Is it John or Johns?

I've always been confused by the name of this institution.  Is it "John" Hopkins or "Johns" Hopkins?  Were they two guys or one?  Why is this place so embedded in the medical folklore of our country?

This week, I started a one month course in tropical diseases here.  (I snapped this photo walking by the original hospital entrance).  The course itself is pretty intense.  I'm in class all day, every day.  But it's amazing.  The material is great and the lecturers are the best in their fields.  But what really has fascinated me is this place.

In 1873, Johns Hopkins (yes, it was one guy - his first name was his mother's maiden name) died and bequeathed $7 million to the city of Baltimore to start a hospital and a university.  Hopkins was a devout Quaker whose faith influenced his philanthropy and a desire to provide medical care for the marginalized.  He was also a staunch abolitionist whose family had freed their slaves when he was 12 years old.  Hopkins vigorously supported Lincoln and the cause for emancipation.  When he died, his financial gift to the city for the hospital was the largest single philanthropic gift in the history of the country up to that point.

Over the years, Hopkins (the hospital) has become a bit of a mecca for modern medicine.  It was here that William Osler, "the Father of Modern Medicine," first organized a residency program.  He was also the first to bring medical students to the patients' bedside for teaching.  Dr. William Halsted, a surgeon and another of the founders with Osler, introduced the surgical glove here and championed aseptic surgical technique.  In more recent times, the hospital was ranked as the number one hospital in America from 1991 to 2011.  It is considered to be the founding institution of American medicine.

Isn't it interesting that all of it was started by a bequest from a man whose passionate faith motivated his giving?  To think that American medicine, touted by some as the best in the world, and the medical education system has, at its roots, a man who worshiped the God of the Bible.  He once said, "Like the man in the parable, I have had many talents given to me and I feel they are in trust."  Freeing his slaves before it was cool, giving his money to healthcare for the poor, founding an orphanage.  Here was a man who truly lived radically and as a result advanced the kingdom of God.  And many are still benefiting from it to this day.

Medicine in the First World

I hadn't worked a shift in a "Western" emergency room in over a year and a half.  So, a few days ago, while passing through Austin, I hung out with some of my old colleagues while they were at work.  Why?  Partly just curiosity.  Had anything changed?  Was there some radically new technology that I wasn't aware of?  I also wondered if I was still comfortable taking care of developed world problems.  You see, there isn't a lot of coronary disease and stroke in my new practice area.  So I wanted to see if the "bread-and-butter" diagnoses that I used to treat were still familiar to me.

In the few hours I was there, I experienced a whole gamut of emotions.  I was in awe of the efficiency of it all.  (I didn't notice that when I was working in it before).  I was amazed at the breadth of technology and tests available.  I was occasionally frustrated by all the hoops that my colleagues here have to jump through.

But overall, I have to say that it restored my faith in Western medicine, and in particular ER docs, since I am one.  We hear a lot of talk about the failure of the American healthcare system.  And I am always having people say things to me like, "Aren't you glad you're really making a difference, now that you're working in Africa?"  There's this idea that much of the healthcare here in the US is superfluous, and in Africa, we are really helping people.  Well, it's just not true.  I'm here to tell you that I watched my old colleagues in action the other night.  And they are helping people.  People with insurance.  People without it.  Older people with a million medical problems.  Younger people with no chronic diseases but a real emergency.  What they are doing matters to a lot of people.

Sure, I saw some waste.  I saw some people get extensive lab and radiologic workups that they maybe didn't need.  Some of it to be thorough because the patient didn't have a primary care doctor.  Maybe some of it driven by fear of malpractice lawyers.  It was nothing that I didn't do when I practiced here.  And perhaps there is less of that in Ethiopia.  But there are other problems there - see countless other blog posts here.

Overall, the highlight of the night, was an man in his late fifties who had come in after syncope (passing out).  He had a history of CHF (congestive heart failure), and because those people are at high risk of sudden cardiac arrest, he also had an implanted defibrillator that had been placed in his chest.

Well, earlier in the day he had been driving, and felt a little woozy so he pulled over.  It was after that that he passed out.  He wasn't sure for how long.  He came in to the ER, and we had the defibrillator technician check his device to see if anything out of the ordinary had happened.  Well, it had.  The reason he passed out is that he had gone into ventricular fibrillation - a cardiac arrest.  And the device had (appropriately) shocked him, and saved his life.

This is the triumph of Western medicine.  For all of the negativity, it was amazing to see this life saved, and there are tons of others like him.  Sadly, much of this great technology is not accessible to us in Ethiopia.  But that is changing.  Things there are getting better, albeit slowly.  But that's another post for another day.  This post is for my colleagues in medicine here.  What you are doing matters. Cardiologists, ER docs, nurses, lab techs, surgeons, pediatricians, everyone.   Keep up the good work.

Wandering eyes and ears

Christians today seem to be jumping from one extreme to the next.  In the last week, I have read several articles about Christians moving away from one trend and onto another.  A few years ago, all of us were living "radically", "not wasting our life", and adopting orphans.  Today, we are talking about being "normal", taking a job in the suburbs, and not supporting child trafficking (a.k.a. adoption).

It all goes back to Adam and Eve and their wandering eyes and ears in the Garden of Eden.  We inherited ours from them and we are always looking at what others are doing to affirm ourselves.  We would rather get advice from others than from God, the Omniscient One.  We would rather covet the call on another's life, then ask God what He is calling us to do.

 "You shall not covet your neighbor's house; you shall not covet your neighbor's wife, or his male servant, or his female servant, or his ox, or his donkey, or anything that is your neighbor's."  Exodus 20:17
 
As a Christian, I struggled with this when we first moved to Ethiopia.  I was always looking at what other missionaries were doing and wondering if I should be doing that too.  I feel into the trap of comparing myself and my ministry with my other brothers and sisters here.  The outcome of this is never healthy.  It takes our eyes off of Christ and onto ourselves.  In worst cases, it can paralyze us from doing any work for the kingdom at all.

So, I want to encourage you today by challenging you to train your wandering eyes and ears to seek God first.  Do what He wants you to do with your life.  Adopt.  Don't adopt.  Join the mission field.  Stay in corporate America.  Whatever it is, if it is God's will for your life, then it will be radical!