By Maria Evans
"Silence has become God’s final defense against our idolatry. By limiting our speech, God gets some relief from our descriptive assaults. By hiding inside a veil of glory, God deflects our attempts at control by withdrawing into silence, knowing that nothing gets to us like the failure of our speech. When we run out of words, then and perhaps only then can God be God. When we have eaten our own words until we are sick of them, when nothing we can tell ourselves makes a dent in our hunger, when we are prepared to surrender the very Word that brought us into being in hopes of hearing it spoken again--then, at last, we are ready to worship God."
~Barbara Brown Taylor, from "When God is Silent"
One of the most basic, crucial parts of my job, in terms of what matters to the patient, are the words I speak into our dictating system that create the written record of the surgical pathology report. Until the moment my thoughts and impressions leave me and become words that can be shared, they are useless to the patient. Once spoken, dictated and signed, the patient and I have entered into a covenant. The patient has offered up a bit of flesh and I honor that by creating words that name it.
So you can imagine the office-wide consternation a little while back when my transcriptionist met me at the door with what I call the "Now, don't blow a gasket," look.
She took a deep breath and blurted out, "All your 'grosses' from yesterday are gone. They can't find them in the dictating system anywhere!" She was referring to what's known as the "gross dictation"--where I actually open the various biopsy and specimen containers, describe what's in them, state what is submitted for processing, to be turned into paraffin-embedded tissue blocks and, subsequently, slides for microscopic examination. We had been suffering massive computer woes in the office and the files of what I had dictated had disappeared from the server, beyond retrieval.
Needless to say, it was incredibly frustrating that words I've come to depend on, were suddenly absent.
One of the things we discover after we've grown in our Christian faith for some time, is that there will suddenly be a time that the words we've come to depend upon in the Bible, from the pulpit, and from each other in the gathered community, are also suddenly absent. Perhaps we've encountered a tragedy that has shaken our faith. Perhaps it is the departure of a rector whose homiletic skills hooked us in an authentic way to God. Perhaps our best friend in the parish died or moved away. Perhaps it's simply that little edgy gnawing that our prayers seem to be going nowhere and God is silent. We look up and realize the screen on our spiritual GPS is blank, and the little voice in it is going, "Recalculating...recalculating."
For most of us, our first reaction is panic, and all the subsequent actions that go with it--fight, fright, or flight. "Sit still and work with this" is generally NOT the action we take.
I know what I would probably be doing if that were my GPS. I'd be yelling at the little voice, for one thing. I would project that it was displeased or irritated with me. I would be calling it some rather foul names (I've been known to do that with my GPS)--and I'm pretty sure when it got absolutely intolerable, I'd grab it from its cradle and bang it up and down on the dash. But I also know I'd never have stopped the truck--I'd have kept on going in whatever direction I was headed and possibly be endangering other people with my multitasking. Not exactly the brightest move in the world, is it?
I would have been carrying on at how IT is not talking to ME, yet not hearing what it WAS saying to me..."Re-calculating," as it dug into its memory and got instructions from the satellites.
On the day I lost all my gross dictations, I had to re-create my "grosses," relying on my memory, coupled with what I could perceive from what I had available. Now, with the larger specimens, that's fairly easy--I could always go back to what's left of the actual specimen and do things like re-weigh, re-measure, and re-look. But with the smaller specimens--the small biopsies that were entirely submitted for processing--I could only look at the slides we made, and estimate the number of pieces and the size of them, which isn't entirely accurate. Tissue shrinks about 10-15% during processing. They are no longer the color they were at the time I saw them. I am trying to recall them in three dimensions based on a rather two-dimensional slide. I could only make my best guesses based on that and my memory, and the factual truth is that these re-created dictations are not as accurate, but luckily that level of accuracy is not all that germane to the diagnosis.
In short, once I signed the report, the "truth" about those gross descriptions was no longer their actual physical measurements and appearance of the tissue; it was the memory of them that went into the signed record and became the legal and medical truth.
Recalled truth--a truth forged from memory--has transformational power. In fact, we engage in such an exercise each time we celebrate the Eucharist. We hear in the Words of Institution, "Do this for the remembrance of me." The times we are spiritually dry or blank invite us to enter into an ever-growing collective memory that stems from the memory of the Last Supper and continues to expand each time the Eucharist is celebrated. We are not required to remember anything on our own--only to trust its own power to transform--and accept the revelations that emanate from it. Are we brave enough to sit still and let it re-calculate for us?
Maria Evans, a surgical pathologist from Kirksville, MO, writes about the obscurities of life, medicine, faith, and the Episcopal Church on her blog, Kirkepiscatoid