Freeing Gospel Truth of the Day

“Only the Gospel can truly save you. The Gospel doesn’t make bad people good; it makes dead people alive...the Gospel is God’s acceptance of us based on what Christ has done, not on what we can do.”

~Tullian Tchividjian~

The Gorgeous Message of the Gospel

"Create in me a clean heart, O God."

~Psalm 51:10

Here is the gorgeous message of the Gospel: even though I have bowed again and again to an endless catalog of God replacements, even though I've loved myself more than I have loved God, even though I have rebelled against God's kingdom and sought to set up my own kingdom, God comes to me in grace and wraps arms of love around me and begins a process that will result in the total transformation of the core of my personhood, the heart. He won't rest and He won't relent until He's created in you and me a completely pure heart! So we wake up every morning knowing that by His grace they will be purer than they are today. So with thankfulness for the transformation that's already taken place and with courage of hope of the transformation that is to come, we wake up, look to heaven, and say with David, "Create in me a clean heart."

-Paul David Tripp-

Top 10 Lessons Learned My First Month as a Doctor

Disclaimer: No patients were harmed in the making of this list.

10. You're sure to get super excited in your first c-section so be sure to tie your mask just right so you don't get all fogged up--that's one thing you're gonna want to do by sight and not by faith the first time.

9. If you're going to break someone's bag of water AND sit on the end of her bed make sure you brought a fresh change of drawers…you just may need them.

8. When a patient begins a conversation with, "Doctor, do you think something could have crawled inside me and be living in there..." pray your pager goes off STAT.

7. If you struggled to tie your shoe as a child, those knots in the OR are gonna be a booger for you. Practice makes perfect.

6. If someone says they heard it was pouring in triage don't just assume that means there is an abundance of patients. Who knows, water just may be gushing from the ceiling.

5. Warm chocolate chip cookies on a busy day are the best, just make sure you get all the chocolate off your face before you go see a patient. A delivery is the worst time to discover you have something on your face that may or may not be chocolate.

4. Wear a mask or make a conscience effort to keep your mouth closed during a delivery. See #5.

3. Don't ever tell a patient she is "grossly ruptured." Just because that's normal talk to you, her husband thinks you're saying she's disgusting, and you’re going to feel rather silly explaining the use of the word “gross” to him.

2. Being an OB/GYN is the coolest job in the world.

1. Nothing is impossible—in every sense of the expression.

Janice Mitchell, MD

Today I will graduate from medical school.

I cannot believe this day has come. When I was a little girl I had a Fisher Price doctor kit. I took good care of my baby dolls. I even delivered my own babies. Here is some evidence...

5 years old and about 42 weeks pregnant--Haha!

5 years old making house calls

Today I will leave my short white coat of medical school education and don the stitches of the long white coat I have earned.

Today I will become Janice Mitchell, MD.

Thanks be to God, the One who keeps me from stumbling and presents me blameless before His throne, my Rock and my Refuge, my Refiner and Disciplinarian, my Lover and closest Friend, my Creator and Sustainer.

What an incredible day!

Shout for joy to God, all the earth;

sing the glory of his name;

give to him glorious praise!

Say to God, "How awesome are your deeds!

Come and see what God has done:

he is awesome in his deeds toward the children of man.

Bless our God, O peoples;

let the sound of his praise be heard,

For you, O God, have tested us;

you have tried us as silver is tried.

You brought us into the net;

you laid a crushing burden on our backs;

you let men ride over our heads;

we went through fire and through water;

yet you have brought us out to a place of abundance.

Come and hear, all you who fear God,

and I will tell what he has done for my soul.

But truly God has listened;

he has attended to the voice of my prayer.

~Psalm 66:1-3,5,8-12,16,19~

Here Lately...

Just in case you were wondering, the following is an update on my life and adventures!

Many of you have asked me, “Are you a doctor yet? How much longer? What are you going to do? And how does all this work?” Well, let me explain—

I’m currently in my fourth and last year of medical school, and I’m going to be an OB/GYN (Obstetrician and Gynecologist)! I am PUMPED about it. I feel like I am only paces away from the place I strived for for years. I know this is God’s calling on my life. I know I was made to take care of women from all walks of life through many stage of their lives. Doing so brings me such great joy! I am excited about helping bring new lives into this world, being a surgeon as well as primary care physician, and being an advocate for women and their health. This is the very thing I have been working for for so many years. It is incredible to finally see it all materialize.

After I graduate in May with an MD, I will begin an OB/GYN residency in July 2011 that will last 4 years. Last week I began the process of interviewing for a position in an OB/GYN residency program. Interview season typically lasts from late October through January. Many students travel widely and interview at approximately 10-15 programs, sometimes even more. I chose to apply throughout the Southeast—including Texas, Arkansas, Tennessee, Kentucky, the Carolinas, and a few other random places here and there. I had a couple interviews in Texas in October and will be doing the bulk of my traveling outside of Texas in November in the form of a 3-week long roadtrip. Then in December I will be back in sweet home Houston traveling to several interviews in Texas.

At the end of this whole process, I will rank all of the programs I have interviewed at, and likewise, they will rank their interviewees. Then in March, someone presses some big magic button and every fourth year med student across the country gets ONE residency position (or not, but we won’t talk about that side of things :0). Then on March 17, the nationwide Match Day, there is a ceremony where each student receives an envelope containing the results of the match and the program to which they have been accepted and everyone opens their envelope in the presence of friends and family!

Some would say this whole interviewing and matching process is a bit stressful and nerve-racking. Yes and no. There are lots of little details, lots of unknowns, lots of meeting new faces, and lots of big decisions. But over and over, I hear the Lord whispering in my ear. I know the plans I have for you. Good, good plans. Plans to prosper you. And never to harm you. Plans for a hope. And a future. I am confident that the Lord saw these days ahead of me long before I was born. And He knew. He knew exactly what I would need. He knows the perfect place for me.

I have had a lot of time to myself over the last week or so. I have driven from Houston to San Antonio to Dallas to Nashville, well over a thousand miles, and about 24 hours worth of car time. I’ve sung my favorite songs at the top of my lungs, I’ve listened to some great sermons and audiobooks, and I’ve sat in complete silence—praying and listening and thinking. I’ve run the list of all my hopes and dreams and fears and expectations and much, much more. I’ve reminisced about where I’ve come from and where I’m heading. My heart is full—full of gratitude for all the wonderful things the Lord has done to bring me to this place and full of excitement over where He is taking me. But even in all of that there is that tinge of fear of the unknown. Will I move far away or will I stay close to the ones I love? Will it be super hard?? Who are these other folks who I’ll be spending days and nights with training to be OB/GYNs?

However, these unknowns, these fears, are overshadowed by the remarkable goodness of God in my life. He had done more than I could have ever asked or even imagined. He has been faithful. And He will forevermore be. So I give him my hopes, my dreams, my fears, my expectations, my future plans. They are safe with Him. And I am safe with Him.

Thank you, thank you, thank you to each of you for being such incredible friends, cheerleaders, prayer warriors, running buddies, confidants, and the list goes on. You are my people, and without your support in so many different seasons of my life I would have never made it to this place. I thank God for each of you!!

Please continue to pray and praise God for all He’s up to. Hopefully I’ll snap a few pics of my journey and keep you posted on my whereabouts via the Facebook stalking-machine!

Much love to each of you,

Janice

Speeding Tickets and Bunny Rabbits

“So, so sorry Ms. Huge Scary She-Man Police Officer with the fire darting from the eyes, nasty tongue ring bobbing around as you speak, and chill radiating from the heart--I know I whipped right around you going 85 in a 60 but I am just trying to get to the hospital...ya know to see my sick bunny rabbit, Mimoso. It’s been a tough day."

These thoughts raced through my mind and a more condensed, polite version came out in my shaking voice as my heart did laps in my chest on the side of the highway—during rush hour traffic nonetheless. The lovely lady had caught me red-handed, and though the Houston heat was blazing, it was about as cold Santa’s North Pole in our freeway-side conversation.

"HoustonMetroPD.LiscenseAndProofOfInsurance,” this woman spurted out at record speed. Ya know, normally the general speeding ticket stop begins with a greeting. Something like “Ma’am where you going?” or “What’s the rush?” or “Do you know how fast you were going, miss?” No, no greetings here, only business. I just knew I wasn’t wiggling out of this one without a big fat ticket.

I handed her the goods for her to do the usual background check and approximately an eternity later she returned to my window.

I braced myself.

Then I heard a crack—you know the kind you hear on a warm day in Antarctica when the ice breaks apart.

Warning!

OMG, somewhere in that tough body there was a heart after all! I nearly jumped out the window and kissed her. But the bar in her tongue frightened me right back into some good sense.

It was probably the bunny rabbit part that won her over I’m sure. She really seemed like the bunny rabbit kind of girl. A least maybe 34 years ago, when she was 3.

As I drove away, I didn’t know whether to laugh or cry or do some weird awkward combination of both.

When God Cries

I never run in the rain. I don't like getting wet. I don't like getting mud on my shoes. And wet socks are my worst enemy. Besides, I have this incredible fear of being struck by lightning. Crazy, I know. So if there is more than a 0.2% chance that it will rain at any point in the day, you will find me either on the treadmill or in my bed (probably in my bed 99.9% of the time, as the treadmill and I just aren't close friends either).

But today I woke up ready to hit the Park and RUN! I just knew it would be a gorgeous day for such and got all geared up to go. Upon opening the door, disappointment washed over me. It was drizzling. Not bad, but enough to get wet. So I did what every logical person would do and downloaded 2 additional weather apps to the 2 I already had on my phone and looked to see just how bad the rain would be and at what hour it would let up. It wasn't even forecast to rain much, so I headed out praying lightning wouldn't strike, of course.

Even on my way to the Park the sky cleared. Sweet. It was meant to be after all.

I ran my first 3 steps and the sky suddenly opened up. I was drenched within 5 minutes.

The rain was cold and stung my skin. I squinted my eyes in a futile attempt to keep the drops from burning my eyes. I pressed on and ran faster hoping it would let up again soon. It didn't.

The drops got bigger and fell quicker.

And I heard the voice of the Lord gently remind me that He knows the whole world is broken. It was as if He was saying, "I see, Janice. I know. And it breaks my heart too." I really felt like God was crying. Weirdest thing. I just wished I could get Him a tissue or something so He wouldn't get me so wet.

I shivered in the cold. The drops continued to sting my skin and flood my eyes. My socks were wet and mud flung up the back of my legs with each step. But there was something incredibly peaceful about knowing that God sees the brokenness and is moved by it. And there was also something about the way the rain washed the earth--like a cleansing rain to wash the brokenness away. Like springs of water would be in the desert. And I felt the Lord washing over me, reminding me, "Blessed is the man who walks not in the counsel of the wicked, nor stands in the way of sinners, nor sits in the seat of scoffers; but his delight is in the law of the Lord, and on his law he meditates day and night. He is like a tree planted by streams of water that yields its fruit in its season, and its leaf does not wither. In all that he does, he prospers" (Psalm 1:1-3). I felt the Lord reminding me that my life is His, that His ways are higher than mine and are PERFECT and beautiful and joyous. I knew He was reassuring me that I wasn't going to miss His best for me.

When I got home I was stirred to read the one recorded time in Scripture where God Himself cried. I LOVE the story. Check it out in John 11. Pretty much what happens is Jesus's friend Lazarus dies. He's been dead for 4 days when Jesus gets there. And He is told at least twice, "Man, what the mess?! If you would have gotten here 4 days ago this would have never happened! Could not he who opened the eyes of the blind man kept this man from dying?!"

Jesus is lead to Lazarus's tomb, and I guess it suddenly hits him that his friend is gone. Dead. In the grave. And He weeps. Right there along with everyone else, He weeps.

Crazy story really--because His first words to them when He arrived were, "Your brother will rise again." I mean, He knew the grand finale. But there was something in Him that drove Him to tears even knowing that everything was going to be awesome in the end. He loved His friend. And, well, His friend was dead. So He wept. The sisters wept. The family mourned. And Jesus did too.

But not for too long I guess because before we know it Lazarus is up and walking and needing some new clothes lest he embarrass himself and everyone else for that matter.

And in a sense this is exactly what happened to me today--I felt the rain as tears of the Lord. And suddenly the clouds cleared and the sun even peaked out. I was soaked to the core but full of joy knowing that we serve a God who sees and is not the least bit absent from our pain, a God who weeps with those who weep, a God who is more than able to cause life to spring up in the dead, a God who mends the breech and breaks every fetter, a God who is our very own Resurrection and Life.

I am confident that ultimately there will be a place where there are no more tears and no more pain. There will be a place were all is made new.

And the Lord said,

"Be still, and know that I am God.

I will be exalted among the nations,

I will be exalted in the earth!"

The LORD of hosts is with us;

the God of Jacob is our fortress.

Selah

(Psalm 46:10-11)

-J

Confessions.

I am terrified of wasting my life.

There--I said it.

Here's the thing. I've spent most of the last 11 years of my young life trying to find my place in this world, trying to do something that will count. Something that will change lives for eternity. Something that will bring unchanging hope and peace to the darkest corners of the world. I've dreamt about it. I've tossed and turned in my bed many sleepless nights wondering how on earth my life can change someone else's.

One thing has lead to another and here I am today in my third year of med school, arriving rather firmly and affirmedly at a decision to pursue OB/GYN. I love OB/GYN and have for a long time. I love the primary care, the surgery, the babies, the ladies, the whole nacho.

And while my passion to live a life that affects change and inspires hope in the lives of others around the globe has remained unchanged, let's not lie--my life for the past 4 years has been all about none other than me, me, me, and well, me. How will I get into med school? Where will I go to med school? How will I survive med school? How will I make the grades? Where will I go to residency? Will I get to go where I want to go? How much longer do I have to stay at this dreary hospital today? I take call how often?! When do I get to nap?! Do I really have to do that?! And I guess, partly it has to be this way--I do need to study. I do need to work. And, well, the good Lord knows, I do need some sleep from time to time too. And it would also be nice to make sure I have some plan as to what I'm doing when I graduate next year.

(Geez, if I had that many new I's all the blind folk in Texas would be able to see by next week.)

However, I feel rather self-absorbed lately thinking and planning and scheming and trying my best to sell myself to attendings to make the grade and get favorable evaluations. And I often have to stop and recollect and ask myself why I really do all this anyhow. What was that thing about changing the world again? And is that even possible? And will I be old and grey and disillusioned once I am finally trained to do all this stuff? Oh, and do I have to go there ALONE? O geez... A whole 'nother fear for a whole 'nother blog!

But I have these friends who, and read blogs about and hear of folks, just normal folks like me, who are doing INCREDIBLE things right now to reach the nations with clean water and save women from human trafficking and help starving kids learn how to grow crops for whole villages and do just about anything to suffer with the suffering and shed any amount of the light of hope possible into dark, dark places.

My heart about beats out of my chest when I read of it.

And I wonder if my life will ever amount to anything....

I wonder if I will ever finish all this doctor-making stuff, first of all!

Then, I wonder when it's all said and done, if I will bite into the American "dream" and find myself in 10 years buying a new house and driving a new car and living in the suburbs sending a few dollars over every now and again so I can feel good about myself and feel like I am helping out. I wonder if I will find myself living the doctor high life and never having done anything that really matters.

I wonder if I will get too chicken to ever make the wild, crazy, risky decision to just GO. To drop what the world has convinced me I "deserve" and go somewhere dark and bleak and miserable and hard and uncomfortable and joyous and beautiful.

I wonder if I will be bold enough to follow those dreams that often haunt me at night and that come to life when I read of others willing to give their lives for something beyond themselves.

So, in short, I am afraid of wasting my life. Of settling for less. Of becoming numb to suffering around the world and not daring to do something about it. Of getting tired and jaded and of feeling as if I deserve comforts and trinkets and treasures.

I am afraid of forfeiting all my dreams and what I've worked so hard to obtain only for an empty box of perishable goods.

Dietrich Bonhoeffer says it like this in "The Cost of Discipleship"--

Costly Grace is the treasure hidden in the field; for the sake of it a man will gladly go and sell all that he has. It is the pearl of great price to buy which the merchant will sell all his goods. It is the kingly rule of Christ, for whose sake a man will pluck out the eye which causes him to stumble; it is the call of Jesus Christ at which the disciples leaves his nets and follows him. Costly grace is the gospel which must be sought again and again, the gift which must be asked for, the door at which a man must knock. Such grace is costly because it calls us to follow, and it is grace because it calls us to follow Jesus Christ. It is costly because it costs a man his life, and it is grace because it gives a man the only true life.

May my heart not be lured so much toward the world and all its trimmings and trappings, but to the grace which costs me my life that I may find my only true life!


-J

"He is no fool who gives what he cannot keep to gain that which he cannot lose."

-Jim Elliot, missionary and matryr

Palm Reading

The scene: Day 1 of my new internal medicine rotation with my new team and new attending nervously beginning my first presentation of a patient I just met a few minutes ago.

Me: Ms. So-and-So is a 20 year old on hospital day number 3 admitted for end stage renal disease and severe anemia. She is--

Attending: (Dramatic stopping gesture.) Woah. Woah. (Looking to my team.) What have we got here?

(Long, awkward pause.)

Me: (Trembling quietly, fearing I have said something wrong in just the first sentence of my presentation.)

Attending: (Looking back at me.) Let me see your hands, young lady.

Me: (Timidly tucking my notes under my arms and stretching out my hands.)

Attending: Turn them over!

Me: (Timidly allowing him to examine my hands.)

Attending: I knew it all along!

Me: (Flushed, fluttered, and terrified of my attending's palm reading skills.)

Attending: (Looking back at the team with a eureka sparkle in his eye.) I knew it! We have ourselves an OB/GYN!




Guess there's no escaping the OB/GYN in me!

-J

Support Me in the MS150!

Greetings dear friends,

As many of you may have heard, in a few short weeks, April 17-18, I will be riding my bike from Houston to Austin in the MS150 to raise money for the National MS Society. The National MS Society serves to move research forward by relentlessly pursuing prevention, treatment, and a cure; to move to reach out and respond to individuals, families and communities living with MS; and to move politicians and legislation to champion the needs of people with MS through activism, advocacy, and influence.

So what is MS anyway, you ask?

MS, short for Multiple Sclerosis, is an autoimmune disease that affects the brain and spinal cord (aka the Central Nervous System or CNS). In MS, the body's white blood cells attack tissue called myelin sheath. Myelin sheaths are the protective covering for nerve fibers in the brain. Much like an electric wire is insulated with rubber or plastic, the myelin sheaths cover nerve fibers as they transmit nerve impulses within the brain. When a myelin sheath is worn down or destroyed, the process is called demyelination. Demyelination causes the nerve fiber to be exposed. The exposed nerve fiber is less able to transmit nerve impulses. As a result, messages between different parts of the body are not transmitted as effectively. After the myelin is destroyed, scar tissue called sclerosis is left behind in the damaged areas, which are referred to as lesions or plaques.

Here’s a pic for you visual folks—

So what does that really mean?

Demyelination can take place anywhere in the CNS and cause a myriad of symptoms that vary from person to person. MS can cause blurred vision, loss of balance, poor coordination, slurred speech, tremors, numbness, extreme fatigue, problems with memory and concentration, paralysis, and blindness and more.

Who is affected?

MS affects over 400,000 people in the United States and up to 2.5 million people worldwide. Since most people are diagnosed before they turn 30, MS has been called the most common disability-causing illness for people under 45-years-old.

· Women are 70% more likely to have MS than men.
· People of European descent are twice as likely to have MS as African Americans and Asian Americans.
· MS also occurs more often in relatives of people with MS—Children, siblings, and nonidentical twins of someone with MS have a one in 100 to one in 40 chance of having MS themselves. The identical twin of someone with MS has a one in four chance of having MS.
· Multiple sclerosis is more common in cooler areas of the globe. In the United States, Northern states have higher rates of MS than Southern states, and Canada has a rate of MS double that of the US.

A Little Closer to Home

My dad was actually once diagnosed with MS—though if you know anything about my dad, his words on the subject were rather few and vague. “Well, I dunno what it was, they said MS, but whatever it was sure made me sick.” That’s about all I can get out of him on the topic. Silly man. Maybe one day I can sneak him into an MRI when he’s not looking and check him out, but until then the mystery remains unsolved.

In November 2009, I spent 4 weeks on the Memorial Hermann neurology service, and while neurology is by far not my forte, I sure did learn a lot—a lot that far surpassed the treatment of those with some sort of, well, neurologic problem. We had many folks on our service suffering from MS exacerbations as the heat provokes such, but one particular woman stands out in my mind. We’ll call her Ms. Felicidad. She was a rather pleasant woman who we spoke with each day. When she arrived, she was having trouble with her vision and was unable to move any of her extremities. After a week of intense treatment, we had her back to her baseline of functioning—still unable to feed or cloth herself without assistance, unable to see in some visual fields, and trouble with memory. Despite all her problems, or maybe inspite of them, what sticks out most glaringly about her was her gratefulness. Every day she would show off her ability to raise her right arm. She did it with such difficulty, but she was so excited to be able to move at all. She was the strongest woman I’ve met in quite awhile—her drive to keep fighting for life even a life that was still imperfect at best, was astounding. Her smile and her laughter will be hard to forget.

Thanks for reminding me to be grateful and rejoice always, Ms. Felicidad. This ride’s for you.

I’ve read ALL this stuff, so now what?!

This is where you come in, friends! Each rider is required to raise a minimum of $400 for the National MS Society. I would love for you to sponsor me in whatever way you can—financially, of course, in prayer, through encouragement. Any amount you can give counts and is much appreciated! There is a link on my Facebook page for you to sponsor me or you can click here. You can also give cash or checks directly to me. If you have any questions don’t hesitate to call or email me at Janice.L.Mitchell@uth.tmc.edu. You can also check out my MS150 fundraising page or the general MS150 website.

Thanks so much for all your encouragement and prayer! I am grateful for each of you.

Saved by grace. Motivated to race.

Therefore, since we are surrounded by so great a cloud of witnesses, let us also lay aside every weight, and sin which clings so closely, and let us run with endurance the race that is set before us, looking to Jesus, the founder and perfecter of our faith, who for the joy that was set before him endured the cross, despising the shame, and is seated at the right hand of the throne of God. Consider him who endured from sinners such hostility against himself, so that you may not grow weary or fainthearted.

Hebrews 12:1-3

This Is Who I Am

There are several things I love about Shane & Shane. On the top of that list is the gift they have of singing scripture over us. They released a new album this week called "Everything Is Different." It's wonderful. Chalked with the Word of God and truth. Check out www.shaneandshane.com for some of the songs and the stories behind them. Here is one of my favorites--

I am a new creation,
the old is passed away
and I’m made new
I’m made new.

And I have been adopted,
the door is opened up
for me to know you
be like you

This is who I am
I’ve been born again
the Cross is my defense,
my hope secured
now my life is in Your Hand
on Your every word I stand
Lord I’m finding who I am in all you are

When my heart condemns me
tells me I am guilty
Your greater
Your greater

Jesus you have searched me,
and even in your finding
You have loved
and You love me

This is who I am
I’ve been born again
the Cross is my defense,
my hope secured
now my life is in Your Hand
on Your every word I stand
Lord I’m finding who I am in all you are

For He made Him who knew no sin
To be sent
On our behalf was crucified
Oh that we could be the righteousness
Of our creator

I am a new creation,
the old is passed away
and I’m made new
I’m made new.

This is who I am
I’ve been born again
the Cross is my defense,
my hope secured
now my life is in Your Hand
on Your every word I stand
Lord I’m finding who I am in all you are

This is who I am
I’ve been born again
the Cross is my defense,
my hope secured
now my life is in Your Hand
on Your every word I stand
Lord I’m finding who I am in all you

-Shane & Shane

Don't forget who you are, friends--loved deeply by God, His greatest treasure, His child. The old is passed away and, behold, ALL things are made brand-spankin' new!!

Subway Sandwiches, Goodness, and Mercy

I caught a glimpse of a beautifully-crafted, ultra-fresh, veggie-filled Subway sandwich on the television in a patient’s room today. My mouth began to water. And I dreamed of the possibility of indulging in such a delicacy at the next free moment. Rounds finished. Patient duties were mostly done. My stomach was beginning to growl. I was on call, but surely I could make the approximately 1 mile journey away from the hospital cafeteria grease and mush, down the block to where freshness lives and dwells. I carefully calculated my escape, power-walked with unprecedented determination, reached for the Subway door handle with great victory in my heart, and crossed the threshold into the smell of oven-fresh bread. Instantly, my pocket began to echo with the all too familiar ear-splitting siren clamor of the trauma surgery pager. Code 3 trauma. Life flight. Estimated time of arrival: 2 minutes. Greattttt. The last time I ran a 2 minute mile and crossed the finish line sweat-less and not panting like a puppy was a few summers back when I was being chasing by a cheetah in the jungle. It was really no big deal.

I swiftly exited the sweet aromas with great defeat in my heart and blazed down the street praying I wouldn’t become the next trauma of the evening as an auto-pedestrian accident. I arrived in the ER dripping from the brow with a pulse and blood pressure that possibly could have classified me as a Code 3. I tried to hide my winded-ness and reach for something productive to do, pretending as if I had been there all along. The whole thing was a wash and my team was ripping off their gowns before I could even get mine on. My resident nodded, patted me on the back, and we all went on our separate ways. My mind quickly raced back to that sandwich. Was it worth chancing again? You betcha.

With more determination than before I raced back down the street to Subway. I grabbed the door handle with slightly more caution than previously, looking down at the black box attached to my pants and giving it the “you behave, now” glare. As the fresh bread was sliced and the veggies were placed, my heart swelled with victory. Now, if only I could make it back and have a moment to savor the victory before the pager siren roared again.

A grand total of 4 miles for the God-blessed thing—a mere Subway sandwich never tasted so good. As I savored my dinner I was amazed at the length I went to just for a rather extraordinarily ordinary sandwich. Past the fresh bread and perfectly sliced tomatoes, my heart was quickly drawn to and captured by the last verse in Psalm 23--Surely His goodness and mercy shall chase me all the days of my life. I replayed my small and petty pursuit over the last hour. The entire hour had been dominated by a quest to bound every obstacle between me and Subway. And I was amazed that the God of the universe would chase me, pursue me, bound every obstacle with His goodness and mercy…not just for one hour but for all the days of my life! Conclusion: I must be worth far more than a Subway sandwich.

I am grateful for the tail end of that verse—and I will dwell in the house of the Lord forever (where I am sure things far greater than fresh sandwiches abound).

Praise be to a Good Shepherd Who never leaves us in want, Who brings us to green pastures and quiet waters, Who restores our souls, Who leads us on right paths, Who is near in the valley, Who comforts, Who prepares a table for us even in adversity, Who anoints, Who overflows our cups, Who chases us with goodness and mercy ALL the days of our lives, and Who ultimately brings us to dwell in His house forever.

Fear

Fear has always been a companion in my life, and most of the time, I welcomed him to some extent. Ironically, he felt safe enough and I would allow him to tag along as I walked through my day. I guess I’d liken him in some regard to my little brother (no offense, Paul), always following one step behind.
Sometimes, he annoyed me a bit, getting in the way when I needed him to leave me alone. On other occasions, he’d embarrass me at the least opportune times. I couldn’t always hide him and it was obvious to everyone around that Fear was with me.

And then, in my weakest moments, I’d let his presence overshadow me. That’s when it would get really ugly. A moment in time would pass when I knew I should say something, do something, offer something, or be something to someone else but with his strong arms wrapped around my own will, I gave in to Fear. Too easily. Not even putting up a fight.

Fear won.

After thirty years of letting Fear bully me, I decided enough was enough. It’s time to fight back. Fear may still exist and hide in the corners of my heart and my mind, but I refuse to allow him to have the control he once had.

Well, at least I’m attempting to try.

I realized Fear isn’t only affecting me but humankind as well. As I look around today, I see him latching on to most people I encounter. Their hearts are on fire for their dreams, yet Fear tells them those dreams are impossible.

These people want to have a family, go back to school, quit their job and move to Africa, volunteer at a shelter, stand up for justice, ask a question, right a wrong, or even say hi to their neighbor, but Fear soaks into their bloodstream and prevents them from taking a step in the beautiful, wonderful, difficult life that lays in front of them.

Fear wants to stop our stories.

And with the pain and brokenness and hurt in this world, we simply can’t let it. The human race needs a hope and faith and light now more than ever.

The Ancient Scriptures say through the love of Christ, we are to be that hope. That light. Burning brightly on a hill.

Not hidden in the darkness of a shadow by a nemesis named Fear.

Yet, we can’t go at it by ourselves. I think that’s why so many of us get so close to crossing over the border from darkness into light.

From Fear into boldness.

However we know that once we take that step into that which illuminates, we’ll be exposed.

Naked.

Ashamed.

Broken.

Possibly alone, and desperately longing to go into hiding again.

We know what it’s like to have Fear screaming in our heads.

The way our minds tell us to run, our hearts palpitate, our hands sweat, our voices tremble, our bodies toss and turn in an ocean of confining sheets as the ceiling moves in closer and closer.

Fear’s voice is loud.

Earthshatteringly loud.

But our voices are louder.

Yet most of us don’t know that.

We don’t know the power we have when we fight Fear back. Fear isn’t strong. He’s derived from something ultimately weak and powerless.

Have you noticed how we’re often impressed by people who appear to be fearless? The ones who fly to the moon. Chase tornadoes. Enter dangerous war zones. Skydive. Speak in front of thousands of people. Stand up to cancer. Raise money and adopt a child that isn’t their flesh and blood?

Why are we so inspired by them?

Because deep down, we are them.

We all share those characteristics. They’re divinely human.

Just like us.

Something subconsciously in us begins to glow when we see people overcome Fear. Their actions push us to find that divine piece (or is it peace?) within ourselves in order that we may also overcome Fear.

A majority of people in the world live with some kind of baggage. A shame. A weight. A burden. A question.

And Fear continues to tell us that we’re alone.

And that we can’t speak freely.

But Fear is wrong.

We are not alone.

Regardless of what shame, what question, what trepidation, what history, what anxiety, whatever you are carrying deep inside, you are not alone.

And you can speak freely.

-from Anne Jackson's Permission to Speak Freely-

One Bloody Night in the ER...

David was a shepherd boy. This David* was a young boy with a C-collar and a scalp lac secondary to a bathtub accident. Injury-wise, nothing critical really. I mean, there was no LOC, amnesia, AMS, neck pain, or fractures. The C-collar was cleared and we moved on to assess the situation with the lac. No biggie—2.5 cm, nothing a few staples couldn’t fix in a hot second. Socially, David’s story was quite similar to many of the other patients we serve at the county hospital—poor, living with grandma and several other children, young mom in and out of the home, no dad to speak of, sleeping on the floor of a one-bedroom apartment. I left to write my note and patiently wait to present him to my attending who would most likely say, “Okay. Staple him up and write his discharge.” Easy enough.

About 5 minutes into my note the nurse came over to say that my patient was bleeding pretty bad and that the grandmother was asking for me. I kept writing, knowing that it probably was nothing urgent as he was fine just minutes ago. Upon completing my note, I lackadaisically walked over and pulled back the curtain to find my patient sitting in a pool of his own blood. Four-letter words flooded my mind. Alerting my attending to the situation at hand, I was reprimanded for failing to hold pressure on the wound. Frustration washed over me. Seriously?! It was barely even bleeding 5 minutes ago, I swear. Just my luck.

Now the blood was pouring from his head. Knowing that we are unable to sew or staple actively bleeding wounds because a hematoma will form at the site, I firmly gasped David’s head to apply some pressure. He screamed bloody murder and fought me something fierce. He was too strong for me. There was no way. Blood was gushing from the wound and flying everywhere as he fought against me. I feared for the demise of my new white shoes. The nurse laid on him as I braced his head. Our 2 woman team had finally defeated our 5 year old muscle man, and I pressed down on the gusher as hard as I could showing it who really was boss. I prayed that David’s blood-curdling screams could maybe turn into some blood-clotting.

5 minutes past. Nothing. 10. Nothing. 20. Nothing. Half an hour and the booger was still oozing like there was no tomorrow.

Grandma was in the corner hysterical, chanting the name of Jesus as if she was going to coax a genie out of a bottle or something. The nurse had left to attend to other patients, and I was left to my own devices to keep young David pinned down on my own. He was still fighting me and it became a war of who would tire first. Covered in blood, sweat, and David’s tears I was wearing out, but determined to complete the relatively simple task given to me, hold pressure. Pinned under my weight, I held pressure with one hand and stroked his face, catching his tears with the other as he cried out for his mom who was nowhere to be found. Eventually, his screams turned to mild cries to mere whimpers as he drove himself to sheer exhaustion.

As time passed I was able to loosen my grip on David a bit, but his grip on my heart only tightened. As he began to relax I was able to hold his head and stroke his back giving him some of the affection and comfort that a young hurting boy so much needs. My mind wondered to what his life at home must be like and what it must be like for a young boy to live without a father in a pretty rough neighborhood. I began to pray that God would father him and raise him up to be an incredible man after His own heart that would break the cycle of brokenness and poverty in his family. I prayed that against all odds, despite all outlooks and circumstance, that the Lord would break through to him and rescue him. My spirit truly cried out for his young heart and life. An hour passed. Then two. And while the blood was still ‘a flowin’ I was sure that my spirit had prayed the kid into being the next Billy Graham or at least something to that effect.

I can’t help but think about the anointing of God on King David’s life. When he was anointed to be king he was only a young shepherd boy. In fact, he was originally overlooked because of his lowliness and age. But the Lord spoke rather clearly to the situation when he said, “Do not look on his appearance or on the height of his stature…. For the LORD sees not as man sees: man looks on the outward appearance, but the LORD looks on the heart." In the end, God raised David up to be a mighty king and accomplish many great things. And not only that, God raised David up to be known as a man after His own heart.

In this blog, I will never use the real names of my patients and will often change identifying factors so as to guard their confidentiality (and protect my behind too for that matter :0). In this account, I changed the young boy’s name to David. Why? Because the Lord is going to father him and guide him and love him and rescue him and raise him up to be a mighty man of God that chases after the heart of the Lord. Why? Not because his life circumstances will point him to that end but simply because the God of all hope is able.

That bloody night in the EC, I learned a lot. I learned that scalp lacs bleed—a lot. I mean, you would have thought the child lost a limb or something. I learned that I am weaker than a 5 year old boy. I learned to sew a few stitches. But most of all, I learned to pray. I learned to catch a vision for all that could be and cry out to the Lord that it simply would be.

I will probably never see David again—that is until the Lord raises him up to be the next Billy Graham. Just playing. But really, the possibilities are endless. And God is able. More than able.

*Names and certain identifying facts are changed in this blog so as to respect the confidentiality of the patients whose stories are told.

Jesus Wants the Rose!

I really love this video.

...we implore you on Christ’s behalf, be reconciled to God. For He made Him who knew no sin to be sin for us, that we might become the righteousness of God in Him.
-2 Corinthians 5:20b-21

For while we were still weak, at the right time Christ died for the ungodly....but God shows his love for us in that while we were still sinners, Christ died for us....More than that, we also rejoice in God through our Lord Jesus Christ, through whom we have now received reconciliation.
-Romans 5:6,8,11

O I am ever thankful that the Lord would want me, the broken rose, breathing new life, restoring me.

What was said to the rose to make it unfold, was said to me here in my chest. So be quiet now and rest. Here is our King. Here is our Love. Here is our God who's come to bring us back to Him. He is the One. He is Jesus....

The Most Glorious, Trying, Beautiful, Exhausting, Frustrating, Exciting Day Ever- AKA LBJ Day Uno

There is a code to the bathroom door. Who would have ever thought? I asked for it once. The second time I was embarrassed to have forgotten. Was is 2-5-6-1? 3-5-6-1? Or maybe 5-2-6-1? Crap. Can’t even seem to get the dad-gum bathroom code right today. I asked the nurse again and got that same O you poor, stupid med student, your life will never amount to much look I had been getting from every direction, so it seemed, for the majority of the morning. First it was the gauze I couldn’t find that happened to be in every room just under my nose, then the wrong speculum I picked from the closet, followed by a completely off-the-wall totally-wrong diagnosis and the shower of gloves I spilled in the exam room.

LBJ hospital is quite the place. It is exquisite. Truly. Maybe not my first thought walking in the door the first time, honestly, but really. The people are beautiful. I mean, some of them have about the IQ of a rock, but others really surprise you. Getting to serve them is a privilege. Whether talking to them is about as useful as talking to a barn or not, I love it. They are made in the imago dei and they are beautiful.

In true fashion, my first shift in the Pedi EC today was quite the experience. It was surely no different from any other day there, maybe even more calm than usual, who knows, but it made an impression on me already. It was the most glorious, difficult, trying, exciting, rewarding, fun, exhausting day ever.

There was one patient in particular that stands above all the rest, maybe because she was the only one all day I never had to fill out paperwork on or present to someone on the totem pole above me and inevitably feel like the dumbest person alive having overlooked some part of the exam (those of you in my shoes know exactly what I mean :0). I never knew her name—I probably never will. The sight of her precious face made my eyes well with tears, which I quickly choked back knowing that was not the professional, grown-up doctor-type thing to do, or something to that effect.

I knew excitement was coming when someone ran into the EC shouting stuff I could only partially understand. I had no idea what was up but I ran outside with the best of them. As I passed the gloves on the wall I thought I ought grab a pair but not wanting to break suit or be over-zealous I followed everyone else gloveless. I felt like I was in a scene from Grey’s Anatomy, if only for a moment—you know when they run out to the ambulance dock and something crazy, wild happens just as they cut to a commercial break? I just knew I would see Katherine Heigl out there talking to Denny or McDreamy glowing in the sunshine in all his hotness or something bizarre. Ha. Anyhow….

There was quite the crew of folks gathered around the vehicle parked just outside. I stood on my tippy toes to see what all the excitement was about and before I knew it a baby was handed out of the car. Someone called out the time. I noted it in my mind. 3:21. I have no idea why out of the 20 or so medical personnel types gathered around they thought I looked like the appropriate person to hand a fresh child to, but nonetheless, next thing I knew the baby was handed to me. I gladly accepted, gloveless and all. (Though my attending sure didn’t miss the opportunity to fuss me—dang, if only the thought counted!)

I heard her precious cries. She opened her eyes and I felt like she looked straight at me. Welcome to the world, sweet one.

The scene was chaos. Mom was in pain and still needed to deliver the placenta. No one could seem to find the appropriate wrist bands. But I was in my own world with a beautiful baby girl in my arms. O bliss.

I carried her around for what seemed like forever as things were sorted out. I thought of names for her and wondered at what she would be when she grew up. I thought of running as fast as I could and taking her home to be mine!—just kidding. Don’t tell anyone. They will never let me around small children again!

For all the moments I felt like a retard, unable to even open the bathroom door, dropping all my stuff on the floor during a pelvic exam, and answering even the simple questions 100% wrong, there were the moments of tickling cute little kids, having real-life talks with teenagers, and of course, delivering babies in the parking lot. Exhausted? Check. Fulfilled? Double check.

Bring it, day 2!

Coffee Shop Creeper

As the words came off of her green pen, I totally knew I was being an ultra creeper. I mean, poor woman was just trying to pull her thoughts together as she enjoyed some coffee, and here I was looking over her shoulder reading her deepest hurts. Only a tinted glass window and a matter of about a foot separated us. She had no idea I could see her every thought on that paper—and I had no idea I would be enough of a creeper to read them. Maybe it was the amount of bacteria I had studied that morning and the antibiotics I was getting mixed up in my mind, anything probably seemed exciting compared to that—even the private musings of a stranger, I guess.

What’s so strange about the whole thing is— 1) I don’t normally go to this coffee shop—it’s too dark, too loud, too crowded, and too overpriced on top of all that. 2) I normally don’t pay a bit of attention to anyone in the coffee shop when I study—the place could get robbed for all I knew and I would still be sorting out the antibiotics I can never seem to keep straight. 3) I don’t have a habit of stalking complete strangers—facebook stalking, definitely, strangers, now that is a little freaky-er.

So, she begins to write: She wishes she was somewhere else. She wishes for a friend, someone to talk to, even a stranger.

O-M-G! Maybe she does know I can see her every word! OMG! I am such a creeper. I try to divert my attention back to the fluoroquinolones. But my eyes keep wandering out the window, trying to decide if she knows I am watching, trying to see what she will write next. She pulls out a small book—a Bible. She begins to pray.

And then it dawns on me—maybe, just maybe, I am the answer to her prayer today. Being personally a little freaked out by my own creeper-ness, I hesitate, say a quick prayer, and head outside.

“Hey, I’m Janice.”

Tears filled her eyes.

About an hour went by of sharing the whole “what’s your name, where are you from, where did you go to college” business. But it was deeper than that too—turns out I was, indeed, the answer to her prayer this afternoon. I gave it my best shot to encourage her and prayed with her before she left. And I, in turn, made a new friend.

I mean, what were the chances of all of this, that I would be sitting at the point of exhaustion and boredom, and that my new friend Becca would just so happen to be sitting outside the window at just the perfect angle for me to catch her need for a listening ear. AND that I would be crazy and random enough to approach her.

Strange how God works, even through window coffee shop creepers sometimes, I guess. His love for us truly is deeper, wider, and higher than we could ever imagine.

Let Us...

Let me just first say-- Summer is here in Houston and it is HOT!

Today my friend Joy and I were running around Rice when, about a mile in, I totally ate it. Despite my best efforts to catch myself, I hit the ground and I hit hard. (Wish there was a video for some of you compassionate types who find great joy in witnessing such events.) I wanted to cry, so, naturally, I began laughing. I collected myself, dusted off, and we were back at it in less than 30 seconds. I was hurting. I was sore from a week of pushing myself to begin with, my hands still had rocks in them, and my leg was throbbing. Not to mention--it was well over 90 and I was HOT. I had every reason to stop. And with each step I thought--at least now I have a good excuse! But we pressed on. We were a little sluggish, but we ran til the end and finished strong.

As we picked up the pace the last quarter of a mile or so, I realized that I would have never made it without Joy by my side. I would have fallen, cried, wallowed in self-pity, turned around, and walked with a limp back to my car. I am a wimp--me and pain are NOT friends in the least bit. But Joy encouraged me to keep going and finish hard and strong. And for that I was incredibly grateful--we rounded that last corner with a sprint and it felt great. As I surveyed the damage, a little extra pride bubbled up in my heart knowing that we endured the heat, the fatigue, and the fall.

I can't help but think of this afternoon as a summary of how this past semester has been for me. Community has always been a beautiful word to me, but I don't know that I have ever lived in community the way I have this past semester. The Lord has truly provided immeasureably more than all I could have asked or even imagined. And we have run the race together. We have fought through the valleys of life together. We have fallen and helped each other up. We have prayed. We have cried. We have nearly peed ourselves in laughter. We have shared meals and life stories and burdens and moments of great victory and joy. We have endured. We have confessed our sin and shame and have loved unconditionally. We have seen God move us and change us. Gosh, incredible would be such a small word to describe what God has so graciously done in us. I am so blessed to have friends who have loved me so deeply, fought in prayer on my behalf, encouraged me to press on through hardship, and rejoiced with me in times of great joy. I know that without them I would have quit long ago--I would have thrown in my towel and said that med school and life in general are just plain too hard. But they have been so faithful to love and to encourage even in my ugliest of moments. And, best yet, they have rejoiced with me in moments of victory.

I thank the Lord constantly for each of you and the way you love the Lord in such beautiful and different ways, the way each of you paint such a glorious picture of who God is and how truly deep, wide, and high His love is for us. Thank you for feeding me, for being my study buddies, for running and sweating with me, for encouraging, for praying, for loving unconditionally.

I love the exhortation of the author of Hebrews, "Let us draw near with a true heart in full assurance of faith, with our hearts sprinkled clean from an evil conscience and our bodies washed with pure water. Let us hold fast the confession of our hope without wavering, for he who promised is faithful. And let us consider how to stir one another to love and good works, not neglecting meeting together, as is the habit of some, but encouraging one another, and all the more as you see the Day drawing near."

If I have learned nothing else this semester (and, God, I sure hope I learned a few other things too!), I have learned that the Christian life is meant to be lived together. I love how we are encouraged to let US draw near and let US hold fast and let US consider... We need each other. We need to point each other to Christ. We need to hold fast together. To meet. To pray. To encourage. To draw hope from the source of all life and joy. And we need Jesus--we need Him so desperately to be our way, truth, and life and enable us to be the voice of such hope to those around us.

SO, thank you SO much sweet friends. Words are not enough to describe the way you have revived my spirit and enabled me to run the race with endurance. Thank you for the many, many ways you love unconditionally and encourage so faithfully. It is indeed a pleasure to run side by side with each of you.

May the Lord bless you and keep you and make His face to shine upon you and be gracious and give you peace. And may there be many, many more miles of sweet fellowship and freedom in Christ.

Bless the Lord, O My Soul

Bless the LORD, O my soul,

and all that is within me,

bless his holy name!

Bless the LORD, O my soul,

and forget not all his benefits,

who forgives all your iniquity,

who heals all your diseases,

who redeems your life from the pit,

who crowns you with steadfast love and mercy,

who satisfies you with good

so that your youth is renewed like the eagle’s.

~King David, Psalm 103:1-5

Beautiful, beautiful words. These words have been like cold water to my thirsty heart recently. May they bless you today as much as they have blessed me this weekend and may you truly be forgiven, healed, redeemed, crowned, satisfied, and renewed. And may we in turn bless the Lord with all that is within us--

Peace,
J

A Few Thoughts on H1N1, Swine-Origin Influenza A

The alarms have sounded and the world is on alert as everyone watches and waits for something that has been described as “inevitable” and “uncontrollable” by some in authority. While the government responses are not completely unwarranted, they should be seen as preventative and nothing more for now. In my personal opinion, declaring a “national emergency” is a little premature and only serves to scare people into the ED and further enable the spread of disease. Maybe it is all semantics though, as declaring such things allows for the distribution of resources for prevention and early intervention, both very necessary responses at this point.

Be reminded that non-swine origin influenza is VERY common and kills 35,000 people in the US each year. SO what we have seen so far is simply a scratch on the surface. What is of particular concern with influenza of swine origin is its ability to mutate rapidly. However, this is not an uncommon phenomenon with the typical strains of influenza—hence the far less than 100% effectiveness of the vaccine each year.

Many of you have asked my opinion/forecast on this issue. I honestly don’t know that I really have one. Ha. :0) The truth is that no one really knows what is up. It could be a complete wash or a complete disaster, and really, only time will tell. So I guess my only opinion is that no one should be freaking out at this point. Use your common sense and such. And when you get a little worried just grab a slice of bacon or a good pork chop and feel like a conqueror.

This is going to be your most reliable source of information-- http://www.cdc.gov/swineflu/?s_cid=swineFlu_outbreak_001.

And here is something to pass along to your friends who are coming down with something-- http://doihavepigflu.com/.