a good number of you have heard my song "1967 rebel" over the years, and if you haven't now is your chance. This is a live version from the house show that Nick Flora did back in November. For those who are wondering, it is safe for little ears (which it wasn't about to be, but then I realized halfway through the song that there people there that didn't know and didn't want to accidentally hurt the feelings of.
1967 Rebel
Sunday, January 22, 2012
Wednesday, November 16, 2011
my brief opinion on how to be a good intern, for anyone wondering
1. Just write the damn note. The time spent trying to get out of doing it probably isn't worth it.
2. Do unto others, especially your fellow doctors-- but this also extends to nurses, techs, other hospital staff, and even patients.
3. Pay attention-- it's easy to get overwhelmed by the number of details you'll hear that are unnecessary, but often there are gems for listening closely.
4. Listen, then speak.
5. Tell a story-- don't just regurgitate information.
6. Help the nurses and support staff-- this is kind of like #2, but more specific. There's no law that says that you can't change a bedpan or help a patient out of bed.
7. Ask why if you don't understand. I'm really bad at this one.
8. Ask for help if you need it.
9. Stand up for your patients. Sometimes you might be the only one to do it.
10. Listen to people who are standing up for your patients. Sometimes you might be tempted to ignore complaints or concerns. You may be right in doing so, but it never hurts to double-check.
2. Do unto others, especially your fellow doctors-- but this also extends to nurses, techs, other hospital staff, and even patients.
3. Pay attention-- it's easy to get overwhelmed by the number of details you'll hear that are unnecessary, but often there are gems for listening closely.
4. Listen, then speak.
5. Tell a story-- don't just regurgitate information.
6. Help the nurses and support staff-- this is kind of like #2, but more specific. There's no law that says that you can't change a bedpan or help a patient out of bed.
7. Ask why if you don't understand. I'm really bad at this one.
8. Ask for help if you need it.
9. Stand up for your patients. Sometimes you might be the only one to do it.
10. Listen to people who are standing up for your patients. Sometimes you might be tempted to ignore complaints or concerns. You may be right in doing so, but it never hurts to double-check.
Saturday, October 15, 2011
follow-up: what is an autoimmune neutropenia, anyway?
I realize that for folks who read my previous post about my low white blood cell count, there is still perhaps some mystery about what's going on (especially if you're not friends on facebook or twitter or whatever.) Or if the whole subject is just still confusing for you and you're too polite to ask me directly, here's what's going on!
I have a specific deficiency of one particular variety of white blood cells called neutrophils. My bone marrow biopsy did turn out to be negative, which of course was a huge relief. However, that simply ruled out any problems in the bone marrow, that is, it is clear that the deficiency was not a problem with producing new neutrophils as much as it was a problem with neutrophils dying or being destroyed. The first possibility is almost certainly ruled out by normal neutrophil counts before, the latter is the diagnosis that we've rested on.
What would destroy these poor, innocent neutrophils? Well, without going into the fascinating world of immunology too deeply, I will briefly say that sometimes other parts of the human immune system get confused and think that your own cells are invaders. This is called "autoimmune disease" and it's the phenomenon responsible for lupus, multiple sclerosis, rheumatoid arthritis, immune thrombocytopenic purpura (what I had last year), and, apparently, what's going on now. My Absolute Neutrophil Count (which they figure out by counting how many neutrophils they can see on a sample of my blood) has been in the "severely low" range for a while. Any particular reason for why this happened is pretty much unknown; sometimes this can happen after a viral infection when a pumped-up immune system confuses something in your body with the virus.
My counts have been up and down the last few weeks, and because technically that means I'm more at risk for infection, I haven't been allowed to see patients. We've tried a few things to treat it; nothing has really worked. Fortunately, though, things are coming back a little, so I'm allowed to see patients again!
Thanks to all who have been praying for me through this or have sent me notes of encouragement. I'm really thankful for y'all and I am so glad that I didn't actually get sick while I was at this "severely low" neutrophil count. Hopefully that updates you appropriately?
I have a specific deficiency of one particular variety of white blood cells called neutrophils. My bone marrow biopsy did turn out to be negative, which of course was a huge relief. However, that simply ruled out any problems in the bone marrow, that is, it is clear that the deficiency was not a problem with producing new neutrophils as much as it was a problem with neutrophils dying or being destroyed. The first possibility is almost certainly ruled out by normal neutrophil counts before, the latter is the diagnosis that we've rested on.
What would destroy these poor, innocent neutrophils? Well, without going into the fascinating world of immunology too deeply, I will briefly say that sometimes other parts of the human immune system get confused and think that your own cells are invaders. This is called "autoimmune disease" and it's the phenomenon responsible for lupus, multiple sclerosis, rheumatoid arthritis, immune thrombocytopenic purpura (what I had last year), and, apparently, what's going on now. My Absolute Neutrophil Count (which they figure out by counting how many neutrophils they can see on a sample of my blood) has been in the "severely low" range for a while. Any particular reason for why this happened is pretty much unknown; sometimes this can happen after a viral infection when a pumped-up immune system confuses something in your body with the virus.
My counts have been up and down the last few weeks, and because technically that means I'm more at risk for infection, I haven't been allowed to see patients. We've tried a few things to treat it; nothing has really worked. Fortunately, though, things are coming back a little, so I'm allowed to see patients again!
Thanks to all who have been praying for me through this or have sent me notes of encouragement. I'm really thankful for y'all and I am so glad that I didn't actually get sick while I was at this "severely low" neutrophil count. Hopefully that updates you appropriately?
Tuesday, September 13, 2011
in response to "john brown's body"
Graham Andrews is a gentleman and a scholar, and I was gonna write a long facebook comment but just decided to make it a blog post of my own in response to his rather thoughtful post, "John Brown's Body."
So, here's my thoughts: violent revolutions and wars to correct injustice have been happening since as long as we could figure out that if Urg stole our goat, we could take a rock to his head (unsurprisingly, we all learn this behavior without much guidance around age 2.) They are usually unsuccessful in achieving their desired aim. I know you're obsessed with the glory of violent revolution to the point that you have to change your pants when you spend too time thinking about it, but I don't think that violent revolution has an awful lot of show for itself. Most violent revolutions create societies that are not particularly more just than their predecessors (America 1776, France 1793, Cuba 1959, Iran 1979, etc.)
Even the Civil War, which, as you noted at the beginning, was in some senses just retribution for the horrors of slavery and crucial turning point in achieving justice, was still not particularly effective in actually changing the economic or social situation for a lot of African-Americans. That took the Civil Rights Movement, which was a militant, fire-breathing, Bible-thumping group of preachers & political agitators who wouldn't take no shit from nobody. And they also wouldn't fight back. I'm sure there's some pithy quote from Martin Luther King Jr. about nonviolence and justice that's appropriate to squeeze in here, but I think it's fair to say that the most lasting change for justice tends to come from the long, slow, hard work of sacrificing yourself and the needs of your community for the needs of another whilst defiantly and militantly defaming the lies of the overlords who try to keep you in line.
In a world where every ideologue is waving guns and money and power around trying to prove that their dick is bigger, laying all of those things down for the good of others (in a way that actually disadvantages yourself) is the only truly radical thing left to do. It may be loving, every now and then, to kill someone else in order to save a few people (John Brown is a particularly controversial example.) What is definitely loving, though, is spending your whole life dying for other people. It takes a lot of people doing this to change a society, but it has happened. I see it in Sandtown every day, and I think that sort of ethic has done far more for folks in my neighborhood than years of people doing good from a distance. John M Perkins is another great example, as is this dude, who is pretty hilarious to listen to even if you totally disagree with him.
There's obviously a lot of human failure and selfishness that stands in the way of this. You and I both know the dismal record that people have with helping others or sacrificing anything for anyone else. That's why Jesus is important-- He suffered the greatest injustice so that those of us who act unjustly could be called just, and those of us who suffer injustice can be restored and reconciled. As Tim Keller says, "So the gospel has got enormous social justice ramifications. It’s there, in Luke 1: 'He has brought down rulers from their thrones, but has lifted up the humble.'" And that sort of change-- not forced by some revolutionary gun, but by a tremendous, deep inner transformation-- lasts and endures, even to death. You mentioned in your post about how John Brown loved black people enough to kill some slaveowners. But "greater love hath no man than this, that he lay down his life for his friends." The greatest revolution in history took place when a peasant king got lynched-- and then lived to tell about it.
If you're ever curious to see this in action, I'd invite you to come visit New Song, where people are doing the slow, humble, militant work of loving people every day. Come on the first Sunday of the month so even if it's a total drag and you can't even write an incisive blog post about it later, you can at least get some good fried chicken and curry.
So, here's my thoughts: violent revolutions and wars to correct injustice have been happening since as long as we could figure out that if Urg stole our goat, we could take a rock to his head (unsurprisingly, we all learn this behavior without much guidance around age 2.) They are usually unsuccessful in achieving their desired aim. I know you're obsessed with the glory of violent revolution to the point that you have to change your pants when you spend too time thinking about it, but I don't think that violent revolution has an awful lot of show for itself. Most violent revolutions create societies that are not particularly more just than their predecessors (America 1776, France 1793, Cuba 1959, Iran 1979, etc.)
Even the Civil War, which, as you noted at the beginning, was in some senses just retribution for the horrors of slavery and crucial turning point in achieving justice, was still not particularly effective in actually changing the economic or social situation for a lot of African-Americans. That took the Civil Rights Movement, which was a militant, fire-breathing, Bible-thumping group of preachers & political agitators who wouldn't take no shit from nobody. And they also wouldn't fight back. I'm sure there's some pithy quote from Martin Luther King Jr. about nonviolence and justice that's appropriate to squeeze in here, but I think it's fair to say that the most lasting change for justice tends to come from the long, slow, hard work of sacrificing yourself and the needs of your community for the needs of another whilst defiantly and militantly defaming the lies of the overlords who try to keep you in line.
In a world where every ideologue is waving guns and money and power around trying to prove that their dick is bigger, laying all of those things down for the good of others (in a way that actually disadvantages yourself) is the only truly radical thing left to do. It may be loving, every now and then, to kill someone else in order to save a few people (John Brown is a particularly controversial example.) What is definitely loving, though, is spending your whole life dying for other people. It takes a lot of people doing this to change a society, but it has happened. I see it in Sandtown every day, and I think that sort of ethic has done far more for folks in my neighborhood than years of people doing good from a distance. John M Perkins is another great example, as is this dude, who is pretty hilarious to listen to even if you totally disagree with him.
There's obviously a lot of human failure and selfishness that stands in the way of this. You and I both know the dismal record that people have with helping others or sacrificing anything for anyone else. That's why Jesus is important-- He suffered the greatest injustice so that those of us who act unjustly could be called just, and those of us who suffer injustice can be restored and reconciled. As Tim Keller says, "So the gospel has got enormous social justice ramifications. It’s there, in Luke 1: 'He has brought down rulers from their thrones, but has lifted up the humble.'" And that sort of change-- not forced by some revolutionary gun, but by a tremendous, deep inner transformation-- lasts and endures, even to death. You mentioned in your post about how John Brown loved black people enough to kill some slaveowners. But "greater love hath no man than this, that he lay down his life for his friends." The greatest revolution in history took place when a peasant king got lynched-- and then lived to tell about it.
If you're ever curious to see this in action, I'd invite you to come visit New Song, where people are doing the slow, humble, militant work of loving people every day. Come on the first Sunday of the month so even if it's a total drag and you can't even write an incisive blog post about it later, you can at least get some good fried chicken and curry.
Friday, August 26, 2011
the hurricane and the healer
"Leukemia."
It is not one of those words that you ever want to hear from your doctor, even if it is only a possibility among several others that he lists off. By the time that he says it, though, you usually know something is up. Otherwise, you probably wouldn't have come to see your doctor. It may have been the night sweats, the weight loss, a weird pain that was diagnosed and treated elsewhere. For me, it was an abnormal lab test, done on a routine follow-up for another little hematologic problem (which has been stable for months now.) I spent a couple of days wondering if that could be one of the causes before the word was spoken.
Most of us, I think, have given at least a moment's thought to what our lives would be like if we had some horrific disease (or maybe it's just a doctor thing.) It's different when there's a needle scratching the insides of your bone. It's different when your white blood cell count is so low that the smallest infection could cause some real harm.
It could be something totally harmless, or it could be something very harmful. It is only a small comfort right now that I don't know what's wrong with me and that numerous tests are pending. I'm thankful that God has blessed me with all the resources I need to have experts analyzing my bone marrow. It's a big comfort that I only have very minor symptoms that I wouldn't have been worried about otherwise. It's a big comfort that I have a doctor who is thoughtful and compassionate and was very careful to say the word "leukemia" when I was ready for it, after he had listed off a few other common causes of my lab values that were entirely benign.
The uncertainty, though, is no fun.
It's almost like a hurricane. You know it's coming. It's all over the newscasts, the information I've been taught to trust. It's all over my lab tests, the ones I order everyday. I don't know if the hurricane will divert and pass back over the ocean, or if it'll come right for me. I don't know if it'll hit others worse than me. I know that it has. I have my nice, cozy house and the nice, cozy life I live inside of it, but that could always be torn apart with me inside. Or the storm could come and I'll rebuild. I don't know.
It goes to show a lot. Having the best health insurance in Maryland, a healthy diet, graduate education, and a great paycheck didn't protect me from the slings and arrows of outrageous fortune, and they sure as hell can't protect you.
I don't mean to be too dramatic. But I do have a very bad diagnosis floating over my head, waiting to either disappear or fall like a foot of rain. I face the very real possibility of losing everything that I enjoy in this life, from the wife I am just starting to learn how to love to the work that I enjoy so much to the dreams for my future career that I've nurtured for years to the friends who are just so much fun to be around to the goatee I've worked so hard to enjoy (chemotherapy alone will steal that last one!) This isn't a certainty even if I do have leukemia, but it is certainly a thought that frequently crosses my mind as I wait for the pathologist to analyze my cells.
I think the temptation to furious despair is certainly a logical conclusion. We can stay there and wrestle for a while. I sure have today, and I'm sure I'll keep going back there, especially if the diagnosis is as bad as I'm afraid it might be.
There's something worse going on, though. I have always had a war in my blood, a malignancy down in my very marrow that you don't need a needle to scrape out or a lab test to ascertain. It's a mutant perversion of what I was meant to be. I won't go into the details, but I have done some very bad things and struggle with very bad thoughts on a pretty regular basis. If you think this is just verbal exaggeration to make a theological point, go ahead and e-mail me and I can tell you what I won't share on my blog. It's the moral equivalent of leukemia.
But there is a Great Physician, and to ignore His presence is foolhardy and disappointing. Beyond all the good things in this life is a better life in Him, and it was the shedding of His perfect, untainted blood that enables me to live. Even if I lose everything, I have an eternal joy and an everlasting satisfaction in Him. This is real and it cannot be taken away from me by any hurricane inside or outside. And even though the shadow of death hangs over my next few days, I am confident that even death itself will be destroyed, and that beyond death communion with Jesus in a new body borne out of the seed of this clumsy, gangly, aplasia-prone body will be sweeter than any earthly joy, even as my earthly joys have pointed me to the heavenly ones.
I hope you have this confidence, too, and if you don't I have a lot more time on my hands now that I'm not really allowed to see any sick patients. Let's chat.
Your prayers and love are appreciated in this time. We will be having the usual New Song prayer time on Sunday evening at 8pm at our house, which will also double as a prayer time for me. I will let everyone know what's going on via facebook/twitter (follow me here if you wish)
It is not one of those words that you ever want to hear from your doctor, even if it is only a possibility among several others that he lists off. By the time that he says it, though, you usually know something is up. Otherwise, you probably wouldn't have come to see your doctor. It may have been the night sweats, the weight loss, a weird pain that was diagnosed and treated elsewhere. For me, it was an abnormal lab test, done on a routine follow-up for another little hematologic problem (which has been stable for months now.) I spent a couple of days wondering if that could be one of the causes before the word was spoken.
Most of us, I think, have given at least a moment's thought to what our lives would be like if we had some horrific disease (or maybe it's just a doctor thing.) It's different when there's a needle scratching the insides of your bone. It's different when your white blood cell count is so low that the smallest infection could cause some real harm.
It could be something totally harmless, or it could be something very harmful. It is only a small comfort right now that I don't know what's wrong with me and that numerous tests are pending. I'm thankful that God has blessed me with all the resources I need to have experts analyzing my bone marrow. It's a big comfort that I only have very minor symptoms that I wouldn't have been worried about otherwise. It's a big comfort that I have a doctor who is thoughtful and compassionate and was very careful to say the word "leukemia" when I was ready for it, after he had listed off a few other common causes of my lab values that were entirely benign.
The uncertainty, though, is no fun.
It's almost like a hurricane. You know it's coming. It's all over the newscasts, the information I've been taught to trust. It's all over my lab tests, the ones I order everyday. I don't know if the hurricane will divert and pass back over the ocean, or if it'll come right for me. I don't know if it'll hit others worse than me. I know that it has. I have my nice, cozy house and the nice, cozy life I live inside of it, but that could always be torn apart with me inside. Or the storm could come and I'll rebuild. I don't know.
It goes to show a lot. Having the best health insurance in Maryland, a healthy diet, graduate education, and a great paycheck didn't protect me from the slings and arrows of outrageous fortune, and they sure as hell can't protect you.
I don't mean to be too dramatic. But I do have a very bad diagnosis floating over my head, waiting to either disappear or fall like a foot of rain. I face the very real possibility of losing everything that I enjoy in this life, from the wife I am just starting to learn how to love to the work that I enjoy so much to the dreams for my future career that I've nurtured for years to the friends who are just so much fun to be around to the goatee I've worked so hard to enjoy (chemotherapy alone will steal that last one!) This isn't a certainty even if I do have leukemia, but it is certainly a thought that frequently crosses my mind as I wait for the pathologist to analyze my cells.
I think the temptation to furious despair is certainly a logical conclusion. We can stay there and wrestle for a while. I sure have today, and I'm sure I'll keep going back there, especially if the diagnosis is as bad as I'm afraid it might be.
There's something worse going on, though. I have always had a war in my blood, a malignancy down in my very marrow that you don't need a needle to scrape out or a lab test to ascertain. It's a mutant perversion of what I was meant to be. I won't go into the details, but I have done some very bad things and struggle with very bad thoughts on a pretty regular basis. If you think this is just verbal exaggeration to make a theological point, go ahead and e-mail me and I can tell you what I won't share on my blog. It's the moral equivalent of leukemia.
But there is a Great Physician, and to ignore His presence is foolhardy and disappointing. Beyond all the good things in this life is a better life in Him, and it was the shedding of His perfect, untainted blood that enables me to live. Even if I lose everything, I have an eternal joy and an everlasting satisfaction in Him. This is real and it cannot be taken away from me by any hurricane inside or outside. And even though the shadow of death hangs over my next few days, I am confident that even death itself will be destroyed, and that beyond death communion with Jesus in a new body borne out of the seed of this clumsy, gangly, aplasia-prone body will be sweeter than any earthly joy, even as my earthly joys have pointed me to the heavenly ones.
I hope you have this confidence, too, and if you don't I have a lot more time on my hands now that I'm not really allowed to see any sick patients. Let's chat.
Your prayers and love are appreciated in this time. We will be having the usual New Song prayer time on Sunday evening at 8pm at our house, which will also double as a prayer time for me. I will let everyone know what's going on via facebook/twitter (follow me here if you wish)
Thursday, August 11, 2011
important dates in the near future
so I figured I should make a list of all the cool stuff that's happening in the near future so you can keep track for yourself. Also, your chances of seeing me otherwise are low, so take advantage of these opportunities!
Sunday, August 14th @4PM-- Music Day
We are having people over at 4pm tomorrow to play music, eat some good food, and in general have a good time. Bring an instrument, a dish to share, and a friend!
Thursday, August 18th @6PM-- Jenny and Tyler House show
I really like Jenny and Tyler. They're funny, they're sincere, and they're damn good musicians. They will be playing in our living room, which is always an awesome experience. If you've never come to a house show at the Loftus house, now is your chance. We will be cooking out starting at 6, then music starts at 7pm with a few songs from me. After that, prepare yourself for the thoughtful, beautiful, and fun music of Jenny & Tyler! The show is $10, which includes free dinner!
Sunday, August 21st @8PM-- Leagues show
If I could be a full-time musician, I think I'd most want to be like Thad Cockrell. One of his stated goals is to "put the hurt back in country," and his debut album "To Be Loved" did that pretty perfectly. He has a new band, Leagues, and I am very excited about going down to Virginia to see them play. It's only $12, and it will be awesome.
Saturday, September 3rd @7PM-- Dinner at the Loftus Family House
A lot of you haven't met my whole family yet, nor have you experienced dinner at the Loftus house. It is not to be missed, and so there's an open invitation to eat at my parents' house on Friday, September 3rd. Show up when you can, RSVP as you can, and just be prepared to be someone's new best friend. E-mail/call me for details.
September 16-18-- Spaceship Building Weekend
This is not relevant to most of you, but I will be part of the Leonard the Lonely Astronaut spaceship building weekend in Nashville, TN. If you live in Nashville (or nearby!), this would be a great opportunity for us to see each other, especially since I don't get down south as nearly as often as I'd like.
November 10-12-- Global Missions Health Conference
The Global Health Missions Conference is my favorite conference I've been to, and I'm always really glad when I get the chance to go. If you are in some kind of medical field or interested in ministry & health-- which I think covers a lot of people who read my blog-- you should think about coming. It's not too expensive if you're a student and you can get housed for free!
well, that's about all. There may also be another end-of-summer cookout coming up, and we haven't confirmed it yet but you should probably not schedule anything important for Saturday, November 5th because someone awesome might be playing a house show then.
Sunday, August 14th @4PM-- Music Day
We are having people over at 4pm tomorrow to play music, eat some good food, and in general have a good time. Bring an instrument, a dish to share, and a friend!
Thursday, August 18th @6PM-- Jenny and Tyler House show
I really like Jenny and Tyler. They're funny, they're sincere, and they're damn good musicians. They will be playing in our living room, which is always an awesome experience. If you've never come to a house show at the Loftus house, now is your chance. We will be cooking out starting at 6, then music starts at 7pm with a few songs from me. After that, prepare yourself for the thoughtful, beautiful, and fun music of Jenny & Tyler! The show is $10, which includes free dinner!
Sunday, August 21st @8PM-- Leagues show
If I could be a full-time musician, I think I'd most want to be like Thad Cockrell. One of his stated goals is to "put the hurt back in country," and his debut album "To Be Loved" did that pretty perfectly. He has a new band, Leagues, and I am very excited about going down to Virginia to see them play. It's only $12, and it will be awesome.
Saturday, September 3rd @7PM-- Dinner at the Loftus Family House
A lot of you haven't met my whole family yet, nor have you experienced dinner at the Loftus house. It is not to be missed, and so there's an open invitation to eat at my parents' house on Friday, September 3rd. Show up when you can, RSVP as you can, and just be prepared to be someone's new best friend. E-mail/call me for details.
September 16-18-- Spaceship Building Weekend
This is not relevant to most of you, but I will be part of the Leonard the Lonely Astronaut spaceship building weekend in Nashville, TN. If you live in Nashville (or nearby!), this would be a great opportunity for us to see each other, especially since I don't get down south as nearly as often as I'd like.
November 10-12-- Global Missions Health Conference
The Global Health Missions Conference is my favorite conference I've been to, and I'm always really glad when I get the chance to go. If you are in some kind of medical field or interested in ministry & health-- which I think covers a lot of people who read my blog-- you should think about coming. It's not too expensive if you're a student and you can get housed for free!
well, that's about all. There may also be another end-of-summer cookout coming up, and we haven't confirmed it yet but you should probably not schedule anything important for Saturday, November 5th because someone awesome might be playing a house show then.
Sunday, July 10, 2011
song post #7-- "tasted twice"
there is a pretty funny story I like to tell about God's sense of humor. this is a song about that story.
tasted twice
Thanks to some of my fellow Presstman Preachers-- on this track, Tim Milligan plays bass, Evan Tice has the keys, & Mike Uhl steps out into new territory on drums!
tasted twice
Thanks to some of my fellow Presstman Preachers-- on this track, Tim Milligan plays bass, Evan Tice has the keys, & Mike Uhl steps out into new territory on drums!
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