Lessons from Ephesians

 For the word of God is alive and active. Sharper than any double-edged sword, it penetrates even to dividing soul and spirit, joints and marrow; it judges the thoughts and attitudes of the heart. - Hebrews 4:12

Seasons pass, where reading the Bible and listening to sermons becomes a chore. During those times, I hear an exasperated voice say within, I've heard this so many times already, what can I possibly learn from hearing it again? Yet, seasons come when it's fascinating to study God's words, even if we are going through the same handful of chapters, for months and months. During these times, it's a delight to discover the depth of God's word, and amazing to hear each day, a living truth that we would do well to take to heart.

Some lessons and ponderings from Ephesians, mostly from this week's studies.

1. Knowing Christ

"You, however, did not come to know Christ that way." - Eph 4:20

What does it mean, to know Christ? What did it mean earlier in the letter, when Paul prayed for the Ephesian church (who were obviously Christians already) to know God better?

It's more than hearing, or even believing, that he exists. One of our speakers put it as, the difference between knowing about someone, and actually knowing them, personally.

2. Deceitful desires

"You were taught, with regard to your former way of life, to put off your old self, which is being corrupted by its deceitful desires..." - Eph 4:22

Deceitful because, it can be an innocent desire itself, but become corrupt as it overshadows or distracts our focus on God. Deceitful because, sometimes even we have difficulty seeing the layers of good and pious reasons we give for something that is essentially self serving.

Apparently there is a hymn, "prayer is the soul's sincere desire". And the challenging question is, what do you pray for in your quiet moments before God?

3. New attitudes

"to be made new in the attitude of your minds..." - Eph 4:23

For myself, it's interesting to see that in very real ways, knowing God has brought me new attitudes and desires that are quite distinct from my original self.

Also, I liked the study guide question - what are you doing to renew your mind in Christ?

4. Holiness is not a mystical state

"and to put on the new self, created to be like God in true righteousness and holiness" - Eph 3:23

Holiness is more than something that just happens where we become crowned with a halo, wear white robes, stand with a calm but solemn expression, and have sun rays shining upon us! Living out holiness involves taking off our old self, and putting on our new selves, which requires practical actions, and our active participation.

5. Consider needs of others

"and live a life of love, just as Christ loved us..." - Eph 5:2

All the practical examples Paul gave from 4:25 to 5:4 in regards to living out holiness, can be summarised by living a life of love which puts others before ourselves - for example, practicing unity in the church by being slow to anger and forgiving one another. Or, building others with the words we say. Godliness isn't practiced in isolation.

6. Being very careful

"Be very careful, then, how you live - not as unwise but as wise..." - Eph 5:15

This is my last point because I can read the passages every day, listen to the sermons every week, and discuss it in Bible study twice a week. But, every day, I want to pursue my own desires without stopping to evaluate whether that is in line with what God desires. Every day, out of boredom, jest, spite, carelessness or, in particular, in anger, I speak (or write, ha) words which neither build up nor benefit those who listen.

Beware, be intentional, because it doesn't come easily or naturally to live wisely. Thank God, for being gracious towards us.

But because of his great love for us, God, who is rich in mercy, made us alive with Christ even when we were dead in transgressions - it is by grace you have been saved. - Eph 2:4-5

Change of pace

For a few days, I exchanged my scarves for slippers, and saw a sun which glowed with real brightness and intensity. For once, my thoughts were occupied not just with discharge summaries and the whirlpool of my own feelings, but with the lives of old friends, and medicine that touched poverty, politics, and the wider world. As I weaved up into vast skies and layers of clouds, once again I was struck by the consciousness of my own mortality, despite knowing that statistically, dying from a plane crash is extremely unlikely.

From waking up to noisy neighbours and train hoots, there, I woke up to an unnecessarily loud and horribly evil laugh of a kookaburra, followed by a colourful choir of tweets, which reminded me so much of home. My never changing breakfast of two minute oats, milk, and bananas, was changed to, waking-up-too-late-for-breakfast, which would be promptly followed by scoffing down dry scones at morning tea, binging on tea and milk for lack of good food options, piling massive plates of not so filling vegetarian meals (organisers were going green), and diving for fried finger foods in the evenings. Each night would conclude with a stroll down to the night markets, armed with a delicious roll of Japanese crepe with whipped cream and ice cream.

Instead of (mentally) speaking with myself at my desk, which makes for poor and tiresome company, I sat with old friends on quiet benches outside loud and drunken parties, indulging in long overdue catch up chats. We talked until early hours of the morning, about our careers and futures, above love, about makeup and clothes; laughing at how each of us, from the pink-loving girly girls to the tomboys who never wanted to be girls, were on a journey of transformation, from a girl to a woman. Having often lamented on lost friendships during university years, I delighted in discovering that old high school friendships could mature into something better, where even the craziest girls, or the boys who adored only games and Anime, could develop a thoughtfulness and patience to listen and connect on a meaningful level.

A few days of warmth and a change of scene, away from the unbearably stubborn fog through which everything becomes indistinguishable shades of grey; respite, I think that is what they call it...

Life, not love

It's about life, not love.

It was and is my dad's favourite line. Probably mum's too. Not that I was ever a hopeless romantic. But as teenagers do, you half listen and half think, how cold is that? Maybe that's how things worked in your times, but... just a bit outdated! They never tire of repeating the phrase. Whether we are sitting back lazily on the bed in our new house, in a quiet evening stroll beside the sea-facing resort pool in Bali, or chugging along a bumpy train in China. More and more this year, I have been thinking about this phrase, weighing up its truth, its value.

A: We did all the corny things that couples do, just sitting and holding hands. Beach, mountains, sunsets. It was nice, like being on drugs, all the time.
B: Or having a mental illness.
A: Now we see couples and laugh at them, ha. Well, you can't have that forever, the feeling fades. Unless you start a new relationship.
B: I guess you can't do that indefinitely.
A: Yeah, and it will never be the same as the first one.
A: He used to really love me, doing all the sweet things. He says all the right things now but...
B: He could do more?

Despite that, they are getting married this year.

We too laugh at young couples. Couples making out on open grass, blissfully oblivious to the other users of the busy park. Those glued tightly next to one another, so much so that they bump one another awkwardly and walk down the street in zig zags. The two in an adjacent table looking intently into each other's eyes, holding hands across the table, with an endless flow of soft sweet words and laughter. I guess they weren't too interested in the meal itself. Meanwhile, I eat in silence - looking intently at my mouth-watering, spicy crispy pork ribs, picturing how delicious another bite would be. Friends celebrating their one month, one and a half month, two months, three months, one hundred day anniversaries; that's nice, I say, but what I'm really thinking is, with that plus Christmas, Valentine's Day, birthdays and more, how many presents and special meals can you manage to buy in a year?!

As fire in a fireplace changes from hungry flames to a quieter glow, changes in relationships are inevitable. Perhaps necessary, because reality can't be held off forever. How quickly the buzz which is often called "love" gives way to "life". Doing life. Living with each other's imperfections, and somehow reconciling a growing realisation of differences in personality, backgrounds, interests, communication styles, ways of thinking, ways of feeling, basically everything. In handling daily life with studies, work, careers, household chores, church, children, property, finances, and more.

Life not love.

Mum and dad, is that what you meant? But, in a way, marriage is about love, as much as it is about life. Love, not the intoxicating feeling, but a quieter, selfless love that lasts and sees through the challenges of life. Also, I'm not old or cynical enough to agree with you completely just  yet - a little craziness, not every day not even every week, but once in awhile, would be nice.

love is more than a buzz
(Started drawing the original version of this whilst jotting down sermon notes!)

On false peace

A few weeks ago I was in a conversation, where a friend was speculating about afterlife, and what it entails. I wasn't sure what to say. It wasn't an appropriate time to articulate my views on the topic, yet I couldn't simply agree with what was said either.

How tempting it is, to only speak of God's great love, omitting an aspect of his character which is just as important - his holiness. Yet, by doing so, are we not leaving out an essential piece of the gospel, the good news? For what is so amazing about grace if there was no judgment.

Reading Jeremiah, I have been struck by how Jeremiah repeatedly speaks of judgment and then a time of peace and restoration, in contrast to the many false prophets of his time who declared peace, without acknowledging the judgment of Judah which was to come first.

So do not listen to your prophets, your diviners, your interpreters of dreams, your mediums or your sorcerers who tell you, 'You will not serve the king of Babylon.' They prophesy lies to you that will only serve to remove you far from your lands... - Jeremiah 27:9-10

For example, in Jeremiah 28 there is a prophet called Hananiah who takes a yoke off Jeremiah and breaks it, falsely declaring that the Lord had revealed to him that the rule of the Babylonian kingdom will be broken within two years.

Then the prophet Jeremiah said to Hananiah the prophet, "Listen, Hananiah! The Lord has not sent you, yet you have persuaded this nation to trust in lies. Therefore this is what the Lord says: 'I am about to remove you from the face of the earth. This very year you are going to die, because you have preached rebellion against the Lord.' " In the seventh month of the same year, Hananiah the prophet died. - Jeremiah 28:15-17

The false prophets were harshly rebuked for proclaiming a message of peace without judgment, and for opposing God's message of judgment through Jeremiah. In agreeing that there is no judgment, but that afterlife is a beautiful place of rest, am I not giving a message of false peace that is not from the Lord? But what else can I possibly say, without being insensitive?

It is also unsettling just how unpopular Jeremiah's message was, resulting in hatred from the general populace to officials and religious leaders, resulting in his imprisonment and various murder plots directed against him. I suppose it's not just our generation which tolerates a message of love, but finds the message of judgment offensive.


Towards the end of high school, we flipped through a huge phone directory sized job guide, which has now become fully electronic. Abattoir worker, actor, aerobics instructor, agricultural engineer, analytical chemist, anthropologist, archaeologist. We have barely begun in covering the range of jobs starting with "A". By the way, anthropology was the one that sounded the coolest at the time. Oh well, maybe I will go back and do that BA one day.

At that time, I couldn't understand why training as an apprentice chef, was considered a "lower" job than say, an accountant. Or, why three years of university education was considered so much more worthy than a three year TAFE course. Or, why was it that, the higher a score that was needed to enter the course, the more students wanted to get into the course. Again I thought about the question, whilst working as a kitchen hand, alongside those who were a similar age to me, most who did not attend university, and many who did not complete high school. But, if you work hard at what you do, contributing to society in a meaningful way, what does it matter what you do? Even now, I'm not sure I completely understand the way our society ranks different occupations and careers.

In the same way, I don't understand why medicine is so prestigious. The expression of respect, especially but not exclusively within Asian circles, that becomes evident when one hears that you are studying medicine. Wow, you must be really smart. Uh, thanks? Not infrequently, I have had others misinterpret "studying medicine" to mean that I am going to be a nurse, or a pharmacist. It's when I feel the twinge of irritation of, no I'm going to be a doctor, that I realise, I have also adopted the attitude that we are smarter, better and simply superior. We joke about this so often and perhaps, one by one, we really start to believe it, if we didn't already upon entering medical school.

Elitist. Being in an old and well established university, our students are known for being stuck up, often making snide remarks about the incompetence of students studying on the other side of town. What, you are at a rural hospital for clinical school, you couldn't possibly have chosen to be there. Where are you going next year? Congratulations on your internship destination, largest is the best, the hardest places to get in, so you must be really good! Er, no I'm not, how do I explain that neither my marks nor my life achievements are amazing. I feel uncomfortable that my extended family is more excited about my internship destination than I am - uncomfortable, because I know they are happy because they love prestige. Anyway, how does older and bigger automatically equate to a better place to work and grow?

It just doesn't stop here. Which specialty training program are you in?  The enthusiastic "wow" for someone on the R.O.A.D. to happiness (radiology, ophthalmology, anaesthetics, dermatology), or training in a much admired field such as neurosurgery, is such a stark contrast to the "oh" someone training to be a general practitioner often receives - oh, why don't you want to specialise? Just like when we were in high school and choosing what to study in university, we equate more "difficult" entry requirements, to a better specialty, and a better person. Not just academically, but smarter, richer and more important. Therefore, we treat them with special favour. Or should we?

Good marks and hard work are fine in themselves, and indeed, many of those in highly sought after specialties are talented, committed, and deserve the respect that they have. But it really bothers me, the obsession of prestige and achievement that surrounds this profession. How across every level, from medical students to consultants, we are judged, and in turn judge one another, based on rank, specialty, place of training and other such criteria. Not only professionally, but just as much in personal and social interactions. And how we judge those outside medicine to be just... well, not as good. Why aren't you dating someone in medicine - or conversely - of course my parents will be happy with my sister's new boyfriend, he's going to be a doctor!

Perhaps, most troubling, is when this occurs in fellowship. Attending a medical Christian event over the weekend, we were asked to add our year level and university, or specialty for graduates, to our name tags. I thought, does this really matter, and pondered whether it would affect the way we talked and interacted with one another. More than a year ago now, I attended a talk at Christian medical event where I clearly felt the hospital hierarchy in the room. I happened to be seated next to registrars who seemed to want to make it clear that they were registrars (not intern or residents), and seemed to change their manner when they talked to fellow registrars, and when the medical students talked to them. Or it could be purely my interpretation; or, they were shy and not very talkative anyway.

The speaker in front was the head of the endocrine unit at this hospital, and the director of that very prestigious specialty college. During the talk (on a topic which I have now forgotten) I wondered whether at times the speakers were not speaking more as consultants to their junior doctors, on how to do medicine and life, rather than humbly sharing God's words and God's work in their own lives. Considering how important connections are, in turn, I wondered how many students were using refreshment and mingling time as career networking opportunities, rather than seeking genuine fellowship and spiritual growth. Maybe I was being over cynical, but certainly, the thought of focusing on the networking aspect did not escape my mind.

So in Christ Jesus you are all children of God through faith, for all of you who were baptised into Christ have clothed yourselves with Christ. There is neither Jew nor Gentile, neither slave nor free, nor is there male and female, for you are all one in Christ Jesus. - Galatians 3:26-28

At work, we should respect those in authority, including brothers and sisters in Christ. However, it was disappointing to see hospital heirarchy, reinforced by junior and senior doctors (and students) alike, permeating into church life and ultimately, hindering fellowship and taking the focus away from God. Recognising that we are all sinners, and recipients of God's grace, why should one (no matter who they are in the medical profession) exalt themselves over another? Perhaps that experience made me reluctant to join the medical fellowship events in M. Until recently that is, when I was once again reminded of the importance of being inspired by, encouraging and being encouraged by other Christians in medicine. Just as those who are proud stand out, there are of course, many who are marked by faith, having lives which point clearly to God.

Do nothing out of selfish ambition or vain conceit. Rather, in humility value others above yourselves, not looking to your own interests but each of you to the interests of the others. In your relationships with one another, have the same mindset as Christ Jesus: Who, being in very nature God, did not consider equality with God something to be used to his own advantage; rather, he made himself nothing by taking the very nature of a servant, being made in human likeness. And being found in appearance as a man, he humbled himself by becoming obedient to death — even death on a cross! -
Philippians 2:3-8

What's wrong with being elitist? What's wrong with loving prestige? What's wrong with having an elevated view of our profession, our university, our hospital, our specialty, our rank? It matters what we value first and foremost. We lose perspective when self becomes bigger and more important than God. We forget who we trust in, who we should be thankful towards for all that we have. We compare with others, begin to focus on collecting trophies, aiming for what is "best" and most prestigious, to serve our pride and desire for recognition. In doing so, we lose sight of our purpose, and become distracted from working for God, and living to love others. Jesus, king of kings, did not exalt himself but came to serve. How each of us, not least myself, should be constantly reminded to do likewise!

The hardest things

Assignments. Midsemester tests. Exams. Assessments. Tutor marks. Not being able to answer questions. Not knowing doses of medications. Not remembering pathophysiology. Not being sure of clinical signs.

A classmate was saying that the thought of the physician training exams terrifies him, because of what he had heard about the low pass rates. I laughed and replied, you can always take it again, and if you fail too many times, maybe you're really better suited to doing something else. I hear of students in science, pharmacy, arts, architecture, engineering, law, each talking about how stressful it is to have weekly assignment, midsemester tests, or exams coming up. Each, including medical students, sighing and not so subtly implying that their course is harder than everyone else's.

I guess I don't completely understand. Not that I don't feel the stress of assessments. But for many years that type of anxiety has not progressed beyond a useful prompt to open my textbooks and get on with work. So with a tad of arrogance, and disdain, I frown in scepticism when people around me rant about how hard everything in university is. I can't help wondering, which part of writing an essay, even if it's several thousand words in length, is difficult when you only have ten contact hours a week? Which part of medical school is difficult, and how much does that first class honours really count, especially when, being old and grey one day, you look back at your life? How are clinicals overwhelming? We keep learning, and have many years ahead to learn. Plus with so many iPhone apps (what a serious disadvantage, not having one yet!) what does it matter if we don't have encyclopaedic knowledge on every topic?

Lately, in my possibly excessive hours of self reflection, I found that the hardest things in university, in medicine, in hospital rotations, have little do with the studies, or even the clinical work itself. Not saying there isn't much to be learnt as a junior doctor. But, being a scribe/secretary/PA/intern for a team during ward rounds, writing scripts, filling in pathology slips, making phone calls - these are not difficult tasks, and hardly deserve the respect bestowed by the "Dr." title.

Rather the hardest things are to wake up to an alarm clock, or worse still, long before the alarm clock sounds. Day after day, after day. It's waiting for trains on a chilly morning, or cold afternoon, and attempting to use the vending machines at the platform to barricade against the wind, only to realise that it's impossible to do so because the wild wind constantly blows where it wills, in multiple directions. It's uncomfortably shifting weight between the collapsing arches of two feet in uncomfortable shoes, and pouncing on opportunities to sit on ledges, lean on benches, kneel on the floor whilst leaning on patient beds to write notes on. It's driving home at night blinking constantly, feeling like there is glue trying to close my eyelids shut. It's being too tired to asleep, or when insomnia lingers. It's when too many early mornings make the days of the week blur into one another, until I score a patient wrong on the mini mental examination, when it was really me who had the days and dates mixed up.

It's being easily upset, fiercely angry, and excessively sad and teary. It's wondering whether it would be better if I live alone forever so that no one else needs to deal with these emotions. It's when the monsters pay frequent visits, when gradually the sorrows of the night spill into the morning, yet there is still the obligation to get ready for the day, be functional, and deal with the grief of others. It's when grief spills into the unconscious world, manifesting in restless dreams with deaths of loved ones, hurtful words, being attacked with a ballpoint pen, lost friendships - waking up with palpitations, elevated heart rate, hearing my own voice cry out, and starting the day with a discomfort that is difficult to describe. It's when, working next year, staying home to sort myself out for non physical illnesses is no longer an acceptable option. It's being physically unwell and feeling guilty for resting at home for a minor illness. It's being disheartened at the room with suitcases, bits of paper, bags, shoes and clothes strewn over the floor. It's at the end of a day, being reluctant to be at home amongst another family's world of hidden but palpable sadness, conflict, uneasiness, which I feel for almost as much as if it were my own. Yet having no real alternative, unless I wish to wander from restaurant to restaurant, bubble tea to bubble tea stores, taking long strolls around the city, or purposely making the train journey home longer, every evening.

In writing I realise, perhaps it's not that I hate medicine, but that I use it as a scapegoat. What is hard is the weariness of functioning reliably, and managing the difficult feelings that come with daily life, both personal and those which arise from clinical encounters. I think that's what my Boggart would be shape shifting into, if there was a physical, tangible, pictorial representation of that fear. I shouldn't scorn at others for what their Boggarts turn into, for them finding their greatest fears, the hardest things, to be other aspects of life.

Day by Day

Day by day, and with each passing moment,
Strength I find to meet my trials here;
Trusting in my Father's wise bestowment,
I've no cause for worry or for fear.
He, whose heart is kind beyond all measure,
Gives unto each day what He deems best,
Lovingly its part of pain and pleasure,
Mingling toil with peace and rest...

God, help me to walk with you through each day, through everything I find difficult. In toil and rest, pain and pleasure, finding strength and purpose in you.

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