[00:00:08] Speaker A: You're listening to faith in healthcare, the cmda matters podcast. Here's your host, Dr. Mike chubb.
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On today's program, we focus on the vexing and tragic escalation of firearm injuries and their growing impact on children.
We're joined by a remarkable guest who faces these realities nearly every week of his pediatric trauma practice.
Dr. John Petty is a Professor of Surgery and Pediatrics at Wake Forest University School of Medicine. He actually helped launch North Carolina's first Level 1 pediatric trauma center and served as its Pediatric Trauma Medical Director through early 2024. He's chaired the American Pediatric Surgical Association's Committee on Trauma. He is the current President of the Pediatric Trauma Society and certified serves as Director of the Childress Institute for Pediatric Trauma.
In addition to his national leadership here at cmda, he has been involved in Medical Education International's Mongolia Project and has served on global missions in Haiti and Ecuador, Bolivia, the Dominican Republic, and as I mentioned, Mongolia.
Dr. Petty brings both years of expertise and a deep, authentic compassion to this discussion. He explores with us what makes children uniquely vulnerable to firearm injury, how can we help prevent tragedy and save kids lives, and how to care for our teams in the aftermath of such tragedies.
He also reminds us that as Christian healthcare professionals, we are called to live out Christ's call, to be peacemakers in a polarized world and to nurture our spiritual lives through those demanding years of our training and practice.
Let's dive in.
[00:03:58] Speaker C: Well, today on Faith in Healthcare, I have invited a pediatric trauma surgeon, Dr. John Petty, to the program.
The reason I've done that today is because we have a new board appointed committee entitled the Violence Response Committee. With escalating violence in our culture in the US Our board is concerned as all kinds of violence is increasing in the United States or last several years. And I had a chance to meet Dr. John Petty at a Medical Education International Advisory Council meeting last December here in our headquarters. And when I was sharing with you, Dr. Petty, about some of the things that we were doing at cmda, issues we were addressing, you got real.
And then you told me about a paper that you've been a part of and you told me a little of your background and I was like, oh my word, we have a pediatric trauma expert in our midst and you've been involved in CMDA for a long time, I guess.
Welcome to faith in healthcare, Dr. Petty, and tell our listeners how long you've been involved with cmda.
[00:05:03] Speaker D: Well, it was really since my first year of medical school. It was one of those student organizations and back then they had chalkboards, right? So they put up on the chalkboard the days, you know, meetings and clubs and things to get involved in. And, and so a friend invited me along and you know, it CMD changes as you make your way through medical school and throughout your career. But for those first couple years it was, you know, a lunchtime Bible study and either different faculty members or pastors would come in and just have some time with us and encourage us. And it was, it was great in so many ways, not the least of which is occurred where we were. You didn't have to make another trip or carve out separate time or that.
And that element of ministry is just so important to all of us in healthcare.
[00:05:54] Speaker C: Well, a lot of water has gone into the bridge since that time. You've gone through training, general surgery, pediatric surgery, and you are now chair of the Committee on Trauma for the American Pediatric Surgical Association. You're current president of the Pediatric Trauma Society and you serve as director of the Childress Institute for Pediatric.
So some pretty impressive credentials. And that's why, listeners, I wanted Dr. Petty to come on the program today to talk about the issue of firearm violence in children because I have a friend whose daughter was in medical school around 2020 and he relayed to Me that she was working on a project, orthopedic Trauma related to gunshot wounds in Memphis, and that it was like that around that time that the number one killer of children was no longer motor vehicle crashes, it was now gunshot injuries.
How did it happen that you were the lead author on the position statement for the American Pediatric Surgical association entitled Firearm Injuries and Children?
[00:06:57] Speaker B: How did you get involved in being.
[00:06:59] Speaker C: The lead author on that?
[00:07:00] Speaker D: Well, I said yes to an invitation.
So part of it was that at the time I was serving as the chair of the Committee on Trauma for the American Pediatric Surgical Association.
There's a lot of activities that group does, but one of them is to speak for the organization on certain issues.
And APSA had had a position on firearm injuries previously, but it was time to revisit it. Those things, timeout in certain elements, you know, policy changes, numbers change, all that sort of thing. So it was an opportunity to do that. And I got to work with some really great people on that group and put together something that we were all proud of and was endorsed by the board and hopefully is a common sense sort of approach to this. I think, you know, it's hugely contentious to sort of say that word, right? Firearms or guns or any of these sorts of things. And there's plenty of landmines. And, you know, I may step on, it's a few of those today, but it's important. And I have so much optimism for cmda, for Christian physicians and just the opportunities that we have, not just in firearm injuries, but in all sorts of different ways of sin and its consequences, how that plays out in people's health, that Christian physicians of all stripes are trying to help patients who are in circumstances or environments or choices that affect their health. And yet we lean into caring for them. So this, in my mind is just sort of one more of those areas. But it is something that in my professional practice, you know, I do work at a level one pediatric trauma center. I see children with all manner of life threatening, threatening injuries, including firearm injuries too. So it's not hypothetical. It isn't sort of one set of numbers after another.
It's part of how I get through the day. Yeah.
[00:08:54] Speaker C: In the trenches. So, speaking of in the trenches, let's just get started with a basic question. How do morbidity and mortality differ between adults and kids in terms of gunshot wounds and morbidity mortality?
[00:09:06] Speaker D: Yeah. There's a lot of ways to come at firearm injuries, and one is thinking it through in the manner of injuries. So there's unintentional injuries there's homicide and suicide. That's one way to break it down.
And I think if we hold onto those categories, you can imagine that those are distributed differently in children than in adults. So unintentional injuries are more highly represented in children, even though they're still the minority of firearm injuries compared to homicide and suicide in adults, where unintentional injuries are not as common.
I think in terms of just the vulnerability of children to any firearm injury, you can imagine that the proportions of children sort of proportionally larger heads and torsos, the lesser calcification of the skeleton, the soft tissue coverage, there are just ways in which the same bullet would cause different damage in a child compared to an adult. So I think we have to keep that in mind. I think when the Bible speaks of children, it's postures towards care and nurture and protection and teaching and leading and other things too. But it's the uniform approach that God has us to take towards children. Is that so? In that regard, I think thinking of their health speaks about how we think of our society and the most vulnerable among us.
[00:10:39] Speaker C: So my assumption is that a huge number of these injuries in kids, with the escalating numbers come in teens. And up to what age typically do you and your colleagues count as pediatric? Is it up to 18?
[00:10:52] Speaker D: Yeah. It affects what your numbers are as to where you draw that line. And there is no sort of national, sort of Federal Bureau of Weights and Measures.
What is the age for children? So I think 18 is a number that we use because 18 is used in other contexts as well. But some of the numbers, if you go to the CDC site, they're lumped in categories. And sometimes that goes to 19, some people consider up to age 21. So it is. Anytime you see numbers, it's worthwhile asking that very question because it does change the distribution. So I would say that homicide becomes more represented as a, as a manner of death.
The older, the more sort of adolescents and teenagers that you include in your population cohort.
[00:11:39] Speaker C: So, John, what's the big rock in terms of this, this escalating numbers of firearm related deaths in kids that pass up motor vehicle crashes? I'm assuming, correct me if I'm wrong, that is in the older bracket from suicide and homicides. That's where the big increase has happened. That's taken it past the accidents.
[00:11:56] Speaker D: Yeah, yeah. There's really two stories in that. And you're absolutely right, that that trend that this friend of yours who was in orthopedic surgery commented on, sadly, that has continued since around 2020, that those lines crossed. So the hopeful sort of trend in that is that motor vehicle fatalities are decreasing.
I think there's a lesson on injury prevention and management and trauma systems and something that from a health care standpoint, the work isn't done, but the direction of that is something that we take courage from. But firearm injuries are increasing independent of what's happening with motor vehicles. So those lines have crossed not just because motor vehicle crashes came down, but firearm injuries are increasing and sort of across the age spectrum from 1 to 18, about half of those are homicides and the bigger portion of the remainder are suicides.
And then unintentional injuries are the smallest fraction, even in children, but they're a bigger proportion than in adult firearm injuries. So all three of those areas matter and it's worthwhile to sort of break them down and think of them independently because some of the ways to protect our children are different, depending on which of those categories you're considering.
[00:13:14] Speaker C: Your position statement from 2019 specifically addresses this all under the moniker public health issue.
And I have run into some, not many, but some people who don't like that. In relationship to firearm injuries and violence, how do you respond to whether a physician or non medical person who says, well, this isn't really a public health issue?
[00:13:36] Speaker D: Well, there are plenty of opportunities to use language that make this more contentious. And so I think as Christians and in the spirit of peacemaking, we don't ever want to obfuscate what we're talking about, but we can use.
So the term gun violence has an emotional quality to it.
And because it depends on how you think of something like suicide, is that violence or not? It belongs in the considerations of firearms. So we sort of chose the sort of firearm injuries and we use that language just it's true to what we're talking about. It's not a misrepresentation. So the public health issue has some of that too. The idea is we're doctors, right?
So we talk about health. That's our area of expertise.
Those are the patients and the activities that we're doing during the day. So I'm not a constitutional lawyer.
I don't have much expertise to say how personal freedoms intersect with one another in a good society and all that kind of thing too. But I do take care of children who are injured and I take care of children with all manner of surgical problems. So the public health framework has to do with. One way to sort of break that down is called Haddon Matrix, where you look at sort of before the event, the Insult event. And then afterwards, and then you think across a grid of the host and the agent and the environment.
And so it's just sort of one way to say in each of those boxes, you can talk about what health or change looks like. So, so in the, in the spirit of firearm injuries, it isn't just about the bullet.
It's about what's going on in front of that event in terms of the context and the environment, the age of the child, the location of the injury, the number, all of those sorts of things. Access to trauma care, aftercare and recovery. When you put all those things together, all of a sudden you're talking about health. And so the pediatrician who's getting ready to start her day, and she's going to be talking to children about anticipatory guidance, among the things that most pediatricians want to talk about is safer storage or secure storage of firearms in your home.
Like, that's. That's a public health move. That's injury prevention. We will never know whose lives are saved by those kinds of conversations, but that belongs in this category of firearm injury because the best recovery is from the injury that never happens. So when we talk about public health, it isn't just sort of counting things, but it's sort of breaking down the pieces of health in this manner and saying if we have an anticipatory guidance conversation with a patient and family, that's health care. That's not politics, that's not sort of opinion that that is connected to the health of that child.
And those are appropriate conversations. And they're. And that's true of other difficult things that we talk about with patients. And so there's more in common with that type of approach than there is different. Just because we're not talking about meningitis or something where the agent is a bacterial infection as opposed to a firearm interaction.
[00:16:48] Speaker C: We're talking about kids here. We're talking about vulnerable kids, adolescents that some of the rhetoric, political rhetoric, and the concern about don't touch my guns, that we can set that aside because we are talking about kids here. So the research that's being done, and in that regard, let me segue to fatal accident reporting, it can get political in a hurry. But you've invested a lot of your professional energy in prevention and management of pediatric and adolescent trauma. So where do you think research on violent deaths in children, including those related to firearm injuries, how can it be improved so that we protect more kids?
[00:17:26] Speaker D: There are a lot of ways to come at that. I think one of the areas of common ground has to do with secure storage or safer storage. There are very few sort of responsible minded gun owners that object to that.
And the benefits of that are really significant, particularly for children. It's pretty well demonstrated that children are not able, able to discern between a real gun and a fake one. And one approach to firearm storage safety has to do with what's called active safety measures, which is sort of scolding a child or I'm going to hide the firearm or sort of put out. Those sorts of things are not very effective. Children are curious, they'll find things. And even if they're sort of told not to, there is a level of curiosity for so many things that, that doesn't make them safe.
So we talk about passive storage where it's sort of locked and the best ways to secure a firearm are unloaded, locked, separated from the ammunition, and the ammunition locked up as well. That probably decreases firearm injury rate. So in homes that have their firearms securely stored, injury events and fatalities are about 80% decreased. So it's a difficult scientific question to ask, but to the extent that you can compare those things. So I think we can all get behind that.
When you store a firearm securely in your home, there are benefits for that, for things like suicide and domestic violence and sort of this halo of safety is more than just unintentional injury. But I think when we focus on children, there is nobody in this country that is happy when children get shot. There is no one that sees that as some sort of political win that is across the board, something to be grieved and lamented. And so I think we need to think about areas of common ground as we do this. I think we need to do the science and epidemiology on it. It's been difficult to do scientific study of firearm injuries because up until recently there was sort of a freeze at the federal level and funding for that sort of thing that's been sort of opened up. So I think we have a lot to learn and I think as doctors we need to be asking scientific questions. I think that's one of the privileges of being a physician is that you get to be a mediator, sort of scientific discovery and the care of a human being and our patients trust us with that. And we need to discern good science for bad science. And I mean, I do a lot of appendicitis, right? So you know, there's controversy about non operative management of that and papers come out. And I think that's part of like wisdom is trying to use the Mind that the Lord's given you and be aware of these things. But at some level, we need to represent decisions or help our patients make decisions. And so the fact that there's controversy or, or sort of mixed results on things, that's true of so many areas of medicine. So we don't take that as a rejection of the method, But I think we need to be open and curious and asking the right questions. And that's true in the firearms space, too. If we think of it as something that has to do with health, it's a lot easier to kind of open ourselves up to that kind of discovery.
[00:20:43] Speaker C: Correct me if I'm wrong, but I think as I read your position paper from 2019, that that when there is a gun in the home, that the data would show that there are more accidental suicide deaths in that home than there are in defense. The shooting and wounding or killing of an intruder. Is that correct?
[00:21:05] Speaker D: Yeah, that's right on. And I think one way to think about having a firearm, probably the majority of Americans that own firearms envision that as something for defense, for home safety, and that certainly there are people that also use it for sporting activities and hunting and all of that. And that's great. I think the second Amendment is here.
I think we need to think about how do we make firearm safety, firearm ownership, as safe as possible for those that choose on them. But that question of home defense is a live motivator for a lot of people. And, and I invite, when I give talks on this to people just to do that mental experiment of how many accidental deaths would. Would you trade off for a home defense? You know, that. That the rates of accidental death are not zero.
And if you think that through, I don't know what the. What the number is or what the right number is, but if you look at how these things actually play out, it's a difficult study to do, but they did it in King county in the Seattle area. And it's a little bit of an older study, but it was published in the New England Journal. For every one death by sort of home safety, home defense, for every one of Those, there were 1.3 accidental deaths, and it was something like 37 suicides and homicides. So you sort of pile those up. And. And if the mental framework is making my house and my family safer from the death, the danger that's out there, we also have to acknowledge that there's a danger in here right inside our own homes for. For those sorts of things.
So there's context to that and nuance. And, and all of those events were not the same. But I think just by the, I think the stark nature of those numbers, we need to think about how to make it as safe as possible if you're going to have a firearm in the home. But, but those other events, unintentional, you know, shootings, homicide and suicide, those are much higher likelihood just numerically than home defense. So. And there's other things you can do to make your home safe. Right. You know, have motion activated exterior lighting or alarm systems or dogs or, you know, these other sorts of things too. So it's not the only way to do that.
[00:23:24] Speaker C: Right.
[00:23:25] Speaker D: So, so I think that also belongs in these conversations as we think about, say, firearm ownership.
[00:23:31] Speaker C: So what do you say to our fellow believers, maybe other CMDA members and ministry partners, those you go to church with, including healthcare professionals, who struggle with this reconciliation of firearm ownership and the biblical call to be peacemakers and for the most part, nonviolence.
[00:23:51] Speaker D: Yeah, yeah. You know, one of the groups of children I take care of are children who are attacked by dogs. And you know, the part of a child that's injured is the part that's at the dog's level. So a toddler who's attacked by a dog, it can be. I mean, we see fatal injuries from that sort of thing. One of the things that's often part of those conversations with family is this posture of people trying to justify the dog to talk about what it was about the dog or the event or what they must have been thinking or no, he's a good dog or whatever. And when families go into that, I try to reframe it. Let's focus on the child, let's focus on what's going on here. The dog doesn't need an advocate in this sit that the child does. And I feel similarly about that. We need to keep at center the safety and health of our children and those other things can move out from there. It doesn't have to be a trade off. Again, I think for those that choose to own firearms to make that as safe as possible.
But I don't think that abdicates us of the privilege of being peacemakers and I think seeking peace. I think one of the themes of CMDA, since I've been involved that comes up on interviews like this is the idea of shalom, this sort of everything being in my relationship to the Lord. So your physical health, your mental health, your emotional, your volitional, your relationships, even communities and things. There's this beautiful sort of completeness to what shalom looks like in its most reductionistic sense it does mean peace. And so that's interpersonal conflict that that plays into violence. That's within my self conflict. Right. So you think of drivers of suicide. You know, we talk about depression and mental health.
[00:25:39] Speaker A: Before we continue with this week's episode. Here's a special announcement for you.
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[00:27:01] Speaker D: I think one of the things that also needs to be mentioned is impulsivity.
That connects to anger, but it also connects with suicide. People who have attempted suicide and survived, when they have been interviewed, about half of them say that the interval of time between when they decided that they were going to attempt suicide and when they took the action was ten minutes or less.
[00:27:26] Speaker C: It was very short.
[00:27:27] Speaker D: And only about half of children who complete suicide or die by suicide have a diagnosis of depression. So depression is important, but it isn't completely explanatory. And I think that in suicide, and probably in interpersonal violence as well, we have to talk about impulsivity. And how do you, how do you deal with that? Part of the response to that is decreasing the availability of a lethal means, you know, by having a firearm secured or somebody who is depressed and contemplating it, having that conversation with them. And, and I've had these conversations with friends and people in our church and they're not easy but to kind of say, I know you're in a really hard time right now.
I really care about you because I care about you. I want to ask you, do you have a firearm in your home? Do you have access to that? Can I hold on to that for you? Can we think of a way to have that away while you're in this hard time and then when you're feeling better, talk about moving on from there. I think that's, that's a kind of peacemaking. That's, that's not easy.
But I think as physicians and as members of the body of Christ who care for one another, I think we need to be willing to embarrass ourselves or have blowback from those kinds of questions.
But always framed in the spirit of we care about each other. I think peacemaking, it's not this sort of dreamy, sort of doughy eyed sort of sugar and sunshine sort of activity. I think that, that it's really hard and it requires a lot of wisdom and being willing to be misunderstood or having things put back at you. But I think that's the nature of stepping into different kinds of conflict, whether it's interpersonal or within yourself to be willing to try to point people to the Lord and offer the hope that's there.
[00:29:15] Speaker C: You've mentioned several times now gun safety practices and I'm just wondering, any other take home lessons on gun safety practice. I have adult kids with kids who have grandchildren and this is an issue just even recently that we've been talking about for protecting our four year old granddaughter who gets into everything. I mean, she's very curious.
So anything else other than things that you've mentioned as we've been talking that are just tried and true, things that whether from the AAP or from the APSA are very clear?
[00:29:48] Speaker D: You know, I think it is not unimportant to talk to especially your children about guns. If you see a gun, don't touch it. You know, like let an adult know. That's not a sufficient response to that. But we do want to let our children know that this is something that's dangerous and it's an adult thing. And it's, you know, because just like you mentioned, they're curious and they're going to try to figure stuff out and all that. So I think that's in the category of good advice. I think one of the areas that we probably don't talk about frequently enough has to do with storage in a vehicle.
Stolen firearms are a big part of sort of homicide story.
Guns that are obtained illegally. And so I think having a lockbox in your car, if you're going to be transporting a firearm that is somehow secured to the vehicle, one for the safety of sort of inadvertent use, but the other would be when you're out of your vehicle and the firearm is there, is that sort of protected from theft. There are a few states that have vehicle storage where they don't want it accessible to the driver because of road rage and other sorts of things, too, which I think is an interesting sort of phenomenon. So I think that. I think we can get. Get behind that.
I think what goes in the category of lethal means counseling. Sort of like we were talking about that somebody who is in a position of anger. I mean, you think about, you know, the neighbor next door and the yelling and screaming and stuff that goes on there. If a firearm becomes part of that conflict, that will not end well. And then the suicide question, the depression, you know, substance abuse in all of those situations, those are just pouring, you know, accelerants on a fire. And so I think addressing this is sort of that public health approach, like, from different angles, what goes into an injury event.
Because if there's one thing that's true about firearms compared to other mechanisms, they are highly lethal. So compared to other means for suicide, firearm suicides are on a case, fatality ratio the highest. You know, if it's overdosing on pills or cutting or. I mean, we don't like to talk about the other ways that people or any of the ways that people commit suicide. But if the means of firearms are removed from the equation, people who survive suicide. This was a statistic that really grabbed me when I heard it. Most people who survive suicide do not go on to die of suicide. So the thinking of, oh, well, you know, they're gonna try it again anyway, or they're, you know, this is an inevitable progression to death by suicide. That's really not true. And actually it's the opposite. It's only about 7% of people who attempt suicide and survive will eventually die by suicide. 93% of people will survive. So if you can intervene in a person's life or environment in a way that makes a suicide attempt less lethal, that person is likely to go on and die of something else. Most don't. You know, it's about 70% that don't even attempt again. And so surviving suicide becomes this sort of moment to change direction for whatever it is that goes into the suicidal ideation of that. That person.
And so decreasing the lethality of that event becomes an important sort of way to think about health and suicide. And I. I would love, you know, Mike, if sometime you had somebody on here to talk about suicidality and a Christian approach to that. And. And you probably have before. But.
But that particular component of firearm injury, we're losing that battle. I mean, in children and in adults, suicide is going in the wrong direction. And there are a lot of cultural and mental health explanations for that. But I think as Christian physicians, we have our eyes open to that, and those are our patients, too.
[00:33:48] Speaker C: How do you deal with your team, faculty, fellows, residents, all the way down, in terms of moral injury, moral stress, moral injury that's related to pediatric trauma, violence of any kind, firearms and otherwise?
How are you taking care of your team with a lot of tragedies that you encounter?
[00:34:08] Speaker D: Thank you for asking that. And I am thankful that it isn't nonstop that all day long.
I don't know that I would have a long career if that were all that I did. So I don't want to exaggerate that element of my practice. But those are significant events. And that phenomenon, especially for the medical students who come, or, you know, interns, where this is sort of their first sort of experience with pediatric trauma at all, much less lethal pediatric trauma, much less something that can be really gruesome, like firearms. So I would say there's some things that we do, and in a way it can never be enough. But one is we have a practice when a child dies in the trauma bay, to have a moment of silence. You can imagine that in any code of any patient at any age, there comes a point of decision to sort of say, we have really done everything that we can and doing more of what we're doing is not going to change the outcome. So we need to stop. If you subtract five minutes from that decision and say, we're going to everybody sit here for a few minutes, and we're just going to have a moment of silence and honor the life of this child. We actually have a little script that we do in the pediatric emergency department regarded to that. And if I'm leading it, I'll say a little prayer for the family and express appreciation for the efforts of everyone who contributed to honor the life of this child, this total stranger who came to us for help. And people really do put their hearts and souls into that, too. That is not enough to offset the grief of that, but it does acknowledge that. And so with that, it's usually a sense of let's follow up or for people to make an agreement with themselves that this is just because everybody has something else that they are going to go run off and do. And that's true. It doesn't mean this is okay or that that's the end of the matter, but to make an agreement with yourself that at some point I'm going to open up the bottle on this and let some of this stuff out and work through it with somebody. So I think that approach to it within the context of all the other things that we're doing in the emergency department or in the operating room or what have you, is probably the best that we can do, even though it's not enough.
[00:36:19] Speaker C: Yeah. But it's very intentional. I applaud you for that.
I'm going to completely switch gears because I want our listeners to know.
Been very involved in a project in Mongolia and just briefly talk about, because this is something that you care about deeply. Outreach in Mongolia.
[00:36:38] Speaker D: Yeah. Yeah. I have had the privilege of being part of mei Mongolia since 2018. Can't remember. No, it was earlier in that 2017.
And the previous project director, Sam Alexander, is a dear man and a good friend.
And he called me up out of the blue and said, hey, we're doing a series at the Children's Hospital there on congenital anomalies, and I'm looking for a pediatric surgeon. And he found my name in the.
In the roster of CMBA and gave me this cold call and he talked through it. So I had a privilege to go that very first time. And I made a connection with the pediatric surgeons at the sort of National Children's Hospital there.
And they're friends, they're people that I look forward to seeing again. And we. We laugh and joke and, you know, do operations together and talk about our kids and. And all of that. So it's in the context of education, which I appreciate because I'm at an academic place and I teach students in residence here, and I really enjoy the Mongolian students in residence there. So if anyone's interested in going to Mongolia, certainly in participating in Mei. I mean, Mei is everywhere. It's all over the globe. But Mongolia is a very dear place for me. And I've come to a point where, in terms of. Of my sort of overseas global surgery and missions activity, I really do want to focus on that. I mean, there's no end opportunities and the needs are so deep, so many places, and we need the Lord to raise up people to go and serve and help. But I found that with Mei Mongolia, to sort of have the option to play the long game with some of these folks, to establish friendships and. And certainly to participate in the healthcare part too. It's a fascinating country. I think it's got a lot going for it. It's got a fascinating history.
So it's a place that is enjoyable in that way, too. So, anyway, this isn't an interview About MEI Montgomery.
[00:38:38] Speaker C: I know you care a lot, and as I shared with you what we got going, I'm going with CMD's largest Mei Cuba team this weekend for a week to do some teaching there. And you don't have to be academic, you don't have. Have an appointment as a faculty to teach.
[00:38:54] Speaker D: That's right.
[00:38:55] Speaker C: So I think that's important for people to know. In fact, the founder of MEI was my chief of surgery and he was not an academic guy either, Dr. Bob Schindler, but he enjoyed instruction. He did lots of new things and like to share that with others.
So I do want to wrap up our time's drawing short, but I know another passion that you have, which I share with you is that spiritual well being for those in training, whether students, but especially residents and fellows, where the time crunch is difficult, on maintaining spiritual life that still is vibrant. What thoughts do you have as you went through that? And then you've seen other, I'm sure Christian residents and fellows come through your thoughts and insights on that.
[00:39:40] Speaker D: You know, one, just to sort of be in this moment for me and sort of participating in what is now a podcast. When I was a resident in general surgery, getting that CD in the mail of what was then Christian Doctor's Digest, it was, it was a lifeline for me, you know, because I'd be, you know, driving up in pitch black at 5 in the morning to go make rounds at the VA and it's pouring rain. I did residency in Oregon, so it's all, you know, miserable. You're driving up to Werliger, this sort of windy road, and, you know, the thought of sort of having a weekly Bible study at a fixed time and all that, like, like those were not those days. This is before, you know, work hour limitations and all of that. And so it can be very isolating even in the best of circumstances. I just found that having that sort of at my fingertips and listening to that on the drive up or the drive home, it was a real connection, even though it was just media. Right. But it was hearing people talk about the challenges of their practice, what they were thinking about, you know, there would be scripture in there and all that. So. So this particular activity that we're doing now had a very important place in my life at that time. And I think in residency we probably all come to a point of being completely at the end of our rope. I think, you know, we talked earlier about in your first and second year of medical school, at least back the way medical school used to operate, you Know, it was very sort of classroom oriented, and you had, you know, a fixed schedule and the thought of meeting people for lunch and reading the Bible, that was a very reasonable sort of way to connect and be fed.
You get to your clinical years and your schedules are all different, but the partitions on your time are more structured during the residency years.
I just found probably two or three years into residency, that feeling of, at some level, isolation.
There weren't a lot of other residents that I was around that were Christians. And even if there were, you're scattered around and every month you're changing gear. So it's not like you have sort of these fixed moments of connection and it's hard work and you're not good at it. That's why you have to learn it. So you have this feeling of imagining that I could do better than I'm doing, and you really start taking on responsibility for the lives of the patients that you're caring for, and you can't save them all. And there's a different gravity to that when you're their physician than when you're a student watching their physician and do the best they can. So I think that feeling of sort of hitting the wall, of I'm trying the best I can, but I'm coming up short on this. You know, a lot of us were married in residency. I'm, you know, coming up short as a husband. You know, we started having children in residency.
There are better fathers in the world than me. You know, just that sense of accusation, sadness and loss and, and what am I doing? And, and yeah, I would just encourage any resident who's hearing this, that God is with you, that the Lord convict me of a very real role for being a resident, of putting me in a place that other people weren't able to go and being in front of patients that. That had needs and needed compassion and care and that, that, that was also God's goodness. Even though being in a Bible study and praying together has, has a, A, a type of goodness as well.
It is a season in your life. It, it certainly, I mean, there isn't a day that goes by that I'm not hearing one of my sort of surgery faculty's voice in my head about something when I was in residency, like the longitudinal benefit of that time, professionally and otherwise, too. But just be encouraged, you know, that God hasn't forgotten you. He keeps all of his promises.
He's good to you in different ways. You know, I think, think I've been just increasingly aware of all the ways that we're told in the Bible that God does want us to know that he loves us. He wants us to experience his love as well. You know, he wants us to know it in, in a deep heart conviction sort of way. Not just I, that I acknowledge the forgiveness, but I experience that, that the Lord is near to all who call on him and he fulfills the desires of those who fear Him. He lifts us when we're down. And so Psalm 145, this is great stuff.
[00:44:07] Speaker C: Yes.
[00:44:08] Speaker D: Yeah, it's one thing to believe that and it's another to kind of be in the pit and experience that. And residency had some of those pit moments for me, but the Lord was good to me as well. I can say that looking back on it. And even in those moments that I just knew that God hadn't forsaken me or abandoned me to all of those shortcomings. So anyway, just an encouragement to the residents and some of that, that grace that came to me was through CMDA and getting those little CDs in the mail and, you know, listening to them. I mean, I had Christian friends and was part of a church to the best that I could be and those things too, not to the exclusion of that, but there was a particular grace of getting, you know, words from Christian positions in my car speakers as I'm driving up in the wee hours in the morning. So anyway, so it's, it's a real privilege for me to be on this and just sort of say thank you to you and everyone else at CMDA that does this because it does make a difference. And I'm one of those sort of testimonials for the value of this kind of thing.
[00:45:11] Speaker C: We've been working, John, on a brand promise, actually, with one of our board members and a task force and one of the interesting statements about cmda. We get you because we are you.
We do get you because we've been on this path and I pray for these residents that you've just now admonished. I'm so grateful that each one of them can find a John Petty somewhere in their institution, hopefully in their residency. But if not someone else been down this path that you've been and can encourage them. Also did not want to be remiss that we have produced a statement out of cmda, a Prevention of Firearm Violence Firearm Prevention Task Force that we had, that produced a position statement on a Christian healthcare professional's view on firearm violence. And that's available online. We'll have that in our show notes today. So thank you for your time in the middle of a clinic day, for joining us today. And thanks for being a part of our violence Response committee. John, Grateful for that.
[00:46:11] Speaker D: Well, Mike, I would just say thank you for taking the initiative on some of these things. These are very delicate things and people have a lot of emotions and perspectives. But I think if nothing else, we can model Christian charity towards each other and a willingness to listen and care about each other and want what's good.
There is not enough of that in our world right now. And so I'm very thankful for you and the leadership. In terms of, let's think through what, what does a Christian response to violence in health care look like? And can we step out in areas? Because we already do. I mean, you think of infectious disease and some of the things that our members are taking care of, like those are hard conversations and those are delicate personal choices. And it we're physicians, you know, we get this privileged position to be in those clinic rooms with the doors closed and talk about all manner of very personal and delicate things. But because we're what we want for them in those conversations is something really good.
And so this is just one more element of that. So I'm so thankful for your courage to kind of put this in front of CMDA in a new way, because I think it's a real healthcare problem and we haven't figured out all the solutions to it.
[00:47:25] Speaker C: All right, thank you for those words.
God bless you. Dr. John Petty. Thank you.
[00:47:29] Speaker D: Thanks, Mike.
[00:47:35] Speaker B: Many thanks to Dr. John Petty for sharing his wisdom and experience on such a difficult topic. His insights remind us that conversations about suffering and trauma, well, they're not only medical, they're also deeply spiritual opportunities to reflect Christ's compassion in the hardest places of our lives.
As Christian healthcare professionals, we're called not just to treat injury, but to help restore peace and hope in our hurting world.
If this episode encouraged you today, friends, please share it with a colleague, a student or a friend.
And be sure to follow Faith in Healthcare on your favorite podcast platform and social media to stay connected.
As mentioned, cmda, we've published a public policy statement on firearm violence. You'll find a link to all of our public policy statements in today's show notes. Or you can just go to cmda.org ethics and you'll find the long list of our ethics and public policy statements. You can also explore all of our CMDA resources, training opportunities and upcoming events by going to Our main webpage, CMDA.org you know, if you're not yet part of this growing and thriving community. We'd love to welcome you to cmda. We're here to help you walk faithfully and to equip you in your training years, your practice and beyond. You can visit CMDA.org join and become part of a 995 year old movement of Christ followers who are transforming health care through the love of Jesus Christ.
Next week I'm going to be joined by Dr. Brick Lance as co host and our guest, ICU physician and bioethicist Dr. Ewan Gallagher to probe the rise of physician assisted death and how Christians can respond.
He draws on Canada's trajectory and explains why language matters, why most requests stem from spiritual, not physical pain, and how our culture's obsession with autonomy leads to great despair.
He's also going to draw a clear line between euthanasia and true palliative care.
And Dr. Yuen offers a hopeful path path forward, robust palliative care, conscientious refusal, church anchored community and a recovery of medicine's true purpose. So you don't want to miss next week's episode thank you for listening today to Faith in Healthcare, the weekly podcast from CMDA where our mission remains the same, bringing the hope and healing of Christ to our world through committed Christ followers in healthcare. Like many of you listening today, that's what matters to cmda friends.
May you recognize this week, wherever you are in whatever you're doing, that the Lord is with you and that he is for you to do his good work. Thank you for listening and we will see you next time, Lord willing, on Faith in health care.
[00:50:54] Speaker A: Thanks for listening to Faith in Healthcare, the CMDA Matters podcast. If you would like to suggest a future guest, guest or share a comment with us, please email cmdamattersmda.org and if you like the podcast, be sure to give us a five star rating and share it on your favorite social media platform.
This podcast has been a production of Christian medical and dental Associations.
The opinions expressed by guests on this podcast are not necessarily endorsed by Christian medical and Dental Associations.
CMDA is a non partisan organization that does not endorse political parties or candidates for public office.
The views expressed on this podcast reflect judgments regarding principles and values held by CMDA and its members and are not intended to imply endorsement of any political party or candidate.
