Yesterday my dermatologist removed the basal cell skin cancer from my lower left eyelid. In Mohs surgery, the doctor removes a slice of the affected area. They examine it microscopically and, if there is more cancer, they remove another a slice until the margins are clear of cancer. Usually one or two slices are needed, but in my case he needed to take four layers, as it extended down and to the sides. This involved 60% of the lid. If it had been 30% or less, the plastic surgeon could have just pulled it together, but more extensive surgery was needed. Mary took me from the dermatologist’s office to the out-patient surgery center. God gave us the two best doctors possible. So the plastic surgeon grafted a sliver of skin from the fold of my upper eyelid to repair the lower wound. Then she made a flap of the cartilage from the upper eyelid and stitched it to the wound site. Consequently, my eye is sewn shut, allowing the cartilage to establish a blood supply and grow into the wound site. In three weeks, she will snip the shared cartilage and, aside from missing 60% of my lower eyelashes, the repair should not be noticeable. The amazing thing is how the body repairs itself—we are fearfully and wonderfully made!
I suppose that I am too much of a Puritan not to reflect upon lessons to be learned and to examine myself after going through these surgeries. I hope that such self-examination is a good thing, although it can be painful in itself, and, of course, it can become too introspective if it is not corralled by biblical principles, such as those taught by John Calvin. Calvin taught that self-examination is necessary and profitable so long as it is based on the Scriptures, ends in Christ, and is guided by the Holy Spirit. Here are ten practical reflections the day after my surgery which I hope you will find helpful:
- Unlike God, doctors are not infallible, sovereign, and almighty. They too can make mistakes. I have a very skilled dermatologist with whom I often talk theology—he’s read a number of my books. Despite having a great dermatologist, he wrong diagnosed a wart on my lower eyelid early this year, and told me it was definitely not cancerous. Four months later, it proved to be cancerous, however. “Regretfully,” he said, “I was wrong last time, but you know your theology well enough to know that only God is infallible!” Well, I couldn’t argue with that! Meanwhile, it kept growing until I could finally get the two specialists scheduled back-to-back for yesterday, but I see even more clearly now that this is all, of course, God’s sovereign will for me. (Positively speaking, my dermatologist has been right the other ten times when I’ve had less serious spots taken off by him, mostly on my face. I seem to have inherited this thorn in the flesh from my father. My brothers and nephew have it too.)
- Under God, doctors are invaluable and important. We don’t put our trust ultimately on earthy physicians but in our heavenly Triune God, but even as we do so, we recognize that the Ultimate Cause of all things (our fatherly sovereign God) normally carries out His fatherly will through secondary causes (like earthly doctors). Therefore it is not wrong but actually important to ask meaningful questions and seek for highly qualified physicians in whose abilities you can have confidence on the human, secondary level. The doctors God appointed me are both well-known as being highly skilled and gifted—and I took some comfort in the fact that several of my friends who are physicians concurred strongly with this. I regard this as a significant act of God’s grace in the larger picture of what I experienced yesterday.
- Faith versus sense and unbelief wages a fierce war at times. That already began early this month when the plastic surgeon told me in a pre-op appointment that though it was rare (5 per cent chance, she said), there are times that if more than 30 percent of the lower lid needs to be taken, then the surgery becomes “messy and complicated,” and the eye must be stitched shut for about three weeks. Knowing how long this cancer had been growing, I was immediately afraid. A week later that fear was compounded by speaking with someone else who went through this surgery and developed severe problems such that another surgery was needed three months later. So, when my dermatologist yesterday said that a second surgical extraction needed to be made because the cancer was both deeper and wider than thought and the first extraction made was like mush, I asked the doctor if that means he’d have to take more than 30 percent of my eyelid, and that I would have to go through the more difficult plastic surgery route. When he said, “I’m afraid that it is looking that way,” my immediate thought was, “But Lord, didn’t the last person who prayed with me at the seminary this morning ask that Thou wouldst do exceedingly abundantly above all that we could ask or think—which was exactly my prayer the day before”—and isn’t this prayer being refuted now? The battle of faith versus sense was enflamed. My only recourse was to consciously discipline my mind to fly to Christ.
- Faith and pity can far too easily coexist. After the dermatologist took a large chunk the second time, I felt confident that the cancer was all removed, but the report came back that there was still cancer on both sides, which meant that even more of my eyelid had to go. For a few minutes faith receded and self-pity rose it’s ugly head. Again, my only recourse was to think about Christ—specifically that beautiful first question of the Heidelberg Catechism that my only comfort in life and death is that I belong to Him.
- Faith and false submission are often hard to discern apart. When word came back that I would need a nearly unprecedented fourth extraction, I felt nothing but submission, but it was a mixed submission. On the one hand, I felt like I could surrender all into Christ’s hands but at the same time I felt rather numb and stoical. I gave up the battle but that surrender was not pure in its motivation. Once more I had to flee to Christ for help and forgiveness in all my unworthiness.
- Despite faith’s activity, God’s deliverance is often like a beautiful surprise. The one time I expected the nurses to come back into the waiting room and say, “You still need more taken,” was when she said, “You can go to the plastic surgeon now!” I was so surprised that I had to ask her to repeat it. God’s goodness overwhelmed me, though I knew the road before us was not an easy one.
- Meditating on Christ is by far our most important help in days of affliction. The fact that He has suffered and died for me, is always interceding for me, never allows me out of His perfect high priestly eye, and has perfect plans and goals for me so as to wean me from this world and ripen me for glory helped more than anything else to make me submissive throughout this day more than anything else. Most helpful of all was this thought: if Christ was submissive while going through far worse sufferings for me as an unworthy sinner, why should I not be submissive to Him when His providence is leading me through trials for His glory and my good?
- A God-fearing spouse to support you and help you pray your way through a day of surgeries is a priceless gift. My Queen’s prayers with me throughout the day’s waves of disappointment, together with her periodical comments, “It is going to be OK, honey,” and “God will help you through this,” together with meant more to me than sermons at this point.
- The prayers of believers are also a remarkable support, both in person and through electronic media, particularly when they briefly stress one or two of God’s sweet and powerful promises. Each time we would go back to the waiting room after another layer of cancer was removed, we would pray, meditate, and then open up email and Facebook to find new prayers waiting for us. The love and help we felt from this—often coming from people who I have often visited in time of need—is beyond words. The communion of saints is sweet.
- Kindness, touch, and clear communication are significant human helps in distress. In both offices, the doctors and nurses were remarkably kind and empathetic, and also used touch in a non-flirtatious way, such as rubbing the shoulder empathetically while speaking to me. Their clear, honest communication was also a great help. For example, just before I went into surgery, my plastic surgeon, whom I had only met once before, assured me that though the stitched procedure was necessary and not pleasant, she had done a goodly number of these and believed it would turn out well long-term. She did a great job of encouraging me to meditate on long-term benefit rather short-term discomfort. She also gladly let me pray for her and thanked me warmly for doing so. After the surgery, she was very reassuring again, and told me exactly what to expect, and made clear she was available at any time to address any complications that might arise.
In conclusion, let me say that it is good for a minister to be on the receiving end of surgeries. Over the last four decades, I have had the privilege of visiting more than 5,000 parishioners in the hospital. Being on the receiving end makes one realize more strongly than ever how important bedside manners and words and prayers are on the part of physicians, ministers, and nurses.
It also gives me renewed respect and love for those who have had to face larger, more life–threatening illnesses and to reflect on their acquiescence. Their trials have a way of making us face our own mortality and the need to prepare to meet our God.
Well, the 20-minute ice-packs on and 20-minute ice-packs off over the next few days should give me more time for reflection, but I pray that these ten reflections may be of some help to all of us now.