“What Do You Think?” (Isaiah 5:20-21)

Over thirty years ago, I interviewed for my dermatopathology fellowship. I joined other applicants as we sat around a multi-headed microscope. The chairman of the department was showing microscope slides of interesting cases and was quizzing each one of us to gauge our knowledge and efficiency of our diagnostic skills. The first two applicants had relatively straightforward cases. Good, I thought! Perhaps I will get an easy case. When it was my turn, the chairman placed a slide on the microscope stage and said, “This one is a bit of a challenge!”

Great! Just what I needed for this crucial interview! I examined the slide as he moved it around on the microscope stage. It was odd. It reminded me of a condition I previously saw, a rare manifestation of lupus, but it was not classic. I wasn’t sure if I should mention this disease.

“What do you think?”

I began to hesitatingly describe what I saw. The chairman smiled then chuckled. “Well, this is a bit of a trick question! It is a biopsy of a Shar Pei! A veterinarian friend of mine gave me this slide. There is no disease. This is what the normal skin of the Shar Pei looks like under the microscope!”

Oh my!

Many of us are familiar with the characteristic appearance of the Shar Pei with its numerous wrinkled folds of its coat. What is less familiar is what causes these folds. Under the microscope, the cause is revealed. All skin contains something called the dermal ground substance comprising what is known as the extracellular matrix.  Composed of water and organic molecules, it provides support for the different elements of the skin as well as an environment that allows the diffusion of important biochemicals. The Shar Pei breed has increased production of this ground substance. 

Source: Breedadvisor.com

There are several disease states that may present with increased dermal ground substance in the skin of humans. Lupus erythematosus is one and, without the clinical history and proper setting, the histopathologic changes are nearly identical and may lead to an incorrect interpretation and diagnosis. Same ground substance but completely different interpretations depending upon the setting. One is a normal variant found in a rare breed of dog. The other is a rare disease with potentially life-threatening implications. What is true in medicine may also be true in our spiritual walk with God. 

Woe to those who call evil good, and good evil; Who  substitute darkness for light and light for darkness; Who substitute bitter for sweet and sweet for bitter! Woe to those who are wise in their own eyes And clever in their own sight! 

Isaiah 5:20-21 (NASB)

There are many ideas and concepts that were previously considered evil but are now considered good. Politicians and social scientists manipulate language attempting to render it gender neutral. Businesses may not refer to their bosses as owners since it evokes memories of slavery. Terminology that was never inflammatory or divisive has become just that for a growing chorus of dissenters. And they will not stop until all groups, including Christians, walk in step with their beliefs. If not, Christians and all who disagree with them are immediately labeled as bigots and divisive.

What do I think? 

I think we need to be wary of everything we hear from the popular media and press. Subtle changes in tone and shifting contexts may lure us into believing good is evil and evil is good. We need to cling to the Word of God and hold everything to the light of His Truth.

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

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