Competence

The scriptures referred to are Exodus 20:1-17.

In high school I was in our production of The Music Man. I think I got a part because I had memorized the entire “Trouble in River City” patter song from the soundtrack album we had at home. But I didn't get the lead of Professor Harold Hill. The part I actually got was that of the anvil salesman who tries to expose Hill as a fraud. I really love that musical. Which makes me uncomfortable in view of the fact that were Harold Hill real, I would be on the side of the anvil salesman. Hill is a conman, manufacturing a crisis and then selling a solution that doesn't stand up to critical thinking. He sells band instruments but he really doesn't know how to teach the kids to play them. He uses the “think” method, which is just substituting positive thinking for actual instruction. He is also a womanizer, targeting Marion the librarian as a potential conquest. The reason the story of this sleazy guy is such a beloved musical is not just because of Meredith Wilson's great songs and the perfect casting of Robert Preston and Shirley Jones in the movie. It's because of this idea we have in America that if you just wish hard enough, your dreams will come true, as the song from Pinocchio assures us at the beginning of almost every Disney production. But anybody who's actually succeeded will tell you wishing alone doesn't accomplish much. You need to master what you are trying to do. You need to put in the time learning and practicing what you want to do until you know how to do it and do it well. You need to be competent.

Competence is the 3^rd C word that British RN Caroline Kingdon listed as a key element of treating her patients with ME/CFS. Now of course what she means by competence is the “clinical and technical knowledge to deliver effective care and treatments...” But she also says, “Competence means all those in caring roles must have the ability to understand an individual's health and social needs.” So competence for a nurse means understanding not just medical knowledge and techniques but also understanding the person to whom they are giving care. So how does that apply to our metaphor for this sermon series, of Jesus being the Great Physician and we being his spiritual healthcare team?

What we offer as Christians is the gospel, the good news of who Jesus is, what he has done and can do for us and how we can respond to it. That's the knowledge we are trying to apply. But unfortunately, as a people of the Book, the Bible, many Christians don't seem to know as much about it as they think they do. In 2007 a survey found that in a nation where 78.4% of US adults identified as Christian only 14% could name all 10 Commandments. More people could name all 7 ingredients of a Big Mac (25%) or all 6 kids of the Brady Bunch (35%). I guess it's something that 55% of them knew that the Golden Rule is not one of the Ten Commandments. However only 45% knew that the 4 Gospels are Matthew, Mark, Luke and John. But 74% of Americans could name all 3 Stooges.

Clearly a lot of people who call themselves Christians are deficient in basic knowledge of the contents of the Bible. The Ten Commandments give us a basic moral framework. It reveals how to show our love for God through commitment and loyalty to him, by not putting other things ahead of him, by not misusing his name or misrepresenting him, and by dedicating one day a week to him. It reveals how to show love for other people by respecting and caring for our parents, by not harming others, by not being unfaithful to our partners, by respecting the property of others, by speaking the truth and not having designs on things that belong to others. I wonder how many people, if surveyed, would recognize that the Two Great Commandments underlie the Ten. I wonder how many people know and more importantly understand the truths of the Bible summarized in the Apostles' Creed. For that matter, given that the average American home has 4 Bibles, and that there are numerous free Bible apps for your phone and other devices, I wonder how many people read the Bible regularly, or have even read it through once. How ignorant of the basics of Christianity can one be and still claim to be a Christian?

Being a Christian is not like declaring a political party affiliation where they don't really care if you understand what they actually stand for as long as you vote for them. “Disciple” literally means “student.” Being a Christian means having at least a basic knowledge of the beliefs and behaviors. EMTs and CNAs know the basics of what is healthy for a person and what is not and they know how to help and they know to do no harm. Yet on a clergy Facebook page, a colleague relayed the story of a parent who killed their family including an infant. And a “helpful friend” told the grandmother that the baby wouldn't go to heaven because it wasn't baptized. Which is saying that God is not merciful and gracious but a stickler for technical details. And the colleague was telling us what they were doing to help the grandmother and asking for additional advice on undoing the damage done by the supposedly “helpful friend.”

And this is why we as Christians need not only to know the Bible and basic theology but know how to apply it to real people in real situations. And sometime we have to know when not to be too doctrinaire. Once when I was working in a nursing home I was attending to a patient in their room when another patient fell right outside the door. She cut her scalp and was bleeding profusely. Now standard protocol would be for me to leave the other patient, strip off my gloves, wash my hands, and put on other gloves before touching the second patient to avoid possible cross contamination. But I stripped off my gloves as I ran to the fallen patient, yelling for someone else to help me and to call 911. Cradling her, I reached into my pocket and pulled out a 4 X 4 gauze and held it to the bleeding patient's wound with ungloved hands. Technically I broke sterile technique. Nobody said a thing about it, even after reading the incident report. They understood that there is a hierarchy of values in giving needed care in an emergency.

Jesus touched bleeding women and lepers and corpses, rendering himself ritually unclean. After every healing, he shouldn't have been able to touch anyone else for a day. In the eyes of the experts he also broke the rules whenever he healed on the Sabbath. He didn't do it to flout the rules. He did it to obey the greater commandment to love one's neighbor. The rules are there to guide us in behaving as God wants us to: as his loving and just people. The Spirit is there in us to make sure we right thing even when it's not the ideally correct thing.

If a cop pulls you over for speeding, only to find you are trying to get a woman in labor or a bleeding person to the hospital in time, he will not likely give you a ticket. He will speed ahead of you, lights and siren going, letting you speed in his wake. He has the discretion to do that when someone's life and health are at stake. But only a fool would think that gives you a blanket permission to speed at other times.

In Caroline Kingdon's power point presentation, she emphasizes listening to the patient first of all. She doesn't want to make a knee jerk decision based on an incomplete understanding of what is going on. And I think for Christians it is hard for us when faced with someone suffering to just listen to them and not subject them to our thoughts about God. We are told of Job's friends, “When they saw him from a distance, they could hardly recognize him; they began to weep aloud and they tore their robes and sprinkled dust on their heads. Then they sat on the ground with him for seven days and seven nights. No one said a word to him, because they saw how great his suffering was.” (Job 2:12-13) In other words they showed the culturally appropriate signs of grief and then simply sat with him, saying nothing. Had they continued that way, they truly would have been Job's comforters. But they just couldn't resist trying to fit his tragedy into their understanding of theology, so they opened their mouths and tried to justify why this happened to him.

Rule number 1 of dealing with a suffering person: when faced with an unspeakable tragedy, don't speak! Don't tell them God has a purpose in this or that it was God's will or that the angels took their loved one. That is not helpful at this point. And don't tell them their loved one isn't going to heaven. You don't know that. Jesus said not to pass verdicts on people; that's not our job. Our job is to weep with those who weep. Be a shoulder to cry on, a chest to beat against in anger and grief, a sounding board for the person who cannot understand why this has happened. Job questions God's justice while his friends defend God. And at the end God sides with Job! He's a big God; he can take our grief. Read the psalms. They are full of people asking God why is he letting this happen to them and how long will it go on?

Competence in helping someone starts with learning to listen to the person. Want to hear a terrible fact? A study found that on average a doctor will listen for 11 seconds before interrupting their patient! Don't be like that! Let the person talk and pay attention to what they say. You may learn that the situation is more complicated than you thought. I have known people who, when their loved one died after a long and miserable illness, were wrestling not only with their grief but with a sense of relief. And then guilt for feeling relieved that they wouldn't have to deal with catheters and diapers and wheelchairs and IVs and seeing their love one waste away or suffer pain or disappear into dementia. God hears our cries. We need to do the same for each other.

Caroline Kingdon deals with patients with ME/CFS, a condition which as yet has no known cause and no reliable treatments. Because of the internet, many of us have done considerable research on it because the vast majority of doctors know little about it. That may change because long-haul Covid sounds just like ME/CFS, as Dr. Fauci pointed out. But, because of the scarcity of solid facts, Kingdon says even well-informed patients may have some erroneous knowledge. She says it may need gentle correction.

Competence in showing compassion and care for a person having a crisis is knowing when and if you should correct erroneous ideas about God and spiritual matters. If it is trivial, on the level of thinking God really has a long white beard, leave it be. If it is essential to the issue at hand, only say something if you have studied the matter in detail and prayed on it. Otherwise refer them to their clergy or a chaplain. They should be trained for this. What you can do is reassure them of God's love, mercy and grace.

Kingdon says we should “acknowledge where we stand with our professional knowledge of ME/CFS and the paucity of treatments.” In the same way we Christians should not pretend to be omniscient and know the reasons why God has allowed the tragedy to occur. It may be hard to say “I don't know why...” your child died or your brother overdosed or your wife got cancer. But it's better to be honest than to pretend that you know precisely what God's role was in this. His role now, as yours should be, is to comfort the afflicted.

Now if you have gone through the same thing or something extremely similar, you can, when and if appropriate, share that fact. If they are fighting despair and you have too, share that. If they are stunned and unable to think and you have been there too, share that. If they are angry with God and you went through that, share it. It doesn't eliminate the pain but it does help if someone feels they are not alone in feeling the pain.

And don't forget to be practical. If their refrigerator is full of casseroles sent by friends and acquaintances, think of something else they need. Maybe instead of food, they need detergent. Maybe the kids need to be driven to school or soccer. Maybe someone needs to be driven to the store or the doctor's or to see the funeral director. And don't think that they don't need you after a funeral. Often after the bustle of dealing with that is over, the full sense of the loss starts to settle in. Be there for them.

But the hardest problems to deal with are the ongoing ones, like the chronically ill person and their caregiver, if there is one. When suffering is going on every day with no end in sight, that can cause crises of faith in the person suffering, in the caregiver and in the Christian trying to help. Actually the sufferer might have a crisis of hope, that things are never going to get better. And the caregiver might simply be exhausted. And the Christian might suffer compassion fatigue. When the horizon seems too far away, focus on each step. Focus on the moment. When the big picture is terrifying, think small. Find small and maybe even ephemeral joys. Provide small Sabbaths, breaks in the routine, times for rest and replenishment. The way you eat an entire elephant is one bite at a time.

Now this is going to sound contradictory in a sermon on competence, but remember what G.K. Chesterton said: “Anything worth doing is worth doing badly the first time.” The first time you do anything it is most likely going to suck. But if it is worth doing, you do it anyway. And you do it again. And again. And you improve. You note what you are doing wrong and try to do it better. And you continue trying to do things better.

To be competent as disciples we need to read and know the Bible and be able to understand and communicate the essentials. The Creeds and the catechism help. There are excellent books out there spelling out the basics of the faith as well as how to help people. Be well-informed but also be humble. Remember that just being there for someone can help. It's what we chaplains call a ministry of presence. Listening, truly hearing and understanding what another person is saying, is becoming a lost art. Revive it. And you may have to hear the person go over the same thing again and again as they try to understand it and fit into their personal story this horrible plot twist. Be patient.

And remember that we have a God who knows firsthand what suffering is. Not just physical pain, but being misunderstood, being misrepresented, being persecuted, being betrayed, being abandoned by friends and apparently by God. Not only Jesus' knowledge but his experience makes him competent to understand and help us in our suffering. And we should aim to be competent in helping others too. Because becoming competent is a key element of following Jesus.