A good chunk of my time in the clinic is spent trying to help people with nerve pain. We have a small arsenal of medications that can be really helpful to keep this pain under control. There are several effective drugs which don’t have much or any addiction potential. Medical management of neuropathic pain usually requires playing Goldilocks until we find the drug and dose that is just right for the patient, balancing the benefits and side effects.
It can be surprisingly difficult sometimes to recognize the benefits of a therapy. I often have conversations in my clinic that go something like this:
ME: Last time you were here we tried increasing the dose on the gabapentin. How is that going?
PATIENT: I don’t notice any difference. I don’t think this med is doing anything.
ME: Are you having any side effects at the higher dose?
PATIENT: I did for the first week or two, but now I don’t really notice.
ME: What happens when you miss a dose?
PATIENT: I don’t feel any different.
ME: Alright, so you’re taking this medication but not really noticing any benefits of it, but you’re also not having any major side effects.
PATIENT: Yeah. So what do we do next?
ME: OK, here’s our options:
#1) Do nothing. Make no changes. This is always option #1.
#2) Increase the dose. Maybe we just don’t have it high enough to get traction yet.
#3) Stop taking it for a while and see if you miss it. Sometimes you don’t know how much a drug is helping until you take it away.
PATIENT: Let’s try stopping it, and we’ll see how it goes.
It is not unusual to get a call from the patient a few days after a conversation like this, saying that their symptoms got a lot worse and that now they want to increase the dose. Gabapentin is not the kind of medication that you take and feel better in 30-45 minutes — it’s the kind where you take it consistently on a scheduled basis for several weeks and over time it takes the edge off of your pain. Because the benefits accrue so gradually it is possible to overlook them entirely, and only notice them when they are gone.
There was a time in my life for several years when I didn’t attend church regularly. I would often miss my Sunday meetings for several weeks in a row, then attend once or twice before missing again for another month. Why was my attendance so spotty? Because other priorities were getting in the way.
I tried to rationalize that working in the hospital was an important, even essential, community service. And really there is no way of avoiding Sunday work in my profession. The greatest burden of weekend work at a teaching hospital falls on the trainees, and no amount of squirming or squealing on my part would have changed that fact. If I wanted to be a fully credentialed doctor someday, then working on Sunday — a lot of Sundays — was the only way to reach my goal.
But you know what? I missed going to church! Those years were hard on my soul. My faith in God’s healing power was weakened, and I didn’t have as much of God’s presence in my life.
When I graduated from residency and started attending church again every weekend there was a big difference in how I felt. It wasn’t anything specific, and I had a hard time putting my finger on what had really changed, but I certainly noticed it. I was walking down the church hallway with my wife about a month after I finished residency, and I kept saying how good it was to be in church again.
I once had a conversation with a man who felt that attending church meetings was not helping him in any way. His doubts were eroding away his testimony as he careened through a crisis of faith. He had decided to step away from the Church and its programs.
We spoke about uncertainty, and I told him about my personal experience of overcoming my doubts. He was interested in my experience, and appreciated my empathy, but I was not able to persuade him to reconsider his decision. In the end I simply told him that he was always welcome at church, and that we would love to have him come back some day.
As I watched this man walk out of the church building and into the parking lot I wondered how long it would take him to find his way back to the Lord. Would he ever come back, or would his life get stuck on some permanent detour? And what would happen to his precious children, who would grow up with less of the nurturing experiences of Church activity to gently grow their testimonies? Will the word some day grow in their hearts if their souls become choked with weeds, riddled with stones, or trampled to compactness?
I don’t recommend to anyone that they stop attending church meetings and activities. To do so is to lay aside your shield of faith, put down the sword of the Spirit, and take off your helmet of salvation. This world is spiritually dangerous, and you should not go through life without adequate protective gear. But to those who are bent on leaving and cannot be talked out of it, I would say, make sure you pay attention to the consequences. At some point down the road you should pause and take stock of how your life is different without the gospel. Are you happier? Are you more certain of your future? Are your children following your example, and is this a good thing for them to do during their formative years? Are you getting by okay without the association of committed disciples of Christ in your community? Are you better off without the Lord’s Church in your life? Or do you miss it?
Like medications for neuropathic pain, sometimes the benefits of church attendance are not apparent until you lose them. If you stop attending, you’ll probably miss it, but you might not realize what you’ve lost until you come back.
My purpose in writing this post is not to criticize or berate or even to judge the people who struggle in the Church because they have doubts or questions. I have those things myself, and I know from my own experience how hard it is to build, maintain, and defend faith, especially when logic appears to get in the way. This post was written in a spirit of understanding, respect, and earnest invitation.
I hope that the man I spoke with will someday have the same experience that I did of coming back to church and feeling the Lord’s blessings return to his life. Someday I hope he realizes that he has gone off course and will make his way back to the covenant path with his family.
Alan B. Sanderson, MD is a member of The Church of Jesus Christ of Latter-day Saints and is a practicing neurologist.