More Embryonic Stem Cell Info

I’ve recently referenced an excellent article on the huge gap between hype and reality with embryonic stem cell research (as opposed to the real and growing applications of adult stem cells), and Michael Fumento again points out the huge gap between myth and reality here (HT: Instapundit). Maybe the word is starting to get out — although I’m not holding my breath.

On a separate note, I’ve been quite busy lately, with several personnel changes in the office in the works, but have a few essays near completion on the Faith series (part 1 and part 2 here), Moving the Ancient Boundaries, as well as updates on the Narrows Bridge construction — so stay tuned.

God bless, back soon.

Embryonic Stem Cells

A.M. MoonIf you have any interest in the ongoing debate, ethical issues, and clinical promise of embryonic stem cell research, you should take a few minutes and read this excellent article by Maureen L. Condic at the always-excellent First Things magazine.

Dr. Condic is an associate professor of neurobiology and anatomy at the University of Utah School of Medicine and conducts research on the development and regeneration of the nervous system.

You will find the article immensely helpful at clearing away the fog generated by ESCR proponents and their supporters in the media, politics, and the shallow, vapid, intellectual pools of Hollywood.

Do yourselves a favor and give this a read — and save a copy as a reference for the next time someone waxes poetic about their promise, or the “cruelty” of exercising the utmost caution in pushing ahead with such research.

The Engine of Shame – Pt II

This essay, the second of a two-part series, was originally posted in October 2005.
 
DRGWIn my previous post on guilt and shame, I discussed their nature and differences, their impact on personal and social life, and their instrumentality in much of our individual unhappiness and communal dysfunction. If indeed shame is the common thread of the human condition–fraught as it is with pain, suffering, and evil–it must be mastered and overcome if we are to bring a measure of joy to life and peace to our spirits and our social interactions.

Shame is the most private of personal emotions, thriving in the dark, secluded lairs of our souls. It is the secret never told, the fears never revealed, the dread of exposure and abandonment, our harshest judge and most merciless prosecutor. Yet like the Wizard of Oz, the man behind the curtain is far less intimidating than his booming voice in our subconscious mind.

The power of shame is the secret; its antidote, transparency and grace. Shame thrives in the dark recesses of the mind, where its accusations are amplified by repetition without external reference. Shame becomes self-verifying, as each new negative thought or emotion reinforces the theme that we are rejected and without worth. It is only by allowing the light of openness, trust, and honesty that this vicious cycle may be broken.
 
Continue reading “The Engine of Shame – Pt II”

The Engine of Shame – Part I

This essay, the first of a two-part series, was originally posted in October 2005.
 

Steam locomotiveA wise friend–a man who helped me emerge from a period of considerable difficulty in my life–once taught me a simple lesson. In less than a minute, he handed me a gift which I have spent years only beginning to understand, integrating it into my life with agonizing slowness. It is a lesson which intellect cannot grasp or resolve, which faith only begins to illuminate–a simple principle which I believe lies close to the root of the human condition.

My friend taught me a simple distinction: the difference between guilt and shame.

While you no doubt think I am devolving into the linguistic morass of terminal psychobabble, I ask you to stick with me for a few moments. What you may discover is a key to understanding religion, terrorism, social ills such as crime and violence–and why the jerk in the next cubicle pushes your buttons so often.
Continue reading “The Engine of Shame – Part I”

Healing Faith

chains
A reader named Katherine recently e-mailed me. She had lost her husband, a man some years older than she, to multiple myeloma and Alzheimer’s disease. She is a Christian, and is struggling to make sense of his death, and the difficult questions of why God allows suffering. She writes, after giving me some details of his life, death, and fine character, and asks:

Why does God allow such terrible illnesses to such a kind person? I know there is really no answer as I know all about Job. The thing I am really afraid is that I prayed for his healing, and it did not happen. When I became a Christian back in the 80’s, the health and prosperity gospel was big at the time, and I guess it really influenced me more than I care to admit as I now know it is false. Even though I know it is false, I have become obsessed that God did not answer my prayer because of not being able to get rid of all the sin in my life (as if this were possible to do). One of the teachings of that movement was that if your prayer for healing went unanswered it was either because of lack of faith or sin in your life. I kept thinking that I don’t always put God first in my life, and that I spent more time reading secular magazines than reading my Bible and listening to more secular music than Christian music. These were my “main” sins, at least in my mind and thinking. Can you shed some light on this for me? I would be very appreciative.

The problem of suffering and evil is an ageless one. It poses a particular challenge for Judaism and Christianity, because of the seemingly insoluble tension between a world filled with suffering and evil, and the belief in a God who is good and all-powerful. Solutions to this dilemma, both adequate and inadequate, abound. It is the desperate hope of the atheist that this logical incompatibility proves beyond question the nonexistence of God. Others, less willing to ditch a Divine order, have concluded that God is good, but impotent; or that God is detached and uncaring, or capricious, or moody, or sadistic — and therefore not good.

It must be said plainly that answers to this paradox are neither simple nor entirely satisfactory. The dilemma as it stands may be solved in a global and satisfactory way — as has been done by both Judaism and Christianity — but invariably the lofty principles seem to break down at the moment when a solution is most needed: in the time of crisis when we ourselves experienced the depths, hopelessness, and irrationality of suffering in our own lives. CS Lewis, whose tightly reasoned treatise The Problem of Pain provides an extraordinarily deep and thorough discussion of this dilemna–later in life nearly repudiates his faith and sound theology after the death of his wife, a process painfully detailed in his diaries, A Grief Observed. It is indeed unsettling to watch Lewis discard all of his carefully reasoned and theological understandings of pain and suffering in the brutal crucible of unbearable pain and loss. Nonetheless, he ultimately comes to terms with the paradox, and undergoes an embracing of this profound dilemma far deeper than the intellectual by means of his own trial of fire.

At the heart of this difficult issue lies the human heart. God undertook a vast and dangerous experiment when creating man: He wanted, not merely another animal — of which there were countless — but an animal capable of something He alone understood: love. He gave this exalted animal vast intellect — but this was not sufficient to engender love. He gave His creation powerful emotions, the capacity for both creation and destruction, which He alone had possessed — but this also was not sufficient. For love — the utter, uninhibited emptying of self for another — required that most dangerous license of all: free will. This being thus created, designed with the capacity to love, must of necessity be utterly free to choose — for choice is the very heart, the very essence of love.

It was, by all measures, an experiment gone wildly awry. Having given this creature the extraordinary capabilities required to love fully — intellect, emotion, passion, empathy, the ability to feel intense pleasure and pain both physically and spiritually — he set this creature free to love, first of all Him, and then others of its kind. And the first choice of this pinnacle of creation was the decision to turn away: to replace the intended objects of love with the sterile altar of self. Thus was unleashed the monstrous liability of a truly free creature: the ability to hate, to cause pain, to kill, to destroy.

If we are to be honest, much of the pain and suffering which comprise the evil of the world is due to nothing more than this: that man, having been given the ability to choose, chooses wrongly, and uses the gifts and abilities given for the purpose of love to instead elevate himself at the expense of others, often in ways stunningly malicious and utterly wicked. Look around you, at the world both near and far: pride, selfishness, greed, lust, rage, jealousy — all these things manifest themselves in our lives and those of others, causing great pain and endless suffering. The child abused; the wife abandoned; the drive-by shooting; the greedy CEO who bankrupts the company and rapes the stockholders; the serial killer and the rapist; genocide; wars of conquest; torture; senseless massacres: these are the actions of men and women putting self above others — and each of us does it, to a greater or lesser degree, though we minimize our own roles to justify our own actions. We all wish for a world where God would eliminate evil — but all assume that we ourselves would be the only ones left standing when His judgment is delivered. A world in which God eliminated evil would by necessity be emptied of all mankind.

Yet there also exists those evils which have been called, in days past, somewhat ironically, “acts of God” — those circumstances or events which cause pain and suffering, not directly engendered by human evil. Thus the child is born with a severe birth defect; hurricanes, earthquakes, and tornadoes cause death and destruction; chronic and devastating diseases fall upon those who seemingly deserve a far better fate. It is with this, this seemingly capricious evil, with which we struggle most earnestly, straining to understand, yet to no avail. Judaism and Christianity both imply that some such evil may be consequential, the result of punishment or predictable consequences for the malfeasance of man. A more robust theology is less accusatory and thereby more coarsely granular — maintaining that such evil has entered the world because of the fall of man. Under such design our divine divorce has corrupted not only behavior, but our very natures, and all of creation. Yet such theology is of little comfort to those who are the objects of such seemingly random evil; we demand to know of God, “Why?” — and in particular, “Why me?” Yet there is no answer forthcoming, and we are left assuming a God either powerless to stop such evil or unwilling to do so.

Yet the problem of a good God, an omnipotent God, and an evil world of His creation is not entirely insoluble. Much lies in our projection of human frailty onto the nature of the Divine, and the impreciseness of our definitions of good and omnipotent. When we say God is good, we tend to mean that God is “nice” — that he would never do anything to cause us pain or suffering. Yet even in our limited experience, we must acknowledge that pain and suffering, while not inherently good, may be a means to goodness. We choose to have surgery or chemotherapy, though painful and debilitating, that our cancer may be cured. The halls of Alcoholics Anonymous are filled with men and women who, having faced both personal and relational destruction, have used their former liabilities as a gateway to a new, more fulfilling life — one which could not have taken place apart from their harrowing journey through alcoholism. To a misbehaving child, the discipline of a loving father is not perceived as good, but such correction is essential for the development of personal integrity, social integration, and responsibility. Our inability to discern the potential for good in pain and suffering does not by necessity deny its presence; there are many who, when asked, will point to painful, difficult, and unbearable times in life which have brought about profound, often unexpected good in their lives, unforeseeable in the midst of their dark days. There surely is much suffering which defies our capacity to understand, even through we strive with every fiber of our being to find the goodness therein. But the fact that such inexplicable suffering exists, and that answers are often lacking, does not preclude the possibility that God is good, or that such suffering may ultimately lead to something greater and more noble than the pain endured.

In our egocentricity we often neglect to look for the benefit in our suffering which comes not to us, but rather to others. Caring for someone suffering unbearably provides an opportunity to the caretaker to experience selfless love, compassion, tenderness, patience and endurance — character traits sadly lacking in our selfish world, which routinely turns its back on suffering to pursue an untroubled life of self-fulfillment and self-gratification. It is not inherently evil to be called to give beyond our means and ability — as caring for someone suffering always demands — for in the exhaustion and inadequacy thus revealed, we may discover unknown inner strengths, and come to a richer, and more fulfilling dependence on God. We are, as CS Lewis so accurately described, “not merely imperfect creatures that need improvement: we are rebels that need lay down their arms” — and finding how shallow are our reserves of love, compassion, and strength, we may through this brokenness seek to acquire them, humbly, from their Source.

But surely an omnipotent God has the power to stop suffering — is He not either impotent or evil when failing to use such power to remove our suffering? The omnipotence of God, like His goodness, is but dimly perceived. For the power of God is in perfect harmony with the purpose of God, and is thus used to advance these purposes for the greater good. Thus, the good deed of creating man with free will — and thereby capable of love — by its very nature restrains the omnipotence of God to violate that free will. The evil of the world exists in large part, if not wholly, because this free will has been abused. Yet the abuse of free will must be permitted, that the proper use of free will — the laying down of arms, the surrender to the sovereignty of a wholly good God — may take place, freely and unfettered as required by love. God must tolerate the existence of suffering and evil, that all may have the freedom to choose the good — though many will refuse to do so. Yet he does not merely tolerate the presence of suffering, but provides for its very redemption: that suffering, though itself evil, may ultimately produce good. Thus pain, suffering, death, and evil need not triumph: they may provide the means that some may turn toward the good, or bring forth further good for themselves or others. This is redemption: to buy back that which is destructive, worthless, of no value, evil, and make it worthwhile, valuable, even priceless.

Christianity, throughout its history, has struggled with and largely resolved the problem of pain, within the confines of the mystery of God. Yet Christianity in its many doctrinal eddies has sometimes chosen the wrong path and the wrong answers to this challenge. Such errors generally fall into two broad categories: the concept of suffering as punishment or retribution from God, and the manipulation of God for man’s gratification. The first of these runs counter to the core doctrine of the cross: that God has chosen to provide in Christ a sacrificial lamb — that Christ, through his suffering, may bear the justice of God, so that we may see the mercy of God. Our suffering is not a punishment for sin, as such punishment negates the purpose of the cross. Correction, it may be; discipline, it often is; opportunity, it always is; punishment, it never is.

The countering position — that of God as divine opiate, ever present to kill our pain — is a variant of the faith which has become perniciously widespread, feeding on a culture of ease and self-gratification which creates God in its own image. Thus God becomes a font of wealth, of health, of prosperity, of a trouble-free materialistic lifestyle, a divine vending machine whose coinage is faith. Faith, however, in such a worldview is no longer a profound trust in a God who is beyond understanding and infinitely wise, but becomes instead a means of buying from God all which we demand. Hence, we may be wealthy, if we only have enough faith; we may be healed, if our faith is sufficient; we will not suffer if we will but strengthen and enlarge our faith. Our faith must be prefect, lest our pleas go unheard. The strength of faith matters more than its verity; we charge the gates of heaven with the bludgeon of self-will.

The perniciousness and destructiveness of this perversion of historical Christian faith lies in removing from the hands of God decisions of life and death, health and illness, wholeness and suffering, while burdening us with the hopeless demand that we steel our faith to impossible heights to coerce and manipulate the will of God. That such efforts are typically fruitless seems self-evident: God most surely is capable of healing — and does indeed do so at times — but most surely does so in accordance with his divine wisdom and will. Should His wisdom dictate that suffering, poverty, brokenness, even death and despair would better serve the purposes of drawing men to Himself, what measure of human obstinacy and recalcitrance will change this will? When such “faith” proves futile, it destroys trust in God, and not infrequently leads to utter loss of belief, a bitter agnosticism born in false expectations and misplaced hope. Hence, we demand of God that which we alone deem to be good, then blame Him when He pursues a greater good beyond our understanding. This is the struggle to which Kathleen is alluding, as she questions the goodness of God in failing to heal her husband, blaming her own “sins” for his untimely demise. To us, such a healing seems only good — in so far as it mitigates our pain and loss, as well as that of those we love — but like the surgeon’s knife, sometimes such pain must not be withheld that evil may be conquered by the good. Were he healed, and restored to full health, would he not then face death on yet another day? Our lives have both purpose and a proper time: we live for that purpose, and we die when that purpose is fulfilled. That those who are left behind cannot grasp that purpose — and appropriately suffer profound pain and loss at this separation — does not negate that purpose nor impede its culmination.

We live in a time when our expectations of health, of prosperity, of a pain-free life are increasingly met in the physical realm, while we progressively become sickly, impoverished, and empty in the realm of the spirit. Despite our longer lives, we live in dread of death; despite our greater health, we obsess about our ills; despite our comfortable lives, we ache from an aimlessness and purposelessness which eats at our souls and deadens our spirits. Though we have at our command the means to kill our pain–to a degree never before seen in the history of the world–yet we have bargained away our peace in pursuit of our pleasure. The problem of pain has never been an easy one; in our day, it has not been solved, but rather worsened, by our delusions of perpetual comfort and expectations of a trouble-free life. Until we come to terms with suffering, we will not have comfort; until we embrace our pain, we will never have peace.

The Path – I:
Genesis

The Path Part 1: Genesis

A journal of one fool’s journey, and the faith which found him.
Genesis It was, at the outset, about direction. Direction demands trust.

At the outset, I had neither.

Faith came easily when young, with a naturalness almost peculiar in retrospect. Ours was a religious home, Roman Catholic, not by any means an oppressive one or coercive as are some, but one in which faith was real, taken seriously, practiced more than preached, rather a quiet but ever-present fact of life. I took to it easily, a shy, timid kid, more at home with books and fantasy than with games and friends. The inner life was lord–for the outer life was, if not utterly chaotic, not entirely healthy or sane either.

My mother ruled the roost: daughter of an alcoholic father who abandoned his family when she was young, and an immigrant mother from Poland whose rage at her own abandonment (sent by ship alone to America at age 14, married at 16, abandoned by her drunken spouse after 3 daughters a few years later) was never resolved in any meaningful way. Grandma’s bitterness was never far from the surface, poisoning my parents’ lives in a host of ways–and she passed this dark inheritance to her daughter. Grandmother had moved in with them shortly after their marriage, and lived with us throughout their married life, outliving my father–to my mom’s deep and oft-expressed resentment. My dad was quiet, gentle, rather a passive man, a physician adored by his patients and loved by his staff, but rarely seen by his family–in part due to devotion to his profession, in part, I suspect, to spend as little time with his mother-in-law as possible. My mom, left to husband a mother she at once loved and detested, concocted thereby a semi-toxic brew of smothering love and unpredictable rage which made engagement with her either emasculating, or terrifying–or both. To hide was the safest path–and hide I did. I learned to live alone while living among others.

Our home was but a few blocks from our parish church–a magical walk, with aged oaks hung low, cool and verdant in the moist heat of summer, stark and graceful in winter snows. I found the church a place of refuge–not during Mass, when far too crowded–but in those quiet times when pews were empty, lights were low, soft echoes of footsteps on marble, shadows of votive lights darting on darkened walls and sainted statues. The flickering candles whispered of a quiet presence: a comfort, a peace I rarely if ever found elsewhere. I loved it there: God was close. It was the only place where I knew no fear.

But children grow, and become teenagers. The Jesuit prep school I attended–men only, a tedious commuter train trek from home (my love of the rails its only saving grace)–fed me robust education and rotten theology. It introduced to me an angry God, constantly seeking to catch you in your faults, punishing you for every misdemeanor, trivial and trite. For a timid, wounded kid, it was hell: a lonely, graceless, fearful place with few friends and no happiness. It was a glorious day when I left those dark halls, their lockers like cell blocks in juvenescent jail. Abandoned in tatters was a simple faith of earlier years, replaced with cynical disgust for the hypocrisy of self-righteous religion.

College was liberation–a liberation, like most, more enslaving than ennobling. Whiskey, weed, and women were the new watchwords–success forthcoming in but two of three, as my social ineptitude and painful interpersonal impotency made relations with the opposite sex futile at best, moot most often. But booze and bogies trumped babes in spades–tequila demands no small talk, rejection revels in rotgut wine. These chemical friends restored a measure of serenity, divine ecstasy in empty bottles, cannabis incense, and solemn hymns of Hendrix and the Dead. There were, by grace, sufficient periods of sanity and enough non-toxic neurons to survive with good academic achievements. Miracles do happen, indeed.

There is in life always a guiding theology–though you be atheist or agnostic, religious or indifferent–as was I. Mine in this period was remarkably feeble: a passing acknowledgment of some vast Being able to create a billion unique snowflakes, yet caring not one wit about some solo slob stumbling through life. So, I figured, I was on my own–and on my own wasn’t going well: my chosen major, chemistry, a crushing bore, and a career therein unimaginably awful; an aching loneliness for relationships never fulfilled; the dreaded demand to settle on a lifelong career with no inkling whatsoever of a course which might bring happiness or satisfaction. My draft lottery number–31–assured a rapidly evaporating school deferment would soon sweep me to new and untold adventures in the steamy jungles of ‘Nam. Panic is not too strong a term to describe my state of mind.

The decision was easy–if profoundly superficial: with my father a physician, and a brother headed as well down this path, medicine was the default choice–and offered an extended student deferment, and the faint hope of the approval of a remote father–a hope never to be realized.

Was there ever a more noble calling to the healing profession?

But the simple fact was that I had not one clue: no way of knowing if the choice was the right one; no means to judge my own suitability for such an undertaking; no tools, skills, or craft for assessing such a weighty decision; no sense of calling or direction. I was a blind pig praying acorns weren’t afflictions, stumbling forward with blind faith in pure dumb luck.

And thus, as if guided by some mighty unseen hand, I chose a course of life which would by turns transform that very life, in ways I could neither anticipate, nor plan, nor hope for, nor even dream possible. That journey, and the faith thus engendered, I hope to share in some yet unwritten and undiscovered entries in this path’s journal.

The Call

The Call

cancer Damn!, I hate these calls… Lying on my desk, clipped to a yellow manila binder, is a single sheet of paper. Its pleasant color format and sampled photomicrograph belie the gravity of its content:

Adenocarcinoma, Gleason grade 9, involving 60% of the specimen.

How do you deliver a death sentence?

Your first impression of Charlie is his sheer mass: 50 years young, healthy as a horse, built like a tank, a former football player turned popular coach at a local high school. He arrived at my office after seeing his family physician for an acute illness, with fever, chills, and problems urinating. His doctor had diagnosed a urinary tract infection, placed him on an antibiotic, and drew a PSA–a screening test for prostate cancer. It was markedly elevated: over 100, with normal being less than 4. I grumbled to myself as I reviewed his chart: Those damned primary care docs shouldn’t draw PSAs when patients have prostate infections–it just muddies the waters.

PSA (prostate specific antigen) is a test which measures a protein in the blood stream released by prostate tissue. It has greatly improved early detection of prostate cancer in the 20 years it has been in widespread use–but it is not, strictly speaking, a cancer test. It is noisy–often abnormal in other conditions, including benign prostate enlargement (BPH), inflammation, and prostate infection. It is virtually always elevated in the presence of an acute prostate infection–often markedly so–and can take months to return to normal. The high PSA alarms the patient, however, who is told he may have cancer. But most do not–and Charlie looked like a classic case of infection.

His history was typical, and his response to antibiotics appropriate, so this seemed at first glance like so many other similar cases I had seen. His prostate exam was alarming, however: rock-hard and irregular, unlike the typical soft, boggy texture of an infected gland. Experience and training kicked in, and I knew exactly what we were dealing with: a relatively uncommon form of prostate infection called granulomatous prostatitis. I had seen dozens of cases–always alarming on first exam, with very high PSA values–and always responding to long-term antibiotics. Charlie was started on a one-month course of high-powered, high-priced bug exterminator, and came back for follow-up after its completion.

He was feeling better, and his PSA had dropped markedly, to 45. His prostate exam also seemed improved, but still quite abnormal. I remained quite confident in my diagnosis–after all, cancer doesn’t get better on antibiotics–but was unwilling to wait much longer to know for sure. I scheduled a prostate biopsy, reassuring him after its completion of my optimisim that the results would show only infection.

The report was a blow to the gut. I sat silently, staring at it, in stunned disbelief.

In the age of PSA screening, most prostate cancers are detected at an early, curable stage–although their slow-growing nature makes treatment less important in very elderly patients. The chances for cure at diagnosis are determined by an estimate of the size and aggressiveness of the tumor. Size is determined by exam, ultrasound findings, and total PSA values; aggressiveness by the Gleason score–a value indicator (between 2 and 10) of the aggressive appearance of the cancer cells under the microscope. Higher is not better: Gleason scores of 9 and 10 indicate rapidly growing cancers which tend to spread early and are difficult–if not impossible–to cure. Charlie had drawn a pair of deuces in a high-stakes poker game: large volume, high-Gleason score cancer. The statistics were dismal: he would likely be dead of cancer in 5 years, regardless of treatment. And as cancer deaths go, this one’s not pretty: pain is a huge management problem in many, as the cancer infests and erodes the spine and long bones, breaking even the strongest of men. One learns to hate this disease before very many such cases have been seen.

And now I had to call him with his biopsy results.

The actual call will be brief: I will inform him that, unfortunately, the biopsy has shown cancer, that additional tests will be needed to determine its extent and the best way to manage it, and arrange for a follow-up visit in the office. The real bad news will be transmitted then, face-to-face, with more than enough information for its gravity to sink in. To do this–without robbing hope–will require more inner strength than is readily at hand.

But for now, I simply need to tell him he has cancer.

The word cancer encapsulates the deepest fears and anxieties of man, embodying in one small word pain, suffering, loss of control, hopelessness, dependency, death, the fragility of our dreams and hopes, and our uncertainty about the hereafter. To inform a patient that he has cancer is to shatter the illusion, the daily denial that death may yet be outmaneuvered, forestalled, kept on hold for some future date of our own determining. It is an illusion which dies hard–surprisingly so, as we alone among all creation are cognizant of its inevitability and certainty.

Perhaps the cruelest wish a man might be granted–were there some bottled genie passing out such favors–is knowledge of his own future. Yet, in some small measure, that power has been granted to me, and others of my profession. Not in any specific manner, of course–not of days or years, details or circumstances–but in knowledge deep enough to see the broad strokes: shadowy figures through rippled glass, of pain, and loss, and shattered dreams, of desperate grasping at the frail straws of fading hope, as the drumbeat of mortality pounds ever louder toward its dark crescendo.

Patients receive the call in different ways. Most accept it with seeming stoicism, and little expressed emotion–yet it is not hard to imagine–and sometimes to sense–the tight grasp of fear that grabs the throat and grips the heart. When wives are listening, the fear is more immediate, more palpable, as voices tremble with panic despite every effort to control it. A million questions will arise–but almost never on the initial call. On rare occasion, there is a casual indifference to the news–prompting reflection on what strength of spirit–or dense denial –such men possess.

I often wonder how I would receive the call. As a Christian, I am confident of a life hereafter, eternal, spent in the presence of Him who loves me. Some call that arrogance, or self-righteous; it is not. God alone knows better than I the darkness of my heart, the depravity that makes me uniquely unsuited to be in the presence of the Holy One but for one moment, much less eternity. But I have been adopted–an unwanted child by an unspeakably loving and merciful Father, who only asks submission to His tender guidance and direction, and transforms a lost fool into something useful, something cherished, someone with purposes aligned–though poorly so–with His own.

But the call of death–so confidently faced from the comfortable vantage of good health and cheap grace–will strike fear into my heart when it arrives, for far smaller challenges have brought dread in larger measure. There will be the fear of the ordeal, the journey of suffering, the loss of things now treasured but instantly made worthless. There will be the pain of watching the loss of those close to me, struggling to make sense of a relationship, undervalued while unthreatened, yet now more precious while counting down inexorably to its end. I know–by the tutor of past and bitter experience–that faith will sustain me and mine through it all. But one cannot know what that day will be like–nor should we wish to ever know.

But for Charlie, the battle will now be enjoined–the weapons and werewithall of modern medicine in all-out war against its implacable foe. Perhaps by some miracle or unexpected grace he will be given a reprieve, a window to revalue and reassess life’s course, its priorities, its purpose. For even when we are cured, we are healed to face death again: Lazarus, once risen, will revisit the stony crypt. Yet the Voice which called him forth calls us also, beckoning toward a painful light from the cold terrors of death.

How difficult to be the herald of another’s mortality–it is a burden no man should have to bear. Some will deliver it through the steely detachment hammered hard by years of training; some avoid it altogether where possible, through choice of profession or abdication of responsibility. But for those who must speak this hard truth, may there be grace and wisdom, empathy and compassion. May it be also for me.

Voice Recognition Redux

trollSeveral months ago, I upgraded my voice recognition software to Dragon NaturallySpeaking version 8. I have been using voice recognition software for over five years now, and have been very satisfied with it, although older versions could be maddening at times–and hilarious at others. This version is amazingly accurate–my only complaint since upgrading is that I am not having nearly as much fun proofreading my notes as I have the past.

Voice recognition software is rather remarkable technology, and to watch the medical version crank out complex terms with aplomb is almost magical. The software does not make spelling errors, but contextual errors are relatively common, and need to be carefully screened before sending your documents out the door.

A few of the contextual swaps I have encountered are as follows:

What I said: The patient said Viagra wasn’t working, and wanted to try Cialis.

What it typed: The patient said Viagra wasn’t working, and wanted to try and see Alice.

What I said: The patient was thoroughly reevaluated by her previous physician.

What it typed: The patient was thoroughly violated by her previous physician.

What I said: The patient will be started on depot testosterone.

What it typed: The patient will be started on devil testosterone.

What I said: The patient has prepubertal pubic hair changes.

What it typed: The patient had puréed pubic hair oranges.

The accuracy of this latest version has made such–ahem!–interesting errors quite a bit less common — to the point where I was becoming a bit complacent about careful proofreading. That is, until today:

What I said: The patient was seen several years ago for problems of urge incontinence, and has been on Detrol with good symptom relief.

What it typed: The patient was seen several years ago for problems of urge incontinence, and has been on a troll with good symptom relief.

And you thought they spent their entire lives living under bridges