A Broken Hallelujah

I am joining with Prodigal Magazine and SheLoves Magazine to explore A Broken Hallelujah.
There's a big link-up so go and check it out for lots of different takes on the theme.

***

She apologises. She can't come because of the funeral, and I nod, that's fine. Please don't worry. I ask a little more and she tells me of a young boy's death. She whispers 'suicide' not wanting to tempt, by saying it aloud. Perhaps if the word is swallowed, unspoken, it will not have happened.

Family draw around as his mother bears and breaks. She bears as a mother should never have to. To imagine the loss of a son is not enough, but it is all, at this moment. To carry a little of the pinching, endless discomfort of walking in her shoes. The complexity, the mystery, of bearing one another's burdens.

I feel it too, with my friend as her shoulders shrug and fall. 'What can I do?', says her helpless, uncomfortable expression. We are so like animals, who retreat to tend their wounds, because we do not quite know how to be broken in company. We are reluctant to be a bother, but it's being broken together that makes us family. That bonds us indelibly.

Judas hung himself, you know. Matthew said so. And he did it after the men who paid him washed their hands of him. "That's your responsibility" they said and would not accept the bribe back. The temple door slammed in his face.

So utterly alone. Left with his own failure. Unbearable. And he could not contemplate asking another to help him carry it. This is despair. To be so separated from community that no one can reach you to help.

And the paradox of desolation is that, in the midst of the deepest need for community, the desolate one feels an ocean away from everyone. How do we reach them? And how do we recognise who is desolate? There is no simple answer for recognising risk and who is really despairing. Psychiatrists struggle to predict suicide risk, and despairing people do not want to cause us inconvenience, so they do not let us see their struggle.

Our sensibilities make some subjects harder to talk about and I think that despair and suicide are difficult topics to raise. I think we would learn more grace if we could allow more despair to be acknowledged. If we could listen to more struggle and allow our community to help us carry burdens. Sometimes soldiering on and covering up struggle teaches others that despair and brokenness are not acceptable.

There is one broken hallelujah we could look to. Jesus in the garden of Gethsemane, asks his friends to pray with him because he is sorrowing to the point of death. He does not hide his despair or withdraw from support. He is hungry for it in his time of need.

And I'm preaching this one to myself.

Blangst, navel-gazing, call it what you will.

In blogging, I'd rather be artless, than artful. I'm not a writer and I struggle with self-revelation. I'm naturally a listener and the contents of my heart stick in my throat.

I spent a weekend with kind, comfort friends, sisters of many years standing and it was a gentle massage to my soul. Susan asked me about this blog, and I nodded that I'd been a little quiet. I'd like to ask more of her opinions and thoughts, but its hard to let anyone know that I worry what they think. That I know I struggle in relatability and funny stories. And I lack focus.

Here's her opinion. That people would be interested in hearing more about the life of a doctor, who works with people who have psychiatric problems and addiction problems, who has four children, is a baptist pastor's wife and lives in Macquarie Fields (yes, there was a riot). In hearing more about my life.

Maybe.

There's a few difficult spots.

I don't do advice - I find it hard to look at my life and tell you what you should do with yours.

I don't do contentious issues - I am not spilling my partisan beans about women's roles, Calvinism, creationism, same-sex marriage, schooling choices, denominational issues - yadda yadda yadda... Call it my concession to fence-sitting.

I don't do design or fantastic images or cool stuff. I am extremely un-hip. I am everything Frankie magazine is not. I dream about having a funky blog design. But I'm sure just as I get totally white/pastel/multi-image and have interesting fonts, hip blog design will have moved on anyway.

I do write about the following - emotions, anxiety, failure, grace.

I plan to write more about - listening, complexity and paradox ('nuance' as Tim Keller would say), not having all the answers, faith, and my work.

I am also open to suggestions or opinions or pointers from you. What are you interested in here?

Finally, some self-revelation - to engage you ;)

I love to skim gossip magazines, but I hate to buy them. Perhaps this reveals my tight fist and the messiness of my heart. Or that I like my vices surreptitious and almost acceptable.

I never put money in shopping mall rides. Never. Even when you have put money in for your child and let my kids ride too, I won't reciprocate. Thanks for your grace to me and mine.

I am not a good person. Even if you think my job sounds altruistic or hard, or wonder how I listen to people. Stop. I bet I couldn't do your job, or cope with your kids.

I love being alive. I revel in cheek laid on cheek, full-blown magnolia blossoms, beer-battered fish, passionfruit pulp, striding uphill in the city, patterned tights in boots, short-legged dogs running to keep up and footballs kicked hard past the goalkeeper.

I enjoy my 3 year-old's story, told in his bunk, about Simon the purple apple and Jude the green apple. My stories for him are lame in comparison.

Just saying.

Waiting

I was seven months pregnant when I realised it. The waiting wasn't just for bones to get long enough, a heart to beat reliably or lungs to blossom into countless sacs of diffusing membrane. I needed the waiting too.

The unsettled pregnancy sleep prepared me for waking to someone else's need. And the inability to be relaxed and comfortable in my skin for nine months made me appreciate returning to being me. Somehow, the waiting is how I gradually prepared myself to care for a tiny being. For the emotional reality of it.

Plenty of people are happy to remind me that change is hard. Sometimes marathon hard. Sometimes hit by a semi-trailer hard. And waiting is a way to build up for the struggle of change. A long slow drink before we walk out onto an unknown path.

I have been waiting.

And waiting is not a passive time. I wait with my family amidst the squabbles and raucous laughter, the scrapes and the home reader books. I stopped blogging for a few weeks and didn't miss it. Waiting was busy and absorbing. I am getting ready. Unsure for what.

Caught in that moment of knowing preparation is necessary, but bewildered about how to get ready.

I started to think about the group of faithful waiting in Jerusalem. They didn't really know what for. Just told to wait for the gift. They had no idea what would happen to them.

“Do not leave Jerusalem until the Father sends you the gift he promised, as I told you before. John baptized with water, but in just a few days you will be baptized with the Holy Spirit.” Acts 1:4-5.

They could not have anticipated seeing the flames of God, hearing the wind of his presence and the flurry of talk amongst them. How could they have understood what Jesus meant about a counsellor coming to be with them? That God himself would come amongst them in a new way. A reinvention of the tabernacle.

The pastor reminds me that this is the one festival that the early church celebrated - Pentecost.

 As I wait, I am sharing in that mysterious expectation. I am preparing myself to see God flaming in the world, to hear him blowing past my ears, to witness him bring understanding.

Waiting is the time to pray for eyes to really see and ears to truly hear.

Are you waiting for something?

Linking with Emily at Imperfect Prose

Wondering...

(Yes. I drove past this bilboard. And took a photo.)

I'm wondering how they do it?

How can someone keep all the things up to date that need to be up to date?

When I consider the following list that one woman might need to get done

• going to the dentist regularly
• getting regular pap tests
• staying healthy in other ways - doctor/chiropracter/counsellor/whatever
• keep leg hair waxed
• getting haircuts
• getting hair colours
• taking children to the doctor/dentist/hairdresser
• I'm sure I've missed some - what is on your list?

How do people do it? How do they get their children looked after for one thing?

Just thinking this, as I realise that I haven't been to the doctor other than for pre-natal visits for the last ten years (possibly indelicate to tell you how long since my last paptest?). That I ignored a reminder from the dentist twelve months ago, that I wear long pants for 80% of the year due to unsightly leg hair and that I stopped colouring my hair (myself admittedly) when I was 25.

Is it just me?

Declutter (part 3)

I started to write a series about decluttering my heart. I wish the ideas would roll out comfortably, into a clear, neatly spaced list (perhaps in a cool font).

But my heart is much more complicated than I planned. The phrase "pure in heart" weaves in my thoughts, conscious at times. Sometimes it is the inconvenient heaviness at the back of my head as life crams out contemplation. Is purity possible?

So much of my life is all about maintaining. Making sure the need-tos happen each day - food, clean clothes, and, let's face it, TVs don't watch themselves. Conversations get caught in details and I run out of time to share dreams.

I read bits in wide-ranging places and respond to the beauty of phrases that make pictures. I see glimpses of others drinking in the intimacy of living the grunge of life side-by-side. It is liquid down a dry throat. It clicks that I had ignored my thirst, perhaps so I would not be overwhelmed by it.

My heart is buried deep beneath skin, muscles, ribs and lungs. Absorbed in its task of relentless beating. Much of the clutter is actually around it rather than in it. Briars grew over many years around a sleeping princess's castle and this is what we do to our hearts. It's protection - so that we hurt and bleed less. An unbriared heart can be cut and bruised by debris.

I cannot have a pure heart, until I begin to dismantle the fences I've built around it. My heart cannot do it's task properly until it can connect more directly with pain and joy. Because when my heart is engaged, then I listen, then I pray, then I puzzle out how best to love.

Declutter (part 1)

Contrary wishes clutter my heart. It beats and pumps and I waver in the wind.

My mind is a cupboard filled with hoarded bits and pieces. I long to unpack the piles that have collected on the shelves, but I can't do more than move them from one to another.

A preoccupation with what I want and need, crowds inside me. I witness dramas and imagine myself in the starring role. I long for significance and to be noticed. I want to be the one who gets it done. In the nightclub that is my soul, the crowd on the dancefloor are all me just trying to catch someone's eye.

I look around the house, discouraged by the similarites of outward and inward life. Stacks of books. Collected toys and games. Mount Washington just in, off the line. No space to spare.

No one is surprised, that decluttering and simplifying are national pastimes. We talk about them, anyway. We pay to hear the secret of making them reality. Maybe if I buy the book, order, rationality, simplicity, will be possible.

But I need to ask the real question.

How do I declutter my heart? Simplify my mind? How do we purify our lives?

Any suggestions?

Just wondering...

I've got a question for you

We had a church meeting today and our pastor suggested that we think about becoming members (of our church). I've thought about it a few times over the past nine years, but never made the step of doing it. Our church has ten members but  about three times more associates (regular attenders who aren't big M members). Our church is part of the Baptist Union so membership requires baptism by full immersion.

Perhaps I should mention that the pastor making the suggestion is my husband. But anyway...

I have been baptised, in a childhood, Presbyterian fashion. When I was a teenager, I went to youth group, and then church, with some friends from school. At that church, I began to understand God's grace, and started following Jesus. I decided to take part in Confirmation and told my family and friends that I was following Jesus. That was more than twenty years ago. Since then I've graduated from University, worked at a different church, studied some theology, got married, had children, and done twenty years worth of stuff. For the vast majority of that time, I've tried to make decisions in the light of God drawing me into relationship with him.

So what would it mean to get baptised now?

If baptism is a sign of repentance and of new birth, shouldn't I have done it a long time ago? If I get baptised now, is it just for pragmatic reasons? Is that enough?

I ask myself all sorts of hypothetical questions about how other people will interpret the pastor's wife getting baptised. Maybe I just need to explain myself clearly. But I'm not exactly clear why I would be doing it.

Which explains why I'm still thinking about it nine years later.

I'm just wondering what you think. Do you have an opinion about the when, where and whyfore of baptism?

And do you have an opinion about how? Some would say my sprinkle on the forehead, and believing confirmation was entirely adequate.

*complicating factor* I haven't heard him say it directly, but I suspect my husband doesn't think it is. He's hedging in this discussion.

I'd love to hear your comments.



Things I am thinking about...

1. The difference between being innocent and naive.
2. Wondering when being demonstrative or open becomes boasting.
3. That people who say things that make me uncomfortable are not necessarily wrong.
4. How my hands can be different temperatures on a cold night.
5. Whether I write too much about internal/thought life and not enough about details and events.
6. That suffering can lead to deep loneliness.
7. That brains are immensely mysterious and interesting.

What about you?

I'm facing backwards as I ride. The train swings and I see clouds layered thousand-fold. It's the vastness of it all that grabs me. My bag is draped across my legs, full of 'maybe I'll need that today'.

And the God who layers clouds listens to my prayers. Mumbled, halting, inept prayers. Some forgotten in the midst. I am thankful that it doesn't rest on my shoulders to make it right.

I puzzle at the vastness (layered clouds) alongside the small (a little more breath, or a steady hand). He manages both, and does them carefully.

And I realise that we expect it will be the earthshaking, lifechanging events that will destroy us. But somehow we survive and we go on. We keep it together. Then the little incidental undoes us. A child's hand slipped in ours, a breath that faintly wheezes - the reality of that one moment brings a deep flash of emotion. Sadness that breaks us.And we can let it slip past barely noticed.

Or it can be the window to our very hearts. Sometimes a glimpse is all we can bear.

God has no such pretense. He does not need to mask his pain, nor his joy. He can bear it. He can layer clouds and soothe a breath.

Reflections on Family

The kids had started to call me Dad...

Desperate to belong, to fit in the picture. You know the one. The smiles range from awkward to delighted. It was taken the last time we all got together. "Do we have to take one?' someone groans, but we cherish the have-to. The necessity is the mark of belonging together.

He's been her boyfriend for just on three months, and one of them calls him Dad. Of course he's not their dad, but the instinct is deep in both of them. The pitiful story of a fatherless child looking everywhere, because he longs for that loving eye on him. The bedraggled, broken man clinging to this glimpse of himself with possibility. Wondering how to earn the name and the love bestowed so early and indiscriminately.

Is it the expectation which leads to his retreat? He turns his back on the lisped invitation to fatherhood, ends the relationship. Disappoints himself, and the child, because he is afraid of being a bigger disappointment.

My mind turns to the disappointments I create. When I cannot be what someone in my family needs. When I don't try because I'm afraid. When I try so hard to please that I miss seeing what is really needed. Family and childhood memories blind me to reality. Emotions rise, so deeply familiar, so sharp-edged with anxiety. I realise, too late, that I've made the wrong choice and disappointed again. It makes me sob - and I'm not one to sob - frustrated, disappointing eight year old me sobs.

I marvel at this messy, paradoxical invention - family. Delight in the belonging, the familiarity, the shared history - we can laugh, and care, so deeply. Frustration with the misunderstandings, the different perspectives, the pleasing everyone and no-one. Hurting and healing in one complex gift. God knew we would need family, but he also knew that family would need his redemption.

No wonder the church is complicated when we are seeking to be family.

'The kids had started calling me Dad' at Circumstantial

Is she playing with my mind?

Is she playing with my mind?

Desperation. It drips from him. Only to be sopped and dried by lasting reassurance that he's loved. Where can he find it?

He's stuck at the question about a game, this playing. Urges me to see the proof and decide. Why does my opinion matter? Especially when others have already gently (even roughly) laid this possibility in him.

He trawls an ocean of emotion in the wake of her messages. Rocked, pulled under, lost. Washed up on unfamiliar sand expanses. He has no map, no compass and nothing to steer.

No wonder that he sees her as malevolently controlling. That he suspects her motives, her actions and her ability to control him. He is consumed by her.

Reassurance is impossible, brief at best. Can he even hear me through the confusion?

I long to tell him - no human exerts this God-like control over another. He has been tricked into powerlessness. He is blind and lost. She is much more inert, broken and confused than he imagines. She is washed ashore on her own forsaken place, adrift from him, yet seeking. Desperate, too.

Know that we are like grass, every one of us. That we are all desperate, lost and blind.

THIS IS NOT A CONSPIRACY. A game. To be played by another.

We all need someone to find us, to heal our blindness, to love us out of our desperate confusion.

Jesus traveled through all the towns and villages of that area, teaching in the synagogues and announcing the Good News about the Kingdom. And he healed every kind of disease and illness. When he saw the crowds, he had compassion on them because they were confused and helpless, like sheep without a shepherd. (Matthew 9:35-36)

'Is she playing with my mind?' at Circumstantial.

Post triggers

How to prompt a post?

Talking with a faithful friend of mine has made me realise that I often blog in response to things that happen to me during the day. (You may have picked this up?) I keep it pretty general/anonymous but the emotions are often the trigger for me.

So I'm going to post once a week in response to a question or statement that someone makes to me. The twist to the challenge, is there will be two posts - one here and one at my other blog. Two perspectives. This post is an example of one I've already done that sprang from a statement someone made to me one night.

My friend also mentioned wondering what had happened to prompt a particular post. If you do the same, I'd love to hear from you. Email me or leave a brief comment and I can tell you a bit more (with some confidentiality limits). I don't share specifics because this is a public space, but I'm happy to 'talk' more in other places.

Procrastination

I have some climbing I need to do - figurative rather than literal.

When it comes right down to it, I'm just putting it off.

If I don't get it done then I won't find out that I've failed. I've embedded myself in other pastimes that are more fun, less demanding and let me be comfortable.

Is it the voice that whispers, "I'm not good enough?", right behind my ear? A chance question or overhead comments on my lack can set that refrain cycling overtime. Tears in my eyes, embarrassing. The lie I'm believing - that I need to be good at everything - that I am God.

No. It's just that I'm putting off wrestling with the monster (externalise it, turn it into a battle). I need to grit my teeth. I need to gird my loins. I need to pull my finger out. Otherwise, in a year or two's time, I'll be sitting here in front of this screen, writing incidentals, reflecting on the life I'm too mealy-mouthed to get on with.

Go on. It just needs to be done.

I don't know

'Any philosopher's argument which does not therapeutically treat human suffering is worthless; for just as there is no profit in medicine when it does not expel the diseases of the body, so there is no profit in philosophy when it doesn't expel the sufferings of the mind.' Epicurus.

We search. We stretch our thoughts, our minds, and explore to gather morsels of meaning. Heartfelt longing for a feast of truth, so we can know and understand. This longing is a gift, a desire that can drive us Godward.

Gradually, we place the multitude of puzzle pieces into a mosaic. Gleaning, gathering, for the Big Picture. The Truth. Are we satisfied with the answers we find? Often we are, we can be bold in our answers, intrepid in searching. But sometimes we are not. Sometimes I am not.

The balance for the search is that we cannot always know enough. We cannot look at the whole sky from horizon to horizon, 360 degrees, without moving our heads and shifting perspective. We lose sight of the beginning when we turn to see the conclusion. Oh, for fish-eye lensed eyes.

The dialectic of earnest truth-seeking with the difficulty of finite mind knowing infinite truth.

Suffering begs the question 'why?' Sometimes we even cling to the wrong answer just because it feels safer than not knowing. Is that man blind because of his parents' sin? Did my child die because of my failure to care for them? Am I alone because I am not good enough? Do those people starve because God doesn't care?

Sometimes 'I don't know' is the hardest idea we could ever express. Indeed, me not having a clear, cogent, compelling response, does not mean it doesn't exist. It just means I am yet to find it.

I think that Jesus' answer to suffering is enough for me. But it isn't enough for everyone. Why not?

To seek, to wonder, to question is an attitude we need to have. But we need to stop and rest sometimes. To say 'I don't know' and trust. Trust that there is someone who can see the whole sky, horizon to horizon, all points of the compass.

We don't yet see things clearly. We're squinting in a fog, peering through a mist. But it won't be long before the weather clears and the sun shines bright! We'll see it all then, see it all as clearly as God sees us, knowing him directly just as he knows us! 1 Corithians 13:12 (The Message)

A reflection on Rest, in response to Ann at Holy Experience's Walk With Him Wednesday.

Yesterday's Big Question

After recent conversations about babies and how they work...

S: Mum, how did you get milk in you?

Me: (pause)...

Is it really Science vs. Religion?

Save Our Scripture - Make A Stand seems to have taken over my Facebook newsfeed today. I popped over and read Greg Clarke's article about biblical literacy being important in cultural/historical/literary understanding, as support for continuing scripture in schools. Some of the comments on the article and on the Facebook link were caustic and derisive. There is a fine line between critical evaluation and personal attack apparently.

I have also just listened to "All In The Mind" (Radio National show) podcasts from the World Atheist Conference in Melbourne, last month. PZ Myers, Richard Dawkins, Peter Singer and AC Grayling all spoke on the relationship between religion and science.

Not surprisingly, there was little sympathy for religion as an issue of faith and it was roundly dismissed as an academic discipline. The opinions of scientists who have academic credibility and are known to be Christian (eg.Francis Collins - previous head of the Human Genome Project) were described as having "cluttered up our understanding with pointless nuggets of myth".

I was surprised at the way religion was set up as a stereotype and then cheap jokes were made about it. It was obvious that these men had some factual information about biblical content, but their understanding of faith as a value which informs life, experience and choices was pretty limited.

Some of the ideas were...Science as a rational, quantifiable exploration of the truth is what rescues us from the lies and myths of religion. Science is directly in opposition to religion as a way of knowledge. "Faith is not information and it is antithetical to critical examination and honest understanding". It was a dualistic view of the world in which people either believe in "Science" or "Religion". To see them as mutually exclusive seems limited and rigid to me.

"Science is what we do to keep from lying to ourselves" PZ Myers

"Religion is the lies we tell ourselves to justify our biases" PZ Myers

I can see where both of these statements are evident, but the reality of the relationship between opinion, knowledge, gut instinct and critical evaluation is much more complicated. I know instances where scientific method has been used to propogate lies. I also know instances where religion or faith has been the means of identifying and then protesting about accepted human biases. Science was behind the push for eugenics in 1930s Germany while faith drove Wilberforce to work to end slavery, to name just 2 examples.

Where does this leave us? I am more and more convinced that all of us argue from instinct and our own experience - both of life and of knowledge. Some of us just dress it up better and make it look more logical. Deep down, no one has flawless logic and no one really escapes their gut and its drives.

Science is actually a great gift from God. The ability of the human mind to explore, postulate, test and observe are attributes given to us by a God who loves intricate beauty and complicated workings. But science is not itself a truth. It is a theory, a way to understand the world. Testable, repeatable but not infallible.

Now we see things imperfectly as in a cloudy mirror, but then we will see everything with perfect clarity. All that I know now is partial and incomplete, but then I will know everything completely, just as God now knows me completely. 1 Corinthians 13:12

image from stock.xchng

ANZAC DAY

Jarrod McKenna posted some thoughts about Anzac Day and the following vimeo on Sojourners blog.

Many people have participated in a whole array of conflicts with deep conviction that they were fighting and serving to protect people, places and traditions which they loved. Many people who also loved the Lord. I don't want to disrespect those people or the acts of sacrifice in which they participated.

War, however, is ugly. No one who has been part of it or experienced its aftermath would deny its horror. Every war in the modern era has spawned its own traumatic effects - battle exhaustion (1800s), soldier's heart (American Civil War), shellshock (WWI), battle fatigue, combat neurosis (WWII), Post Traumatic Stress Disorder (Vietnam War), and Gulf War Syndrome, are some of the psychological descriptions. 

Families of veterans have experienced death of loved ones, along with the results of trauma in those who return - depression, anxiety, rage, substance abuse, violence to name a few. Children have grown up fatherless or in orphanages as a result of conflicts all over the world. In some countries, those children have become the army when there are not enough adults to fight.

Being Christian is not synonymous with being a pacifist. People of faith can find justification to participate in conflict. History is proof of that.

While I would not want to take part in war (and have always called myself a pacifist), what would I do if my home or family were threatened? If I lived in a place like Rwanda, Sudan or the former Yugoslavia? Am I just blessed to have never had to answer the question for real?


Gallipoli or Calvary from The Work Of The People on Vimeo.

The challenge for me here, is how will I respond to conversation about Anzac Day this weekend? Will I let the platitudes slide by? How will I respond if human sacrifice in the depravity and brokenness of battle is equated with the innocent, life-giving, relationship-renewing sacrifice of Jesus?

McKenna quotes Bonhoeffer in a challenge that we are too inclined to be inoffensive. That I would rather let an insult to Jesus and his ministry go than risk offending my mates. I have to plead guilty to that charge, all too often. I am a coward when it comes to controversy. Here goes for trying to be offensive 'for the right reasons'.

Then I need to consider the deep need many people have to identify with this ANZAC sacrifice story. Our local Dawn Service has been growing in attendance over the last few years with many young people and families.

People have a longing for the humble hero. A connection with the someone just like them, who has participated in the transcending narrative, been part of history. Anzac Day is safe, circumscribed and does not demand response, other than respect and admiration - a raising of  the glass to the heroes.

The sacrifice of Jesus, however demands the ultimate paricipation as he calls us to take up our crosses, too.

May people long to participate rather than just admire and raise a glass this Anzac Day.

Feeling helpless...

Around me, things go wrong that I cannot fix. My friend's father dies during a time when my friend and his wife are already dealing with significant loss in their lives. Someone in our community struggles with finding out their son has been sexually abused. Sick people cannot manage to live the lives they would like to, and labour under constant, chronic pain.

I wonder why some people carry such heavy burdens. Why others can seem blessed in every aspect of their lives. I cannot frame an answer that truly satisfies.

I pray irregularly and unsystematically about these things. I am so human in my lack of faith, lack of compassion and lack of perserverence. Even though I feel helpless to change things, I still cling desperately to thoughts of what I can do.

I long for a day when helplessness and sadness about the state of the world drive me desperately to prayer.

Help me Lord, to remember that you are here.

Help me see you as you weep with the hurting.

Help me ask you to change things and to bring your kingdom.

Help me to trust you.

Help me to accept my own helplessness and let you work through me.

Help me to believe that you are powerful to help.

My current dialectic -

"I do believe, but help me overcome my unbelief." Mark 9:24

What do you think of a doctor who says 'I don't know?'

This week I attended training in how to deal sensitively with families of patients in mental health. We began discussing difficult questions which we sometimes get asked by families. One of the common themes that comes up is concerns about prognosis, the future for the patient and their family, and 'is full recovery possible?'.

Really important, practical questions. Extremely difficult to answer, to really answer what that family are asking. I'm not sure that giving people a list of statistics for prognosis or recovery is all that helpful. They have a place in a really comprehensive answer, but I suspect that we doctors hide behind statistics because questions like this make us uncomfortable. It is hard to tell people that not everyone recovers or that people have relapses or don't return to work.

We need to acknowledge, however, that we do not know the future. We cannot say for a particular individual what is going to happen. We can make educated guesses, based on studies of the natural history of an illness, or on experience with previous patients. But we do not know for sure. In fact, expecting to be able to answer these questions without uncertainty is unrealistic.

What became evident as we talked was a deep reluctance among my colleagues to say 'I don't know'. It was even mentioned that saying those exact words will damage the therapeutic alliance between the doctor and the patient's family, so they should never be said.

But how can we say that we have built a therapeutic alliance if we cannot even acknowledge uncertainty. I think people know that we are fudging and uncomfortable with the question. This damages their trust in us more than admitting we don't know. Saying 'I don't know' opens up a dialogue that includes fears for a bad outcome but also the possibility of a good one. Difficult, confronting questions, with answers that we do not clearly know are an opportunity to talk with the family about what has provoked the question. It gives the chance to educate them about what we do know, to support them in the uncertainty of what we do not know, to ignite in them the hope of recovery.

Where did we get the idea that we are not allowed to be uncertain or not know? I think that our empathy for and alliance with patients is strengthened by admitting that there are some things we do not know. I also suspect that we may couch our reluctance to express not knowing in delicate feelings for the patient or the therapeutic alliance but we are actually protecting ourselves. We are the ones who do not want to hear that we do not know.