...are the ones that make the biggest difference


The ravings

This semester for clinicals, we split between critical care and psychiatric nursing. Why they combined these two hugely disparate areas is well beyond me, but they've both been informative. I already work in an ICU, so the place I learned the most during the critical care portion was in the regional burn unit where I saw a young lady burned over almost her entire body do well and another woman burned over about 30% over her body eventually die because of her inhalation injuries. But the last 7 weeks I have been in the psych rotation and for that we spend time on an inpatient wing, where probably half the patients are on court-ordered 72 hour detentions because they are psychotic (in the technical sense, which basically means out of touch with reality) or suicidal. Or both, as it may be. The rest have usually signed themselves in for drug & alcohol detox or because they recognize they're getting out of control. Kind of in conjunction with that we also observe the "assessment team". Their job is to go out to ER's and assess patients that the police or the hospital have called about to see if they meet the criteria for admission into an inpatient unit. They also take walk-ins and do phone interviews.

This last week I went out with one of the assessment team to a local ER to evaluate a young man who had rather abruptly started acting weird. He'd had a recent diagnosis of a rather severe and life-altering illness and was started on some medications that may have caused this change in behavior. The young man, let's call him Ryan (not his real name, obviously) - Ryan's mother was there and the assessor wanted to talk to her first in order to get a better picture of what's been going on in the month since his diagnosis. For some reason she thought it would be appropriate for me to sit with Ryan while she talked with the mother. So I sit down and ask him how's he feeling. And that is when things got surreal.

At first, Ryan just seemed a bit hyper, which would not be all that unusual with the medication he had been on. But over the course of the 45 minutes I sat with him, it became clear that Ryan was far more than just hyper; he was full-on delusional. To call his delusional world elaborate would be an understatement. In his mind, he is the key player in bringing forth the Next Testament of God. The Old Testament was about God the Father, the New Testament about God the Son, and the Next Testament will be about God the Spirit. He does not know how it will come about but the reason he has been chosen is because he has "figured out the calculus" involved, he has seen the secret key that others in the past have missed. At this point, I have to point out that Ryan was a youth pastor who was also attending a Bible college before all this happened. So during this conversation, he's dropping Bible verses and talking about Ecumenical Councils and doing so in a rather sophisticated, even compelling fashion. He really believes what he's saying to me, believes it way down deep. So much so that he gives me a homework assignment! I'm to get all of the Casting Crowns CD's and all of the books by Ted Dekker and Austin Boyd. These will help me understand what is happening in the world right now, what God is using him to do.

As I'm listening to him there is a little battle going on inside my head, and it began with the simple question of what would someone listening to Paul or James or John have thought? To a first century Jew especially, but likely in general, they sounded crazy. To the Jew, the chance that God would reveal himself in a lowly carpenter who died a criminal's death would have had to sound just as preposterous as the "calculus" did to me on Monday. To a Gentile, the very idea of a single God may have seemed patently false. I don't believe this young man was anything other than completely out of touch with reality. And yet....

And yet I do believe in an active God, a God who moves and works in us and through us to change the world. A God who reveals more and more of himself to us, at least individually if not corporately as well. I guess it boils down to what if? What if these are more than just the ravings of delusionary man? What if they aren't? And who am I to decide?

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