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Medical Perspective: Dn. Euthym Kontaxis

OCAMPR 2017 - Resiliency: Body, Mind and Spirit

With the theme “Resiliency: Body, Mind and Spirit” the Orthodox Christian Association of Medicine, Psychology, and Religion conference was held November 2-4, 2017 at the Ukrainian Orthodox Church Cultural Center in Somerset NJ. OCAMPR exists to facilitate Orthodox Christian fellowship, dialogue and education of professionals in religion, psychology and medicine.

These talks were recorded by Ancient Faith Radio in partnership with OCAMPR and are made available here for free access and download. These plenary talks are in audio format but a video version is provided as a way of showing the slides associated with the talk.

OCAMPR welcomes interdisciplinary dialogue and is committed to exploring an Orthodox Christian understanding and perspective on a variety of pastoral issues. Toward that end, presentations and papers are offered for ongoing discussion and dialogue. The opinions of presenters do not necessarily reflect the opinions of the OCAMPR organization, Ancient Faith Ministries, or of the Orthodox Church.

November 2017

Medical Perspective: Dn. Euthym Kontaxis

Dr. Kontaxis is the Medical Director of the Emergency Department at Eisenhower Medical Center in Rancho Mirage, CA.

November 9, 2017 Length: 54:30

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Dr. Dn. Euthym Kontaxis: In the name of the Father, Son, and the Holy Spirit. Amen. Good morning, everyone! [Good morning.] Well, that was an overwhelming introduction, unwarranted. Your Eminence, God bless you, thank you, pray for me. Honorable clergy, fellow presenters, brothers and sisters in Christ, Dr. Stephen Muse, Presvytera Renée Ritsi, who was at that same trip to Uganda with us; and of course Philip and Georgia: You know, when I first heard of OCAMPR, I was at seminary, 1996, and somebody said, “Hey, you should check out OCAMPR!” And I had two little children at the time and I was working full-time, and I said, “What am I going to do, going on a camping trip with a bunch of Orthodox? I don’t know if I can do this.” [Laughter] Well, they explained it to me, but I thought it was one of those clubs where you go out in the woods. So I found out a lot about it, and I think this has been a wonderful arm of the Church and I think it’s wonderful for all of us to get together and share in the Spirit.

First I want to thank our hosts, the Ukrainian church here. They’ve been beautiful—beautiful facility—and they’ve been very warm and hospitable. I am not a scholar by any means. I’m not a theologian. I’m just a doctor, basically, who has worked in the pit, as we call it, the emergency department. The doctors who are emergency physicians call it the pit, so we all work in the pit. That’s what I’ve done for most of my career. As I’ve gotten older, they’ve moved me into positions of administration, but really my heart has always been in the department with patients. So I want to share with you just some of my experiences and maybe how that might tie into the idea of medical resilience.

Let’s just define resilience. I had to look it up. First when somebody told me I was going to give a talk on resilience, I thought, “Oh, that’ll be fun,” and then I thought, “What am I going to talk about?” So I looked it up, and it says: “the capability of a strained body to recover its size and shape after deformation caused especially by compressive stress, or the ability to recover from or adjust easily to misfortune or change.” So that kind of intrigued me, because in the emergency department I see a lot of that. You see a lot of deformity and impact and stress and injury, so it kind of intrigued me.

I thought about the talk and maybe what we could share about, and one of the things… A lot of the emergency medicine literature and a lot of the physician literature, and I’m sure in the psychological world, resilience is a big deal now. Before it was burn-out. There’s all sorts of things that kind of go through cycles, but resilience has been somewhat popular, and that’s not what I’m going to talk about—the caregiver resilience—at all. I’m going to share with you a little bit about the idea that resilience is not a static thing or innate, like, “Oh, that’s a resilient person; that’s not a resilient person,” but it can be developed and acquired.

There’s a Stanford study that’s been going on since 2010 that shows resilience can be cultivated and learned, and there’s a Rand study they did on Air Force veterans that they looked at how they could be ready for battle—it’s the Rand Air Force study—and how they can have more resilience to things like PTSD, how their physical readiness can be improved, and how to maximize them. So there’s some actually interesting research going on about resilience as something you can acquire.

There was a Duke study on longevity. So what they did was they took all the studies on longevity, and they looked at the subgroup that were people that lived really old that had no reason to. So they picked people like Holocaust survivors or people who had smoked their whole life, but they were in their 90s, and they looked at those parts of the study. They looked at over a thousand studies, and when they reviewed the literature, only three of those authors concluded that it’s a personal trait. Every one of the other studies said there were aspects of it that could be acquired. So that’s actually good news, because if resilience is innate, the talk’s over; we have to have something to talk about.

I’m going to share with you some case studies on resilience, develop the idea of community resilience, and how biological resilience is an icon for us. I’ll talk about that a little later. See, I got the word “icon” in, Your Eminence. [Laughter] It’s good for a…. So, resilience: a diamond is just a piece of charcoal that handled stress exceptionally well. [Laughter] So that’s a good thing to keep in mind when the world is pushing on your head. It might turn you into a diamond.

Let’s talk a bit about the body. Something that, in medicine, we don’t use the word “resilience”; we use “homeostasis,” which is: where the body is supposed to be at any given time. That’s our go-to point: how we were created. There’s about a thousand different systems that are always going imbalanced. As His Eminence said yesterday, it’s no accident we exist. This didn’t happen out of randomness. These are complicated systems; they don’t develop without some sort of wisdom in my mind. Then when we look at the little picture here with the young man, exhausted from the sun—he lives where I live: in the desert—the whole body is working to keep him from either burning up, passing out, or ending up in our emergency department for 500 liters of fluid. It is basically maintaining life. So let’s go on.

Let’s look at it from the point of creation. We look at these beautiful icons of creation, and we were created in the image and likeness of God. The image is Christ taking our flesh; it’s the Person of Jesus Christ; it’s who we look like; it’s who we are here. So we are in the image of Jesus Christ. We took bodies that God gave us. And our likeness refers to our participation in his divinity. I want you to keep this in mind. Also, that we were created out of nothing is very important because somehow nothing is where our bodies are going to return, and it’s important to think about that in terms of the idea of resilience. Each person is a microcosm of the entire creation, the Fathers of the Church say. They talk about all of us being a small, little icon of the entire creation. St. Gregory the Theologian said we were created for eternity and to be stewards: as we go, creation goes. So if we are spiritually on the right path, all of creation around us will head that way. If we aren’t, destruction happens, and we see it in the world. We see it in our own world.

This is something that people may not know. We are programmed to die. This is called programmed cell death. I don’t mean to break any bad news. If anybody’s upset about this, come talk to me after. [Laughter] Death is inevitable. Our DNA is programmed to basically implode at some point. We’re walking time bombs, and there’s about three different pathways that are genetically organized to knock us off. One is one-enzyme dependent, one is non-enzyme dependent, and one is external exposure dependent. So if you escape one, the two other ones will get you. But our physical existence is limited no matter what we do. Good news, right? I don’t know. Is it? It depends on your attitude, but our bodies are spending their time healing and repairing. We try to help each other heal. We are trying to return to our original state. The sun comes out, our bodies cool down. It gets cold, we warm up. We’re always trying to stay alive, but inevitably we’re going to die. Hmm.

We start out as a baby, miraculously we become an adult, we get a wound: in two weeks it heals. The doctor didn’t do anything here; I’ll tell you that right now. One of my professors in medical school told me, “Hey, the dumbest kidney is smarter than the smartest doctor, so don’t forget that.” [Laughter] We grow, we heal, we procreate, and then we break down. So there’s a paradox here. The paradox of healing and a return to homeostasis, to resilience, to be back to where we were formed—and inevitable cell death. So we’re living with this dichotomy at all times; all of us are, both in our cells and when we look at others.

How do we resolve that? How does that get straightened out in our minds, or do we just walk around confused all the time? Usually the latter. Well, we can learn to be resilient, so it’s important to realize… I’m going to start a little bit talking about how we can learn to be resilient and how we can see it in the world around us. Athletes train themselves to be resilient. This guy didn’t start out the fastest man in the world; he started out running in his neighborhood in Jamaica, chasing after chickens or something, and then he started to formally train, and he became faster and faster. He improved his lung capacity. He had a thing around his mouth where he’d check to see if he increased his oxygenation. They sleep in oxygen tents, they do high-altitude training, they do [resistance] training, they do flexibility training, they do extreme conditioning training. I watched a video of a guy that had this—I don’t know—200-pound weight and he’s standing on a ball this big and he’s doing squats. I said, “Okay, that’s pretty intense,” but these are the kinds of things that people do to be resilient as an athlete. They’re training themselves.

Bacteria train themselves. We give lots of antibiotics, usually inappropriately, I’ll confess. Most people just want a pill; most people should have nothing. The virus will run its course. But people have always: “Oh, give me something, Doctor. Give me something, Doctor.” Well, we do, and then we develop organisms like methicillin-resistant staph aureus or super-resistant pseudomonas that actually creates all sorts of havoc in people. So these organisms all have a drive to survive. They all want to live, too, but they do it in a different way than we do. An adaptation is a natural form of resilience in the created world, and we can see it around us.

Then you look at these extreme existences. So these are animals that live… This [alga] lives in a volcano. I think it’s—I don’t know how hot it is; it must be 300 degrees or something, on the edge of a volcano. And this thing lives I don’t know how far deep in the ocean, and look at how it looks, for goodness’s sake. But they’ve adapted; they’ve become resilient to their environment. This [alga] lives on spiderwebs in a desert in Chile. It’s the driest place on earth, and the reason it lives on the spiderwebs is because the spiderwebs collect any little dew that comes, and that’s the water that it lives on. So you see these spiderwebs with a bunch of algae on it. It’s pretty cool, really.

Then we have this what we call thermococcus microbe which lives in New Guinea on the super-hot water little geysers that come out. It lives with and has developed an energy, a kind of chemical reaction inside that people didn’t think could support life, but it supports these guys, and they survive and live right there. They’re collected. I think when they bring them into the lab, they all die, because it’s too cold, but it’s pretty interesting. You see these extremes. So we look around, and we can see that life, created world, is resilient. It wants to survive.

We have a learned resilience internally. It’s called medical immunity, our immune system. Biological immunity is both innate and learned. Our immune system has certain already-principled ways of keeping us alive, but then it learns as we get exposed to things how to fight off. It learns to heal itself and protect itself through exposure. The immune system is kind of like the de facto example of biological resilience which kind of translates to medical resilience, and it’s constantly learning and improving through repeated exposures.

As people have learned to manipulate the immune system to prevent horrible diseases by giving little bits of diseases—and that’s what vaccines are—now we’ve developed ways of using immune therapy, so we develop antibodies against cancer cells to kill them. It used to be we died of heart disease. Right around my age, everybody keeled over from a heart attack. Now everybody’s getting treated and changes their diet and they get statins, so now everybody dies of cancer. Pretty soon, we’re going to cure cancer, and then we’re just going to die. [Laughter] But it’s learned resilience.

I’m going to share with you some experiences that I’ve seen of resilience in real life. We have this idea of biological resilience, we have innate resilience, we have learned resilience. I just want to share a few stories that I think illustrate the kinds of things and the ideas that help us become resilient as people. This first guy, I call it the Circle-K shooting. I was in Arizona working in the trauma center, and a guy came in, and he was shot right in his head. He was sitting; the ambulance brought him in, he was on the gurney, we put him on the thing, and he was holding a Bible like this, and they wanted to put an IV in: he let one arm go. They want to do something else, he let the other arm go. He said, “Don’t take my Bible.” We were all shocked, and I said, “Okay,” so we worked around the Bible. Who am I to argue? He’s talking to me. He got shot right in the head, and he’s talking.

Turns out, he was a deacon at his Bible church, and he was reading the Bible, and the guy came in to steal from him. He shot him in the head, point blank, and the guy went back. He grabbed his Bible and held onto it. The guy took the cash, ran, and then—he was alive! He was holding; he wasn’t letting go of the Bible. So when he got in, we found that the bullet had gone right between the two halves of the brain into the middle of the brain. There’s a falx there, the corpus callosum, and it just lodged there. It really doesn’t cause too much trouble, but we were like— The trauma surgeon came down, I was there, and he said, “Get that out of—” I go: “Don’t take the Bible from him. He’s okay.” “Okay, leave the Bible.” The whole department: “Leave the Bible! Don’t let that guy’s Bible leave his side.” [Laughter] So he got up and left.

I call that the resiliency of prayer. Our prayer lives lead to a resiliency in our physical existence and lead to a deeper resilience. This is one of the hallmarks of resiliency: having a spiritual formation in your life, developing that. There are studies that show that people that have some spiritual compass are much more resilient when it comes to disease and illness and things like that. There are many studies that show that.

The next is the pie lady. The pie lady is an eight-time survivor of cancer. She had her first cancer in her 20s, and then she had eight recurrences. When I met her, she was on her last one, and she would come to the ER all the time. Every time she came to the ER, she made her daughter bring a pie. She was the most positive person in the world. When she’d come to the ER with her pie, she thought it was like a party. “Oh, I’ve got pie for you!” And she’s sick! I mean, she really was sick, and we took care of her maybe once a week, once every two weeks. She’d come in for dehydration or her cancer was causing her pain or there was some bleeding or something. It went on and on. So we probably saw her over a six-month period, maybe 20 times. All those pies kept coming in. That’s how the deacon got a little chunky. [Laughter]

This was the beauty. The pie lady finally died, but every time she’d come in, we’d see the whole department light up like a Christmas tree. Everybody was in a good mood. “The pie lady is here!” They’d actually announce it, and she started to call herself the pie lady. “Who wants to—” “I get to take care of her!” They were fighting over who gets to take care of the pie lady. [Laughter] So when she died, her daughter brought 30 pies into the emergency department. The whole place was crying their eyes out. We missed her, but she was an example of how the right attitude can improve resilience. So we have to remember that, as caregivers, the attitude when you are sick makes an extreme difference in your outcome, and there are good studies that support that. Again, I’m not a scholar, so I’m not going to recite them all, but there are, and I’ve witnessed it.

Another story. This is one of my partners, Dr. C—I’m not going to identify his name. He was a good friend of mine. Our children were born within a day of each other, our first children, our first babies, and we went through the pregnancy classes—actually, we skipped them and went out to dinner most of the time, but anyway. He was a great doc and a good guy. One day he had an older guy come in [who] was coding, was in full arrest. He was working on him and doing resuscitation and shocking him. Finally, he said, “Okay, that’s it. There’s nothing we can do.” So he called the sister, and he was on the phone with the sister and actually had it on speaker because he was trying to do something as well, so the speaker was on.

I was standing outside to see if I could help, and I hear him on the phone with the sister, saying, “I’m really sorry that your brother passed away,” and the nurses start doing this. [Laughter] And his heart rate had—he’d come back! So he’s on the middle of the conversation, already told her that her brother was dead, and he didn’t know what to say. So he said, “It’s a miracle! He came back!” He just shouted it like that. We were all like this. The lady—there’s this quiet—and she says, “Don’t feel bad, Doctor; he’s hard to kill.” [Laughter] I never forgot that! We called him Dr. Lazarus for about a year after, poor guy. She said, “Don’t worry.” She felt bad because he was apologetic. “I’m so sorry, but he came back,” and she said, “Don’t worry, he’s hard to kill.” Practical. She was very practical about his state of health.

He knew, she knew, that he was pretty sick, and she didn’t see it in a way like, “Oh, you did something bad” or “What’s wrong? You guys are crazy.” She was very practical. “Oh, he’s done this before. He’s hard to kill.” So be practical as caregivers and as patients and as people who are alive in our lives. There are a lot of physicians who are theoretically brilliant. They know everything, but when it comes down to the brass tacks, how you handle somebody when they’re sick, they might as well be putting their thumbs in their noses: they have no idea what they’re doing, they’re fumbling, they don’t… This was practical, and I love that he said, “It’s a miracle!” I love that it came naturally to him to say, “It’s a miracle!” So that’s the kind of… We have to [be] practical about our existence and about our resiliency. Resiliency, for the most part, is taking the path that’s going to get us back to normal. It’s look for the practical way to do that. It’s not a theory; it’s a practice.

One of my partners escaped Romania with his wife at a very young age, late teens. They barely got out. He became a physician and an emergency physician. He is one of the most dedicated people I know. He had never had a vacation, and they decided to go on a cruise. It was off Italy, so they went for a week cruise, and it was their big deal. She started to get short of breath. The ship’s doctor kept telling her that it was just a cold and it would pass. He, in the back of his mind, thought something’s really wrong here. Well, it turned out… They’re going by a port city in Italy, and he said, “My wife needs to get off this ship now. She doesn’t look good.” And the doctor on the ship said, “No, she’s fine. Just take the antibiotic. She’ll get better.” He said, “No, put this ship in port.” So the captain came down, a big hullabaloo, he said, “She’s not doing well. We have to get to a port.” So they did.

She got off the ship. She arrested on the way to the hospital; they brought her back. She had a massive pulmonary embolism. He called me in the United States and said, “Can you find out who does thrombectomy?”—which is where you actually take the clot out, because there’s no treatment for this. It’s very difficult. They started her on some blood thinners, and she was going to die. Her blood pressure was down; she was intubated. He then knew the hospital he was at was ill-equipped to do it, so we called around. The guy in San Diego near us is the guy that developed this thrombectomy procedure. We called down there. He said, “There’s a guy in Milan, Italy.” So we called Sabin, I told him it was in Milan, and he said, “Okay.” He told the hospital, “I want her transferred to Milan.” The guy was on vacation at the time. He said, “I want him to come back to see my wife from vacation.”

He’s the nicest guy, but he was persistent, never stopped: “This is what’s next.” It’s like they were around him, but they couldn’t say no to him. He knew what he wanted, he knew what he was going to do, and he knew he was going to try to save his wife. She arrested two more times. They got to Milan, they took her in surgery, they took out the clot, she arrested again during the surgery, they brought her back. She spent I think two weeks there in rehab, and this was eight years ago, and she’s doing great today. So, persistence. He really talks about this. They actually published his story in the Annals of Emergency Medicine. He talks about this. I saw this as an example of the kind of persistence you need if you want to stay well, stay in homeostasis. An organism, a person: we need to be persistent in our pursuit.

“Well, Deacon, why are you talking about all these things, when you know you’re going to die anyway?” I’ll get to that. But the stories are fun to tell, and I don’t get a chance to very often. [Laughter]

So I had two doctors that got sick while I was working with them. One had a stroke, and he started to move his hand funny. We were sitting next to him, and we were like: “Frank, are you all right?” “I’m fine.” “You’re having a stroke, Frank.” [Laughter] So we put him in a room. “Oh, I’m okay.” “No, Frank, you’re having [a stroke].” So we got the stroke team, and as we’re getting him organized for his MRI and everything, he pulls the computer over to finish his charts, because “what about my patients? Who’s going to take this one? This guy…” He’s talking about his patients while he’s having a stroke. He started to get droopy, his right side… He’s fine now; he’s still giving me a hard time. But he had a purpose, and he was thinking about his purpose during that time that he was sick. He wasn’t thinking about me, me, me; he had something outside.

Another one of my partners, he had a cardiac arrest. It was in Phoenix. He collapsed, and we got the paddles, and we shocked him. He was in V Fib. He was my age—now; then I was young [Laughter] well, now I’m still young; old is two years older than whatever age I’m at; that’s my definition of old. But anyway, he collapsed, we shocked him, and he came back. We wanted to take him to the cath lab to look at his heart, because that’s the common thing. He was saying, “Well, can I finish my shift before I do the cath?” I’m like: “Are you crazy?” But they all had purpose. It’s so funny, because I would never have thought that. When you ask me what’s the first thing they’d say… they were going to get technical, talk about their health—they wanted to finish taking care of their patients. So there still are good doctors these days.

Finally, there was this one night, New Year’s Eve, in Palm Desert, Rancho Mirage. I was in the ER. I always work New Year’s Eve because I wanted Christmas off, so I did New Year’s Eve. New Year’s Eve: a young lady, a woman about 40, had four beautiful daughters between the ages of about 16 and about 8. They were in the desert for New Year’s Eve; they were having a family time together. They played games. She went to take a shower. Her husband finds her collapsed. She had a massive hemorrhage in her brain, at 40-something years old. It was an aneurysm, and it blew, and you can see the CAT scan image here. She was basically comatose; she couldn’t move; she was out.

We intubated her; we actually put a bolt in her head to decompress the brain. The neurosurgeon came in, and I spent a lot of time with the husband; the daughters were all surrounding her. The husband looked horrible. I mean, his whole life was leaving him, his bride, the mother of his children. He asked me, “Can I have my pastor come in and pray?” I said, “Absolutely.” We called him, and he drove in from Los Angeles. I was devastated, seeing her, and she went up to the intensive care unit. I thought, “Well, this poor guy is going to lose his wife, and the four daughters are going to lose their mother.” I did the best prayer I could, and I had ten more people to see, so I just kept going.

Well, about a month later, I was walking into the front of a hospital for a meeting, and I was walking in… There is a lady in a wheelchair, and I didn’t recognize her, but I recognized the four girls that were surrounding her with the balloons coming up from her wheelchair, and her husband behind her. It was her. She had survived, and she had recovered. I mean, she had very little residual deficit. I looked at her, and I got down on my knee in front of her, and I started to cry. I said, “You’re alive!” [Laughter] The husband looked at me and said, “She’s alive.” The joy in her daughters’ faces—their whole feeling of joy was so powerful, and I realized that not only do we have to have persistence and be positive and be practical and be purposeful and have prayer, but we have to have love. The power of love is what drives the engine of resilience.

These are the attributes and the characteristics that are acquired that contribute to resilience. What about the idea of community resilience? Prayer, purpose, be practical, be positive, be persistent, and have the power of love in all things that we do.

There is a doctor—I think he’s retired now—Dr. Kawamoto at UCLA. He’s a facial and reconstruction specialist. This is sharing with you a couple of ideas about community resilience. These are people… this is a burn victim. The young child in the top has a cleft lip and palate, and this man has I think a large, cancerous carving-out of his face. Dr. Kawamoto and his team repaired all these, and look at the outcomes next to them. Amazing, isn’t it? But it doesn’t happen with just one guy and the scalpel. That’s the set-up for a reconstructive surgery. There’s like four or five different specialists, there’s all this equipment, there’s planning, there’s 3-D reconstructions, there’s all this sort of thing. So the idea is there’s a lot of thought and care in deciding how to fix those problems on somebody, to get those faces back to normal.

To think that God created us with a breath! with some dirt and a word, out of nothing! Just out of nothing: he made some dirt, said a few words, breathed on us, and here we are. And we have to have a team of a hundred people with thousands of pieces of equipment, with months of planning to fix a lip and some skin. When we think of the Creator and when we think of what we are trying to do, we are dwarfed in that, and that humility is really important in terms of resilience. In other words, recognizing that there’s more than your plan in life.

I’m going to tell you a story. A 21-year-old young man had a brain tumor, severe epilepsy, autism at 15 months of age. He’s experienced over 40,000 seizures in his life; he had two brain surgeries. He’s had a vagal nerve stimulator, multiple falls, broken bones, dental soft tissue injuries. He’s been on a ketogenic diet his whole life. He takes five anti-epilepsy medicines after failing another ten; two of them have black-box warnings, that you could die if you take them. He seizes still between three and seven times a day. He’s had life-threatening allergic reactions; Stevens-Johnsons syndrome twice. He has daily speech, occupational physical therapy, and behavioral therapy. He has severe speech delay; he can’t talk very much. Right-sided weakness and spasticity. He was 16 when he was finally toilet-trained. He has feeding issues and other weaknesses in terms of feeding himself and self-care. It took three years to teach him how to swallow pills. He has a very slow processing time, and he requires supervision all the time.

We’ve tried to do job training; he failed seven times. He drooled too much in the restaurant that they tried to put him in to work. He couldn’t do the Marshalls stuff to help package stuff, because he would seize and then they would want to call the ambulance. He couldn’t really do anything.

What’s interesting about him is that he has a certain love of life, a certain joy that never stops. He always wakes up with a smile every day. He laughs after every seizure. I think that was taught to him by his mother. He never says a bad word about anybody, because he doesn’t speak, so, as his brothers say, he doesn’t sin. [Laughter] He is now painting! and he makes beautiful artwork. He prays. He never misses church. He’s been 100% attendance in Sunday school since he was four years old. He’s practical, because the only way you can survive with that kind of a debility is to actually work around it. He has a purpose, because he paints. He is sincerely positive. He has the same breakfast every morning—bacon and eggs—and every day he acts like it’s the greatest thing that was ever given to him. He never gives up; he’s very persistent. The monks say you fall down seven times and you get up eight? That’s Nicholas. And he is powered by love; he’s never expressed any malice towards anybody.

He’s my son, and he is my example of resiliency, and he’s a good example of the community effort that is required for resiliency. Our church, our community, his school, our neighbors, his caregivers all have worked together to get him to have a purpose in life and to express his joy.

What is the point of all these examples? I asked you that before and you thought, “Well, the deacon’s just going to go on and on.” He did, but that’s okay. [Laughter] Especially if we know we’re going to die, why do our bodies fight; why do we fight? Why do these examples move us in some way or another? C.S. Lewis said, “We are souls who have bodies.” I love that. “We are souls who have bodies.” Most of us say, “I have a soul.” No, we are souls who happen to have bodies. They were given to us to dress us. We were created in the image and likeness of God. We have flesh, and we have spirit.

When our souls are de-formed through sin, we have a desire to return to our original state: resiliency. When we sin by our calling from God, we want to come back to how we were created. Remember, Adam and Eve were created in paradise perfectly; that’s where we want to come back. This occurs through the process of confession and repentance. This is spiritual resiliency. These physical examples of resiliency—you might want to call it medical resilience, since that’s the topic—are models and reminders for us every day to focus on the resiliency of our souls. Nothing happens in this life without some purpose, so when we are witnesses to these things that happen around us, well, if we’re going to die anyway, you might as well say, “Who cares?” but it’s a sign, it’s a book, it’s a movie, it’s something that’s telling you something, and you have to listen to it. And what are you listening to? You’re listening to it to focus on the resiliency of your soul, to focus on your spiritual life, through the saving power of Jesus Christ, through the mystery of confession and repentance.

A return to normal: it starts with baptism, and it continues with repentance, and it is strengthened by the love of Christ through holy Communion and the other sacraments of the Church. It’s a beautiful image of our return to where we belong, and it’s not temporary; it’s eternal. That’s the difference. So these worldly, bodily resiliencies are little road-maps for us to wake up spiritually.

There are many medical miracles in Scripture, right? Why? Because it tells us something. Christ always tied it in with a spiritual lesson, some spiritual improvement, some spiritual reconciliation. So we look about the man born blind. “Who sinned, his mother or him?” Neither one; so that the glory of God could be revealed in him. That’s what we’re talking about. All these little medical miracles, resiliencies, our personal resiliencies, these are all so that the glory of God can be revealed around us in others. Even the three resurrections from the dead tell us something: that’s what we long for. We don’t want to die; we want to live. Unfortunately, our DNA are going to let our bodies die, but Christ is going to let us live. When we tell people that, that’s the purpose. So when somebody’s “having a bad day,” medically, it’s a perfect soil for repentance. It’s the best soil.

I had a guy; he hated our priest—hated him. Never went to church. I ended up seeing [him] in the ER one night. He was bleeding to death from an ulcer, and his wife was there. I didn’t know this—I was new to the community—but he had a grudge. I went in; I saw his last name was Greek. I said, “Are you Orthodox?” “Yes.” “I’ve seen your wife at church.” “Okay.” I’m trying to resuscitate him, I’m giving him fluids, I’m giving him blood. I tell him, “You’re really sick. Do you want me to call the priest?” He said, “No way.” [Laughter] So I looked at his wife, and she said— [Laughter] “Call the priest.” So I’m like: “Okay, what’s going on?” She pulled me over and said, “He really is mad at the priest.” I said, “Even now?” [Laughter]

When he got a little better, I pulled him aside and said, “You really should not be angry at a priest,” and he said, “I am!” I said, “You know, honest truth is, I am, too. Let’s go talk to him.” That’s what my priest told me to do. He said, “When somebody’s mad at me, agree with him and bring him with you.” So I did. I said, “He drives me crazy, too. Let’s go talk to him.” [Laughter]

So when he got out of the hospital, made an appointment, and we talked to him. He told him all the things he had against the priest, and the priest said, “Forgive me.” Just like that. And then the guy started crying, and he said, “I’m sorry” to the priest, and he never missed church after that. He died a few years later, and his wife gave me one of these wooden ships that he built, and I have it in my office. I think about it all the time, because, see, he needed the two-by-four to wake up, and when he got the two-by-four, he woke up. Unfortunately, most of us, we start with the switch, we get the two-by-four, we still ignore the two-by-four; we need a four-by-six, and then we have to have the whole building fall on us before we wake up. [Laughter]

When we’re physically deformed, we can be re-formed. When we suffer wounds, we can heal. When our bodies are assaulted externally, we combat the assault internally. Our bodies are designed to return to their original state. The personal witness of this process in the created world, especially in our bodies, gives us a model for the spiritual aspects of our existence. Our image is a model for our likeness. So this is what we call theosis, is the idea of becoming holy in our lives. This resiliency spiritually is the return to the normal spiritual state.

That’s where I think the medical and the spiritual connect. It is our road-map. We see it, and then we can try to do it internally. When we’re deformed by sin spiritually—our souls are deformed by sin—we have an opportunity to be re-formed and healed spiritually through confession. When we are wounded in spirit by others or external circumstances, we have an opportunity to heal that external wound through love, forgiveness, and acceptance. When our minds are assaulted by demonic thoughts, we can combat those thoughts internally through a spiritual immune system, which includes prayer, fasting, and living the sacramental life. The more we are exposed to those things and we fight them, the better we get at fighting them. Whenever you start to have those overwhelming thoughts and difficulties, look at it as: I’m ready for battle; let’s go, because it’s going to make me closer to Christ at the end.

Remember St. Anthony, wrestling with the devil? That’s the kind of attitude [we need]. We’ve got to be tough, we’ve got to be strong, we’ve got to get into it—not be afraid; we’re not scared. Give me some more immunity. Let the kid get sick; he’ll be stronger when he gets older. We hear it all the time.

And we have really good examples of community resilience, and it’s really important to remember that, from a spiritual point of view, we need a community of believers. Somebody said to me—no, I read—where if you don’t pray personally, how do you expect the communal prayer to be of any value? In other words, you come unprepared, you come not ready for communal prayer. And we need our brothers and sisters in Christ to get through things, to help us.

So I just want to leave you with a couple thoughts. Death is a catastrophe, according to Florovsky. Sin does not belong to human nature but is a parasitic and abnormal growth. Separation from God leads the creature to decomposition and disintegration. God took flesh in the Person of Jesus Christ, conquered death through his crucifixion and resurrection. His suffering, his disfigurement, and death were reversed and restored, and in that [he] reversed the inevitable destruction of his creation out of love. He physically showed us that we can be saved. He physically showed us. So he’s giving us the idea that we look at the physical to understand the spiritual. This is resiliency par excellence. That’s the peak of resiliency: Christ’s suffering and coming out on the other side, still perfect. That’s resiliency in a nutshell.

As medical caregivers and other caregivers, we can act as witnesses and facilitators of the return to the original state. Really, we can’t really heal anybody, to be honest with you. We try, and we do some things that are pretty good, but in general… It’s not going to go well in the long run. We’ve got maybe a couple decades we’re going to give, but not much more than that. If we look at the physical process as being an icon, then what we express to somebody is deeper than just “Oh, we’re going to fix your wound, and it’s going to get better.” We’re going to fix your wound with an attitude that, in that healing process of your wound, you’re going to start looking inside more, and maybe think more about true repentance and a change in life.

I’m open to any questions. I don’t know if that’s part of the deal. Is that how it works? Great. [Applause]

Facilitator: We have time for one or two questions, and if you’d like, the double microphone set-up.

Q1: Thank you for your talk. It was wonderful.

Dn. Euthym: Sure.

Q1: I was reminded of the idea of falling down and getting up and actually building spiritual resilience in these physical catastrophes that happen. I am a chaplain at Sloan Kettering. I have two questions for you. Do you have chaplains at your—?

Dn. Euthym: Yes.

Q1: And do you call them?

Dn. Euthym: All the time.

Q1: And the other question is: I just read a study on resilience that talked about resilience personally and in community. Have you altered anything in terms of the system in your hospital to help the physicians and caregivers be more resilient? And has spirituality or religion played a part in that?

Dn. Euthym: Well, that’s a great question. We meet… I actually meet with the local clergy: a priest, an imam, a group of us meet pretty regularly and talk about spiritual needs of patients. We have a chaplaincy program that’s very active. There’s always somebody on call. I have talked to a lot… Just in the training of residents and some of our younger docs, I talk a lot about how to ask somebody about their spiritual life. In other words, it’s become a… I remember 25, 30 years ago, we would get a list of all the Orthodox in the hospital. And you’d go: “Oh, there’s all these Orthodox. Let’s go see them.” Now, no lists, none of that, nobody’s business. Everybody’s kind of covered up. So I tell our parishioners and I tell other people: If you want us to call one of the clergy, let somebody know in the hospital. But we try to be proactive, and it really behooves us as physicians, nurses, to ask people: What is your belief system? How do you believe? Are you a person of faith? I ask simple questions like that. It really changes things. I have prayed with patients. The lady with the stroke? Their pastor came in that night, and we prayed together. Some of my own parishioners, I’ll just take care of them and we’ll put our head down and pray. I don’t do it with just… I say my own prayers, but I don’t force anybody to pray with me, believe me.

I think your point is that the hospital needs to look at that. They have a lot of alternative medicine things going on. I think that’s been a substitute in my mind for spiritual nurturing, and I think it’s fading at some level. We’re all afraid to talk about what we believe, because it might offend somebody, but I’m pretty bold about it. In fact, some of the nurses in our department tell the ladies that are in there, “Oh, he’s a deacon in the Church.” They’re Jewish; what do they…? [Laughter] And the best part is, the old Jewish ladies go: “That’s great. I want him to be my doctor.” See? Because everybody wants that in their caregiver. They want somebody who is concerned about their spiritual existence.

And God bless you for the work you do, because cancer patients have a big challenge. Keep up the good work. We’ll try to… I think there should be better programs; I really do. It’s just one of those things that you have to work through the system.

Facilitator: We have time for one more question and it’s been selected. [Laughter]

Dn. Euthym: Thank God.

His Eminence Metropolitan Isaiah of Denver: I simply want to say that I thank the Lord for being here at this conference. Everything that you said is in harmony with Orthodox Christianity, totally in harmony. Hopefully, if you can put all this in writing, it would be a best-seller—forget the word “seller,” but it would be very, very necessary.

I have been serving our Lord as a clergyman—I’ll say over 50 years; I’ll stop at that. But you reminded me when you first started talking that in my years in the clergy, a good number of people passed away within two or three years after they retired because after retirement they had no purpose in life. You gave to us today many reasons why we were created, and you brought out something that, thank God, it goes contrary to what I briefly said yesterday: doctor-assisted suicides. That’s why what you said today is a perfect explanation, a beautiful explanation, why we should continue in what you have told us today and taught us so that when we see medical science not bringing the human soul into perspective, that is going in the wrong direction. God bless you. I thank you very, very much.

Dn. Euthym: Thank you, Your Eminence. [Applause]

Facilitator: Please join me in thanking Dn. Euthym for the wonderful presentation. [Applause]


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