Reading between the lines...

One of the problems that people with autism spectrum or Asperger's commonly have, is that they can be very concrete and struggle with metaphor. They tend to take things literally and not to understand allegory, allusion or simile.

We were explaining this to the parents of a boy with Asperger's and how this makes completing high school English difficult, as a high level of interpretation and understanding is usually required. These children may have done well early on, with more concrete comprehension tasks especially those requiring good memory, but the interpretation part often takes them by surprise. Some will say things like "but the answer to the question wasn't in the book!"

Today, we were saying to these parents that Asperger's boys often have trouble reading between the lines. With a panic-stricken expression he said "What do you mean reading between the lines? There isn't anything there!"

Which is, of course, the point.

Ethics of gambling post

This was a great post on Feb 8 by Ben Witherington (read the whole thing on his blog) about the ethics of gambling and why Christians should not participate. His excellent points are:

- that gambling is the opposite of the usual work ethic, where a worker is worth his hire, and tries to get something for nothing, or at least a lot for a little.
- gambling relies on most people losing most of the time, and is therefore probably against the laws about not lending at excessive interest or profiting from the poor.
- gambling is not a good use of the money under our stewardship, since it is purely a personal and selfish entertainment, and an addictive one.
- often, it is driven by a selfish fear of poverty or a wish to provide luxuries for oneself. Really, God provides for our needs, through work or through the church and luxuries which we can't earn or be given we can learn to do without.
- gambling is a whole industry based on the sin of greed, and plays on this in order to make a profit. Everyone who participates in this either supports it by losing money to it or profiting from those who.

Quote of the day:

Gambling is an act of despair by those who either never trusted God or have given up doing so. James was right--- "the love of money is a root of all imaginable sorts of evil".

Go Ben!

The Muslim Jesus speaks

Something from Jesus Creed, which is a quote from the Muslim scriptures about Jesus:

“It is of no use to come to know what you did not know, so long as you do not act in accordance with what you already know. Too much knowledge only increases pride if you do not act in accordance with it”

I love this, and it reflect the very Westernized concept of learning being totally separate from our actions. When I am trying to educate parents about their child's health, people often say "Oh yes, I know that." I always want to say "Well, why don't you do it then?"

I have heard of ministers who say that they are not going to preach more until the congregation puts into action what has been taught so far. Some therapists do the same, and until the patient starts following the advice already given, won't give any more. It is so true that most of us already have more Bible and theoretical knowledge than we will ever use, so why this need to read more, know more, etc. Could it be pride? Or laziness? Could it be that "learning" is easier than doing?

A flash of psychiatric light...

I may end up doing psychiatry after all! Yesterday we had an amazing discussion about the nature of psychiatry from one of the consultants who obviously remembers what it is to be a registrar and just starting out. He talked about when you get the patient who presses all your own buttons about your childhood traumas, and when you feel inadequate, or when you find yourself taking your work home and you can't stop thinking about it. He remembers.

Even better, he has answers! I recognize gold when I hear it, and this was 90 minutes of solid gold. He talked about boundaries and keeping them intact both for our sakes and also for the patient. He talked about our job as making the diagnosis and formulation of the problem, and the fact that this may include the patient's inability to accept help or to move past the problem - this is therefore part of the problem and not our fault. He very rightly said that if we were presented with a patient with small cell carcinoma of the lung, we wouldn't be talking about cure because we would have a realistic approach to what is possible, and psychiatry has these cases as well. Taking on multi-generational abuse and relationship dysfunction and expecting to fix it all in a six-month rotation - well, denial ain't just a river (for doctors as well as patients).

He reminded me of that old, old, but still true saying: the patient is the one with the problem. He reminded us that our job is to diagnose, formulate a plan, help and advise. If the patient doesn't accept the help, take the advice or follow the plan, that is the patient's problem. There is only so much that people can be helped. There comes a point (even with kids) where you have to either take them home with you and adopt them, or let them go.

They belong to their parents to take care of, and though the parents feel inadequate and want us doctors to take over, we can't. Even though we are nearly all compulsive care-givers (so true!) and we want to take over and make it all better, we can't do that either. Even when parents project helplessness and weakness and we just want to take it all on and fix the world and make it all better - we can't. At the end of the day, we make the diagnosis and the plan and give it back to the parents.

I hope this doesn't all sound too cynical, but this was a cold, hard shot of reality where I really needed it. I know that I do take too much on myself, and wonder why I feel inadequate and frustrated. Responsibility for the problem without power for change is the ultimate recipe for frustration, and one hour a week is just not enough leverage to change what goes on in these families every hour of every day.

Now I know that, I think I can get back to doing my job (and, I hope, doing it well) and leave all the emotional baggage at work, where it belongs.

Leviticus 5

After so many years of reading the Bible, it seems strange to be redicovering it now, but there it is. I am becoming increasingly aware of the call to dwell in the Living Word and let God speak to me and change me through it. Even the old statutes which I struggled to read the first time through the Bible, now speak of relevant and serious commands from God, Leviticus being a particularly striking example.

The LORD said to Moses: "If anyone sins and is unfaithful to the LORD by deceiving his neighbor about something entrusted to him or left in his care or stolen, or if he cheats him, or if he finds lost property and lies about it, or if he swears falsely, or if he commits any such sin that people may do; when he thus sins and becomes guilty, he must return what he has stolen or taken by extortion, or what was entrusted to him, or the lost property he found, or whatever it was he swore falsely about.

God is very concerned with how we treat each other, and speaks to this as seriously as the more obviously "religious" commands. Any speech to another person is taken as seriously as a vow to God! How amazing would it be if all Christians could be so trustworthy! This sense of trustworthiness is extended also to found items and property held in trust or borrowed, which I have observed that most people would not feel so stringently about returning. God tells us the opposite of "finders-keepers", and I wonder if this should be taken to refer to all games of chance and opportunity? Gambling would seem to me to be against the spirit of only taking what you have made or earned or own - perhaps it is a kind of extortion, since one man's gain is another's loss?

If a person sins because he does not speak up when he hears a public charge to testify regarding something he has seen or learned about, he will be held responsible.

The social responsibility side is also emphasized, much more than in our society today where people generally disclaim any responsibility which is not directly ours. The responsibility to "blow the whistle" is positively discouraged in some industries (medicine is one) and the charge to publicly testify to wrongdoing is often subsumed in worries about what such speaking out might to do one's career. Witnessing to the crimes of our society is also not popular, though in some areas it is becoming more so. A Christian responsibility to stand up and make a fuss! Now that would be worth doing!

Leviticus 4

In Leviticus 4 there is a comment about if someone sin unintentionally, he is still guilty of sin.

This is an interesting statement in a society where "I didn't know" seems to be considered the excuse for everyone from politicians on up. Claiming not to have been there, not to have been aware, not to be responsible all seems to add up to it not being my fault or my responsibility to fix. It is interesting that God says otherwise.

To me, this means that it is my responsibility to be aware of the law under which I live. It is my responsibility to follow both the laws of the country and the commands of God. Ignorance of the law is no excuse.

More than this, it is also my responsibility to be aware of what is happening in the world around me, especially the part of it for which I have accepted a duty of care. It is my business to know what is happening to my patients and in my unit and on my ward. It is also my responsibility to know what is happening in my community and in my church, in my society. Ignorance of the facts is no excuse either.

This is a very interesting article about a philosophy of evangelism:

http://www.youthspecialties.com/articles/topics/recreation/entertained_to_death.php

I think it is a symptom of living in a pluralistic world, where the church is afraid to teach it as it is, and instead relies on "marketing techniques" to appeal to people. People brought into the church by the appeal of prosperity gospel teaching are not necessarily going to like being told to reform their lives, bear the yoke of persecution and engage in social justice.

When Jesus taught, he was not afraid to say up-front that the way of following Him demands personal sacrifice. It wasn't in the fine print of the contract, it was on the front page. No-one could ever say to Jesus that they were disappointed that they weren't getting their needs met, yet I think this happens quite often in the modern church. Is the problem in the structure of the church in meeting needs, or is the problem the expectation that the church should meet all our needs?