...are the ones that make the biggest difference


Necrotizing fasciitis ate my butt...

OR Why the little things matter.

Today I helped do a dressing change on a guy who has a gigantic wound on his butt from the a very bad internal infection that was not detected until they did a little work to clean up a very minor, superficial wound. Once they started they realized that this infection was deep, dangerous and spreading fast, so they did some emergency surgery to clean out the infected tissue. This infection was not going to respond to antibiotics and playing wait-and-see would likely have killed him.
They had to go in aggressively. So he now has a 4" deep crater about the size of a dinner plate a little up and to the side on his rear end. Its a huge wound and one that is going to take a long time to heal. I mean months of being in a hospital, of needing medication and a special diet. While its open he will be at risk for other infections, sepsis and is in for a whole lot of pain - lots and lots of pain. He will be left with a huge scar and will require skin grafts, which themselves will be quite painful and leave scars. For the next several months, his whole life is going to revolve around that wound and his healing progress, or lack thereof depending on his body's ability to heal and good care, will determine the quality of the rest of his life. And possibly its length.

The worst part about all of this, though, is that this all started with a tiny little bed-sore. A little bitty break-down in his skin, probably no bigger than a pencil eraser, that in all likelihood could have been prevented with good skin-care and regular turns. And these are minor things, tiny little jobs that don't take more than a few minutes of a caregiver's time. But either they couldn't be bothered, or he wouldn't let himself be bothered long enough to get these things accomplished. It is a very little thing to turn a patient or apply some protective ointment. It is clear now to him, and to his family and to everyone who has suffered like this, and to me, that these little things matter. They are not dramatic, they generally win little thanks and certainly one is not well-compensated for performing them. But oh, do they matter and perhaps they are not so little, after all.

Now to my real point. In our relationship with God, that seemingly endless movement of ebb and flow, passion and apathy, it is the little things that matter the most. The little things of prayer, of devotion, self-denial - the daily disciplines that sharpen the edges of our faith and make it stronger - are what make the biggest difference for us and those around us. While we are "healthy", when we shrug many temptations off with ease and we feel nearly constantly in the presence of the Spirit, we can tend to get lax in our discipline and overlook those little things; at least I know I do. And in those times, such failures may not be catastrophic and may even be inconsequential in that immediate space of time. But(t) when we are unhealthy, when we are beset by temptation and God feels not just absent but nonexistent, if we have not cultivated those little disciplines, then we are in a for a very rude awakening. In those times of struggle and weakness, the seemingly insignificant wounds produced by ignoring those little things can blossom into deadly infections almost overnight. What starts as a minor annoyance, a small frustration or temptation may end up leaving scars we never thought possible.


Jeff Wright said...

Interesting application. For what it's worth, I think you are right. Your post is a strong arguement for practical sanctification and spiritual disciplines.

On another note: bed sores have always confused me - why do they form on someone who hasn't been turned regularly?

The Scrivener said...



I admit, I laughed.

I had to re-read the whole paragraph, your little joke threw me for such a loop.

Nathan said...

Jeff -

At first, I just wanted to write a post with the title "necrotizing fasciitis ate my butt" when I imagined this poor guy having a conversation at some future point wherein he describes the reason he was in the hospital for so long. I'm really amazed at not only what I'm learning medically in this position, but what I'm learning spiritually as well.

As to your question - decubitic ulcers/pressure sores/bed sores generally form where a bone presses against the skin. The sustained pressure from the bone cuts off circulation to that immediate area and also causes minor friction irritations when the patient moves slightly. As that small area breaks down and loses the top layer of skin, the lower areas under and around it are exposed and dry out, causing the sore to get bigger.

Nathan said...

Doug -

I wasn't sure how many opportunities I'd have for toilet humor after getting out of youth ministry...

Jeff Wright said...

Thanks for the info.

I don't know if I would have ever found out otherwise - not really the kind of thing you bring up in casual conversation, you know.