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The Hour Has Already Come

Part III, Len Ministries Annual Gala Keynote

“And do this, understanding the present time: the hour has already come for you to wake up from your slumber, because our salvation is nearer now than when we first believed.” Romans 13:11

In medicine, some things can’t wait. As a medical student, I found this exciting. I could hardly wait until I had the skills and opportunity to be there at those life-threatening moments and snatch souls back from the jaws of death. I think in some form it is a common, maybe universal, desire. Remember the tortured teenager, Holden Caulfield, in “Catcher in the Rye”? He didn’t understand at all what he wanted out of life, and the best he could articulate was that he would stand in a field of rye at the edge of a cliff where children played and, if they got too close to the edge, he would catch them.

In medicine, it’s much more specific. Someone has meningitis, someone has had a heart attack, someone has airway obstruction, someone has been shot, someone is paralyzed, someone bled in their head, or the baby has come too soon, or the baby is coming too late. They all need a “Catcher in the Rye” and they need him or her, now.

This is when it is “the hour to wake up from your slumber” if you are the doctor. You put down your fork and leave the meal, you leave the movie before the climax, you roll over and get out of bed. I remember once leaving one of my children’s birthday party before he blew out the candles.

It doesn’t matter how hungry you were when you put down the fork, how tired you were when you got out of bed, how disappointed your child would be when you left his party. It doesn’t matter if your marriage is on the rocks or if your best friend just died. It doesn’t matter that the last time you got a call like this, you did your best and somebody sued you. The hour has come. Not because our salvation is nearer now than when we first believed, but because someone else’s destruction is now imminent.

Paul felt just like this when he wrote this line to the nascent church in Rome. Someone else’s destruction was imminent. Only the destruction that he saw was the destruction of joy and purpose in this life and, in the next, the destruction of a soul. Paul took his responsibility as a follower of Christ just as seriously as a doctor takes his or her responsibility as a healer. In his “Present Times,” greed and lust and violence prevailed, and souls were falling left and right. He had woken from his slumber and wanted other Christians to wake up too.

After about the first three times a medical student or doctor gets woken for an emergency, he or she doesn’t look forward to the next time. We would rather sleep. But once awake, there is a purity of purpose. You don’t have to order priorities, or worry about who you might offend, or if your actions will be profitable, or even rewarded. You have the opportunity to be who you were created to be. A savior.

But most of the time, you are not a savior. Sometimes whatever you do will be an exercise in futility.

On a third-year medical school rotation, before I had focused on a specialty, I was assigned to neurosurgery at the University Hospital in Minneapolis. One Sunday evening, I followed the second-year resident, Fernando Diaz to our little ER to see an unconscious man–elderly to me then, about my age right now–who had slipped on the ice and fallen while taking out the garbage. We rushed him through our evaluation and then to the operating room to remove his acute subdural hematoma. This was my first time being part of the team that stood in the gap between life and death. I was more than excited to be standing at the operating table as the second assistant, and I expected nothing less than success, partly because I felt quite certain that something as mundane as a slip and fall while taking out the garbage should not be the cause of death. But by the end of the operation it was apparent that something was wrong. The blood was not clotting properly. We did what we could, sent the appropriate labs, administered the best medicines and blood replacement products available, and 24 hours later the patient re-bled and died. Welcome to neurosurgery, Mr. Lohse. The hour had come, I woke from my slumber, and nobody was any nearer to salvation…at least not in this existence.

Maybe you have met with a friend on the eve of destruction. You tell them not to take that job or trust that person’s affection or take that drug or take that next drink, because you see the path that they cannot and you love them more than they love themselves. They think that your message about being a child of God and a person of worth is quaint. They smile and pat you on the arm, or worse, laugh in your face. And you experience futility.

Then sometimes, in medicine, the patient seems unwilling to participate in their own salvation.

Our surgery internship class inherited a man named Archie. About a week before we started, while most of us were at our medical school graduation celebrations, he suffered a shotgun wound to the abdomen when a heroin deal went south and had the first of many operations to save his life. Any abdominal wound can be fatal, but a shotgun is particularly nasty because of the multiple intestinal perforations, each of which can be the source of infection–peritonitis–and potentially life-threatening sepsis. Some of the intestine can be sacrificed, but if too much intestine is taken, the body cannot absorb adequate nutrition to survive.

Archie survived his first operation, but had recurring bouts of peritonitis and sepsis. At one point his respirations failed and he needed a ventilator for nearly a month. To “rest” his intestine and minimize further infection, he required total parenteral nutrition, TPN, through central intravenous lines. Over the next few months, he underwent several more operations to find and repair damaged intestines or drain abscesses. Every one of our surgical interns was “woken from his slumber” more than once to take care of Archie.

He was a likable guy. We–all eighteen interns–suffered with him, and never lost hope for his eventual healing, even though every week seemed to bring a new complication and the months dragged on. In all those months, no friends or family members visited. We had the feeling that he had become part of our family at the hospital–the pseudo-family that comes together when dedicated people work together for a common purpose.

Finally, one day in early Spring, word spread throughout the interns scattered through the hospital: after nine months, Archie had made it out of the ICU! Then a few days later–miracle of miracles–he was released from the hospital. The interns and ICU nurses actually had a party for him. With cake!

Three days later, he was back in the ER with a new abdominal problem. This time he had been stabbed.

He actually looked sheepish. He knew how much literal blood, sweat, and tears had been poured into his care. Then we did what we do; we took care of him. But we were deeply disappointed.

The care was simpler this time. Knife wounds are ever so much easier than shotgun wounds. A few weeks later, Archie was discharged again and we never saw him again. Maybe he mended his ways. Or maybe he moved, or maybe he died after the next injury. I don’t know.

What I do know is the change in us, his caregivers. We lost a certain enthusiasm for our unbridled altruism, recognizing that sometimes we care more and work harder at fixing our patient’s injuries than they work at saving their own lives.

We had woken from our slumber and, for a moment, Archie’s salvation had seemed nearer than when we first believed. But only for a moment.

It’s hard not to become cynical. It’s hard not to let the dying die by their own choices. In this evil world, it is easy to let those who have been taken in by the lies of this world to perish. You have told your friend that there is a better way, that they can turn their life toward love and purpose, and they agree, maybe even come to church with you some Sunday morning. Then they turn back and you have to let them go. They know where to find you Sunday mornings if they change their mind.

But Sunday morning is not enough. Sometimes–most of the time, really–someone needs to awaken from their slumber to bring someone else nearer to salvation.

In my office, I kept a photo of a young woman wearing a headscarf and holding a newborn baby. Standing beside her is her proud and happy husband, salt-and-pepper hair, unsuppressed grin. Above is a Thank You in large caps and script. Below, in fine print, I added a line as a reminder to myself: This is why we do what we do.

This couple had waited a long time for a baby. Career choices, late marriage, and fertility issues had all played into delays. Now, as she neared 40, and her husband had already passed that landmark into middle age, their first, and probably only, baby was on its way. Then, during the last trimester, she experienced increasingly severe headaches, severe enough that her OB abandoned her usual caution about x-rays during pregnancy–“woke from her slumber” so to speak– and ordered a CT scan.

Our patient had a large brain tumor with surrounding swelling. Labor and delivery would likely be fatal for the mother, and the pregnancy was not advanced enough that the baby would be safe with C-section delivery. So the mother underwent a long, difficult, but ultimately successful operation to remove her tumor completely in time for her to recover for a normal labor and delivery. They brought me the thank you card on their second post-op visit.

This is why we do what we do as neurosurgeons. Moms and babies live, families are created in a spirit of thankfulness and remembrance.

This why we as Christians do what Paul referred to as the “Do This”–act like Christ–to bring the Kingdom of God into the Present Times. We tell people with our words and our actions that they are children of the Living God and persons of worth. Sometimes our efforts are unnoticed, sometimes noticed and ignored, and no one seems any closer to salvation. But sometimes the Kingdom comes to a little corner of our present times and someone’s salvation is nearer than we first believed.

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