Saloons and Seeing Clearly

I stumbled into Dornan’s Saloon at the end of a long and amazing day.  Early that morning a pronghorn antelope had rushed across the high prairie as my car drove along the aptly named Antelope Flats Road, as if running to greet me, then tip-toeing across the road after I passed.  I then saw the Teton range reflected in the still waters of Jackson Lake, walked in snow in the Yellowstone Park, watched a lone buffalo graze in the Yellowstone basin unconcerned about either the eruption of Old Faithful or the large herd of humans who had come to watch.  Now I envisioned the perfect closure to the day: a beer and pizza while quietly watching the sun set over the mountains through the generous west-facing windows of that venerable saloon.

That didn’t happen.

Monday nights are “hootenanny” nights at Dornan’s.  Open mic for any and all locals.  Food available by lining up at a window to place an order and the bar is open.  The place was packed.  Lacking any alternative plan, we took the last three available chairs just off the right side of the tiny stage and re-considered our options.

While we made alternative plans, an old man took the mic first.  He had performed every Monday for the past twenty years or so, always first.  He had been introduced as a local legend in the ski world, performing some incredible backcountry feat, the details of which were lost on me, and becoming a founding father of extreme skiing.

He didn’t look like an extreme skier or talk like a singer.  His voice was raspy with age and hard use, but the room immediately silenced.  He pointed to the mountains and identified the Grand Teton.  Then he outlined a snowfield halfway down and told us it had snow all summer, more than last year, and although he had heard there was global warming, that snow field told him the year had been cooler than the year before.

With no further introduction, he started playing an autoharp beautifully, a tune vaguely familiar.  Then he started singing the lyrics with little improvement over the tonal quality of his talking voice.  But the words and melody were clear and sung with unwavering courage, a song from the 70’s made famous by Jimmy Cliff and Johnny Nash.

I can see clearly now; the rain is gone.

I can see all obstacles in my way.

Gone are the clouds that got me down.

Gonna be a bright, bright sunshiny day.

Then something magic happened.  My ears heard his raspy voice, but my mind played the sweet melody, the mountains and snowfields came into focus, and the cold blue of the sky and fading orange of the few clouds became something felt more than seen.  He continued:

Oh yes, I can make it now–the rain is gone.

All of the bad feelings have disappeared.

Here is the rainbow I’ve been waiting for.

It’s gonna be a bright, bright sunshiny day.

He finished the song, and we slipped out the side door with me still seeking a better setting for alcohol and food consumption.  Yet, I felt like I’d been given a gift of some sort with that song.

I thought about the times I couldn’t see clearly.  When I went to medical school, there were no CT scanners.  We had no way to X-ray the brain.  Our imaging studies were angiograms that x-rayed the arteries of the brain, or pneumoencephalograms that x-rayed the fluid containing spaces of the brain.  We would have to deduce from the displacements of these structures whether or not a mass was present.  Often we would resort to exploratory burr holes or biopsies.

We could not see clearly.

We had a CT scanner at Yale by the time I was a first-year neurosurgery resident.  For the first time, we could get direct x-ray images of the brain.  By today’s standards the resolution was poor and the length of time to do a CT scan made the procedure very restrictive–fifteen minutes for a single cross-section, one hour for a “complete” scan consisting of four sections.  (Today’s scan’s have near anatomic resolution and a twenty section brain study can be done in two minutes.)

We could see clearly now.  But we could not see the obstacles in our way.

About six years after I finished medical school, during my last year as a neurosurgery resident, I talked to a neurosurgeon in Kansas City who had been a resident at the Mayo Clinic in Rochester when the one of the first CT scanners was installed in the U.S.  He described a post op patient who had deteriorated after a brain tumor removal.  The staff did an angiogram which showed nothing amiss.  So then they decided they might as well do one of these new-fangled CT scans just for the experience.

The CT scan showed a big white spot in the surgical bed, something we all know now represents a big blood clot.  But then the Mayo staff, certain of their familiar angiogram and experience, didn’t believe it.  The first thing they did was to contact the manufacturer’s representative to tell them the CT machine must be broken.  Then, when he assured them the machine was just fine, they grumbled and took the patient back to the OR to remove the clot they were so sure was not there.

They could see clearly now, but they did not.  Obstacles remained: in this case, understandable ignorance.

So I wondered if the singer in Dornan’s Saloon was just singing his favorite folksy kind of hit from the 70’s.  Or did he have a special message about the things he could see clearly now, but had not in the past?  Or maybe a prophecy for me?

Was this about global warming?  We had come from the warmest September on record in Florida to a place where the mountain spoke to those who listened to tell them the year had been cooler.  Is that what he saw more clearly?

Or was just my reaction to a very special day?  After being surrounded for several days in the strange and wonderful natural beauty of the Grand Teton range and Jackson Hole valley, the traffic jams, urban noise, and city lights that dim all but a few of the stars faded away as I re-discovered that we live in a place more majestic than cities and suburbs and airports.  Sometimes I need to touch the wilderness to remember.  To see clearly.

Or was it all about the rainbow?

We had come to Jackson Hole to celebrate the wedding of two young men, one of whom we have known since his birth.  We love his parents and we love him, so he is more like a nephew to us than simply the son of our friends.  And now he is getting married.  How could we not celebrate the greatest joy of his life with him?  How could we not encourage two people to do the hardest thing in the world: to love each other to the best of their ability for the rest of their lives?  So I showed up in spite of the qualms I have when I see two guys kiss.  I smiled, celebrated, listened, and watched.

I watched two men who love Jesus and love each other.  I watched two families–big families–who love Jesus and love their sons for how they have been created and who they have become.

I returned home the next morning without qualms.  Maybe I can see more clearly now.  I can see that the North American continent is warming now, but there has been a cool summer on the Grand Teton.  I can see new gas stations and tawdry apartment houses in my city, but the sun still rises over the Atlantic and sets over the St. John’s River with spectacular displays of color.  The rain has gone and here is the rainbow I’ve been waiting for.

And I can see that there are wise and ancient guidelines that are God-ordained so that His people can live with justice and joy.  But, I can also see that God creates His children just as they are, and loves them profoundly.

Paul starts a paragraph in I Corinthians 13:8 with the sentence, Love never fails.  He goes on the list the things that pass: prophecy, tongues, knowledge.  These are the things he confesses to being unable to see clearly now.  He finishes the paragraph with verse 12: Now we see but a poor reflection as in a mirror; then we shall see face to face. Now I know in part; then I shall know fully, even as I am fully known.

In other words, when in doubt, trust love.  What prophecy you may have heard, what words you may have spoken, what you think you know, are but a shadow of a deeper truth that is about love, a love that never fails.

I, like Paul, look forward to the day I can see clearly, when the rain is gone, all obstacles are clear, the clouds no longer get me down, and I find the rainbow I’ve been waiting for.  It’s gonna be a bright, bright sunshiny day.

Forgiving the Innocent







Adam got well.

After a long, hard winter of radiation, infections, a second operation, antibiotics, his hair started growing back–first with wispy strands, finally morphing into a confident mop.  He let it get long; I didn’t object.  He finished his junior year in high school, and we celebrated by going cycling in Europe as a family.  The following year he finished high school and started his first year at a prestigious college in Atlanta.

But I found myself emotionally distanced from him.  A little voice in the back of my mind told me I should be more grateful, more joyful.  I hope I disguised my emotional desert well and did the right things as a father.  It was depression, I told myself, and I’m sure that’s part of it, but the emotional distance from Adam was specific and held a thinly veiled streak of anger.

Many months, perhaps years, passed before I realized my anger was in response to his illness.  He quite unintentionally terrorized me with the specter of grief that came from nearly losing him. And he also held the power to terrorize me again.  I feared to get too close.

But if I were to have an authentic father-son relationship, I had to get over my fear and my anger.  I had to forgive my son for having a brain tumor.  The tumor wasn’t his fault, obviously, and it wasn’t his choice to make me vulnerable or to hurt me.  But emotionally, I somehow held him responsible.

Once I understood that neither Adam, nor his tumor, caused my fear, my anger dissolved easily.  My fear of loss came from something within me, something beyond my ability to give up: the power of love.  And that love is without choice; he was born, I held him, I loved him.

Love is always a risk.  Give your heart away, and it can get weighed down so that it can drag you to the depths and destroy you.  If I were to continue to love him, I had to forgive him–even though he was innocent–and I had to accept the consequences of love.

Forgiving Adam for his tumor is not so much granting absolution as it is granting permission to hurt me again.  It is saying Go ahead, get sick if need be, because I will be there and I will not flinch, I will not distance myself, I will not walk away.  Because fear of loss is the cost of love, the dark side of the coin whose other side is shining joy.  And Adam gives me great joy.

I am awed now by the infinitely better love of our heavenly Father who loves me and forgives me–and I am not innocent.  He gives me permission to get sick, to sin, to live like a prodigal son–not encouragement, but permission–even though what I do may break His heart, cause angels to weep, and the world to become more like hell than heaven.  Yet He promises to be home waiting, ready to get up and run to meet me.  What I now understand in a small way is the cost of that great love, the dark side of the coin He is willing to pay because in some unimaginable way I must give Him great joy.

If this sounds like I am special in the eyes of God, I am.  So is Adam.  But the good news is, so are you.  You give Him great joy.

Stuff It Down


One Friday afternoon in August of 1991, Adam, Mary and I sat waiting for his MRI to begin.  I had scheduled the scan myself a week before when his opthalmologist couldn’t explain his double vision and referred him to a neuro-opthalmologist.  I had already become secretly concerned.  Then that morning the neuro-ophthalmologist called me to tell me he had a condition that was nearly always associated with a tumor.  I knew then what the scan would show, yet I hid my anxiety from Adam and Mary and held onto the slim hope that I would be wrong.  Mary was a mere six months from surgery for her breast cancer and had one more chemotherapy session to go.  We weren’t ready for more bad news.

Then my junior partner called from the operation room.  His patient had a rare and life-threatening complication in the middle of an operation, and he asked me to come and help.  No other neurosurgeons were nearby; it was me or nobody.  I left Adam and Mary blithely ignorant of the pending disastrous results of the MRI and went to the operating room.

The next three hours challenged my ability to segregate my feelings from my thoughts and actions, but that was nothing new.  For two decades I had learned that when you’re the one involved in direct patient care, everything else gets stuffed down.  You’re hungry or tired or sick?  You just had a fight with your wife?  Your mother and father are coming to visit?

Nobody cares.  Stuff it down.

Dr. Harvey Cushing, widely considered the father of neurosurgery, once did an appendectomy on one of his own children.  Another time he received the news of his son’s death in a car accident and took fifteen minutes of solitude.  Then he went directly to the operating room and performed the previously scheduled operation.

Stuff it down.  Deal with it later.  Even when your kid is sick.

After the crisis abated I left the OR and received the expected message that the radiologist wanted to review the MRI.  The images had been transferred to the hospital.  All I had to do was walk across the hall to radiology.  The images hung on the view boxes–crisp, clean lines of black and white on film representing the dark, uncertain future of a boy with a brain tumor.  The reality stunned me.  The words “evil incarnate” came unbidden to my mind.

I was particularly overwhelmed because I’d ordered the scan myself.  Now I had to deliver the news myself without the buffer of an outside authority figure, a professional in a white coat.

I felt terror.  I didn’t want to be the doctor; I wanted to be the dad.  But I couldn’t be dad.  Not yet.  I stuffed my feelings down again, and we did our family conference at home.  I remember only a little about that night.  Mary and Adam and I talked.  Then we included my parents and Jay and Brieanna.  Then we prayed.

The next morning I cancelled my appointments and spent the morning on the phone with neurosurgeons across the country searching for the best answer for Adam.  At the time, therapeutic options for his type of tumor were hotly debated.  Which surgical approach was the best?  What was the role of radiation therapy?  How to deal with tumor-associated hydrocephalus?  I had my own opinions, but had at least enough sense to realize my judgement was clouded.  I needed someone else to be his doctor.  Two days later we checked him into Shands Hospital at the University of Florida in Gainesville, and I could be the dad again.  Only then could I cry.

The ability to “stuff it down” is important.  No one wants a surgeon, a policeman, a fireman or an EMT dealing with their own emotions when they are dealing with your needs.  But this ability also has its own consequences, its own scars.  Once you’ve stuffed down your own fear and grief, it doesn’t easily resurface.  Then if I am insensitive to my own emotions, I could be nothing but insensitive to Adam and Mary.

I was a good cheerleader, but a bad listener.  “You have a good prognosis,” I would say.  “A ninety-percent cure rate.  I looked it up.”

They would stare back at me, sometimes blankly (Adam), sometimes with frustration (Mary).  And I would stuff down the fact that ninety-percent now terrified me.  A cure rate that sounded so good to me when I told patients now sounded way too low.  We had a ten-percent chance of repeating the current nightmare, and the next time would hold no chance of salvation this side of eternity.

Over the next few months Adam underwent two operations, one spinal tap, several weeks of radiation therapy, two weeks of antibiotics.  He lost his hair and he lost his strength.  I told him the prognosis was good.

The day after we returned from Gainesville Mary went in for her last chemotherapy treatment.  Her eyelashes fell out and she couldn’t eat.  I told her the prognosis was good.

It was a hard four months.  Then the active medical interventions were over for both of their cancers.  It was time to get better.

Adam tried to resume normal activities.  Chemistry was hard.  Sports were impossible–anything requiring hand-eye coordination was downright dangerous.  Mary tried to find clothes to fit her new shape.  They would tell me it was hard; I would tell them they had a ninety-percent cure rate.

Soon we stopped talking about illness and recovery as each of us drifted into our private world of terror and grief.  On the outside we looked like a normal family going about work, school, and community activities like anyone else.  Scratch the surface, and any one of us could fall apart.

Then, in the Spring of 1991, I bought a self-help book–not for me, you understand; I thought it would help me provide direction to my other son, Jay.  One chapter dealt with the skill of listening.  Some people don’t need instruction in this, but I did.  Don’t think of your response while the other person is talking.  Repeat what they say as a question to 1) make sure you understand, and 2) give them permission to keep talking.  This is instruction so simple it borders on stupid to repeat, but there it was.  I tried it out on Mary the next time she spoke about her cancer treatment, her scars, her fears.  She kept talking; I kept listening.

Her depression started to lift.  (She has an amazing testimony about a dramatic moment of recovery, but that is her story to tell.)  On the other hand, all the fears and grief I had stuffed down now floated up.  I had to start dealing with the fact that I and everyone I loved was going to get sick and die, and that fact terrorized me.  I could no longer be the cheerleader with “the ninety-percent cure rate,” since I was now quite conscious that the cure rate was a temporary illusion, a distraction from the fact that life has a one-hundred-percent mortality.

But I became a much better listener.

Listening, I learned, has a cost.  If you listen to those who have suffered loss and fear for the future, you will mourn.  So I mourned the scars of Adam and Mary, the loss of their hopes, and the fears of what the future would inevitably bring to all of us.  But if I mourned with them, we were no longer alone, and if we were no longer alone, we were comforted, and if comforted, loved.  And if we had love, we had hope.

Jesus knew this.  His first public declaration in his ministry was that the kingdom of God was near.  His second was that the poor in spirit are blessed because they would receive the kingdom of heaven.  But his third was that those who mourn are blessed because they would be comforted.

There are times to stuff it down, those griefs about things lost and the fears of future sufferings and separations.  But do not fear listening, do not fear mourning.  Because we are blessed to mourn.  Then we shall know comfort.  And love.  And hope.