I will dwell in the house of The Lord

Psalm 23:6

"Surely your goodness and love will follow me all the days of my life and I will dwell in the house of the Lord forever"




With my job comes an insurmountable task of paperwork....writing notes about the daily patient visits, signing paper orders for medications to outpatient hospice agencies, signing off on electronic chart summaries, hospital orders, medication orders. That is not even to mention the amount of paperwork the insurance companies require. If I write a prescription for an expensive medication, I will then have to complete no less than 3-4 pages of additional forms explaining why the patient needs the medication (as if I am not really prescribing it for the right reasons...but I will try to hold back my cynicism here), and then usually re-writing the same prescription order on a form that the insurance company requires. I cannot begin to understand how creating such a lengthy paper trail and increasing the work load on so many people saves money somehow, but that is the reason I am given for why I have to do all of this extra paperwork. Easily, on any given day, I may spend 5 or more hours actually face to face with patients. For that level of patient care, I will have no less than the exact same amount of time spent in paperwork just for that day. I never seem to finish. It is quite literally one of  the must burdensome aspects of medicine these days!

Hebrews 10:36 

For you have need of endurance, so that when you have done the will of God you may receive what is promised.

Perhaps making the problem worse is the fact that I am somewhat of a perfectionist. (My coworkers and staff please don't laugh here...).  I want my charts to have all complete details, and I do everything I can to leave no stone unturned when reviewing patient histories. Every detail can be important. I sometimes lie awake at night feeling like I have missed something....And when I have that feeling, I have no option but to get up and look over a chart that is nagging me, to figure out what I have overlooked. The shocking thing is, I usually haven't forgotten anything, but those trips to the computer to review "one more time" always lead to an important discovery somehow.  I may run across a telephone message that came in after I left the office. Or I may see a test result that just came through. What is it that pulls me in the direction of my patients, or of anything, when I should otherwise have my mind off of work? I honestly know the answer to this question, and yet I am still always astonished when this happens to me. The Lord prepares me for work, and He expects me to respond to His calling.  And yet I constantly feel compelled to "do it myself." I feel like I am the one in charge, and I have the responsibility to comb over all details and make all of the decisions.

Romans 8:28

And we know that in all things God works for the good of those who love him. who have been called according to his purpose.

This "perfectionism" and need to feel like I am in control interferes with my ability to listen to God.  I lose the ability to hear Him when this happens. I think I need to check off my list of things to do: sign the charts, dictate my notes, go home, spend time with family, help my son with homework, shower, go to bed...check, check, check things off the list. When I get in the rut, sooner or later I get blindsided. I am in the routine and comfortable with my abilities. Patients are doing well. No catastrophes. The chemotherapy worked just like it was supposed to. No patients are getting the "rare 1% side effects." Then a storm rolls in and all of the sudden things fall apart. I am once again humbled and I realize...I was never in charge at all. I never was in the driver's seat. How could I be so proud? And yet the Lord knows this about me. Psalm 139 speaks so clearly on this.

You have searched me, Lord,

    and you know me.

² 

You know when I sit and when I rise;

    you perceive my thoughts from afar.

³ 

You discern my going out and my lying down;

    you are familiar with all my ways.

⁴ 

Before a word is on my tongue

    you, Lord, know it completely.

⁵ 

You hem me in behind and before,

    and you lay your hand upon me.

⁶ 

Such knowledge is too wonderful for me,

    too lofty for me to attain.

God is patiently always waiting for me to acknowledge that He is in fact, the one in the driver's seat, if only I will get out of His way.

I recently took care of one of the sweetest souls this earth could ever know. She was quite ill, but her cancer was not so terribly rare, and the treatment had a greater than 80% chance of a complete remission as long as she could take chemotherapy. There was NO chance, in my mind, that she would not get better. She sailed through her treatments, always getting the chemotherapy doses on time and without any complications.




Through our relationship, we just fell in love with each other. I loved her family. I felt I had known her for years, not just months. We became great friends. She was incredibly grateful, thanking me profusely every time I saw her. This is always astonishing to me - that people thank me for giving them treatments that make them feel so terrible. And after all...I am just the instrument writing out the recipes that will heal the cancer. I did not create the solution...but I have been placed here to implement what God has been behind for far longer than I have even been alive. But nonetheless, she was grateful for her treatments, and I was grateful to be a part of her life.

But when we did her final scans, her cancer was strangely still there. What the heck?? That was not the plan at all!  I looked at her scan and felt I had been hit in the stomach. At that time, I did not turn to God to question anything. I felt like He had a plan for all of this.  I immediately knew what needed to happen. I felt despair for literally a few moments, and then as quickly as those feelings came, they left, when I came up with the solution...she just needed radiation therapy and she would be fine. I knew in my heart that she would be okay.

So I met with her and her daughter, we reviewed her scans, and she was ready for radiation. I felt relief that we had a "plan B." But in the back of my mind, I had a nagging feeling that I cannot to this day put into words. Something just was not right.

Psalm 46:1-3 

God is our refuge and strength, an ever-present help in trouble. Therefore we will not fear, though the earth give way and the mountains fall into the heart of the sea, though its waters roar and foam and the mountains quake with their surging. "Selah"

She had completed a few days of radiation therapy but was getting sicker. She had to be hospitalized, and she continued to decline. Her inpatient evaluation unveiled another problem, one that would require a major operation just to save her life. We were at the unfortunate 'fork in the road.' With surgery, she may survive and proceed to radiation and everything will be okay. Without surgery, she may not survive. She decided to go ahead with surgery, and again I felt relief. Okay God, thank you for showing us the way to her healing!

She survived the surgery, and everything on paper and on her x-rays looked promising. I could see no reason at all that she would not recover. She did not, however, regain strength. We as her doctors believed that she would make a full recovery. We pushed her to get up and about. We gave her nourishment. We gave her pep talks. And she wanted more than anything to do all that the doctors were telling her to do.

But for some reason, her body was making a different journey than we had planned. At last, we realized that she was in fact dying. Despite all of the medicine, all of the support, and all of the tests indicating she should be getting better, she was dying.

Her daughter was at her bedside when she went to heaven. She told me of the miracles she witnessed that night. There is no greater gift than being next to the one you love when they get to go to heaven. Her mother's healing came, but not in the way we all expected or the way we wanted. We had to let go of our control, of our perfectionism and our expectations and accept what God's plan was for her. God was gracious to us. He did not take her too soon, before we were ready. He led us to the point where we could join her journey, and understand what was happening. And when we were at that place, with His comfort and grace surrounding us, only then did He take her home.

Heaven got a new angel that night. She told her family before she went that she was ready and she wanted to be with Jesus.  And there, with Jesus, she will wait for the rest of us to one day join her.

Her daughter of course has given me permission to write about her here, in case you recognize her story. As I was in the midst of this very recent journey, I did not even realize what was really happening until close to the very end. I became so attached to her, my sweet darling patient, I could not let go of the control I wanted to have when it came to her treatment. I must always be careful about that - - listening to God's plan is sometimes hard to do. It is sometimes - OFTEN - very different than the plans we have ourselves.

But our loving wonderful ever-present God is gracious. He knows we hurt and we miss our loved ones when they leave us. And looking back, I know now that the entire journey my patient took was not a journey to healing her physical earthly body, but rather a journey to prepare her spirit and to prepare her loved ones - the ones that would be left behind for a while - to be ready for her departure. Her family was blessed with so many more memories even after her sickness came. Even at the time of her death, her family witnessed the miracle of her last breath...when they were strangely awakened without a stir in the room in the middle of the night, in a quiet hospice room, just in time to see her final breaths here as she went to heaven. What an awesome moment.

In your loving sweet memory, until we see each other again...I will miss you

Matthew 11:28-30 

Come to me, all who labor and are heavy laden, and I will give you rest. Take my yoke upon you, and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light.