Throughout the summer, we McCropders have continued to ponder long-term locations: Sudan, Swaziland, Niger, Zambia, Equatorial Guinea, Liberia? Each option presents its own interesting mixture of situational intricacies.

One of the countries we have discussed is Liberia, a post-conflict nation in West Africa. The medical need is great, and the post-war situation affords opportunities to positively impact the rebuilding process. We have entertained the possibility of pursuing faculty positions at the medical school.

I, Jason, was recently presented with an opportunity to work in Liberia from September 14 to October 4 as a surgeon with Mercy Ships. I jumped at the opportunity, eager to help and excited to explore future McCropder possibilities. I also anticipate stretching my surgeon wings on what should be some interesting and challenging cases. Like a cantaloupe-sized thyroid for example.

I am looking forward to a stretching, exciting, and enlightening three weeks with Mercy Ships!


Paradigms - Part II: Henri Nouwen Book Titles

As the ideas discussed in the prior posting swirl around in my head and heart, a phrase climbs slowly out of the fog, giving itself an extra prominence: The Wounded Healer.

The Wounded Healer is a book written by Catholic priest and contemplative writer Henri Nouwen in 1972. Nouwen was a fascinating man, and the book a worthwhile read, though the title itself has more bearing on the present discussion than does the content of the book. The phrase, of course, makes me think of Jesus, and Nouwen uses it to describe us as we imitate Christ. It does not at all remind me of the medical institution’s image of its own practitioners. There, the two pervading images are, either the healer who needs to be whole himself/herself before extending help to others, or the healer whose personal condition has no bearing on his/her healing work.

How is Christ a “wounded healer”, and in what sense are supposed to imitate this? I can think of two ways. First, Christ’s wounds are substitutionary, as Isaiah wrote centuries before Christ, “The punishment that brought us peace was upon him, and by his wounds we are healed (53:5).” Because he was wounded, we no longer have to be. I can envision a few glorious human examples where one might imitate this (such as the end of A Tale of Two Cities), but overall this provides little in the way of guidance for my own medical practice.

But there is a second and more subtle way that Christ may model the “wounded healer”. The unknown writer of the letter to the Hebrews writes that part of the reason Christ is the greatest “high priest” (able to mediate perfectly between God the Father and mankind) is because he “has been tempted in every way, just as we are – yet was without sin. Let us then approach the throne of grace with confidence, so that we may receive mercy and find grace to help us in our time of need (5:15).” Did these temptations “wound” Christ? I do not know. But what is evident is that the personal story of Christ (both its ebb and flow) enables his healing of others, instead of detracting or even distracting from it. There is potential here for an appropriate guide for us to model. But how?

I do recommend Ellen's comment from the first post for more food for thought.


Paradigms - Part I: Medical Care for Friends

We were asked the other night how we felt about being the medical provider for our friends. This is hardly a theoretical question, as Rachel has agreed to provide obstetrical care for a good friend of ours. The institution of medicine does not provide a definitive stance on this, but it does provide a thought framework that lends itself to a certain position: We are uncomfortable with it, because though it may be enjoyable and rewarding as long as everything is straightforward, the possible threat to our personal relationship that is created by a possible bad outcome is a risk most are not willing to take. You are caring for a friend, and they are diagnosed with late-stage cancer. Will you ever be able to forgive yourself for not finding it sooner (even if there is nothing to forgive)? What will become of your friendship and the relationships you hold in common?

We recognize that we had better make peace with this. If my appendix ruptures in a couple years, Jason Fader will become intimate with my colon, and will have to deal with the responsibility of operating on me. If little Elise Cropsey gets malaria, it will likely be my treatment plan that will recuperate her. This is part and parcel to a desire to work in an area where there are minimal other medical providers.

The medical paradigm that creates these (and other) levels of discomfort with treating friends seems to be this: You are the patient. You are coming for help. I am the doctor. To best help, I need to be disconnected, and thus objective. I should not be bringing my personal story into yours, because this is about you, not me. And from this comes a separation between your patients and your friends, for friendship requires a give and take, an intermixing of personal stories. I think that our pastor at Knox was correct is stating this is likely an outgrowth of medicine’s modernistic bent.

And so I question this: Is it really possible to separate yourself personally from the patients you treat? If so, does this really provide objectivity? Does objectivity lead to healing? (If a person can be treated as a scientific physical specimen, then perhaps.) Is this a paradigm that will make a drop of sense in Africa? Is this consistent with Christianity?

More to come, but I would appreciate any thoughts from those who may read this.