Mr. Warren Buffet is a rock star in the investment world. He is well-known for his time-tested investment practices, and his company, Berkshire Hathaway Inc., is one of the most consistently profitable worldwide. A single share of Berkshire Hathaway common stock (A-share), which was sold for less than $10,000 in the early 1990's, is currently worth more than $120,000. Nearly every major investment decision that he makes is immediately broadcast worldwide in minutes, if not seconds. When Warren Buffet speaks, people listen. He is known as the "Oracle of Omaha", and writings about him, his investment methods, and his words of wisdom abound in books, magazines, newspapers, and on the Internet.
I am not Warren Buffet. I have neither Mr. Buffet's financial insight, nor monetary wisdom, and I have made poor investment decisions that he likely would not make under similar circumstances. It therefore stands to reason to believe that I will be a better steward of God's material resources if I try to think like Mr. Buffet when I make major financial decisions. Would Mr. Buffet buy or sell? Would he build cash reserves or purchase investment property? Would he leave his estate to his offspring or donate it to charity? Would he buy gold, stock, or bonds? Would he collect art or antique cars? WWWD (What would Warren do)?
Unfortunately, I can ask all the WWWD questions, and never arrive at a proper answer. The problem is that while I have heard about Mr. Buffet, occasionally read about Mr. Buffet, and even own an infinitesimal fraction of his company in the form of Berkshire Hathaway B share common stocks, I have never actually read any book about him or by him, have never listened to his speeches or interviews, and have never studied his company's financial statements. WWWD? I have not the faintest idea.
While "WWWD?" has not yet become a popular expression, "WWJD?", or "What would Jesus do?" has become a fashionable statement among Christians. Someone just cut me off on the road - WWJD? A friend owes me money but will not repay me - WWJD? I need to buy a car...new or used - WWJD? "WWJD?" became a fad expression on posters, billboards, bracelets and bumper stickers. It sounds cool, as if you say it often enough, it makes you seem to know Jesus.
Sadly, just as I do not know much about Mr. Warren Buffet, many who glibly ask "WWJD?" do not truly know Jesus. They may know something about Jesus, and have seen drawings of a gentle Jesus holding a young child, healing the sick, and speaking to gatherings of thousands by the sea or the hillside words of wisdom about doing good deeds and being kind. However, do they remember that Jesus is God, who willingly became man and suffered utter humiliation and death for our sins, who rose from the dead and is in the place of highest glory? For it was written about Jesus,
"who, though he was in the form of God, did not count equality with God a thing to be grasped, but emptied himself, by taking the form of a servant, being born in the likeness of men. And being found in human form, he humbled himself by becoming obedient to the point of death, even death on a cross. Therefore God has highly exalted him and bestowed on him the name that is above every name, so that at the name of Jesus every knee should bow, in heaven and on earth and under the earth, and every tongue confess that Jesus Christ is Lord, to the glory of God the Father." (Philippians 2:6-11)
When we ask "WWJD?", do we know the Jesus in the book of Revelation, who not only encouraged, but also corrected and rebuked the seven churches?
When we ask "WWJD?", do we realize that Jesus' twelve disciples, after spending considerable numbers of days and nights with him, still knew little about him when he calmed the storm? For it was written:
And the men marveled, saying, “What sort of man is this, that even winds and sea obey him?” (Matthew 8:27)
Do we know the full picture of Jesus that is in the Bible? Many who claim to be Christians have never read much of the Bible, and the Jesus in their minds is only the Jesus of their imaginations. Before we ask "WWJD?", we need to make sure that we do not violate the first commandment,
“You shall have no other gods before me. (Exodus 20:3)
Hmm, I wonder if Warren Buffet would put money on this pizza franchise....
Monday, June 11, 2012
Sunday, June 10, 2012
Resuscitation
"You may go ahead and push the fentanyl. Slowly, please."
I instructed the nurse at the neonatal intensive care unit to start administering the sedation medication to the baby as I started to arrange the sterile medical supplies and equipment for the procedure. The patient was an infant girl with serious neurological deficits who needed supplemental tube feedings for nutritional support, and her attending neonatologist asked me to place in her a special feeding tube through the abdominal wall into the stomach. It is a relatively simple but also painful procedure, and as a rule it is performed under sedation or anesthesia. I have performed many of these procedures in infants without complications, and was optimistic that this one would also go well.
As the nurse started to give the medication intravenously, I spoke with the doctor and two nurses who were immediately assisting me, and reminded them that the first two minutes of the procedure, during which an endoscope (a small, thin, flexible tube with a camera) is inserted into the stomach, could be the most critical, and dangerous. I explained that the sedated baby could potentially stop breathing as a reaction to the scope, and that it might be necessary to temporarily interrupt the procedure to resuscitate the baby by giving her supplemental oxygen. I also reassured the team that nearly all my patients who previously experienced this temporary interruption was able to have the procedure completed without difficulty. One of my nurses nodded in agreement, as she had previously assisted in the same procedure many times before.
The assisting doctor suddenly directed my attention to the baby's cardiorespiratory monitor, and appeared quite concerned. The baby's oxygen saturation started to drop precipitously because she was not breathing. I asked the nurse to give the baby oxygen by mask. Still no improvement. The baby's oxygen saturation, which normally should be about 100%, now dropped to about 70%. I asked the nurse to start ventilating the baby with the bag-valve-mask assembly and 100% oxygen, while the other doctor repositioned her head to allow air entry into the lungs. I looked at the monitor, and was dismayed to see that there was no evidence of chest movement. We were trying to push air into the baby's lungs, but air was not getting inside her. The oxygen saturation reading now dropped below 60%. She might die soon if things didn't improve quickly.
The baby likely experienced what is known as "rigid chest syndrome", a rare but well-known potential adverse reaction to fentanyl, the sedation medication used for the procedure. A patient with this condition develops severe tightness and spasms of the chest wall muscles that it becomes impossible to breathe, and sometimes the only thing that can be done is to medically induce muscle paralysis so that oxygen from a ventilator can move into the lungs to save the patient. The other doctor and I were seriously considering the possible need for this, when suddenly a couple of faint chest movements were noted on the monitor. I asked the nurse to keep resuscitating the baby, offering reassurance that the baby appeared to be recovering slowly by herself. A few seconds later, the monitor showed that the oxygen saturation started to rise from 57% to 60%, and after a few more ventilation attempts with the bag-valve-mask assembly, oxygen finally started to move freely into the baby's lungs as the chest relaxed and started to rise and fall visibly with each delivered breath of air. Within a couple of minutes, the oxygen saturation appeared stable, and we eventually felt confident enough to actually start and finish the procedure, with no further difficulty. I appeared calm throughout the situation, but emerged from the procedure drenched in sweat, knowing that the baby could have died. Thankfully, the baby did well after the procedure, had no trouble with tube feedings, and was being prepared for hospital discharge within a few days.
The only reason that the baby survived the ordeal was that she, for a lack of better words...stayed alive. It would be impossible to resuscitate a dead person. "Dead" is also the word that describes us before we become Christians:
"And you were dead in the trespasses and sins in which you once walked, following the course of this world, following the prince of the power of the air, the spirit that is now at work in the sons of disobedience - among whom we all once lived in the passions of our flesh, carrying out the desires of the body and the mind, and were by nature children of wrath, like the rest of mankind. But God, being rich in mercy, because of the great love with which he loved us, even when we were dead in our trespasses, made us alive together with Christ - by grace you have been saved." (Ephesians 2:1-5)
Unless God first breathes life into us spiritually and awakens us, we will remain spiritual corpses that will not respond to the most valiant effort by men and women who try to blow the air of the Gospel message into us. May we who believe in Christ thank God for giving us life in the first place!
I instructed the nurse at the neonatal intensive care unit to start administering the sedation medication to the baby as I started to arrange the sterile medical supplies and equipment for the procedure. The patient was an infant girl with serious neurological deficits who needed supplemental tube feedings for nutritional support, and her attending neonatologist asked me to place in her a special feeding tube through the abdominal wall into the stomach. It is a relatively simple but also painful procedure, and as a rule it is performed under sedation or anesthesia. I have performed many of these procedures in infants without complications, and was optimistic that this one would also go well.
As the nurse started to give the medication intravenously, I spoke with the doctor and two nurses who were immediately assisting me, and reminded them that the first two minutes of the procedure, during which an endoscope (a small, thin, flexible tube with a camera) is inserted into the stomach, could be the most critical, and dangerous. I explained that the sedated baby could potentially stop breathing as a reaction to the scope, and that it might be necessary to temporarily interrupt the procedure to resuscitate the baby by giving her supplemental oxygen. I also reassured the team that nearly all my patients who previously experienced this temporary interruption was able to have the procedure completed without difficulty. One of my nurses nodded in agreement, as she had previously assisted in the same procedure many times before.
The assisting doctor suddenly directed my attention to the baby's cardiorespiratory monitor, and appeared quite concerned. The baby's oxygen saturation started to drop precipitously because she was not breathing. I asked the nurse to give the baby oxygen by mask. Still no improvement. The baby's oxygen saturation, which normally should be about 100%, now dropped to about 70%. I asked the nurse to start ventilating the baby with the bag-valve-mask assembly and 100% oxygen, while the other doctor repositioned her head to allow air entry into the lungs. I looked at the monitor, and was dismayed to see that there was no evidence of chest movement. We were trying to push air into the baby's lungs, but air was not getting inside her. The oxygen saturation reading now dropped below 60%. She might die soon if things didn't improve quickly.
The baby likely experienced what is known as "rigid chest syndrome", a rare but well-known potential adverse reaction to fentanyl, the sedation medication used for the procedure. A patient with this condition develops severe tightness and spasms of the chest wall muscles that it becomes impossible to breathe, and sometimes the only thing that can be done is to medically induce muscle paralysis so that oxygen from a ventilator can move into the lungs to save the patient. The other doctor and I were seriously considering the possible need for this, when suddenly a couple of faint chest movements were noted on the monitor. I asked the nurse to keep resuscitating the baby, offering reassurance that the baby appeared to be recovering slowly by herself. A few seconds later, the monitor showed that the oxygen saturation started to rise from 57% to 60%, and after a few more ventilation attempts with the bag-valve-mask assembly, oxygen finally started to move freely into the baby's lungs as the chest relaxed and started to rise and fall visibly with each delivered breath of air. Within a couple of minutes, the oxygen saturation appeared stable, and we eventually felt confident enough to actually start and finish the procedure, with no further difficulty. I appeared calm throughout the situation, but emerged from the procedure drenched in sweat, knowing that the baby could have died. Thankfully, the baby did well after the procedure, had no trouble with tube feedings, and was being prepared for hospital discharge within a few days.
The only reason that the baby survived the ordeal was that she, for a lack of better words...stayed alive. It would be impossible to resuscitate a dead person. "Dead" is also the word that describes us before we become Christians:
"And you were dead in the trespasses and sins in which you once walked, following the course of this world, following the prince of the power of the air, the spirit that is now at work in the sons of disobedience - among whom we all once lived in the passions of our flesh, carrying out the desires of the body and the mind, and were by nature children of wrath, like the rest of mankind. But God, being rich in mercy, because of the great love with which he loved us, even when we were dead in our trespasses, made us alive together with Christ - by grace you have been saved." (Ephesians 2:1-5)
Unless God first breathes life into us spiritually and awakens us, we will remain spiritual corpses that will not respond to the most valiant effort by men and women who try to blow the air of the Gospel message into us. May we who believe in Christ thank God for giving us life in the first place!
Subscribe to:
Posts (Atom)