Author: Dr. Michael Johnson

Mrs. JK is sitting quietly in the room and she seems deep in thought. The waiting room is crowded with other patients and in my usual fashion, I just want to get through the morning workload without a lot of processing of extraneous information. Mrs. JK seems depressed, and I don’t have an inkling of why. What I do know is that she missed her last two visits. She has not been taking her cholesterol medications and she is still smoking. She has gained 20 pounds in the last 6 months and did not get her mammogram as instructed. What else could possibly be wrong?

I am a slow learner. After almost 20 years in Kenya, I should know how to start a conversation. Whenever you meet someone in the African market place, on a dirt road or even on a city street, you always have the courtesy of asking questions that infer your interest in their life and family. “In Swahili the question starts with Habari yako; which really means, What’s up? How are you? How is your family? Any news you would like to share?” The most common answer is ‘Hakuna Matata, a phrase made common in the Lion King movies which means, I have no problems, no worries. With all of this courtesy learned on the continent I forgot it after crossing the Atlantic ocean back to America. I have resumed my usual ‘straight for the kill’ approach in my every day conversation. It is appropriate when asking for the price of an item at the grocery store, or inquiring about my flight reservation. But in the clinical setting, it is not a good approach.

It is not the approach I should have taken with Mrs. JK. She needed me to listen to her. After my examination and explanation of the necessity of following my instructions and being sure to take her medicines I leave the room for a minute. My wife who is our clinic administrator pulled me to the side and quietly informed me to speak to Mrs. JK about the death of her husband two months ago. ‘Michael, be sure to express your condolences and try to be sincere.’ Ooopps!!

I answered, I have already messed that up. I went ‘straight for the kill’. I went directly to the objectives of the clinical encounter, completely ignoring the fact that Mrs. JK is not an object for me to manipulate and instruct, but a person who is in need of compassionate care. She did not need me to teach her about her illness and her failings to comply with therapeutic regimen. She needed me to reach out to her and acknowledge the pain in her heart and mind from her most recent loss. She cannot listen to me, unless I have taken the time to listen to her.

If Mrs. JK was in Jesus’ waiting room, He would certainly know how to approach her. He would do so with compassion. Matthew 9:36 When He saw the crowds, He was moved with compassion for them

The bottom line is, never go straight for the kill. Always take the time to observe, listen and when the time comes, counsel and treat. Habari yako?

Yes sir. No sir. Yes, I can help with that sir. No mam. Of course, I can do that mam. Don’t bother with that, Miss, that is why I am here.

Oh, I am sorry. I should have checked the toilet paper. I will be right back with another roll. I will make sure the toilet and face bowl are clean also.

I will have these shoes shined for you before you disembark from the train sir. Yes, of course, I will wake you in time for breakfast. What is that you say? You want it served in your compartment? Yes sir, I can do that, and I will have your suitcases on the platform in time for your departure. Will there be anything else sir? Miss? Okay. I will see you in the morning. Sleep well. And if you should need anything during the night, ring the bell and I will assist you immediately.

This is a sample of the discourse I had with passengers who were traveling in the overnight sleeping cars in which I was assigned to work. It was the way the ‘well-to-do’ traveled on trains before airplanes became so popular. It was decent, honest work for the summer, and it helped pay my way through school and of course, give me some extra spending money.

My job was to make each passenger feel special during their journey from city to city. For trips from New York to Chicago, Denver, Los Angeles and Seattle, my job was to make people feel at ease.

I did this work in during my summers in college and the first two summers of medical school. Before this I worked in the kitchen as a prep cook and dish washer at restaurants which refused to hire black people as waiters or other out-front staff.

These memories flood my mind as I now sit in places to literally make life and death decisions. How did my early life experiences prepare me to order the appropriate lab studies, x-ray images, make the correct professional consultation and communicate this clearly to the staff and of course, the patients who depend upon me to make unbiased, professional decisions. My job is once again to make people feel at ease.

What did I learn as I shined those shoes, carried the luggage, answer the bell in the middle of the night to bring a cup of milk or a glass of sherry?

Yes sir. Yes mam. I learned to serve. I did not learn to be subservient, self-demeaning, or self-effacing. The Lord was teaching me that I am not the center of attention. Service does not mean I am less. In fact, it means I am more. In order to lead, I must serve. To be less is to be more. To serve is the calling in Christ.

The patients I serve now, want to know they are of value. They want to know that whatever ‘class’ they may have been born into, they are important to me and that I will serve them with professional courtesy and care. Making them feel special in that encounter is what it is all about.

John 13:12-17

When he had finished washing their feet, he put on his clothes and returned to his place. “Do you understand what I have done for you?” he asked them. 13 “You call me ‘Teacher’ and ‘Lord,’ and rightly so, for that is what I am. 14 Now that I, your Lord and Teacher, have washed your feet, you also should wash one another’s feet. 15 I have set you an example that you should do as I have done for you. 16 Very truly I tell you, no servant is greater than his master, nor is a messenger greater than the one who sent him. 17 Now that you know these things, you will be blessed if you do them.

There was only one thing clear. There was only one thing to be noticed. She was is only caregiver. He was obviously infantile. He had full physical appearance of a man in 3rd or 4th decade of life. A full Adam’s apple, hair on his face chest and a deep voice. However, his responses were typical of a 6-year-old child. He spoke most readily in the affirmative. No matter what the question was, he seemed to want to please me as the questioner. The right answer must be ‘yes’. It seemed he did not want to disappoint me. She was the only one in the room that would notice and cry.

This 50 year mother old accompanied her son 35 years. It was clear that she loved him deeply. The medical assistants had done their part. They had taken his blood pressure, measured his pulse respiration and temperature. They did their work with accurate precision. They input the data into the computer including his chief complaint as related by his mother and specifics as best as he could tell them.

It was clear that without his mother no one would notice, and no one would cry.

Being autistic and completely dependent upon others to navigate the common encounters of life is something I can write about, think about, pray about. I have no idea of the complexities of wondering who will notice or will cry.

His complaint was that his feet hurt. His mother noticed that he could not stand or walk because of the severity of the pain in doing so. It would be several weeks before he could see a podiatrist willing to accept his insurance, make an appointment, examine his feet, provide relief and support for in ability to walk without pain.

The only one who notices is his mother. The only one who cries is his mother.

The Holy Spirit laid upon me the most obvious thing. He told me I must notice. He told me I must examine the calluses and recognize the pain of being delayed and ignored. The treatment is delayed and the pain is ignored. It hurts the mother and her son.

Within 15 minutes I was able to give significant relief of his pain and incredible joy to his mother by simply examining the calluses, using a scalpel to shave the thick skin and apply a soothing ointment. It was as if Jesus himself had made the lame walk. He entered the clinic limping and he left leaping.

I wonder if anyone noticed his pain except his mother. I wonder if anyone cries but he and his mother.
I wonder from my own life. Does anyone notice I am here? Will anyone cry when I am gone?

Do something of value to make someone notice Live your life in such a way that someone will cry when you are gone.

Lord make me rich 
In  the year Twenty Twenty
Where I have but little 
Lord please give me plenty 

The wealth of great mercy
Treasures of unlimited love
Rich with forgiveness
Like yours from above

Lord help me set 
A most sumptuous table
Giving generously to
Those who are less able

Lord let me dress
In the most fabulous fashion
Clothe me with garments
Of your grace and compassion

Lord give me only
Things of great price
I want others to see
The wealth found in Christ

1 Timothy 6:17-18
Charge them that are rich in this world, that they be not highminded, nor trust in uncertain riches, but in the living God, who giveth us richly all things to enjoy  That they do good, that they be rich in good works, ready to distribute,  

How long will it take this man to get in the room? He is already 20 minutes late for his appointment. If it were not for all his paraphernalia including, his walker, shopping bags and seemingly endless layer of clothing this clinical encounter could be at least halfway finished. And now he is finally in the room. It takes another 2 minutes to sit down. Much of this time is taken to remove the coat, jackets and shirts. This layered clothing is necessary for these cold winter months. Each layer removed allows the emanation of increasingly pungent body odor. He has not bathed for days or even weeks. Because of patient confidentiality I have to close the door and I am trapped with seemingly visible vapors. I must make this encounter is brief as possible.

Mr. PJ ‘I exclaim with forced smile and enthusiasm. It is so good to see you. I am glad you were able to keep your appointment. We have not seen you and several months. I was beginning to worry about you.’

Mr. PJ remains silent. He has a worried look on his face. This is part of his natural demeanor. Sleeping on the streets this time of year takes away any pretense of being comfortable. He wears most of his collection of garments because he cannot trust the boarding houses to keep these precious items from being stolen. He only goes there at night when it is too cold to lay on the vents on the street and too late to beg. He is only here this late morning because he wants to show me something.

‘Dr. Johnson’, he begins ‘I had a very difficult time making it here today. I am having a lot of trouble walking lately because of some sores on the bottom of my feet.’

He then begins to remove his boots. They appear quite heavy and are laced up to mid-calf. It seems an interminable amount of time. Each boot is covering layers of dirty socks which cover dirty, smelly feet. Time drags on. The odor is now palpable. I move forward to open the door, but he stops me.

‘Dr. Johnson, don’t you want to see?’

With that he displays the warts on the bottom of his feet. I must hide my revulsion and take time to visually as well as manually inspect his feet. I don a pair of latex gloves and turn on the bright overhead lamp. I recognize it has been a struggle for him to come to see me. I must be patient enough to overcome my own struggle so that I may pretend to thoroughly examine. This Dr. must learn to be patient.

‘Oh yes I see Mr. PJ.’ I have come to a clinical decision in less than 10 seconds. ‘We will have to find a way to clean your feet here today and apply some ointments. You also need some clean socks. How long have you had these boots?’

‘Dr. Johnson, he replies, ‘these are my favorite boots because they keep my feet warm even when they get wet. I don’t have any place to wash my feet and I don’t have any money to buy new socks. How can you help?

I happen to have in my car several pairs of new socks which I purchased just for such an occasion. But I have no answers as to how to keep his feet clean and of course what will be doing about these sweaty dirty boots. A cursory wipe with a moist clean towel and the application of moisturizer is all I can afford right now. I give him the socks and advise him to return as soon as possible that I may inspect his feet again. He needs to see a podiatrist to provide definitive care for his plantar warts. However, he doesn’t have the money for transport, and I don’t have the patience to untangle the web of social economic determinants which prevent him from getting proper care. I am not that patient.

The word ‘patient’ has its origin in Latin. It means “quality of being willing to bear adversity, calm endurance of misfortune and suffering”. These are the very things I avoid. As a busy doctor in a busy office the last thing I want to do is be patient. I would rather Mr. PJ be the patient. I would rather him bear adversity, the endurance of misfortune and suffer. That is his role not mine. But to be truthful if I am to be a good doctor, I must learn to be a good patient. I must begin to understand the suffering, the challenges, weaknesses and even bear the smells.

Jesus the Christ was the perfect patient. He was the great healer. He understood suffering. If I am to be the healer He wants me to be, I must make it my goal to listen to even if I cannot fully appreciate the misfortunes of the many Mr. PJs that come to my office. To be a good doctor is to be a good patient. Learn to suffer as Jesus did.

Romans 8:17 KJV and if children, heirs also, heirs of God and fellow heirs with Christ, if indeed we suffer with Him so that we may also be glorified with Him.

I was dressed professionally with blue shirt, matching tie and crisp, clean, white lab coat.  I had an ink pen in my breast pocket and name badge clearly displayed. There was no lint in my hair, no hint of the chocolate bar on my teeth.  Having thus prepared, I stepped into her room and greeted her. The two children remained silent except for their coughing.



Good afternoon Ms. H. How can I help you?



I don’t remember much after this.  It seems everything went downhill.



How long have you been coughing?  Do you have a fever?  Is anyone else at home sick?  Are you taking any medicines?



She answered each of these in a monotone as if I was not asking the right questions.

Then, she went on to relate the multiple situations, signs and symptoms that had brought her to be treated today.  I lost track after the first 6 or 7 complaints because they began to overlap.



Well, it all started when my boyfriend accused me of paying more attention to my other boyfriend’s children than his children.  He screamed at me and would not let me get in a word.

Then he raised his hand and struck at me.  Luckily, I turned my head and he only got the back of it, but just enough to make me hit my head and mouth against the wall.  My lip started bleeding and my front tooth came loose.  Can you see it here doctor?’  She raised her upper lip with her fingers revealing the bruising and cut on the inside and a broken tooth.



She went on. ‘Then he grabbed me by my hair and threatened me that I better pay more attention to his two children than the other four or he would move out and leave me to pay the rent, lights and buy the food by myself.  I don’t have a real job.  I just take care of these babies. Then he left me and I started coughing and it won’t stop.  The kids are coughing too, she said pointing to them. Both had running noses, and were coughing’



At this point, I am trying to figure out what does this have to do with her diabetes and hypertension.  I can’t begin to address the smoking cessation that is obviously affecting the asthma and bronchitis of her children.  I dare not go down the road of the necessity of immunizations.  That only leads to a quarrel.

She is in the way of helping me tie all of these significant illnesses into a neat and easily treatable package.

She is not making it easy for me.  I face the computer and start my charting.  Everything is in perfect order on the screen.

Unfortunately I don’t have the option of only treating the x-rays, lab studies or physical findings.  The patient gets in the way of doing this.  Their social comorbidities overwhelm the coding of the physical diagnoses and undermine my clean, crisp treatment plan.

Patients will get in the way of the treatment plans.  I need to address their concerns and give them room so that with time, they will hear me.  I must not be the help that hinders.



Jesus asked the man in John 5:6  ‘Do you want to be made whole?’  The man’s answer was not a yes or no, but a list of things that prevented his healing.  The Healer of healers was there and this man was in his own way of being healed.



He did not condemn the man for his excuses or failures, He just healed him.



I must learn to address both their chief complaint with my chief concern.   I know there are obstacles for their healing.  I should not be one of those obstacles.  She will return if I don’t stand in the way.  And if she does, it gives me another opportunity to show compassionate care and help her get out of the way for her own healing to take place.  

And inquiring child
Asked his father one day
Father what would you think
If I went astray?

If I wasted my blessings
Resources you gave I squandered
Places unknown and unsafe
Getting lost as I wandered

If I did things that were evil
Things that only cause shame
To your good reputation
If I spoiled your name

Would it bother or hurt you?
Disturb your peace of mind
Would you forget me, your child?
For all I did so unkind

His Father took only an instant
Not a moments delay
You are My dear child
Even when you do stray

And as any good father
Would do for his own
I would search the whole world
I would never leave you alone

For all My children do wander
And all My children do sin
But because I AM the good Father
I welcome them home once again

Luke 15:18-20

Father, I have sinned against heaven and against you. 19 I am no longer worthy to be called your son; make me like one of your hired servants.’ 20 So he got up and went to his father.

“But while he was still a long way off, his father saw him and was filled with compassion for him; he ran to his son, threw his arms around him and kissed him.

The headlines of the newspapers read 
Sleep better our now our enemy’s dead 
Indeed, oh my, we finally got him
Blew himself up before we shot him
Let’s get back to entertainment instead 

The man on the breaking news said
Active shooter keep low cover your head
The police are now in hot pursuit 
However he is still able to shoot
I groaned and got back in bed

Be careful where you step or tread
In mosque where your prayer rug is spread
In church, or synagogue when praying
Make ‘keep us safe’ the words you’re saying
Give us comfort as our daily bread

Things that cause deep fear and dread
Is the bad news I am constantly fed
Violence, brutality, vengeance and greed
Done in God’s name by some creed
Dear Lord please say what lies ahead

Thou wilt keep him in perfect peace, whose mind is stayed on thee: because he trusteth in thee.
Isaiah 26:3 KJV

My Arrogance With Fish

It has been said if you give a man a fish, he will eat for the day. If you teach him to fish, he will eat for a lifetime.

I like to hear myself talk. My wit can be arrogant, demeaning and belittling. I say: ‘if you give a man a fish, he will probably ask for tartar sauce.’ I say this. Then I wait for everyone to laugh with me as I speak from my position of neither having to ask for fish or tartar sauce. The truth is, I have access to almost every kind of fish, relish and sauce any time I have a desire to eat in any quantity I desire. Everything looks good from the point of view of a man who has a freezer full of frozen Alaska crab legs, Tilapia, shelves full with sardines and a variety of hot sauces. My arrogant wit is an attempt at poking fun at a people who have the audacity to ask for my help.

‘How dare they? Why don’t they just go get a job and quit begging for help? They should get off of the corner with their cardboard mats and take care of themselves. The last thing I want to do is to give them a fish. I don’t want to make them dependent on me.’

Jesus never asked anyone he encountered ‘why didn’t they get it together?’ He never prodded to find out why they were in trouble. He just gave them fish. He didn’t inspect, interrogate or admonish them for being on the side of the road, hiding in a cave, or waiting by the poolside. He just fed them.

Of course people should to learn to fish. To do this requires a willing teacher, someone who knows how to fish, proper equipment, fishing gear, bait and possibly a boat and of course access to a body of water that actually has fish.

Whenever I pass someone on the street corner I need to check my arrogant humor. I don’t know what teachers they may or may not have had, I don’t know what equipment life offered them and I don’t know what access to opportunity they may have had to care for themselves. And so what if the man asks for tartar sauce? I enjoy the extras in life. Why shouldn’t he?

And why shouldn’t they become dependent on me? Shouldn’t they be dependent on me to show them human kindness, a respectful look, a smile and yes even a fish with sauce now and then.

Luke 6:30-31 says, “Give to everyone who asks you”

John 9:1-3 Now as Jesus was passing by, He saw a man blind from birth, and His disciples asked Him, “Rabbi, who sinned, this man or his parents, that he was born blind?” 3 Jesus answered, “Neither this man nor his parents sinned, but this happened so that the works of God would be displayed in him

Let’s kill all the evil people
Those intent on doing bad
For rhe evil they have done
Or the evil thoughts they’ve had

Let’s kill them while they sleep
Before they open eyes
Killing is most efficient
When it happens by surprise

Let’s do this hastily
Don’t make such a fuss
Let’s kill all the evil people
That means…,even us

There is none that understandeth, there is none that seeketh after God.
Romans 3:11 KJV