As the anxious minutes click away in the pediatirc ICU, two doctors transform life-and-death struggles into opportunities for ministry.

Early in the morning, the Air-Evac helicopter lands at Phoenix Children's Hospital. Dr. Paul Liu quickly assesses the condition of 5-day-old Karrie Kirschoff, his newest ICU patient. She is mottled, pale, with gasping respirations and a pulse of 210. She's in serious trouble and failing fast.

The team swings into action, placing the baby on monitors. Suspecting overwhelming sepsis, Dr. Liu begins immediate resuscitation. They intubate, place arterial and central venous lines and order lab tests. As lab tests come back and further treatments are ordered, Karrie stabilizes and begins to improve slightly. Liu leaves her in the care of a resident and goes out to talk with the baby's parents, Mike and Kathi.

After introductions, he tells them, "Karrie is stable, for now. But she's still very sick, and we're not certain why. We're working on that, and we'll keep you informed. We'll do everything we can to help her." He pauses, knowing how tenuous is Karrie's grip on life, then adds, "We'll also do everything we can to help you, because we care about you, too."

By noon, the symptoms point toward toxic megacolon. Immediate surgery is needed. At 1:00 p.m., Liu visits the parents again, while the surgeon works. "These things can be so very stressful," Liu says. "I'd be interested in knowing where you look for comfort and support."

"I look to God and my church," Kathi replies.

"That's good," Liu says. "Faith makes a big difference in times like this."

Mike looks away, silently. Obviously, he doesn't share his wife's perspective, nor does he care to discuss it with Liu. The doctor makes a mental note to communicate this to his partner, Dave Tellez, who will handle Karrie's case overnight.

By 4:00 p.m., when Liu signs off to Tellez, baby Karrie is failing. Surgery has confirmed toxic megacolon, but the damage is too widespread for resection. Within the last hour, the medical team has begun using hand ventilation to augment the normal ventilator. Liu and Tellez discuss their options, including jet ventilation. They discuss how to help Mike and Kathi face what now seems inevitable, unless God intervenes with a miracle. Liu tells his partner about Mike's coolness toward spiritual things. As Tellez takes over, he begins watching for an opportunity to follow up with Mike.

Missionary Doctors

As far as Tellez and Liu are concerned, taking a "spiritual history" of their patients' parents is just part of providing quality care. Day after day, as they function in their chosen high-stress specialty, they make the most of every opportunity to let parents know that only faith in God can bring real peace while the life of their child hangs in the balance.

"We focus on the whole family," Liu says. "That's really our patient. When families are stressed, they don't do well if they don't know who is in control-God. If the child dies, most of those families end up divorced. And if the child is severely disabled, about half of those end up divorced. So when you fail to address these needs of the family, you're abdicating responsibility and practicing part medicine."

Dr. Tellez agrees, while admitting that doing medicine in this way was not always his goal. "For Paul, this is a fulfillment of his long-term goals," he says. "But for me, medicine isn't anything like I dreamed it would be as a non-Christian in medical school. I thought I'd be caring for people, working hard, enjoying a good job and relatively good standing in the community and be able to provide for my family. But those are such minor, minor benefits. The most phenomenal reward is the fulfillment and joy from helping others understand God's love for them. That is my focus, my ministry. It's probably the best experience any physician could ever attain."

Divine Placement Service

Despite their common commitments, Drs. Tellez and Liu did not end up working in the same ICU by their own design. Tellez had worked at Phoenix Children's as a resident and was invited back by the program director, after he finished a fellowship training at Children's Hospital of Los Angeles.

Liu's move to Phoenix was more a matter of strategy. As a resident at the Mayo Clinic, he had established a friendship with Dr. Yang Chen, who went on to the Medical Strategic Network. Near the end of their training, they discussed where they should try to position themselves for the greatest impact after they left Rochester. Liu's "assignment" was Phoenix.

"When I got there," Liu mused, "I was wondering, I'm in Phoenix..... whole new ground. Where do I start? Lo and behold, the very first day on the job I met Dave. He took me to pick up my car, which was being repaired. He noticed the fish symbol on the back of my car and asked if I was a Christian. I told him I was and asked if he was, too.

"Although Dave said yes, we didn't really pursue the question for quite a while. I was so new in town, about all I knew was where I worked and where my house was. Besides, when I asked Dave if he wanted to get involved in a Bible study, he turned me down. So I didn't know where he was in terms of faith. But I didn't give up, either. When we started to develop a medical missions outreach to Imuris, Mexico, I asked Dave to go there with me to scout it out."

Liu's goal was to light a fire in his partner's heart for ministry through medicine. Since that fact-finding trip, the doctors have led several missions to Mexico, with as many as 60 participants, including a number of physicians of various specialties. In 1992, their church asked them to spearhead a similar outreach to Argentina. This time, Tellez scouted the way.

Life Laboratory

While the medical missions trips got Tellez more involved in evangelism, attending his first Medical Strategic Network conference in 1989 clarified his vision for making his career his calling. After that, he began sharing the gospel with confidence with his patients and their families. The joy this brought into their lives-and his-encouraged him to continue. But a personal crisis in the summer of 1991 gave the physician a testimony that would make his ministry even more effective.

For several years, Tellez and his colleagues had enjoyed high community visibility through their work on drowning prevention. The news media relied on them as their source of information on these tragic mishaps. They were recognized as experts throughout the state.

Late one August afternoon, the doctor learned for himself how quickly a bouncy toddler can become a statistic, even with very careful adults nearby. Alaura, Tellez' 2-year-old niece, and her baby sister were staying with the Tellez family while their own parents vacationed. Alaura had been swimming with another child and two adults, when the Tellez baby started crying hysterically nearby. The swimmers climbed out of the pool, and everyone crowded around the infant to see what was going on-everyone, that is, except Alaura, who climbed into the spa without her floatees.

"I found her floating face down," Tellez recalled. "After four minutes of aggressive CPR, she took her first gasp. By the time the paramedics arrived, she had a pulse and regular respirations but was not very responsive."

Dr. Liu was waiting for them when the Air-Evac arrived at the hospital. "As I rushed in, I had this sick feeling in the pit of my stomach," Liu said. "We're trained to think of the worst possible scenario, and I knew Dave wouldn't be bringing her in unless she was fairly bad."

"It was touch and go for a while," Tellez added. "And of course I wanted to be in there. That was hard for me, knowing what I know. So they threw me out, gently, and treated me as they would any other parent or guardian, But Paul kept me updated, and throughout the night we all prayed for her-the nurses, residents and paramedics."

Alaura recovered quickly. By the next morning she was her normal self. She went home that very evening. With that crisis resolved, a press conference followed. This gave Tellez an even more credible platform to remind people about the importance of knowing CPR and how dangerous it is to let down your guard for even a few moments.

Tellez had also gained credibility in another sense. Prior to this, he had tried to comfort parents agoni7ing over the possibility their child might not survive. Suddenly, he understood their pain. Using this new understanding as a platform, he has been able to reach more parents or guardians with the truth that forgiveness and strength are available through faith in Christ.

Redeeming The Pain

This commitment motivated Tellez to speak to Mike Kirschoff, baby Karrie's father, in the early morning just a few hours before she died.

"I started where Paul had left off," he recalled, "then told Mike my own story, focusing on how hard it is to face things we can't control or change. I discussed my belief in God and how the knowledge that others were praying for us had helped when it was touch and go with Alaura. Mike was pretty stressed out and had a lot of questions, but eventually he prayed to receive Christ that night."

The change in Mike was immediate. Instead of fighting the tension, he began giving it to God through prayer. It also created a bond with his wife, Kathi, who had been praying for years that he would come to know Christ.

After Karrie died, Mike demonstrated the reality of his decision by requesting that the pastor include an evangelistic message in Karrie's funeral, which Drs. Liu and Tellez and their wives attended.

Although not every doctor-patient evangelistic encounter will turn out this way, Drs. Liu and Tellez believe any physician who wants to help patients with their spiritual needs can learn to do so effectively.

The first step is prayer, asking God to clarify your vision for touching lives in this way. You may not be able to do tag-team evangelism, but you can develop a style and content that fits your own context and personality. For example, Dr. Tellez is more likely to initiate a discussion about Christianity with colleagues as well as patients. Dr. Liu, by contrast, is less overt. He tries to plant seeds or leave impressions that result in others asking him about spiritual things.

A crucial next step is to verbalize the vision, preferably in writing. To get started, you might answer these questions: What does God want you to do in terms of outreach through your practice? Why is this important? How will it change the way you do medicine-, especially, how will it transform your medical activities from the provision of services to the fulfillment of a calling?

Just as doctors become most effective through skills training, the most effective evangelistic physicians invest time and energy to learn how to effectively share their faith. Drs. Liu and Tellez are regular faculty of the Medical Strategic Network, which offers seminars on evangelism nationwide.

The goal of this process is to help physicians integrate faith and medicine in their own setting and in their own way.

"Christian doctors are very busy folks doing all sorts of things that the church needs to get done," Dr. Liu explained. "Quite often they're frustrated because it seems that the church is competing with family time and work. But the trichotomy between family, work and ministry isn't necessary. They can be folded together into one specific vision."

Dave Biebel is director Of communications for the Christian Medical and Dental Society.