A Matter of Confidence

"What did you find, Doctor?"

The mother was in her usual anxious self when I greeted her in the GI lab after her teen daughter's endoscopic procedures.  Jenna had been complaining of stomaches for years, and recently the pain got to the point where she stopped going to school.  She was getting depressed, not sleeping well, and also started to complain of headaches and pain all over the body.  Her recent laboratory test results were largely normal, and physical examination findings did not suggest the presence of any serious disease.  I was quite certain that Jenna had a "functional" disorder such as fibromyalgia.  These conditions mostly present with various types of pain and discomfort that are not due to infections, obvious inflammation, cancer or any disease that requires surgery, and test results are almost always negative.  I was quite reluctant to perform additional studies on her, but recently indicated that I would consider performing GI endoscopies on her if the results, which I expected to be normal, can provide the family reassurance that Jenna does not have any other serious disease.  She ended up getting both an esophagogastroduodenoscopy (scoping from the mouth) and a colonoscopy (scoping from the rear end).

"Jenna handled the procedures pretty well.  Here's a copy of the photographs that I took inside her."  I handed the mother the endoscopy pictures, and did my best to explain the findings.  "This picture is from the first part of the small intestine...this one from the stomach looking toward the intestine...from the stomach looking up toward the esophagus...from the lower part of the esophagus...from the area of the large intestine next to the appendix...the rest of the large intestine...rectum...."  I paused for a moment.

"Basically all the parts of the digestive tract that were visible on endoscopy were completely normal.  Jenna does not have ulcers, does not have infections inside her stomach, does not have bleeding, does not have polyps...does not have cancer.  I hope that you take this as good news, and the negative findings were basically what I expected before going into the procedure."

"You're sure that the tests were negative?"  Jenna's mother asked, staring blankly while her daughter, still under the influence of sedative medications, giggled unintelligibly in the gurney beside her.

"I've learned in medicine never to actually say 'never' or 'always', but I'm as certain about this as I possibly can be.  I did take some biopsies during the procedures, and the results should be available next week to further confirm that Jenna does not have a serious organic disease."

My confidence in what I said was based on what I learned in medical school, in my residency training, in my pediatric gastroenterology fellowship, in my work experience, in books, in journals, in discussions with families, colleagues and mentors, and in attending numerous national medical conferences.  The only thing that would further increase my confidence would be if God actually told me that it was so.  Unfortunately, I wouldn't be surprised if the mother wanted a second opinion.

Is there anything in which I can have true confidence?  Being one who has lived under God's grace as a Christian for many years, I have full assurance of my salvation.  Jesus said,

"All that the Father gives me will come to me, and whoever comes to me I will never cast out.  For I have come down from heaven, not to do my own will but the will of him who sent me.  And this is the will of him who sent me, that I should lose nothing of all that he has given me, but raise it up on the last day.  For it is my Father's will that all who see his Son and believe in him should have eternal life.  I will raise them up at the last day."  (John 6:37-40)

The first of two diagnostic questions that are taught in Evangelism Explosion training is, "Have you reached the point in your spiritual life where you know for certain that if you were to die tonight you would go to heaven?"

My answer is yes.  I'm even more certain of it than I am of Jenna not having cancer.

Scooter the Pruner

I was never fond of eggplants, or aubergines.  In fact, it is the only vegetable that I actually dislike, but it wasn't for lack of trying.  After weeks of overexposure to weekend television gardening and cooking shows with my lovely wife early in our marriage, I somehow drove home one evening with some bell pepper seedlings and a potted Japanese eggplant.  I guess the Frugal Gourmet must have subliminally suggested against my better judgment while I was at the garden shop that a properly prepared eggplant parmigiana could actually be quite tasty.  Being a neophyte gardener, I didn't actually seriously believe that the seedlings would survive under my hands anyway, so chances were that there wouldn't be any eggplants on the dinner table.

I was almost correct.

Scooter, our rambunctious Labrador mix, was furiously yapping with excitement when I brought the seedlings into the backyard garden.  After sternly warning her to stay away from the plants, I carefully dug well-spaced holes in a plot next to the garage, added planting mix, plopped the seedlings in place, watered, and warned Scooter again to stay away from the plants.  "Scooter, you can run circles around them.  You can even pee and poop next to them.  But if you try to pull them out...grrrr!"  I scowled and bared my teeth, thinking that she got the message.

The verbal deterrent lasted about 20 minutes.  The bell peppers escaped injury, but the entire Japanese eggplant seedling was bitten off just above soil level, leaving only a frayed stump behind.  I didn't think that it stood a chance, but watered it a bit more, and left it alone.  On subsequent days, what remained of the eggplant seedling sprang to life, sprouted out multiple branches, and within a few weeks became a sprawling, fruit-bearing monstrosity.  We had enough Japanese eggplants to feed an entire village.  We gave them to our friends, and I'm sure that our friends gave them to their friends.  It turned out that while Scooter nearly committed auberginocide, she actually pruned the eggplant and caused it be more productive than otherwise possible.  The bell pepper plants remained unscathed and did well, but their production paled in comparison.


"That which does not kill us makes us stronger."  Friedrich Nietzsche, German philosopher and atheist


"I am the true vine, and my Father is the vinedresser.  Every branch in me that does not bear fruit he takes away, and every branch that does bear fruit he prunes, that it may bear more fruit.  (John 15:1-2)

It is comforting to know that God is in charge of our lives when we experience hardships and circumstances that are beyond our control.  It sure beats the alternative of atheists being fortified by near-death experiences.

By the way, I still am not crazy about eggplants.

Snowplay at Weed

"Daddy, can we play in the snow a little longer?"

It was a cold December afternoon during a family road trip to Portland, Oregon.  My children were only five and seven years of age, and growing up in the Los Angeles area, the only snow that they had played in so far was the machine-made stuff at local winter carnivals.  There was only a couple of inches of packed snow on the ground, but this time the stuff was real, and the kids were busy pelting me with snowballs, building snowmen and lying on the ground making snow angels.  I reluctantly agreed that we'd stay a little longer.

My wife stood next to me, and seeing the snow-capped mountains, exclaimed how beautiful the scene was, and dashed off with the camera to take a better shot.  I admit that I was also drawn in by the splendor of the surroundings, and was thankful for incidentally finding this patch of snow-covered landscape.

Eventually it was time to leave, but the kids were having too much fun to get in the car.  I had to remind them that we still had a long way to drive that day, and that we couldn't spend the entire afternoon at a the freeway rest area.

Yes, a rest area.  Somehow, the roadside potties by Interstate 5 near the California/Oregon border became a major winter vacation destination.  We pulled the car into the rest area at Weed, California, for a quick potty break.  It became a very long potty break, and we made sure that everyone had a chance to use the toilet a second time before we left for good.

Christians often describe our earthly existence as a journey, as we are reminded that there is a destination that is far more appealing than where we are right now:

These all died in faith, not having received the things promised, but having seen them and greeted them from afar, and having acknowledged that they were strangers and exiles on the earth.  For people who speak thus make it clear that they are seeking a homeland.  If they had been thinking of that land from which they had gone out, they would have had opportunity to return.  But as it is, they desire a better country, that is, a heavenly one.  Therefore God is not ashamed to be called their God, for he has prepared for them a city.  (Hebrews 11:13-16)

Jesus said to his disciples during his last supper with them:

"Let not your hearts be troubled.  Believe in God; believe also in me.  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?  And if I go and prepare a place for you, I will come again and will take you to myself, that where I am you may be also."  (John 14:1-3)

None of us will live forever in this life.  Some experience journeys of suffering and torment, and wish that their days are shortened.  Others' lives are full of earthly pleasures and success that they loathe the notion of ever departing from them.  Nevertheless, the journey will continue, and for those who call Jesus as Lord and Savior, our destination is far greater than Portland in December.

Unequal Friendship

There is no doctor who commands from me greater respect than Dr. Frank Sinatra.  Despite sharing the same name with the late famous entertainer, Dr. Sinatra bears little resemblance to the leader of the famous "Rat Pack" of Hollywood stars.  He is a pediatric gastroenterologist, an internationally known expert in childhood liver diseases, and for many years was the director of the pediatric gastroenterology training program at Children's Hospital Los Angeles/University of Southern California.  Dr. Sinatra is deeply devoted to the training and development of young doctors under his charge, and I am forever indebted to his several years of hands-on mentorship.  He also played a few years of minor league baseball with the Los Angeles Dodgers organization, loves horses, is often rather self-effacing for someone of his professional stature, is committed to his family, and enjoys Italian opera.  The one time that Dr. Sinatra really got mad at me was when I brought a UCLA coffee mug into his office.  I should have known that he was a die-hard supporter of USC Trojans athletics.

I would love to be like Dr. Sinatra when I grow up...someday.

I still remember my first meeting with Dr. Sinatra after I started my training.  He reached out his hand, and offered while warmly gazing at me with his sparking eyes, "Glenn, call me Frank."

I have known Dr. Sinatra for over 18 years, and have spoken with him on countless occasions, sometimes as a colleague and friend.  However, I have never called him Frank.  I simply respected him too much to call him anything other than Dr. Sinatra.  We may be friends, but it is an unequal kind of friendship.

A similar unequal friendship was also offered by Jesus to his disciples:

"This is my commandment, that you love one another as I have loved you.  Greater love has no one than this, that someone lay down his life for his friends.  You are my friends if you do what I command you.  No longer do I call you servants, for the servant does not know what his master is doing; but I have called you friends, for all that I have heard from my Father I have made known to you."  John 15:12-15

Indeed, Jesus called us his friends, but this does not necessarily mean that our relationship with God is equivalent to those with our friends at the office, school, gym or even at church.  The authors of the New Testament, including those who walked with Jesus on earth, never lost sight of this, as they never called Jesus "friend".  I am Jesus' friend because he chose to lay down his life for me and befriend me.  Jesus is my Lord and Savior, and that will not change no matter how long I know him.

Special Occasions

Most of my clothing occupies about one-third of the walk-in closet in the master bedroom.  It includes about a dozen well-worn dress shirts in various colors, several pairs of dress pants and slacks, about twenty neckties, a green sport coat that I purchased for a special dinner event twelve years ago, miscellaneous clothing that my brother-in-law no longer wears (but my wife thought that I would want), various casual stuff, and a two-piece suit.  I am particularly fond of the suit, as it is a gift from my father almost twenty years ago when I was in Taiwan for a short-term medical missions project.  It was hand-made by my father's tailor, and it is the only tailored suit that I have ever owned.  The simply designed dark single-breasted wool suit has only been worn a few times a year, but has served me well in job interviews, weddings, funerals, graduations and special dinner parties.  It has been impeccably maintained over the years, has only been dry-cleaned, and likely will remain quite serviceable for several more years, provided that I maintain my figure, and only wear it for special occasions, in the same way that vintage Ford Model T's are only taken out occasionally for Sunday morning drives.

It is natural for us to regard certain events as being more special or important than others.  At school, daily reading assignments and homework are mundane, but final examinations and term papers require special attention and preparation.  A major league baseball game in late spring is only a game, but come World Series time, every game, every inning and every pitch becomes of great importance.  Getting dressed for work is no big deal, but getting dressed for a wedding, especially if it is one's own wedding, is sufficient cause for anxiety attacks.

What about getting ready for church on Sunday mornings?

It wasn't long ago when being in one's "Sunday best" meant that he or she is dressed up in a fashion that is appropriate for going to church, where believers gather before the presence of God.  However, as churches are increasingly reaching out to "seekers" who may be uncomfortable with the idea of visiting houses of worship, there has been progressive emphasis on making the church experience more inviting, friendly and comfortable.  The house of worship, where the focus was rightly on God, has become a community of believers, where people, rather than the Almighty, now occupy the center of attention.  Instead of trembling before a holy God, the new image of our deity is one who is "with us", "in our hearts", demands little of us, is not intrusive, and is available to our whims whenever we feel like it.  As we pay less thought to gathering before the holy Creator of our very existence and more on bringing "seekers" to the "community of believers", it is natural to become more casual in our church attire.  After all, why dress up if we're just getting together with friends, right?  After all, didn't Jesus himself say to the disciples that he called them friends?

On the other hand, there was no mistaking the holiness of God when Moses led the Jews in the desert:

And the LORD said to Moses, "Behold, I am coming to you in a thick cloud, that the people may hear when I speak with you, and may also believe you forever."


When Moses told the words of the people to the LORD, the LORD said to Moses, "Go to the people and consecrate them today and tomorrow, and let them wash their garments and be ready for the third day.  For on third day the LORD will come down on Mount Sinai in the sight of all the people.  And you shall set limits for the people all around, saying 'Take care not to go up into the mountain or touch the edge of it.  Whoever touches the mountain shall be put to death.  No hand shall touch him, but he shall be stoned or shot; whether beast or man, he shall not live.'  When the trumpet sounds a long blast, they shall come up to the mountain."  Exodus 19:9-13


Although as Christians we now live under grace rather than under law, the holiness and awesomeness of God remains unchanged yesterday, today, tomorrow and forever.  While I may not necessarily put on my suit next Sunday, I nevertheless need to approach the house of worship with expressions of reverence that is fitting before the throne of the Almighty, both inside and out.

Thrill of a Lifetime

I turned to the business section of the Los Angeles Times on October 17, 2011, and was instantly transfixed by the article with an unusual title, "Virgin Galactic moves into New Mexico spaceport".  Galactic?  Spaceport?  Sounds like science fiction...or something that Buzz Lightyear from Toy Story would say.  I read on, and learned that multibillionaire Sir Richard Branson has invested considerable resources during recent years to make the space travel experience a reality for non-astronaut, paying passengers.  It will be the ultimate thrill ride for those with large amounts of, uh, disposable income.  Instead of paying nearly $100 to go to Disneyland and wait in line for 1-2 hours for the Space Mountain ride, aspiring space travelers have already signed up by the hundreds over several years, for the very reasonable price of $200,000.  Two hundred thousand dollars!  That's nearly four times the median household income in the United States.  I couldn't help but make the following observations:

1.  Sir Richard Branson's going to get a lot richer if he succeeds in this venture.
2.  There are lots of very wealthy people who can afford to drop a lot of money for a thrill ride.
3.  A lot of very wealthy people are very, very bored with their everyday existence.

What kind of experience is worth $200,000?  I thought about the most thrilling, memorable moments in my life, and the list did not include anything that could easily be purchased, at any cost:

1.  My son delivering a game-changing sack against the opposing team's quarterback in a league football game...during elementary school.
2.  My daughter scoring a totally unexpected, game-winning goal as time expired in a soccer match.
3.  My wife surprising me at work during the first year of our marriage, wearing a beautiful floral dress and bringing a large birthday cake for me and my colleagues.
4.  Answers to prayers uttered during my most desperate, darkest moments.

God, in His generous grace, often rewards us with remarkable experiences that sustains us through our days.  Striving for the ultimate experience, on the other hand, tends to disappoint, as King Solomon discovered:

"I said in my heart, "Come now, I will test you with pleasure; enjoy yourself."  But behold, this also was vanity.  I said of laughter, "It is mad," and of pleasure, "What use it it?"  I searched with my heart how to cheer my body with wine - my heart still guiding me with wisdom - and how to lay hold on folly, till I might see what was good for the children of man to do under heaven during the few days of their life.  (Ecclesiastes 2:1-3)


So I became great and surpassed all who were before me in Jerusalem.  Also my wisdom remained with me.  And whatever my eyes desired I did not keep from them.  I kept my heart from no pleasure, for my heart found pleasure in all my toil, and this was my reward for all my toil.  Then I considered all that my hands had done and the toil I had expended in doing it, and behold, all was vanity and a striving after wind, and there was nothing to be gained under the sun.  (Ecclesiastes 2:9-11)

Will the hundreds of fare-paying space tourists be satisfied once they experience supra-stratospheric flight?  Probably not.  For the ultimate hard-core thrill seekers, may I suggest that they experience for themselves, for a nominal charge, colonoscopies without sedation.  Their nerves will scream like they've never screamed before.

Brand Spanking New

When does something cease to be new anymore?  A new year will remain "new" as long as I continue to accidentally write the date with the recently expired year.  A new car will still feel like one as long as the "new car smell" lingers.  My wife and I were considered newlyweds during our honeymoon, as we opened our first joint bank accounts, and as we awkwardly referred to each other as "my wife" and "my husband" in public.  After our son was born, we became new parents, but the label of freshness and inexperience wore off fairly quickly, say, around the time when we started to shop for cheaper diapers a couple of months into parenthood.  As a physician, I was the new doctor on the block until my patients and their families finally stopped asking, suspiciously: "So, how long have you been a doctor?"  I've aged visibly since then...soon they'll start asking when I'm planning to retire.


One thing's for sure - new things don't stay new forever.  I spent innumerable hours at the Kaiser Foundation Hospital - Bellflower Medical Center, which was a state-of-the-art medical facility that was featured in national magazines when it opened in 1965.  The hospital earned top honors nationally in multiple measures of quality well into its final years as a full-service hospital, but it was starting to show its age after decades of service.  The facility was replaced in September 2009 by the brand spanking new, 300-million dollar, state of the art Kaiser Foundation Hospital - Downey Medical Center, located about a mile away.  Planning and construction of the hospital took years, and there was palpable excitement and anxiety as transition to the new medical center occurred.  Were the rooms clean, modern, and well appointed?  Check.  Elevators working?  Check. Medical equipment and monitors functioning properly?  Check.  Cafeteria food better than the stuff from the old hospital?  Uh, check.  So far, so good.  How long will it stay new?  No idea.


I pulled my car into the hospital doctor's parking area a few days later, and saw the familiar ambulances parked in front of the emergency department.  The ambulances looked fine, but upon closer inspection, there were huge dents formed into both of the twin steel columns that led to the ambulance entrance.  It didn't take long before careless ambulance drivers were backing up their vehicles right into the columns as they approached the building.  So much for "new".  Large water-filled barricades were seen protecting the entrance the next day.


Although we live in a decaying world where "new" becomes "old" just as quickly as "tomorrow" becomes "yesterday", the apostle John saw a glimpse of the world to come that will one day replace our current existence:


Then I saw a new heaven and a new earth, for the first heaven and the first earth had passed away, and the sea was no more.  And I saw the holy city, new Jerusalem, coming down out of heaven from God, prepared as a bride adorned for her husband.  And I heard a loud voice from the throne saying, "Behold, the dwelling place of God is with man. He will dwell with them, and they will be his people, and God himself will be with them as their God. He will wipe away every tear from their eyes, and death shall be no more, neither shall there be mourning, nor crying, nor pain anymore, for the former things have passed away."

And he who was seated on the throne said, "Behold, I am making all things new." Also he said, "Write this down, for these words are trustworthy and true."  (Revelation 21:1-5)

Unlike our current dwelling, God's new creation will stay new forever.  At least there won't be any ambulances there.