Tuesday, March 24, 2020

Love In The Time Of Coronavirus


Love is sacrifice. There is no greater love than this, to lay down one's life for one's friends. All across the world, healthcare workers are sacrificing for their friends and for strangers alike. They are sacrificing for those who contracted COVID-19 from willful ignorance, from reckless disregard, and others innocently from some unsuspecting source. And yet medical workers treat them all the same, fight tirelessly for their healing. For this and so much more we all owe a great debt of gratitude and honor. 

But that is only a small part of what I want to say, and it is to those medical workers I write, I want you to be prepared. Your life is about to change forever, your sense of fairness, justice, and right and wrong may soon suffer so great an upheaval that it leaves you reeling in shock and existentially wounded. Please hear my words. I write them in love.

There is a term, many of you may know, a condition of the soul called moral injury. It is also a condition that many medical professionals already have from years of working in the healthcare industry. For anyone unfamiliar, “Moral injury refers to an injury to an individual's moral conscience resulting from an act of perceived moral transgression which produces profound emotional guilt and shame, and in some cases also a sense of betrayal, anger and profound 'moral disorientation’.” 1

“The concept of moral injury emphasizes the psychological, social, cultural, and spiritual aspects of trauma. Distinct from pathology, moral injury is a normal human response to an abnormal traumatic event.” 2

Moral injury refers to the “the lasting psychological, biological, spiritual, behavioral, and social impact of perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations” 3

Said another way, moral injury is “A deep soul wound that pierces a person’s identity, sense of morality, and relationship to society”. 4 

There are critical distinctions that need to be made between moral injury, burnout, compassion fatigue, and post traumatic stress. Moral injury is primarily an existential crisis, and while it is often exacerbated and usually accompanied by the physical exhaustion of burnout, the ever narrowing emotional bandwidth of compassion fatigue, and the unconscious and very normal response of stress after trauma, it is more fiendish and perhaps more debilitating than all of the others combined.

Moral injury can be divided into two categories: individual responsibility, that is the perpetration of, or the failing to prevent, harm, and other responsibility where we witness the dereliction of sacred duty and/or betrayal by trusted others.

In this current crisis you are going to be asked to do more than you've ever done, with less than you've ever had, for more people than you could have possibly imagined. Resources will run out soon. At the time of this blog, New York has 5-6 days of critical medical supplies left. Already doctors and nurses are being asked to recycle disposable protective gear, or wear it long after it is safe to use. The decisions being made in boardrooms and political dens are affecting you and your patients in real time. And the stark reality of limited ventilators and other life saving devices is about to have a very real cost in human lives. This is battle field medicine, and no amount of training could psychologically prepare you for this.

Tomorrow, or maybe the next day you will have to choose which patient gets life saving resources. Tomorrow or the next day, another of your peers will fall ill, a victim of recycled masks, of compromised immune systems due to physical exhaustion from endless shifts. The blame may be easy to spot, the mistakes glaring and some even seemingly avoidable, but you will have no time to obsess on that, you will be in the fight of your life, perhaps the fight for your life.

The cumulative effect of all of this, the damage from this perfect storm of ignorance and unpreparedness, will leave your soul wounded. The unfairness, the tragedy, the inequality will fracture your heart, your mind, your spirit. Moral injury fills the vacuum where the illusion of human virtue once was. People will fail you, the system will fail you, your leaders will fail you, and you will be altered in ways unimaginable.

When this over, and it will end, you will be forced to deal with the moral injuries. Some will come from events where you failed, or perceive you did, the decision to give the ventilator to one patient over another. This will lead to toxic, negative, internally directed emotions and cognition like guilt, shame, and lack of self-forgiveness. Other events, those outside your control, administrative or political decisions or inaction that cost lives, will surface as toxic, negative, externally-directed emotions and cognition like anger, inability to trust, and lack of other-forgiveness.

Both types of events are associated with spiritual/existential issues, the loss of "faith", of questioning morality, and until resolved, these internal conflicts can in turn exacerbate social problems like isolation and aggression along with inducing mental health symptoms such as anxiety and depression leading to substance abuse and greatly heightened suicide risk. Doctors are already at one of the greatest risks for suicide, even in non-coronavirus times.

Limited life saving resources, the desire for personal safety over patient care, outright mistakes, administrative decisions with dire consequences, even co-workers playing God will all wound your soul, but the greatest existential crisis that you may face, will be why must the innocent suffer. This virus preys on the vulnerable, the weak, the defenseless. The ones who need us most. Where is the fairness, the justice in the universe? Where is God? If God exists, why doesn't He intervene?

There are no easy answers. There may be none you find satisfactory. But for your own well being, for the care of your soul wounds, let me offer what I believe is the only true inoculation against, and the only cure for moral injury: hope.

If you are reading this as a Christian, than you will perhaps appreciate what I am about to say, but in the event you do not believe in God, or the Christian God, please consider the thoughts to follow objectively. Every code seems nonsense without the key, a jumble of words and phrases with no meaning. If your universe seems dissonant, confusing, and indecipherable, (or when it does after this is all over) let me humbly offer the Key.

First you must realize you are not alone in this, hundreds of thousands of medical professionals are going through or will go through the same things. Secondly, I believe in a God who suffered in every way, bore every burden any human would ever suffer, and understands intimately your moral crisis, your soul wound. Feeling alone in this is an inescapable prison, but knowing you are not alone, that others, most importantly that God understands, is the beginning of comfort, the first glimmer of that hope.

The Christian bible says “Not only that, but we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope,” Romans 5:3,4

Scripture makes many promises, and perhaps none as seemingly unfathomable as this: “suffering produces hope”. The promise that for the believer, good will come from our afflictions. 

As I've written about before, I spent 16 weeks at a field hospital near Mosul, Iraq. There I saw the worst humanity can do to the most innocent among us. Children targeted by drone strikes, hunted by snipers. One night I carried five children to the morgue. It leaves you breathless, concussed. It shakes your faith. No easy answers come in those moments, no words of comfort for others come easy either. And yet something in us holds fast. Words form on our tongue that are not our own…

"…rejoice in your sufferings, know that suffering will produce endurance, and endurance character, and character will produce hope."

This passage is saying that when Christians suffer, they have a strength that is not their own, in their weakness they find God's grace, His great power, holds. When they would run in fear or in despair, when they would curse sacrifice and live for themselves instead, His nature in them holds. When in the midst of their worst physical, mental, even existential crisis, He never leaves them, hope is produced and that hope holds. For the Christian hope is not an abstraction, it is a person, His name is Jesus Christ.


Christianity is much more than a path to follow, a philosophy to obey, it is the transformation of our very nature by God Himself living in us. The power and the intimacy this affords us becomes such great confidence in the darkest hour. For the Light of the world is in us and even death could not extinguish Him. 

My prayer for you is this: Fall to your knees as you fight this wretched demon COVID-19, or perhaps it has already knocked you to your knees, and cry out for God of the universe to give you the hope of Jesus. He promises to work all things together for the good of those who love Him. He is infinitely able, and His love for you both unfathomable and unstoppable. 

Love is sacrifice. There is no greater love than this, to lay down one's life for one's friends. Jesus calls you friend, He laid down His life for you. So that you could live this life with the same power that raised Him from the dead and destroyed the sting of death, the power of the grave forever.

Let His perfect love casts out all fear. Let Him start to heal those soul wounds. Let Him be your peace in this storm, your shelter from more moral injury, from fear itself. 

Keep your chin up and wash your hands. Love you all. Xoxo




1. Litz, Brett T.; Stein, Nathan; Delaney, Eileen; Lebowitz, Leslie; Nash, William P.; Silva, Caroline; Maguen, Shira (December 2009). "Moral injury and moral repair in war veterans: A preliminary model and intervention strategy". Clinical Psychology Review. 29 (8): 695–706.

2. Molendjk, Tine (2018). "Toward an Interdisciplinary Conceptualization of Moral Injury: From Unequivocal Guilt and Anger to Moral Conflict and Disorientation". New Ideas in Psychology. 51: 1–8

3. Litz, et al. 2009, p. 697

4. Silver, D. (2011). Beyond PTSD: Soldiers have injured souls. Truthout.org (9/3/11). Retrieved from http://www.truth-out.org/news/item/beyond-ptsd-soldiers-have-injured-souls




Friday, October 19, 2018

A Letter to Men, Chiefly on Women




Dear Brothers of the X and Y chromosomes,

It is with great heaviness of heart that I write to you. Because in an age where your sisters are finally being heard, finally finding their voices, many of you seem to have taken a dismissive posture, a condescending tone, you're talking over them, and some of you are even mocking their historic #metoo movement. I love you brothers, but I'm angry.

Let us avoid a protracted history here of the marginalization of women. Although it would do us all well to know that history, to take ownership of our complicity, to mourn it and repent. Let's just look at a few grotesque and urgently relevant facts about the genders.

1 in 3 women will be sexually assaulted in their lives. 1 in 10 will be raped.  91% of all rapes are committed by men. Let that sink in.

Overwhelmingly, in 80% of rape cases, the victim trusted her attacker. She trusted you, man, brother of mine. She, trusted, you.

The threat of violence, even death as retribution for speaking out, keeps rape as the number one underreported crime. Almost 2/3rds of sexual assaults go unreported!  That amounts to tens if not hundreds of thousands of women who cannot point to their attackers, either from fear of violent repercussions or the very real issue of post-traumatic symptoms that can incapacitate victims.

We don't have time here to chronicle how the justice system has further marginalized women, slapped the wrists of violent rapists like Brock Turner, consistently blaming women, telling them to keep their legs together, to dress appropriately, to not be so careless. These malignant, misogynistic pronouncements from presiding judges are well documented and only further demonstrate the patriarchal system currently in place.


The statistical evidence that points to men being the vast majority of sexual predators and violators of women is mountainous and undeniable and yet it seems that some of us brothers want to make ourselves out to be the victims of some great conspiracy against males. With the suggestion recently made that "it's just not safe to be a man anymore". The truth is that there are those females who misrepresent their rapes, but that number is around 2% and certainly not justification for men to dismiss the greater, pandemic issues of male on female violence. Men are not at so great at risk here that we must co-opt the #metoo movement and try and make a moral equivalency. It's a non-starter guys, a false dichotomy, a futile narrative that seems whiney in light of our universal entitlement. And in our hearts we know it.

So let's address a few actual statements men have said, ignorant pronouncements that shouldn't even merit discussion but apparently still do.

1. "If women were more careful where they went, what they wore, what they drank, and how much they drank, they wouldn't be so prone to assault." Women being in the wrong place, at the wrong time, wearing the "wrong thing" is not an invitation to rape them. Brothers, no matter what, to be a real man means to control one's urges. You are not an animal. But when you make any excuse for your brother's violent behavior you erroneously attribute their perverted will to only animal urges. Should women walk alone, wear what they want, go wherever they want, even at night? The statistics say if they do they have very real chance of being brutalized by a man. So maybe until men quit acting like animals women will have to circle their wagons in self-protection. And so we have the #metoo movement. Brothers, for those of you who want to continue to paint a moral equivalency between women dressing "seductively" and rape shame on you. You merely reveal your own sexual objectification of women, your own deeply ingrained belief that a women's body is a function of your desire. "Modesty" or lack thereof is not the frontline of the battle against rape, the unbridled lust of men and male entitlement is. Brothers, do you know the rape crisis line number by heart? Your sisters do. Brothers can you leave your drink at the bar unattended? Your sisters can't. Brothers do you text your friend when you get home to let them know you are safe? Your sisters do. Brothers does it ever cross your mind that what you're wearing might so inflame the lusts of the opposite gender that you're in danger? It stays on your sisters mind. All. The. Time.

2. "What else did they expect would happen?" The #metoo movement started in Hollywood, a place known for its promiscuity and sexual permissibility, for objectifying the female body, and yet rape is still just as wrong and damaging to Hollywood females. Some of the men talking about this movement seem to be implying that because Hollywood portrays, even elevates a certain sexual lifestyle where anything goes, that this is the inevitable conclusion, the judgement if you will, the natural result of a permissive culture. But when we listen to the testimonies of Hollywood women, the abuse of power in a male dominated industry is what created the fertile environment in which hundreds if not thousands of women were sexually assaulted. Men, using the positions afforded them by a patriarchal system, abused their subordinates, leveraged their power to coerce women to acquiesce for their career's sake. Victim blaming is always wrong because it always implies that men cannot control themselves and shouldn't be accountable for their own actions. Brothers you are not animals. Your sisters are not your prey. 

3. "This is a politically motivated agenda." Saying the #metoo movement is a political agenda cold-heartedly and ignorantly implies that women are using their sexual assaults as fuel for a political fire. Almost as if they waited for an opportune time to make these revelations known, for the greatest political impact and the most debilitating damage to their political opponents. Shame on you for even suggesting such a thing. Women who have been abused live every day in the dark shadow of their trauma. We don't get to decide when and where they speak. And if they are being emboldened to speak now, even years after the event, they must be honored, must be heard, must be respected. Furthermore, even if a women's testimony is "politically motivated" that doesn't excuse the indefensible behavior of any man. Recent hearings in the Judge Kavanaugh have magnified our inability as men to listen and to respectfully respond to women who have experienced sexual trauma. Whether Dr. Christine Blasey Ford was raped by the Judge or wasn't does not excuse the way she was talked about, the way she was grossly maligned. When we speak so viciously to a victim, we are speaking to all victims, past present and future. We are speaking to our mothers and wives, and maybe most heinously we are speaking to our daughters. Will they feel safe to speak up about their own attacks? Or will they be silenced as so many women in the past have been silenced, by fathers and brothers, presidents and judges, speaking so dismissively, so corrosively about women. By most accounts, Dr. Ford's reliability as a witness was never in question. Could she be mistaken of some of the facts, even who attacked her? Yes. Was she attacked by someone? I also believe yes. Was she treated with the decorum and compassion victims of sexual assault deserve? Not even close. But, let's assume for a second Dr. Ford was lying, was a political plant? Can a man act judiciously, empathetically, even when being falsely accused? I'd hope so. Especially when we are demanding women act a certain way to not find themselves victims of sexual assault. And yes, I always want the truth to come out. I always want an end to politically motivated attacks of any kind. And yet, once again I say, this is not the time. To conflate the greater #metoo movement with this one instance is to confine and redefine an epidemic by one symptom, real or imagined. No matter what the truth is in from the Kavanaugh hearings, millions of women have been brutalized by men. Let's not paint the Judge as a victim of character assassination at the expense of an entire movement of women who have had infinitely more than their character assassinated. 

4. "Men are abused also, often by women." Yes, this is true, in 1 out of ten cases. And yet it is not our time to distract from the super majority of cases that are male on female assault. As with the #blacklivesmatter movement when some tried to co-opt the phrase by espousing #alllivesmatter, we must remember that these movements are about upsetting the status quo, confronting an imbalance of power, about certain voices finally being heard and not the silencing of other voices. No one, not once, said white lives don't matter. The movement was and is to say black lives are equal and haven't been treated that way. Such is this #metoo movement, not to disqualify male victims of sexual assault, but to say women's voices have long carried less weight and now there is finally a choir of female survivors saying if we put our voices together we will be heard. Sing my sisters.

5. "This is all just the consequences of sin, the reality of a fallen world." To my Christian brothers especially, to paint any issue so indiscriminately undermines both the validity of your message and the sincerity of your motives. To state something so unequivocally lacks all the intellectual nuance that communicating Truth about complex issues in a modern world requires. Yes, sin, the consequences of sin, the entropy of the universe that sin began, are all apropos to the larger discussion about any type of evil and injustice. And also this is not the time for that, we know that broken people break others, that is not in debate. What is at the forefront of the #metoo movement is the reality that men abuse their power, power afforded to them by institutions that have been built to both preserve male dominance and female subjugation. We as Christians must denounce the inequality of those systems. Christ came to bring equity to His church. We must repent where we have knowingly or unknowingly been party to the marginalization of women and the muting of their voices. We must remain defiant against the enemy who would deface the image of God by repressing women. We must also stand defiant against the very "consequences of sin" in our own hearts and minds. We must root out sexual entitlement from our thoughts, our actions, and even some of our doctrines. We must remember the charge to submit one to another in love. Christlikeness looks like gentleness, kindness, and longsuffering. Not brashness, defensiveness, and self-justification. This isn't about us men. Mainly because it always has been.

Brothers this is what you can do: Stop objectifying women. Stop using their bodies, whether by pornographic images or in your imagination, for sexual gratification. Stop telling jokes that are sexually perverse, or disparaging of women. Stop justifying the crude and cruel, debasement of women by our President, by musicians, by celebrities, by your friends as "just joking". Quit telling women to lighten up. Brothers remember women are the image bearers of God. When you debase that image you fight against God, you spit in His Holy face. Brothers listen to your sisters, tell your other brothers to shut up and listen too. Brothers you are the image bearers of God too, mimic Christ in His love for his bride by laying down your life for the women in your life. Brothers love all women like your daughters, respect all women like your mothers. 

I waited to say these things until the political circus of the Kavanaugh hearings were over, until Harvey Weinstein wasn't the token face of the male violator allowing other men to hide in his very large shadow. And though there is a culture of rape, a culture of misogynism that must be urgently addressed by all of us, right now this is about a #metoo movement of sexual assault survivors, their stories, their demands. It's about shutting up and listening. It's not about men being heard, we've always been heard. Right now it is about our sisters speaking and men not speaking over them.

I wrote this to address my brothers, not to defend those men who support the #metoo movement. Brothers who love women, it is not our time to be acknowledged for being decent humans. Because brothers, once again, this isn't about us. If you want to help, hold a megaphone for your sisters to shout in. And only then if you are asked, and there is no available women to do the same.

And to my sisters. I am sorry, words cannot, will not suffice. But I hear you. And I am listening intently. And I want to be part of a culture shift where men no longer abuse their power to feed their sexual appetites.  Where men no longer hold the power, where it is equitably distributed to the most capable, regardless of gender. I'm listening so let me know what I can do, or let me know if you want me to do anything at all. This is about you.

I love you my sisters. You hold up more than half of the sky. Xoxo


Tuesday, October 16, 2018

Jonah. A Prophet's Pride and the Relentless Grace of God.



After almost two years of reading, studying, wrestling, and writing, my book on Jonah is finally finished! What a labor of love it has been. With so many of my friends along the way letting me flesh out these thoughts in conversation, in bible studies, and in less than literate first drafts. I wanted to take a moment here to thank them all again, and also to give a little insight into why I wrote this book, why I felt it is a story that urgently needs to be read.

Nearly 22 months ago I stepped off of a plane into Northern Iraq in the middle of the night. After a long day of security training and a longer night of restless sleep I traveled with new and returning team members to a field hospital 8 miles from Mosul. Coalition forces were in the final phases of liberating East Mosul from ISIS and here I was on the plains of Nineveh about to enter a heavily guarded and fortified compound and face death like I'd never before. Bombs shook anything that wasn't made of concrete and our on-site orientation included a tour of the compound's many bunkers. I was a long way from Mississippi, surrounded by real enemies, about to be changed forever. And while the story of my time in Iraq is referenced in this book, the majority of that experience will have to wait to be told. The pain is still too fresh, the memories yet to be completely processed.

During the lead up to my deployment I read as much as I could on the region. Its geopolitical history and current state. And of course the rapid rise and spread of the scourge that was ISIS. The terror ISIS was inflicting on the innocents of Northern Iraq cannot be described more accurately than to say it was demonic. 

I also read the biblical narrative of Jonah. In fact I was drawn to it over and over. As I write in the book:

Perhaps it was the intensity, the urgency, the utter insanity of a war zone and grasping to make sense of my surroundings, but I was drawn over and over again to Jonah and the story of Nineveh. And as they had many other times in my life, the words of the book seemed simple and unrelated to my spiritual journey. Jonah remained a mythology of my youth, a fantasy of Sunday school. That story that so quickly captures the imagination of a child and insults the intelligence of an adult. The story of a big fish and a wayward prophet sulking in its stomach. And yet, continuously I was drawn back to it, until the Spirit began to unravel Jonah to me, piece by piece, line by line.

I read the book of Jonah maybe 25 times before it started to make sense. As I began to dig into the geopolitical narrative of Jonah's day I began to see modern America. And as I began to get insight into Jonah's heart and motives, I began to see myself, and my brothers and sisters in Christ. Jonah's day was rife with nationalism and his heart was too. He hated Nineveh, they were ethically inferior in his mind. He wanted their destruction, in fact he tried to sabotage God's mercy to achieve just that. 

Today I see an American church clamoring toward isolation, conflating patriotism with nationalism, and resisting the call of mercy toward its neighbors. I see a deep riff forming between "us" and "them". And it breaks my heart. At its root I believe the issue is pride. It is the false belief God is on our side and against those we despise. And we couldn't be more wrong. And the results of our pride and lack of mercy are disastrous.

As I write in the book:

God is not the god of America, He is the God of the universe. Like Jonah, if we forget that God is sovereign over all nations, we make God small, we remake Him into our image. He starts to speak like us, starts to look like us, and starts to hate all the same people we hate.

Throughout the story of Jonah, from his call, to his rebellion, and all the way to his ultimate decision to sit outside of Nineveh and hope for her destruction, we also have God relentlessly pursuing Jonah with grace. My book is about that grace. It's about the true nature of God and how we should and can image that. I hope you will read what I wrote, ingest it line by line, and be fed on the richness of God's word. There is so much truth in the 48 verses of Jonah. And yet most urgently is the cautionary tale of a nation and its prophet choosing nationalism over God's desire for inclusion. Jonah was and is a prophet with an important message. One the modern American church cannot afford to miss.

I'll leave you with this short passage from the book:

The Church of Jesus is so much bigger than the Church in America. And the gospel is not best told in English, nor best represented by our idioms and American personality. The gospel is fuller, richer, more vibrant when spoken in diverse languages and expressed through many cultures. This great flavorful feast, this common meal, with so many savory spices. The worldwide Church has so many beautiful reflections of God’s glory. Like an infinitely sided diamond each of us reflects the light of God’s image in a beautifully unique way. You and I will understand God more fully when we meet Him again through the testimonies of believers from all over the world. That’s a promise. There is absolutely nothing nationalistic about grace. The Gospel gloriously transcends all governments, all nations. It speaks clearly and precisely about the day when we will pass from this world to the next. In heaven any deference or exclusion due to national identity will be locked in the prison of the past.

“After this I looked, and behold, a great multitude that no one could number, from every nation, from all tribes and peoples and languages, standing before the throne and before the Lamb, clothed in white robes, with palm branches in their hands, and crying out with a loud voice, ‘Salvation belongs to our God who sits on the throne, and to the Lamb!’” (Revelation 7:9,10)
 
You can read a sample of my book and purchase the electronic version here.

xoxo

Saturday, October 13, 2018

Behind Those Blast Walls





My first day at the emergency field hospital just east of Mosul, Iraq was very much like my last day. Mortar strikes on civilians, children bloody and broken, black bags to hold the dead. The slow, solemn walk, cradling a ten year old in my arms, counting the steps to the morgue. Laying someone's son down on cold gravel, reading his name one last time on the death certificate taped to the body bag.

Time of death 18:17.

Patient #855.

I'll never forget the sounds of his dying. The rattling and the gurgling. I'll never forget the songs we sung over him, the prayers strangled by grief and sorrow. The tear stained cheeks and our righteous anger. I'll never forget the faraway look on his precious face. I'll never forget his face. What was left of it.

Many of us were strangers a week before, two days before. Strangers taking care of other strangers. One set from the west, a land of peace and prosperity, one set from northern Iraq, a region ravaged by terrorism and war. And now here we all were, doctors, nurses, pharmacists, translators, construction workers, administrators, and HR reps.  One and all hearts turned inside out and taking care of the dying while other new friends fight for the living in mobile operating theaters a few hundred feet away.

That last night may have been the worst. The toddler with ribs exposed from mortar wounds. 9 children in one day. But there were other days, other nights when I thought my heart might die. The toddlers with their feet shot off. The whole families targeted by drone strikes. The burnt and blackened restaurant patrons, victims of a suicide bomber. One night in particular I carried five children to the morgue. It leaves you breathless, concussed. The mortar of sorrow, a direct shot to the soul.

I'm processing, I'm free bleeding my heart and thoughts here so I don't explode and because I don't have the luxury of denial. I cannot separate my belief in a good and sovereign God and the suffering of innocence. If there is no reconciling the two than I am lost. We all are. Especially Christians, fools to be pitied of all men.

But what we found there, behind those blast walls, with the ceaseless drums of artillery fire, the strangled song of the whine and wail of one ambulance after another, was that hope is not a thing you wish for, it is the only thing afloat in a raging sea of chaos. It is what you hold on to, what holds on to you so you do not go under the relentless waves of grief. And we found that you hold on to each other. And you pray like gasping for your last breath. And you plead with heaven, even when heaven is silent. And you raise your broken hearts together in a pitiful little petition, more whimpers than words, and you beg, unified in grief, "Jesus please....."

The Bible says that suffering produces hope. A comical, sadist thought when the belly is full and the sun of our futures never sets, always shines on our glorious destinies. But when the night never ends, when the morgue is full, when evil seems to be laughing in every shadow, on those nights you somehow see it. Suffering produces hope in this way: when terrorism and hate and the cancer of evil spreads over all that is good with a blight of darkness, the light still does not go out. There is a flame in the hearts of those who have known the love of God. There is a song of praise that is not stalled on their lips, is not silenced. There is a light in the inner places of those who have heard the Word of Life and believed. This is the flower of hope that grows in the garden of souls by heaven's Holy seed. This is the hope that springs eternal, because it has always existed, always will exist apart from the human stain, in the Holy heart of God.

Suffering produces hope in the same way bomb blasts produce the broken bodies of children. It is the inevitability, the cause and the effect of universal laws. But only one will remain. Hope will swallow grief one day because Love will conquer all. But Hope is inevitable in us only when we trust, against our own instincts, in the goodness of God and allow ourselves to be taken deep into our own human frailty, far past vulnerability to the point of despair. And in that wasteland of our utter uselessness, in that wilderness of our unraveling, God is there, He is faithful, He alone, as He has always been, is holding the universe together and simultaneously holds us in the palm of His hand.

That is the only hope: that God holds His own in the palm of His hands while they yet suffer. And that the insatiable hunger of the mouth of Hell cannot devour the ragtag, broken band of believers called the church.

In the picture above I hold in my hand a 50 caliber bullet taken from the body of a pre-teen boy. An ISIS sniper shot him because their's is an ideology of fear. They target the weak, not just because the weak are a low-hanging fruit, but because most of us are weak. Most of us are trying to live our simple lives in peace. ISIS needs capitulation. They need submission. A sniper bullet in the side of a child reminds us the world is not at peace and things are not simple. It reminds us that suffering isn't a concept, that no abstraction paralyzed this young man. It reminds us that we are fragile and vulnerable. It reminds us that to walk the way of love our hearts will be obliterated by suffering.

And so against all hope we hope, that Love will one day conquer all. But not human love. Only God's selfless love, for with it carries His perfect all-powerful justice and the promise and ability to make all things new. Godspeed that day. Especially for the precious children of Mosul.


Wednesday, July 5, 2017

Same River Twice




For the last ten weeks I have been back in Iraq at the same emergency field hospital I worked at earlier this year. The bombs were not so close this time, the acuity rate not so high, but the scars of evil were just as ugly and ever present. 

I am changed forever. We all are. We have seen things that cannot be unseen. Our heart's have been crushed, ground to dust, blown to bits, over and over again. And the thing is, what each of us will confess, is that it was a sacred honor, one we wouldn't trade for all the glittering things. And that for most of us this was the first time in our lives where all of our passions were engaged; personal, professional, and spiritual, in a community of our peers doing the right thing, at the right time, for the right reasons. And that's what we all long for isn't it? Isn't that what it means to be fully alive? And maybe that's strange, to feel so alive under the shadow of death. To travel to a war-zone to find family. But maybe what is more strange is we weep when we have to leave, and many of us dread the coming home. 

And so I write this for my field hospital family, I write this for those that love them. They are not who they once were, they are stronger and yet more fragile. The have gone to a place of bombs and terror and seen what those evil forces do to the bodies of children. They have sat countless hours with the dying, held out hope with trembling hands to the living. They have stifled the urge to scream too many times to count. They have fought back tears daily so the floodgates wouldn't open forever. They are not who they were when they left you, they are better than before, but they are more broken. Over them hangs an invisible shroud of grief, they must mourn for what's been lost, for what they've left behind on the war ravaged plains of Nineveh.

So please be careful with them, let them tell you their story in their own time, even if it's a long time. It's a story that costs them in heart-break. The words conjure images that will haunt them forever. Let them have their silence and space, to process, to heal. Be patient with them, small talk may be unbearable after a season so intense, so pregnant with purpose. A trip to the mall or Walmart might be unhinging for them when they've seen those fleeing war in tattered rags and matted filth, gaunt with emaciation. They see with new eyes now, hear with new ears. There has been a deep shift in their sense of justice, a widening of their worldview. You will alienate them quickly if you politicize refugees, or paint Muslims or Middle Easterners with a broad blunt brush. These are no longer abstract terms to them, no longer strangers from news footage. They have done life with these precious people, they've listened to stories of horror so unimaginable that it left them reeling and speechless. The throats of babies slit in mother's arms, whole families mowed down by ISIS snipers as they ran to freedom. Daughters hiding in the piles of the dead, sons surviving on cardboard and blades of grass. Your churches may seem more shallow to them, words like suffering and persecution now have faces and stories, have a new infinitely higher ceiling of meaning. They have seen the cost of faith. But they love you, they still need you, maybe more now than ever. Brokenness isn't a switch that can be flipped on and off, a setting to be dialed down. So be gentle. Please.

And now to my EFH peeps. I love you and miss you. More than words can say. I want to honor you, you crazy ragamuffin crew. You are my family. You are my heroes. I have tasted heaven behind those blast walls in our little community, I have seen the image of God in each of you.

In the OR doctors and nurses who had to amputate the limbs of babies through the tears in their own eyes I have seen the image of God. You put back together bodies without enough pieces to put together.

In my ICU nurses I saw God's heart everyday. I love you so much it hurts. I cannot say your name or conjure your faces without tears. You lovers, you fighters, you wonder workers, you solvers of the riddles of the body. 

To my charge nurses, you bosses, you beasts, you rock solid sisters. You led like lions with the hearts of lambs. I saw the Lion of Judah in you, the Lamb that was slain. 

To my ward nurses, nothing is beneath you. You feet washers and bum washers and all the parts washers. You emptiers of endless bedpans. You radiate the humility of the Light of the world. The One who was equal with God but came to wash our feet. To die for us.


For the keeper of sacred stats, the lighter of candles. For the master of all the moving parts. I love you two, you Sriracha sisters, you dumpster fire choir. I saw the humanity of Christ in you, the toll it took on your hearts.

In the anesthesiologists and CRNAs, you givers of sleep and wakers from slumber, I saw the Breath of Life in you.


In those that came with blow up dinosaurs and bags of toys because laughter heals and a child's playthings shouldn't be bullet casings, you are a flood of joy, I have seen Him in you.

For the Marine making balloon animals and keeping us safe (sometimes from ourselves). For the makers of big decisions who fight the war of head verses heart every single day. I see the Father in you. 

For the set up crew and construction teams. You turned an empty muddy field into a full blown trauma hospital all the while war raged around you. You imaged the Risen One.

For the maintenance men who battle nature and entropy and never sleep too deep. Who fight fires figurative and literal. Who make medical devices from spare parts and hold the whole thing together with zip-ties and duct tape and bailing wire. You look like your Creator to me.

For the Triage nurses who conducted the whole chaos like a symphony. For the trauma nurses who work magic on the hairbreadth edge of a razor. You look like your Abba. 

For staff care who tried to lighten our loads, who sat with the dying, who kept us in chocolate, and led us in communion. I have seen the High Priest in you.

For the ER docs steady, ready, wise and gentle.The pharmacists, phlebotomists, sterilizers, med supply, bio-med and lab techs your skill and ceaseless hard work was never sexy but was the science in saving lives. I saw my Savior in you all.

You are all the broken-hearted healers. You cups for Living Water in the desert. You are the pierced hands and feet. I have such a clearer picture of God because of you, I have such a deeper understanding. There is an old proverb that says, "no man ever steps in the same river twice, for it is not the same river and he is not the same man". You will never be the same, but the fire and the hand of Grace have made you like glowing gold, even when you feel like you'll never shine again. The grief will lessen, the sorrow too, but it will never leave you. That's the price of loving, it always has been, from long before time began when the Lamb was slain.

And finally for my Iraqi, and Kurdish, and Yazidi brothers and sisters. You are so brave. You have lived in the shadow of war and terrorism all your days. Tragedy has been your food and sorrow your drink. And yet you hold onto life in spite of what has been stolen from you. You have opened your hearts as wide as the horizon and embraced a ragamuffin band of westerners with so many misconceptions. You have taught us about love and humanity, honor and sacrifice. You have shared your food and your tears, your stories and laughter. We miss you, we love you. You are in our hearts forever, precious habibis.

Thursday, April 20, 2017

Happiness Is (Not) A Warm Gun


A look inside the Emergency Field hospital where patients wounded from the battle to retake Mosul and from ISIS terrorist attacks are treated by brave medical professionals from around the world.


In 6 days I head back to Iraq. Back to the emergency field hospital near Mosul where I was earlier this year. As I've processed working in a trauma hospital so close to an active war zone, having seen so much death, especially the death of children, I realize it will take a long time to unpack all I've experienced. Trauma, like grief, is a sucker punch. It blindsides you, it staggers you, it leaves the mind, the heart, the psyche reeling. It's much like this: the burning fragments of film frames temporarily illuminated by the same fire that is destroying them. Trauma, like grief, changes everything, forever. It clings to our days with a grayness, with nagging sadness, with wondering whether you'll ever be truly whole again.

It is said trauma is "not the thing that happened but the effect left on us by our experiences". Rates of alcoholism, drug abuse, and increasingly irresponsible sexual behavior spike among survivors and witnesses to trauma. The suicide rate among trauma survivors is 15X higher than the rest of the population. Isolation, anxiety, depression, loss of appetite for food and fun are all symptoms of a post traumatic experience.* It can feel like a low grade fever of unhappiness, constant and incurable. To be sure, trauma is a toxin, it tires the body, it wearies the blood.

Much of trauma counseling seeks to normalize the effects of trauma, reinforcing the idea that what survivors and witnesses of trauma feel (and do) as a result of trauma are very normal reactions to an abnormal situation. This is a permission to forgive ourselves as much as it is a building block for recovery. It's saying "You are not defective, you've just been broken by your experiences and need help putting the pieces back together". It helps us understand that fatalism born in self-defeat because of a negative response to trauma is a downward spiral. And that coping mechanisms can become a new self-perpetuating prison and actually keep the survivor from starting to heal. Self-loathing and self blame are very real responses to trauma and can be extremely high among first responders. Those that go to help in traumatic situations often feel like we couldn't do enough and wear the guilt and shame of those feelings of failure for years. 

Studies on trauma reveal relationships are the key to coping during and after a crisis. In fact the number one predictor for resiliency after a trauma is existing healthy relationships. Psychologists are also finding that the opposite of addiction is connection. The greatest factor in not becoming an addict and in ultimately beating addiction is healthy relationships. Recently the results of one of the longest, most comprehensive studies on human happiness were released. For 75 years researchers at Harvard tracked the emotional and physical well-being of the studies participants. What they found is no shock, it's been said for years, by many similar studies of smaller scope, the key to a happier and healthier life: good relationships. According to a Harvard researcher, "It's not just the number of friends you have, it's the quality of your close relationships that matters." More specifically it's the amount of vulnerability and depth within those relationships, and how safe we feel sharing with one another. In other words, the extent to which we can breathe deep and be seen for who we truly are, and truly see others the same way. We long for connection, for acceptance, for love. It's the universal human condition. We were made for community, we are programmed to not be alone. 

One of the biggest reasons I am OK is because of a wife and friends that have shared similar experiences with me. They push back against the inertia of isolation that would be my natural tendency. It doesn't mean we effortlessly talk about our darkest days but we do understand each other's silence. We know what the far away look in the eyes means. And we also share a common faith. We know that the most important part of our relationships is the community, the family that we are as believers in Jesus. 

Happiness does come from relationships, and everlasting, perfect happiness, what the bible calls joy, comes from relationship with the One that will never leave us or forsake us. In Jesus alone can we have limitless vulnerability and bottomless depth. In Him alone can we be known completely, He did in fact create us. So it follows then, perfect healing, the truest resiliency, the best inoculation against the prison of our desires can only come from knowing we are accepted with all of our faults, and that we are loved unreservedly and endlessly by the One who proved it by dying for us. And the path forward for any of us is to accept Him, on His terms, and remain in relationship with Him for all our days. 

There are gifts of clarity that can come with trauma, albeit with a heavy cost, like a magnifying glass brings such focus, such illumination, right before it burns a hole in the leaf. I fear death less, I cherish life more. We're so fragile, all of us humans. I also hate evil more, and realize that fear is its most powerful weapon. And I know that being good is more than just behavior, more than just abstaining from wrong. Good's gotta be brave, and it's gotta fight back. And that sometimes the most powerful weapon in that fight is forgiveness. And I learned, by watching people transformed by love, that loving your enemy is not just a suggestion, its a command. And it's evil's greatest fear.

Looking back, sometimes it's as if I am looking at these memories through that magnifying glass again, other times it's a microscope. One can make everything too bright, too volatile, the other too close and clinical. I have found the only way I can look back and consistently see clearly is through the lens of scripture. And though scripture doesn't always give us the answers to the questions we ask, it does however give us the answer in the person of Jesus. Knowing my Savior has experienced the full horror of hell means he understands all I am going through, means He has felt it too. And the Spirit that was in Him through the entire ordeal lives in me. The Spirit of all hope, all peace, all comfort, and all joy. The same Spirit that raised Jesus from the dead and will one day raise me to be with Him forever, to the eternal hope that all these things will pass, and that the destiny for the beloved is beautiful, and painless, and never ending bliss. 

One more thing, when I write about my time in Iraq, a wave of guilt tends to wash over me as I remember the mothers and fathers of the children who were torn apart by ISIS, as I recall the many stories of my Iraqi co-workers who have lived under the dark shadow of terrorism and war most of their lives. I would never, will never place my experiences on the same plane as theirs. These words are for the others like me, who have had similar experiences. Who have suffered trauma or seen it. For those medical professionals and relief workers who go to help. These words are to honor them. They are my heroes, mostly because they don't see themselves that way. For my EFH people. I love you. If you ever need to talk you know how to find me. We're all in this together. 

We have been broken by our experiences, He is putting us back together. xoxo




*Other symptoms of post traumatic experiences can include aggressive, erratic or self-destructive behavior, disassociation or memory blanks, numbness and the lack of ability to concentrate. Many people experience sleeplessness and irrational fears.You can read more about the symptoms here. If these symptoms persist for more than 30 days they can be PTSD. Please see a counselor.




Thursday, April 6, 2017

They Were Like Birds




Tuesday Syrian President Assad's coalition forces used a chemical agent on civilians living in the Idlib Province. Official counts of the dead now exceed 80. Including 22 members of Abdel Hameed Alyousef's family. A picture of him holding his two dead babies is all over my social media and news feeds. The world is weeping at such grotesque tragedy, weeping for Abdel, weeping for the 28 other children and 20 women who were killed in the attack. Most died foaming at the mouth, choking, suffocating from the sarin gas. These are war crimes. These are crimes against humanity. 

A year ago I was in Greece. Working in the north near the border with FYROM at the refugee camp called Idomeni. There I met hundreds of Syrians running from Assad's 4 year assault on his own people, running from ISIS, running from a war with too many factions and not enough heroes. The drawing above was given to me by Razan, an 11 year old from Damascus.

One very cold morning I got to the camp early to find protesters all along the rail tracks that used to provide unfettered train access to FYROM for trade and passengers alike. 





The presence of protesters wasn't anything new, a daily occurrence for a beleaguered population of 13,000 whose lives were stuck in limbo while politicians pulled their strings from warm boardrooms thousands of miles away. But this morning the signs were different, this morning the mood was especially somber. Protesters seemed hopeless, far away in their stares. They were looking homeward, but through a thick fog of grief. Aleppo had fallen after almost four years of fighting. By the end of 2016 the battle for Aleppo would have become one of the longest sieges in modern warfare, 31,000+ people dead and 36,000+ buildings completely destroyed. 



Picture from Business Insider

Sitting in the tents of Syrian refugees, listening to their stories, the string of tragedies that had become their story, I found myself sharing chai and tears with total strangers. I will never forget their words. The Syrian boy below was shot in the leg by a sniper. His mother suffered from PTSD, her husband had been murdered by ISIS. Wet-eyed and weary she recounted both incidents, showed me the pictures on her phone. Showed me the decapitated child that was her daughter's best friend. Her little body left in the street as a warning to submit or be killed. This trembling mother had left before her children shared their father's fate, or before they became another lifeless example, lying in the road.









Above, the photos of Rostem, a young man shot in the head as he walked home from work in Damascus. His mother Amina wept as she told me about him, how she didn't know if it was Assad or IS that had killed him. She'd fled Syria with her daughter, to get her to safety anywhere. And then she teared up again, apologizing that she had no food to offer me, and then with great pride said if you were in my country, at my home, I would feed you the biggest meal. Her husband Omar smiled for the first time, but only for a moment as he told me of Amina's brain tumor. His words were slow and anxious. He he couldn't lose her too.

Now another year has passed. There are thousands of other stories to add to these. Refugees still pour out of Syria and other war torn countries. Still make treacherous journeys with their young, the infirmed and elderly, for the hope of safety. Thousands have died, drowned in cold seas off the coast of Turkey, Greece, and Libya. Thousands more will drown. Stories like that of the chemical attack Tuesday reveal what these people are running from, what's at stake.

I'm angry, I'm heartbroken. I hear the politicking, the rhetoric. I hear the hard-hearted diatribes against refugees, read the ramblings of those that have never tasted terror. I understand the complex nature of this issue. I understand the scrutiny and vetting of refugees, of governments being safe and responsible. But what I cannot understand, what I cannot stomach are the accusations levied at these families fleeing from terror. Accusations, some of which are made by people calling themselves Christians. Accusations of people they've never met, whose stories they've never heard, whose lives they've never had to live. Accusations like:

"They should stay and fight." "The men are cowards for leaving." "This is opportunistic migration." 

Stay and fight? While their families are being picked off by snipers, mowed down by air attacks, gassed with chemicals? Stay and fight and send their families along the treacherous journey to safety? Where many women are raped, many children exploited, many never make it at all. Stay and fight for who? With who? In a war with no rules, no boundaries. Where is the hope for defeating so many enemies on so many fronts? 

Cowards? These people have lived in these conditions for years, bravely, defiantly. Where is the cowardice, the opportunism in wanting to get your family out of harm's way? Get them to a life without war. What kind of coward, what sort of opportunist braves human traffickers, frigid waters, and years mired in refugee camps for freedom? I'd say that people like that have incredible internal fortitude, anything but cowardice.

To be sure, this is not the face of cowardice. This is shock. This is a father who has lost his 9 month old twins, Aya and Ahmed, and 20 other members of his family to a chemical attack from his own government. This is what staying gets you. A mass grave with 22 members of your family.*



Are there opportunists? Yes. Are there terrorists lurking in the ranks of this great throng of the dispossessed? Sure, probably. Will we stand before God and give account for the selfishness and self-protection that kept us from helping the hurting huddled masses? You know in your heart we will. 

Let us remember carefully the words of our Savior. "For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me." (Matthew 25:25-36)

We don't have to be anti-American to be pro refugee. We don't have to work against the security of the state to obey the mandate of Scripture. We don't even have to demand our government do anything but we have to. As a Christian our personal safety is not paramount, as a disciple it's not really even an option. What is paramount is our expressing the love and mercy of God is. Our obedience to His Holy word is. Our citizenship is in heaven. Our allegiance is to Christ. Our job is to build His kingdom not our own earthly one. And this is how we begin:

Get on our knees. Let us repent of failing to weep for the children of Syria, of Iraq. Let us repent of choosing self-preservation over fighting for the sanctity of these lives. Let us ask God to show each of us what to do. How we can be a light in this darkness? How we can welcome the refugee into our homes, or go and meet their needs where they are? This is our solemn duty and sacred trust. And it's the right thing to do. These are image bearers of their Creator. Let's not live in fear of hostile takeover, or religious subversion. We have not been given a Spirit of fear but of love and power and of a sound mind. We have been given the same power that defeated hell, death and the grave. We should be the bravest, most selfless and loving people on the planet. We have the perfect example. We, of all humanity, have the precious gift of Jesus. Love like He did. Even if it costs us our lives.

  


*Another member of the family, Aya Fadl, recalled running from her house with her 20-month-old son in her arms, thinking she could find safety from the toxic gas in the street. Instead, the 25-year-old English teacher was confronted face-to-face with the horror of it: a pick-up truck piled with the bodies of the dead, including many of her own relatives and students. “Ammar, Aya, Mohammed, Ahmad, I love you my birds. Really they were like birds. Aunt Sana, Uncle Yasser, Abdul-Kareem, please hear me,” Ms Fadl said, choking back tears as she recalled how she said farewell to her relatives in the pile. (from an Independent UK article)