Dear Mr. Fingerly (my middle school math teacher),
Thank you for all that you did to help me learn the deep joy that can be found in doing math. I vividly recall the fun we had plotting catapult trajectories and testing the load bearing limits of our tooth-prick bridges. But moreover, I remember the class where you gave us just enough guidance before pushing us to discover the FOIL principle for solving binomials independently. I remember the moment it clicked, and how I understood without being shown, what needed to be done. I believe that single success and the joy that I found in that grappling and intuition, started the process of turning me into the geek-doctor that I am today – thank you.
I also want to let you know that about once every month or so I use the fraction cross-multiplication and unit cancellation that you taught us in 7th grade (You had us use very silly made-up measurement systems) to save someone’s life.
This morning for instance, I had a critical potasium on a septic baby right as I had begun working on making breakast for my girls. I promptly abandoned the omlet I was making to its fate (but Bethany saved it and got it to Ruthy’s plate), grabbed a #2 pencil and a blank sheet of paper and then started recording my data points to begin setting up my fractions. A 8.3 kg baby needs IV potasium. The dosing is 1mEqu/kg/hr. The potasium comes in 20mEqu/10ml. How much normal saline should the potassium be diluted into and at what rate should the pump be set…
Multiply denominators and then numerators,
check that units cancel,
cross-multiply to find the amount of dilutent and
(I did send my calculations to a colleague for confirmation before starting the drip.)
So thank you Mr. Fingerly, and all my other wonderful and profoundly influential teachers. I pray that you are richly blessed in the knowledge that your lives are being and have been well spent, that you have and are doing kingdom work as you labor to light a spark in your students.
Grace & Peace, Nathan Gilley
P.S. The title pun is especially for your enjoyment Mr. Fingerly
Warning: The following story may prompt incredulous laughter and children to ask uncomfortable questions.
Maybe I should have followed in your footsteps and become a better baseball player, you know, to make me a better doctor.
Nevertheless, I am happy to report that the secret playroom kickball matches that Jerod and I played allowed me to develop the skills necessary to become a competent physician. You see, just a few weeks ago, as I started my morning rounds, my very unpracticed sliding-into-homeplate manuever was put to the test:
I heard a yell in the hallway leading to surgery and went to investigate.
Arriving there I saw a pregnant woman, waddling towards me. Her eyes were wide with the shock and terror of a person betrayed by their own body. And as I ran forward to assess the situation I quickly saw the reason; upon seeing my querying expression she hiked up her hospital gown to reveal her baby crowning.
Her family and a few nurses were trying desperately to help her get to our labor and delivery room. But I determined this baby was going to come before we could possibly get her to a bed.
“We’re going to need to deliver the baby here,” I said with authority.
With relief the mom stopped trying to move forward and immediately began to sink to the floor. Fortunately her family members promptly stepped up to support her as she began sitting back. Unfortunately, as soon as her knees bent and she began to squat, her baby took advantage of the more open pelvic outlet as well as the increased abdominal pressure generated by her squat.
Noting this, I dove forward, my arms reaching out to catch the slowly falling baby and mother. The amniotic fluid on the tile floor helped me to slide easily into position at the mom’s feet. With my right hand I worked to catch the baby that was slipping rapidly out for a head first dive. And with my left hand I tried to push up and away on the mom’s buttocks that was coming down to land on top of her baby.
When the proverbial dust settled, we’d managed to all land safely in a somewhat slippery and slightly bloody pile, with a joyfully screaming little baby cradled in my arm connected by his umbilical cord to his mom who was slightly shocked and somewhat on top of me.
All we needed was an umpire to stare down at our strange pile and then after a pregnant pause, dramatically yell, “Safe!”
Love, your son, Dr. Nate
Remember one New Year you asked Dad, Jerod, and I to each tell about a miracle that we’d seen. Ultimately that led to a discussion about miracles, because for you, every day was filled with miracles: from rainbows to children to happenstance meetings- you saw Divine fingerprints everywhere; for Dad, Jerod, and I the world was a significantly less miraculous place. We weren’t sure we’d ever seen God reach down and definitively perform a miracle.
Well, I’ve decided that your view of the world is the better one, and I would like to tell you about a miracle I recently witnessed.
You see, the little baby that I caught in the story above (Yes, the story above is totally true, and yes Jerod and I did secretly play kick ball in our playroom, frequently, and without ever breaking a window), that baby started to turn yellow 12 hours after he was born. Now that’s not too uncommon, he was jaundiced, and we can treat that. We put him under some blue lights that convert the yellow, problematic bilirubin to a form that can be disposed of by most any liver.
I say, “most any,” because on rare occasions the drainage system of a liver is incompletely formed or the infant’s liver cells are genetically incapable of doing some basic function that causes excess production or diminished disposal.
I say all that because, after we put the baby under lights, instead of turning a beautiful Honduran brown and going home, he turned green. He turned green because his liver had one of the two problems detailed above.
When I investigate what could be done to help this little fellow, I found myself running into dead ends (grim pun intended). In Honduras, you do not want to be a green baby. Most likely you are stuck looking for an expensive, risky surgery that only a handful of hard to get to surgeons can do (to repair your drainage system). The other, equally tragic etiology, for our low resource patients, is that this disorder could arise from a super rare genetic problem that will be almost impossible to diagnose and likely will be equally untreatable.
As I often find myself doing, I first explained the poor medical prognosis. In this case I explained to baby’s mom that from strictly a medical perspective her baby had a serious and life-threatening problem. As stated above, the most likely cause was a problem with the liver’s drainage system. Untreated, this often results in death after a few months. So we would do further investigation and begin reaching out to arrange for treatment if necessary and possible. (We would also be reaching out for help from our donors because just the trip to see the surgeon in the big city would have been cost prohibitive)
Then, I concluded with your perspective, mom. I reminded this mother that we believe in a God who is all powerful and can do miracles. So even as we do everything we can medically, we also pray. The mom and I prayed for healing multiple times, specifically for God to allow this little boy’s bilirubin to get out of his system.
I have prayed many such prayers, and most of the time God either answers those prayers through the medical care being provided or the patient dies. But, occasionally, Divine fingerprints are a little more overt. Like this time, where visit by visit the little boy’s color, weight, and labs improved with no treatment beyond earnest prayers of hope and thanksgiving. A few days ago he came in for a check up and was totally normal.
Whether this was God directly altering the baby’s physiology or not, I do not know. But one thing I do know, he was a sickly-appearing, green baby and now he is healthy and brown.
And at that visit I praised God with his mother for the miracle of her son’s life.
Sometimes, I’m exasperated by the sheer number of times my daughter asks “why?”
Yesterday, after a long day, I asked her to go outside and play just before supper. She asked, “Why?”
Knowing my logical answer would be a bit raw I went the whimsical route (for sanity’s sake). I dutifully explained that over the course of the day, due to a lack of sunshine, argumentative imps had began growing and multiplying on her shoulders. At first whispering in her ears then climbing into her ears and finally crawling out her mouth and attacking her sisters. The only easy cure for this problem, I explained, was sunlight, which melts argumentative imps into nothingness.
This brought out enthusiastic and playful obedience as my daughter went outside with me and asked me to flesh out this new imaginary game.
And as I played in the evening sun with my daughters. Watching with my imagination as the little murky figures on their shoulders dissipated, and their attitudes and dispositions truly transformed, I wondered how much truth my fiction spoke.
In our missionary training we discussed how world view differences that can be so difficult to overcome. Particularly the gulf between the scientific and the animistic world views.
In general my culture adopts a scientific view of the world that is largely mechanical, and completely compartmentalizes the spiritual reality (when it allows for one). The animistic worldview is one of myth, magical thinking, and indivisible interplay between the spiritual and physical world, with all creatures, things, and ideas having spiritual essence. Christians who attempt to submit even their worldview to the truth of scripture have the tricky task of trying to look through the lens of their own worldview at scripture, spot the defects within the lens through which they’re looking, and correct it.
One such defect in my own worldview is an artificial compartmentalization of the spiritual – especially when it comes to medicine. In my worldview there is scarcely any overlap between the physical and spiritual causes and effects. But when that overlap does occur, when the physical and spiritual realities are obviously present together, (in a consistent manifestation of God’s grace) , as in the case of the Lord’s Supper or baptism, we call those nexuses sacrament.
So what if sunlight is not just a calculable photon bombardment, what if it exerts a spiritual force. What if just as it catalyzes reactions in our bodies, triggering the release of chemicals in our brains, it’s does something at the soul level? Or what if, as in my imp explanation, it negatively affects the powers that war against us that are not flesh and blood?
Either way, as a doctor and minister, I recommend at least 10-15 minute of sunshine each day for its salutatory effects.
The Reverend Doctor Nathan
- Sacrament can also be more specifically defined as specific actions that were instituted by the Lord, and commanded to his followers in perpetuity. Clearly, the sacraments that conform to this more narrow definition sacrament are to be performed and reverenced above all others.
The views and opinions expressed in this blog are not the views of Samaritan’s Purse or World Medical Mission.