Tuesday, 31 July 2012

Give us eyes to see.

Lord,  purge our eyes to see
Within the seed a tree,
Within the glowing egg a bird,
Within the shroud a butterfly:
Till taught by such we see 
 Beyond all creatures Thee
And hearken for Thy tender word
And hear it, "fear not;  it is I."
Christina Rossetti

Thursday, 26 July 2012

It's Olympic time!

At Grace last week we began an evening series looking at Scriptures with an olympic theme. I was given 1 Corinthians 9.24-27.
24 Do you not know that in a race all the runners run, but only one gets the prize? Run in such a way as to get the prize. 25 Everyone who competes in the games goes into strict training. They do it to get a crown that will not last, but we do it to get a crown that will last forever. 26 Therefore I do not run like someone running aimlessly; I do not fight like a boxer beating the air.27 No, I strike a blow to my body and make it my slave so that after I have preached to others, I myself will not be disqualified for the prize.

The Olympic torch passing though Bedford last week.
I was reluctant to merely give a talk on the importance of discipline in the Christian life least it should lead to a misunderstanding. So many people still think that becoming and being a Christian is all about trying to be good and engaging in religious activities. Now neither of those things are wrong but they are not the essence.

The Christian gospel is a message of grace which we receive by faith. That is to say that God has provided a way to repair the broken relationship between us and Him, through the willing sacrifice of His son, the Lord Jesus. It is through faith in what He has done that the Christian believer now finds motivation to live life for God's glory. That isn't to say that at times the Christian life is simply about doing the right thing in the right situation irrespective of how we feel, but mostly it is about living a life of gratitude.

So I tried to be careful in how I spoke from this passage. I concluded with three practical ways to train ourselves in how to life a life for God's glory.

1. We should immerse ourselves in Scripture. The Bible is a rich source of teaching, guidance, comfort and so much more. To expand our view of the grandeur and beauty of God and to wet our appetites for the 'things that God has prepared for those who love Him', the Bible is in dispensable.

2. We should make the most of worship opportunities. Although all of life is worship, I particularly wanted to focus upon the benefit that comes from engaging in the songs we sing in our meetings together. A really good song will teach, it will help us express longings (what one of the old hymn books used to call 'songs of aspiration'), and it will re-implant gospel truths in our hearts. As St Augustine said, 'to sing is to pray twice'. Thus as we reflect upon the words and enjoy the melody we both engage our hearts (or rather emotions),  and minds and in that sense grow in grace.

3. We should develop a 'whole-life' view of Christian living. How much I have been helped by Michael Green and LICC is seeing all of life as an opportunity to live for God's glory.Whether providing the 'cup of cold water to the least of these', or explaining the gospel to someone. I mentioned that I have begun to ask shop assistants what sort of a day they are having. It's very simple, but it keeps me other centred and can be surpassingly up-lifting to someone not expecting it!

Take a listen if you have half and hour.

Tuesday, 24 July 2012

Tim Keller on how to maximise our enjoyment of God

Some great practical stuff from Tim Keller as he chats with John Piper about the patterns of life he adopts as he seeks to stay close to God. Not to be slavishly copied, but excellent advice nonetheless. Start watching from 11.35 secs.

1. Read through the Psalms every month-using their immense variety of forms of prayer.
2. Figure out a personal 'rule' of life
3. Use Matthew Henry's Pray the Bible edited by Ligon Duncan. Available online here or buy the book. Tim say he uses it and takes about two months to get through it, covering every type of prayer.
4. The use of Thomas Cranmer's collects. The best version can be obtained here.
5. Don Carson's two volume For the love of God
6. Have a rhythm of spiritual life with a variety of prayer and reading.

He concludes, 'there's no doubt that the best defence is offence and the best defence against temptation is to keep your affections for God up. So I don't want anything to come in-between me and God. Ten minute quiet times three times per week just won't do it'.

All truth is God's truth

Some great stuff in Cornelius Plantinga's book, Engaging God's World.

'The Holy Spirit authors all truth, as Calvin wrote. We should therefore embrace it no matter where it shows up. Well instructed Christians try not to offend the Holy Spirit by  scorning truth in non-Christiam authors over whom the Spirit has been brooding'

Tuesday, 17 July 2012

'The one who sings prays twice'

There is very little communal singing in contemporary life other than in churches, at football grounds and at the Labour party conference. I suspect very few indeed still gather around the piano for a good old singsong,  neither at the 'The Old Bull and Bush',  nor in the home.

But I'm a big fan of singing together. Indeed I think I would go so far as to say that I think just about every gathering of Christian believers should find space for at least one communal song.

Singing together in some ways breaks down barriers between us. However poor our individual voice may be (and if poor we should probably keep the volume down a bit!),  joining with others encourages a sense of community, especially when there is a shared conviction about the truthfulness of the words sung.

There's a very helpful piece by David Koysis,  Church Practices and Public Life: Recovering the Practice of Communal Singing  in which he concludes,
A dozen years ago Robert Putnam published Bowling Alone, in which he argued that Americans are gradually losing the social capital that facilitates co-operation in a variety of venues. The decline of occasions for singing together is perhaps a symptom, and possibly even a contributing cause, of this loss. Could it be that we will reinvigorate our social and political culture by turning off our private mp3 players, pulling out the earphones, and joining our voices together in song? It might just be worth a try.
And for Christians there's great benefit too to be had from singing about the truths which we believe. It was a shrewd observation of St Augustine to say 'The one who sings prays twice'.  I think what he is getting at that as we sing words of great significance and truth, which are offered to God,  it as though we are praying twice over-with our emotions and with our intellect. There is nothing quite like music to touch us, body and soul. Tim Keller in a sermon on 'Singing' points out that the command(!) to sing is one of the most repeated in the Bible.

Just last Sunday evening we learned a new song at Grace, Behold our God.

Who has held the oceans in His hands ? Who has numbered every grain of sand?
Kings and nations tremble at His voice All creation rises to rejoice
Behold our God seated on His throne 
Come let us adore Him
Behold our King nothing can compare
 Come let us adore Him!
Who has given counsel to the Lord? Who can question any of His Words?
Who can teach the One who knows all things? Who can fathom all His wondrous deeds?

Behold our God...
Who has felt the nails upon His hands?  Bearing all the guilt of sinful man
God eternal humbled to the grave Jesus, Saviour risen now to reign!
Behold our God..

Sunday, 15 July 2012

Christians against poverty

A really good morning service at my church this morning. We were celebrating the work of Christians against poverty, a national charity based in Bradford founded by John Kirkby. Heather Solesbury from Grace leads a team of volunteers. It was great to hear her interview Steve and Gayle Gale.

Despite working in general practice for many years I don't think it'd ever struck me quite so forceifully just how much distress financial debt causes. From relationship breakdown, to depression or contemplation of suicide. The cost is so very great.

What wonderful stories of hope we heard. Check out John Kirkby and this video.

And what great hope we have through Jesus Christ. The apostle Luke records some words of Jesus during the early part if his ministry.
“The Spirit of the Lord is on me.
    He has chosen me to tell good news to the poor.
He sent me to tell prisoners that they are free
    and to tell the blind that they can see again.
He sent me to free those who have been treated badly and to announce that the time has come for the Lord to show his kindness."

Thursday, 12 July 2012

Ticked off.

I've removed two ticks in the last couple of weeks. It's all part of the rich tapestry that GP provides. Having a conversation with a man whose bowel cancer is getting the better of him one moment, and just minutes later trying to rationalise the polypharmacy of a reluctantly ageing 92 year old, and then the 5 year old whose mother noticed a tick at the nape of her neck when brushing her hair for school this morning.

My patient's neck
The blood sucker proved very resistant to loose it's grip. However my wife (a practice nurse at the surgery) had a particularly effective pair of tweezers with an integral torch available and the beasty had to admit defeat. Here he (?she) is before the extraction.

Having removed it, I placed the tick on a white piece of paper for the little lass to see, and the tick promptly ran off! Only however to be flattened and consigned to the bin.

The big concern with ticks is the possibility of Lyme disease as a result of the transmission of the bacteria from an infected tick. According to the Health Protection Agency there were 972 cases of Lyme Borreliosis in England and Wales last year. It's an interesting infection which has three stages.

Erythema migrans-from wikipedia-
not my patient.
In stage one there is localised infection at the site of the bite. With an incubation period of from 3-32 days, a spreading red rash called erythema migrans gradually develops. Stage two follows with  variety of neurological and more vague symptoms of myalgia and fatigue. Stage three represents a persistent stage with joint symptoms predominating (in 60% of untreated cases in the US), and less commonly neurological problems.

Fortunately it is relatively easily treated with antibiotics if the treatment begins early enough. Although one textbook states,
If an attached engorged nymph is found a single 200mg dose of Doxycyline effectively prevents the disease. This measure is not routinely recommended.

I found this a little confusing. Since a very simple measure could effectively prevent an illness that can be very debilitating, why not 'routinely' give it?  So I contacted the HPA to ask the likelihood of the Lyme bacteria in being present in the ticks in the north Bucks area where I practice. I wasn't particularly helped by the reply I received.

'Lyme is found all over the UK and cannot be excluded on the basis of geography.  There are a few hot spots where it is particularly common such as Exmoor and the New Forest; as far as we are aware Bucks is not one of these.

However, there are reports of Lyme from every UK region'

So I've just decided to wait. If a spreading rash appears in the next month or so, I'll jump straight in with the antibiotics.

A typical conundrum for a GP in the midst of a busy day.

Sunday, 8 July 2012

The knife man

Just enjoyed an excellent biography of John Hunter (1728-1793). A Lanarkshire man from humble beginnings, who in many ways was the father of modern surgery. He was a remarkable man with a phenomenal capacity for hard work and application to his pursuit of knowledge-particularly with reference to the anatomy and physiology of the human body.

 However his interests reached beyond human biology and spanned a vast range of subjects, including the anatomy of giraffes, fish and silkworms as well as the study of fossils. Working in the mid-18th century, it's hard to imagine what it must have been like performing post-mortems ( a practice very much pioneered by Hunter) in the summer, with no refrigeration, and even on the bodies of former friends and colleagues!

As a doctor it's humbling to realise just how dedicated and courageous-if not reckless (Hunter inoculated himself with gonorrhoea so that he could trace it's effects on his own body!!), our forebears were in their pursuit of knowledge. Hunter meticulously dissected and studied anatomy, which subsequently informed his surgery. He was not one simply to accept previous ways of doing things (or not doing things, as is the case in the fascinating opening chapter in which Hunter's operation upon a popliteal aneurysm proved successful and was based upon his applied anatomical knowledge).

However he was not foolhardy and knew when not to operate,
Hunter's profound awe at the beauty of  human anatomy, coupled with his deep respect for the healing powers of nature, had of course taught him chiefly that surgery should only ever be considered as a last resort. 'Operations should never be introduced but in cases of absolute necessity', he explained in a contemporary magazine.
I'm not a surgeon, but how valuable the advice to know when not to intervene, especially when so many of our patients suffer consequences more from their treatment than the disease one is trying to treat or prevent.

The chapter headings themselves are fascinating, from  The Chimney Sweep's teeth, to The Chaplain's neck and The Professors testicle, there is so much of interest.

It really does help our practice of medicine to have a historical perspective. Most of us as doctors recall teachers who inculcated in us attitudes and practises which we have developed and modified throughout our own careers.  And sometimes deciding that a way of doctoring which we have observed is not what we wish for emulate is as helpful as a more positive example. By broadening the influences upon us throughout our career, it enables a more rounded doctor to surface as the years go by. Even though I'm not a surgeon I found so much here to challenge and inspire. A lengthy book and at times the detail was a little forbidding, but I persevered and I don't think you'd regret the time invested in reading it.

Enjoying creation

When I started  blogging a couple of years ago I said that it would be about 'enjoying creation' and I realise that most of my posts have been about practicing medicine or living as  a Christian. So I'm glad to remind myself of the joy of being part of  God's creation.

 Last  week Biddy and I  enjoyed a week in Slovenia for the first time. Our friends Dave and Sue Greaves went last year and asked us to join them this year. It's a beautiful small country.  This was the view from out chalet.

And this is looking down the valley where we were staying.
It's said that 54% of Slovenia is covered in forest and how green and beautiful it all looked. A somewhat humble and scarecly noted country-very well worth a visit.

A message from the other side

No, not that side! But thank God got through surgery ok yesterday. And thanks to all for love support and prayer.