volume 44 no. 3 fall 2013
TODAY’S
CHRISTIAN DOCTOR The Journal of the Christian Medical & Dental Associations
Standing Against Persecution: IN THIS ISSUE
My Journey to Start a CMDA Campus Chapter Being equipped to serve in medical missions
Facing change in the midst of a natural disaster
Exposing the problems behind telemedicine in abortion
CMDA MEMBER SERVICES Dedicated to serving you
“I’m proud of the work of CMDA. My Lifetime Membership allows me to voice my strong support of this ministry. Additionally, Lifetime Membership saves me the time and worry about annual membership renewal.” - Lisle Whitman, MD CMDA Member since 1991 Lifetime Member since 2006
LIFETIME MEMBERSHIP A LIFETIME OF OPPORTUNITY A LIFETIME OF CHANGE
A Lifetime Membership to CMDA offers extensive benefits to you as well as helps to ensure that the important work being done for healthcare continues far into the future.
HE MADE THE COMMITMENT.
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Letter from the President
In thinking about these four principles, the concern I have is the lack of influence that we Christians seem to have in the world. When 88 percent of Americans own a Bible, why is there so little impact? As
As you can see from the following remarks, the answer lies in our response to the gospel. John V. Taylor said, “Salvation is not the same as a solution; it precedes it and makes it a possibility.” “Truth is powerful when it is argued; it is even more powerful when it is exhibited.”2 “Most Americans esteem the Bible and have access to it. However, even if there’s a baseline of respect, people aren’t sure how to apply the lessons of Scripture to public life or society, particularly in an increasingly pluralistic nation.”3 “Obedience to Christ demands change, the world becomes His world, the poor, the weak and the suffering are men, women and children created in His image; injustice is an affront to His creation; despair, indifference and aimlessness are replaced by hope, responsibility and purpose; and above all selfishness is transformed by love.”4
Richard E. Johnson, MD
from the CMDA
I was struck once again by the analogy that Christ gave in Matthew 5: we are to be salt and light. In his book Involvement: Being a Responsible Christian in a NonChristian Society, John Stott reminds us of four basic truths about salt and light. • Christians are fundamentally different from non-Christians, or at least we ought to be! • Christians must permeate non-Christian society. We are not to be socially segregated. The lamp is no good under a bowl, and the salt is no use in the shaker. • Christians can influence non-Christian society, but are we? • Christians must retain their Christian distinctness. Here we have the tension of being in the world without becoming assimilated into it.
Stott says, “If the house is dark when nightfall comes, there is no sense in blaming the house, for that is what happens when the sun goes down. The question to ask is ‘where is the light?’ If the meat goes bad and becomes inedible, there is no sense in blaming the meat, for that is what happens when the bacteria are left alone to breed. The question to ask is ‘where is the salt?’”1
president
As I begin my two-year position as President of CMDA, my first letter to you is written with a deep appreciation for all of our members who are ministering so effectively in this and other countries. As you read the articles in this issue of the magazine, you will be struck by the diversity of our member involvement. That involvement happens because we have a passion to make a difference where God has called and placed us. There is no “one role” that is more significant, no one calling that is more important and no inherent significance to our giftedness. For it is God’s design to use the minority, the insignificant by the world’s standard, the uniqueness of the mustard seed and the five small stones taken from the stream to make a significant impact on our world.
When you read these articles, my prayer is that you will be inspired, not just by what these people are doing, but inspired to return to the gospel and listen to Christ’s call on your life. Are you being salt and light where you live and work? Bibliography 1 John Stott, Involvement: Being a Responsible Christian in a Non-Christian Society, (Revell, 1985), p.101 2 Ibid. p 110 3 The Barna Group Website 2013 4 Brian Griffiths, Morality and the Market Place, (Sevenoaks: Hodder & Stoughton, 1982), p.154-155
Look for this interactive icon throughout the magazine for links to videos, interviews and more resources from CMDA. CHRISTIAN MEDICAL & DENTAL ASSOCIATIONS www.cmda.org
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contents Today’s Christian Doctor
I VOLUME 44, NO.3 I Fall 2013
The Christian Medical & Dental Associations®— Changing Hearts in Healthcare . . . since 1931.
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Transformations Are You Willing? by Brett Burton
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COVER STORY Standing Against Persecution: My Journey to Start a CMDA Campus Chapter by Amanda Lucashu
Overcoming obstacles to ministry on campus
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by David W. Croy, MD
Facing change in the midst of a natural disaster
Being equipped to serve in medical missions
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The Winds of Change
Telemedicine Abortions: Misfits Lowering the Standard of Care by Sandy Christiansen, MD, FACOG
Exposing the problems behind telemedicine in abortion
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Classifieds
Scientific Demagoguery in the Stem Cell Wars by David Stevens, MD, MA (Ethics)
Analyzing the status and ethics of current stem cell research
REGIONAL MINISTRIES Connecting you with other Christ-followers to help better motivate, equip, disciple and serve within your community
Western Region Michael J. McLaughlin, MDiv P.O. Box 2169 Clackamas, OR 97015-2169 Office: 503-522-1950 west@cmda.org
Northeast Region Scott Boyles, MDiv Midwest Region P.O. Box 7500 Allan J. Harmer, ThM Bristol, TN 37621 9595 Whitley Dr. Suite 200 Office: 423-844-1092 Indianapolis, IN 46240-1308 scott.boyles@cmda.org Office: 317-556-9040 cmdamw@cmda.org Southern Region William D. Gunnels, MDiv 106 Fern Dr. Covington, LA 70433 Office: 985-502-7490 south@cmda.org
Interested in getting involved? Contact your regional director today!
TODAY’S CHRISTIAN DOCTOR®
EDITOR Mandi Mooney EDITORIAL COMMITTEE Gregg Albers, MD John Crouch, MD Autumn Dawn Galbreath, MD Curtis E. Harris, MD, JD Van Haywood, DMD Rebecca Klint-Townsend, MD Robert D. Orr, MD Debby Read, RN VP FOR COMMUNICATIONS Margie Shealy AD SALES Margie Shealy 423-844-1000 DESIGN Ahaa! Design + Production PRINTING Pulp CMDA is a member of the Evangelical Council for Financial Accountability (ECFA).
TODAY’S CHRISTIAN DOCTOR®, registered with the U.S. Patent and Trademark Office. ISSN 0009-546X, Fall 2013, Volume XLIV, No. 3. Printed in the United States of America. Published four times each year by the Christian Medical & Dental Associations® at 2604 Highway 421, Bristol, TN 37620. Copyright© 2013, Christian Medical & Dental Associations®. All Rights Reserved. Distributed free to CMDA members. Non-doctors (US) are welcome to subscribe at a rate of $35 per year ($40 per year, international). Standard presort postage paid at Bristol, Tenn. Postmaster: Send address changes to: Christian Medical & Dental Associations, P.O. Box 7500, Bristol, TN 37621-7500. Undesignated Scripture references are taken from the Holy Bible, New International Version®, Copyright© 1973, 1978, 1984, Biblica. Used by permission of Zondervan. All rights reserved. Scripture references marked (KJV) are taken from the King James Version. Scripture references marked (MSG) are taken from The Message. Copyright© 1993, 1994, 1995, 1996, 2000, 2001, 2002. Used by permission of NavPress Publishing Group. Scripture references marked (NASB) are taken from the New American Standard Bible®, Copyright© 1960, 1962, 1963, 1968, 1971, 1972, 1973, 1975, 1977, 1995 by The Lockman Foundation. Used by permission. Scripture references marked (NIV 2011) are taken from the Holy Bible, New International Version®, NIV® Copyright© 1973, 1978, 1984, 2011 by Biblica, Inc.™ Used by permission. All rights reserved worldwide. Scripture references marked (NKJV) are taken from the New King James Version. Copyright© 1982 by Thomas Nelson, Inc. Used by permission. All rights reserved. Other versions are noted in the text. For membership information, contact the Christian Medical & Dental Associations at: P.O. Box 7500, Bristol, TN 37621-7500; Telephone: 423-844-1000, or toll-free, 888-230-2637; Fax: 423-844-1005; Email: memberservices@cmda.org; Website: http://www.joincmda.org.
transformations
WIMD Annual Conference
September 19-22, 2013 • Dallas, Texas As a female healthcare professional, do you deal with the accumulated stresses of work, family, church and a host of other activities? Are you struggling to stay focused on God’s plan for your life in the midst of personal and family issues? Then we invite you to join Women in Medicine and Dentistry for this special and unique conference that is specifically geared toward women. This conference is designed to address the professional, emotional and spiritual needs of women physicians and dentists. It also provides continuing medical education on a variety of healthcare topics, with the goals of improving clinical knowledge and skills, in order to improve patient care outcomes. A wide range of sessions and workshops are offered so you can tailor your conference experience to fit your specific needs. Student scholarships are available for students wanting to attend. With an emphasis on creating a supportive and encouraging environment, the WIMD Annual Conference will help you be renewed as you focus on shining like the stars and holding to the Word. Register today at www.cmda.org/wimd.
Visit www.cmda.org/wimd or scan the smart tag with your mobile device to listen to a conference promo interview.
As of August 1, 2013, the CMDA affinity credit card program is no longer being offered through Bank of America. This affinity program had been providing funds for CMDA’s Medical Education International (MEI) program, as well as Women in Medicine and Dentistry. In 2012, Bank of America completed a comprehensive review of their affinity program customers and decided to discontinue providing affinity programs to organizations of our size. If you are a current participant in the program, you will continue to be serviced by Bank of America without interruption. Existing cardholders will be notified on their billing statements. For more information, please contact Bank of America using the contact information provided on your statement. If you’d like to continue supporting MEI and WIMD through direct contributions, please visit www.cmda.org/giving.
If you are interested in submitting articles to be considered for publication, visit www.cmda.org/publications for submission guidelines and details. Articles and letters published represent the opinions of the authors and do not necessarily reflect the official policy of the Christian Medical & Dental Associations. Acceptance of paid advertising from any source does not necessarily imply the endorsement of a particular program, product or service by CMDA. Any technical information, advice or instruction provided in this publication is for the benefit of our readers, without any guarantee with respect to results they may experience with regard to the same. Implementation of the same is the decision of the reader and at his or her own risk. CMDA cannot be responsible for any untoward results experienced as a result of following or attempting to follow said information, advice or instruction. CHRISTIAN MEDICAL & DENTAL ASSOCIATIONS www.cmda.org
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transformations
Seen
The CMDA Voice in Ministry “God really captured and encouraged my heart as He allowed me to see small glimpses of His greater plan. Scripture tells us that God goes before us and I certainly saw that during my time in Mongolia. I was humbled as I repeatedly witnessed God bring just the right group of people together at just the right time for His purpose. I felt like I was standing only centimeters away from an enormous mosaic. Every once in a while I’d catch a glimpse of the greater masterpiece and was reminded of God’s perfect plan....” —A participant on a MEI trip to Mongolia
& Heard the CMDA voice
“To say I am blessed to have you in my life is an understatement. Your love and support has gotten me through some of the darkest days of my life. Because of you, I will become a doctor this spring. I consider you family and hope to keep in touch long after graduation.” —A CMDA student member “Christ’s love touches people’s hearts and transforms their lives. All our sacrifices are worth nothing without the love of God. When we pray for God to humble us and show His love to people through us, we are calling down the power of God into our relationships with one another. What I learned is that loving people and serving them makes the Great Commission real for us and for them.” —A participant on a GHO trip to El Salvador “It has been said that in the dental profession you need three important attributes: your head, your hands and your heart. The mission trip last week to Haiti gave me an opportunity to see these three attributes exhibited to their fullest extent by every member of our team. A servant’s heart of love and compassion was demonstrated by each member of our team members on a daily basis. Their willingness to put others before themselves and work long, difficult hours in adverse conditions without any complaints really touched my heart.” —A dentist on a GHO trip to Haiti
Website Directory Transformation
Equipping
Campus Ministries cmda.org/student Chapel & Prayer Ministries cmda.org/chapel Community Ministries cmda.org/ccm Dental Ministries cmda.org/dentist Medical Malpractice cmda.org/mmm Side By Side cmda.org/sidebyside Singles cmda.org/singles Specialty Sections cmda.org/specialtysections Women in Medicine & Dentistry cmda.org/wimd
Christian Doctor’s Digest cmda.org/cdd Conferences cmdaorg/meetings Donations cmda.org/donate Human Trafficking cmda.org/trafficking Membership joincmda.org Placement cmda.org/placement Today’s Christian Doctor cmda.org/tcd Weekly Devotions cmda.org/devotions
Service
American Academy of Medical Ethics ethicalhealthcare.org Washington Office cmda.org/washington Freedom2Care freedom2care.org
Center for Medical Missions cmda.org/cmm Global Health Outreach cmda.org/gho Global Health Relief cmda.org/ghr Medical Education International cmda.org/mei Pan-African Academy of Christian Surgeons cmda.org/paacs Scholarships cmda.org/scholarships 6 TODAY’S CHRISTIAN DOCTOR FALL 13
Voice
Social Media Blogs cmda.org/blogs Facebook facebook.com/cmdanational Twitter twitter.com/cmdanational YouTube youtube.com/cmdavideos
Enter CMDA’s Photo Contest Do you enjoy taking pictures? Are you always snapping photos when you meet up with your CMDA friends? Did you take your camera with you on a recent mission trip? If you answered yes, then this new contest is just for you! Photographs tell a story and we need your help to tell the story about CMDA’s ministry. We are looking for great photos from your local CMDA gatherings, regional conferences, mission trips or other events to use in our publications. Submit your photos to the new CMDA Photo Contest and you could win an iPad Mini! Each photograph you submit possesses the power to grow and promote Christ in healthcare. To get started submitting your photos, visit CMDA’s Flickr site at www.flickr.com/groups/cmdaphotolibrary/. The contest ends on October 31, 2013, and the winning photograph will be announced in the spring 2014 issue of Today’s Christian Doctor. The grand prize winner will receive a FREE iPad Mini! For a full list of contest rules and additional information, visit www.cmda.org/photocontest.
In Memoriam William R. Cutrer, MD, passed away on Saturday, July 13 at the age of 62. Dr. Cutrer served as the former area director of CMDA’s Dallas Area ministry. He was the first medical doctor to join the faculty of Southern Seminary in Louisville, Kentucky, following a successful career as an OB/Gyn in Texas. Dr. Cutrer, who spoke at conferences about various topics such as marriage enrichment, bioethics and wellness lifestyles, was the author or co-author of several books, including Sexual Intimacy in Marriage, The Infertility Companion and The Contraception Guidebook. He also performed missionary work in a variety of countries and contexts. He held a medical degree from the University of Kentucky in Lexington, Kentucky, and a master’s degree from Dallas Theological Seminary in Dallas, Texas.
c Memoriam and Honorarium Gifts d Gifts received April through June 2013 Nathan and Christina Van Embden in honor of David Fuller, MD Henry R. Lesesne, MD in memory of Dan Fountain Bonnie Wonnacoff in memory of Lauga Einarsson Judy Petry in memory of John Petry, MD Russell and Sally Martin in memory of Lee Flynn David Hill and Janet Lynn Chestnut in honor of Lynn and Joan Colop Saundra L. Blanchard, MD in honor of Dr. and Mrs. Glenn & Bernice Verbrugge Tom Duncan, MD in honor of Dr. Tom Duncan Donald M. Waltz in honor of Ed Read, MD George Courtney in memory of Bob Scheidt, MD Donald Wood, MD in memory of Bob Scheidt, MD Don Crabtree, MD in honor of John Crabtree For more information about honorarium and memoriam gifts, please contact stewardship@cmda.org.
Have you been
transformed? Are you
transforming others?
We want to hear from you Send your transformation story, letter or photos to communications@cmda.org or to P.O. Box 7500, Bristol, TN 37621. Please include an email address for us to contact you.
We want to hear your story It can be a simple comment about a CMDA ministry; it can be an account of your experiences on a missions trip; it can be a profile of a member who has had a huge impact upon you; it can be photos from a campus meeting; it can be statistics showing how your trip served the needy; it can truly be anything— we want to see how your work is making a difference.
We want to hear your ideas Do you have a great idea for Today’s Christian Doctor? Send your ideas to communications@cmda.org.
Transformations one story at a time
showcasing the impact of CMDA
CHRISTIAN MEDICAL & DENTAL ASSOCIATIONS www.cmda.org
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Are You Willing? by Brett Burton
“Who is willing to consecrate themselves to the Lord today?” —1 Chronicles 29:5b, NIV 2011
Visit www.cmda.org/gho or scan the smart tag with your mobile device to watch a video from one of GHO’s recent trips to Haiti. 8 TODAY’S CHRISTIAN DOCTOR FALL 13
A
fter finishing up class for the day, the four of us sat huddled around the phone for a conference call to discuss our upcoming medical missions trip to Haiti through Global Health Outreach. As physical therapy students, we had committed to go on the trip about two months before, but the trip had filled up quickly and no physical therapist was scheduled to go with us to serve as a mentor. On the other end of the conference call was Rick Schurman, a physical therapist from Wisconsin who serves as the physical therapy specialty coordinator for GHO. He walked us through what we could or couldn’t do on the trip without a mentor and recommended that we look into taking medical equipment such as wheelchairs, walkers, crutches and canes with us. He also wanted to make sure that we all felt comfortable going on the trip without a mentor. As the four of us looked around the room at each other, it was clear that no one was questioning their commitment to the trip. Our team was willing.
But we had no idea how this would work since it was less than three weeks until our departure date. We received the green light from our trip leader the day after Grandthe ’ Anse call and decided whatever equipment we could get in the next 15 days would be able to go with us to Hai-
Sud
ti. The next day, our group Nordprayed, brainstormed some ideas and left with a plan to round up as much equipNord - Est ment as possible in the short time frame. Little did we know how eager people would be to give as we began seeking out resources in our community in Nebraska. Our community was willing.
Artibonite
We started first by contacting HELP Adult Services, a local business in town that provides in-home family care support and rents medical equipment at very low rates to those in need. I was hoping they would be willing to give us a wheelchair and a few walkers, but they told me to send a wish list and they would do what Centre they could to help out. Everyone on our team of nine from Nebraska had agreed to pack all of their personal items in carry-on bags, allowing us to check in all the equipment at the airport. So I tried to calculate what would be feasible to take on the trip, but I clearly underestimated as we still had room for more even after HELP Adult Services fulfilled the entire request except for two canes.
HAITI
DO RE
Port - au - Prince
At the same time, I also placed a random post on Craigslist seeing if anyone Ouest had any equipment they were not using that we could collect. The first response C Sud -MEst& D HRISTIAN
EDICAL
ENTAL
ASSOCIATIONS www.cmda.org
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and everyone who was willing and whose heart moved them came and brought an offering to the Lord for the work on the tent of meeting…” (NIV 2011). As the chapter progresses, it continues to mention that all who were willing brought materials to be contributed to the cause, and offerings continued to be brought “morning after morning” (Exodus 36:3, NIV 2011). In the end, Moses has to give an order to send throughout the camp, “‘No man or woman is to make anything else as an offering for the sanctuary.’ And so the people were restrained from bringing more, because what they already had was more than enough to do all the work” (Exodus 36:6-7, NIV 2011). This ancient biblical story played out in our modern scenario, as we were overrun by the generosity of God being portrayed through the willingness of others.
was from a guy who was willing to donate 15 walkers. I could only smile as I called him the next morning and he told me he was wrong and was going to bring a pickup full of equipment over to my house. That afternoon, we unloaded countless walkers, crutches and canes that belonged to former military veterans. He was part of the American Legion Post in Waterloo, Nebraska, and was just as thankful as we were that he spotted the listing. They had been accumulating equipment and the previous year had to throw equipment away because they ran out of room to store it. And that wasn’t all. We also received some generous donations from private donors to top off our inventory. Within the span of eight days, my house had taken up the appearance of a medical retail store. When my landlord came home, he was certainly shocked, but was understanding and supported us all the way. In the end, we had to turn others down and find ways to redirect the support because we couldn’t get all the equipment to Haiti. It was such an astonishing response. Our support was willing. Being a recipient of God working through and revealing Himself through so many people reminded me of Exodus 35-36. In these chapters, Moses leads the Israelites in gathering and finding materials for the tabernacle. Exodus 35:20-21 says, “Then the whole Israelite community withdrew from Moses’ presence, 10
TODAY’S CHRISTIAN DOCTOR FALL 13
The willingness of His people did not stop with just the donated equipment. About eight volunteers came over during the week of mid-terms to help us select and package equipment to board the plane. After going through hundreds of yards of bubble wrap and plastic wrap, we had 10 blocks of equipment ready to make the trip. We called the airport ahead of time to see if they would let us take the equipment for free, but they couldn’t grant our request. So we were just praying that everything would go though when we got to the airport.
entire life. An individual who helps people with special needs in the area went to Gingi’s home and brought him to the clinic, and we were able to get him a wheelchair. This reminded me of Mark 2, when Jesus heals the man that his friends brought to Him though the roof because it was too crowded to get to where Jesus was located. Gingi is mute and when the gospel was shared with him through picture illustrations, he raised his hands in the air when it was explained that Jesus was raised from the dead. It is an image that will stay with me long after returning home. Because of the willingness of so many in such a short time, we were equipped for far more than we realized. God revealed how a willing heart can be contagious and how amazing experiences can result through the willingness of many. We didn’t know how equipped we were to be serving on our own as students, but God provided and equipped us with resources that could meet others’ physical needs as we shared the hope that we have in Jesus, the ultimate Healer. You, too, can experience this life-changing experience if you have a willing heart. Are you willing?
Upon arrival, we talked to the woman at the front desk about the purpose of the trip and she ended up putting it on the plane for free. What a blessing! The equipment arrived safely in Haiti at Port au Prince, survived the 10-hour bus ride to Jeremie and was ready to distribute at the clinic. God continued to work as He brought people to the clinic who needed what we had to offer. Of the 54 pieces of equipment we transported to Haiti, the majority was given away and those left were given to the local churches to provide to others within the community. The willingness of so many back in Nebraska made a difference for dozens in Haiti, specifically Margarette and Gingi. Margarette is an eight-year-old girl who suffers from cerebral palsy. I carried her into the clinic in heavy leg braces. We were able to get her out of the leg braces, and she walked for the very first time with assistance from a walker we were able to provide to her and her family. We only had one child’s walker and it fit her perfectly. I’ll forever remember the smile on her face! Gingi is a man whose deformities forced him to crawl through Jeremie on his hands and knees for nearly his
“Lord our God, all this abundance that we have provided for building you a temple for your Holy Name comes from your hand, and all of it belongs to you…All these things I have given willingly and with honest intent. And now I have seen with joy how willingly your people who are here have given to you” (1 Chronicles 29:16-18, NIV 2011).
About The Author
BRETT BURTON is a third year physical therapy student at the University of Nebraska Medical Center (UNMC) in Omaha, Nebraska. Prior to studying at UNMC, he graduated from the University of NebraskaLincoln with a degree in athletic training. He currently serves on his campus chapter’s CMDA student leadership team and has a passion to see lives transformed by Christ. CHRISTIAN MEDICAL & DENTAL ASSOCIATIONS www.cmda.org
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cover story
Standing Against Persecution:
My Journey to Start a CMDA Campus Chapter by Amanda Lucashu
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TODAY’S CHRISTIAN DOCTOR FALL 13
A different kind of mission field
My journey with medicine began when I was only eight years old. As I listened to a missionary speak about the need for the next generation to continue the work and become missionaries, I felt God impress upon me that He wanted me to become a missionary doctor to Mexico. From the beginning, missions and medicine were intrinsically linked for me. So when I started school at Touro College of Osteopathic Medicine in Harlem, New York in the fall of 2011, I knew that I wanted to be used by God even before I got to the “mission field,” but I had no idea how much of a mission field I was walking into.
The best-laid plans “‘For I know the plans I have for you,’ declares the Lord, ‘plans to prosper you and not to harm you, plans to give you hope and a future’” (Jeremiah 29:11). The school year didn’t start out the way I planned. My husband’s search for a job and our search for an apartment had turned up empty, leaving me without a place to live by the time I started school. In
desperation, I posted on my school’s Facebook page asking if anyone would let me stay with them for a month or two. God prompted my future roommate to respond to the post and invite me to stay, even though she normally “never does anything like that.” When I moved in and we started talking, I discovered that she is also a Christian and had been on medical missions trips to Mexico. It was such a blessing to know that God had paved the way, even if it wasn’t in the way I expected. But even school didn’t seem to be what I was expecting. Touro was quite different from Houghton College, the Christian school I attended for undergraduate. I was shocked to see students partying every weekend and even having kegs in the cafeteria for the end-of-the-year party. In the midst of the rough transition, however, God brought other Christians into my life through what would appear to be otherwise insignificant encounters. Two different Christian girls came up to me because they recognized my Houghton sweatshirt. Then I noticed another student from my class post a Bible verse as her Facebook status. And it made me start to think: how many other Christians were in my school that I didn’t know about?
Visit www.cmda.org/students or scan the smart tag with your mobile device to learn more about getting involved with CMDA’s Campus Ministries.
CHRISTIAN MEDICAL & DENTAL ASSOCIATIONS www.cmda.org
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Searching for a community “For where two or three gather in my name, there am I with them” (Matthew 18:20). It wasn’t long before I felt motivated to start a Christian club on campus. A vague memory from high school about a Christian organization for healthcare professionals spurred me into searching online where I found Christian Medical & Dental Associations and immediately became a member. I was surprised to find out from Northeast Regional Director Scott Boyles that Touro already had a CMDA campus chapter. When I contacted the chapter’s student leaders, I was even more surprised to find out that the school’s administration had refused to recognize the chapter, the students weren’t allowed to hold events and the group had died. Along with fellow students Christianna and Manoucheka (the two girls who recognized my Houghton sweatshirt), we started working to revive our CMDA campus chapter. Since Christianna lived only one block away from the school, she opened up her apartment for us to hold Bible studies during lunch. As I worked to make our group official with the school, I discovered that there was a policy in our student handbook stating that student organizations could not form on the basis of race, religion, politics or sexual orientation. Even though there was something in writing prohibiting our group, I was determined to make the group official and have more of a presence on campus. I asked the administration if we could be a student “interest group” instead of an organization, a loophole around the policy that would still allow us to meet on campus and use the school’s email servers to publicize. The request was denied. Even though the policy was applied to other types of student groups, I felt persecuted and singledout. My next step was to call a Christian legal ministry to see if there was anything that they could do to help. Unfortunately, this case was beyond the scope of their ministry since Touro is a private school.
Perseverance in persecution “However, if you suffer as a Christian, do not be ashamed, but praise God that you bear that name… So then, those who suffer according to God’s will should commit themselves to their faithful Creator and continue to do good” (1 Peter 4:16,19). 14
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At the bottom of all emails sent from my school email address, I listed my credentials and included “President of the local chapter of CMDA.” At one point, I received an email from the Dean of Students asking me to change my email signature, demanding that I remove all CMDA references from my email since CMDA was not affiliated with Touro. In my reply, I politely explained that I intentionally wrote “local chapter” in order to show that distinction as we weren’t affiliated with the school. Nevertheless, he insisted that I remove it. I was furious and was tempted to test the waters by writing “President of the local chapter of the knitting club” or something equally non-controversial to see if it would elicit the same attention as my mention of Christianity. However, my dad, in his God-given wisdom, encouraged me to pick my battles wisely, so I decided to let it go. While I was at the CMDA National Convention in May 2012, I met a few students from our sister school, Touro Nevada. I found out that their school fully recognized their CMDA chapter and had even partially funded their trip to the convention. It had been implied by our administration that an Orthodox Jewish school would never be able to recognize a Christian club, but here was another Orthodox Jewish school that was doing just that. This renewed my hope that something could be done to change the policy at my own school. During the summer, I researched the student handbooks of several other Touro campuses across the country and discovered that my school was the only one prohibiting the formation of religious groups. I also no-
ticed that student organizations like CMDA were actually proudly displayed on the websites of these other schools. I printed out my research and wrote a petition requesting the administration change its policy. I gathered 175 signatures among the first and second year classes. These signatures represented students from multiple religions, ethnicities and sexual orientations, displaying a united desire for freedom of recognition even amongst such diverse groups.
Trying to do the impossible “With man this is impossible, but with God all things are possible” (Matthew 19:26b). The next step was presenting my petition and research to the Student Government Association (SGA). The night before the presentation, I was reading a chapter in Dr. David Stevens’ book Jesus, MD about how he thought building a hydroelectric dam in Africa was an impossible task, but the Lord disagreed. I prayed diligently that the same would be true in this situation as I asked a Jewish institution to allow the formation of a Christian group, a task that had so far seemed impossible. It was also such a blessing receiving the encouragement and prayer support of the National Student Council and my CMDA family. I later found out that they were even praying for me at staff meetings at CMDA headquarters in Bristol, Tennessee. I walked into the meeting the next day feeling emboldened yet humble. The SGA asked me several questions about my petition and its ramifications, but at the end of the meeting, they voted 5-1 in favor of presenting my research and petition to the administration. Two weeks later I met with the deans, having the support of the SGA behind me. After I presented my research, the deans explained that other students had complained about this issue in the past but that no one had ever done the research to show the discrepancies among the different campuses. They always had believed that this policy was dictated by the Touro system at large. However, my research showed that this policy was not present on all of the campuses and that our school should therefore have the liberty to change it. The deans were in favor of my petition and forwarded it to the president and board of trustees of the entire Touro system. Toward the end of meeting, one of the SGA members tried to reiterate why this policy was so badly needed, and one of the dean’s replied, “You can stop, you have already sold us.”
in the country would now be able to form student organizations on the basis of race, religion, politics and sexual orientation. What an answer to prayer! On October 24, 2012, the Touro College of Osteopathic Medicine chapter of CMDA had its first meeting on campus with almost 30 people in attendance. Regional Director Scott Boyles joined us and spoke about sacrificing for less than God’s best, illustrated by Esau selling his birthright to Jacob for a cup of soup. It was so encouraging to hear the Bible read and the Word of God proclaimed in my lecture hall. Some students who had class in that room before and after lunch simply stayed in their seats during the lunch hour. One such student was an Islamic woman wearing her head covering. Most of the time she pretended to be studying, but I praised the Lord for those moments when I noticed her listening and engaged in what Scott was saying. This was the benefit of being able to meet on campus—that we could minister to this woman and other marginally interested students.
Staying in the fight “Therefore, my dear brothers and sisters, stand firm. Let nothing move you. Always give yourselves fully to the work of the Lord, because you know that your labor in the Lord is not in vain” (1 Corinthians 15:58). Even though we were victorious in this first struggle, we still faced more hurdles. After becoming an official student organization, we were told that we would not receive funding. The SGA decided to make a distinction between “academic” and “non-academic” organizations, deeming us as “non-academic” and therefore ineligible to receive funding. I brainstormed ways that we could prove CMDA is academic, but that required changing the new policy which automatically catego-
Shortly thereafter, the CEO of the school called me into his office to tell me the petition was approved and our school would begin implementing the policy change. He also explained that students at every Touro CHRISTIAN MEDICAL & DENTAL ASSOCIATIONS www.cmda.org
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mission to meet on campus. I have tried to clarify this with the SGA and the administration but have not been given a straight answer.
God’s Not Done Yet “However, I consider my life worth nothing to me; my only aim is to finish the race and complete the task the Lord Jesus has given me—the task of testifying to the good news of God’s grace” (Acts 20:24).
rized all religious groups as “non-academic.” In the meantime, we applied for separate funds to help cover the costs of our leaders attending this year’s CMDA National Convention. The request was denied with the explanation that since we did not receive funding from the SGA, we were not eligible for conference funding either. The SGA did recently vote for us to start receiving funding and will be presenting their recommendation to the administration. But even without funding, our group continues to be active and members even donated funds to cover our expenses. We also were looking forward to an upcoming health fair as this would be our first opportunity to be involved as an organization. We filled out the necessary paperwork stating that we planned on talking to the community members about the connection between faith and health and that we would have a box where people could write down prayer requests. We then made a brochure showing the link from faith to medicine. Unfortunately, all brochures have to be approved before they can be distributed and our brochure wasn’t approved. Our new president Kylie tried to work with the administration to reformat the brochure in a way they would find acceptable. The Dean of Students (the same one who had antagonized me about my email signature) stated that we could not say anything about a connection between faith and health. In fact, in order to say anything, we needed to have members of other religions standing at our booth as well. As if that wasn’t disappointing enough, he added that we are not actually an official club but have only been given per16
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When I initially got involved with CMDA, I wanted to have an official chapter to be able to minister to non-Christians on campus who might not come to a Bible study at someone’s house. Now that we are officially recognized, we have a name on campus and are known by almost every student in the school, not just those attending Bible studies. Recently, a Jewish student who recognized I was a Christian through my involvement with CMDA asked me about books on Christian philosophy. That one question sparked a multi-week discussion on the basic tenets of Christianity, Jesus as fulfillment of the law and Jesus as Messiah. It was the realization of my dreams to have such far-reaching ministry opportunities; opportunities that we would not have if we had remained an off-campus group. We can’t sit idly by and watch the work of God be prohibited. Just as David had to fight Goliath because he “defied” the Lord, so I continue to fight the administration at my school so that the Lord will not be defied. In 1 Samuel 5, the Philistines captured the Ark of the Covenant and placed it in the temple of their false god Dagon. By the next morning, the idol of Dagon had fallen on the floor in front of the ark. They returned the idol to its shelf, but the next morning Dagon was once again on the floor before the ark, this time with its head and arms broken off. In the midst of feeling dejected about our current situation, God reminds me to trust in Him. This story in 1 Samuel is so encouraging because it reminds me that even though it currently seems like the work of God at my school is in an inferior position and a place of humiliation (like the ark in the temple of Dagon), ultimately God will triumph. I originally felt that sense of triumph back in October at our first on-campus meeting, but I don’t feel that triumph now. Our success has not been as victorious as we thought. Instead of having an amazing success story
The Big Picture J. Scott Ries, MD Vice President, CMDA National Director, Campus & Community Ministries
If only Amanda’s story was a struggle unique to Touro’s Harlem campus; unfortunately, it is not. I recently heard from student leaders at our CMDA chapter at the University of Illinois-Chicago (UIC) School of Medicine that their chapter had been de-recognized by the university. Despite providing every requested piece of information about the nature of the chapter’s purpose and ministry, plus more than three decades of formal approval from the administration, the school was kicking them out and shutting the door behind them. The university claimed that the chapter discriminated on the basis of religion since agreement with CMDA’s statement of faith is required of its leaders. This “violated” UIC’s non-discrimination policy and therefore our chapter was disallowed. Nearly every month or two, a student contacts us with a concern about their campus ministry being limited or somehow threatened in their existence. There are individuals on every campus that would prefer the light of the gospel be shown elsewhere, certainly not on their campus. The battle for religious liberty in our country rages on, quite clearly one that is spiritual in its nature. Thankfully, the threat at UIC has a happy ending. In consultation with our colleagues at the Christian Legal Society, I wrote a letter to the Vice Chancellor explaining that the CMDA chapter on UIC has actually enhanced religious di-
to share, all I have is a work in progress. Our ongoing struggles at Touro only make it even more important for us to continue in our efforts to keep CMDA on campus. And it makes it even more important for our CMDA brothers and sisters across the world to join with us in prayer for the work God is doing at Touro. God’s not done yet, and I know that it will be better than I could have ever imagined when I first felt God’s calling into medicine. Perhaps our efforts on the mission field of our campus will one day make it possible for all Christian clubs to be fully recognized on our campus, opening up a vast array of opportunities to share the gospel with our peers. Perhaps our story will serve to encourage other students at other campuses to start their own chapters. Perhaps this is only the beginning of the impact we can have on our campus, our community, our world. I can’t wait to see what God does.
versity on the campus for more than 35 years, while also contributing to the wellbeing of hundreds of medical students over the years. Explaining that CMDA’s criteria for leadership is not discrimination, but rather common sense and basic religious liberty, I urged them to re-recognize our chapter not only because the law requires it, but because it is the right thing to do. Two weeks later (during which time I’m certain more than one university attorney reviewed the evidence), I received compunctious phone calls and written communication from university authorities profusely apologizing for the “debacle of de-recognizing the CMDA chapter.” The chapter was immediately re-approved without reservation. Glory to God for His grace and faithful answer to prayer! Right now, though, other campuses remain in the crosshairs of enemy fire. We need your help. Though your student years may be well behind you, your ability to influence the next generation is not. What can you do? 1. Pray. Intercede before the Lord for our campus ministries across the country, and pray specifically for the one in your backyard. 2. Support. You’ve been on the receiving side of the ministry in the past, now it’s time to give back. Would you be willing to make a gift to support a specific growth project for CMDA’s Campus Ministries? 3. Engage. More than anything, students want to know what a Christian doctor “looks like” in real life. You don’t have to be perfect; you just have to be engaged. First step? Drop me a note at ccm@cmda.org, and I’ll gladly talk with you about getting involved!
About The Author
AMANDA LUCASHU is a third year student at Touro College of Osteopathic Medicine. She formerly served as Secretary and is now President of CMDA’s National Student Council. She has spent three wonderful years married to her college sweetheart Mark. Her future plans include being a family practitioner among the underserved in Mexico.
CHRISTIAN MEDICAL & DENTAL ASSOCIATIONS www.cmda.org
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Scientific
Demagoguery in the Stem Cell Wars by David Stevens, MD, MA (Ethics)
T
he “Stem Cell Wars,” as they were called on the cover of Newsweek on July 9, 2001, are over, and we won!
I remember that magazine issue because it hangs framed in our CMDA offices in Bristol, Tennessee as a remembrance of one of CMDA’s early forays into representing you on a contentious bioethical issue. My half hour interview with the reporter got dehydrated to one sentence in the cover article called, “Battle for Bush’s Soul,” where it was introduced by saying I was part of the “religious right.” The entire article was full of hyperbole, scientific demagoguery and anti-religious bigotry. The first sentence asserted that if thenPresident George W. Bush didn’t allow federal funds for human embryonic stem cell research (hESCR), the name of the GOP should be changed to “POG – the Party of God.” It went on to assert that this was a life and death issue and those opposing funding were sentencing people to death. That was just the warm-up for those claiming that the faction opposed to sacrificing human beings on the altar of research was playing “politics with sci-
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ence.” Demagoguery is appealing to the emotions, prejudices and ignorance of the population to gain power, influence or money. It usually involves politicians, but in this battle, scientists led the way. Science and society both paid the price as researchers ridiculously claimed that Parkinson’s, diabetes, Alzheimer’s and a host of other diseases could be cured within the next five to 10 years if the federal coffers would just be opened to fund “lifesaving” research. Researchers occupied the scientific high ground and took shots at everyone who opposed them, asserting that the ends justified the means, even if it involved destroying nascent human life. Gone were the claims of “my body, my right,” “a woman’s choice” or “reproductive rights” commonly heard in the abortion debate. Instead, it was about wasting “unused embryos” and the nobility of parents donating them to science. It was a horrific battle. I know; I still have some “scars.” I remember being called a “Luddite” in one interview. I didn’t know how to respond because I didn’t know what a Luddite was! My later research revealed that unbeknownst to me, I was “against all
new technology.” In a CNN interview after a video montage of stem cell scientists manipulating cells to save lives, the host turned to me and said, “Dr. Stevens, you’re a physician and you have children. Why would you be opposed to something that could save so many people’s lives?” I answered, “I believe stem cells will usher in a new era of regenerative medicine that will rival the development of antibiotics in the 1930s in saving lives. The question is not whether we should do stem cell research but where do we get the stem cells?” I then stated that hESCR was immoral, impractical and unnecessary. I even pointed out that the main scientific “authorities” advocating funding had completed more than 200 radio and TV interviews in the last few months and not once had they revealed the fact that they were shareholders, patent holders or officers in for-profit companies and stood to benefit from the government’s largesse.
Where are we now? The scientists, the commanding officers in the stem cell wars, have largely surrendered on the last two points of conflict in the last 12 years. They admit that hESCR is impractical and unnecessary. Not only have there been stunning developments using umbilical cord, amniotic and adult stem cells, but by inducing the forced expression of specific genes, somatic cells were turned into embryonic stem cell-like induced pluripotent cells (iPSCs). While many scientists were marching in lock step down the dead-end path of embryonic stem cells, Shinya Yamanaka in Japan and John Gurdon in England made this scientific breakthrough, earning them a Nobel prize in just six years.
lular development. They want to know the factors involved in the cellular decisionmaking process resulting in cell specialization. What genes are involved and what modifies their expression so that a stem cell turns into heart muscle rather than nervous tissue? Many of our most serious medical conditions, such as cancer, are due to abnormal cell specialization and division. Recent research reveals that declining levels of protein BubR1 occurring in stem cells causes cellular senescence, leading to weight loss, muscle wasting, cataracts and other symptoms of aging. Dr. Michael Rudnicki’s research in Canada found the trigger to cause adult muscle stem cells to develop in brown fat instead of muscle fibers when cellular microRNA-133 is reduced. This could play a critical role in the fight against obesity. Scientists at Yale, using sophisticated gene sequencing and analysis techniques, found a regulatory link in stem cell factor Lin28 that affects the microenvironment in ovarian carcinogenesis that could lead to effective treatments for this deadly disease.
The cells they developed avoid the need for harvesting women’s eggs and sacrificing embryos. The iPSCs can be made from any somatic cell from a patient and the cells developed will immunologically match that patient. Using these and other sources of non-embryonic stem cells, significant progress is being made achieving in four out of the five main scientific goals of regenerative medicine. The first goal is functional cellular genomics so that scientists can understand the complex events of celCHRISTIAN MEDICAL & DENTAL ASSOCIATIONS www.cmda.org
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The second focus of stem cell research is to develop disease-specific cell culture mediums to use in new drug testing. Stem cells could allow scientists to test new drugs using human cell lines which could hasten new drug development and make it much cheaper. Only drugs found to be safe and beneficial in cell line testing would then graduate to animal and human testing. Last May, researchers at UCLA successfully developed a “disease-in-a-dish” model from iPSCs developed from patients with ataxia telangiectasia skin cells. This will speed drug trials for treatment of this neurodegenerative disease. The same has been done for Alzheimer’s and other diseases. This technology will have profound economic effects. The present cost of developing, testing and getting approval for a new drug can approach a billion dollars and it is having a chilling effect on development. The third goal of regenerative medicine is to develop specific cell therapies to replace damaged or destroyed tissues, and many are already in use. Pau Gasol, a 12-year veteran of the Los Angeles Lakers, had autologous stem cell injections to stimulate cartilage regeneration in his knees during the offseason. Scientists are growing and implanting bone grown from iPSCs made from the patient’s skin cells and repairing bone defects. Bone stem cells have been successfully turned into brain cells, opening the door to new treatments for central nervous system diseases. Scientists recently isolated adult stem cells from human intestinal tissue which will al-
low the exploration of new tactics to treat inflammatory bowel diseases. There has been only limited success in growing new heart muscle in patients after heart attacks using stem cells. One of the problems has been tracking the stem cells going to the damaged areas. In March, scientists announced they have successfully injected silca nanoparticles into stem cells which enables them to be tracked real time by ultrasound. The Mayo clinic is now conducting clinical trials of an adult stem cell treatment for ALS. In New Jersey, trials of stem cell and physical therapy combinations in chronic spinal cord injury patients have reported increases in bladder control, sensation and muscle function. Progress is being made on numerous fronts at an ever increasing pace. Lastly, regenerative medicine will enable the creation and transplantation of organs. Building tissues have four levels of complexity. The easiest is creating flat structures, such as skin because they are made up of just one type of cell. Tubes, such as urethras or blood vessels, serve as conduits and have two types of cells so they must be made in layers. Hollow non-tubular organs like the bladder and stomach have more complex structures and function. Solid organs, like the kidney, heart and liver are the most complex to engineer. Tissues of the first three levels of complexity have been created and implanted in humans already, including growing a trachea and implanting it in a two and a halfyear-old girl born without one. One of the challenges is creating the “scaffolds” to grow the stem cells, but progress has been made using cellulose, silk and even sugars as the matrix for stem cells to cling to and grow.
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Recently, U.S. scientists made news when they successfully cloned human embryos using fewer eggs and then successfully developed ESC cultures from them. The scientific community yawned. Though, sadly, they still don’t see the immorality of sacrificing nascent human beings for their biological parts, they are pragmatic. The train has long left the station of ESC research. The good news for Christian healthcare professionals is that ethical sources of stem cells are transforming medicine as we move further in the era of regenerative medicine. Neither patients nor their physicians will have to abuse their consciences to access real cures for real people for the diseases that beset our culture. The stem cell wars are over. We won! For more information about CMDA’s ethics statement and efforts on the legislative, ethical and medical aspects of stem cell research, visit www.cmda.org/ethics.
About The Author
DAVID STEVENS, MD, MA (Ethics), serves as the Chief Executive Officer for CMDA. From 1981 to 1991, he served as a missionary doctor in Kenya helping to transform Tenwek Hospital into one of the premier mission healthcare facilities in the world. Subsequently, he served as the Director of World Medical Mission, the medical arm of Samaritan’s Purse. As a leading spokesman for Christian doctors, Dr. Stevens has conducted hundreds of television, radio and print media interviews. He holds degrees from Asbury University, is an AOA graduate University of Louisville School of Medicine and is board certified in family practice.
Visit www.cmda.org/ethics or scan the smart tag with your mobile device to learn more about the ethics of stem cell research.
Oxford Graduate School
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Stress, conflicts, problems; they are present too frequently in our personal life, family life, and workplace. The doctoral program at Oxford Graduate School grounds the students in the fundamentals of conflict resolution and problem solving. The scholarly program inculcates a disciplined approach, enabling the student to use Christian beliefs to effect change locally and globally. The masters program uses Christian beliefs to train the student in Organizational Leadership or Family Life Education. Spending two weeks per year on campus allows the missionary, the dentist, or physician to prepare for a career change or continue current pursuits without interruption.
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Loren Humphrey, MD, PhD Member CMDA Chairman, Board of Regents Oxford Graduate School CHRISTIAN MEDICAL & DENTAL ASSOCIATIONS www.cmda.org
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s d n i e W g n a e th of Ch
by David W. Croy, MD
George Carlin once said, “I put a dollar into the change machine—nothing changed.” I knew that sarcastic sentiment well. I practice oncology in a regional referral hospital, trying to balance the demands of my private oncology practice with those of my family. My wife is also a physician; despite that insight, for many months she had expressed frustration with my excuses for time spent with the practice rather than with our family. I knew I needed change in my life. I began working hard with a life coach to define a path to that change. I made hard-fought progress pushing back on the demands from both my practice and the hospital. But status quo can be a difficult task master. In some ways, I still felt “stuck.” Life demanded progress; excuses were all I could manage. And then, one warm spring evening in May … everything changed. We live in the country on 13 acres of hilly Ozark terrain outside the city limits of Joplin, Missouri. The fields had grown over the warm spring months and my John 22
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Deere was calling. Tractor time can be therapeutic for me. As the diesel engine powered through the grass and brush, I felt better about life as evening came. But the music I listened to on my headphones while I worked was frequently interrupted with weather bulletins about storms building to the west. My wife and I have two teenage sons. Our eldest son Sam had been playing earlier in the afternoon in the band for the high school graduation, but was now home. Our youngest son Ben had several friends over playing paintball. But now, we all listened to severe thunderstorm warnings and tornado watches. A line of severe storms extending north of Joplin was headed our way. I turned my attention to stowing our farm equipment (and Sam’s classic Chevy pick-up we were restoring) under cover, and then retreated into the house to read a medical journal and continue listening to the radio for storm reports. As I listened, I learned that three storm cells converged on Joplin, producing an EF5 tornado that devastated our entire community. It wasn’t long before my cell phone rang. A close friend, an oncology nurse, informed me that the hospital where I practice had taken a direct hit. I rounded up chains, a chain saw, shovels, a pick and an axe, and my oldest son and I drove toward the destruction. The main roads into the hospital were blocked with downed power lines, poles and debris, requiring us to walk in the last four blocks. The next six hours flew by. We initially helped evacuate patients from the main hospital towers
to the rehabilitation building, and then we assisted the countless EMS professionals load patients onto ambulances, pickup trucks and school buses so they could be transferred to other facilities in the region. The next day, I was joined by one of my partners and we spent several hours surveying the damage to our clinic. The upper floor was in shambles. It appeared as if a giant spoon had stirred the contents. The condition of the lower floor exam rooms ranged from a sickening mixture of slightly disturbed to completely destroyed. The doctor’s dictation area was centrally located and contained no windows. It was water damaged but intact. The poignancy of the scene I now witnessed did not escape me. Had I been on call that weekend, I would have been in that area completing paperwork, as I usually was on Sunday nights. We salvaged some pictures, several of the computers, the cash box and our diplomas. But in the midst of our “gathering,” police arrived and began securing our building, forcing us to leave everything else behind. We were never allowed to return. CHRISTIAN MEDICAL & DENTAL ASSOCIATIONS www.cmda.org
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nado came along and blew life up in the air. A disaster simply removes the camouflage, exposing mechanisms and amplifying chaos. As the days passed and I drove through the devastation on a daily basis, I asked questions of God, but I didn’t receive answers to those questions. Rather, I felt a challenge had been laid before me. While little cosmic sense can be made of a tornado and its aftermath, I became convinced that a character test had been presented. “…From everyone who has been given much, much will be demanded…” (Luke 12:48). My ability to navigate the uncertainty and the profound changes I was experiencing would be defined by my trust and my faith in Christ. My spiritual character was being put to the test. Of course, my life and practice wasn’t the only one impacted by those “winds of change.” Massive change and great uncertainty permeated our entire community following those 24 minutes of fury in late May 2011. It still continues. I frequently encounter colleagues and friends who share their own, personal experiences as they struggle toward defining their own “new normal.” The path in the midst of change is not clearly marked for anyone in our community.
After the storm faded, the catastrophic details started to emerge. In total, at least 158 people were killed, 1,100 were injured and the damages were expected to be close to $3 billion. The hospital was declared unsafe and eventually demolished. It was the costliest single tornado in U.S. history, leaving a wide path of destruction to homes, businesses and schools. The devastating changes in our town left little time for thoughtful contemplation and planning. Action— immediate action—was on everyone’s minds. The post-tornado professional environment in Joplin was chaotic. Fear and uncertainty sometimes seemed to prompt rash and selfprotective decisions. “Protect your interests first and then reach out to recruit others to support your position,” seemed to be a common default response. As I watched these processes evolve, I became certain that the same forces I was watching were already present in my daily walk, before a tor24
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In reality, my new normal was “uncertainty.” Uncertainty leads to ambiguity, ambiguity to loss of control, and loss of control can create an atmosphere of chaos. Facing this uncertainty required a steadfast “compass,” a standard that does not change despite circumstances in turmoil. “Jesus Christ is the same yesterday and today and forever” (Hebrews 13:8). I have come to a new understanding and appreciation for my need of an ever-
present, ever-reliable Guide who paradoxically asks me to relinquish control to Him. Change is a fickle monster. It can lay waiting just around the corner. Change can be desired, pursued and chased. It can occur painfully slowly or forever transform a life in a single moment in time. We’ve all heard the phrase, “The winds of change are blowing.” Now, I can truly say I understand that metaphor. The results of the 2012 presidential election demonstrated that sweeping change and uncertainty are coming to all of us in medicine. The conditions and circumstances of that change may not be as exposed and raw as my post-tornado experience. But the realities remain the same: Change is everywhere we look. I am reminded of Psalm 15, “Lord, who may dwell in your sanctuary? Who may live on your holy hill? He whose walk is blameless and who does what is righteous, who speaks the truth from his heart” (Psalm 15:1-2). Our response to that challenge represents a defining moment. We must choose which Compass will guide our professional lives, avoiding the temptation to pursue our own self-interests.
About The Author
DAVID W. CROY, MD, currently practices in Joplin, Missouri with board certifications in medical oncology, hematology and internal medicine. His wife Cindy is also a physician in a family medicine practice. David and Cindy married just after completing medical school at the University of Missouri--Columbia. Their training continued with residency and fellowship at the University of Kentucky. They have two sons currently in high school. The family attends First United Methodist Church in Joplin.
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CHRISTIAN MEDICAL & DENTAL ASSOCIATIONS www.cmda.org
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Telemedicine
ABORTIONS ABORTIONS Misfits Lowering the Standard of Care by Sandy Christiansen, MD, FACOG
B
orn out of necessity to bring needed services to patients in remote locations, telemedicine had its origins in the military and space program in the 1950s. According to NASA, “Telemedicine is the interactive transmission of medical images and data to provide better health care (emphasis added) for people in remote or medically underserved locations.1 Today, more than half of all U.S. hospitals use some form of telemedicine, and the Veterans Health Administration delivered more than 300,000 remote consultations in 2011.2 The American Telemedicine Association has developed standards for practice to promote safe and secure delivery of services. Alarmingly, some are using this technology to provide medication abortions, casting a long shadow on the original intent and purpose.
®
The Mifeprex Abortion In 2008, the Guttmacher Institute reported that medication abortions accounted for 25 percent of the 1.2 million abortions performed under nine weeks and 26
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17 percent of all abortions that year.3 Mifeprex® (mifepristone, RU-486) was the 38,486th compound developed by the French company Roussel-Uclaf as part of a glucocorticoid receptor antagonist research project. It was discovered to be a potent progesterone receptor blocker which spawned investigation of its use as an abortifacient. In 2000, the Food and Drug Administration (FDA) approved it for inducing abortions in women up to 49 days from the start of their last menstrual period (LMP). Mifepristone is one of a growing class of anti-progesterone drugs being developed for abortion and emergency contraception.
How Does It Work? Given to a pregnant woman, mifepristone binds to the progesterone receptors, blocking progesterone’s critical role in sustaining the embryo’s attachment to the uterus and thus his/her blood supply. Mifepristone alone only completes the abortion 4 percent of the time, so the regimen includes the administration of a potent prostaglandin, misoprostol, given two days
later if the abortion is not complete, to cause intense uterine contractions that result in expulsion of the embryo.
Side Effects & Risks: The Tip of the Iceberg Since approval in 2000 through April 2011, the FDA received reports of 2,207 cases of adverse events (AERs) among approximately 1.5 million users. This may not seem significant, but according to the Government Accountability Office (which provides post-marketing oversight to the FDA to ensure drug safety), common estimates of the proportion of AERs captured by FDA range from only 1 to 10 percent.4 Extrapolating, a closer estimate of the actual number would be anywhere from 22,000 to 220,000! Of the 2,207 AERs, more than one-half of the 612 hospitalized women bled enough to need a transfusion. Gary and Harrison analyzed AERs in 2006 and found that more than one-third were due to hemorrhage, the majority required a blood transfusion and 18 percent were lifethreatening.5 More than 5 percent of women undergoing medication abortions between eight and nine weeks from their LMP will need a D&C to stop the bleeding.6 A study of more than 233,000 medication abortions reported a mortality rate of 0.4 per 100,000 (one death due to undiagnosed ectopic pregnancy) and had an overall clinically significant adverse event rate of 16 per 10,000.7 Holly Patterson was only 18 years old when she died of septic shock following a mifepristone abortion. Ten of the known 14 deaths were due to overwhelming sepsis caused by toxin producing Clostridia sordellii. The FDA and Centers for Disease Control hypothesized mifepristone’s immunosuppressive effects coupled with the “ideal bacterial culture” of the aborting uterus created a perfect storm to produce the rapid fulminating lethal shock syndrome observed.8 Victims do not develop fever and, once established, the infection is 100 percent fatal.9 Off label use (buccal or vaginal misoprostol) was associated with eight of the 10 known victims who died of sepsis. Danco Labs and the FDA deny a causal link between the mifepristone regimen and the reported adverse events, yet it is undeniable that young healthy women became sick and some died after its use. The psychological impact of a medication abortion is unknown. Touted as “private and safe,” women who choose medication to terminate their pregnancies are effectively “giving themselves” abortions. Unlike the surgical counterpart, these women are wide awake and see
everything that is passed. One woman describes it this way: “I woke up in excruciating pain; it was like cramps, but the worst feeling I had ever had...Once it was all over I wanted to die. Blood and tissue were everywhere. I looked in the toilet and all I could think is ‘those are pieces of my baby.’”10 No less expensive than a surgical abortion, one 2009 Finnish study found mifepristone abortions to have four times the rate of adverse events.11 A significant portion of women who choose medication to avoid the surgical abortion will get both as the failure rate rises with increasing gestational age (per the sole U.S. uncontrolled, non-blinded, non-randomized trial on which the FDA approval was based):12 • Up to 49 days from LMP: 8 percent of women fail to abort • 50-56 days from LMP: 17 percent of women fail to abort • 57-63 days from LMP: 23 percent of women fail to abort
Prompted by concerns, the FDA added mifepristone to the list of drugs requiring a Risk Evaluation Mitigation Strategy (REMS) to ensure the benefits outweigh the risks.13 Abortion providers routinely prescribe this drug in an off-label manner, based on reports of increased efficacy rates, taking a chance that the complications associated with alternative regimens won’t manifest.
The Iowa Story In 2008, Planned Parenthood of the Heartland, a network of 16 clinics located in Iowa, began offering telemedicine abortions in select clinics not staffed by a physician. Their objective was “to improve access to early abortion and reduce physician travel to outlying clinics.”14 CHRISTIAN MEDICAL & DENTAL ASSOCIATIONS www.cmda.org
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On the first visit, the patient’s medical history and ultrasound report are sent to the offsite physician. By videoconference, the doctor reviews her medical information then enters a password on the computer that unlocks a drawer in front of the patient containing the mifepristone and misoprostol tablets. Using an off-label protocol, the physician observes the patient swallow the mifepristone tablets and instructs her to take the misoprostol tablets in two days. A two-week follow-up visit is scheduled where a repeat ultrasound is performed and, if still pregnant, she is given the option of taking more pills, scheduling a surgical abortion or continuing her pregnancy, knowing that birth defects are possible.
Induced Abortion: A Basic Human Right? The Iowa clinics’ primary motivation presumed that women need to have ready access to abortion. Some abortion proponents assert that induced abortion is a basic reproductive right and should be easily available to every woman. Why should this procedure merit special status? Some men want vasectomies, must there be a urologist in every town? People need root canals, yet we don’t hear a public outcry about insufficient numbers of endodontists. Further, the vast majority of abortions are non-emergent, elective procedures. A woman who decides to abort her pregnancy is not being compelled or required to do so, but is simply choosing that outcome for her pregnancy. It is her right under the law, but that does not translate into a basic human right.
Better for the Patient–or the Doctor? The second rationale for the telemedicine program was to “reduce physician travel to outlying areas.” So, there was not an actual lack of providers, just a lack of willingness to drive. Instead, the woman suffering complications is forced to drive or see a stranger. What reputable physician performs a procedure on a patient but doesn’t provide emergency coverage? This used to be called patient abandonment. Former abortion clinic director Abby Johnson recalls how medication abortions were handled in her clinics: “In our Gulf Coast of Texas Planned Parenthood clinics during 2008-09, doctors routinely authorized medication abortions remotely. They would be sent the ultrasound images, the patient’s vital signs and would then text back, “Okay for abortion,” on their BlackBerrys while sitting on the beach in Cancun, Mexico.”15 This brings new meaning to the term, “Beach bum.”
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How Safe Is It? A 2011 prospective cohort study of the Iowa group found no significant differences between the telemedicine group and the face-to-face group in overall satisfaction or adverse event rate, but 25 percent of the telemedicine group said that they would have preferred to be in the same room with the physician.16 This small study does little to inform about the true safety of telemedicine abortions in remote areas, but does expose an important point: many women want to sit eye-to-eye with their physicians. Women considering abortion don’t need less professional contact, they need more. If complications arise, a virtual doctor just doesn’t cut it.
Second Chances Some women who begin a medication abortion regret their decision and are desperate for a chance to save their babies. Family physician Dr. George Delgado met one of these women in his office and wanted to help. The patient had taken mifepristone, but not misoprostol. Dr. Delgado hypothesized that administration of progesterone might outcompete mifepristone for the progesterone receptors, thus restoring the integrity of embryo’s attachment to the uterus. He has developed a protocol of administering intramuscular injections of progesterone in oil, and in his small series, two-thirds successfully delivered healthy infants at term. Dr. Delgado is looking for physicians who are willing to help women in their communities who want a second chance. For more information, visit www.abortionpillreversal. com.
Take Action Americans United for Life (AUL) is seeking to partner with physicians willing to advise courts, state legislatures and/or the public on the dangers inherent in off-label use of the Mifeprex abortion drug regimen. At least eight women have died of bacterial infection following the offlabel use of the Mifeprex; in contrast, there have been no reports of women dying from bacterial infection after using the FDA’s approved protocol. AUL has drafted model legislation requiring abortion providers to abide by the protocol outlined in the drug’s labeling. For more information, contact Staff Counsel Mailee Smith at Mailee.Smith@AUL.org.
Bottom Line: Not Good for Women Planned Parenthood calls the Mifeprex abortion “safe and effective” and likens it to a “natural miscarriage.”17 There is nothing natural, safe or effective about a medication that ends a life, carries the risk of massive hemorrhage and life-threatening infection and has a significant failure rate. While reported risks of severe complications are low, discovering the actual frequency of adverse events is limited. Telemedicine creates access to services where there are none. Medication abortion prescribers are required to ensure that the patients have ready access to surgical intervention, if needed. If these services are in place, then telemedicine isn’t needed; if there isn’t a qualified professional available, then the procedure should be automatically disqualified from a telemedicine application. This is the medical equivalent of forcing a square peg in a round hole: abortion and telemedicine are misfits. To pair them lowers the standard of care for women. This is just plain bad medicine.
Visit www.cmda.org/ ethics or scan the smart tag with your mobile device to learn more about the ethics of abortion.
Bibliography 1 http://spinoff.nasa.gov/spinoff1996/27.html 2 http://www.americantelemed.org/learn/what-is-telemedicine/faqs 3 http://www.guttmacher.org/pubs/fb_induced_abortion.pdf 4 Souder, ME. The FDA and Ru-486: Lowering the Standard for Women’s Heath. (Accessed June 25, 2012 at www.usccb.org/prolife/issues/ ru486/SouderStaffReportonRU-486.pdf). 5 Gary, M. (2006). Analysis of severe adverse events related to the use of mifepristone as an abortifacient. The Annals of Pharmacotherapy, 40, doi: DOI 10.1345/aph.1G481 6 Stubblefield P. (2004) Methods for Induced Abortion. Obstetrics & Gynecology. 104(1), 174-185. 7 Cleland, K. (2013). Significant adverse events and outcomes after medical abortion. Obstetrics & Gynecology, 121(1), 166-171. 8 Department of Health and Human Services. Emerging Clostridial Disease Workshop. Summary of Proceedings. May 2006 9 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5429a3.htm 10 http://www.silentnomoreawareness.org/testimonies/testimony. aspx?ID=2650 11 Niinimaki, M. (2009). Immediate complications after medical compared with surgical termination of pregnancy. Obstetrics & Gynecology, 114(4), 795-804. 12 Spitz IM, Bardin CW, Benton L, Robbins A. Early Pregnancy Termination with Mifepristone and Misoprostol in the United States. New England Journal of Medicine. 1998;338(180):1241-7 13 http://www.fda.gov/downloads/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/UCM258412.pdf 14 Grossman, DA. “Effectiveness and acceptability of medical abortion provided through telemedicine.” Obstetrics & Gynecology. 118.2 (2011): 296-303. Print. 15 Used with permission. 16 Grossman, D. (2011). Effectiveness and acceptability of medical abortion provided through telemedicine. Obstetrics & Gynecology, 118(2), 17 http://www.plannedparenthood.org/health-topics/abortion/ abortion-pill-medication-abortion-4354.asp
About The Author
SANDY CHRISTIANSEN, MD, FACOG, is an advocate for the sanctity of human life from conception to natural death, and for healthcare professionals’ right to practice according to principles of conscience. Dr. Christiansen writes and speaks about abortion and associated risks, pregnancy and Hippocratic medicine in a variety of forums including the United Nations, legislative bodies and media outlets. She is the National Medical Consultant to Care Net, a pro-life Christian organization that educates and supports their network of more than 1,100 affiliated pregnancy centers, and is the medical director of a pregnancy center in her community. Sandy and her husband Kyle live in the Washington, D.C. metro area along with their three sons.
CHRISTIAN MEDICAL & DENTAL ASSOCIATIONS www.cmda.org
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classifieds Position Wanted – Dental Experienced Christian Dentist – CMDA member seeking part-time, general dentistry position in Southern New Hampshire or Northeastern Massachusetts. Contact information: phone: 603-893-3670; email: drjosephdds@aol.com. Dental Positions Open Independent Oral & Maxillofacial Surgery practice is seeking faith-based associate who will eventually assume the practice due to pending retirement. Physician must be Christ-like in dealing with both patients and staff. Physician will see approximately 1520 patients per day and takes own calls during weekdays and rotates with others on the weekends. Inpatient and outpatient duties are required. Practice has three operatories and two consult rooms. Candidate must be general anesthesia trained, CPR, ACLS and board eligible or certified. Practice in hospital annex, leased space and has outstanding relationship with medical and dental staff. East Central Wisconsin college town known for quality education, cultural outlets, finedining, hunting, water activities and the Green Bay Packers. Producing $1 million on three-day work schedule. Contact drangell@ execpc.com or david@angelloralsurgery. com.
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contact Sharon Bond, MD, at 308-440-3945 or sbbderm@charter.net, or Lori Grubbs, office manager, at 308-865-2214. Emergency, Family, Hospital Medicine – Ready for a change of place? Think Polson, Montana! Our multi-specialty clinic and critical access hospital serve a vital purpose in Northwest Montana. Our providers are needed and deeply appreciated. Our founders were missionaries who arrived to care for the poor and vulnerable in 1864. Our time-tested mission lives on. “Providence” is good currency here. We treat everything – from bronco kicks to bronchitis. And we do it all in a most extraordinary setting: a stone’s throw from Flathead Lake, with views of the Rockies in almost every direction and Glacier National Park only 45 minutes away. Traffic congestion? Probably a herd of elk crossing the road. Are you ready for a change of place? Give Polson a look. Might be just the change you need! Contact Brandon W. Byars, Providence Health & Services, 503215-1036, brandon.byars@providence.org, www.providence.org/changeofplace. Family Medicine/Internal Medicine – Come have fun in the sun with Baptist Primary Care, the largest network of primary care physicians in Northeast Florida, with 193 physicians and 48 outpatient offices. Baptist Primary Care patients benefit from access to Baptist Medical Center, the most preferred healthcare system in Jacksonville, with over 2,500 specialists and five nationally accredited hospitals. Patient’s requiring hospitalization are cared for by our hospitalist team providing 24/7 oversight. Full-time and job share opportunities available. Qualified candidates must be BE/BC. Attractive compensation and benefit packages allow for a perfect balance between work and play. Contact Jolene Bowman at 904-376-3727 or Jolene.Bowman@bmcjax.com. Family Medicine – Mad River Family Practice is a progressive community-based family practice in West-Central Ohio. Currently seeking a full-time family physician to join a practice founded on lifelong learners and forward-thinking clinicians. Enjoy the rewards of a full scope of practice in a supportive group environment. Our family physicians place strong emphasis on addressing spiritual needs, as well as physical and mental needs. Practice offerings include: a vibrant and long-standing practice with varied demographics, flexibility in style and range of family practice, opportunities to foster medical education among students in healthcare, a welcoming community in West-Central Ohio, with easy commuting to Columbus and Dayton, Ohio and a competitive salary and benefits package. Contact Tara Wagner at tara.wagner@maryrutan.org or call 937-465-0080. OB/Gyn – Southwestern Medical Clinic, a Lakeland HealthCare Affiliate seeks an OB/ Gyn for its Niles, Michigan Center for Women’s Health Clinic. Enjoy the opportunity to
combine medical care, Christian witness and missions. Benefits include: 1:5 call, an established practice in a beautiful new building seated conveniently next door to the hospital, site visit expenses covered, generous relocation assistance, house hunting allowance. Southwest Michigan offers sandy beaches and dunes, hiking, biking, seasonal festivals and cultural activities, excellent schools and family-friendly communities located only 90 miles from Chicago. For more information on Southwestern Medical Clinic, please visit www.SWMC.org. For more information on Lakeland HealthCare, please visit www. lakelandhealth.org. If this opportunity is of interest to you, forward your CV to lscheer@ lakelandregional.org or fax to 269-985-4486. BE/BC Otolaryngologist – needed for wellestablished, busy two-man practice located in a Big 10 college town in Lafeyette, Indiana. Excellent opportunity for fast track to full partnership. Our private practice includes: general ENT, head and neck, facial plastics and allergy. Onsite physicianowned ASC, CT scanner and voice lab with video stroboscopy staffed by speech language pathology personnel. The audiology department provides a full range of services staffed by AuD. Please contact Ruth at 765477-7436. Send CV to 2320 Concord Road, Lafayette, IN 47909, or email lafayetteent@ comcast.net.
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Several Administrative/Faculty Positions at New Christian Dental School – Bluefield College School of Dental Medicine (www. bluefield.edu), part of Bluefield College (Virginia), a Christ-centered learning community, will hire many committed Christian dental and biomedical sciences faculty over the next several years. Initially, the SoDM is recruiting for an Associate Dean for Academic Affairs, an Assistant Dean for Student Affairs and Admissions, an Associate Dean for Clinical Affairs and a Chair of Biomedical Sciences. The school will commence operations in August 2016. Interested parties should send a cover letter and CV to Dr. Francis G. Serio, Dean, at fserio@ bluefield.edu. A position description and information on how to formally apply for the position of choice will then be sent to the candidate. The currently posted positions require previous experience in dental and/ or health sciences education. The institution does not discriminate on the basis of race, gender, color, national or ethnic origin, age, disability, military service or genetic information in its employment.
To place a classified advertisement, contact communications@cmda.org.
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