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From Luke’s Journal June 2018 | Vol. 23 No.2 | Disarming Disability

What follows is the major part of the story as to how I progressively became more unwell at work until I could no longer continue. I also include some of the reactions I experienced as a Christian, and the encouragements I found. My hope and prayer is that it may help someone, in some way, to cope with comparable circumstances. 

2002 – 2004

In 2002, I was 50 and married to Catherine with three young children. I had been working at an essentially solo general practice for about 9 years when I was diagnosed with bronchiectasis and hypertension. This required hospitalisation on average three times per year for intravenous antibiotic treatment of the bronchiectasis. 

In early 2003, investigations of ongoing nausea, weakness, malaise, fatigue and palpitations revealed an undetectable serum cortisol and low ACTH levels. My endocrinologist thought that the hypothalamic-pituitary-adrenal axis suppression was due to inhaled steroids I was taking for asthma, and that it would spontaneously resolve in some months. When it didn’t, I began to pray earnestly that God would heal me of the adrenal insufficiency because I found it to be quite distressing and disabling. The symptoms were worsened by illness and also by the natural stress of working. However, months rolled into years with no improvement, until it became evident that God had chosen not to heal me.

“However, months rolled into years with no improvement, until it became evident that God had chosen not to heal me.”

At that time, I was working full-time at the medical practice – ten to eleven sessions per week – but unable to find anyone to work part-time with me. Because of the worsening in my conditions I attempted to sell the medical practice. However, this proved fruitless, because it was a unit under lease in a shopping centre. So, in early 2004, I closed the practice.

2004-2012

I then began work with a group of general practitioners who opened a practice nearby. Here I worked part-time, six sessions per week, and initially this greatly eased the pressure I was under and my quality of life improved. 

By 2012, however, my condition had deteriorated and, because of weakness and fatigue, I had begun to miss going to work and to church on Sundays. In April 2012, I experienced an episode of idiopathic multiple bilateral pulmonary emboli. The symptoms mimicked those of my bronchiectasis exacerbations, which meant that future similar symptoms had to be treated with caution.

“By late 2012, in view of an ongoing decline in my health and the difficulty I was having managing my weakness, anergia and fatigue at work…”

By late 2012, in view of an ongoing decline in my health and the difficulty I was having managing my weakness, anergia and fatigue at work despite using supra-physiological doses of Prednisone (10 mg or more), my endocrinologist advised me to stop work and take a total and permanent disability (TPD) payout. When Catherine and I calculated what living expenses would be required and to put our three children – then at high school – through University, by depending for five years on my income protection and then on the payout, we determined that we couldn’t afford for me to cease work. So I renewed a decision I had made earlier, that I would aim to work until the age of 70, if God permitted. 

January – July 2013

By 2013, it seemed as though I was contracting a virus every two weeks on average, despite wearing a face-mask. These would then magnify my adrenal symptoms. Between the beginning of March 2013 and the end of July, I had five hospital admissions. As well, in the two or three months prior to July, I was missing about a day a week due to sickness. I often went to work feeling unwell with malaise and weakness and my symptoms would progressively worsen during the day. By the end of the day, I would experience breathlessness, chest tightness and pain. This limited my quality of life severely and was virtually beyond my ability to cope. Throughout this time, my medical judgment would come to the fore and insist that this situation could not continue. 

After each admission, I was able to have a graduated return to work. However, by early July I simply could not work. A number of times I arranged for the receptionists to book patients in to see me but, on each occasion when the time came, I was too unwell to work.

July 2013 onwards 

For some months before stopping work I had been feeling depressed and suffering insomnia. In July, I became deeply conflicted – wanting to work to provide for my family, yet simply unable to. And to my shame, I must confess that I was distrustful of God. So I was admitted to hospital yet again – this time to treat depression. During the admission, under the oversight of the psychiatrist treating me, I made the decision to discontinue work and to accept that I was no longer capable of it. This decision was based not just on my current state, but on the progressive decline in my health over eighteen months or more. It was also during this time in hospital that God made Himself more precious to me. Richard Sibbes wrote: “God is nearest to us when we are in our greatest straits.” That was my experience – I can truly say that this ultimately compensated for the suffering.

Because my income had ceased, and it took perhaps two months to receive the first payment from my income protection, we had no cash flow for a time. Since we were without any savings, we struggled to buy food, even groceries, and didn’t know what to do. Then something startling happened. We started to receive cash donations. I was quite overcome by this, having not expected it at all. This continued until my income protection payments commenced. These people displayed fine acts of Christian kindness and love. It also reflected the immense care and love of God who had moved them to take this course of action. He who feeds the ravens did not fail to feed the Greenburys! 

“It also reflected the immense care and love of God who had moved them to take this course of action. He who feeds the ravens did not fail to feed the Greenburys!” 

My income protection was accepted promptly on the basis of letters from two specialists, but the process of seeking a total and permanent disability payout was quite the opposite. 

When the TPD insurance company asked to examine my bookings for some of the time before I had stopped work, I found that my policy stated that I had to have worked a minimum average of fifteen hours per week in the six months prior to ceasing work to be eligible for a payout. This came as a shock to me. Time spent outside of appointments, such as arriving earlier and leaving later in order to peruse results, letters, etc. was not included. Fortunately – no, I should say providentially – my average was a little over sixteen hours! 

In December, 2013, I received notification that I was required to be assessed by an independent medical examiner (IME) which was booked for six weeks’ time. I contacted the AMA legal team who advised me that the IME could overturn the judgments of my specialists. The insurance company had earlier indicated that they expected me to deregister myself – which I had done in September 2013. So I faced the dismal prospect that the TPD payout might be denied to me, which would then cause my income protection to cease – and I was deregistered! 

However, thankfully, the IME agreed with my doctors’ judgment. Shortly afterwards, one of my specialists sent me to a neurologist to investigate ocular symptoms I was experiencing. The neurologist found, incidentally, that I had a mild cognitive impairment. Shortly after this I was granted the payout, some nine months after I had discontinued working. Though this seemed an extended period to me, some have told me that TPD payouts can take much longer to be approved.

Provision despite Anxiety

The period from July 2013 to April 2014 was a very dark time for me. Throughout it I suffered a lot of anxiety. I would continually ask for forgiveness for my lack of faith and prayed for faith to endure. I would often remind myself of God’s promises of earthly provision (Phil 4:19; Heb 13:5 and Matt 6:31-33). A further source of abiding comfort was the recollection of divine providence.

“When I look back on the many times I cried out to God not knowing how to continue or what to do, I see that my anxious concerns were for nothing.”

When I look back on the many times I cried out to God not knowing how to continue or what to do, I see that my anxious concerns were for nothing. He always sorted out the problems. Though He gave me the answer “No” a number of times, I know that He does all things well and will ultimately direct all things for my family’s and my welfare (Rom 8:28). Finally, communion with God and Christ would often bring me a deep-seated joy and comfort in the midst of outward turmoil. 

From 2014 onwards the frequency of infections gradually reduced. Now, though I cannot work, I have a new-found quality of life. And God has enabled us to manage financially. In view of all this, I believe I can gratefully acknowledge with Samuel, “Up to this point the LORD has helped us!” (1Sam 7:12).

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