Month: September 2019

Many years ago, I was faced with an ethical dilemma. The billing company with which our pathology group was contracted alerted us that there were some minor discrepancies in the way we were billing for certain services. If we were to accept their conclusions, it would mean a loss of revenue on some of these charges. When I discussed this issue with my physician partners, they were as surprised as I initially was and suggested that we discontinue our contracted billing services, especially when we queried other pathology groups and discovered they were billing for services the same way we were. However, upon further investigation and consulting our attorneys, we had to reluctantly agree that the new billing company may be correct in their assessment. After a weekend of examining all possibilities, I, along with my partners, agreed to abide by the billing company’s evaluations. Although we considered continuing the questionable billing practice, something that all other pathology groups did, we agreed to abide by the current legal definitions of the billing codes, even if we disagreed with the interpretation.

 

We are all faced with temptations in life. For many years, I believed that these many temptations were a certain sign of my sinful nature. However, it is only when I act upon them and disobey God do they become sins. Even Jesus Christ was faced with temptations. Yet, He is the only person who ever lived on this earth that never sinned, regardless of the severity or frequency of the temptations.

For we do not have a High Priest who cannot be touched with the feelings of our infirmities, but was in all points tempted as we are, yet without sin. Let us therefore come boldly unto the throne of grace, that we may obtain mercy and find grace to help in time of need.
Hebrews 4:15-16 (KJ21)

 

The temptation is not a sin. Giving in to the temptation is a sin. Some temptations can clearly lead to very bad and sinful outcomes if acted upon. Anger toward another person may foment hate and lead to an act of aggression, including murder. Other temptations do not seem egregiously bad. It was easy to dismiss this billing issue, especially if other pathology groups were also doing it, but we could not overlook our own consciences nor the legal consequences. 

 

The only hope we have in this life is to acknowledge that we are powerless to always withstand these temptations by our own efforts. We need a supernatural intervention. We need a Savior, one who has faced all of these temptations but never succumbed to them. 

 

We need Jesus Christ as our Lord and Savior.

 

Love and trust the Lord; seek His will in your life.

 

Like many people, I use several personal computers at home and my office. I compulsively update all of my computers whenever an operating system update is ready. Although all are running the same operating system, each computer is made by a different manufacturer. Thus any update to the operating system needs to be coordinated with the respective computer manufacturer, something that is easier said than done, as many can attest. 

 

Recently, I experienced this annoyance, when a software program malfunctioned on one of my computers, despite working on the others. After several email exchanges with the company that created the program, they directed me to another website which stated that the problem is well-known to users of this particular personal computer manufacturer and provided a software download for a quick fix.

 

Isn’t life often like this? When we attempt to fix a problem in our life, it leads to a complication in another area and we need to search for yet another solution. We think we can anticipate every minor mishap and take all the necessary precautions and something still goes awry. As an anonymous wise man once stated, “Inside every small problem is a large problem struggling to get out!”

 

What about our relationship with God? So often I think that if I pray, read the Bible, and attend church, I have anticipated every spiritual mishap that may occur. Sure, I got this covered! Yet, things still go awry. After getting my spiritual schedule back on track and having regular devotional times and prayer sessions, I encounter a new trial that arose from my schedule changes, one that evades the usual solutions that have worked in the past. Can I get a quick spiritual fix?

 

Count it all joy, my brothers, when you meet trials of various kinds, for you know that the testing of your faith produces steadfastness. And let steadfastness have its full effect, that you may be perfect and complete, lacking in nothing.

James 1:2-4 (ESV)

 

Steadfastness is patience. Patience is what I am sorely lacking. I am unwilling to sojourn through this life and have my faith tested by trials. I want a quick fix but the irony is I am seeking a quick spiritual fix that has already been given to me! My Savior, Jesus Christ, has already provided the eternal fix by living and dying on the Cross and being resurrected after three days. By conquering death, the penalty of sin, Jesus showed all of Creation that we will lack nothing in life as long as we place believe in Him as Lord and Savior. 

 

There are no quick fixes in life, all are impermanent. Only Jesus Christ can fix our lives and He desires to do it for everyone who will place their trust and faith in Him.

 

Love and trust the Lord; seek His will in your life.

 

My medical school classmates and I were on high alert. That afternoon, our in-patient rounds were being conducted by the chief of medicine of our medical school. In our group was a senior medical resident who was currently supervising us. The chief led us into a patient’s room and he politely introduced himself and the rest of us to the patient. 

 

“Dr. Smith. What can you tell me about this patient?”

 

The senior resident quickly responded, “Mr. Jones was admitted with worsening chest pain that occurred over several hours, unrelieved by rest. Our initial tests ruled out an MI (myocardial infarction) and he is scheduled for a coronary angiogram.”

 

“His history is suggestive of angina. What do you think, Dr. Smith?” 

 

Our resident confidently declared, “Wasn’t it Osler who first coined the term, ‘pre-infarction angina’ to describe the disease we now call unstable angina? I believe his history of continual chest pain, unrelieved by rest, fits this diagnosis.”

 

The chief’s eyes twinkled. “Very good. Yes, this was Osler’s original description of this disease.”

 

After our rounds, my classmate looked at me with eyes opened wide and declared, “He quoted Osler!”

 

“I know!” I nodded. “Never thought I would hear that!”

 

Dr. Osler ushered in many advances in medicine that are still relevant to today’s physicians. His medical observations and his quotations frequently find placement in medical books and journal articles. In spite of his revered status, it is almost a joke amongst medical students if we hear of another medical student or physician quoting Sir William Osler because it is perceived as an over the top, ostentatious display of knowledge, uttered only by sycophants. While this quotation did provide an eloquent and historical definition of unstable angina, it undoubtedly was used to impress the chief of medicine. 

 

Quoting an authoritative source or reference usually commands our attention, but sometimes, it can seem trite and contrived. Politicians are fond of quoting the Bible. Some believe it projects an air of credibility and allows them to identify and curry favor with a particular constituent base. Others may do it with hostile intent to make a point about some perceived racist or misogynistic slant of the Bible. Regardless, the fact that the Bible is quoted should give one pause to realize the Bible must contain some element of Truth, otherwise, it would not be referenced. How can we know if someone quoting the Bible is sincere?

 

Abide in me, and I in you. As the branch cannot bear fruit by itself, unless it abides in the vine, neither can you, unless you abide in me. I am the vine; you are the branches. Whoever abides in me and I in him, he it is that bears much fruit, for apart from me you can do nothing.

John 15:4-5 (ESV)

 

Jesus Christ gave this commandment to guide His followers after He was crucified and resurrected. 

We can only abide in Jesus Christ by remaining immersed in His Word, the Bible. If we do this, we will bear fruit and our actions will advance the Kingdom of God on this earth. We can only understand the true motives of anyone who quotes the Bible by measuring their actions against this Truth. 

 

Love and trust the Lord; seek His will in your life.

 

At a recent event, I was seated in the second row of a large auditorium. As the audience filed in, two people strode to the front and took their seats, facing us. At first, I thought they were some of the presenters, but when the lead presenter began speaking, their identities were clear, they were signers.

 

I never had the privilege to sit so close to a signer of ASL (American Sign Language). At most events when a signer was present, they were positioned off to the side or I was too far back to clearly discern the nuances of their actions. Not this time. Although no audible sound was heard, they were communicating far more clearly than the actual speaker. At most, there was a second delay between the spoken word and their signing. Even if I tried, I would not be able to verbally repeat what a person was saying with the same rapidity. These signers were not only keeping this remarkable pace, but they were also embellishing it with their expressive body language.

 

Some cultures incorporate expressive movements of their hands and face when speaking. Signing is an even more refined presentation as I was delighted to learn that day. Even subtle expressions of speech were slightly exaggerated by the movements and facial expressions of each signer bringing a fresh and engaging mode of communication.

 

It was beautiful and mesmerizing!

 

Having eyes do you not see, and having ears do you not hear? And do you not remember?

Mark 8:18 (ESV)

 

God gifts most of us with all of our senses and how often I take these gifts for granted, failing to be thankful for the blessings that God has given me. The signers were communicating directly with two audience members in the front row and the joy and appreciation on their faces moved me to tears. I thank God for such wonderful people who sign and provide such a precious service to the many deaf people of our world. They communicate louder and more clearly than many people who only audibly speak. I am humbled and in awe of their great skill and dedication and their generous spirits to serve God’s Creation.

 

Love and trust the Lord; seek His will in your life.

 

“Do you need some help?”

 

The eager young man wore a bright t-shirt emblazoned with the words, Move-In Day. We were immediately surrounded by dozens of similarly garbed students, all pushing large transport bins, designed to carry the endless number of boxes, suitcases, and clothes that were arriving by the carload. Above the din of the traffic, strains of the latest hip-hop chart-toppers were played by a D.J. Canopies covering food, cold drinks and college swag were positioned at every corner. What a production! Everywhere I turned, all activity was focused upon welcoming the new students and this college definitely knew how to make it a memorable and pleasant experience. What could have been a daunting challenge became yet another reason that I was grateful for my daughter attending this college. Hours of planning were on glorious display for this successful college move-in day to come to fruition. It was definitely worth it! 

 

What about move-in day for eternity? What kind of preparations are taking place? What kind of welcome awaits the Christian believer in Heaven? 

 

In my Father’s house are many rooms. If it were not so, would I have told you that I go to prepare a place for you?

John 14:2 (ESV)

 

Jesus Christ has already promised every believer a move-in day that will exceed our wildest expectations. A heavenly mansion awaits us. Fears? Concerns? There will be more tears, pain, or sadness, only overflowing joy and happiness. What kind of planning and preparation is needed to make this a reality?

 

Jesus Christ has conquered sin and death so that all who confess their sins and place their trust in Him as Lord and Savior will be saved. Jesus has completed all the preparations for all of us. All we need to know is accept His offer! It will be definitely worth it!

 

I can’t wait!

 

Love and trust the Lord; seek His will in your life.

 

During my years in college, I would deliberately choose to study at a library that was at least a twenty-minute walk from my dormitory. I did this so that during the commute, I would have an opportunity to be alone with my thoughts and converse with God. I relished these intimate encounters but after I graduated, I stopped having these long walks with God. While it would not have been difficult to restart these walks when I was in medical school and residency, my priorities had unfortunately shifted. I continually felt pressed for time and I decided that giving up forty minutes a day to walk and commune with God was too burdensome. I turned my attention away from walking with God and instead focused upon walking alone and doing things my way. Only many years later did I restart these walks. I was thankful that my desire to walk with God was quickly rekindled. 

 

When Enoch was 65 years old, he became the father of Methuselah. After the birth of Methuselah, Enoch lived in close fellowship with God for another 300 years, and he had other sons and daughters. Enoch lived 365 years, walking in close fellowship with God. Then one day he disappeared, because God took him.

Genesis 5:21-24 (NLT)

 

Perhaps my love of walking with God echoes the longing that all of us desire to walk closer with our Creator? The Bible movingly illustrates this with the beautiful story of Enoch. Enoch was blessed to be able to walk with God for three hundred years. What were the topics of conversation? Why did God wait 300 years before He took him? How did this remarkable relationship even begin? Did God just appear before Enoch and said, “Let’s take a walk!”?

 

While God may not physically appear before all believers, He is always available to walk with anyone who calls upon His Name. Don’t squander the opportunity as I did for so many years of my life! Walk with God and tell Him the desires of your life and allow Him to take your burdens and pains. 

 

Love and trust the Lord; seek His will in your life.

 

 

The text messages extended for several consecutive screens on our mobile phones. We were “invited” to participate in a squabble between a property manager and contractor who were both doing work for my business. As my wife and I read the exchanges, it was clear that each party was attempting to gain the upper hand and throw the other under the bus. 

 

When the text messages morphed into CAPS, it was clear that both parties were extremely agitated, silently yelling into cyberspace. Finally, in a huff, the contractor signed off, then separately texted my wife and myself stating, “Jake is a good property manager, but I will never do another job for him.”  I turned to my wife and whispered, “I don’t think we should have been included!”

 

A wise colleague once told me that if an issue cannot be resolved by one exchange of a text,  email, or phone call, an in-person meeting is needed. Even if inconvenient, a face to face meeting can make a huge difference. Nuances in the tone of voice, body language, all of these can reveal a more complete characterization of the other party and potentially eliminate confusion and offense. Texting, emails, and even phone conversations have erected a false barrier to entry and sometimes embolden one to say or write things that one may be unwilling to do in person. It is ironic this contractor attempted to soften his blow by adding the last faint praise that “Jake is a good property manager…” Perhaps he was attempting to leave a small door open to reconciliation? Was there a better path that could have been taken?

 

Therefore let us pursue the things which make for peace and the things by which one may edify another.

Romans 14:19 (NKJV)

 

It is sobering to know that even in the first-century Church, when the Apostle Paul wrote the above cited verse, disagreements occurred. Many of these early Christians, including Paul, had actually seen the resurrected Jesus Christ. In spite of this assurance of God’s promise to them, they still bickered and needed reminding to seek the heavenly things above in Jesus Christ and not be mired by the earthly pursuits below. If I spent more of my time and energy seeking ways to build peace and edify others, all of my relationships would benefit. My model is Jesus Christ. This is what Jesus did when He was on this earth and this is what the glorified Christ in Heaven now does for all believers, interceding for everyone who calls upon His Name.

 

We should always be included in reconciliation because this is the eternal work of Jesus Christ.

 

Love and trust the Lord; seek His will in your life.

 

My wife and I were attending an orientation session for parents of incoming freshmen for my daughter’s college. Informative and timely, all of the speakers endeavored to keep their discussions humorous and light. One speaker began with an instant online poll asking, “How many times will you be communicating with your child in the first year?” The audience took out their cell phones and migrated to the website of the poll. Within seconds the overhead screen flashed a live summary of responses. The most frequent answer was 1-2 times per week. Yet the range varied from 2-3 times per day to once a quarter! The speaker then shared a story from his life. 

 

“I had been texting my daughter for several days and even calling her, but there was no answer. I was about to call the college but finally, my daughter sent me a brief text message…P.O.L.”

 

Some of the audience knowingly snickered.

 

“Proof of life!”

 

In this hyperconnected internet-driven world, it is easy to take for granted the ease by which we may communicate with one another, even half-way around the world. Unfortunately, family members are sometimes neglected. Being labeled a helicopter parent has become a pejorative description, yet, it is difficult to let go after 18 years. As parents, we need to have some affirmation and reassurance that our children are fine, especially when we have seen them every day up to this point. Our children are seeking independence and learning to be on their own and it is a delicate balance between keeping in touch and letting go.

 

…Because I live, you also will live.

John 14:19 (ESV)

 

There are few events in life as reaffirming and reassuring when we hear from someone we love, whom we fear is missing or worse. The Apostles were devastated after their Lord Jesus was tortured and executed on the Cross. For three days they lived in fear of their own lives, certain they would also be hunted down. They had forgotten the promises that Jesus had given them before He died. No worries, Jesus gave them His unique version of P.O.L.!

 

Because He lives, we can have eternal life, through faith in Jesus Christ as Lord and Savior. 

 

Love and trust the Lord; seek His will in your life.

 

The ocean waves softly splashed against the shore and the pillars supporting the hotel room we were staying. Our family was vacationing on the tropical island of Minaloc, one of the more than 7000 islands in the Philippines.  It was an idyllic setting with modern air-conditioned hotel rooms perched over the shallow ocean water designed to resemble ancient grass huts. The soothing sounds quickly lulled me to sleep as it blocked out all other sounds. 

 

Scientists call it white noise. Just as the color white is the summation of all color frequencies, white noise is the summation of all sound frequencies. It is often used to mask other sounds. Common examples including a blowing fan or the sound of gentle rain. The waves were accomplishing the same task for me, masking the sounds of conversations and televisions of the adjacent hotel rooms. It was very peaceful and welcome. 

 

What if there was a spiritual white noise that could mask random and sinful thoughts and prevent them from infiltrating my mind and enticing me to sinful behaviors. Spiritual white thoughts! Wouldn’t that be desirable?

 

Finally, brothers, whatever is true, whatever is honorable, whatever is just, whatever is pure, whatever is lovely, whatever is commendable, if there is any excellence, if there is anything worthy of praise, think about these things.

Philippians 4:8 (ESV)

 

I desire this because God has already provided it to me, all I need to do is ask Him to focus my random thoughts upon His goodness and blessings. It sounds simple but instead of always doing this, my mind focuses on the worries and cares of life. I concern myself with falsehoods, dishonorable relationships and bemoan situations that I cannot fix. Is it any wonder that I continue to yield to the temptations of sin?

 

Spiritual white noise for my soul. Praise God that He has already provided it through faith and belief in Jesus Christ!

 

Love and trust the Lord; seek His will in your life.

 

 

It was 8 AM and I was reviewing the slides of the cases that were removed by the surgeons from the day before. My duty as a first-year pathology resident was to pre-view each slide and order any additional studies that may be needed to render a diagnosis and complete the case. I would then sit at a multi-headed microscope with my attending pathologist and give him my interpretation. Depending upon the complexity of the case and body site, the attending pathologist may ask me to show the case to another pathologist with expertise in that particular organ system. The most common intradepartmental referrals were to the neuropathologist (brain and nerve pathology), hematopathologist (lymph nodes and bone marrow), and dermatopathologist (skin pathology). This collegial professional environment first attracted me to pathology since it required humility and self-confidence for any surgical pathologist to admit they could not be a master of every disease within every organ. 

 

During this morning’s case reviews, the department dermatopathologist, Dr. Jake Lee, strode by my desk. “Hey, Paul. Got any interesting skin cases you want me to take a look at?”

 

I smiled and nodded. The entire pathology department always deferred to Dr. Lee’s expertise in skin pathology. Even if the skin biopsy was quite routine, all of the other attending pathologists would insist that the residents show the case to Dr. Lee for his diagnostic blessing. In the decade of the eighties, within this mid-western university medical center, Dr. Lee was the only Asian attending pathologist in the department. Being one of the two Asian pathology residents, I felt a kinship with him, reciprocated by his amicable nature. One of my skin cases was very difficult with a complicated medical history. Although I had yet to show the case to my primary attending, I had no doubt that he would ask me to review the case with Dr. Lee. 

 

As Dr. Lee and I peered at the slide together through a double-headed microscope, it was clear that the case had piqued his interest and after several seconds of conflating the histopathological features of the skin biopsy with the clinical history and physical examination findings, he rattled off a list of obscure differential diagnoses, before narrowing it down to the final diagnosis. Once again, I was in awe of Dr. Lee’s expertise and elated to save some time by bypassing the usual triage process. 

 

By 1 PM, my primary attending, Dr. Smith, had entered the signout room and I joined him with my trays of microscope slides at the multi-head scope. The first hour was uneventful as he reviewed my cases and made insightful comments about how I could improve my observations, suggesting additional tests I could order to better define my diagnosis. We then arrived at the skin biopsy. As I read the complicated history from the requisition sheet, Dr. Smith nodded as he reviewed the skin biopsy. I was surprised. Perhaps he did know the diagnosis? A few seconds of silence passed between us and he looked up from the microscope and smiled. “Well, I don’t think I am going to get very far with this case. Why don’t you show Dr. Lee this case?

 

Yes, I thought! 

 

“Dr. Smith,” I began. “Dr. Lee has already reviewed the case and he thought it was an example of a Sweet’s-like hypersensitivity reaction secondary to the colony-stimulating factor medication he was receiving after his induction chemotherapy for leukemia.” I proudly regurgitated what Dr. Lee told me. I was expecting a compliment from Dr. Smith, instead, I received a cold stare. He pushed himself away from the microscope and snarled at me, “If you prefer to sign out with Jake, go ahead!” 

 

I was stunned by his reaction.

 

“Dr. Smith, I don’t understand…I..”

 

Before I could finish my statement, Dr. Smith interjected, “You obviously prefer to be with your kind!”

 

My eyes opened wide in horror as my sensibility snapped.

 

“What do you mean, ‘YOUR KIND’ ?” I glared at him, my entire body shaking.

 

Dr. Smith immediately realized his blunder and attempted to back it down, but it was too late. “I…uh…no, I didn’t mean anything by that.” He fumbled with his words. “I just meant…that you obviously feel more comfortable signing out Dr. Lee than with me….so maybe you should just sign out all your cases with him.”

 

Now I was shouting. “NO, Dr. Smith. I am always happy to sign out with you or any attending pathologist. You are the attending pathologist I will first show any case to but Dr. Lee just happened to walk by my desk and he asked if there were any interesting cases for me to show him.” I tried to calm myself down but my voice was still quivering. “HE asked me to show the case to him.”

 

Over thirty years ago, such politically incorrect statements were not uncommon, particularly within the minority deficient medical center and training program where I was situated. Yet Dr. Smith’s statement was over the top. It revealed his intense insecurity over his own diagnostic abilities and obvious jealousy that he harbored for Dr. Lee. Needless to say, the remainder of the signout was frigid and in the end, Dr. Smith abruptly stood up and left the room, without saying another word or issuing an apology.

 

Racism has existed since the beginning of mankind. Although there were traces of racism in Hawaii, where I grew up, the multi-cultural and ethnic diversity on that small Pacific island population always served as a social damper because of the continued integration.  Few ethnic groups ever felt denigrated to minority status. It was only when I began my pathology residency in this midwestern university teaching hospital that I began to be keenly aware of my minority status. This was reinforced by several racist encounters, including this one. 

 

There is neither Jew nor Greek, there is neither slave nor free, there is no male and female, for you are all one in Christ Jesus.

Galatians 3:28 (ESV)

 

Racism is an oxymoron. There is no superior race amongst many, there is only one, the human race. We are all created in God’s image. We can choose to fan the flames of prejudice and focus upon perceived or imagined differences or we can embrace our diversity and look beyond our human relationships to our higher calling. In Jesus Christ, all of us are equal, sanctified and justified through faith in His Name. We are equal because we are all sinners, in desperate need for a Savior and redemption through the death and resurrection of Jesus Christ.

 

Yes, I do want to be with my kind. I want every person of all ethnicities and cultures to freely and willingly accept by faith, Jesus Christ as their Lord and Savior.

 

Love and trust the Lord; seek His will in your life.