Tuesday, January 31, 2012

A Wife in Medicine

I am thankful for Christians in the medical profession who see medicine as ministry—or at least those who spend time thinking more deeply about the strange world of medicine (as one of my old professors, Dr. Verhey, would say).  This past Sunday I sat down with Danielle to talk with her about a presentation she had on abortion.  The question was, “what will you do when a patient comes in and asks for an abortion?” 

I have posted her response below.  It is long, but I think it is worth the read:

I would like to begin with a story. It was told by the Dean of Duke Chapel Sam Wells. He says,
“Several years ago I sat down with Brian and Clare. Clare was 15 weeks pregnant. They’d recently been told
that the child she was expecting would be so severely disabled that it might survive only a few agonizing days after birth; maybe only minutes. I asked them the two questions I always ask. “What’s the best thing that can happen?” Clare said, “That I might find peace”. “What’s the worst thing that can happen?” She said, “That I might have this child, and it might live, terribly troubled and hugely disfigured, and that my friends might come round once or twice, and then I’d be left all alone.”

So I said to Brian and Clare, “What you want is peace, and what you fear is being alone. But may I suggest that what you need is the church?” “Oh” said Clare, “My dad is right against abortion. He thinks people who have abortions go to hell. My mom is all for women’s rights. She thinks it should be my choice.” I replied, as gently as I could, “Can I suggest to you that we’re not really talking about campaigning for abortion or campaigning for women’s rights? I’m not sure it’s really about legislation and I don’t think it’s really about going to hell. Because all these people with their certainties, for all their self-importance, have left you all alone. Alone now, with your decision: and alone in six months time, when you might need all the help you can get. You don’t feel able to ask for real help, and you sense, probably rightly, that real help isn’t there. It’s perfectly understandable that you’re drawn to a technological solution. But the real problem is one that an abortion won’t solve. You need people who won’t leave you on your own. You need a hope that knows there are things worse than physical suffering. You need people around you who will make your life beautiful even if it’s not happy. What you need is the church.

What will I do when a pregnant woman comes in and asks about abortion? First thing’s first. Find out her story. Ask Why? What’s going on? And then after hearing her story ask her

What is the best thing that could happen??
What is the worst thing that could happen??

 The most important thing I could do at this moment is listen.

As an FNP my responsibility is to educate, inform and keep my patient safe. According to the National Abortion Federation there are numerous aspects of abortion I could perform after training, but I would choose not to. I would focus my care on educating and informing my patient the best I could.

The best thing to do for this patient is to build a relationship. Let her talk. Let her share. Find out why. Find her a place to belong, whether it is the church or not. It might be a support group. It might be a women’s home. The point is that I would help her see that there is hope and that there are options. I would help her to try to find the beauty in the darkness.

We have around 4 million live births a year in the US. And we have a million abortions. This is such a common procedure that just does not make sense to me. The problem is much bigger than abortion. In my opinion the bigger problem that should be dealt with is a lack of education to women and girls. I truly believe that the ‘abortion issue’ could be almost completely avoided if we would begin educating women and girls more thoroughly. As we have seen in our readings this week there are numerous ways to have effective birth control. We should be educating women on the chance of pregnancy and the need for birth control. We should be telling even younger girls on risks of sex. We heard in our lecture that middle schoolers are having oral sex. They (most likely) have no idea about protection, and of course we all know that oral sex is just going to lead to sex sooner or later.

Girls are being bombarded with media presenting teen pregnancy as a “fun/trendy/cool” thing. Teens aren’t worried about becoming pregnant and then, ones that are, are not practicing safe sex practices. Teen pregnancy has become idolized in the past 5 years and is now something to be admired. This is clearly a problem.

It is our job as NPs to educate all aged women on the proper ways to protect themselves from pregnancy. And at EVERY visit.

On my first day at clinical we had a 15 year old seeking out contraceptive use. The mid-wife at the clinic spent 20 minutes discussing all sorts of birth control with the patient and then after she picked the one she wanted, the mid-wife continued to discuss sex with the girl. I will also add that since I have only been to clinic one day (before I saw this assignment) I was not able to ask if anyone in the practice performs abortions. But I will look into it.

So to close. Back to the topic at hand.

Why do we even have abortions? People feel ashamed. Because we feel abandoned. We don’t feel we have the emotional support or the money or security to meet all our commitments or give a child a chance in life without destroying our own.
One reason is we fear that a disabled life is less than a full life. We’re so concerned to abolish suffering that we would rather end life than watch a life in distress.

I can help my patients see that those are not the truth. Ashamed? We have all made mistakes. Alone? There are support groups. There is the church. Perhaps family.

And if you are a Christian- or maybe not a believer at all--We ALL, but especially Christians, should be in the business of forming and fostering communities in which unexpected life is welcomed as a gift rather than a threat. Christians should be opening our arms saying, “come and live with me”.

Danielle and I would have liked to take a lot of the argument a step further and explore abortion and the Church, but that was not the specific topic at hand. The questions, “when does life begin?” or “whose right is it to decide?” are unnecessary or secondary to Christians. Instead, there are Christian categories that are more important and need to be invoked. These are some of the theological categories we would have likely explored further:

Baptism—what does it mean that children are welcomed into a Church family through baptism? Or, that every adult is a parent to all of the children in the Church? Does this affect one’s “right” to choose or who raises the child?
Hospitality—what does it mean to welcome the stranger or the unwanted? What does it mean that Christians believe all life is able to build up our community? What does it mean to sustain a hospitality of life?
Kingdom of God—what does it mean that our citizenship is not primarily in the USA, but in the kingdom of God? Does this change the idea that, “it is your right as a citizen of the USA to choose?”
The Gospel favors the oppressed—What does it mean that the Gospel favors those who are oppressed—particulalry women and children? Is it ironic that the abortion debate pits women against children?
Suffering—What does it mean that suffering is not to be avoided at all costs? After all, we worship a God who suffered, in some sense.  Compassion is radically different than “preventing suffering.”

These are just a few of the Christian categories that are important and need to be unpacked further. But, I think they start to put us in the right direction. Instead of lobbying for or against abortion. The Church should focus its energy on creating a space for “unwanted” children to become wanted.  We have to actually be the Church. 

There was a girl in Durham that wanted to have two abortions. Both times her Church said, “No. We will help you raise this child.” 

That strikes me as the right thing to do. 

Saturday, January 21, 2012

Speaking Carefully

I made a mistake a few Sundays ago.  Walter Brueggemann once advised pastors to never use the phrase “good morning” when greeting parishioners. For some it might not be a good morning, but it might be a bad morning. Worship is a place where we go to meet God even if we are having a bad morning.   It is a space for joy and a space for lament—though we often do not do a very good job in creating a space for lament.

I knew this.  Yet, I was standing in the narthex greeting my parishioners and a “good morning” slipped out of my mouth.  A parishioner replied, “bad morning” and hurried to their car before I could apologize for speaking carelessly. Epic. Fail.

Of course this is one of the reasons why we greet each other by saying, “peace” or “peace of Christ.”  The impact of the passing of the peace is that we have been reconciled to God and we are also reconciled to one another.  Also, the peace can also function like a blessing—may the peace of Christ be with you, whether it is a good morning or a bad morning.   “Peace” is one of the most meaningful phrases we can say to one another, especially when we are at a loss of words.

Careless speaking is endemic in our society and Churches.  But, our words matter. Saint Basil says, “those who are idle in the pursuit of righteousness count theological terminology as secondary.” Consider how important words are to Christianity.  Our faith is grounded in a written book.  Our faith is also handed down through written and oral words. We believe that Jesus speaks each week in the words spoken in the sermon.  Our words matter and they can’t be thrown around carelessly.

Stanley Hauerwas notes that Christians must learn to speak a new language. The sad part is that most Christians will never realize this. We have a language that is deeply formed by Scripture and tradition and we have to start using it.

“Peace” may mean nothing to a non-believer, but there may be nothing more powerful to a Christian immersed in Scripture and tradition.

What other words do we need to reclaim?

Friday, January 13, 2012

Solving Problems

Advent and Christmas have passed and a new secular year has begun. December and January can be a time of reflection and new beginnings. Many of us will make resolutions—to shed a few pounds or to exercise a little bit more.  I want to make a resolution to “pay attention.”

Eugene Peterson’s memoir The Pastor has been very influential to me over the past month. Peterson makes the case that the Church often tries to function in the business realm and becomes an entity that exists to “get things done,” or to “solve problems.”  I see this all of the time.  Church becomes a “problem solver” when we do things for people without entering into a relationship with them. Church even becomes a “problem solver” when we merely try to fill up pews at the expense of discipleship.

Everything has the potential to be a technical problem that is solved in technical ways.  Problem: attendance decline. Solution: membership growth techniques and workshops.  Problem: membership decline. Solution: get a new pastor.  The technical solutions we propose often to do not fix the problems, because the problems are often infinitely more complex. These kind of technical solutions can fix problems briefly, but unless people change and are transformed the problems will keep coming back. 

It’s so easy for pastors to get caught up in solving problems at the expense of their congregations.  A pastor ceases to be a pastor and becomes a CEO when the Church becomes a “problem solver.” 

Conversely, Eugene Peterson paints a portrait of a pastor as person who “pays attention.” “Peterson says,

“As pastors, we’re not trying to get something done. We’re not looking at people and thinking about what we can convince them to do. That’s not the goal. As pastors, we’re trying to pay attention to what’s going on now, right here—right now. We’re trying to pay attention to what God is doing. And we’re trying to share that in the community.”

 I have felt called to pay better attention to what God is doing in our lives, Church, and community and then share that information in worship. The Church life can be busy—full of meetings, grand ideas and visions. I want to stop trying to solve problems, but to take more time just to pay attention to God, to my own life, to your life, and to our lives together.

It’s when we really start paying attention that change is going to take place. Because as we start to really pay attention to God and each other we will find ourselves being changed—our hearts, minds, churches, and communities will become transformed.

Problems are all around us. But so is God. Sometimes we have to put our own agendas behind us to see where God is really working. 

Wednesday, January 4, 2012


This New Year I am deciding to write more.  I don't know how often I will write, but I wanted to have a space to do so when I have time. 

It's customary to make the purpose of one's very first blog an explanation of one's title, right? You might think that the title, “in the middle” is a reference to my being a middle child, but thats really not that important. 

“In the middle” is a reference to a concept in Dietrich Bonhoeffer’s work; I was very much influenced by Bonhoeffer’s Creation and Fall and Christ the Center in seminary. It has shaped my goals for ministry more than most books I have read.

I offer two caveats: My blogs will not always be this long or this detailed and this summary of Bonhoeffer’s work is not in any way exhaustive.

For Bonhoeffer, there are two senses of the middle:

First, Bonhoeffer notes that humankind finds itself at a middle point after the fall. We are between creation and consummation. Bonhoeffer says, “Humankind no longer lives in the beginning; instead, it has lost the beginning.  Now it finds itself in the middle, knowing neither the end nor the beginning” (CF 28).  Humankind does not have knowledge of the beginning—creation—or of the end—where we are going.  We are purposeless and directionless in life. But, with the Scriptural story, humankind is able to realize the beginning and locate their place in the middle. Scripture becomes a directive for those of us living in the fallen middle.

More importantly for my purposes, Bonhoeffer also imagines the middle in another way.  Humankind is also at a middle point in a circle without a center as a result of the fall.  Adam and Eve seize the center through the fall, where God stands as the source of life, freedom, and truth. In short, Humanity chose to leave creaturely freedom and the limits created by God in order to become Master—self-sustained and unlimited in boundary. At this middle point, there is no center but ourselves.

Without limit, humanity enters a new state—sicut deus (like God). Bonhoeffer succinctly summarizes, “Sicut deus—humankind like God in knowing out of its own self about good and evil, in having no limit and acting out of its own resources…bound to the depths of its own knowledge of God, of good and evil…the creator-human being who lives on the basis of the divide between good and evil” (CF 113). God no longer mediates our relationships, but humanity seeks to rule over all its relationships in seeking to be like the Creator.

            However, Christ invades the middle and becomes the center of the circle. Christ becomes the center that was lost through the fall. By becoming incarnate, God constitutes a limit to human personhood. In Christ the Center Bonhoeffer notes that, “Christ is at one and the same time, my boundary and my rediscovered center. He is the center, between ‘I’ and ‘I’, and between ‘I’ and God. The boundary can only be known as boundary from beyond the boundary” (60). Importantly, Christ becomes our mediation to God, oneself, one’s neighbor, and creation.  As the new center, Christ reminds us of our creaturely existence, liberates us from self-sustainment, and restores its freedom for God and one another.

It is precisely this last point that has been central to me. The idea of Christ as the mediator and middle has stayed with me during my six short months of pastoral ministry. I keep this quote in the back of my head to guard and shape my interactions and relationships: “Christ is at one and the same time, my boundary and my rediscovered center. He is the center, between ‘I’ and ‘I’, and between ‘I’ and God. The boundary can only be known as boundary from beyond the boundary” (CC 60).