I’ve been thinking of giving up my life as a surgeon and joining the opposition as a member of the Form Police. Now, you’ve probably never heard of them, but the recently passed healthcare legislation has a provision for the establishment of a review panel that will ensure that certain standards of care are maintained. In order to monitor these standards a cadre of healthcare professionals is to be recruited: the Form Police.
First a bit of background for the uninitiated. In the course of providing medical care for the sick and injured it is necessary that certain items be properly documented. When I started in medical school, thirty years ago, such documentation consisted of a complete, thorough history and physical, appropriate orders and daily progress notes. Upon completion of a hospital stay the patient was given discharge instructions, prescriptions and a discharge summary was generated, documenting the pertinent information relative to the just completed hospital admission. All these items carried a single purpose; to create a clear and concise record of an individual’s hospital stay so that other healthcare providers, (I believe they were called physicians and nurses in those days), at future dates, could review the events, which facilitated future care.
If surgery was performed, the surgeon would sit down with the patient and explain the procedure and document, in the progress notes, that the procedure had been explained to the patient, including all risks, benefits and alternatives. The nurse would then obtain the proper consent, based upon the doctor’s order and the surgery would proceed.
During surgery the circulating nurse kept a record of events, who was present, the procedure and any other pertinent information. The anesthesiologist generated his record of time the surgery started, medications administered, patient’s condition at fifteen minute intervals and any unexpected events. The surgeon dictated an operative report immediately following the procedure; the patient spent an hour in the Recovery Room (now the Post Anesthesia Care Unit of PACU), where another record was generated and then the patient returned to his hospital room or was discharged home.
But, times have changed. Our benevolent government, as part of its self proclaimed mandate to eliminate medical errors, has instituted a variety of protocols designed to optimize, standardize, epitomize, quantify, enhance and beautify many aspects of patient care. We have been given SCIP, the Surgical Care Improvement Program. This is a program that was instituted to ensure that appropriate prophylactic antibiotic protocols are followed as well as proper prophylaxis against deep venous thrombosis. There are other aspects to the program, but these are the two that are most pertinent to surgery.
Prophylactic antibiotics are given prior to elective surgeries to help minimize the risk of infection. They are most appropriate for procedures that involve placement of foreign material in the patient, such as a total knee replacement, or in cases where some contamination is unavoidable, such as colon surgery. The antibiotics are given preoperatively and for a brief period after surgery, usually stopped within twenty four hours after the surgery has finished. Instruction in proper prophylactic antibiotic regimens is part of every surgical clerkship in medical school and is repeatedly drilled into the heads of surgical residents.
Similarly, prevention of deep venous thrombosis (DVT) is an important part of the care of the surgical patient. Practices such as early ambulation, utilization of anti-embolic stockings or pneumatic compression stockings and administration of various blood thinners are all in the armamentarium of weapons for the fight against DVT. Such prevention is important because DVT’s can be life threatening if they lead to pulmonary embolus, which is a blood clot breaking off from a major vein and traveling to the lungs, which can cause sudden death. Once again, instruction in DVT prophylaxis is part of medical training at every level.
But, now we are being monitored; which is OK. The hospitals, however, have been given significant financial incentives to be sure that the SCIP protocols are properly addressed. I would have no problem with this if the personnel that have been delegated the task of monitoring SCIP were properly educated, so that they would be able to understand that patients that are on preoperative therapeutic antibiotics do not fall under SCIP. Such patients are being treated for active or presumed infections and are on scheduled antibiotics. Also, patients that are found at surgery to have an active infection, such as a perforated appendicitis will remain on antibiotics for a longer period of time than the SCIP prescribed twenty four hours and also fall outside SCIP’s purview.
Likewise, patients that have undergone surgery and have the potential for bleeding in the immediate post operative period may not be appropriate candidates for some of the powerful anticoagulants utilized for DVT prophylaxis. Intermediate measures, such as stockings, which carry fewer risks of bleeding and may be nearly as effective can usually be instituted, particularly if they are applied before surgery, which is, of course the hallmark of true prophylaxis.
But, I digress. All this bureaucratic insanity generates an enormous amount of paper. Endless forms that are designed to document compliance with the rapidly reproducing protocols, require constant monitoring to maximize physician compliance and hospital profits. The amount of paper is becoming so enormous that last week, after signing a stack of forms that made Mt. Everest look like a gentle hill outside Austin, I found my poor patient at the bottom of the pile, crushed to death. Of course such an event required even more forms be filled out and signed.
And so, we will have the “Form Police”. This elite squad of enforcers will be directly under the auspices of the Dept. of Health and Human Services. The team, composed of physicians, nurses, lawyers and health care administrators will be charged with the task of disciplining wayward healthcare professionals who are noncompliant with the current form requirements. Neatly outfitted in light brown uniforms, with a blue “FP” on the sleeve and shiny black boots, the Form Police will have the authority to make immediate judgment and mete out appropriate punishment to noncompliant individuals.
It is expected that first offenders will be let off with a simple warning, an admonishment to refrain from such dereliction of duty in the future. Repeat offenders will receive “Form Detention” which will put them in a room by themselves where they will be required to read the entire “form” manual, write “I will fill out all forms properly and in a timely manner” 1000 times on the blackboard and pass an exit exam before being allowed to return to their healthcare position.
The rare person that persists in “form” negligence will undergo a thirty day period of rehabilitation, during which the finer points of “form” etiquette will be driven home via twenty four hour, nonstop “form” video and audio. Completion of this “Form Boot Camp” will be mandatory for all multiple offenders and may be repeated as often as necessary until the healthcare provider achieves adequate levels of compliance.
Finally, incorrigible, unrepentant, hardcore “form” violators will be sentenced to three months of solitary “form” confinement. During this time the latest methods of persuasion, developed jointly by the CIA, Israeli Secret Police and Pre-school Monitors, will be utilized to give the offender one last opportunity to comply with proper “form” protocol. Those deemed incapable of rehabilitation will expelled from healthcare permanently.
And so it’s good-bye surgery, hello Form Police. I figure that the income from extortion alone will far exceed the meager reimbursement I now receive for saving lives and stamping out disease. And I will be performing a great service for all humanity.
Saturday, January 15, 2011
Tuesday, January 11, 2011
Parking in LA
Last week I was in Los Angeles for a few days on vacation. My wife and I played the part of tourist, took a personalized trip around the city perusing the walk of Fame, Grauman’s Chinese Theater, the Hollywood Hills and went by many stars’ homes. There was also a VIP tour of Universal Studios where we were treated to a gourmet lunch, front of line passes to all the rides and a personalized visit to a soundstage and backlots, all expertly shepherded by Donna, a truly amazing guide.
But, the most memorable thing about LA was the maze of parking options we were required to negotiate. I need to point out that we live in Houston where the city sprawls for miles and miles and every little shop has its own parking lot. Los Angeles, however, has primarily street parking, parking meters and confusion. I did not enter this fray unprepared; I did my research online and was ready to deal with this situation. One frequent LA traveler reported that after 5:30 pm paying the meters was not necessary. Of course I assumed that this included all the meters around this vast urban area. I quickly learned how mistaken I was.
On our first full day we had dinner at a wonderful Japanese restaurant called Ajasai, featuring the freshest sushi I’d ever had. We parked our rented car around the corner at a metered spot; the sign clearly stating that after 5:30 one did not need to pay the meter. There was a lot more on the sign, lettering that ran the down the pole almost to the curb, which I didn’t bother to read. I wish I had taken the time, but, I assumed it was all some legal disclaimer. The internet had said that meters didn’t apply after 5:30 pm and, if it’s on the internet it must be true, right?
Well, after our marvelous dinner we walked back to our car and were greeted by an empty spot. Only then did I notice the sign, just above the sidwalk that said “Tow Away after 6:00pm. Taxi Stand, except on Tuesdays.” Of course, this was in small letters at the bottom of a totem pole of messages and regulations. My wife’s first thought was that the car had been stolen, but, no, it had been towed. $150.00 later I had the car out of hock and back in my possession and for the remainder of our trip I took to reading the parking signs posted on each meter.
Least prevalent were the simple posts “Metered Parking from 8:00 am – 5:00 pm”. More common were “Metered Parking 8:00 am-5:00pm, No Parking Tuesdays and Thursdays; space reserved for Vampires after Dark, except for Full Moons when the space is reserved for Werewolves”. Several streets had a separate sign for each spot. One said: “Metered Parking Mon/Wed/Fri; No Parking Tues/Thurs, All day Parking allowed on weekends, except Holidays”. Two slots down the sign read “Metered Parking Tues/Thurs, Meter charges doubled on Holidays and Weekends, except from May 15-September 1”.
Another noteworthy sign read “Parking Only Allowed on Even Days, No Parking when Raining unless One of the Passengers or the Driver is a Standard Poodle, Please leave Proof of Poodlehood with the Meter”. We saw far more dogs in LA than children, although I really didn’t see many poodles; Shih-Tzu’s were most common. The city really seemed to be going to the dogs.
Some of the ritzier areas had special parking spots. The highest end stores had signs bearing images of Bugattis, Rolls Royces, Maybachs or Ferraris along with rules that stated, “No Parking Anytime, Unless Vehicle Appraisal Greater than or equal to $250,000”. We saw this sign all along Rodeo Drive.
The finer restaurants all had valet parking and the competition for available spaces was fierce. Cars could be seen slowly circling the block in search of the elusive parking space. When a space would miraculously appear a dozen cars would rapidly appear and spectators were treated to an impromptu demolition derby. Improv still lives.
I don’t know if we’ll go back to LA. Despite our adventures in parking we did have a wonderful time and there are certainly more unique California venues to explore. We certainly won’t be bored, even if most of our time is spent reading signs posted at the parking meters.
But, the most memorable thing about LA was the maze of parking options we were required to negotiate. I need to point out that we live in Houston where the city sprawls for miles and miles and every little shop has its own parking lot. Los Angeles, however, has primarily street parking, parking meters and confusion. I did not enter this fray unprepared; I did my research online and was ready to deal with this situation. One frequent LA traveler reported that after 5:30 pm paying the meters was not necessary. Of course I assumed that this included all the meters around this vast urban area. I quickly learned how mistaken I was.
On our first full day we had dinner at a wonderful Japanese restaurant called Ajasai, featuring the freshest sushi I’d ever had. We parked our rented car around the corner at a metered spot; the sign clearly stating that after 5:30 one did not need to pay the meter. There was a lot more on the sign, lettering that ran the down the pole almost to the curb, which I didn’t bother to read. I wish I had taken the time, but, I assumed it was all some legal disclaimer. The internet had said that meters didn’t apply after 5:30 pm and, if it’s on the internet it must be true, right?
Well, after our marvelous dinner we walked back to our car and were greeted by an empty spot. Only then did I notice the sign, just above the sidwalk that said “Tow Away after 6:00pm. Taxi Stand, except on Tuesdays.” Of course, this was in small letters at the bottom of a totem pole of messages and regulations. My wife’s first thought was that the car had been stolen, but, no, it had been towed. $150.00 later I had the car out of hock and back in my possession and for the remainder of our trip I took to reading the parking signs posted on each meter.
Least prevalent were the simple posts “Metered Parking from 8:00 am – 5:00 pm”. More common were “Metered Parking 8:00 am-5:00pm, No Parking Tuesdays and Thursdays; space reserved for Vampires after Dark, except for Full Moons when the space is reserved for Werewolves”. Several streets had a separate sign for each spot. One said: “Metered Parking Mon/Wed/Fri; No Parking Tues/Thurs, All day Parking allowed on weekends, except Holidays”. Two slots down the sign read “Metered Parking Tues/Thurs, Meter charges doubled on Holidays and Weekends, except from May 15-September 1”.
Another noteworthy sign read “Parking Only Allowed on Even Days, No Parking when Raining unless One of the Passengers or the Driver is a Standard Poodle, Please leave Proof of Poodlehood with the Meter”. We saw far more dogs in LA than children, although I really didn’t see many poodles; Shih-Tzu’s were most common. The city really seemed to be going to the dogs.
Some of the ritzier areas had special parking spots. The highest end stores had signs bearing images of Bugattis, Rolls Royces, Maybachs or Ferraris along with rules that stated, “No Parking Anytime, Unless Vehicle Appraisal Greater than or equal to $250,000”. We saw this sign all along Rodeo Drive.
The finer restaurants all had valet parking and the competition for available spaces was fierce. Cars could be seen slowly circling the block in search of the elusive parking space. When a space would miraculously appear a dozen cars would rapidly appear and spectators were treated to an impromptu demolition derby. Improv still lives.
I don’t know if we’ll go back to LA. Despite our adventures in parking we did have a wonderful time and there are certainly more unique California venues to explore. We certainly won’t be bored, even if most of our time is spent reading signs posted at the parking meters.
Friday, December 24, 2010
The Visitor
This is a strange place, I thought, as I stared into the darkness of my solitary room. I’m not sure this is the place for me. I opened the curtains and stared into the darkness outside and then went back to the bed. There was nothing in the room except the bed, a large TV that didn’t’ work and two books in the drawer next to the bed. The first was a fat and flimsy phone book. I thumbed through its pages, but the lists of names and places seemed like a foreign language and had no meaning. I looked at the other, with its black cover and its simple title, “Holy Bible”. Inside was a stamp, “The Gideons International”.
I opened it up to the first page “In the beginning, God…Let there be light”. I stopped at this point and went to the window and opened the curtain. Rays of light pierced the black horizon and I saw the outline of a large tree which became sharper and filled with color as the light rose in the east. This God must be wonderful to create such a world. I closed the book and left my room and went outside into this new world.
I felt a cool nip from a brisk wind as I stared at the tree that I’d seen outside my window. Its leaves were a bright gold and, as the wind blew, I saw several of them carried on the breeze. They settled on the ground with silent resolution as I walked on, following the last leaf to its resting place far away from the mother tree. As I walked I saw many buildings and vehicles and the air became filled with a foul smell as I walked past a large black building that was sending its smoke high into the morning sky. I guess this world is not as wonderful as I thought. And I went back to my room.
I sat on the bed and read more of the book.
“Now the serpent was more crafty than any other beast of the field that the Lord God had made”.
And I read how the beautiful Garden was spoiled and I cried. This
God must have given something more. He wouldn’t allow his creation to exist with such despair. And I read on. So many of the people were cruel and hateful, but a few remained true to God. And then I read the answer:
“I am the Lord your God, who brought you out of the land of Egypt, out of the house of slavery.
You shall have no other gods before me…”
I read those commandments over and over. These are words that will cause the ruin of Satan and surely will allow the world to return to its original beauty. And so I went out again, filled with hope that the laws of God were all that the people of the world needed.
I walked for a while. I saw the people milling about, some smiling, some hand in hand and I was filled with joy. God’s commandments were all the world needed. But, as I walked along I glanced down a side street and saw a man strike a woman. She fell to the ground and he ran off with the bag she had been carrying. But the laws; what about the laws? I walked on. I saw a group of men and women beating an old man, laughing as they kicked him in the side. I ran to help the old man as the vicious mob left him lying on the ground. I stooped down and held his bloody face, but there was no life in him as I gently laid his head on the ground. God’s laws mean nothing to these people. And I went back to my room.
These people have forgotten what’s in this book. Surely they all must have read it. I read on and on.
“For everything there is a season, and a time for every matter under heaven.
A time to be born, and a time to die…
A time to love, and a time to hate…
A time for war, and a time for peace”
Maybe it’s not the time for God? I’ll venture out into the world again. And so I went out, again. The sun was high in the sky and people milled about as before. I passed a building filled with people, laughing, singing, a place of celebration. I went inside. There were men and women mingling about, all of them smiling and laughing. I stood at a long wooden counter and a man asked me if I wanted anything. I looked at him and smiled, but I didn’t say a word and he went away. I looked up at the large TV “…war in the Middle East seems to be escalating as Israel and Lebanon traded bombs earlier today…” I picked up the newspaper that was on the counter “…terrorist attacks in Europe have raised the alert level to red…” A time for war, but is there a time for peace? I left that place and went back to my room. The crispness of autumn had given away to the frigid snow of winter.
I continued to read.
“For unto you is born this day in the city of David a Savior, who is Christ the Lord. And this will be a sign for you: you will find a baby wrapped in swaddling cloths and lying in a manger…
‘Glory to God in the highest,
And on earth peace among those with whom he is pleased!’…
…he was called Jesus…”
And I read on. Surely this Jesus is the answer. His words bring strength and meaning to God’s laws. And so I went back into the world. Outside the ground was white with snow and bright colored lights were everywhere. The world is celebrating the news, a giant, joyful gala for Jesus. The people must be very happy that God has remained faithful to them.even when they are bad.
I heard all types of song, about the joy of Christmas and people wishing each other Happy Holidays and exchanging gifts. But, the songs carried a different massage. The music sounded joyful, but the words were empty. I heard about Santa Claus and reindeer and snow and trees and poor Grandma was run over by a reindeer and there was something about a “Grinch”. But nary word about God or Jesus. I guess was wrong to think that a holiday called Christmas would be about Jesus Christ. There must be some other Christ that is being celebrated.
In despair I went back to my room. I read more of the book.
“So they took Jesus and he went out, bearing his own cross, to the place called The Place of a Skull, which in Aramaic is called Golgotha. There they crucified Him…
…it is finished, and he bowed his head and gave up his spirit.
…go to my brothers and say to them, ‘I am ascending to my Father and your Father, to my God and your God’. Mary Magdalene went and announced to the disciples, ‘I have seen the Lord…’.”
And I read on and then I knew. God never gave up on his creation. His love is so great that He gave all that he could so that mankind would be free. Even though the world wallows in sin, God’s grace overcomes the evil and his love shines through. And, finally, I understood and I went back into the world. I still saw the wickedness and corruption, but I also saw hope and truth; truth that needs to be shared with all the world.
MERRY CHRISTMAS!!
I opened it up to the first page “In the beginning, God…Let there be light”. I stopped at this point and went to the window and opened the curtain. Rays of light pierced the black horizon and I saw the outline of a large tree which became sharper and filled with color as the light rose in the east. This God must be wonderful to create such a world. I closed the book and left my room and went outside into this new world.
I felt a cool nip from a brisk wind as I stared at the tree that I’d seen outside my window. Its leaves were a bright gold and, as the wind blew, I saw several of them carried on the breeze. They settled on the ground with silent resolution as I walked on, following the last leaf to its resting place far away from the mother tree. As I walked I saw many buildings and vehicles and the air became filled with a foul smell as I walked past a large black building that was sending its smoke high into the morning sky. I guess this world is not as wonderful as I thought. And I went back to my room.
I sat on the bed and read more of the book.
“Now the serpent was more crafty than any other beast of the field that the Lord God had made”.
And I read how the beautiful Garden was spoiled and I cried. This
God must have given something more. He wouldn’t allow his creation to exist with such despair. And I read on. So many of the people were cruel and hateful, but a few remained true to God. And then I read the answer:
“I am the Lord your God, who brought you out of the land of Egypt, out of the house of slavery.
You shall have no other gods before me…”
I read those commandments over and over. These are words that will cause the ruin of Satan and surely will allow the world to return to its original beauty. And so I went out again, filled with hope that the laws of God were all that the people of the world needed.
I walked for a while. I saw the people milling about, some smiling, some hand in hand and I was filled with joy. God’s commandments were all the world needed. But, as I walked along I glanced down a side street and saw a man strike a woman. She fell to the ground and he ran off with the bag she had been carrying. But the laws; what about the laws? I walked on. I saw a group of men and women beating an old man, laughing as they kicked him in the side. I ran to help the old man as the vicious mob left him lying on the ground. I stooped down and held his bloody face, but there was no life in him as I gently laid his head on the ground. God’s laws mean nothing to these people. And I went back to my room.
These people have forgotten what’s in this book. Surely they all must have read it. I read on and on.
“For everything there is a season, and a time for every matter under heaven.
A time to be born, and a time to die…
A time to love, and a time to hate…
A time for war, and a time for peace”
Maybe it’s not the time for God? I’ll venture out into the world again. And so I went out, again. The sun was high in the sky and people milled about as before. I passed a building filled with people, laughing, singing, a place of celebration. I went inside. There were men and women mingling about, all of them smiling and laughing. I stood at a long wooden counter and a man asked me if I wanted anything. I looked at him and smiled, but I didn’t say a word and he went away. I looked up at the large TV “…war in the Middle East seems to be escalating as Israel and Lebanon traded bombs earlier today…” I picked up the newspaper that was on the counter “…terrorist attacks in Europe have raised the alert level to red…” A time for war, but is there a time for peace? I left that place and went back to my room. The crispness of autumn had given away to the frigid snow of winter.
I continued to read.
“For unto you is born this day in the city of David a Savior, who is Christ the Lord. And this will be a sign for you: you will find a baby wrapped in swaddling cloths and lying in a manger…
‘Glory to God in the highest,
And on earth peace among those with whom he is pleased!’…
…he was called Jesus…”
And I read on. Surely this Jesus is the answer. His words bring strength and meaning to God’s laws. And so I went back into the world. Outside the ground was white with snow and bright colored lights were everywhere. The world is celebrating the news, a giant, joyful gala for Jesus. The people must be very happy that God has remained faithful to them.even when they are bad.
I heard all types of song, about the joy of Christmas and people wishing each other Happy Holidays and exchanging gifts. But, the songs carried a different massage. The music sounded joyful, but the words were empty. I heard about Santa Claus and reindeer and snow and trees and poor Grandma was run over by a reindeer and there was something about a “Grinch”. But nary word about God or Jesus. I guess was wrong to think that a holiday called Christmas would be about Jesus Christ. There must be some other Christ that is being celebrated.
In despair I went back to my room. I read more of the book.
“So they took Jesus and he went out, bearing his own cross, to the place called The Place of a Skull, which in Aramaic is called Golgotha. There they crucified Him…
…it is finished, and he bowed his head and gave up his spirit.
…go to my brothers and say to them, ‘I am ascending to my Father and your Father, to my God and your God’. Mary Magdalene went and announced to the disciples, ‘I have seen the Lord…’.”
And I read on and then I knew. God never gave up on his creation. His love is so great that He gave all that he could so that mankind would be free. Even though the world wallows in sin, God’s grace overcomes the evil and his love shines through. And, finally, I understood and I went back into the world. I still saw the wickedness and corruption, but I also saw hope and truth; truth that needs to be shared with all the world.
MERRY CHRISTMAS!!
Sunday, December 12, 2010
At Night
“I only need the pain med at night”; “I just take one a day, at night when I’m trying to sleep”; “I need something to help me at night”; I hear words like these over and over from patients. Something happens at night, lying in the dark waiting for the escape of sleep to overtake us. The pain of recent surgery often intrudes and seems more intense at these moments. The distractions of the daytime; other people, the humdrum light and noise of the daytime are gone and all the pain that has been buried during waking hours rises to the surface.
Our brain is amazing, the way it filters out wave after wave of unwanted stimuli, selecting only what’s important to capture our attention. But all this stimulation fades away in the night and we are left with only ourselves, our thoughts, dreams and pains. My patients fill out a history questionnaire as part of their initial evaluation; one of the symptoms they can check is difficulty sleeping. I think almost half my patients check this box.
Little children cry out in fear and their parents rush to comfort them; the darkness and solitude are fertile ground for the young imagination, calling up horrible monsters that prey on the innocent, but are frightened away by even the tiniest bit of light and a few sharp words from a loving parent.
The monsters of childhood give way to the demons of our later years. The worries of these supposedly enlightened progressive times creep out during the dark hours, robbing us of the tranquility that sleep promises. Perhaps the monsters are real; a prodigal child, a wayward spouse, financial burdens or disappointment over perceived failure, concerns that well up into our consciousness at a time when we yearn for the serenity and peace of sleep.
Charlie Brown of “Peanuts” fame would lie awake at night and ask questions out loud addressed to no one in particular or, perhaps, to God. The answers were never particularly comforting:
“Sometimes I lie awake at night and ask ‘where did I go wrong?’ And a voice answers ‘This is going to take more than one night.”-Charlie Brown in ‘Peanuts’
“Sometimes I lie awake at night and ask ‘Why me?’ And a voice answers, ‘Nothing personal, your number just came up’-Charlie Brown in ‘Peanuts’
Is God so arbitrary? I doubt it.
But, the night isn’t always bad. Triumphs and successes of the day bring a sense of joy and excitement that can keep us from the peace of sleep. It is far more likely that elation leads to celebration and sleep is banished for a while; our day to day struggles pushed back into the recesses of our brain, quietly waiting for the moment to emerge and send our joyful feelings crashing into the abyss.
The Bible speaks of rest as a reward, something given by God for work well done.
"Come to Me, all you who labor and are heavy laden, and I will give you rest. Take My yoke upon you and learn from Me, for I am gentle and lowly in heart, and you will find rest for your souls. For My yoke is easy and My burden is light." -Matthew 11:28-30
At the end of a long day or a long life God rewards us with His rest. Scripture presents rest as the ultimate gift from God. Over a six day period God created the universe and our world and on the seventh day He rested. Number four of the ten commandments is to remember the Sabbath day and keep it holy, which means set apart as something special, a time for rest.
So night is the time for rest, to be alone with God and with our thoughts; a time of reflection on the day’s events and a time to anticipate the days to come. So many times at night I think about the day that has just past, surgery’s that have been done, family concerns and any troubles. It’s a time to offer prayers of thanks and supplication. Personally, I think God listens best at such moments or, more likely, I can focus better at these times; the quiet darkness shielding my thoughts from unwanted intrusion.
And then there’s sleep. We drift away from consciousness, but remain alive. While we sleep amazing things happen. Although it has never been proven I think that sleep provides a time for repair: physical, mental and emotional. Body temperature falls, heart rate decreases, blood pressure decreases and vascular resistance falls. Our organs are bathed in blood that seems to circulate more slowly during sleep, allowing built up toxins to be released and disposed, focusing our immune system on potential invaders, repairing damages done and probably a multitude of other functions that remain a mystery.
Sleep is the time for dreams, our pent up thoughts and feelings released into a private theater that may be cryptic, vivid, heart-warming or terrifying. Sometimes in color, sometimes in black and white, Freud wrote a whole book on the interpretation of dreams. The Bible gave special credence to those that could interpret dreams and treated our dreams as messages from God. Daniel and Joseph were the premier dream interpreters of the Bible; they both suffered because of this skill, but were also rewarded. Most often our dreams leave us confused and often we forget them as soon as we awaken; leaving us with a vague recollection that something of importance may have transpired, but little more.
We may never remember a dream and remain oblivious to our environment, but we still yearn for sleep, for this time of physical, mental, emotional and spiritual repair. We cannot live without its benefits and yet it can prove to be so elusive. Lying awake, tossing and turning, counting sheep by the millions, downing pills and elixirs; searching for the elusive rest. Our world has become so complicated that moments to relax, do nothing and dream become fleeting until they seem lost forever.
Where can we find peace? As children the comforting word or touch of a parent was all that was needed. So, we come back to our parent, to God, our Heavenly Father. His word, His grace, His promise are all that we need to find rest. It is promised throughout the Bible and night is the time when we can feel His soothing touch and receive His peace.
Our brain is amazing, the way it filters out wave after wave of unwanted stimuli, selecting only what’s important to capture our attention. But all this stimulation fades away in the night and we are left with only ourselves, our thoughts, dreams and pains. My patients fill out a history questionnaire as part of their initial evaluation; one of the symptoms they can check is difficulty sleeping. I think almost half my patients check this box.
Little children cry out in fear and their parents rush to comfort them; the darkness and solitude are fertile ground for the young imagination, calling up horrible monsters that prey on the innocent, but are frightened away by even the tiniest bit of light and a few sharp words from a loving parent.
The monsters of childhood give way to the demons of our later years. The worries of these supposedly enlightened progressive times creep out during the dark hours, robbing us of the tranquility that sleep promises. Perhaps the monsters are real; a prodigal child, a wayward spouse, financial burdens or disappointment over perceived failure, concerns that well up into our consciousness at a time when we yearn for the serenity and peace of sleep.
Charlie Brown of “Peanuts” fame would lie awake at night and ask questions out loud addressed to no one in particular or, perhaps, to God. The answers were never particularly comforting:
“Sometimes I lie awake at night and ask ‘where did I go wrong?’ And a voice answers ‘This is going to take more than one night.”-Charlie Brown in ‘Peanuts’
“Sometimes I lie awake at night and ask ‘Why me?’ And a voice answers, ‘Nothing personal, your number just came up’-Charlie Brown in ‘Peanuts’
Is God so arbitrary? I doubt it.
But, the night isn’t always bad. Triumphs and successes of the day bring a sense of joy and excitement that can keep us from the peace of sleep. It is far more likely that elation leads to celebration and sleep is banished for a while; our day to day struggles pushed back into the recesses of our brain, quietly waiting for the moment to emerge and send our joyful feelings crashing into the abyss.
The Bible speaks of rest as a reward, something given by God for work well done.
"Come to Me, all you who labor and are heavy laden, and I will give you rest. Take My yoke upon you and learn from Me, for I am gentle and lowly in heart, and you will find rest for your souls. For My yoke is easy and My burden is light." -Matthew 11:28-30
At the end of a long day or a long life God rewards us with His rest. Scripture presents rest as the ultimate gift from God. Over a six day period God created the universe and our world and on the seventh day He rested. Number four of the ten commandments is to remember the Sabbath day and keep it holy, which means set apart as something special, a time for rest.
So night is the time for rest, to be alone with God and with our thoughts; a time of reflection on the day’s events and a time to anticipate the days to come. So many times at night I think about the day that has just past, surgery’s that have been done, family concerns and any troubles. It’s a time to offer prayers of thanks and supplication. Personally, I think God listens best at such moments or, more likely, I can focus better at these times; the quiet darkness shielding my thoughts from unwanted intrusion.
And then there’s sleep. We drift away from consciousness, but remain alive. While we sleep amazing things happen. Although it has never been proven I think that sleep provides a time for repair: physical, mental and emotional. Body temperature falls, heart rate decreases, blood pressure decreases and vascular resistance falls. Our organs are bathed in blood that seems to circulate more slowly during sleep, allowing built up toxins to be released and disposed, focusing our immune system on potential invaders, repairing damages done and probably a multitude of other functions that remain a mystery.
Sleep is the time for dreams, our pent up thoughts and feelings released into a private theater that may be cryptic, vivid, heart-warming or terrifying. Sometimes in color, sometimes in black and white, Freud wrote a whole book on the interpretation of dreams. The Bible gave special credence to those that could interpret dreams and treated our dreams as messages from God. Daniel and Joseph were the premier dream interpreters of the Bible; they both suffered because of this skill, but were also rewarded. Most often our dreams leave us confused and often we forget them as soon as we awaken; leaving us with a vague recollection that something of importance may have transpired, but little more.
We may never remember a dream and remain oblivious to our environment, but we still yearn for sleep, for this time of physical, mental, emotional and spiritual repair. We cannot live without its benefits and yet it can prove to be so elusive. Lying awake, tossing and turning, counting sheep by the millions, downing pills and elixirs; searching for the elusive rest. Our world has become so complicated that moments to relax, do nothing and dream become fleeting until they seem lost forever.
Where can we find peace? As children the comforting word or touch of a parent was all that was needed. So, we come back to our parent, to God, our Heavenly Father. His word, His grace, His promise are all that we need to find rest. It is promised throughout the Bible and night is the time when we can feel His soothing touch and receive His peace.
Monday, November 29, 2010
Aliens Among Us
I just read an article which discussed how the teenage brain is wired differently than the brains of other normal people. Apparently, there was a study done that proved this difference; a fact that has been obvious to parents for ages, probably since the days of Cain and Abel.
That teenagers function on a different level when compared to younger children or adults is more than the result of “different wiring”. No, it is the consequence of a much more sinister plot; a plan that could eventually lead to the end of civilization as we know it. Recent observations out of Roswell, NM have clearly demonstrated that during a child’s thirteenth year aliens visit and our sweet innocent children are replaced.
Every parent has had the experience. That sweet child that loved to be with Mom and Dad, be it a simple walk or a game of catch, suddenly can’t be seen with parents. But it’s more than this. There is no question that teenagers are not human.
For example, years ago I had a simple surgery scheduled on a fifteen year old girl, excising a cyst from her scalp. It was too big to do under strictly local anesthesia in the office, so I scheduled the surgery to be done in the OR utilizing local anesthesia along with intravenous sedation. The procedure started uneventfully; the area on her scalp numbed adequately and her peaceful snores indicating an appropriate level of sedation.
As I made my incision she became agitated and started to scream that someone was trying to cut off her head. I have to comment at this point that local anesthesia will eliminate most sensation, but pressure feelings and awareness that something is being done still are maintained. As she became more agitated the anesthesiologist gave her more sedation, actually enough to stop a charging elephant. My patient tried to jump off the table.
Needless to say the surgery was stopped, she was given general anesthesia and we finished the procedure without incident. At that time I chalked it up to a single paradoxical reaction. But, about six months later I had another similar occurrence. A minor procedure on a sixteen year old boy, once again under local anesthesia with IV sedation yielded the exact same outcome. This time we were better prepared and as soon as it was apparent that the sedation was not effective, general anesthesia was induced and we finished the operation without further mishap. After these two episodes I decided that teenagers were not like normal people and since then all operations on this subspecies of humanity have been done either with straight local anesthesia, that is, sans sedation, or with full general anesthesia. I have to add that, at the time, my own kids were all sweet, innocent toddlers and young children. They’ve since grown and I am older and wiser.
But, what is the underlying mechanism for this devious transformation? Prevailing theories are that rapid hormonal changes coupled with the growing social pressures of the teen years lead to the instability of the teenage specimen. This explanation is at best inadequate. No, there is much more to the phenomenon and the answer, undoubtedly, is alien invasion.
During the seventh grade, usually a few months after the start of the school year the exchanges begin. Our teenage children are snatched away as they sleep and transported to alien space ships hovering just outside the Earth’s atmosphere, shielded from any prying military probes. Exact physical copies of our precious children are created and, unlike Stepford, where the wives were replaced by docile, compliant androids, the replicants are programmed to disrupt the lives of all the sane adults and younger children they encounter.
Because they are artificial they have no fear of driving too fast, or drinking excessively and, being perfectly engineered machinery, they believe it is beneath them to fraternize with imperfect biologically based beings like parents or younger siblings. Instead they prefer their own kind, congregating at malls, particularly around the Apple Store or in arcades where other machines can be found.
Oh, they are devious, that’s for sure; pretending to be sweet and innocent for a moment, filling their forlorn parents with hope that their baby has been returned, but it’s all a trick. Once rewarded with spending money and car keys, they revert to their real selves, congregating together to prowl the streets in packs and wreaking havoc at every turn. Of course it isn’t all bad. These alien creations have remarkable central processors that can soak up Shakespeare or trigonometry like a dry sponge. When properly motivated they are capable of performing a Vivaldi Violin Concerto or winning Olympic Gold in gymnastics. Through all this we cheer them on, pray for them and hope, deluding ourselves into believing that these ‘replacements’ are truly ours.
Is there hope for humanity; will we ever be released from these thorns in our sides? I don’t know what happens to the real children as they are held prisoner on these alien ships, but most of them manage to escape shortly after they enter adulthood. The vicious, unpredictable beasts are dismantled and our children, now responsible adults, return.
So, if your teenager is getting you down, acting in bizarre ways and causing you to reach for the Ativan two or three times a day, relax. Just say to yourself: “They’re not human, they’re not human, just be patient, just be patient”.
In a few years it will all be over. But, until that time, keep a stiff upper lip, hide the car keys and keep the Ativan close at hand.
That teenagers function on a different level when compared to younger children or adults is more than the result of “different wiring”. No, it is the consequence of a much more sinister plot; a plan that could eventually lead to the end of civilization as we know it. Recent observations out of Roswell, NM have clearly demonstrated that during a child’s thirteenth year aliens visit and our sweet innocent children are replaced.
Every parent has had the experience. That sweet child that loved to be with Mom and Dad, be it a simple walk or a game of catch, suddenly can’t be seen with parents. But it’s more than this. There is no question that teenagers are not human.
For example, years ago I had a simple surgery scheduled on a fifteen year old girl, excising a cyst from her scalp. It was too big to do under strictly local anesthesia in the office, so I scheduled the surgery to be done in the OR utilizing local anesthesia along with intravenous sedation. The procedure started uneventfully; the area on her scalp numbed adequately and her peaceful snores indicating an appropriate level of sedation.
As I made my incision she became agitated and started to scream that someone was trying to cut off her head. I have to comment at this point that local anesthesia will eliminate most sensation, but pressure feelings and awareness that something is being done still are maintained. As she became more agitated the anesthesiologist gave her more sedation, actually enough to stop a charging elephant. My patient tried to jump off the table.
Needless to say the surgery was stopped, she was given general anesthesia and we finished the procedure without incident. At that time I chalked it up to a single paradoxical reaction. But, about six months later I had another similar occurrence. A minor procedure on a sixteen year old boy, once again under local anesthesia with IV sedation yielded the exact same outcome. This time we were better prepared and as soon as it was apparent that the sedation was not effective, general anesthesia was induced and we finished the operation without further mishap. After these two episodes I decided that teenagers were not like normal people and since then all operations on this subspecies of humanity have been done either with straight local anesthesia, that is, sans sedation, or with full general anesthesia. I have to add that, at the time, my own kids were all sweet, innocent toddlers and young children. They’ve since grown and I am older and wiser.
But, what is the underlying mechanism for this devious transformation? Prevailing theories are that rapid hormonal changes coupled with the growing social pressures of the teen years lead to the instability of the teenage specimen. This explanation is at best inadequate. No, there is much more to the phenomenon and the answer, undoubtedly, is alien invasion.
During the seventh grade, usually a few months after the start of the school year the exchanges begin. Our teenage children are snatched away as they sleep and transported to alien space ships hovering just outside the Earth’s atmosphere, shielded from any prying military probes. Exact physical copies of our precious children are created and, unlike Stepford, where the wives were replaced by docile, compliant androids, the replicants are programmed to disrupt the lives of all the sane adults and younger children they encounter.
Because they are artificial they have no fear of driving too fast, or drinking excessively and, being perfectly engineered machinery, they believe it is beneath them to fraternize with imperfect biologically based beings like parents or younger siblings. Instead they prefer their own kind, congregating at malls, particularly around the Apple Store or in arcades where other machines can be found.
Oh, they are devious, that’s for sure; pretending to be sweet and innocent for a moment, filling their forlorn parents with hope that their baby has been returned, but it’s all a trick. Once rewarded with spending money and car keys, they revert to their real selves, congregating together to prowl the streets in packs and wreaking havoc at every turn. Of course it isn’t all bad. These alien creations have remarkable central processors that can soak up Shakespeare or trigonometry like a dry sponge. When properly motivated they are capable of performing a Vivaldi Violin Concerto or winning Olympic Gold in gymnastics. Through all this we cheer them on, pray for them and hope, deluding ourselves into believing that these ‘replacements’ are truly ours.
Is there hope for humanity; will we ever be released from these thorns in our sides? I don’t know what happens to the real children as they are held prisoner on these alien ships, but most of them manage to escape shortly after they enter adulthood. The vicious, unpredictable beasts are dismantled and our children, now responsible adults, return.
So, if your teenager is getting you down, acting in bizarre ways and causing you to reach for the Ativan two or three times a day, relax. Just say to yourself: “They’re not human, they’re not human, just be patient, just be patient”.
In a few years it will all be over. But, until that time, keep a stiff upper lip, hide the car keys and keep the Ativan close at hand.
Saturday, November 20, 2010
Jesus was a Wino...Like Me
A few weeks ago, in the midst of some heated discussion in the OR, my assistant made an interesting, perhaps profound comment. I don’t remember the topic, but the conversation must have wandered into religion and somehow the person of Jesus came up. Sometimes we actually have deep and profound discussions while slaving over hot gallbladders; this must have been one of those times. Anyway, as the conversation heated up, she blurted out:
“Jesus was a wino…like me”.
It sounded funny at the time, and I don’t think anyone in the room really believed it. First of all, although my assistant enjoys a fine glass of Chardonnay on a regular basis, in moderate amounts only (except on the rare occasion when she is celebrating something, when she allows herself a bit more), she does not fit the definition of a wino. There are various definitions of “wino”, but an amalgamation of them all would probably be: “an indigent person, usually homeless, who drinks alcoholic beverages, usually to excess”.
But what she said in the heat of discussion actually contains a great deal of theology and, if examined closely, one can find the gospel. So, let’s deconstruct this simple phrase and uncover its truth.
Jesus refers to Jesus Christ, the remarkable figure on whom the various Christian religions are built. Over two thousand years ago he was an itinerant rabbi hiking around ancient Palestine, trailed by twelve disciples, whose purpose was to deliver the “good news”, a message of God’s love, hope and salvation for all His people; the Gospel. During his three year mission He had no home and it is well documented that he drank wine, although never to excess. He performed many miracles; the first was changing of water into wine at the wedding feast in Cana. But, whereas his disciples may have become drunk on at least one occasion, (they seemed to have a hard time staying awake at Jesus greatest time of need in the Garden of Gethsemane), Jesus never drank inappropriately. Drunkenness would be considered a sin and he lived a perfect, obedient, sinless life, which uniquely qualified him as the perfect sacrifice to satisfy God’s wrath and to take our sins upon himself at the Cross.
So, he does not meet all parts of the definition of wino. Homeless, yes, indigent, yes, drank wine, yes, excessively, no. But, what about the Gospel? At the Cross, the sins of the world were heaped upon Him and by this act of love we are saved. When the believer stands before God for judgment,
God will see the righteousness of Jesus instead of a wretched sinner. This is the heart of the Gospel. At the Cross Jesus takes all the sins of the world upon himself and we, the sinful winos, are cleansed. Jesus becomes the wino in our place.
“He made Him who knew no sin to be sin on our behalf, that we might become the righteousness of God in Him.” -2 Corinthians 5:21
In this sense one could say that it’s true; Jesus was a wino. Perhaps it’s better said, “Jesus became a wino…for me”.
But, what about “…like me”. Can anyone say that Jesus is “like me”? Jesus left heaven; separating from all his glory, and became human, assuming all the frailties and weaknesses of humanity. He suffered all the temptations that we suffer and more. He was offered bread when he was starving, but rejected it, preferring God’s word. He was offered all the world, but chose the promise of God and Heaven and, finally, He refused to put God to the test, holding on to His faith and rejecting Satan. These temptations make Jesus “like me”, except he succeeded where we all fail miserably.
“Jesus was a wino..like me”. The Gospel shouts from these words and, as a result, hope and truth are offered to all of us.
“Jesus was a wino…like me”.
It sounded funny at the time, and I don’t think anyone in the room really believed it. First of all, although my assistant enjoys a fine glass of Chardonnay on a regular basis, in moderate amounts only (except on the rare occasion when she is celebrating something, when she allows herself a bit more), she does not fit the definition of a wino. There are various definitions of “wino”, but an amalgamation of them all would probably be: “an indigent person, usually homeless, who drinks alcoholic beverages, usually to excess”.
But what she said in the heat of discussion actually contains a great deal of theology and, if examined closely, one can find the gospel. So, let’s deconstruct this simple phrase and uncover its truth.
Jesus refers to Jesus Christ, the remarkable figure on whom the various Christian religions are built. Over two thousand years ago he was an itinerant rabbi hiking around ancient Palestine, trailed by twelve disciples, whose purpose was to deliver the “good news”, a message of God’s love, hope and salvation for all His people; the Gospel. During his three year mission He had no home and it is well documented that he drank wine, although never to excess. He performed many miracles; the first was changing of water into wine at the wedding feast in Cana. But, whereas his disciples may have become drunk on at least one occasion, (they seemed to have a hard time staying awake at Jesus greatest time of need in the Garden of Gethsemane), Jesus never drank inappropriately. Drunkenness would be considered a sin and he lived a perfect, obedient, sinless life, which uniquely qualified him as the perfect sacrifice to satisfy God’s wrath and to take our sins upon himself at the Cross.
So, he does not meet all parts of the definition of wino. Homeless, yes, indigent, yes, drank wine, yes, excessively, no. But, what about the Gospel? At the Cross, the sins of the world were heaped upon Him and by this act of love we are saved. When the believer stands before God for judgment,
God will see the righteousness of Jesus instead of a wretched sinner. This is the heart of the Gospel. At the Cross Jesus takes all the sins of the world upon himself and we, the sinful winos, are cleansed. Jesus becomes the wino in our place.
“He made Him who knew no sin to be sin on our behalf, that we might become the righteousness of God in Him.” -2 Corinthians 5:21
In this sense one could say that it’s true; Jesus was a wino. Perhaps it’s better said, “Jesus became a wino…for me”.
But, what about “…like me”. Can anyone say that Jesus is “like me”? Jesus left heaven; separating from all his glory, and became human, assuming all the frailties and weaknesses of humanity. He suffered all the temptations that we suffer and more. He was offered bread when he was starving, but rejected it, preferring God’s word. He was offered all the world, but chose the promise of God and Heaven and, finally, He refused to put God to the test, holding on to His faith and rejecting Satan. These temptations make Jesus “like me”, except he succeeded where we all fail miserably.
“Jesus was a wino..like me”. The Gospel shouts from these words and, as a result, hope and truth are offered to all of us.
Sunday, November 7, 2010
Grown Up
This post talks about "Toy Story 3 and contains spoilers, in case you haven't seen that movie
Last night I watched “Toy Story 3” with my wife and daughters. I thought the story was very touching and I found my eyes filling with tears at the end. Since then I’ve been wondering: what is it about this story that I found to be so moving? The ending was a bittersweet, but it was the best of all possibilities for the motley crew of toys. And, yet I felt far more sadness than anything.
As I reflected on everything the wonderful story contained I realized that “Toy Story 3” wasn’t about the toys at all. Just as “Ben Hur” was really about Jesus (the complete title is “Ben Hur, a Story of the Christ”), “Toy Story 3” is about Andy. Sure, the majority of the time the focus is on the plight of the toys, but at almost every moment it is the plight of Andy that is in the background.
We start with video of Andy playing with his beloved toys, games of make believe that demonstrate the unashamed imagination that is special to young children. But, the screen cuts to Andy preparing to leave for college. What will become of the toys; trash or attic or worse? At this point the viewer gets only a glimpse at Andy’s thoughts. He cares enough to put them away in the attic and he plans to bring Woody to college where he would likely end up as an ornament on a desk, seen, but not to be played with. It is a better fate than the attic.
If you’ve seen the movie you know about the plight of the toys, but one of the most revealing scenes is that of Andy searching for the toys he wanted to save and learning that they were accidently put out with the trash. Andy is visibly upset and then we don’t see him for a while. At that point perhaps he realizes that the childhood memory that he thought he was shuffling off to storage has been lostforever and we feel his loss.
The toys go through a number of misadventures until they find themselves, in a Jonathan Edwards moment, on the brink of annihilation, only to be grasped from the fire by the giant, divine “Claw”. They all make their way back to Andy who gets a second chance at redemption. Through the intervention of Woody he decides to give his toys, except for Woody, to Bonnie, a girl who we know will truly appreciate them and play with them just as Andy had done.
At the point when Andy stops at Bonnie’s home to give her the toys he demonstrates that he has not forgotten what the toys are, what they meant to him and what they still mean to him. He could have just handed the box to Bonnie or her Mother and drove off to college, but that wouldn’t have been right. He takes each toy, one at a time and lovingly hands it to Bonnie, making sure that she knows the true story of each one. And in the end he is left with Woody, who still plans to bring to college. But, Bonnie already loves Woody, just as Andy loved Woody when he was that young age. And Andy sees her love and gives Woody to Bonnie.
At this moment Andy finds redemption, just as Judah Ben Hur found his redemption through his three encounters with Jesus. Because, it is expected that Andy, having been true to his toys, would have left, gone on to the more important task of moving into college. After all he’s seventeen and playing with toys just wouldn’t be proper for someone moving on in this world. But, he stays and for the rest of the day he plays with his beloved toys and with Bonnie, recapturing the childhood he thought he had lost forever. And, it is at this moment that the tears start to flow, because for all of us we realize what we have lost. The childlike innocence that we used to have, imagination that can turn a piggybank into evil Dr. Porkchop, is lost; buried beneath the day to day routine that we call growing up and adulthood.
One of my favorite songs, since I was about eight or so, is “Puff, the Magic Dragon”. Years ago someone wrote that this song is about drugs, but if you read the lyrics it is clear that this song is about the losses we suffer when we grow up. Jackie Paper plays with Puff and the two go on the greatest adventures together, until Jackie grows up, Puff is replaced by other toys and forgotten. Without a little boy to bring the imagination there may be a toy dragon, but that is all there is, a lifeless stuffed animal. The imagination of a child brings toys and us to life.
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Little Jackie Paper loved that rascal Puff,
and brought him strings and sealing wax and other fancy stuff. Oh
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Together they would travel on a boat with billowed sail
Jackie kept a lookout perched on Puff's gigantic tail,
Noble kings and princes would bow whene'er they came,
Pirate ships would lower their flags when Puff roared out his name. Oh
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
A dragon lives forever but not so little boys
Painted wings and giant rings make way for other toys.
One grey night it happened, Jackie Paper came no more
And Puff that mighty dragon, he ceased his fearless roar.
His head was bent in sorrow, green scales fell like rain,
Puff no longer went to play along the cherry lane.
Without his life-long friend, Puff could not be brave,
So Puff that mighty dragon sadly slipped into his cave. Oh
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Last night I watched “Toy Story 3” with my wife and daughters. I thought the story was very touching and I found my eyes filling with tears at the end. Since then I’ve been wondering: what is it about this story that I found to be so moving? The ending was a bittersweet, but it was the best of all possibilities for the motley crew of toys. And, yet I felt far more sadness than anything.
As I reflected on everything the wonderful story contained I realized that “Toy Story 3” wasn’t about the toys at all. Just as “Ben Hur” was really about Jesus (the complete title is “Ben Hur, a Story of the Christ”), “Toy Story 3” is about Andy. Sure, the majority of the time the focus is on the plight of the toys, but at almost every moment it is the plight of Andy that is in the background.
We start with video of Andy playing with his beloved toys, games of make believe that demonstrate the unashamed imagination that is special to young children. But, the screen cuts to Andy preparing to leave for college. What will become of the toys; trash or attic or worse? At this point the viewer gets only a glimpse at Andy’s thoughts. He cares enough to put them away in the attic and he plans to bring Woody to college where he would likely end up as an ornament on a desk, seen, but not to be played with. It is a better fate than the attic.
If you’ve seen the movie you know about the plight of the toys, but one of the most revealing scenes is that of Andy searching for the toys he wanted to save and learning that they were accidently put out with the trash. Andy is visibly upset and then we don’t see him for a while. At that point perhaps he realizes that the childhood memory that he thought he was shuffling off to storage has been lostforever and we feel his loss.
The toys go through a number of misadventures until they find themselves, in a Jonathan Edwards moment, on the brink of annihilation, only to be grasped from the fire by the giant, divine “Claw”. They all make their way back to Andy who gets a second chance at redemption. Through the intervention of Woody he decides to give his toys, except for Woody, to Bonnie, a girl who we know will truly appreciate them and play with them just as Andy had done.
At the point when Andy stops at Bonnie’s home to give her the toys he demonstrates that he has not forgotten what the toys are, what they meant to him and what they still mean to him. He could have just handed the box to Bonnie or her Mother and drove off to college, but that wouldn’t have been right. He takes each toy, one at a time and lovingly hands it to Bonnie, making sure that she knows the true story of each one. And in the end he is left with Woody, who still plans to bring to college. But, Bonnie already loves Woody, just as Andy loved Woody when he was that young age. And Andy sees her love and gives Woody to Bonnie.
At this moment Andy finds redemption, just as Judah Ben Hur found his redemption through his three encounters with Jesus. Because, it is expected that Andy, having been true to his toys, would have left, gone on to the more important task of moving into college. After all he’s seventeen and playing with toys just wouldn’t be proper for someone moving on in this world. But, he stays and for the rest of the day he plays with his beloved toys and with Bonnie, recapturing the childhood he thought he had lost forever. And, it is at this moment that the tears start to flow, because for all of us we realize what we have lost. The childlike innocence that we used to have, imagination that can turn a piggybank into evil Dr. Porkchop, is lost; buried beneath the day to day routine that we call growing up and adulthood.
One of my favorite songs, since I was about eight or so, is “Puff, the Magic Dragon”. Years ago someone wrote that this song is about drugs, but if you read the lyrics it is clear that this song is about the losses we suffer when we grow up. Jackie Paper plays with Puff and the two go on the greatest adventures together, until Jackie grows up, Puff is replaced by other toys and forgotten. Without a little boy to bring the imagination there may be a toy dragon, but that is all there is, a lifeless stuffed animal. The imagination of a child brings toys and us to life.
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Little Jackie Paper loved that rascal Puff,
and brought him strings and sealing wax and other fancy stuff. Oh
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Together they would travel on a boat with billowed sail
Jackie kept a lookout perched on Puff's gigantic tail,
Noble kings and princes would bow whene'er they came,
Pirate ships would lower their flags when Puff roared out his name. Oh
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
A dragon lives forever but not so little boys
Painted wings and giant rings make way for other toys.
One grey night it happened, Jackie Paper came no more
And Puff that mighty dragon, he ceased his fearless roar.
His head was bent in sorrow, green scales fell like rain,
Puff no longer went to play along the cherry lane.
Without his life-long friend, Puff could not be brave,
So Puff that mighty dragon sadly slipped into his cave. Oh
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
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