Asking questions

When the nurse called my name, I hobbled painfully behind him to the examination room. My left knee was pathetically useless and my right knee did as best it could to keep me upright, except in those moments when she just simply gave out. It seemed in just a matter of days I had gone from moving at a fast pace, being active, going to the gym regularly to an abrupt stand still. My knees no longer cooperated. The pain in my joints was becoming increasingly intolerable. As the doctor looked at x-rays, and examined my knees, he looked at me ruefully and said there was nothing more he could do for me.

I am an academic. That means when my doctor tells me that my knees are shot and he can no longer keep them going, I start asking questions and researching my options. If I needed both knees replaced, I wanted to know what the risks were, what would recovery look like, and I wanted the best surgeon possible.

As with most academics, I did my research with a list of pre-suppositions that included: 1) the surgeon needs to be young, because that will mean that she/he is current on the most recent trends; 2) needs to have lots of experience in my particular surgery, and 3) has confidence in her/his abilities to do the surgery well. I did my research and selected a surgeon. That decision started me on a now four-month journey to have both my knees replaced.

Along this journey, I have had many discoveries and surprises; some pleasant, some painful and challenging, and some quite sobering. One of the most surprising to me has been my immersion into the health care system. Unsurprising to social workers and anthropologists, the world of surgical medicine is a well-developed system. Even in the fogged state of post-surgery and pain meds, it was quite startling to me to observe the hierarchy in this system and the affect the hierarchy had on my care.

At the top of this hierarchy, the surgeons, followed closely by anesthesiologists, and hospitalists (the doctors that manage a patient’s care in a hospital setting). At the bottom of this hierarchy are the CNA – certified nursing assistants, with the LPN – licensed practical nurses and RN – Registered Nurses somewhere in the middle. In my case, Occupational Therapists and Physical Therapist were heavily involved in my recovery. They seem to float in their own orbits, independent of the regular hierarchy.

One scene from my experience captures this hierarchical system rather well. About three days after my surgery, I developed serious complications and was quickly moved back from the rehabilitation center to the hospital. The nurses (RN) were compassionate and caring, ensuring that I was comfortable and that my vital signs were monitored. They hovered around as they waited for the internist – my hospitalist – to show up and assess the situation. This doctor was thorough, kind and thoughtful as he evaluated my options. His focus was evaluating the severity of the complications and developing a plan to address them. During these intense moments, the surgeon stopped by. Two things told me his arrival was imminent. First, all of the nurses around me, except for the supervisor, became anxious and began to step backwards toward the side door into my room. Secondly, I became aware of what the nurses had already heard. The sound of several pairs of footsteps emphatically marching down the hall toward my room. Within seconds, the surgeon and his entourage walked through the main door into my room. From their starched shirts to their polished dress shoes, they commanded attention when they walked in. Without any hesitation whatsoever, they took over. I don’t say that with irritation or harshness. I wanted someone in charge of my health that knew what he was doing, had the confidence and experience to make the difficult choices. And that’s what I had. Along with that package also comes a strong ego and arrogance. He’s good and he knows he’s good. He knows what it takes to accomplish the difficult tasks of surgery and recovery and makes no apology for demanding what he needs. Even as I reacted against his cocky, self-confidence, I also knew I could trust my health—my life to him.

It was the people at the bottom of this hierarchy, however, that were the true caregivers. Throughout these three days and as I returned to the rehabilitation center, there were the CNAs. They brought me my meals, they changed my sheets, my hospital gowns, they even bathed me and washed my hair. I can only speak from my own experience, but I have never felt so cared for; ever! Everyone of them in my almost three-week stay was gentle, kind and compassionate. Not one time did any one of them respond to me with harshness or lack of caring. My first shower came about a week after surgery. Maria came and picked me up from my room and helped me get my clothes together. Once she helped me to the shower, she gently helped me remove my hospital gown, putting me in the shower chair. With great tenderness she washed my body and shampooed my hair. As she carefully poured warm water over my hair to rinse it, my mind was drawn to the image of Jesus washing the feet of the disciples in John 13. She brought me to tears when she lovingly wrapped me in warm, fluffy towels. This woman didn’t know me from Eve, but she lovingly and tenderly cared for me.

As she helped me back to my room, I tried to communicate my gratefulness for the shower and for her care. We talked about the work that she does and she remarked that it was a gift to her to be able to take care of her patients. As I lay in my bed later that day, I pondered the contrasts between the different groups of people essential to my recovery. I am incredibly thankful for a surgeon that knew his job and did it really well and for people like Maria, who very caringly took care of my daily needs. One sobering part of this system, that raises a host of questions for me, is the contrast in compensation for each of these groups. The average salary for a Certified Nursing Assistant is $24,000; the average for an orthopedic surgeon; $424,000.[*] As someone that has spent decades getting an education and pursuing a profession, I get that my doctor has done the hard work of training and sacrifice to get where he is. I get that. But Maria has also made commitments and sacrifices and thousands like her. A patient’s ability to thrive and recover depends in no less part on people like Maria. Where is equity in this system?

My thoughts about this system came back full force as the system that I am most closely linked with took a hit this month. The university where I work has been hit with serious financial hard times and we are looking at layoffs, program cutbacks and other difficult financial decisions. We are a system of hierarchy too of staff, faculty and administrators. In tight times, how do we ethically make decisions about how the pie gets distributed or re-distributed. Faculty have worked long and hard to get an education, to invest their time and energies in research and scholarship. They often view themselves as the central cog in the educational system; one can’t educate without educators. But a university also cannot function without the staff to keep things going from maintaining technology, cleaning classrooms and bathrooms, scheduling classes, ordering textbooks and the list goes on. What does it mean to take care of faculty, as well as staff? How does a university do that ethically and equitably? I don’t have many answers, just lots of questions. I am, after all, an academic.

[*] Another systemic question for another day: what are the systemic frameworks that set up my doctor for becoming a surgeon and Maria for becoming a CNA? It’s safe to assume (I think) that they didn’t have the same options and choices before them.

What kind of academic institution are you running here?

I was asked a rather disturbing question in an interview recently.

I was asked “When teaching, how do you both teach and protect the faith of the students in your class? Specifically, how do you protect the faith of godly young men who do not believe women can be in ministry and will likely struggle with females in class who think this is possible?” The unpacking of the question went on to include me, in that I am female, and might actually make a young man uncomfortable having me teach in a position of authority. Ultimately the question was clarified to ask how do I skillfully teach a class, not harm the male students or even push them to a point of questioning what they have been taught about roles of men and women in ministerial leadership and state that it is good and right for them to not believe in women in ministry while standing before them as a woman in ministry.

I think the person asking thought it was rather innocuous. In hindsight, this one question revealed a tremendous amount about the person and consequently the institution asking.

So I'm curious just what this interviewer was thinking teachers do, specifically teachers of theology and ministry. I can appreciate not wanting someone whose agenda was to destroy the faith of young people. But to frame a class around not harming a specific category? This would even have made more sense to me had the person followed with a question about the balance of protecting young women in class who did feel called to ministry and may struggle with the men in class who disagree. But this didn't happen. There was also no concern for what this may do to me as the professor AND a woman in ministry.

The lunacy of this question was that it was posed not by a random peripheral person, or even someone just curious. It was posed by the one charged with casting the vision and protecting academic freedom. There was an immediate assumption that I was going to dismantle the faith of others which is annoying enough itself. The more troublesome assumption is that students can't handle anything beyond affirmation of what they already believe. That students are not mature enough to listen, discern, discuss and have their faith deepened by actual scholarship. Frankly, this person painted the students to be fragile boys who couldn't handle anything outside of their already existent worldview.

We do a disservice to young people when we refuse to pose controversial topics or present a variety of views as valid. We breed future ministers who fail in reflective practices for fear that their precious theological glass houses will shatter. We dishonor God when we treat young people as if they are pathetically fragile in the name of preservation of faith. Assuming these same young people are created in the image of God… That god too is fearful and unreflective.

I am not interested I dismantling faith. I am however interested in helping young people, men and women, to be in ministry for the long haul able to draw strength in the face of diversity and new ideas.


Men AND Women

The Christian blog world lit up this past week with posts and comments all centering around a post by Jared Wilson on The Gospel Coalition web site. Long story short, Wilson wrote a statement about male authority which allowed for a reading advocating marital rape. He later posted an apology / clarification that he was advocating the exact opposite of how it could legitimately be read. He still advocates male authority in church and family but does not advocate marital rape. Ok, that can happen when you intend one thing and it is so clear in your own mind that you don’t even notice the other message present.

Beyond the egregiousness of what was originally posted is the stark reminder of how difficult it is within the Chrisitian community to be an advocate of women AND men. It seems easier to pit one sex against the other rather than to celebrate both. It’s the ultimate both/and versus either/or debate.

I’ve had a lot of affirmation over the years. I thought I found my place serving where I was wanted. I gravitated to ministries where being a woman was either celebrated or a non-issue. I have also been in places which gave a lot of lip service to being in favor of women in ministry but in reality liked the progressive exterior and still treated women differently, and by differently I mean poorly. These are some of the same people who speak and write on being pro-women.

Thankfully, I do have many, many experiences where the question of a woman in leadership is not even an issue. I have just finished a beautiful week serving as a co-pastor with my good friend Nick Palermo at a camp for teens with disabilities. We spent the week looking at unlikely people God set in place regardless of the junk the world names as desirable. We intentionally had a male and female speaker, preached from the Old and New Testaments, chose Biblical characters who were male and female. We never said it, but modeled throughout the entire week the worth of both sexes. It was an incredible experience. One where we were not only open to the Holy Spirit, but by design made room for the Spirit’s leading.

I can hardly believe on many days that women in leadership is still a topic of conversation. I am so glad that I have moved to places of service where both men AND women are celebrated! I’m done with those who proclaim equality but merely offer lip service, and with those who highlight their “inclusiveness” by including a token woman within a male dominant community so that they may feel like or demonstrate that they are inclusive.

Really? Are we still having this conversation?

The answer is yes, and we need to keep having it. Some of you, male and female, will be told again that you are wrong to advocate equality. Some of you will go places you think are safe only to find out later that someone feels threatened, or is a hypocrite or doesn’t have the courage to stand up for what he or she believes. Hang in there! You are not crazy! God longs for us to work together in ways where both men and women are celebrated.