A Deadly Dysrhythmia

Faster Might Not Be Better

Mark Sandoval, M.D.
I don’t know if you see daily trends in your practice, but in my ER, we seemed to have daily trends. One day might be psych day. Another day might be GI day. Another day might be trauma day, and so on. I remember one day in particular. It was tachydysrhythmia day. I had one patient in atrial fibrillation with rapid ventricular response, another was in atrial flutter, another had sinus tachycardia caused by thyroid storm, another had sinus tachycardia secondary to urosepsis, and the last one had sustained ventricular tachycardia.
Each of these persons were in danger of dying, not of too much blood flow, but of too little. Once the heart rate reaches a critically fast rate, as the rate increases further, blood flow actually decreases. Eventually, the heart can beat so fast that there is essentially no forward blood flow and one dies even while their heart is beating rapidly. This phenomenon occurs because the ventricles can only fill at a certain rate, and once that rate is superseded, they begin to fill less with each beat, and therefore the heart pumps less blood.
I would like to propose to you that the devil has inflicted our medical profession with a deadly tachydysrhythmia, which I call, consultus brevis, or short consult syndrome. This condition is the result of the financial system pushing for decreased expenditures while the medical system is seeking increased reimbursements, as well as the growing disparity between the number of healthcare providers and the healthcare needs of patients. The result is a shortening of the time available for consultations and an increase in the number of patients seen in a day.
Symptoms of consultus brevis in the patients include dissatisfaction with the healthcare industry as a whole, frustration with their healthcare provider and the quality of care provided, feeling that the provider has no time to listen to their needs beyond the superficial and immediate health complaint, and eventually seeking second opinions or alternative forms of healing where one is understood and cared for.
Symptoms of consultus brevis in the provider include a continual rushed sensation throughout the day, frustration at patients who present with a long list of complaints, fear of opening “Pandora’s box” by addressing emotional or spiritual issues that may result in strong emotional responses that will take significant time to resolve, exhaustion at the end of each day, and dissatisfaction with one’s purpose and practice which ultimately results in burnout.
As Seventh-day Adventist healthcare professionals, God has entrusted us with a responsibility that is even greater than that of the minister. “Professional men, whatever their calling, need divine wisdom. But the physician is in special need of this wisdom in dealing with all classes of minds and diseases. He occupies a position even more responsible than that of the minister of the gospel. He is called to be a colaborer with Christ, and he needs stanch religious principles and a firm connection with the God of wisdom.”
What is our work? “The Redeemer expects our physicians to make the saving of souls their first work.” And what responsibility do we carry? “Every medical practitioner, whether he acknowledges it or not, is responsible for the souls as well as the bodies of his patients…Every physician should be a devoted, intelligent gospel medical missionary, familiar with Heaven’s remedy for the sin-sick soul as well as with the science of healing bodily disease.”
We know this. We acknowledge this. We emphasize incorporating spiritual care into our medical practices, including praying with patients. And there are wonderful testimonies of how the Lord has worked through us in these brief spiritual encounters to change the lives of our patients. But, does this constitute God’s vision for His last-day medical missionaries?
I fear that trying to inject spiritual care into a system that is plagued by consultus brevis is like giving a blood transfusion to an anemic with life-threatening tachycardia. The blood transfusion will help a little, but if the transfusion is not combined with reverting the heart to a normal rhythm, it will ultimately accomplish little. Injecting spiritual care into a broken system will help a little, but how much more could be accomplished if we made the difficult decision to spend more time with each patient AND practiced spiritual care in our practices?
I was faced with this difficult decision nearly 10 years ago. As I read more and more of the Spirit of Prophecy, I was convicted that my practice needed to change. I was stuck in the typical round of complaint, diagnosis, prescription…complaint, diagnosis, prescription, and I read that I must, “educate, educate, educate.” I also read that, “A physician who has the moral courage to imperil his reputation in enlightening the understanding by plain facts, in showing the nature of disease and how to prevent it, and the dangerous practice of resorting to drugs, will have an uphill business, but he will live and let live…. He will, if a reformer, talk plainly in regard to the false appetites and ruinous self-indulgence, in dressing, in eating and drinking, in overtaxing to do a large amount of work in a given time, which has a ruinous influence upon the temper, the physical and mental powers.”
I realized that if I was going to make the eternal difference in the lives of my patients that I was reading about, I was going to need more time with each patient in order to meet their spiritual and emotional, as well as their physical, needs. If I was going to educate, educate, educate, I would need to have time in order to do so.
Being convicted of the need, I pursued multiple ways that I could improve the impact that I had on my patients. Since I had a limited time myself to spend with each patient, I started developing handouts on common complaints (diabetes, hypertension, hypercholesterolemia, obesity, etc.) that I was dealing with in the clinic, providing more information and guidance than I had time to give in person. I would begin the conversation with the patient and then refer them to the materials I had produced for their continued education and refer back to what they read during our follow-up appointment.
I realized that there was need of more education than this, so I started working on a website that could provide additional health information for them. This way, I could not only hand them a handout, but I could also refer them to my website for additional resources. I would pray with patients frequently, and I did make a difference in the lives of my patients. But I knew that there must be more. I was still unsatisfied with how many patients would simply bypass the information received and rely upon medication to “control” their condition. After a time, I realized that I needed a specialty lifestyle practice, where education, not medication, would be the center of the practice.
To make a long story short, I moved to Uchee Pines Institute to learn how to educate and treat my patients with lifestyle and nature’s remedies like I was reading about in the Spirit of Prophecy. In this setting, I found myself able to spend a significant amount of time with each patient. This gave me the time not only to explore their medical history and understand their lifestyle, but also their traumas, relationship struggles, and spiritual journeys. I began to connect with my patients on a deeper level and entered into their lives more meaningfully. I was no longer afraid of opening “Pandora’s box,” because I now had time to address what would come spilling out.
I began to see that, while my patients were suffering from physical diseases, these diseases were not the problem. They were simply the manifestation of the problem. I began to see and understand the emotional and spiritual issues that were the cause of the physical diseases, and I began to prayerfully learn how to address these issues, as the Holy Spirit gave me wisdom and insight during consultations. And something else marvelous began to happen. Patients started surrendering their lives to Christ in my office! Not only was I educating them how to practice healthy behaviors, but I was bringing them to the Savior who would heal the plague-spots in their souls and give them overcoming power to be successful in implementing and maintaining these health-preserving lifestyle principles.
It is not a rare occasion that patients surrender their lives to Christ in my office. There are frequently tears of pain and fear as we address the traumas of their past and fears for the future. And there are tears of joy as they see and believe the love God has for them and the freedom He offers them right now. This is as God would have our practices to be. The purpose is not so much the healing of the body as it is the healing of the soul. And that healing takes time!
I want to challenge you with this thought. If God has chosen us as His last-day medical missionaries to prepare a people for the soon coming of our Savior, and if our ability to truly accomplish the task in a patient’s life is dependent upon having sufficient time to address the issues of the heart and soul, in addition to the issues of the lifestyle and the diseases, what are you willing to do to make that time for your patients and your Lord?
Are you willing to risk the censure of your hospital or physician group? Are you willing to risk the drop in revenue that will come from seeing fewer patients in a day? Are you willing to exit the system that encourages consultus brevis, and explore alternative forms of healthcare delivery that will allow you to adequately address the spiritual, emotional, and physical needs of your patients, bringing them to the foot of the cross and a saving relationship with Christ?
I know this is a scary thought. I remember when I was making this decision. It was as if I was standing on the edge of a canyon in complete darkness, and God was asking me to jump. I couldn’t see how God would sustain me and my family of 6 (now 8) financially. I couldn’t see how I could pay off the remainder of my medical school loans. I couldn’t see what my life would look like. I feared what would happen to my skills and my reputation. But I can honestly tell you this: I have a practice that is absolutely satisfying. I make little money, but God provides for my needs. I have a practice that is fulfilling, gratifying, and makes an eternal impact in the lives of my patients. I have successfully “cardioverted” consultus brevis, and I am reaping the rewards.
I encourage you to become familiar again with the precious counsel that we have in the Spirit of Prophecy regarding our medical practices. Then compare your current practice to what you read. Ask the Lord for wisdom and courage to make the changes that are necessary so that your practice may be all He designed that it should be. Make the salvation of souls your first work, and in so doing, all aspects of your practice will conform to this goal. Faithfully deal with this deadly dysrhythmia, for doing so has eternal results.