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Archive for January, 2013

The Happiness Canard

Posted by MDViews on January 31, 2013

Many times have I had a patient, or friend or acquaintance speak of their wayward adult/teen/adolescent children through tears saying, “I just wanted him (or her) to be happy,” As in, “What a simple request I’ve made of them. I’ve demanded nothing of them. I’ve paved the way for them. I’ve not insisted they be a sport star, or a straight “A” student, or have a perfect room, or do chores day and night.” But then something happened to disappoint them and their poor offspring was in trouble with the law/divorcing/on drugs/flunking out of school/ and on the list goes.

Few goals a parent may have for a child lack parental insight more than “Be happy.” It’s an easy trap to fall into, but one we should avoid.

First, you are their parent, the authority figure, the one in control of the car keys, the money, the house and the schedule. You are not entertainment, a bank, a car dealer, an endless chauffeur, a video game dealer or a social calendar organizer. You must make decisions for your child and discipline your child which leads to great unhappiness with tears and raised voices and angst. Now, you can try to be their buddy and best friend, but it isn’t what they want and certainly is not what they need. Be the disciplinarian you need to be. Study it. Buy Christian books on it. Read the Bible and pray for your child. Be good at parenting. But don’t think leniency will lead to a happy adult child. A child raised with loving but firm boundaries will fare much better in the world.

Second, once your child is an adult, you can offer advise or counsel, but your adult child can refuse it, listen to it and reject it or just get really angry you are butting into his or her life. MYOB, may be the reply. But whether or not they are “happy” by that time is up to them, not you. Don’t sweat it. In fact, unhappiness, trials and torment can be a great teacher. Don’t try to relieve them of such a valuable teacher.

Third, what is the source of happiness? More stuff? Better sex? Bigger bank account? Better advanced degree? Dying with the most toys? Is the source of happiness random acts of kindness? Serving turkey at a shelter on Thanksgiving? Helping others? Is the source of happiness being “true to yourself?” Looking out for #1? Following eastern religion by meditation and navel gazing? Getting your piece of the pie, whatever it takes? If you, dear parent, can’t answer that question with a resounding confidence, how can you expect your child to find this elusive “happiness” state of mind?

I would posit the ultimate source of happiness is to glorify God and enjoy Him forever. The first question of the protestant catechism wasted no time or words in getting right to the point of the most important question faced by man. The question? “What is the chief end of man?” The answer? “To glorify God and to enjoy Him forever.” John Piper would change the “and” to “by” making the answer read “To glorify God by enjoying Him forever,” meaning enjoying God, taking pleasure in God, making God your ultimate goal and satisfaction is accomplished by glorifying Him forever. Our ultimate joy comes from God and the realization that we are depraved individuals, dead in our sin and unable to see God’s glory and beauty and desirability unless He awaken in us that desire. We deserve Hell and eternal torment. Thus our commitment to Christ, our walk with Him, our joy in making much of God and worshiping Him is totally His wonderful gift. We didn’t “clean ourselves up” to be acceptable to God. We didn’t choose God because we were so smart and good and upstanding. Even our best is as filthy rags to him. It’s only through the cross and God looking at us through the beauty of his son who is perfect and blameless and who presents us as perfect and blameless to God that we have this joy.

Thus the source of our joy.

Knowing God is sovereign and in control and has chosen us to spend eternal bliss with him one day is more than “pie in the sky in the sweet by and by.” It’s our rock, our fortress, our stronghold, our strength. It’s a promise in which we can always take hope.

Does that mean Christians are bubbly happy, always smiling, “chipper” (John Piper’s word!), never down, always trying to prove to the world that “we Christians are happy and have fun, too!” like I seem to hear again and again on some Christian radio stations? No, of course not. Those bubbly, chipper sorts are play-acting in my book. How can we “bubble” when so many in the world are bound for hell? How “chipper” can you be knowing that in the congregation each week sits someone wondering if the cancer has spread, wondering if their husband will file for divorce, wondering if their teenage son is drunk again, wondering if they will miscarry again, wondering how to deal with the guilt of having had an abortion? Church is not “chipper.” Church is a serious time of serious worship to the creator of the universe, the one who hung and named each star, the one who grants the next breath I will take, the one who provides my purpose for living.

Such Christians are joyfully sorrowful–joyful in the service and worship of the King, but sorrowful for all the reasons above. In other words, Christians face the world as it is knowing and recognizing the hurting and pain and suffering that eventually visits all of us in one terrible form or another, but recognizing the Blessed Hope of our dear Savior and the promise to spend eternity with Him one day. Thus our unending joy when surrounded by tragedy, poverty, pain, hurting and death. And, more importantly, our unending joy when tragedy, poverty, pain, hurting and death visit us personally.

I have a hard time imagining how the sprightly, vivacious and chipper Christians handle bad news–really bad news–without going to pieces and denying their faith. Because, if being a follower of Christ is supposed to make you upbeat, bubbly and chipper–then, if you are not upbeat, bubbly and chipper because of the terrible calamity visited upon you–what do you have left? Nothing but questions without answers.

Not that joy in Christ is a slam-dunk. We must fight for joy. How? By staying as close to God as we can through worship, prayer and study. By realizing these trials are temporary and the best is yet to come. By realizing this is not our home, we are just passing through. By associating with like-minded Christians for love, encouragement and support. By serving God with all our hearts, an activity sure to take your eyes off of ourselves and onto Christ, the source of joy.

So, please, don’t tell me “I only want my child to be happy.” It’s an unachievable goal sure to disappoint you and frustrate your child. Rather wish for them commitment to Christ in all His glory. The “happiness” will take care of itself.

Posted in Faith and the Glory of God, Family | 4 Comments »

The HPV Vaccine. Protecting Your Adult Child From Their Own Adult Decisions?

Posted by MDViews on January 9, 2013

A medical news article entitled, “Increasing HPV Vaccination Coverage Needed To Decrease HPV-Associated Cancer Incidence,” caught my eye and took me back to my days at Fairview when I was on the Quality committee. The HPV (human papilloma virus) vaccine (Gardasil) had just been release. The chairman of the committee, Mike Dummer, MD, told everyone that we needed to get as many adolescent girls vaccinated as possible. In order to do that, he said, we should present the vaccine to the mothers of these youngsters as a vaccine to prevent cancer of the cervix. We were not to use the word “STD” or sexually transmitted disease when speaking of the vaccine. He feared mothers of adolescent girls would refuse to have their daughters vaccinated if we called it an STD vaccine.

I challenged him and told him I thought that approach was wrong and could violate Fairview’s diversity and tolerance policies by not being culturally sensitive to devoutly religious folks, Christians in particular. I knew some Christian women who did not want their daughters vaccinated against an STD. He shot back that I was wrong, that it was important to tell them it was a cancer vaccine. After all, we didn’t tell patients with cervix cancer or an abnormal pap smear that it was caused by an STD. I challenged him again and told him I always told my patients with an abnormal pap or cancer of the cervix that the disease was from an STD, more likely in those with early onset sexual activity and multiple life time partners. He was truly surprised, that I would honestly share that information with my patients. The conversation ended with him sticking to his guns, that we should not tell moms of young girls that the vaccine was intended to prevent an STD which caused 70% of cervix cancers.

There were probably 15 docs at that meeting. None supported me. I resigned from the committee after that. I could see I didn’t belong there.

I’ve spoken with doctors and patients who fall on both sides of the issue, but most advance the notion that young girls (and now young boys) should receive the vaccine.

Protecting children from physical harm is a parental duty and cervix cancer causes real physical harm. So, aren’t we obligated to protect our young girls from this STD and get them the vaccine? No, I don’t think so. We can give them the vaccine, of course, as many do. But we are not obligated to do so as I argue below.

A child does not catch an STD by a sneeze or a cough so I can’t place this vaccine in the same category as the vaccine for whooping-cough or measles. If I had a preadolescent or adolescent daughter at home today, I would speak to her around the time of her menarche of the availability of the vaccine, its purpose, its effectiveness and encourage her to remain chaste until marriage. Should she decide to become sexually active prior to that, she would be making an adult decision and it would be her job to make another adult decision and go to her own doctor for the vaccine if she wished to receive it or talk to me about her desire to receive the vaccine. And once she were 18, she could make up her own mind without my input.

Cervix cancer is an adult disease. Currently, the CDC doesn’t even recommend a pap test for any woman until age 21. Receiving the vaccine before exposure to the HPV virus 9,11,16 or 18 will theoretically stop 70% of cervix cancers since 70% are caused by 16 and 18. (9 and 11 cause warts.)  Fortunately, even without the vaccine, cancer of the cervix is uncommon and is treatable in its pre-cancer state. 50% of cases of cervix cancer occur in women who have never (that’s right, never) had a pap test.

And, I would contend that sexual intercourse is an adult act.

I have difficulty generating excitement about protecting my adult children from an adult act for which they are responsible.

The other side of the argument cites the irresponsibility and rebelliousness of adolescent boys and girls who may have sex. Is that really an adult act? Shouldn’t you protect her then? What if your daughter gets raped at age 14? Wouldn’t you want her protected in that event? And what about those cultures in our society in which sex at age 15 or 16 is accepted as the norm, multiple partners are the norm and marriage is rare? I’m thinking of inner city minority populations where 80% of babies are born to unmarried women. Shouldn’t they receive the vaccine at age 10 or 11? Shouldn’t you push hard to get them vaccinated, even if it involved lying to them as in, “This is a cancer vaccine, not STD vaccine?”

My own approach on this issue is to inform patients of the vaccines availability but encourage no sex until marriage and one partner for life. That’s a medical recommendation. (What? A medical recommendation?) By remaining chaste until marriage and having one partner for life, an entire plethora of disease can be avoided, including HPV, HIV, Chlamydia, gonorrhea, genital herpes, pelvic inflammatory disease, infertility, hysterectomy and on and on. That’s what I mean by encouraging no sex until marriage, then one partner for life being a medical recommendation.

Think of this. No doctor hesitates to scold a patient for smoking cigarettes and tell them to quit smoking because of the increased risk of lung cancer, heart disease and emphysema. No doctor hesitates to scold the overweight patient and tell them to start exercising and losing weight because of the increased risk of high blood pressure, diabetes and heart disease. No doctor hesitates to tell a patient to wear their seat belt, lower their cholesterol, treat their high blood pressure, get their eyes checked, and on and on and on.

Why the taboo against recommending abstinence until marriage and one partner for life to avoid the diseases which result from promiscuous sexual activity? Mainstream medicine conveys the message that adolescents will have sex like rabbits anyway, so limit disease and pregnancy. Get the vaccine, wear a condom, use birth control, have an abortion if the birth control doesn’t work, don’t ruin you life with a (gasp!) baby.

Only, that message hasn’t worked, doesn’t work and won’t ever work. Just look around. God knew what He was doing when He defined marriage as the union of one man and one woman and that sex outside of the marriage bond was sin. He defined this morality which, no surprise to me, is medically spot on.

Posted in Doctoring, Medical Issues | 5 Comments »

The Contraceptive Mandate

Posted by MDViews on January 8, 2013

Birth control. Who can be opposed to birth control?

Isn’t birth control just having the babies you want and no more? Isn’t that just common sense? Who can afford more than two kids anyway? Who wants more than two kids any way? Do you have any idea how expensive day care is? And who wants to clean some rug-rats bodily fluids off the leather seats in the back of your Beemer? Do you have any idea how the other passengers look at you if you take your kid on an airplane to go to the Bahama’s for a vacation? Besides, maybe you’re a teenager and a pregnancy would ruin you life. Shouldn’t you be on birth control? Come to think of it, maybe you should be required to take birth control. I mean, isn’t over-population a big problem? Shouldn’t we all have fewer kids, like China? And how are you going to climb the corporate/educational/governmental ladder if you have to worry about day care/dance lessons/soccer/after-school care? Kids! What a noose around your neck! Plus, what if you end up with some disabled kid who cost even more? Do you know what day care is for a kid with autism? (Well, I think they have homes you could put someone like that in, don’t they? I mean, you shouldn’t have to care for a kid like that, should you?)

Let the Duggers have 19 kids. Let those weird Catholics who actually believe Pope John Paul’s Humana Vitae use natural family planning and have 8 kids. (Is it legal to have that many kids? Maybe we should do something about that, too. )

And anything that’s as important as birth control should be covered by insurance, shouldn’t it? I mean, $4 a month at WalMart seems like a lot to me.

And so it goes. The arguments for birth control in general and the contraceptive mandate in particular.

But let’s separate some facts from the fog and see what this contraceptive mandate is really about.

First, define birth control, because you cannot separate birth control from abortion.  Most of you probably don’t know that the government, drug companies, IUD’s companies, birth control pill companies, progesterone-only birth control companies and the “morning-after” pill companies define abortion as pregnancy loss after implantation. That means an egg is fertilized, becomes an embryo, travels down the fallopian tube over 4 or 5 days, but then, instead of implanting in the wall of the uterus, passes through unnoticed because the “contraceptive” made the uterine wall hostile to implantation. One package insert said it prevents the “egg” from implanting in the uterine lining! To those entities above, that is birth control, not abortion. All of the package inserts for the birth control pill, IUD’s, progesterone-only birth control pills and shots and the “morning-after” pill companies list a hostile uterine environment as one of the mechanisms of action. (For birth control pills, the primary method of action is stopping ovulation, but it doesn’t stop ovulation all the time.)

For those of us who are pro-life, that mechanism of action means 1) possible, occasional abortion for the birth control pill, 2) likely abortion for IUD’s and progesterone-only pills and shots and 3) almost certain abortion for the “morning-after” pill.

I’m an OB/GYN doctor and have wrestled with these issues in my conscience for many years. I quit placing IUD’s shortly after I started in private practice, but did place them during my residency. I quit prescribing progesterone-only pills and shots many years ago and I quit prescribing the birth control pill two years ago. I feel good about all of those decisions.

So defining “birth control” helps us, I think, realize why the “contraceptive” mandate is a deep moral affront to pro-life people on its face. “Contraceptives” should be called “contra-gestational” agents, meaning they prevent a pregnancy from “gestating” or growing in the uterus, but don’t prevent “conception.” At least not all the time. In that regard, they are all potential abortifacients, some more than others.

Second, our devout Catholic friends, both patients and doctors, are required by the teachings of the Catholic church to only use periodic abstinence (natural family planning) to prevent pregnancy. I’m much more aware and informed of that teaching now that I work in a clinic with all Catholic physicians who hold to the teachings of the Catholic church. That means they advocate for natural family planning, (specifically NaPro Technology) and never prescribe any artificial birth control agents. It’s easy to see why the mandate would be unacceptable to them. Also, that means requiring a Catholic organization or a Catholic employer to pay for condoms, spermicides, tubal ligations and vasectomies in addition to those other forms of  “birth control” is a moral outrage and mocks our first amendment right of freedom to practice our religion as we choose.

One can argue that our taxes already pay for abortion in the United States, and that is true in some states (Minnesota, for one, where I live) through the Title 19 program.

But our tax dollars already fund program after program I find morally objectionable. I have no choice about paying taxes. When Jesus said to give to Caesar what is Caesar’s and to God what I God’s, the Roman empire was not exactly a morally upstanding place.

However, requiring payment for “contraceptives” by purchased private health insurance when health insurance is a voluntary fringe benefit offered to employees from an organization or employer bears no similarities to a tax. It’s the government interfering in a private fiduciary relationship between an employer and an employee.

It is clearly the heavy hand of government violating the first amendment right of freedom of religion for those organizations and employers who find “contraceptive benefits” morally objectionable.

As my little vignette above describes, the real reason secular people (and many evangelical Christian and Catholic couples) use birth control is, well, because they don’t understand the gift of life. Children are a de facto burden, not a blessing; a curse to be avoided, not a life to be cherished; a pet to be shown off when convenient then shuffled off to daycare, not an integral part of the family to be fully accepted, loved, valued and included; a carbon footprint to be viewed with a jaundiced eye, not a treasure created in the very image of God.

Pro-life Christians and Catholics are in cross-hairs of the liberal establishment because we embrace a morality from outside of who we are, a morality codified first in the tablets from Mt. Sinai and expanded by Jesus and the apostles in the New Testament. Liberals fly by the seat of their pants inventing their morality as they go along, mostly by what ever would increase their personal happiness at that moment in time, whether morally right or wrong (situational “ethics”, or a better description, situational lack-of-ethics). We now live in a liberal echo chamber in which the establishment has never met a death (embryo, fetus, handicapped baby, or elderly ill person) it didn’t like–except for those convicted of capital crimes in which death is a deserved punishment–those deaths they fight against always.

It makes sense, dear Christian friend. God is not surprised, fooled or unaware. Their behavior is nothing new. Read what the Psalmist says in Psalm 106:36-39 and see if it doesn’t describe the current state of our culture to you.

They served their idols,
which became a snare to them.
They sacrificed their sons
and their daughters to the demons;
they poured out innocent blood,
the blood of their sons and daughters,
whom they sacrificed to the idols of Canaan,
and the land was polluted with blood.
Thus they became unclean by their acts,
and played the whore in their deeds.
(Psalm 106:36-39 ESV)

And, we know that we will suffer for Christ’s sake if we take a moral stand. It’s a guarantee from God. Paul’s phrase from I Thessalonians 3:4 makes it clear he knew he was to suffer affliction and then did suffer affliction.

    For when we were with you, we kept telling you beforehand that we were to suffer affliction, just as it has come to pass, and just as you know.
(1 Thessalonians 3:4 ESV)

So the contraceptive mandate is not a surprise to God and should not be a surprise to us. In our culture, what’s right is what’s wrong and what’s wrong is what’s right. Since liberals control the reigns of power in government, entertainment, education and large corporate businesses, we are at the mercy of the laws they pass, the courses they teach, the movies and TV programs they make and the rules they make for employment as they employ many of us. But we don’t have to watch their movies and TV programs which always portray us a incompetent, stupid, bigoted troglodytes. We don’t have to buy the products of those companies actively supporting the goals of more birth control and abortion. We can home-school and choose to attend conservative colleges and universities. And when the laws become too onerous to follow, we can use civil disobedience (and go to jail? Yes, and go to jail). In the mean time, we must fight, protest, vote our hearts and throw every roadblock we can in front of them whenever we can.

Posted in Abortion, Family, Medical Issues, Politics, Pregnancy | 4 Comments »

A Little Bit About a Lot of Things

Posted by MDViews on January 1, 2013

I turned 60 recently. So, maybe it’s time for a few truisms I’ve picked up through the years. Here goes.

God is faithful even though I am not.

Grandchildren add unspeakable joy to my life.

God blessed me with a brother who is my best friend–my salvation in so many ways.

I love my children desperately and when they hurt, I hurt.

Most people I know don’t realize how lazy I am because I work hard at my work.

Nothing in this world causes more heartache than failed relationships.

Working with like-minded doctors and staff blesses me every day.

Hearing a baby’s hear beat always makes me smile.

The older I get, the more precious and wonderful it is to hear a newborn baby take that first breath and cry.

My energy level has declined significantly as I’ve aged.

I cherish the role of doctor, surgeon and birth attendant.

I love to write because writing is just thinking on paper.

I carry deep sorrow and regret about my failings as a Christian, a husband, a father and a doctor.

God is always faithful to forgive.

I pray every day for strength to persevere to the end, to finish well, to honor God and to leave a legacy of faith.

I love ice cream. Dying with a quart of chocolate Dairy Queen and a spoon in my hand is my dream.

Posted in Personal | 2 Comments »