Archive for June, 2009

Different names for the same thing

Americans do medicine differently. I’m not saying better. Just differently.

Sometimes they do it a whole lot better, if you have the money, they seem to do it a whole lot better. Your symptoms will get investigated, and investigated, and investigated some more till they’ve taken so much blood you need a transfusion and you’ve had a camera in every orifice.

You’ve seen House. Well it’s kind of like that. Without the humour, sarcasm and the saving lives.

Sometimes they do the whole medicine thing a lot worse. Like when you don’t have a great deal of money. Which when you look at it is really quite a large number of people.

It is the inequality in the medical care in the USA (or any wholly private system) that offends my little bleeding heart.

On the other hand i’d like to have the resources to stick all the patients through the answer box (also known as the CT scanner…) who i think actually need one.


The medical literature is the source of all these rather academic articles that study fancy new tests and recommend how best to look after your sore toe.

One of my favourites is the case records of the Massachusetts General Hospital (MGH) in the New England Journal of Medicine. These are records of case discussions by groups of erudite doctors who speak very politely to each other (presumably they know they’re being published…) about complicated histories and tests of sick people.

Invariably they go through countless blood tests, consultations and scans till either the patient dies or someone actually gets the diagnosis. And quite often they still die because the disease that is finally diagnosed is so rare that no one actually knows how to treat it.

The most recent I read was from a MGH affiliated hospital in South Africa where the MGH sends its trainees to teach them actual clinical medicine – as opposed to just putting them through an answer box.

The case describes the gradual and slow decline and ultimate death of a young woman with HIV and TB. It is depressingly familiar.

There is then this absurd commentary by renowned experts on what should have been done, and all the fancy tests they could have done to work out was going on. All this with references to the difficulties faced in resource-limited environments.

The sheer gulf between the level of care that that young woman would have got in the MGH compared with what was available in South Africa is staggering.

And perhaps unlike the usual case reports this woman died, not because she had some horrible, rare disease that it took a billion tests to diagnose.

She died because she had a nasty but common and treatable disease in South Africa.


Storm in a teacup

My church had a special wee service to commemorate the 1859 revival that happened in Ulster in… well 1859 i suppose. I know very little about it. I wasn’t born at the time.

The original plan was to have it down beside the wee bowling green in town. You would think in the midst of the Northern Irish summer that you’d be guaranteed a clear, dry summer’s day and there’d be BBQ’s and jumpers for goalposts and it would all be lovely.

Not quite.

There was really quite a lot of thunder and lightning. Some people used to see that as an omen of the gods. When it comes to running a PA rig outdoors then I suppose I still do.

So we packed everything back in the van and went back to the church and unpacked it all in the hall (this was plan B).

Of course at that point it then became very sunny and pleasant. And being the nice, enthusiastic church people we are, everyone plodded back down to town to stand in the sun for a few minutes and hear the moderator speak.

And of course the thunder and lightning came on again and they all got very wet.

I stayed in the hall with the sound monkeys eating the biscuits.

Anyhow. After all the wetting and drying and the singing there was the obligatory cup of tea and a chat.

Standing on the stage packing up the drum kit I decided that there is often more grace and humility and love in a bourbon and a cup of tea than there is in so much of the rest of what we do.

This is a radical concept, but during this point of our time together, people actually smile. They laugh, they even embrace. It is perhaps at this point more than most that we seem together.

As cynical I can be about how the church does the business of church – it is often in the cups of tea and dear old men and ladies wiping tables and young guys packing up sound gear that I find myself most content and happy to be part of all this.

Yes, as zoomie rants, it would be easier to walk away, to gripe and to moan and disengage but under (and it may really be quite far under…)  the politics, and the bureaucracy and the conservatism there is pure gold. And surely that’s something worth sticking around for.

Perfect love, gone wrong

[Some thoughts, only very briefly and incompletely considered.]

There’s this rather uncomfortable bit in Acts 5. Where up to now everyone has been all, “hope, renewal, restoration and the resurrection”. Then we have this slightly jarring bit where the now infamous Ananias and Saphhira hold back some money for themselves and lie about it and next thing you know they’re dead and buried. (Sorry if i paraphrase that too much.)

And it leaves many of us deeply uncomfortable. We’ve just been getting used to this nice, new fluffy god, who seems really quite unlike that wrathful, angry god in the OT (though of course both are just caricatures) – and then this happens.

We are mostly struck by how disproportionate it seems. Yes they fibbed about the money, but being struck dead is perhaps a bit over the top. We are still addicted to our own legalism and sense of justice it seems. Perhaps we’re just too scared for our own skins.

But when you think about it people were probably doing much worse throughout the church at the time and they weren’t dropping dead. So why these two?

Leaving aside, the interesting references to the OT (in the use of the greek nosphizein and perhaps reference to the holiness of the ark), we got into a bit of a discussion this morning on what happened and what the underlying  point (if there was one) was.

Though GOD does seem to punish certain sins in very specific, easily recognisable ways – this is more the exception than the rule. In general we trust (or at least are meant to) GOD for justice, in his time and his way.

We tread on very thin ice when we try to link certain individual happenings to certain individual sins – think of those who feel the holocaust is just punishment for the Jewish people for crucifying JESUS, or those who feel that HIV is a just punishment for homosexuals.

So if they didn’t die for this one particular sin, what what then did Ananias and Sapphira die for? What, almost unforgivable sin had they committed to bring about such a direct and obvious punishment.

And this leaves us with one of those quite basic fundamentals of faith, basic though not exactly simple. That in many ways people get exactly what they want. Like Renton says in trainspotting – choose life , or indeed choose not to choose life.

That at one level we get exactly what we want. Those who choose themselves get just that, they get themselves, shut up and locked inside themselves, like the hell depicted in the great divorce.

And is what happened in Acts 5 just that – the outworkings of choice in someone’s life? The final step and decision of a life that had chosen self over other, self over beauty, and self over all else?

Almost forget myself

if the world exists not chiefly that we may love GOD but that GOD may love us, yet that very fact, on a deeper level, is so for all our sakes

CS Lewis

Problem of Pain


June 2009
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