Paul's Passing Thoughts

Alice (not her real name), is a longtime resident of a long-term care facility somewhere in the United States. On a particular day, Bob (not his real name), is the nurse assigned to the unit where Alice resides. Alice is a high functioning individual diagnosed with dementia. One of the symptoms of dementia is a regression to child-like thinking, but Alice only displays a moderate example of this. Alice has a significant ability to reason, but this ability is hampered to a large degree by emotions.

From time to time, Alice will display emotional outbursts over a trivial matter, much like a child would. These emotional outbursts displayed by her can last for several hours, so, accordingly, Alice has a prescription for an as needed sedative. Unfortunately, due to time constraints, nurses are inclined to quickly resolve these episodes with Alice by administering the sedative. According to nursing regulations of the state Alice resides in, a nurse must show three interventions before administering a sedative or other drugs used to control behavior. Interventions include a distraction, companionship, back massage, or other physical therapies that might invoke a relaxed state. However, in the real world, nurses have little time for these interventions due to unprecedented staffing shortages. Nurse aides could fill the gap, but the present healthcare system has little or no vision regarding the role of nurse aides and their partnership with nurses. One of the symptoms of a nurse shortage is systemic incompetence due to lack of training. In other words, there is no time to train, warm bodies are needed on the floor ASAP.

Now that the table has been set regarding Alice’s struggle, we must begin by pointing out the following: Alice’s struggle speaks demonstrably to all of us in general. We endeavor to understand more about other planets to understand more about earth. Likewise, we endeavor to understand dementia and other related conditions to understand more about ourselves. A commitment to care for these individuals and to understand them always contributes to the greater good. Besides, God is particularly endeared to those who cannot fend for themselves; God is the supreme advocate for the defenseless and the weak. Drunkards and thieves merely annoy God, while, according to the Bible, those who violate their duty to defend the weak would be better off if they drown themselves.

Bob knows something about nursing; being ahead of schedule is a pipe dream. Hence, after finishing his med pass early, and getting ahead on processing new orders, he waits for an interruption to happen. And, something happens right on time. Bob is informed that Alice is in a state of agitation, and she is in her room. Bob arrives at her room, and finds her pacing aimlessly and ranting incoherently. Fortunately, Bob has a rapport with Alice and she agrees to sit down and talk with him.

“So, Alice, what is going on? Tell me why you are upset.” Alice then replies, “I am a bad person!” Bob: “Tell me more about that Alice.” Alice, demonstrating what she did to another person by displaying her middle finger, states, “I did this to another person and said, f___ you!” Bob, at this point, suppressing his laughter, explains to Alice that he has done that in the past while driving, but this does not make him a bad person, per se.

We need to pause at this point. We must understand that people with dementia bring their past experiences into their present life along with old ways of thinking. And, we must also realize that even though the American church decries the idea of being justified by the law, what the church is really saying follows: no person is ever justified, or good, while alive. Why is this according to the American church? Because according to the American church, and its justification by faith gospel, a perfect keeping of the law is what makes a person good. Hence, anyone claiming to be good, is necessarily claiming that they keep the law perfectly. Unfortunately, this definition is a confession that so-called saved people are yet under the law. But, what does the Bible say? The Bible states that there are two kinds of people in the world, those under the law, and those under grace. According to the Bible, those who are under law are unsaved, and not good people, and those under grace are saved, and literal children of God, and are therefore good people. By the way, the biblical definition of “grace” is love in action. Under grace means to be under love. Also, being under grace doesn’t mean that you are no longer obligated to any standards, you are, and that standard is love. We will visit the differences in the two standards later. But meanwhile, let us say that under grace is marked by a desire to love, rather than an obligation to love. A failure to love does not bring condemnation, but an obligation to law does bring condemnation…always.

The world, as well as the church, is under law. However, the church denies that accusation because supposedly, Jesus not only died on the cross to take our punishment for breaking the law (penal substitution), but lived a perfect life to fulfill the law, so that perfect law-keeping can also be imputed to the lives of bad saved people (double imputation). This happens when people, realizing they have violated the law, seek out a ritual that temporarily circumvents the condemnation they are under, until the next time they break the law. With time, mourning for sin will decrease, because after all, what else would we expect from bad people? Yes, you are culpable for being a bad person, because you are, but also unable to be a good person because you cannot keep the law perfectly. Therefore, ironically, a good person is defined by knowing they are a bad person. In the church, this is a “humble person,” which means they excel in knowing how bad they are. In contrast, the Bible states in several places that those who lack goodness will not see God. The church claims that in every one of those verses, it’s talking about Jesus’ substitutionary goodness, and not a goodness that we possess even though that would break every sentence structure rule known to mankind.

Hence, the average American church goer would see Alice’s agony as a good thing, and a grand opportunity to present their under law false gospel. The idea that Alice is a bad person would be reinforced to her, and then the “good news” that we can seek forgiveness in Jesus every time we give someone the finger would be offered as the solution. This presentation to Alice, as proffered by the church, should result in unspeakable joy that she has an antidote for being a bad person, though supposedly, God’s offspring. Bob isn’t sure that selling Alice on the idea that she is, in fact, a bad person, is a great idea. In fact, it would seem that a truly good person would indeed need to be sedated to deal with that reality. All in all, when this ideology is considered, it should be evident why their is no statistical difference between secular behavior and behavior within the church. In fact, an inability to give one’s guilt to Jesus without being sedated may be a virtue. In contrast, “humble” people who accept their personal depravity are exalted in the church as people possessing superior faith.

Bob’s approach is different. Bob reminds Alice that a bad person wouldn’t feel bad because they gave someone the finger. A bad person wouldn’t care. Bob asks Alice if she did what she did because she lost patience with the other resident. Alice concurs. The Bible states that patience is a major pillar of love. Alice, if she is under grace, failed to love because we are still weak as mortals, not because we are bad people. Bad people are under condemnation, and may or may not seek a ritual to relieve guilt. Self condemnation is merely a self-churching ritual. Alice is merely seeking to relieve her guilt through a self condemning ritual that may take hours unless she is medicated. These rituals are potentially destructive because we all have two venues of thinking: logic and emotional. In the latter, feelings determine the logic, in the former, right thinking determines how we feel. Every moment of our life needs to begin with right thinking. Judging the sum and substance of our life based on one action is both illogical and errant thinking. Alice understands this concept, but in order to test the theory, she makes a case to Bob about her long history of bad behavior, viz, “anger issues.” Bob thinks that more than likely, it is a frustration issue more than anger. Having your whole existence turned upside down via being put in a long-term facility will do that. Bob then countered by pointing out to Alice what she brings to the table of life. Bob mentions her participation in self care, which is an encouragement to him. She sheepishly looks at him and says, “I know.” Bob then mentions that she is one of the reasons he looks forward to coming to work, but with that being said, the truth of that hits home and he begins to fight back tears, which she picks up on immediately. Her focus then shifts from herself to concern for Bob feeling bad…because actually, she is a good person.

Another thing that Bob reiterated to Alice is the fact that good people are always on a journey to love people more and that journey will not be done until we die. Of course, it goes without saying that Alice is on a daily journey to love people more, yet, she needed to be reminded of this. Bob thinks of her daily nursing reports to him about other residents in the facility that she is concerned about. It therefore begs the question: what journey are people on who believe they are helplessly bad? And if perfect law-keeping is the standard, so is perfect love-keeping. They can only be on one journey: to escape hell, and they would be foolish to not focus entirely on rituals that impute Jesus’ perfect law-keeping to their lives. Efforts to love others, which they are supposedly incapable of anyway, would be an eternally damning waste of time.

In the end, Bob and Alice are interrupted by an announcement that residents are putting together puzzles in the activity room. Alice cheerfully scampers off to join the fellowship. No sedative needed, just right thinking.

But certainly, a large part of the “normal” world could be benefited by Alice’s testimony.

paul