OF BODIES, BLOOD, AND BOOKS
Karen had managed to stay sober for several years, but a recent relapse of binge drinking had pushed her liver over the edge. Under the renewed onslaught of rum, the normally spongy organ had hardened like a stone.
Ordinarily, blood from the intestines runs through the liver to be cleared of toxins and restocked with proteins. In Karen’s shrunken liver, though, blood could no longer flow, causing a backup of pressure.
As with any plumbing problem, there had to be a release valve. Her body had compensated by detouring the flow around the liver and back into her main circulation through veins in her esophagus.
The benefit of this bypass was that blood flow continued. The price to be paid was a dangerous engorgement of these esophageal veins, as they were asked to carry much more volume than normal and thus threatened at any moment to rupture. These dilated vessels, so-called “varices,” are literally like varicose veins inside the throat.
PICK YOUR POISON
Not only was Karen in an imminent bleeding danger, but also the chemicals normally processed in her liver were now being dumped into her main circulation. This meant that blood loaded with toxins from the gut went directly to the brain, like raw waste from a factory gushing straight into a stream.
With unprocessed ammonia polluting her mind, Karen stumbled into the emergency room, heavily jaundiced, trembling, and mumbling incoherently. While she was being evaluated, catastrophe struck. She began vomiting blood. Her varices had burst and were unleashing a tide into her esophagus.
She arrived in our ICU with dark, partially-digested blood pouring out of her rectum and brighter red blood erupting out of her mouth. She was in immediate danger of drowning, as well as hemorrhaging to death. Either way, her life hung in the balance. My colleague began putting a massive tube, like a garden hose, down her throat to suction out the blood, while I inserted a large-bore IV for rapid transfusions.
Karen moaned in her delirium, recoiling from our efforts, clumsily swinging her arms to fend off what her addled brain no doubt mistook for a mortal assault. She slurred out cries for help, interspersed with curses. She choked and gasped. She clenched her teeth on the large tube, preventing its insertion. She spun away from my massive needle, threatening a dangerous impaling of an artery or even my own hand. She was slipping away.
HELP IS ON THE WAY (OUT)
Into this intense and gruesome scene burst Nat, a third year medical student on our team. I was relieved to see him, if only to have another set of hands to restrain our combative patient.
Nat took one look at Karen, stripped nearly naked, yellowed, swollen, and flailing. He made eye contact with us, as we struggled to save her, and her blood cascaded onto the bed. I will never forget how his eyes widened, and he stopped in his tracks. With wonder he exclaimed,
“Wow, I’m gonna go read about this!”
With that, he promptly turned and left the room, never to return that night. I am not kidding.
Fortunately, we were able to stabilize Karen, and she survived to hospital discharge and even enjoyed a few happy years of sobriety before passing away. I was present at her death.
ACQUIRING AND APPLYING KNOWLEDGE
Talk can be cheap. Actions speak louder than words. The father of modern medical education, Sir William Osler, observes that:
Medicine is learned by the bedside and not in the classroom. Let not your conceptions of disease come from words heard in the lecture room or read from the book. See, and then reason and compare and control. But see first.
Medical education for a time lost this admonition. Nat’s (and my own) first two years of medical school were devoted exclusively to book study in classrooms. We spent hours each day listening to lectures and cramming our heads with as many facts, figures, and mnemonics as humanly possible.
Midway through medical school there was a tectonic shift in the education. We entered the hospital and began to put this knowledge into practice. Suddenly everything was real. Physicians were forged from scholars in that crucible. Statistics became stories. We spent time in lives, not in libraries.
For those who had mastered the cerebral world of books with their tidy, black-and-white solutions, the realm of human beings proved to be a much messier place. Not everyone was able to make this transition smoothly.
Nat was one who struggled, and he missed a chance to master something firsthand. It is far too easy to forget what we hear in classrooms or read in books. Yet lessons like those at the bedside of Karen stick with us forever. Recognizing this, medical education is again emphasizing the application more than just the acquisition of knowledge.
Benjamin Franklin would approve. He notes:
“Tell me and I forget. Teach me and I remember. Involve me and I learn.”
INVOLVE ME AND I LEARN
What does this have to do with our lives in this new year of 2022?
I am certain that God wants us to learn spiritual truths this year through involvement in his work.
Unfortunately, the pandemic has exacerbated our cultural tendency to mistake facts for knowledge. Contrary to the promises of the digital age, living so much of our lives virtually has not freed us from the constraints of the material world. In many cases it has trapped us in our own heads.
Correct theology is absolutely indispensable and priceless. But if the truths of the Gospel remain simply data without application, we rob them of power and value.
James, one of the fathers of the early church, has an admonition for his pupils (that would be you and me) that is similar to those of Dr. Osler and Benjamin Franklin:
“Prove yourselves doers of the word, and not merely hearers who delude themselves.” (James 1:22)
This year – like every year – presents a golden opportunity to grow in our faith by both hearing and doing the word!
God will wisely bring us to places that need his holiness, wisdom, and love. We will find ourselves unexpectedly confronting need, brokenness, sin, pain, confusion, and controversy. It may be:
- A suffering person who needs our prayer, not our platitudes.
- A confused person who needs the wisdom of scripture applied to their lives.
- A needy person who would benefit from our service more than our sermons.
- A non-Christian who needs a gospel witness more than an online argument.
How will we respond? Let’s not just turn on our heels and remark:
“Wow, I’m gonna go read about this!”
Let’s wade into the messy situations of the world, armed with the knowledge of an awesome God and fortified by obeying his word.
In my day the typical 3rd year student, fresh out of the classroom, knew almost nothing about how to be an effective doctor. For that to happen, all that wonderful book knowledge had to work its way into our whole being.
This year may the glorious truths of Scripture make their way to our eyes, ears, mouths, fingertips, and hearts!