Sunday, July 8, 2007

Sermon: "Holy Hand Off"

Scripture: Galatians 6: 7-16

Reverend Larry M. Gerber

 

What do heart surgeons and Christians have in common? Both need a process and procedure to fix brokenness.

In the operating room at Great Ormond Street Hospital in London, 3 year-old Faissan Hussain lies on a table with his chest open while surgeons work to correct a potentially fatal genetic defect in his heart. As a pair of surgeons begin closing the boy's chest after a successful procedure, another doctor begins preparing for what may be the most delicate and dangerous part of the procedure ? the "handoff" of the patient from the operating table to the ICU, which involves disconnecting and reconnecting tubes and wires, passing on information, preparing for contingencies, and transferring care of the patient from one medical team to another.

It's choreography with a sense of urgency ? a medical minuet where one small misstep could have disastrous consequences.

A little more than a decade ago, those consequences were often tragically realized due to a lack of standardized handoff procedures. Between 1987 and 1993, pediatric cardiologist Dr. Marc de Leval performed 104 "arterial switch" operations at Great Ormond Street ? an operation designed to correct a congenital heart defect in infants within the first two weeks of life. In one tragic spate, Dr. de Leval had seven of his tiny patients die in quick succession even though the operations had seemed successful.

After taking some time to work at another institution, Dr. de Leval published a paper in 1994 in order to determine what went wrong. The deaths could not all be attributed to the riskiness of the procedure or the failure of a machine. Rather, Dr. de Leval determined that it was the general "suboptimal performance" by himself and his team that had contributed to the deaths, particularly the "handoff" between the surgical and ICU teams.

Then one Sunday in 2003, after a particularly trying day in the operating room, Dr. Goldman and surgeon Martin Elliott slumped on a couch in the break room and switched on a Formula One auto race. Both doctors were fans of the sport, where precision machines race at high speeds with the help of a team of technicians and an efficient pit crew. Watching the race that day, Goldman and Elliott realized that watching a 20-man pit crew change four tires, fill the gas tank, adjust the air foils, and clean the filters in less than seven seconds made their hospital staff look like shade tree mechanics by comparison. The doctors were inspired.

They invited members of McClaren, the British racing team, to come and share with them some of their procedures for making the human factor of teamwork run more efficiently. The big learning for them was that pit crews are obsessed with recording tiny mistakes and correcting them ? the same conclusion that Dr. de Leval had come to some years earlier.

In early 2005, Drs. Goldman and Elliott traveled to Italy to the headquarters of Ferrari racing to learn some of the techniques that made racing crews so efficient and effective. They also brought with them some tapes of their own hospital team at work to show the Ferrari crew leaders. On a Ferrari pit crew, every man has a specific job, done in a specific sequence, and done without saying a word. The hospital team, by contrast, was noisy, confused and unfocused. On a pit crew, the "lollipop man" holds the sign that ushers the car into the pit, then indicates when it's safe for the car to go again. On the hospital crew, no one and everyone seemed to be in charge at once.

Armed with their findings, Goldman and Elliott began to look at every detail of the handoff procedure, coming up with a seven- page manual of processes and drilling team members on their responsibilities. The result was that technical errors fell 42 percent and information errors fell 49 percent over a two-year period. The bottom line? It pays to sweat the small stuff whether you're in the last lap of a Grand Prix or in the final stages of surgery on a 3-year-old heart. It's all about the process, all about the team, all about everyone knowing their responsibility and executing with precision.

Dr. de Leval got some other surgeons involved in looking at the problem and commissioned a study that confirmed his theory. The study, published in the Journal of Thoracic and Cardiovascular Surgery, determined that while big mistakes cause big problems, it's more often the small, unnoticed and uncorrected mistakes by medical teams that add up and correlate strongly to bad outcomes for patients. The pediatric ICU chief at Great Ormond Street, Dr. Goldman, concurred.

"Our handoffs were haphazard," he says.

When you read Paul's instructions to the Galatians it sounds a bit like an instruction manual for a church that has fumbled some handoffs in the past.

Paul's letter to these folks is a lot less cordial than his other epistles, sounding more like orders from a crew chief than a letter of love. Maybe that's because Paul realized that this particular church team was breaking down because too many chiefs were clamoring for leadership and implementing their own procedures ? like requiring Gentile Christians to be circumcised as Jews before they could participate in the life of the church. Paul also understood that the Galatians were being tempted by a very individualistic gospel based on the works of the law, where outward signs like circumcision gave a person a higher status than others in the church community. Paul's response to all this swirling confusion was to act like a "lollipop man" ? dropping a stop sign in the community's process and doing some remedial training on teamwork.

The Restoration Handoff. One of the handoffs that Paul wanted to train his Galatian team to handle smoothly was how to "restore" a member of the community who was caught in a "transgression" (Galatians 6:1). Moving the identified patient, suffering from the disease of sin, from separation to wholeness requires a set procedure that requires a checklist for both the offender and the community: gentleness, caution, evaluation, and compassion

Call it a holy handoff.

The First Protocol: Gentleness. In contrast to the attitude of pride that seemed to permeate the Galatian church, Paul's first instruction was to approach others, even those caught doing wrong, with "gentleness" (v. 1), which is a practical application of the fruit of the Spirit Paul mentioned earlier (5:23).

It's an important point, because the Greek for the word "restore" evokes the image of a dislocation, of a limb that needs to be reset. While such dislocations are often reset with a violent, sudden and quick snap into position, in the communal life of the church and the spiritual life of the soul, such a quick solution is seldom possible. The pain is so great. that extreme gentleness is required.

The pain of a dislocation is severe. We all know that. Think of the commercial of the athletic wannabe who's in the locker room, waiting to be rubbed down or taken care of. A huge football player sits on the table beside him with a shoulder dislocation. The physical trainer comes in, and pops it back in place.

The little guy faints and falls off the table.

"Restore such a one in a spirit of gentleness."

That the apostle even needs to say this is a commentary on our very human tendency to be critical and judgmental when someone falls into an error or slips into sin. Our treatment of such persons too often can be anything but gentle; frequently it is harsh and uncaring.

The Second Protocol: Caution. This gentleness, however, should be tempered with caution. The context suggests that there were two possible temptations that could botch the handoff to restoration. One involves the healer being tempted by the same sin that put the patient in the situation and the other involves the sin of pride that can be caught by the healer, who can see him-or herself as being superior to the sinner. John Wesley makes the same point, commenting on Galatians 6:1: "Temptation easily and swiftly passes from one to another; especially if a man endeavors to cure another without preserving his own meekness."

Recent scandals in the church have proved both Wesley's and Paul's point. When we choose the path of harsh condemnation and spiritual superiority over others, it can often be a cover for our own susceptibility to the same sin. Paul warns that we must guard our motives even as we implement the procedure for bringing someone back into the life of faith. We're all suffering from the same disease of sin, so boasting about ourselves and our righteousness only splits the team. If we have to boast, says Paul, we should only be boasting in "the cross of our Lord Jesus Christ," the One who gave himself for all of us sinners (6:14).

The Third Protocol: Evaluation. The key process in this spiritual handoff from sin to wholeness, according to Paul, is self-examination. Rather than the finger-pointing that can characterize a team centered on rules and regulations (what Paul calls the "law"), the Galatian team is called instead to focus on the "law of Christ" (6:2). While the written law condemns, the law of Christ is the law of sacrificial love, where people "bear one another's burdens" in mutual support and accountability. Everyone in the community has a responsibility for building up the others in appropriate ways, serving and loving others in the model of Christ. Those who choose moral or spiritual superiority over love "deceive themselves" (v. 3). Instead, Paul urged the Galatians to "test their own work," ? their own motives and actions, their own sins and failings ? instead of focusing on the failings of others. That's one way to avoid pride and another way of carrying one's own "load" as part of the team (v. 5).

The Fourth Protocol: Compassion. Haphazard handoffs happen in the church when we are too focused on being right rather than being compassionate. How many people never get connected to a life-giving faith in Christ because all they have experienced from the church is condemnation? How many of our methods of church growth are more focused on padding our pew numbers instead of focusing on the sometimes painfully slow process of transformation and healing in the lives of broken people? The truth is that if we are "sowing" condemnation, that is what we will "reap" (vv. 7-9). If we're spinning our wheels arguing over the care and restoration of people hurt by sin, we risk having spiritual patients die on the proverbial table because we haven't cared for them according to the procedural law of love laid down by Christ.

The truth is that transforming people' lives under the power of God's Spirit is a long, detailed, and sometimes tedious process. It is easy to give up on people who don't respond to the gospel or who refuse to see how sin has hurt them and those around them. Yet, says Paul, we should never "grow weary in doing what is right" (v. 9). Healing can only happen when the whole church team is focused on doing "work for the good of all" (v. 10).

The church must use caution, gentleness, evaluation, and compassion on all counts if it is to be the true church in action for Jesus Christ. God gives us His grace and compassion only after he evaluates with gentleness and caution. God has given us His Spirit - The Holy Hand Off - will you offer it to others in the same manner?

As for little Faissan in the opening story? As a result of the good teamwork that the doctors of Great Ormond Street Hospital learned from a bunch of gearheads at Ferrari, Faissan made a quick recovery and his parents took him home within a week.

We can heal broken hearts of the spiritual kind, too. All it takes is a Spirit of love and the teamwork of a community focused on grace. Do that, says Paul, and you'll see even the most sin-sick people become a "new creation" (v. 15).

The Holy Hand Off comes from God with all the necessary equipment intact. We the church receive this Handoff intact. The rest of the story is - how well do we hand off the Holy to others who are in need of gentleness and compassion.

 If we are to be the church in love and action we must pass the Holy intact as we have received it - with gentleness, caution, evaluation, and compassion.

 Let us pray??..

Source:

Naik, Gautam. "A hospital races to learn secrets of Ferrari pit stop." The Wall Street Journal, November 14,