God in the ER During a Pandemic - Mike Sunu (Podcast Episode 15)

Leah Archibald: Making It Work is brought to you by The Max De Pree Center for Leadership at Fuller Theological Seminary and the Theology of Work Project.

Mark Roberts: Welcome to Making it Work. 

LA: Through conversation, scripture and stories, we invite God into work’s biggest challenges... so that you can live out your purpose in the workplace. 

MR: I’m Mark Roberts.

LA: And I’m Leah Archibald. And this is Making It Work.

How do you have faith at work when your work is literally the most dangerous place you could go? In the midst of a global pandemic, the last place anyone wants to be is in a hospital emergency room amidst sick people, and yet that's where our guest goes to work each and every day. Dr. Mike Sunu is an emergency room physician in Southern California. He's joining us today to talk about how he has experienced God in the ER during COVID-19. Dr. Mike Sunu, welcome to the Making It Work Podcast.

Mike Sunu: Yeah, thanks for having me.

LA: So, I realized that I started by saying that a hospital emergency room is the last place that most people wanna go in the pandemic, but tell me why I'm wrong there.

MS: Well, actually, when you said that, it started to make me reconsider my career choice. [chuckle] But no, that's actually exactly the feeling that I have at times, when... Especially early on in COVID with all the various fears and uncertainty, I would literally think, "Man, maybe a different specialty would have been a better choice than the ER where patients first land in the hospital and you're the first to see them." So it's certainly a major challenge, particularly during COVID.

LA: So, tell us how working in this current environment is different from your work previously? 

MS: Yeah, so pre-COVID, a normal work day, pretty much we see whichever patient comes through the door. It could be symptoms as minor as a stubbed toe or it could be someone with stroke symptoms. And we would do the various assessments and testing and kinda take care of them that way. In regards to infectious diseases, I mean, there are certainly... Prior to COVID there were certainly infectious diseases that we would also not want at all, whether it's skin infections or GI infections or colds and coughs and pneumonias. And so, there was always precaution, but I wouldn't say there was ever fear of those types of infections. Maybe the closest would be a meningitis or a couple of years ago with Ebola, but that did not have much of an impact, at least in LA.

But during COVID, obviously all that changed, where as we saw reports, particularly in Italy, in New York, that young and old, healthy and sick, everyone was getting really ill from COVID and there was a high appearance of mortality rates. And so, as we were watching that and clicking on the news updates every day, it was just this incredible fear of, "When is this gonna land in LA? When is the first time I have to see a COVID patient? Be in the room within 6 feet, oftentimes bedside within one foot of a patient with suspected COVID?" So it really just changed a lot of the dynamics there, just a lot of weight and gravity to the job.

Interestingly, we didn't really talk about the actual fear, we would talk about numbers and cases, but you could just see just an unease on everyone's faces. We almost didn't need to talk about the fear, just 'cause we all knew it was there.

LA: It's such a... I'm just hanging on every word, 'cause it's such a weighty, insider depiction of the first days of this crisis. 'Cause I don't work in the medical field, so me as an outsider, I was really wondering how people on the inside of the medical field are grappling with this crisis, especially people of faith. I imagine your faith is being tested or challenged in ways that you had not expected before.

MS: Yeah, certainly. I do think the other equivalent was... you know kinda going back to Ebola, Ebola to me was scarier. Essentially, if you contracted Ebola, that's a high likelihood of death within days. And we got a couple of scare cases. And so, the way my department works is, we don't choose which patient we're gonna see, it's assigned to us. So, if you see in the triage, the waiting room area, you can kinda scan who's out there. If you saw the chief complaint of fever, traveled recently from a high-risk area, you're like, "Hmm, I hope I'm not assigned that patient. I hope I'm assigned the person who stubbed their toe." But again, thankfully we didn't see a lot of cases, so that kind of came and went within maybe just a couple months and we hardly saw anyone.

But with this one, with COVID, we're just seeing... That first week we were just seeing more and more cases of fever, cough, and trouble breathing and very low oxygen levels. And so, certainly a lot of fear there. I think how my faith helped me through it... I think when... It's interesting that COVID started to spike in the spring, and as I started to see some patients with COVID, there was one in particular that just really stands out. This was maybe the first couple of weeks, so we were still not sure how severe it was and what treatment modalities we should use in regards to oxygen therapy and intubating people who are really sick. It was still being worked out around the world. But I saw this patient who was probably in their 60s and had every finding of COVID. Their oxygen level was really bad, in the low 80s, and we had them on supplemental oxygen, so they were using a breathing mask, and still not improving.

And I was geared up completely, with two masks actually, and every additional protective gear I was supposed to be in. And I was in the room with the patient and I just remember just a real heavy feeling in the room. I don't get this feeling often or maybe ever, but I could literally just feel like the presence of death lurking. It was a very odd and just a stark experience just being there. Yeah, I've been in rooms with patients who are sick and dying and with other conditions, heart attacks and strokes, and I've never felt that feeling. But in particular with that patient, it was just a real... There was a certain presence there. And I thought about that afterwards, and I had journaled exactly what I had just said just now, but then also reflected on passages that talk about how Christ has defeated death. And that brought me incredible comfort.

So, 1 Corinthians 15, I'll just read it out right now, but "Where O death is your victory? Where O death is your sting? The sting of death is sin, and the power of sin is the law. But thanks be to God, he gives us the victory through our Lord Jesus Christ." And I remember that being around the time of Good Friday and Easter, so those thoughts had also been in my mind. And I had concluded that night that it is true that Christ has defeated death and he's also therefore defeated every precursor of death, including disease, infection and even COVID. And so, I can have confidence that death does not have a final say over me or any of us who believe.

LA: So what does that mean practically in your work as you're treating someone and you feel the weightiness of death in the room, but knowing at the same time, like you said from Scripture, that Christ has defeated death? Does that change the way that you interact with a patient or the feelings of fear that you have when interacting with a patient amidst that infectious disease? 

MS: I think in... It's kind of more a foundational truth that carries me through weeks. On the day-to-day when I'm actually at work in a room with someone with suspected COVID, obviously, we're all using as much protective gear as we can and should. I guess the thoughts of verses like that don't enter my mind on a day-to-day as much, but more so when I kinda reflect how the work day went when I'm driving home. It does kind of give me some calm and peace that I don't ultimately need to fear.

LA: Mark, let me ask you this. You must have been in the presence of some life and death situations in your years as a pastor. A pastor is another role that sees people at life and death moments. Have you ever had kind of a similar experience to what Mike is talking about? 

MR: That's a great question. I've certainly been with people very close to their death, right? So people who are... In many cases, older people whose breathing makes it clear that they're gonna die soon, and it does make it... You know, it does make such a difference if you really believe that death isn't the end of everything, that there is... It doesn't minimize the difficulty of it, often, for the person dying, and then certainly for the family and loved ones and... I don't think, as Christians, we're minimizing the pain or the loss that people experience. At the same time, if you really have confidence that there is something more and... That's based on Scripture and on your faith... I mean, I remember visiting, when I was a pastor, visiting a woman very near to dying, and she knew that, and she said to me, "I'm really ready to go. And I really wanna be with the Lord and... " I just thought, wow, that is so striking to me, encouraging to me. I hope that if and when I ever... Well, I will get to that place, if I'm conscious, that I'll be able to have that same confidence. And again, it's built on Scripture, it's built on really a life of faithfulness and walking with the Lord that comes to that place of confidence. 

By the way, Mike, I just wanna thank you for your work. I've never seen you as an emergency room doctor. I would be... Well, I don't wanna say I would be glad to. 

MS: Right.

MR: But twice in my life, emergency room doctors have made a huge difference in my life. When I was a kid, I ate a whole bottle of baby aspirin, that's not a good thing. And...

LA: Gosh.

MR: The last time I needed an emergency room doctor was really just about four years ago, and I had... Well, I didn't know it at the time, but I had an extreme case of Rocky Mountain spotted fever. I was 16 days in, which is often actually fatal at that stage, and... But it was an emergency doc who was able to recognize that I needed a specialist and literally was part of saving my life. So, I just have such gratitude to you and to others who choose this particular line of work or a sense of calling to it.

LA: Mike, today, as you work in the ER amidst a global pandemic, do you have confirmation of God's leading you to this particular career? Or are there ways that you see God working through your work on a daily basis? 

MS: Yeah. I think the biggest way I think God has used my job personally has been in a very weird way of coming to understand and believe the gospel even firmer. So what I would say is, growing up as a Christian, I was a very headstrong and go-get-them kind of a guy, and I think I would classify myself as a legalist and kind of as the rich young ruler mentality, "Jesus, tell me what I need to do to please you and to get into heaven." And I was fairly convinced I was doing those things. And I didn't have a real understanding of the Gospel. It was a very distorted, untrue version of the Gospel of, "What do I need to do?" And I think...

LA: And just before you go on... So I'll tell our listeners, they can look it up while you're talking. So this is a story that you're quoting that comes from the book of Matthew chapter 19, it's verses 16 to 22. And there's this rich young ruler who comes up to Jesus and says, "What do I have to do? Teacher, what do I have to do to get eternal life?" And Jesus says, "You know the commandments. You don't murder. You don't commit adultery. You don't lie. You obey your parents." And the rich young ruler says, "I'm good, I'm golden. I've done all these things." And Jesus says, "Great. Now just give away all your money to the poor." And then he goes away sad because he has a lot of wealth. So this is the story that you're referring to, Mike. What did this kind of mentality mean for you? 

MS: That story ends with the rich young ruler going away sad because he can't give up his wealth and can't give up his do-it-myself salvation. But I think I really see the grace of God in my own life, because my story to this point has been different, where I may have started with that mentality of, "What can I do, Lord, to please you and to be acceptable to you?" But the way that God's used my work has really kinda shown me my need of him.

The analogy my old pastor used to use a lot was, "When you put pressure on a toothpaste tube, toothpaste comes out." And that's to say when you put stress on a person's life, you really see what's in them by the way they respond to the stress and the pressure. And I would like to say, "Oh yeah, I handled it really well, and I was kind and patient and calm and loving and all these things," but in reality, I've seen just the exact opposite. When I have a stressful day at work, whether it's during COVID or pre-COVID, I'd often see impatience and unkindness and rudeness and anger. And I would see this day after day. And it was very painful to see that and very disheartening to see that. And I have about a 30-minute drive home, and I would think about that on the drive home, of just how ugly I had been that day.

And a lot of that time, that would turn to prayer and confession to God of, "God, this is who I am, and I need your grace." And I think day after day, week after week, year after year of that happening, it just kind of helped me really understand the Gospel, that I don't need to go to the shift tomorrow and try harder to be a nicer person, I need just to go tomorrow and say, "God, I need you tomorrow. I need you today. I need you all the time." Because my sinful nature is so strong and pervasive that there's no hope for me outside of the gospel. I think without my job, if I had worked in some really... Something that I love, and I'm just passionate about and look forward to going to when I wake up in the morning, maybe I wouldn't be seeing my actual nature in me, and maybe I would still be blind to it. And if people have that job, that's an incredible blessing. I'd love to find something like that, but for the meantime, I've had this weird contentment with ER, just because it has really solidified in me just an understanding of the Gospel.

LA: What's so interesting is you work in a place where people go because they need help, and often because they're in dire need of help. And you go into your work spiritually saying, "I need help, God." You're playing both roles in that equation, you're the helper of the people who come in seeking help, and you're also going to God for help.

MS: Yeah, it's kind of an interesting dual role there. I think when I interact with patients, it actually helps me see my own spiritual condition as well. Being in LA, there's a lot of drug abuse just like anywhere, like any major city.

And one of the biggest drug addictions is methamphetamines. And so sometimes we see patients come in, just full-blown meth addiction. They feel horrible, that's why they come to us, and we get them feeling back to their normal. And they go out and do it again, and they come back the next day. And it's incredibly easy to sit back in judgement and say, "Man, can't you see what you're doing to yourself?" But then when I use the gospel lens on my own life, it's, "Am I any different?" My sins are more hidden, and they're not as obvious as someone intoxicated with meth, but I do the same, exact thing. If God treated me with that harshness, then I would have no hope. But God is patient and kind, and he lets me experience the consequences of my sin. And it's painful, but he doesn't turn me away, he doesn't judge me, he doesn't cast me aside. And so that kinda informs how I ought to treat people, particularly when they come in for the same thing day after day.

LA: Mark, I wanna ask your opinion. I think this is interesting, 'cause we often talk about people bringing their faith to their job, like, "I'm coming in as the savior of the rest of my office, and I'm bringing my faith to bear on my work so that my work can be better." Which is obviously valuable. But I... What I hear Mike saying is that his work is actually a place where he diagnoses his spiritual condition, that gives him some information for where he is in his walk with God.

MR: Yeah. Actually, I love what you were saying, Mike, for just that reason. That one of the things we try to encourage people to do is certainly to take their faith and live out their faith in the context of their work. And that's a great thing. But we also try to encourage people to learn that your work, whatever your work is, is actually a place where God can be at work in you. And you just gave up some phenomenal illustrations of in the context of your work, seeing things about yourself, and most of us spend so much of our lives in our work, places of work, if we have them or but doing work, and I just think there are a lot of folk who don't really think of work as, "A major place where God is gonna be forming and shaping me." 

I think it's absolutely right on because it really is in the context of our work that certain parts of our personality come out, are tested, tried. If you're an impatient person, chances are you're going to experience impatience at work, if you're a judgmental person chances are you're gonna experience that in the context of your work. I mean positively too, the good things that God is doing in us if God is helping us to be more gracious, work is a place to express that, so I don't mean only to emphasize the negative, but I just... I love your example because that really is one of the things we wanna say to people that it's not just bring your faith to work, it is really to discover in your work, God's presence in such a way that it really shapes and grows your faith.

MS: Yeah, just kinda going along with that. There was this book, I don't remember the exact title, but it was essentially about how what happens when a doctor themself is sick, there's the... I forget which philosopher said it, but he said, "Physician heal thyself." Meaning we are not super human people and we have many faults ourselves, and what happens when we're not well? And there was a part of... This was probably three, four or five year period where I was burnt out and a good friend of burnout is depression, and it was just in a very low part of life, and I think through that... It was long, I saw a Christian therapist with my wife for a couple of years just to kinda navigate my thoughts and just try to get me out of this cave that my mind and my soul was in.

A lot of it was related to work and the stress. And a lot of it was thinking, What else can I do besides ER? But I think a lot of that was also God graciously showing me that I need... I am not the great physician, he is the great physician, and when I'm sick, I need to turn to him. I don't have all the answers as a doctor, I need the great physician, and that was, again, the whole process of all these trials and down points in my life were just God growing in me a greater faith in the Gospel. And so, I'm thankful for that.

LA: I should note that that proverb that you mention, Physician, heal thyself is something that Jesus quotes in Luke Chapter 4:23. And it's not a proverb that Jesus says. He's not saying, "Physician heal thyself." He says, "Other people are gonna tell me Physician heal thyself." It's not something that Jesus is pointing to you and saying, "Physician heal thyself." He's pointing it out as a proverb that's used often, derisively to point blame at other people. And I think he himself is deriding that proverb of saying, "If you're a doctor, you have to have it under control." I think what Jesus is saying in Luke chapter 4 is that that proverb is ridiculous. [chuckle] That we all have to lean on God. That's my understanding. Mark, you tell me if I'm understanding it incorrectly.

MR: No, you got it right.

So again, Mike you talk about some of the real struggles at work, and that's such an encouragement to others, 'cause I also think there's often a view that, well, if you're a doctor, man, you kinda got it made. High respect, often pretty good compensation, etcetera, etcetera, but what you shared with us it says, you know, there's a lot of hard things we go through, you talked about getting help, obviously doing that with your wife and sharing with her in that and learning and growing through the process. So that's really... It's a great example, whether folks are doctors or brick layers or teachers or whatever it is.

LA: One last question, Mike. Do you see the current COVID-19 pandemic shaping you spiritually in a different way, or shaping your workplace, the lives of your co-workers in a different way? 

MS: Yeah, when it comes to my co-workers, certainly there's just incredible stress and pressure on everyone, we joke often about it, it's literally been the worst year of our lives, 2020 has just been non-stop with COVID and everything else going on in the nation, in the world, just such turmoil and uncertainty pretty much on every front. And so I just feel there's a sense of tiredness among people, rightfully so, they're just... How many new trials can people handle? And I think for me, personally, I'm incredibly thankful for the faith that I have, and I'm incredibly thankful for my church that continues to meet online, and my community group that we meet weekly and share our struggles, a lot of it's related to working from home with kids running around and businesses struggling with closures. But I'm so thankful that we have that community where we can encourage each other and just remind each other to keep perspective.

One of the verses that runs around in my mind these days is... I forget exactly where, maybe Romans, where it talks about, creation is groaning and experiencing birth pains as we're awaiting Christ's return. And so it gives me comfort to know that this isn't unexpected, 2020 isn't unexpected ultimately. It's hard and it's horrible and it's painful, but in the context of the truth that God has given us in the Bible, knowing that this is actually sort of normal or expected, it takes a lot of the sting out of it, and it helps me to endure and persevere. The other verse that's been on my mind recently was 2 Corinthians, I'll read it here, it's 1 verses 3 and 4, "Blessed be the God and Father of our Lord Jesus Christ, the Father of mercies, and the God of all comfort who comforts us in all our affliction so that we may be able to comfort those who are in any affliction with the comfort with which we ourselves are comforted by God."

And just encouraged me to be more intentional of my co-workers who are really struggling with life under COVID and other trials that are simultaneously happening to them, to not just hit them with the gospel, but just to be present for them in their struggles, to share my own weaknesses with them, and to just be present with them, and in some way, be used to comfort them. I do think there's a lot of opportunity to see the hurt around us and just to be present for people.

LA: And certainly as you do that work of comforting, whether it's comforting your co-workers or comforting your patients, doing your work with that comfort that comes from God certainly is a way, a valuable way of sharing the gospel.

MS: Yeah, that's true.

MR: You just cited, Mike, one of my favorite biblical texts for a couple of reasons. One reason is that Paul is writing and in his day, people didn't talk about their struggles really in writing. Finally, you find very, very few examples like that. His willingness to be open about his struggle and pain here in 2 Corinthians 1 was so striking, and I appreciate that 'cause I think it gives us the encouragement to share our struggles with others and not just hold them all in. And then of course, it's exactly as you said, also, the additional encouragement to use what we are experiencing and how we are experiencing God in hard things as ways to encourage and strengthen us to care for others as well. I grew up in a culture in a family where we were reticent to share hard things, and Paul has always been a helper to me in that very text you said. And then it also reminds us, it's not just about you, it's about giving it away to others.

LA: Mike, thank you so much for joining us from the front line of hard things and from sharing your hard things in your work, and giving us the encouragement, and thank you again for the work that you're doing in the emergency room.

MR: Yes, amen.

MS: You're welcome. Thanks. Yeah, it's been great just talking about some of these things with you guys.

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