Saturday, October 16, 2010

Not yet

"Ms. Avery," I said, glancing down at the chart in my hands, and then back up to the woman lying before me on the ER stretcher. "I'm Dr. Lesslie. What can we do for you tonight?"

Mary Avery was 82 years old and had come to the emergency department because of increasing shortness of breath. She told me she had "a touch of asthma" but no other medical problems. Tonight was something different, and not her usual asthma.

"Do you have any history of diabetes?" I asked. "Or any heart trouble?"

"No sir," she answered calmly, between labored breaths. "Not yet."

This last comment took me by surprise, and I looked intently into her eyes. She smiled at me, nodding her head.

She was struggling to breathe, and yet there was a profound peace surrounding this woman. Not yet. I thought I knew what she meant.

A few days earlier, our minister had based his sermon on Paul's letter to the Philippians, chapter 1, verse 21. His message centered on how we ought to live, and where our focus should be. More importantly, he stressed the assurance we should have about where each of us is headed. Our eternal destination, I suppose.

I remembered thinking a good bit about the issue of preventive medicine. Now don't get me wrong. I've long been a proponent of our taking care of ourselves and doing the necessary things to prevent serious medical problems from developing. We should be keeping track of our lipids and our blood pressure, exercising regularly, watching our diet and our weight, not smoking, and generally not abusing our bodies. But I began to think about this term "preventive". Was that really accurate? What are we really preventing? Are we going to live forever if our cholesterol is perfect? Or our BMI is ideal? Or our colonoscopy is completely clear? We all know the answer to that. Yet, there may exist a false sense of security when all of these things are fine. And there's a not-so-subtle danger here. We can easily become distracted by the good health we are enjoying, and quickly lose track of the ultimate realities of this thing called life. But make no mistake - there's always something else looming just around the corner.

Then it occurred to me that perhaps postponing medicine might be a better term. After all, even in the best of circumstances, we are only postponing the inevitable, aren't we? We are all headed to the same final destination.

Yet, I remain convinced that we need to take care of ourselves, of our bodies, so that we can more effectively live. But what does that mean? Our minister also addressed this. He painted the picture of an elderly person who was in excellent health and who had spent his life focused on paying his bills and staying out of trouble. And where did that put him? What was the meaning of his walk on this earth?

Paul understands this, and makes it clear to us today in his letter. He knows where our focus needs to be, where we need to find our purpose and meaning, and where we need to place our hope. Mary Avery understood this as well, and had lived it. That's what she had meant by "not yet".

"Dr. Lesslie," Mary whispered, still quietly panting. "Please do what you can for me. But whatever happens, it will be all right. You know we're all like the flowers of the field. We flourish, and then..." Her voice trailed off.

She was still smiling, still peaceful. And she was still looking intently into my eyes.

Then she said, "There's only one thing that endures."

That night, Mary endured. She was suffering from a worsening of her asthma, and had to be admitted to the hospital. A few days later, she was able to go home.

Over the next two years, we saw her occasionally in the ER with flare-ups of her asthma. She was always smiling, always positive, always at peace. And she never developed diabetes or heart disease.

Then one day we learned she had reached her final destination.



Robert Lesslie is a Christian (Associate Reformed Presbyterian) emergency medicine doctor based in Rock Hill, South Carolina.

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