I thought I might be slipping away again… but obviously I didn’t. This was not the first time, nor the second. Over the past six years since my injury I have experienced several occasions when I thought I was – face-to-face with death. Most of these were in times of sickness, but this one was not.

I had been in the Richmond Virginia VA Medical Center for about a week. Nothing was wrong; disabled vets are awarded several days each year of “respite care.” This provides caregivers a well-earned and often needed break. I’ve been going to Richmond VAMC several times for various needs and am relatively comfortable with the care they provide me. Nevertheless, after a week I was glad to be going home. Before I went however, I had an appointment at the podiatry clinic. The plan was that Judy would meet me at the clinic. Then we would grab my gear and head for home.

Lunch was served in my room and as I ate, I began to perspire. I recognized this as a warning signal and had my nurse check me over. Everything seemed in order. So I went to my appointment – only had to wait 30 minutes. During my interaction with the podiatrists, I realized that I had continued perspiring. The back of my head was wet with sweat and I was feeling flushed. By now Judy had joined me and was immediately aware of my discomfort. She checked for blockages in my drainage tube – everything looked okay. My distress persisted. We went back to my room.

Once in the room, Judy again inspected my tube for blockages and sought the assistance of my nurse. They worked together attempting to alleviate my problem, irrigating my catheter. By now, my blood pressure was elevated and so was my pulse. Someone noticed a small white rice–like particle at the catheter opening. They continued searching for a cause and called for the physician’s assistant. He observed that my new cast was not completely uniform and observe a compression point which could be causing pressure on my leg, which in turn would drive my blood pressure and pulse upwards.

So back to podiatry; the cast was removed yet my symptoms persisted. Back to the room I went. Another check of the catheter. This time it was discovered that the small cap on the drainage tube had not been removed. This certainly would have caused my symptoms. But now there was blood in my urine and my blood pressure and pulse were skyrocketing. Nitroglycerin tape is the immediate response in these circumstances. This appeared to provide some relief, but it was only temporary. Three more applications of Nitro were applied. Finally, this alleviated the escalation. Praise the Lord!

By now my urine was bright red, which caused some concern. The rise in my blood pressure had been arrested and was returning to normal levels. I thanked God for hearing my prayers. I unexpectedly began to feel nauseous and conscious of my breathing. Before long I had to focus on breathing in and breathing out. I became very lightheaded. All of a sudden, I was gasping and struggling to breathe at all. I was fighting for consciousness. Like I said, this was not my first time a situation like this and I wondered if I was going to be face-to-face with Jesus at any moment.

I remember thinking that I had done many shameful and wicked things in my life. I recognized that I had sinned against God and others. I had not loved either God or others with all my heart, soul, all my strength. Although these thoughts were fleeting, I knew they were true. I thought of the promise of Scripture. I thought about the wonderful Bible doctrine of forgiveness through the atonement of Jesus. I reflected on what the reformers called “The Great Exchange.”

This “great exchange” is taught in many places in the Bible, but succinctly summarized in 2 Corinthians 5:21. For our sake he made him to be sin who knew no sin, so that in him we might become the righteousness of God.

This exchange is a “give and take” made between Jesus and sinners. Impeccable and sinless Jesus was made to be sin for us, who are vile and corrupt – hostile and rebelling against God. Jesus not only identified with us in our sin and rebellion, he also absorbed the death penalty required for such atrocity. He suffered and died – the punishment we all owed to God, on account of our rebellion. Those who call upon Jesus receive pardon and righteousness – his righteousness, the righteousness of God! The exchange concerns rebellion and righteousness, life and death, guilt and innocence.

This great exchange is really a good deal – sinful people get what sinless Jesus deserves – pardon, forgiveness, acceptance with God. Jesus, in turn, receives guilt and punishment. This wonderful promise is extended to everyone: Whoever calls upon the name of the Lord will be saved. I pray that you know a good deal when you see it and along with me call upon his name. It is my prayer that you have the same comfort that I do when you are face-to-face with death, the final enemy.

My sin—O the bliss of this glorious thought!— My sin, not in part, but the whole, Is nailed to the cross and I bear it no more; Praise the Lord, praise the Lord, O my soul!

By the way, the small, white rice-like thing was a kidney stone. The tiny obstruction produced a huge effect. I pray this tiny reflection has some positive impact on you.