Published SOAP Notes
Date: 5/1/2019 Title: The Banquet is Ready Proverb: 9:2 Scripture “[Wisdom] has made ready a banquet feast and the sacrifice has been killed. She has mingled her wine, and the table’s all set.” Proverbs 9:2 (TPT) Observation Everything has already been prepared for us to feast at Wisdom’s table. All we have to do is enter in. Application Proverbs 9 contrasts Lady Wisdom with Madame Folly. Let me contrast two patients that I recently saw in consultation who illustrate this point. For each patient, I had ordered imaging and lab work during our first appointment and started a medication that I felt was appropriate for each person’s condition. In follow-up, Patient #1 had started the medication and completed the lab work and imaging. She was already feeling much better, and the test results helped us develop a further treatment plan. Like Lady Wisdom, Patient #1 was prepared. Patient #2, on the other hand, was full of excuses. “Well, I haven’t had time to get the tests done, and I read on the internet that the medication you prescribed could make me grow hair on my knuckles, so I didn’t take it.” Patient #2 followed the path of Madame Folly. In the spirit of not trying to remove the splinter from my friend’s eye before dealing with the log in my own, I realized something. Lady Wisdom has already prepared everything that we need to enter into her realm of blessing and favor. The sacrifice has been killed, the wine has been mingled, and the table’s all set. Everything has been prepared, but God will not force us to enter in. Only we can make that decision. Prayer Father, thank You that You have prepared a banquet of wisdom and blessing for us. I choose to enter into all that you have prepared for me. Help me to remain conscious today of the banquet table You have prepared for me. Amen. Peter Osterbauer M.D. Neurology Anchorage, Alaska |
July 1, 2019
PROVERB 1 : 21-32
TITLE: A Time Limit for Restoration
SCRIPTURE:
‘Yet Wisdom’s Song Is Not Always Heard In The Halls Of Higher Learning. But In The Hustle And Bustle Of Everryday Life Its Lyrics Can Always Be Heard Above The Din Of The Crowd.
Foolish ones, how much longer will you cling to your deception? How much longer will you mock wisdom, cynical scorners who fight the facts? Come back to your senses and be restored to reality.
I’ve called to you over and over; still you refuse to come to me…
Because you have laughed at my counsel, and insisted on continuing in your stubbornness
I will laugh when your calamity comes, when your catastrophe comes like a hurricane,
You will cry out to me, then it will be too late to expect my help. I will be nowhere to be found.
Like an idiot you’ve turned away from me and chosen destruction instead.
Your self-satisfied smugness will kill you. “ (TPT)
OBSERVATION:
This man had been an electrician, but now was in a residential facility for an alcohol use disorder. He looked great after a 90 day stay, and arrangements had been made for a transition to a sober living residence. He refused, chafing at the thought of the facility’s structure After discharge he began drinking, and wanting to be readmitted, but bringing a water bottle filled with alcohol to his intake. He eventually was placed in a house paid by the state where individuals would have housing but could continue to drink. He was the 1st to die there.
APPLICATION:
I’ve often wondered if a time comes when change is impossible with the refusal of many invitations, much instruction, and much warning. As a physician, my patients and I have participated in our own ‘Shakespearian tragedies’. I have trained and read my lines, and my clients have rehearsed theirs. The level of deception witnessed has been sobering..
PRAYER: God, help me not to miss the invitations you give me to gain your wisdom. Cause me to seize every opportunity, that will prevent me from being deceived.
Paula Colescott M.D.
Internal Medicine
Anchorage, Alaska
PROVERB 1 : 21-32
TITLE: A Time Limit for Restoration
SCRIPTURE:
‘Yet Wisdom’s Song Is Not Always Heard In The Halls Of Higher Learning. But In The Hustle And Bustle Of Everryday Life Its Lyrics Can Always Be Heard Above The Din Of The Crowd.
Foolish ones, how much longer will you cling to your deception? How much longer will you mock wisdom, cynical scorners who fight the facts? Come back to your senses and be restored to reality.
I’ve called to you over and over; still you refuse to come to me…
Because you have laughed at my counsel, and insisted on continuing in your stubbornness
I will laugh when your calamity comes, when your catastrophe comes like a hurricane,
You will cry out to me, then it will be too late to expect my help. I will be nowhere to be found.
Like an idiot you’ve turned away from me and chosen destruction instead.
Your self-satisfied smugness will kill you. “ (TPT)
OBSERVATION:
This man had been an electrician, but now was in a residential facility for an alcohol use disorder. He looked great after a 90 day stay, and arrangements had been made for a transition to a sober living residence. He refused, chafing at the thought of the facility’s structure After discharge he began drinking, and wanting to be readmitted, but bringing a water bottle filled with alcohol to his intake. He eventually was placed in a house paid by the state where individuals would have housing but could continue to drink. He was the 1st to die there.
APPLICATION:
I’ve often wondered if a time comes when change is impossible with the refusal of many invitations, much instruction, and much warning. As a physician, my patients and I have participated in our own ‘Shakespearian tragedies’. I have trained and read my lines, and my clients have rehearsed theirs. The level of deception witnessed has been sobering..
PRAYER: God, help me not to miss the invitations you give me to gain your wisdom. Cause me to seize every opportunity, that will prevent me from being deceived.
Paula Colescott M.D.
Internal Medicine
Anchorage, Alaska
July 2, 2019
PROVERB 2: 3-6
TITLE: Wisdom, Hard Won
SCIPTURE: “ ….Train your heart to listen when I speak and open your spirit wide to expand your discernment—Yes, cry out for comprehension and intercede for insight.
For if you keep seeking it like a man would seek for sterling silver, searching in hidden places for cherished treasure, then you will discover the fear of the Lord and find the true knowledge of God.
Wisdom is a gift from a generous God, and every word he speaks is full of revelation.” (TPT)
OBSERVATION:
Proverbs 1 states that wisdom clamors to be heard. Here, it is the pupil who must clamor.
“Yet the search strenuous as it must be, is not unguided. Its starting point is revelation—specific (words) and practical (commandments); its method is not one of free speculation, but of treasuring and exploring received teachings so as to penetrate to their principles; and its goal, far from being academic, is spiritual: the fear of the Lord…..the knowledge of God. With these two phrases the Old Testament terms for true religion are encompassed: the poles of AWE and INTIMACY.” (Derek Kidner)
APPLICATION:
I surmise that pursuing God is much like pursuing excellence in medicine. It requires strenuous training in listening. It is not an arena of random speculation but a challenge to launch out on an adventure of sounding the depths of various principles solidified over years of testing. It has brought me to my knees.
PRAYER:
You are a generous God making a gift of wisdom. Here I am, clamoring for revelation. I long for a life of ‘true religion’—a life before you of awe and intimacy.
Paula Colescott M.D.
Internal Medicine
Anchorage, Alaska
PROVERB 2: 3-6
TITLE: Wisdom, Hard Won
SCIPTURE: “ ….Train your heart to listen when I speak and open your spirit wide to expand your discernment—Yes, cry out for comprehension and intercede for insight.
For if you keep seeking it like a man would seek for sterling silver, searching in hidden places for cherished treasure, then you will discover the fear of the Lord and find the true knowledge of God.
Wisdom is a gift from a generous God, and every word he speaks is full of revelation.” (TPT)
OBSERVATION:
Proverbs 1 states that wisdom clamors to be heard. Here, it is the pupil who must clamor.
“Yet the search strenuous as it must be, is not unguided. Its starting point is revelation—specific (words) and practical (commandments); its method is not one of free speculation, but of treasuring and exploring received teachings so as to penetrate to their principles; and its goal, far from being academic, is spiritual: the fear of the Lord…..the knowledge of God. With these two phrases the Old Testament terms for true religion are encompassed: the poles of AWE and INTIMACY.” (Derek Kidner)
APPLICATION:
I surmise that pursuing God is much like pursuing excellence in medicine. It requires strenuous training in listening. It is not an arena of random speculation but a challenge to launch out on an adventure of sounding the depths of various principles solidified over years of testing. It has brought me to my knees.
PRAYER:
You are a generous God making a gift of wisdom. Here I am, clamoring for revelation. I long for a life of ‘true religion’—a life before you of awe and intimacy.
Paula Colescott M.D.
Internal Medicine
Anchorage, Alaska
May 31, 2019
PROVERBS 2:6
TITLE: Seeing the Morning Sun
Scripture
The path of the righteous is like the morning sun, shining ever brighter till the full light of day. Proverbs 2:6 (NIV)
Observation
The Spirit of God lights our way and brings His Light to the lives of those we serve.
Application
Many of the people we care for are in positions of little or no hope. The medical world is filled with negativity. Many medical professionals do not believe in God and have no hope themselves. It is difficult to give something that you do not have.
This is where we, as children of God disguised as physicians, come in. We can bring the Light of God’s hope and love to these people who are without hope. And by “these people,” I do not only mean our patients. We can shine God’s Light to our patients, their family members, our colleagues and staff, and anyone else within our circle of influence.
As this Scripture suggests, the Spirit of God in us can be like light the sun entering dark, hopeless lives, shining brighter and brighter until they are able to see the Light for themselves.
Prayer
Father, bring to us today those who need to see Your light. Let Your Light shine brightly through us, warming them with Your love and hope until they are able to see Your Light for themselves. Amen.
Peter Osterbauer M.D.
Neurology
Anchorage, Alaska
Date: May 31, 2019
Proverbs 2:6
Title: Bind Them Around Your Neck
Scripture
Let love and faithfulness never leave you; bind them around your neck, write them on the tablet of your heart. Proverbs 2:6 (NIV)
Observation
As physicians, we must remember to work from a position of love and faithfulness.
Application
We physicians are often looked up to by our patients, coworkers, and communities. It can be easy to buy into this elite image and forget that we are servants. I remember as a medical student, wearing my stethoscope around my neck as a badge of honor. In my heart, though, I felt that it also conveyed a symbol of superiority. How misguided I was!
Rather than hanging a stethoscope around our neck, this Scripture encourages us to bind love and faithfulness around our neck. Jesus told us that to be great in the Kingdom of God, we must become servants (Matthew 20:26-27). Let us remember that the title of physician does not make us greater than any of His other children. In fact, we are to be servants to those who are under our care.
Prayer
Father, help us to remember our place in Your Kingdom. It is a great honor and privilege to be a physician, but more than that, you have honored us by entrusting us with the lives of Your children. May we wear love and faithfulness around our neck as a spiritual stethoscope to bring Your love and healing to Your children. Amen.
Peter Ostebauer M.D.
Neurology
Anchorage, Alaska
July 6, 2019
Proverb 6: 6-11
TITLE: Having The Mind Of An Ant
SCRIPTURE:
When you’re feeling lazy, come and learn a lesson from this tale of the tiny ant…enter into wisdom.
The ants have no chief, no boss, no manager—no one has to tell them what to do.
You’ll see them working and toiling all summer long, stockpiling their food in preparation for winter.
So wake up…. How long will you lie there?
When will you wake up and get out of bed?
If you keep nodding off and thinking, I’ll do it later,” or say to yourself, “I’ll just sit back awhile and take it easy.” Just watch how the future unfolds!
By making excuses you’ll learn what it means to go without.
Poverty will pounce on you like a bandit, and move in as your roommate for life.
OBJECTIVE: I think these tiny subterranean insects have chosen to live in every moment, with no one having to tell them what to do with that moment. They must have some internal sense of the season they are in, and that for the few months they live, they can participate in a grand plan involving their colony. And so, knowing there is a time to cast away stones, and a time to gather stones together, a time to seek, and a time to lose; a time to keep, and a time to cast away, they create tunnels of provision. They are resourcing a hidden Kingdom.
APPLICATION: I feel tiny as an ant. But as tiny as that ant is, it just isn’t sprawled out on some sand heap, hopelessly overwhelmed by the goings on of those stepping above them. The ant’s kingdom isn’t one created by the mighty. It is a future hollowed out by tiny individuals, who consistently carry very small burdens in the world’s eye. Such individuals will always have the resources of a ‘hidden provision’.
PRAYER:
Show me the season I’m in. Place me in the right colony. Keep me awake, and create a resolve in me that hates excuses.
PJ Colescott M.D.
Internal Medicine
Anchorage, Alaska
June 8, 2019
TITLE: Waiting at the Doorway
SCRIPTURE: Proverbs 8: 17,34,35
“If you wait at wisdom’s doorway, longing to hear a word for every day, joy will break forth within you as you listen for what I’ll say.
For the fountain of life pours into you every time that you find me; and this is the secret of growing in the delight and the favor of the Lord.”
“I will show my love to those who passionately love me. For they will search and search continually until they find me.”
OBSERVATION:
Wisdom is not found by the half- hearted. One must love wisdom to gain it. A superficial desire will only yield a superficial knowledge
APPLICATION:
A life without delight or knowing for sure I had the favor of the Lord, would be unbearable.
From these verses I understand that God has a particular word of wisdom for ME every day, that will cause joy to break forth within me, as I wait at His door to hear it.
PRAYER:
I am on the search for you. I have determined to continue it. Today let me find you.
PJ Colescott M.D.
Internal Medicine
Anchorage, Alaska
TITLE: Waiting at the Doorway
SCRIPTURE: Proverbs 8: 17,34,35
“If you wait at wisdom’s doorway, longing to hear a word for every day, joy will break forth within you as you listen for what I’ll say.
For the fountain of life pours into you every time that you find me; and this is the secret of growing in the delight and the favor of the Lord.”
“I will show my love to those who passionately love me. For they will search and search continually until they find me.”
OBSERVATION:
Wisdom is not found by the half- hearted. One must love wisdom to gain it. A superficial desire will only yield a superficial knowledge
APPLICATION:
A life without delight or knowing for sure I had the favor of the Lord, would be unbearable.
From these verses I understand that God has a particular word of wisdom for ME every day, that will cause joy to break forth within me, as I wait at His door to hear it.
PRAYER:
I am on the search for you. I have determined to continue it. Today let me find you.
PJ Colescott M.D.
Internal Medicine
Anchorage, Alaska
June 9, 2019
TITLE: I am not alone
SCRIPTURE: PROVERB 9: 11,12
“For with me, your days will be increased; years will be added to your life.
If you are wise, your wisdom helps you; but if you scoff, you bear the consequences alone.”
“I, wisdom, live together with caution; I attain knowledge and discretion. Good advice is mine, and common sense; I am insight, power is mine.” Prov. 8: 12,14
OBSERVATION:
Could this really mean that if wisdom were applied to every facet of a life, days and years of a life would increase? Or does it mean that the days would be fuller, the years fuller?
It is one thing to make a horrible choice, but how debilitating would it be to have to bear the consequences alone? I see loneliness in a new light; it has been with me when I have refused the wisdom offered.
APPLICATION:
Wisdom came alongside Bill and Bob when they formed the principles of AA and many individuals had years added to their lives when they stopped drinking. A middle-aged mother, alcohol dependent, came to treatment after her children cut off all communication and forbade her to see her grandchildren. Her husband moved her out of the home; her marriage was shattered. When she was receptive to wisdom gained through research regarding the treatment of bipolar disorder and alcoholism, she began taking stock of her overall health. A very early breast cancer was discovered, and eradicated. With the wisdom God gave men regarding these illnesses, her days were lengthened and enriched, and she regained her family, home, and marriage. Had she scoffed at wisdom, she would have been left alone to bear the consequences.
PRAYER:
Of all the friends I would desire, let it be Wisdom who is described in Prov. 8:30
“I was with him as someone he (God) could trust. For me, every day was pure delight, as I played in his presence all the time, playing everywhere on his earth, and delighting to be with humankind.”
PJ Colescott M.D.
Addiction Medicine
Anchorage, Alaska
TITLE: I am not alone
SCRIPTURE: PROVERB 9: 11,12
“For with me, your days will be increased; years will be added to your life.
If you are wise, your wisdom helps you; but if you scoff, you bear the consequences alone.”
“I, wisdom, live together with caution; I attain knowledge and discretion. Good advice is mine, and common sense; I am insight, power is mine.” Prov. 8: 12,14
OBSERVATION:
Could this really mean that if wisdom were applied to every facet of a life, days and years of a life would increase? Or does it mean that the days would be fuller, the years fuller?
It is one thing to make a horrible choice, but how debilitating would it be to have to bear the consequences alone? I see loneliness in a new light; it has been with me when I have refused the wisdom offered.
APPLICATION:
Wisdom came alongside Bill and Bob when they formed the principles of AA and many individuals had years added to their lives when they stopped drinking. A middle-aged mother, alcohol dependent, came to treatment after her children cut off all communication and forbade her to see her grandchildren. Her husband moved her out of the home; her marriage was shattered. When she was receptive to wisdom gained through research regarding the treatment of bipolar disorder and alcoholism, she began taking stock of her overall health. A very early breast cancer was discovered, and eradicated. With the wisdom God gave men regarding these illnesses, her days were lengthened and enriched, and she regained her family, home, and marriage. Had she scoffed at wisdom, she would have been left alone to bear the consequences.
PRAYER:
Of all the friends I would desire, let it be Wisdom who is described in Prov. 8:30
“I was with him as someone he (God) could trust. For me, every day was pure delight, as I played in his presence all the time, playing everywhere on his earth, and delighting to be with humankind.”
PJ Colescott M.D.
Addiction Medicine
Anchorage, Alaska
Date:5/28/19
Proverb Chapter and Verse: Proverbs 18:10
Title: The High Tower
Scripture: “The character of God is a tower of strength, For the lovers of God delight to run into His heart And be exalted on high”
Observations:There is a place of strength, a high tower, an impenetrable fortress, that is available. It is not an ordinary place. It is not the hiding places I’ve chosen in the past---Those places that conceal me in darkness, to cower and catastrophize. (The Hebrew word Migdal, translated “tower of strength” is a homonym that can also be translated “bed of flowers”) It is God’s parental character to not only know I am tired and afraid, but to see me running, and to bend time and circumstances so I can reach Him. He does not tire of embracing me, lifting me from the ground He formed me from, and exalting me with a kiss.
Application: As a physician, I’m always running. I will run into the heart of God. I’ll be delighted to find more than just a perspective beyond my own.
Prayer:
You’ve given me legs.
Now, give me the strength to run.
Here I come.
Open your arms.
I’m running.
Paula Colescott M.D.
Internal Medicine
Anchorage, Alaska
Date:5/28/19
Proverb Chapter and Verse: Proverbs 18:10
Title: The High Tower
Scripture: “The character of God is a tower of strength, For the lovers of God delight to run into His heart And be exalted on high”
Observations:There is a place of strength, a high tower, an impenetrable fortress, that is available. It is not an ordinary place. It is not the hiding places I’ve chosen in the past---Those places that conceal me in darkness, to cower and catastrophize. (The Hebrew word Migdal, translated “tower of strength” is a homonym that can also be translated “bed of flowers”) It is God’s parental character to not only know I am tired and afraid, but to see me running, and to bend time and circumstances so I can reach Him. He does not tire of embracing me, lifting me from the ground He formed me from, and exalting me with a kiss.
Application: As a physician, I’m always running. I will run into the heart of God. I’ll be delighted to find more than just a perspective beyond my own.
Prayer:
You’ve given me legs.
Now, give me the strength to run.
Here I come.
Open your arms.
I’m running.
Paula Colescott M.D.
Internal Medicine
Anchorage, Alaska