Almost 30 years ago I had the honor and privilege of hearing Dr. Bill and Annabelle Gilliam for a weekend conference at First Baptist Atlanta. They were gifted speakers.  As an auditory learner, I’m used to hearing and absorbing information by simply listening closely. Sometimes a boring speaker can have the most fascinating information. Lots of medical speakers fall into this category. Sometimes gifted speakers can expound upon utter nonsense. Lots of preachers, unfortunately, fall into this category.  The Gilliams were in the third category—gifted speakers with something important to say. One of the most memorable things they said that weekend was “The world’s definition of a hypocrite is someone who acts other than the way they feel; God’s definition of a hypocrite is someone who acts other than who they are.”


As a “good Christian” I applied this newfound truth to my life with all the gusto of an overzealous enforcement officer.  We all filter new truths through the lens of our own belief system; but, unfortunately, sometimes those “old truths” that comprise our belief system aren’t true at all.  As if I wasn’t already out of touch with my heart and emotions, I became convinced that my emotions didn’t matter. Emotions were “superfluous add-ons” that were given to us for the positive aspects of life only.  So-called negative emotions weren’t “Christian”.


I dearly loved my grandmother.  She was one of the happiest people I’ve ever known.  She loved all of us grandchildren intensely and she had a terrific sense of humor; but I think she unconsciously held this same belief—that good Christians don’t have negative emotions—and passed it on to me if not the rest of the family.


By the time I went away to college, I was “the happiest”, always full of good cheer.  Don’t get me wrong, a person can ignore negative emotions to the point that they don’t truly feel them anymore or at least stop recognizing them for what they are.  That’s not to say the emotions aren’t there lurking beneath the surface. You can be highly functional and successful always pretending to be happy.


Many professions are logic driven and there’s little place for emotions. I think this is particularly true of physicians.  You can’t be a blubbering puddle of tears during an emergency resuscitation. You can cry with a grieving relative but it’s “frowned upon” by the profession and it would not be appropriate to be wailing more than the family. Your job is to comfort not be comforted. Specialists who are frequently faced with end of life scenarios can become so numb to pain and suffering that they don’t seem human.  Being separated from your heart in this way can be an advantage in rare instances and even then it’s only temporary. The pediatric ER physician must eventually deal with the unexpected death of a child. An oncologist must process having to tell a patient they have three months to live.  The emotions are there and eventually will take their toll if not acknowledged and processed. But is this separation of head and heart real? No. It’s just pretend. It’s pretend life.


Jesus said, “I have come that you may have life and have it more abundantly.”  (John 10:10) What does that mean? Well, part of that truth is that we can live the life God intended, full of joy and sadness, contentment and desire, peace and anger.  Over the years I’ve come to understand more and more that part of being alive is to feel sorrow, longing, anger, grief, despair, etc. to live without feeling these emotions is to not be fully alive.


So back to the Gilliam quote, “The world’s definition of a hypocrite is someone who acts other than the way they feel; God’s definition of a hypocrite is someone who acts other than who they are.”  What do you do with emotions when they aren’t “appropriate”? What about the minister who had a fight with his wife on the way to church? What about the soloist who is feeling sad but has to sing a “happy song” at the podium?  What about the physician who is really angry (I mean REALLY angry!) at a betrayal yet must go see the family waiting in room three and smile while he asks, “Why are you here today?”


I’ve come to the conclusion that my emotions are real and legitimate.  “Appropriate” isn’t a word that should be applied to emotions. Behaviors are “appropriate” or “inappropriate”.  Emotions just—are. You can feel an emotion privately and consciously acknowledge it and yet sharing that emotion is a behavior.  There are intimate situations where I should be genuine and honest about my feelings and there are situations where to be genuine and honest about my feelings might be inappropriate.


Take the church worker for example.  A soloist or minister who is having a bad day shouldn’t let his emotions interfere with ministering to the congregation.  I recognize that there are times that emotion can be so overwhelming as to render us incapable of ministering to others whether on a platform or not; but there are times when life sucks and you gotta do what you gotta do.  Is that less genuine? Less honest? No. It’s just life.


The clearest example I know comes from my music training.  When I was in college I sang with a traveling ensemble. The minister who led the group taught us that when someone else was singing a solo, that you should look at that person.  If a member of the congregation sees you looking at the soloist, then their attention will be drawn back to the soloist and the message. If that same member of the congregation sees you looking around the room, then they will follow your gaze to see what’s so interesting and thus they are drawn away from the message.


I think this is a much better and clearer way of looking at our transparency with others.  If I feel bad and I’m singing a victorious song about what Christ has done for me, then I should sing it with an attitude of strength, victory, and over-comeness in spite of what I’m feeling inside at that moment.  If it’s a sad song then I should express that emotion.  Is it acting? Or ministering? Is the “performance” distracting from the message or is it drawing people to Jesus?


My initial interpretation of the Gilliam quote was wrong, plain and simple.  I see now the word “act” in their quote. They didn’t say that feelings weren’t  legitimate. It’s all about behaviors. Maybe a better translation of their quote, if you will, would be, “The world’s definition of a hypocrite is one who behaves differently than they feel; God’s definition of a hypocrite is one who behaves differently than who they are.”  I think that’s a much better definition of a hypocrite.

Of course, I have to process this definition through my own preconceived “truth”.


Jeff Cooper

Efficiency v Empathy

I love my job.  I think I like my job more than anyone else I know.  That’s not to say it’s not difficult or stressful at times, but the rewards far outweigh the stresses. My job is intellectually stimulating, emotionally rewarding, and even spiritually healing.  I’m a pediatrician.

As a pediatrician, my world is both “high tech” and “high touch”.  The tech part isn’t always a lot of fun but seeing a little face light up when they see me makes my face light up.  Oh, it’s definitely high touch.

Surprisingly, for one who loves these personal interactions, I love to be efficient.  My brain works in terms of processes.  How can I do this better?  How can I prevent errors?  How can I make the workflow smoother?  How can I reduce wait times without patients feeling like cattle and staff feeling overworked?  How can I meet the demands of my insurance and government overlords?   How can I design processes to get consistent outcomes across the entire office?  (With five providers and seven nurses that’s not always easy.)  I thrive when I can improve a process.  It makes my insides happy and gives me an internal attaboy.

When I was a resident at Emory, Grady had a horribly inefficient pediatric emergency room.  Don’t get me wrong, we were great at snatching a child from the jaws of death but we didn’t get to do that very often.  The ER—now called the ED everywhere (which I cannot wrap my head around because isn’t ED short for erectile dysfunction?)—anyway, the ER at Grady, unfortunately, was mostly about asthma, ear infections, rashes, sore throats, and a host of other non-emergency conditions.  Most of the time, I hated the ER rotation with its all-night shifts of nothing but ambulatory problems.

One New Year’s Eve (maybe I should say New Year’s morning since it was 1:00am!) I saw a mom with five kids in tow. They all had ringworm. I dutifully filled out the charts and wrote their prescriptions for griseofulvin.  At the end of the encounter, I asked mom why she had brought 5 kids at midnight on New Year’s for ringworm.  Her exact words? “I knew there wouldn’t be a wait.”  Her logic was impeccable.

When I was a senior resident, however, a new attending took over the Grady ER.  Within weeks it was a different place.  She created a whole new triage category called “R-GO” which stood for routine-GO. This was meant for those quick easy to treat ambulatory illnesses.  She assigned a resident to just see R-GOs regardless of whatever else was going on in the ER.  She assigned two exams rooms and a nurse to assist the resident.  It was like a miracle overtook the place.  Wait times went down.  Patient and physician satisfaction went up.  I loved it.

One morning I was assigned to do R-GOs.  I told the nurse I wanted to see how many we could do in one hour.  She was all in.  Admittedly my documentation wasn’t nearly as thorough as modern requirements dictate but we managed to see 12 kiddos in one hour and averaged 8 per hour that shift.  I finished mentally exhausted.  Have you ever been to the point that you just don’t want to make another decision?  Just choose my food.  I don’t care.  The attending said to me that day, “Jeff, you are going to be enormously successful in private practice.” Praise was rare during residency.

Because of my love for efficiency and my need to run an office to my own high exacting standards, I had a morning recently that was very frustrating. Nothing seemed to go right and my “efficiency” was thwarted from all sides.

My second patient, a teenager, wasn’t just depressed, but full-blown suicidal.  I do enjoy psychiatric care but nothing will blow up your schedule like a depressed teenager.  By the time I had made arrangements for her immediate care to prevent her from harming herself, I had six patients waiting for me—one for 45 minutes.

My next one was a 13-year-old new patient with chronic encopresis.  For those of you not in medicine, this kid was crapping his pants routinely.  Encopresis usually starts as a psychological problem.  A kid, usually a boy, with a need to control something about his life will refuse to use the toilet to the point that his colon is swollen and loses feeling. They can even develop a “megacolon” that interferes with proper bowel function.  Encopresis is never easy to treat but this kid had been at it for many years!  These boys are usually 7-9 years old when mom brings them in—not 13!  Treatment requires a bowel cleanse and chronic management to restore proper function. This requires a lot of patience and family education.

My next one was 21 years old and in 10 grade!  The next one was a new 13-year-old with five psychiatric diagnoses. My next one was an Indian mother (a doctor no less) who was very angry that she had had to wait.  After a couple of “routine patients” (as if there ever were such a thing), I had a mom argue with me about vaccines.  It took all my strength and patience to be polite when she told me that I “didn’t understand what was in vaccines”.  Good Lord, I wanted to slap her.

It was a hard day and I was frustrated.  My head hurt and I did not want to take my mood home with me.  I turned to Jesus with my frustration.

“Jesus, what was this about? Could it have been any worse?  I felt like I was hanging on by my fingernails to some semblance of orderliness and efficiency.  Today was not my best work.”

“Yes it was.”

“Pardon?  Jesus, you thought that was good work?”

“Jeff, today you rescued a girl from suicide.  You gave a mother and her son a hope of restoration that he won’t be going to high school next year pooping his pants.  You encouraged, you held hands, you walked alongside.  Sometimes efficiency isn’t about seeing more patients but about following me as we rescue the hurting.  You are my son and I am well pleased.”

“Thank you, Jesus, for trusting me with the greatest job on earth.”