Seminar series on Palliative and Hospice Care

2008-10-21T15:37:00.000-07:00

PSL is presenting a series which started Sept 26th and has more sessions coming on 11/14, 1/9/09, 2/13/09, 3/13/09 on various issues in palliative and end of life care. They are Fridays at Noon, Grand Rounds. COPIC is giving a point toward malpractice discounts. Instruction is by Dan Johnson, Lorrie Odom, or Donna Rosenberg. Christian Docs should be interested in this. I believe one of the drivers of the toxic Physician Assisted Suicide movement is our professions abandonment of the dying and our failures to learn about good pain management and depression treatment in the elderly.

Mother Teresa had a quote that almost brought tears to my eyes:
"A beautiful death," she said, "is for people who lived like animals to die like angels — loved and wanted."

The racism of abortion politics

2008-10-21T15:13:00.000-07:00

Here is a post by an african-american bishop in Washington, DC. Pretty powerful.

Those of us in medicine realize that African-Americans have a higher incidence of hypertension, heart disease, stroke, and prostate cancer among other things. Look at this excerpt from the above link:

Many African Americans are not aware that since the Roe v. Wade decision legalized abortion throughout all 9 months of pregnancy, the number one cause of death in the African American community has been abortion. We have lost over 13 million lives. To put that in perspective, it is one third of our present Black population. Since 1973, twice as many Black Americans have died from abortion than from AIDS, accidents, violent crimes, cancer, and heart disease combined.

Augustine College, Ottawa, with John Patrick MD

2008-09-28T08:26:00.000-07:00

Augustine College is a Christian project in Ottawa, Canada. CMDA top speaker John Patrick, MD is one of the founders. They do several important things: taking students who have graduated high school, college, even medical school and beyond and giving them a one year intensive classic faith based education; taking practicing docs and dentists for a one week series of seminars on similar topics; and sponsoring lectures and writing throughout the year.

I attended one of the week-long sessions and HIGHLY recommend it. During the time we met some of the students and they are a bright and engaging lot. If you have a child of the proper age, you could sure do worse than to send him or her for a year with John and the rest of his accomplished and faithful faculty. They might even come out able to spell Honour, Colour, and Programme Properly!

Here is their fall newsletter in pdf.

Never leave your partner behind!

2008-09-28T08:20:00.001-07:00

Review of Fireproof, a new movie coming out this weekend. I've heard good things about it from a fellow elder at church and from one of our pro-life PA's.

Never leave your partner behind? What fireman or Marine or policeman could live with himself if he left his partner in a dangerous situation? What doc or dentist abandons his colleage in an operation? But, how many of us leave other partners behind--spouses, children, parents, friends? I've done it!

We'll see if we can carve time out to see Fireproof soon so Hollywood gets the message to continue making good films.

When a Christian stops...

2008-09-28T07:47:00.000-07:00

When a Christian shuns fellowship with other Christians, the devil smiles.
When he stops studying the Bible, the devil laughs.
When he stops praying, the devil shouts for joy.
Corrie ten Boom

Financial Peace University

2008-08-07T13:29:00.000-07:00

A couple of churches in the area including mine are going to be offering Financial Peace University this fall. It is a biblically based, practical money management system that can truly be life changing. We docs and dentists think that because we are smarter than average, somehow we know about money. Wrong. There are classmates of ours from college that are just as smart, just as competitive, just as hard driving, who learned about business and finance. Come to FPU and learn a straightforward set of techniques in just a few weeks. Or consider giving it at reduced rate or free to a needy person/couple you know.

Here are just a couple of links:
Starting Sept 3rd, South Denver area
Starting late August, Parker area
A search page for zip code 80113 and surroundings

Irena Sendler, hero of WWII

2008-08-07T09:43:00.001-07:00

This is a very nice, moving tribute to a brave Polish woman from WWII who rescued many children from the Nazis.

Another Adult Stem cell advance

2008-08-01T14:32:00.000-07:00

I get the AMA newsletter daily on Email. It's common to get a story about a new stem cell therapy or advance. Funny how not one has ever used embryonic stem cells. This most recent took skin cells from patients with ALS and did some manipulations to make them more primitive, then re-differentiate them.

Finances, finances

2008-07-27T15:45:00.000-07:00

Proverbs 11:24-25. One man gives freely, yet gains even more. Another withholds unduly, but comes to poverty. A generous man will prosper; he who refreshes others will himself be refreshed.

Think about whether you have your money, or it has you.

Tough question, one I wrestle with. One of the ways of loosening its hold is tithing. I really got inspired by Dave Ramsey, and we will be teaching Financial Peace University this fall at Hope Fellowship Church. There are other courses all over the city, check Dave's website. It is biblically sound and effective.

We docs think we know a lot about money because we know a lot about medicine, but mostly it's not true. As I told the medical students last year, out in the world some of your college classmates who are just as smart as you, and just as competitive as you, and work just as hard as you, went into finance.

What can you listen to on the road?

2008-07-24T16:11:00.000-07:00

I admit to being a podcaster. Each day I bring up iTunes and it automatically downloads the latest broadcasts from Dave Ramsey (Christian-based, but great financial advice for anyone) and Dennis Prager, my favorite talk show. Ramsey's full podcast without commercials is subscription based, Prager's is free. I also download the Mars Hill Audio Journal, with Ken Myers, a wonderful bimonthly or so set of entertaining and informative interviews with a Christian slant on government, books, music, authors, faith practices, all kinds of things. Mars Hill is less than $30/year for podcasts (MP3.)

I really did try the OCD thing, purchasing CME on CD. Maybe your specialty is more dramatic, but listening to a guy drone on about the various immunostains useful for discriminating between Mantle Cell and Marginal Zone lymphoma was a problem for me on I-25. Talk radio is loud and there are a lot of strange commercials. Sports radio didn't do it for me. Music alone is OK but sometimes I'm a LITTLE bit OCD and want information.

Getting started can be a bit weird if you're not a techno-nerd, but it's definitely worth it.

Another Adult Stem Cell advance announced

2008-07-23T16:06:00.000-07:00

The use of umbilical cord blood, or adult, stem cells keeps on progressing. Here is a report of how adult cells can grow new blood vessels.

What about the ethically embarrassing embryonic stem cells? Well, they grow teratomas, malignant tumors!

Pedal for a Purpose!

2008-07-15T17:18:00.000-07:00

There will be a benefit Bike Ride for Missions Ministries in concert with the International Christian Cycling Club on August 2nd, 2008. It starts at Denver Seminary, 6399 S. Santa Fe Drive. Wish I could be there; DenverDoc loves to cycle, but I'm on call (yes, pathologists take call...) and I don't think being half-way up Lookout Mountain and getting paged sounds like much of a plan. Bummer! Perhaps next year.

Missions Ministries is where we've had two Pap Smear mission trips, and we have a third annual event coming up in February. It has been a delight both times. Perhaps this year will be your first Mission Trip?

DenverDoc on the Dance Floor

2008-07-09T17:09:00.000-07:00

Well, it had to be done. DenverDocDaughterOne is married, and DenverDoc had a last Father-Daughter Dance. Touching. Link is to a YouTube video of the event.

New Osteopath Medical School in Denver Area

2008-07-09T09:43:00.000-07:00

There is a new school, Rocky Vista University, opening up in Parker east of Denver. They will have a chapter of the Christian Medical and Dental Associations there. We are looking forward to years of service, cooperation, and good plain fun and fellowship.

seventh "Loser Letter" (Screwtape for Atheists)

2008-06-27T14:48:00.000-07:00

Been off getting DenverDocDaughterOne married this weekend in La Jolla! Wonderful service, food, dancing, both families like each other even. Amazing.

The Seventh "Loser Letter" (Screwtape style) is here. Talks about the Atheist position on Abortion. Funny like all the others. Her logic is great.

By the way, speaking of logic, take a look at this site I found. The story is about a cat up a tree superficially, but it has an interesting part at the beginning talking about the ineffectiveness of pure logical positions in convincing anyone: you have to appeal to the heart. Christians and Doctors must remember this!

Let me see if I can find the others while I am here. These deserve wide readership.

Ahah! Found a link to The Author Archive with links to all her letters.

When will they ever learn?

2008-06-11T07:21:00.000-07:00

Remember that song from the 60's? See this article from AP: 25% of New Yorkers have genital herpes. Herpes doubles your risk of contracting HIV; it appears that people with genital inflammation both spread HIV more easily AND are at higher risk of contracting it. DenverDoc looks at a lot of pathology slides; people with inflammation have poor barriers, and also have a lot of lymphocytes in the inflamed areas. If there are a lot of lymphocytes, there are a lot of viral targets in the uninfected, and a lot of virus in the infected.

Herpes is for life.

Look at the last line. "The health department urges consistent use of condoms..." Yes, it is still important to maintain some fantasy that people can have as much sex with as many partners as they like with no consequences. That is MORE important than saving lives or keeping people healthy. Here is a link to an Annals of Internal Medicine article examining condom use. They loudly proclaim in the Abstract that condoms reduce the risk of HSV infection, but in the fine print at the bottom, they admit that frequent condom users have a 26% lower risk of infection. 26% lower? What a triumph. An incurable disease that puts a woman's pregnancies at risk, causes pain, increases risk of HIV, and we have public health authorities proclaiming that we need to use more condoms. At least the CDC website says that abstaining from sex or having a long term monogamous relationship is the most effective way of avoiding herpes (before bowing to the Condom idol once again.)

We Christians have a problem here, though. If we point out that having sex is dangerous, we get painted as either prudes or even worse, worshiping a God who punishes people for acting the way he created us. Worshiping at the idol of Free Love even takes priority over worshiping at the idol of Health!

I guess my best response is to say that we live in a dangerous world and that God gave us guidelines that help us avoid many of the dangers. If we ignore the guidelines and get hurt, is that divine retribution or our stupidity? If I run a red light and get hurt in a car accident, is that my stupidity or is it Colorado's Dept of Motor Vehicle imposing some kind of unfair punishment? Please.

Health Care Missions Conference September

2008-06-10T13:47:00.001-07:00

I just got an Email from CMDA with this conference in Pasadena, sounds interesting. Wish I could go but I think I'm on call that weekend.

Burn out comment

2008-06-01T13:13:00.000-07:00

When I was in residency, there was a new Pathology resident who had spent several years as a practicing neurologist. One day we were talking, and he said:

Well, what you have to realize is there are two kinds of patients: sociopaths and neurotics.

Neurotics think everything is their fault. Sociopaths think nothing is their fault.

It is important to establish quickly which group the patient is in, because it makes it much easier to communicate with them.

He really needed to be away from patient care at least for a while!

DenverDoc in North Carolina

2008-05-25T19:35:00.000-07:00

DenverDocWife found us a vacation spot in Holden Beach, NC many years ago and we've come back every year. This year for the first time I attended Holden Beach Chapel. It was packed! I'm used to our Evangelical services back home, and the more liturgical service was a nice change. The preacher was a Methodist, which hearkens back to my conversion in Salt Lake City at a Methodist church. On May 24, 1738, John Wesley wrote,

"I felt my heart strangely warmed...and an assurance was given me that he had taken away MY sins, even MINE and had saved ME from the law of sin and death."

Wesley had already been a successful evangelist for several years at this point. It just goes to show how mysterious the Lord is and how individual the walk of faith. Wesley came suddenly one Wednesday night to the realization that Christ went to the cross for HIM alone as much as for all the masses.

The preacher also told a story about Billy Graham's wife, alone with the kids while Billy was out preaching. A friend told her to rephrase John 3:16 personally: For God so loved ME that he sent his only begotten son, that I might have eternal life...

It was good. I walked out refreshed and ready for more recreation with my family.

Google Health comes on line

2008-05-23T13:04:00.000-07:00

Google has announced Google Health, a portable electronic medical record, free like most of their services. This article reviews it.

Marry Him! An interesting article.

2008-05-23T12:39:00.001-07:00

You have figured out by now that I like to podcast Dennis Prager (and also Dave Ramsey, on finances.) I heard Dennis interview a woman who thinks a lot of modern, well educated women miss out on Mr. GoodEnough waiting for Mr. Perfect. She wrote an article in The Atlantic which I recommend to you. This could be particularly poignant for young women in medical training; medicine is a jealous career.

Since DenverDocDaughterOne is getting married in a month (!!!), I'm going to use my soapbox. What did I tell my daughters?
1. Look at how boyfriend's DAD treats boyfriend's MOM. That is his modeling.
2. Use your brain early on. Someone in the relationship has to use her brain, and I'm telling you most of the time it is not the guy.
3. As a Christian, you have the obligation to have some friends that are projects, that need help. But you ALSO need some friends who are good for you. Of critical importance is, you DO NOT marry a project!

(at this point, DenverDocWife pointed out that "Dear, all men are projects.")

Yes, most women do believe this. Many men need a little bit of finishing carpentry and that is a cute hobby. But some men need deep foundation repair, and you do not want to try to repair deep foundational issues in a spouse. You cannot change another human being; most of us have a great deal of trouble changing ourselves!

4. If at any time you decide this guy is a poor risk for the long term, get out now. There are lots of other guys out there. You may get stuck emotionally if you keep going out with the wrong guy.

OK, back off the soapbox.

The Loser Letters, part 2

2008-05-23T11:53:00.000-07:00

in which the author talks about problems atheists (or anyone else, for that matter) has when they claim that "Reason" is on their side. We all need to recognize that reason is only a tool, not a worldview. Reason works with the raw material you give it: the assumptions, observations about the world. Nazi's took the unprovable assumption that there were lives not worth living and applied reason to it to create gas chambers. (Interesting that they began with crippled and retarded children, isn't it?) Anyone who thinks that religious people do not use Reason has not read C. S. Lewis, Thomas Aquinas, Isaac Newton, Augustine, or St. Paul. Science, also, is a tool, a highly successful method for uncovering natural mechanisms and relationships. It has very little use outside of nature, however, and makes a lousy deity.

Addition: A quote from John Wesley, founder of Methodism:
“Passion and prejudice govern the world; only under the name of reason”

The Loser Letters (on the New Atheism)

2008-05-21T10:31:00.000-07:00

A new series is appearing called The Loser Letters. It is supposedly a letter from a Convert to Atheism to some unnamed Atheist, extolling the virtues of atheism (but as you will see it is a lot like the Screwtape Letters...) Enjoy.

The first letter is mostly about sexuality.

Suffering

2008-05-21T07:42:00.000-07:00

I was listening to the John Patrick CD some more and he said that one of the important issues is, what value could there be in suffering?

Dennis Prager said recently in his debate with the American Atheists that the believer has to explain the existence of unjust suffering, and that is a real problem. The atheist has to explain the existence of everything else.

Peter Kreeft has written a wonderful book on this subject that I read for John's Augustine College course for physicians. The link is to Amazon used books; looks like it may be out of print. You could try a used Christian bookstore also. If you can manage it I HIGHLY recommend spending a week up in Ottawa with them--it's like the fun part of College without the angst.

A quote came across my Email today that also may be pertinent:
God is more concerned about our character than our comfort. His goal is not to pamper us physically but to perfect us spiritually. Paul Powell.

If we are citizens of Heaven and visitors on Earth, we need to recognize that suffering has physical, emotional, AND spiritual components. As physicians, we should consider relief of suffering to be important but not paramount. God may be using that suffering for the good of the patient or for someone who is watching the patient and we must be wise. After all, to be incredibly insensitive and blunt, stopping suffering is incredibly easy: just euthanize the patient...

An ethics dialogue, for students and residents

2008-05-20T07:53:00.000-07:00

You, student, go in and do that abortion.

Before I do, may I ask you a question?

Yes but make it quick.

Would you want your doctor to have moral integrity or not?

Uh, of course I would.

I know this is not an issue for you, but abortion is a moral issue for me and if you use your power to force me to do this abortion, you will destroy my moral integrity. Is that your desire?

Paraphrased from John Patrick, MD, latest CMDA Christian Doctor's Digest.

A Christian approach to Depression

2008-05-19T07:21:00.000-07:00

As with many families, depression has touched DenverDoc's family. It is so difficult to watch the suffering of loved ones.

Depression is so complex and multidimensional. I'm convinced that there is in part a biological component, a neurochemical portion. But there are also spiritual, behavioral, learned, environmental, and psychological components and they all interact.

BeliefNet has put out an article on "How to pray when you are depressed." I scanned it quickly and there may be some useful information there. It certainly appears that when depression hits, people tend to isolate themselves from other people and from God. I wonder if that happens in other cultures, or if it is a "show no weakness" American response?

At one of our Resident talks a couple of years ago, there was discussion about forgiveness and the story came out that a depressed patient found great relief in forgiving people in her past. She was actually counseled to make a list of all the people that had hurt her, and was told to pray to learn to forgive those people. (This would require great wisdom in helping discern between forgiveness and enabling or going back into abusive relationships.)

Another of our members told me that he had suffered with depression for years (in his case, in came out as anger. I heard somewhere recently that anger is one of the most common symptoms of male depression.) He read Isaiah 61:3: "...and a garment of praise instead of a spirit of despair." He said that he would take his dog on a walk each evening and praise God during the walk. "The dog was fine with it, but I worried a bit about the neighbors!" he told me. The darkness lifted for him, and one of his nurses noticed that his anger at every little thing had evaporated.

There was also a book called Spark that I read recently. Despite the fact that it was written by a Harvard (not a Duke) psychiatrist it is still worth the read. Apparently there have been some recent studies that aerobic exercise is more effective than antidepressants (if of course you can get a depressed person to stand up and exercise.) The book also contains interesting information about maintaining cognitive abilities and even combating some kinds of learning disability, particularly ADD, with aerobic exercise daily.

That said, do I as a pathologist have the gall to say, "Throw away your antidepressants! Pray, forgive, praise, and exercise and all will be well! (oh and make sure you get lots of bright light!)" No way. My family members have found great relief in well-prescribed medication, and also bright light exposure. But I throw these out for your consideration.

Adult stem cells, again

2008-05-16T13:54:00.000-07:00

Article from Scientific American talks about using attributes of tumor cells to "trick" adult cells into becoming stem cells. There are so many successes with adult stem cells, and so little actual data with embryonic in ANY species, that it is amazing to me that governments still want to put many resources into human embryonic stem cell research. It's also a shame that this constituency has duped so many celebrities (and others) into thinking embryonic stem cells are their hope for the future. My nephew has type I diabetes and used to think this way (until I got ahold of him and told him the truth.)

***Added note. Please click on the comment added by "Don" below. He makes the interesting point that adult stem cells are programmed to make repairs, and so have resulted in numerous potential and real therapies. Embryonic stem cells are programmed to make babies, and have been impossible to control. Not a bad sound bite! Highly recommended post. Here is his link to his website.

The Rebelution

2008-05-14T07:11:00.000-07:00

Two teens have started The Rebelution, a rebellion against low expectations. They are having a conference in Denver on May 31st at Colorado Community Church. This is definitely worth considering if you have teens. Their motto is, "Do Hard Things." Those of us who attended Medical School understand this motto and its importance, but it has become, like, totally countercultural, man.

On Marriage

2008-05-07T13:33:00.000-07:00

Found, of course, in May First Things:

Dietrich Bonhoeffer wrote:

Marriage is more than your love for each other. It has a higher dignity and power, for it is God's holy ordinance, through which he wills to perpetuate the human race till the end of time. In your love you see only your two selves in the world, but in marriage you are a link in the chain of the generations, which God causes to come and to pass away to his glory, and calls into his kingdom.

In your love, you see only the heaven of your own happiness, but in marriage you are placed at a post of responsibility towards the world and mankind. Your love is your own private possession, but marriage is more than something personal—it is a status, an office. Just as it is the crown, and not merely the will to rule, that makes the king, so it is marriage, and not merely your love for each other, that joins you together in the sight of God and man.

As high as God is above man, so high are the sanctity, the rights, and the promise of marriage above the sanctity, the rights, and the promise of love. It is not your love that sustains the marriage, but from now on, the marriage that sustains your love.

Perhaps it is the upcoming marriage of DenverDocDaughterOne that inspires such musings?

Max Planck, Originator of Quantum Mechanics

2008-05-07T07:54:00.000-07:00

Two great quotes:

"All matter originates and exists only by virtue of a force... We must assume behind this force the existence of a conscious and intelligent mind. This mind is the matrix of all matter."

"Anybody who has been seriously engaged in scientific work of any kind realizes that over the entrance to the gates of the temple of science are written the words: "ye must have faith." It is a quality which the scientist cannot dispense with."

Thanks to ThinkExist.com for the quotes...

Primer on Physician Assisted Suicide (PAS.)

2008-05-06T10:53:00.000-07:00

Not a bad little review from the University of Washington. Clearly a secular reviewer, clearly trying to be balanced. Will give you a brief listing of ethical points.

I think the weakness of the article is its relative lack of attention to why so many people support PAS. I remember when we euthanized our dog in the living room. A family friend was a vet tech (sort of like a vet nurse) and brought over the cocktail and equipment, and he just peacefully slipped away. (DenverDoc was crying like a baby, I freely admit.) The vet tech then said, "Why can't we humans have this option?" I totally understood her emotional reaction, and yet disagree completely with her conclusion.

The major reason for PAS is, in my opinion purely emotional. Very few proponents would be able to give you a coherent ethical analysis. (and very few opponents too, unfortunately.) People fear loss of control, they fear pain, they fear the coldness of the healthcare system, they fear loss of dignity. It's fear, pure and simple.

We had a conversation about PAS in the pathology meeting room a few years back over lunch. The secretaries asked me what I thought. As I recall, I said

"The emotional desire for a less painful passing is totally understandable in each individual case. But what would it mean for all the rest of us? I fear giving doctors, who are people, absolute power over life and death. I fear what managed care companies might do with that power. I fear what greedy relatives seeing money going into treatment instead of estates might do with that power. I fear what governments, who have become managed care providers, might do with that power. I fear that the right to die would very rapidly become the duty to die.

I also know that many of those who seek assisted suicide have untreated depression, and when treated most withdraw the request. I also know that the last few months of a person's life can be incredibly meaningful in regards to confessions, re-establishing relationships, passing on wishes or stories Pulling the trigger too fast on PAS denies the patient and their loved ones that opportunity. I also recognize that our medical culture has to learn to care for patients better in terminal conditions."

Physician Assisted Suicide in Washington

2008-05-06T10:34:00.000-07:00

Yes, it is back again. Physician Assisted Suicide is on the march in Washington State. (I was born there, my father grew up there on a farm, and my daughter has just moved there.)

CMDA has some resources available on this topic. I'm going to spend a bit of time on this later but wanted you to have the link ASAP.

Great quote

2008-04-24T10:08:00.000-07:00

on the growth of our faith:

“The chief agents in the expansion of Christianity appear not to have been those who made it a profession or a major part of their occupation, but men and women who earned their livelihood in some purely secular manner and spoke of their faith to those whom they met in this natural fashion.”
-- Kenneth Scott Latourette, A History of the Expansion of Christianity

Thanks to James, Innovative Mission Opportunities, for this one.

Stem Cells, again

2008-04-14T20:41:00.000-07:00

Dr. Condic has done it again, another article in First Things about stem cells. She is someone with principles who knows what she is talking about. She also has several previous articles, and has been punished by the academics who want free for all stem cell research. See what you think.

AIDS and the Churches

2008-04-14T20:30:00.001-07:00

This article in First Things this month is very important reading. The authors are part of the AIDS Prevention Research Center at Harvard. Their point seems to be that:
1. In every country in Africa with a decrease in HIV, there has been a decreased number of sex partners reported.
2. The other behavior associated with decreased HIV is decreased premarital sex.
3. The conventional wisdom is that "Poverty and discrimination are the problem", "Condoms are the answer", or "Sexual behavior will not change."

Here is a telling line: "One must ask whether they are more concerned with upholding a Western notion of sexual freedom or with saving lives."

Some other soundbites: In Africa, the wealthy are more likely to be infected than the poor.
In 30-40% of infected couples in Africa, the woman alone was infected (it's not just the men...)
Sexual behavior in Rwanda has remained conservative, and, at 3%, HIV prevalence is low for the region.
In fact, the mainstream HIV/AIDS community has continued to champion condom use as critical in all types of HIV epidemics, in spite of the evidence. "There are no definite examples yet of generalized epidemics that have been turned back by prevention programs based primarily on condom promotion."

"We must accept that the evidence is much stronger for fidelity or partner reduction than for any of the standard package HIV prevention packages."

(They also mention churches in the article by the way.)

Worth the read for all of us in medicine.

Walt Larimore to speak at Alternatives Pregnancy

2008-04-01T12:24:00.000-07:00

Our own Walt Larimore, who recently spoke to us on His Brain, Her Brain, is at it again. He will be presenting a Spring Talk to Alternatives Pregnancy Center, April 17th from 11:30-1 PM. Here is a link with details. Walt is a good speaker, and Alternatives is a great organization that some of our members have links to. See if you can't drop by.

One of our own has cancer

2008-03-28T15:10:00.000-07:00

Dr. Yang Chen of the University of Colorado has put up a website describing his journey with lung cancer. It makes for compelling reading, as he winds through faith, fear, treatment, hope, and all the other emotions that come along with being human. I recommend it to you.

Celebrate Recovery

2008-03-28T13:12:00.000-07:00

Last night several of us listened to two remarkable people who run a local group affiliated with Celebrate Recovery. Fifteen years ago their marriage was hanging by a thread. Now they are far down the road to recovery and their story was powerful. They minister to those in bondage to alcohol, drugs, sexual issues, anger issues, shopping, anything that gets in control of people's lives.

St. Paul, in Romans, has an amazing thing to say about addictions in Chapter 7.

15I do not understand what I do. For what I want to do I do not do, but what I hate I do. 16And if I do what I do not want to do, I agree that the law is good. 17As it is, it is no longer I myself who do it, but it is sin living in me. 18I know that nothing good lives in me, that is, in my sinful nature.^[a] For I have the desire to do what is good, but I cannot carry it out. 19For what I do is not the good I want to do; no, the evil I do not want to do—this I keep on doing. 20Now if I do what I do not want to do, it is no longer I who do it, but it is sin living in me that does it.

21So I find this law at work: When I want to do good, evil is right there with me. 22For in my inner being I delight in God's law; 23but I see another law at work in the members of my body, waging war against the law of my mind and making me a prisoner of the law of sin at work within my members. 24What a wretched man I am! Who will rescue me from this body of death?

If Paul was stuck, maybe it's OK for me, too.

Pastor Rick Warren's church, Saddleback, has put this program together. It is similar to 12 step programs like AA, but explicitly puts God and Jesus in instead of a vague "Higher power." Originally it was a series of sermons from the Sermon on the Mount.

It came clear to us all that just stopping the alcohol, drugs, porn, etc is not enough. You're just a "dry drunk." There is a lot of soul work to do to recover your humanity.

One interesting statement that stuck out was Otis' remark that people who "have a lot of crises in their lives" probably have undealt-with stuff. If you are taking care of business in a healthy way, you just don't have many crises.

They also discussed an addiction cycle, starting with obsessive planning and thinking, the act itself, followed by anger and disgust that often spill over into relationships. Then there is a variable latent period, followed by a repeat of the cycle. People become helpless to stop it, and don't even get much pleasure out of the act.

Your patients might need this. Your colleagues might need this. Your family or a friend might need this. Dare I say it, even us docs might need this?

Mission Trip makes secular press

2008-03-28T12:53:00.000-07:00

Several of us went to Juarez in February for a Pap Smear clinic. It got picked up by a monthly newsletter of the College of American Pathologists and went out to all 15,000 members. Cool!

Tale of Two Cities

2008-03-04T14:05:00.000-08:00

The year was 1983. DenverMedStudent, soon to be DenverDoc, had decided to do his
residency in Salt Lake City. We were still living in Durham, North
Carolina.

I turned on the TV in May and discovered that a huge snowpack had melted
suddenly, sending floodwaters down into Salt Lake City. Volunteers
showed up in droves with sandbags and built the State Street River. The
water flowed down this major street for a couple of weeks. Then, in
June, the volunteers came back and cleaned up.

"Gee, sweetheart, what kind of place are we moving to? In any normal,
red-blooded American city, there would have been flooding, riots, and
looting. In Salt Lake, they just showed up and built a river. I'll bet
there were women back a couple of blocks making sandwiches!"

Fast forward 22 years. My middle daughter was an upcoming Senior at
Tulane. My brother, the geophysicist, started calling her every few
hours five days before Katrina hit. "Hey, Kate, when are you leaving?
Come to Houston. The worst that could happen is you'll get a nice
dinner and a little road trip. Come on, get out of there."

Kate of course lingered until Sunday. She and two friends left Sunday
morning along with half the city (Thank God.) The five hour drive to
Houston turned into a 15 hour marathon.

The next morning, the levees broke.

My daughter's boyfriend stayed glued to CNN for days. He watched the
endless loop of rushing water, hysterical reports of racial violence
(most of which turned out to be false). But, New Orleans WAS a normal
red-blooded American city and there were, in fact, riots and looting.

Two cities, both flooded. (I don't pretend that the Salt Lake flood was
anything like the scale of Katrina, or course.) One city had a strong,
cohesive social structure formed by a strong, vibrant central Church.
One city had no cohesion at all. The difference in results was
incredibly dramatic.

I'm not a Mormon. I don't play one on television. But I can tell you I
saw a city with some structure, some unity. Did the Mormons of the last
century do some beastly things? Well, probably so. They had to hire
from the Human Race. Have Catholics done some beastly things? Yep.
How about Protestants? You bet. Buddhists? Probably. Moslems? Stay
tuned. As a young agnostic, I was impressed with the power the church
had, mostly for good, in Salt Lake. As an older Evangelical, I was
impressed how rapidly a city could go bad without social and religious
structure. I'm also impressed with how effective all of our Christian
churches, of all stripes, were compared to the governmental agencies in
New Orleans.

My opinion is that only Christianity has much chance of uniting us in a
desirable way. Islam has, unfortunately, a chance of uniting us as
well. Secular humanism? Not a chance.

Introduction to Sharia law

2008-03-02T19:34:00.000-08:00

There is a missionary living in the Middle East that I met recently. He writes an interesting Blog. This article came across recently, explaining what the Sharia really means. Interesting discussion.

His Brain, Her Brain

2008-03-02T19:18:00.001-08:00

Walt Larimore spoke Friday night and it was terrific. See below for the reference to his book, which I went out, bought, and read this weekend. It skillfully weaves his personal story, biblical references, and scientific findings into a wonderful synthesis.

For example, I found out that the woman's brain has a 40% larger Corpus Callosum than mine. There is so much right-left traffic that she can listen to as many as seven conversations simultaneously and get something out of it. (Just ask DenverDocWife: I often have trouble with ONE.)

For women, the release of oxytocin caused by relational activities gives them a feeling of tremendous well being. For men, the release of testosterone gives the same sort of feelings, but it is caused by competition and achievement.

Walt's discussion of Genesis was poetry. In Hebrew, the word used when God made Adam is similar to the word used for making pottery of clay--molding into a structure. But for woman, the word implies an intricate, delicate, valuable construction. And when God says he is making "a helper" in English translations the Hebrew word is actually closer to a "savior." Woman is man's savior, making him complete.

Also he points out how radical the thought that a man should leave his parents and cleave to his wife was in the Middle East at that time.

We had a great discussion, and at least 40 of us were there. See you next time, and be sure and get Walt's book! You can get it with the links below or on the CMDA website.

Men and Women, different?

2008-02-29T13:19:00.000-08:00

Tonight we have the pleasure of seeing Walt Larimore, MD, talk about "His Brain, Her Brain." I've run into a bunch of things recently on this subject, and thought I'd list some resources for you.

1. Great YouTube video on "Two Brains." Everyone I've shared this with loves it.
2. Walt's new book, His Brain, Her Brain, How Divinely Designed Differences can Strengthen Your Marriage. (I think it's at Tattered Cover, or you can Amazon it.)
3. Another pair of books, For Men Only and For Women Only, gave to my daughter and future Son-in law. Terrific resource, easy to read, funny, dead on.
4. Any of the Men are from Mars, Women are from Venus books. I'm reading the most recent, Why Mars and Venus Collide. Interesting discussion about the differences between testosterone and oxytocin as stress reducers in male and female physiology.
5. Dennis Prager, radio talk show host, often discusses the differences between men and women and is sympathetic to both. He for example has a theory that the essential male nature seeks sexual variety while the essential female nature seeks intimacy and closeness, and how marriage has to occur for both to grow up. He also has a great saying: "Only people with advanced degrees from Ivy League institutions are stupid enough to believe that men and women are basically the same." He is on the web, on 710 AM during the day, and you can podcast his stuff. The weekly Ultimate Issues Hour and Happiness Hour broadcasts are wonderful, and he is planning a Man-Woman hour soon.

Guilt and Pain

2008-02-11T20:44:00.000-08:00

Guilt and Pain have a lot in common. Both are unpleasant, both are sometimes unnecessary, and yet both sometimes keep us out of trouble.

Pain often acts as a warning. We know not to touch a hot stove, run a knife over our hands, or drink bad water because we know it will hurt us. Pain prevents us from overstretching muscles, and it can let us know that there may be an internal problem like gallstones before they become dangerous.

Pain also, though, may not be so useful. The pancreatic cancer patient in pain doesn't need the warning. What warning does fibromyalgia pain bring?

We treat pain, trying to be wise and not suppress the pain that is a warning, but at the same time treating the pain enough to prevent useless suffering.

I think of guilty feelings as a sort of spiritual pain. In its useful form, guilt helps to prevent evil, hurtful, harmful, cruel actions. In its gratuitous form, guilt can be as pathological as other types of pain, leading to avoidance of behavior because of imagined transgressions.

I think a lot of us moderns think of guilt as always pathological, always to be suppressed, treated, medicated. That idea ignores the useful, warning aspect of guilt/pain. Of course, the modern or secularist really doesn't have much to offer the guilty person. As John Patrick MD says, the treatment of guilt really involves words like confession, repentance, penance, restitution, and forgiveness rather than words like antidepressants, antipsychotics, or psychotherapy.

Do you or your patients have guilty feelings? Perhaps the treatment really is spiritual?

Kidney Thefts in India

2008-02-03T07:04:00.000-08:00

Seems a ring of docs and others have been kidnapping poor Indian people and forcibly taking a kidney from them. The story is in AP, here. We've heard similar stories from China, where there are rumors of prisoners being used as organ donors.

Terrible stories. I guess I have a little caution to inject. While the stories may be true, how big a moral leap is it from forcible kidnapping and surgery to just murdering the poor guy and getting two kidneys and a heart? I wonder if that is going on, triple the profits? And if it is OK to kidnap someone and do violence to them, removing organs, how long until they decide it is just cleaner to take this homeless person and have them disappear? You know, no witnesses...

Blood Donor Madness

2008-02-03T06:45:00.000-08:00

The national CMDA called me to do an interview about this article. Seems the president of San Jose State University has suspended all blood donor drives on campus. Why, you ask? Because the FDA regulations discriminate against gay men and the college has a nondiscrimination policy.

I'm a pathologist and we oversee blood banks and donor centers. We nearly always have a blood shortage in this country that puts surgical patients, cancer patients, and victims of trauma at risk. Back in the 70's the FDA put in a restriction on donations from gay men, or "men who have sex with men (MSM)". What an interesting coincidence that MSM is also "Main Stream Media", someone wasn't thinking!

The restrictions were based on observations that gay men had a higher statistical risk of having hepatitis which at that time was a big problem with transfusions. The advent of the HIV epidemic certainly did not give any reason to change the regulations.

FDA has a lot of restrictions on donors. IV drugs, taking or giving money for sex, travel to Malaria zones, having lived in Europe for five years (mad cow, don't you know), any contact with a hepatitis patient, tatoos, transplants, prior transfusions, prior receipt of clotting factor concentrates, all join men having sex with men as deferrals of donations for various periods of time. All of these have rational justifications based on risk, in a society that does not consider any risk acceptable.

Blood brothers. Blood is thicker than water. Washed in the blood. Blood sacrifice. Life-blood. Our very language shows the emotional impact of blood. Many more die from medication errors than transfusion problems, but I had to go on national news to explain why one patient died of an ABO mismatch at one of my hospitals. (It was a clerical error by a nurse in a hurry.)

Are all the FDA's regulations totally rational? Please. It's a Federal agency! Of course in light of the amazing recent advances in infectious disease testing for HIV and Hepatitis, it is possible that some of the restrictions need to be updated. It is a scientific and medical question, NOT a political one.

Back to San Jose State. They claim to have talked to AIDS experts, blood bankers, etc. before making their "momentous" decision. Apparently not looking like they might be discriminating is more important than helping the sick and hurt in their community. Those people, of course, will weaken and die silently in ICU's and ER's and this guy won't ever know that his feel-good policy caused their suffering. Is it arrogant of me to think that his judgement day could be, uh, real bad?

Dangers in Oral Sex

2008-02-03T06:37:00.000-08:00

We as a society have laid aside centuries of wisdom, thinking we know it all. One of the things we decided probably in the 60's was that oral sex was safe, entertaining, you couldn't get all those awful diseases, couldn't get pregnant.

Now it looks like despite decreasing smoking and alcohol-related oral cavity squamous carcinoma, HPV-related oral cancer is increasing to take its place. I wonder where us guys are getting HPV from?

I've actually, as a pathologist, recently seen a tongue squamous cell carcinoma in a 19 year old woman! She did not smoke and was in training to become a singer. I've seen a few carcinomas in men with no smoking history, too.

Sexual guidelines are like guardrails to keep us safe. I'd be the last to say to follow all traditions blindly. Remember, however, that our ancestors were just as intelligent as we are and we ignore their observations and experience, which after all is the definition of tradition, at our peril.

Doc Jim takes Angel Lessons!

2008-01-14T20:19:00.000-08:00

My nephew had his 26th birthday party at this place that runs a fan upward at 120 MPH so you can simulate skydiving. Here's DenverDoc learning how to fly!

Peter Kreeft coming to Boulder

2008-01-14T19:34:00.000-08:00

The Thomas Aquinas Center at the University of Colorado is hosting Peter Kreeft, well known Christian philosopher and author, in a debate on the ethics of abortion this Friday night, the 18th of January. It will be at the Humanities Building or you can go to the Catholic Student Center and meet there. They say the room is small and get there early. I'm going, for sure. Peter Kreeft's book, Making Sense of Suffering, should be required reading for medical people.

CMDA Winter Conference

2008-01-03T14:53:00.000-08:00

Feb 15-17, in Bristol, Tennessee, a beautiful place. Topic is Family Health, speaker keynoted is our own Walt Larimore, MD. Wish I could go!

Seven medical myths, exposed

2007-12-31T11:11:00.000-08:00

Eight glasses of water a day? Myth!

Paper in the British Medical Journal referenced by Reuters says that other popular myths with no evidence in the literature include:
Reading in dim light ruins eyesight;
Shaving makes hair grow faster or coarser;
Eating turkey makes you drowsy;
We only use 10% of our brains;
Hair and fingernails grow after death (even a pathology myth!)
Mobile phones are dangerous in hospitals.

Ministry on Sexuality in Denver

2007-12-30T19:57:00.001-08:00

Today in church we had several interesting presentations as part of ringing in the New Year. One was a young man from Where Grace Abounds, a ministry that addresses sexual issues in a Christian context. He comes from a Christian and Homosexual background. He said that their motto is 100% Grace, 100% Truth, no compromise. If you've worked in healthcare very long, you have inevitably met with homosexual people as well as those with other sexual problems: pornography addictions, extramarital sex/affairs, prostitution, many others. I spent a while talking with Scott and came away impressed that they have a good message for us all.

He also suggested an organization called Exodus that deals with similar issues around the country and the world.

I tell you, sex is like nuclear energy. It can keep you warm at night, or it can blow you to atoms.

the Highest Good at end of life

2007-12-30T19:50:00.000-08:00

So, what is the highest good at the end of life? Comfort? Freedom from pain? Alleviation of suffering? Patient autonomy of choice? These are of course good things. Suffering for its own sake is certainly not to be sought.

But aren't there higher goods? Reestablishment of relationships? Asking and giving forgiveness? Mundane tasks like wills, bequests, insurance?

And for those of us who are Christians, if we really believe the story we claim, temporal suffering just isn't as big a deal for us as the decision to pursue God with faith, to confess our transgressions, to reach a saving faith.

An article in Touchstone magazine by a Hospice chaplain covers some of these concerns and I commend it to you.

Carl Jung on Retrieving the Soul

2007-12-28T14:16:00.000-08:00

As a pathologist, my professional reading does not often involve the spirit or mind! It was delightful to come across this quote on a message board from First Things (I still highly recommend the magazine to thinking Christians.)

"Among all my patients in the second half of my life - that is to say, over thirty five- there has not been one whose problem in the last resort was not that of finding a religious outlook on life. It is safe to say that every one of them fell ill because he had lost that which the living religions of every age have given to their followers, and none of them has really been healed who did not regain his religious outlook "

Carl Jung, "Retrieving the Soul."

Maybe the sky ISN'T falling??

2007-12-26T11:29:00.000-08:00

My daughter's boyfriend sent me this story from Commentary. The author argues that most social indicators have actually improved over the last 15 years after much hand-wringing in the 90's (and before.) There are of course still some issues particularly with strength of families in lower income groups, but the article is worth a read.

Addiction to Pornography

2007-11-30T15:58:00.000-08:00

Men are particularly susceptible apparently. And churched men are, well, men. And churched male doctors are...well...men. We need to be very careful. Here's an alarming quote from Wired:

Pornography addicts have a more difficult time recovering from their addiction than cocaine addicts, since coke users can get the drug out of their system, but pornographic images stay in the brain forever, Layden said.

In talking with men who have become addicts, I've been struck with one thing. It destroys their ability to have a relationship with a real woman. Those women on the screen, why they're always excited, always adventurous, their kids (like they have any) are never sick or whiny. What's wrong with my wife, that she isn't this way? There must be one out there like Bambi on the screen, perhaps if I withdraw from my wife (or girlfriend) I'll find the perfect woman...

CMDA National has sent some resources for your consideration. Maybe it's you, maybe a friend, maybe a colleague, but this is a real problem that could hurt us all unto the fourth generation.

Pure Intimacy website

Restoring the Soul

Don't get trapped. Resist the urge to try it even once. I'm a guy and I tell you, I've drawn a line to not ever even try it once. Lord, please help us all with this temptation.

CMDA Winter Conference

2007-11-28T10:19:00.001-08:00

Wish I could be there. Our own Walt Larimore will be there as a keynote speaker. 11 CME hours. Feb 15-17, 2008. Tennessee is beautiful. One of these years!

Article on Cord Blood donation

2007-11-27T13:53:00.000-08:00

Careful who you read! Especially the guy near the end, the pathologist from Christian Medical Association!

Actually I am strongly in favor of cord blood donation. It results in adult stem cells that have advantages over more mature cells, and yet avoids the ethical issues that embryos bring up.

Daily prayer website

2007-11-25T06:06:00.000-08:00

Check out Sacred Space. They present an online, step by step prayer you can work through, daily. It apparently was put together by Irish Jesuits. It's quick, thoughtful, presents a mix of contemplations and scriptures. Thanks to my online Rofter's group. (That stands for Readers Of First Things...)

Thanksgiving Prayer

2007-11-23T07:03:00.000-08:00

For another day of life, to breathe, eat, and enjoy;
For freedom and safety in this incredible land;
For delicious food, prepared with love and laughter,
For the gift of each other,
For grace, faith, and forgiveness,
Lord, we most humbly thank you.
Amen.

STD's on the increase

2007-11-14T07:17:00.000-08:00

According to the CDC, syphilis is on the rise. Their note states that it is mostly due to MSM. This stands for Men who have Sex with Men. And all this time I thought MSM was Main Stream Media. Go figure. They also have just reported surges in Chlamydia and Gonorrhea infections.

One of our own is planning to see if Alternatives Pregnancy Center might be able to set up STD screening. Send your prayers Joyce's way to ease her path. Also, they need some volunteers, pregnant women, for an ultrasound screening training clinic. Women can get a free ultrasound! It will be in December.

I once told my daughters that sex is like nuclear power. It can keep you warm at night, or it can blow you to atoms. Richard Foster, in Celebration of Discipline, says sex is like a river--a good and wonderful blessing when kept within its proper channel, dangerous when it overflows its banks. The banks are one man, one woman in marriage.

We see the results of the overflow in increased STD's. I think people get confused about God's guidance, thinking that it is designed to kill our fun when actually it is more like guardrails to keep us from harm.

Practice by the Book Conference

2007-10-23T13:58:00.000-07:00

Two of the leaders of the national Christian Medical and Dental Associations, Dr. Al Weir and Rev. Ken Jones, are coming to Colorado for two seminars, one in Colorado Springs the evening of November 2nd and the other in Denver from 9-3 on November 3rd. Dr. Weir is a co-author of Practice by the Book, a handbook of being a christian physician. (CMDA is giving copies of the book to recruit new physicians and help them in their walk.) He promises that the seminar will expand on the book not just review it. Ken is the leader of the CMDA in the Bay area and has a reputation as a great evangelist, teacher, and coach to physicians. You've got to come to this one. We are charging due to expenses to bring these two great speakers in.

9AM-3PM, lunch provided, November 3rd.
$125 for practicing physicians, $20 for your spouse (grace for those retired, in missions, etc. Ask.)
$40 residents, $20 students.

Send us back a note!
denvercmda dot hot mail dot com.

A Man's Prayer

2007-10-23T13:53:00.000-07:00

I am a MAN.
I can change.
If I have to...
I guess...Amen

Seen on the Red Green Show, KRMA TV.

What Cancer cannot do, from Dear Abby, 1994

2007-10-14T23:10:00.000-07:00

What cancer cannot do.
Cancer is so limited.
It cannot cripple love, it cannot shatter hope.
It cannot corrode faith, it cannot destroy peace.
It cannot kill friendship, it cannot suppress memories.
It cannot silence courage, it cannot invade the soul.
It cannot steal eternal life, it cannot conquer the spirit.