Revolution of the Soul

In the past several days, through the lens of my profession, I have been given a rather stark and disturbing vision of our current cultural revolution. It is, it seems, a revolution every bit as pervasive and transformational — and destructive — as China’s Cultural Revolution of the 60s — and indeed may be but a different manifestation of a global transformation which transpired in those very same decades in the West. Ideas have consequences, as they say, and we are watching them bear fruit before our very eyes in a slow-motion train wreck which seems now to be accelerating at a disturbing rate.

Exhibit 1: Phyllis Chesler’s recent piece, “Every hospital patient has a story“, at PajamasMedia. It is a piece to be read to completion, including its lengthy comment section. Therein she details a recent experience during a hospital stay for a hip replacement, with a rather remarkable litany of rudeness, neglect, indifference, and suffering sustained at the hands of her healers, at an upscale New York hospital. Her story is shocking enough, and revelatory; the comments provide even further insight, running the expected gamut of such a piece in the New Media. There are those simply shocked; those sharing similar horror stories; those relaying far better experiences in contrast; those defending doctors and nurses, those attacking them. There is the obligate wackjob who blames the AMA, and the usual finger-pointing: not enough nurses, too much paperwork, inadequate pay scales to draw quality; the evil insurance companies and the government. All mostly true, to greater or lesser degree — but all missing the core dysfunction by a wide mark. At the final period of her post, one comes away with a sense of hopeless, feeling out of control and angry, despairing that such a situation may be even a part of our reality (and not knowing how large a part it may be), yet at a loss to prevent its malignant progression through our remaining hospitals which may have been spared to date, the encroachment of such a toxic stew of callousness, indifference, and coldness. There seems, in the end, little cause for optimism.

Exhibit 2: It is late, nearly 9 P.M., seeing a final consult at the end of a punishing call day, in the ICU. The patient, chronologically young yet physiologically Methuselan, lies in his bed, oxygen mask affixed to his face by heavy straps, bleeding, as he has for months, from a tumor in his kidney. He would not survive surgery, nor even radiological intervention to stem the hemorrhage by strangling its arterial lifeline. He is, furthermore, in the parlance of modern medicine, “non-compliant”: refusing treatments and diagnostic studies; rude and abusive to nurses and physicians alike; demanding to go home though unlikely to survive there for any significant length of time.

The nurse — young, competent, smart, hard-working, the very best of the modern nursing profession — apprises me of his situation, closing with this knockout punch: “You know, we just passed that initiative — you know, the suicide one. He’d be an excellent candidate.”

She wasn’t joking.

Taken a bit off guard, I responded that it is most unwise to give physicians the power to kill you, for we will become very good at it, and impossible to stop once we are.

She continued: “No, I would love to work for a Dr. Kevorkian. Be an Angel of Death, you know?”

“I know”, I muttered under my breath, as she ran off to another bedside, competently and with great efficiency, to adjust some ventilator or fine-tune some dopamine drip. And hopefully do nothing more.

These vignettes in modern medicine are really not about medicine at all. They are in truth about a culture which has lost its compassion. Our calloused and cynical society has become a raging river fed by a thousand foul and fetid streams. We have, by turns, taught our children that ethics are situational and values neutral; taught our women that compassion and service are signs of weakness, that they must become hard and heartless like the men they hate; taught our men that success and the respect of others comes not through character and integrity but through callousness, cynicism, and greed; and taught ourselves that we are a law unto ourselves, the sole and final arbiter of what is right and what is good.

We have, in our post-modern and post-Christian culture, inexorably and irrevocably turned from our roots in Christian morality and worldview, which was the foundation and font of that which we now know — or used to know — as Western Civilization. Yes, we have preserved the tinsel and the trappings, the gilded and glittering exterior of a decaying sarcophagus, where we speak self-righteously of rights while denying their origin in the divine spark within the human spirit, made in the image of God; where we bray about liberty, but are enslaved to its bejeweled impostor, the damsel of decadence and libertinism; where compassion is naught but another government program to address the consequences of our own aberrant and irresponsible behavior, duly justified, rationalized, and denied. Others must pay so that I may play, you know.

This toxic stew of self-centered callousness has percolated into every pore of our society. In health care, the effects are universal and pernicious. Patients demand perfection, trusting the wisdom of a web browser over the experience of a physician — then running to their attorney to redress every poor outcome which their disease or their destructive lifestyles have helped bring about. Physicians, hardened and cynical from countless battles with corrupt insurance companies, lawyers, and Stalinist government regulation, forget that they exist solely to serve the patient with compassion and self-sacrifice, and that financial recompense is secondary to healing and empathy. Nurses have in large measure become administrators, made ever more remote from their patients by mountains of paperwork and impossible nurse-to-patient ratios, their patient-critical tasks delegated to underlings poorly trained and ill-treated. Hospital administrators are MBAs, with no interest or clue about what constitutes good health care, and are indifferent so long as their departments are profitable and their marketing wizards successful as they trumpet “Care with Compassion” in TV ads, radio, and muzac on hold.

The list could go on far longer, but the theme is clear: we have as a culture become utterly self-focused, trusting no one, demanding our rights while neglecting our responsibilities, seeking to be profitable rather than professional. We have abandoned the responsibility to be patient and caring of others, forgiving of human shortcomings and humble about the limits of our abilities — a responsibility not merely of those in health care but of human beings in civil society. We have, through the dubious gift of extraordinary technological advances, industrialized our profession, and replaced a sacred covenant of commitment to the patient’s best — and its corollary of the patient’s trust in the integrity and motives of physicians and nurses — with the cold legality of contract medicine. Small wonder we are treated as fungible commodities in doctors’ offices and hospital beds. Small wonder we will be euthanized when we have exhausted our compassion quotient, dispatched by highly efficient providers delivering “Death with Dignity.”

This utter self-obsession and cynical callousness is by no means limited to health care. We long for “bipartisanship” in government (by which we hope for reasoned men of principle to come together for the good of those they represent), but get instead the blood-lust of modern politics, where power trumps principle, money is king, and votes are bought and sold like chattel. Lawyers sue everything that breathes — and much that doesn’t — raking in billions while their “victimized clients” get pocket change they can believe in. Airlines pack in passengers like cattle, lose your bags, and toss you a bag of peanuts for your trouble. Road rage is rampant, rudeness rules, rip-offs too common to count. The coarseness in culture is extraordinary — in language, art, media, fashion, and behavior. It is revealing how shocked we find ourselves when encounter someone — regardless of the venue — who is actually pleasant, helpful, courteous, and kind; we have come to expect and tolerate far worse as a matter of course.

The revolution which started in the 60s with the “me” generation is bearing its bitter fruit — though its aging proponents will never admit it. And sadly, there’s no going back: the changes which have infiltrated and infected the culture, inoculated through education, media, entertainment, scientific rationalism, and a relentless and highly successful assault on reason and tradition, are permanent, and their consequences will only grow in magnitude.

So it’s time for a counter-revolution.

There is an alternative to our current cultural narcissism with its corrosive, calloused, destructive bent. It is not a new government program, nor a political movement; no demonstrations in the street, no marches on Washington. Its core ideology is over 2000 years old, and the foot soldiers of the revolution are already widely dispersed throughout the culture.

This revolutionary force is called Christianity, and it’s long past time to raise the banner and spring into action.

The true antidote to the nihilism and corruption of the age will be found, as it has always been, in the church. It has since its inception been a revolutionary force, transforming the hopeless and purposeless anarchy of the pagan world of its infancy by bringing light, hope and joy where there was none before.

It can happen again.

The church, of course, has to no small degree been co-opted by the culture it should have transformed. From TV evangelists preaching God-ordained health and wealth to liberal denominations rejecting the core truths of their foundation and worshiping instead the god of government and humanistic socialism; from pederast priests to episcopal sodomy, Christianity in the West has whored itself to a prosperous but decadent culture. Its salt has lost its saltiness, and it has, not surprisingly, been trampled underfoot by men.

It is time to return to our First Love. It is time once again to become light to an dark and stygian world. It is time for a revolution of the soul.

We must, first and foremost, be about grace and truth. We must begin with the truth of our calling: to be holy, transformed by the power of Christ and the work of the Spirit. We are, by nature of our new birth in Christ, His ambassadors: we are to be the face, the hands, the heart, the words, the compassion of Him who saved us.

The task is enormous, yet for each of us, the steps are small, easily achievable yet enormously powerful.

It must begin with a renewed commitment to obedience and submission to Christ, a willingness to fully subject ourselves to His will, rather than trying to bend His will to ours. It means getting serious about church attendance — not merely as a consumer but as an active participant. We need to renew our devotion to prayer, to Scripture reading, study, and memorization, to fellowship with other Christians. These are simple steps which ground us in truth, and give us access to that power which can first of all transform us, then radiate out to all around us.

Then we must act like the counter-culturists we claim to be. Be patient with those who are difficult; be generous in time and money; express gratitude to those around us (when was the last time you wrote a thank you note to your doctor, your contractor, your attorney, to the manager of the store employee who helped you?). Lose the profanity; guard your tongue. Repair broken relationships, as best you can. Be joyful in difficult times, knowing that God is at work in your life despite your difficulties. Be compassionate rather than judgmental to those whose life choices are destructive or misguided. The tattoos and piercings we ridicule are cries of desperation from those hungering for purpose and meaning.

These things will not come easily to many of us who claim to be Christians, as we have become complacent in our self-gratification and comfortable compromises, fearful of being viewed as extremist or weird, rejected and ridiculed.

Get over it.

You may just find that such renewed passion for Christ and love for others might, just might, transform your life.

And you might just find that it will change the world.

Got a better idea? Good, I didn’t think so.

Let’s get started.

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38 thoughts on “Revolution of the Soul

  1. Sir: I found your blog via Shoprat. I too have been encountering not just indifference but a callous behavior from the medical profession very recently.

    My father, 88, has leukemia and any number of other disorders. He has survived colon cancer twice, having had 5 major operations in the past 3 1/2 years. He is a fighter and survivor. Unfortunately, I could no longer care for him and could not provide 24/7 care. I had to place him into a skilled nursing facility. Very recently, other medical issues necessitated his transfer to a local hospital for more intensive care.

    That said, I recently asked for assistance for my father last night (at a local hospital existing under a religious affiliation, predominantly known for its competence) who is almost completely immobile, under the affects of morphine, weak, dazed — and he had to urinate and defecate. As there was no bedpan and no other implement present I asked the nurses for help.

    Being a “civilian” so to speak and not knowing anything other than “I need help,” I rapidly became aware of the very structured “class” system extant in medical care.

    I had made the extreme mistake of asking an RN for assistance and, evidently, should have examined her tag prior to the question. She replied quite coldly that she “didn’t do that” and that I should find the NA or Nurse’s Assistant. It then became MY job to examine the name tags of other persons walking by, asking them for help. About five minutes later someone was willing to assist. A moot point, however, as my father had already soiled himself and the bed. Everyone generally disappeared and I was told that “someone” would come back to clean up. A good additional 15 minutes later (this all occurred at night, around 8 PM) a female wearing brightly colored scrubs (I dare not misspeak and label a RN a NA, etc.) entered the room and with disdain told me that my father needed to hold his left arm straight out, as he was occluding the IV and causing the machine to beep, irritating her and others. Then she left.

    If this is the best that medicine has to offer then I, like you, shudder to think of our future. Unfortunately I do not find this to be an isolated incident nor am I seeking sympathy per se; I simply seek to show an example.

    What kind of medical treatment can I expect to encounter when I need intensive hospital care in my later years? And though you’re a doctor, I can somehow surmise that you, in the future, may be held in the same indifferent grip as the rest of us civilians.

    If this is secularism, boys and girls, then all I can say is the care exemplified will some day be rained down, in spades, upon those careless.


  2. I don’t want to seem to be the wet blanket, but exactly when was this culture ever that compassionate?

  3. Thank you for this article. I particularly appreciated your recommendations as to steps to be taken by each of us. We are called to be holy, with prayer being an important part of our lives. If I may, I would like to make two related recommendations: Beginning to Pray by Anthony Bloom, a short, simple, yet profound discussion; and, if available to you, join the Nocturnal Adoration Society. I recently did at my parish and found the hour of prayer before the Blessed Sacrament to be a very powerful experience.

  4. I would second what Julie says about veterinary care often being more compassionate than medical care for humans. My oldest cat (13 years) developed diabetes last year, and I have been impressed by the willingness of her vet and the vet techs to teach me how to care for her at home (test her blood glucose as well as give insulin) and answer my questions as well as being gentle with her during the inevitable office exams. I took a box of chocolates to the staff last week as well as a catnip toy for the office cat– like Julie’s gesture, it was my small way of thanking them all for their kindness.
    On the specifically Christian dimension of Dr. Bob’s post, one thing I find heartening is the increasing convergence of Roman Catholics, evangelical Protestants, and theologically conservative believers in the mainline churches. It is far better that we join forces in prayer and focus on our common faith in Jesus Christ as Lord than argue over differences about matters that are not essential to salvation.

  5. I came through shoprat, too, though I have been here before….wonderful piece, Doctor. EXCEPT, I think Diana said it right; The church is getting a little post-Christian..or SOME far from the truth..”Cafeteria Christians” are thriving!, pastors saying what they have to say in order to get the offering plate filled and the pews warmed, even in normal denominations, not just ‘new age’ groups! Presbyterians are now split, Methodists, Episcopalians and even Lutherans are getting close to yet another split…it’s very sad and we need to encourage our individual churches to get back to scripture and the truth and carry on from there.
    I wish I was as optimistic as Connecticut Yankee in what he says about theologically conservative believers. While I see a really fantastic, more scriptural change in the RC church, I’m not seeing as many theological conservatives as he is. I wish I were.

  6. This piece ended with hope and resurrection–something I need after reading the beginning which vividly reflects my own dark thoughts as I look around me and, worse, as I look into my heart. Since becoming an Orthodox Christian I have found deep wells of living water which both revive me and (when I let them) purify me. I am a psychiatrist with a forensic mentally ill population at a state hospital. In the moments in which I think of myself as of little account, I find myself still interacting with my patients with the fascination and tenderness that drew me to this profession. Though I fall short of any godly measure, there are nonetheless times when I can say I love my patients in my own paltry way. At other times, when the paperwork begins to mound impossibly high (which in a lesser way is a barrier between myself and my patient by virtue of the sheer time it takes to complete, but in a greater way intrudes itself between me and my patients by providing a ready-made ‘reason’ or, better, excuse which allows me to ignore those I am to serve under cover of my professionalism even when I have the time) I am tempted to see my exhaustion, my anger, my wasted time as important. Too often, I stop there and end up going home empty. On some occasions, however, when I think of the long suffering Christ, or the humility of the desert fathers, or the perseverance of the new martyrs of Russia–even if the thought and movement of my heart is slight–I find that the exhaustion and anger dissipate a little and I find myself wanting to serve. I hope for revival of the Church, but, through cooperation with my God, the struggle for repentance, prayer/fasting/almsgiving, perhaps even I can be revived.

  7. Wow! What a tour de force!
    Doc, this essay is among your finest as the comments thread will testify. Before I get to the crux of my own comment, please know and receive my heartfelt encouragement that after the dust settles, the only way out of the “slow motion train wreck” you have pointed to is a path lit by the light of Christ Himself. The outrage of official denominational “worshiping instead the god of government and humanistic socialism; from pederast priests to episcopal sodomy” rings true with all the righteous indignation of Elijah. And I don’t mean for that to sound in any way sarcastic. I really mean it and agree. A revival in the biblical sense not only guides the way, but may already be underway as the counter-revolution to which you alluded.

    Having said that, I would like to inject a couple of contrary observations into this litany of doom.

    First, because you are a physician, the link inspiring this essay was sparked by a variety of medical issues and all of nearly a hundred comments from both of these pieces are voiced in the context of medical care… I gently suggest that just because the world of medicine may be hell-bound it does not logically follow that the rest of the world is in the same boat. (I realize the weakness of this argument in the face of what appears to be a global economic implosion ) The challenges of hunger, terrorism, global pollution, rising crime, drug and human trafficking, and a string of other problems which seem also to be growing worse cannot be resolved all at once, but taken individually, with respect for differing points of view and an appreciation that these problems may be connected, I think the problems described here can be made better somewhere between where we are now, and converting everyone to Christianity. (As far as I can tell, most Christians fall short of the ideals you mentioned. The Christianity you advocate cannot be nominal. It must be genuine, whatever that means.)

    Second, I think it is a mistake to conclude that the picture of medicine infected with a creeping indifference to care and healing is, in fact, the whole picture. What your essay and the one by Ms. Chesler at Pajamas Media have in common is that everyone writing, reading and commenting here have a level of education, political sophistication and social standing that is not reflected in what many would call the “great unwashed,” which I prefer to call the working poor and unemployed. The big picture is in fact even worse than these essays and comments indicate.

    Third, there is an elephant in the room being taken for granted: insurance. Using the Google search bar’s highlight feature I was able to count the number of times that word appeared in all this reading I just did. By copying Ms. Chesler’s essay and comments thread to a Word document I was also able to count the number of words. In over sixteen thousand words the word “insurance” appears two times in the essay and eight times more among the comments.

    My guess is that everyone in these discussions has health care via an insurance company. One lonely comment down the thread said, “Maybe there is a future for universal health care in the USA..” Significantly, this was from a lady in Britain who was critical of the NHS but complimentary of ‘BUPA’ the private, but I presume regulated alternative. Unlike, Canada, which mandates everyone to be in a natiional plan, I understand the Brits allow some kind of private alternatives. This little factoid is typically not mentioned when Americans discuss the alternatives to the best system in the world.

    I tire of references to socialized medicine. The term is without meaning, since we already have at least three delivery systems of health care in place in this country, one of which, the VA, is “socialistic” by anyone’s understanding. The other three are Tri-care (for military and their families), FEHBP (for federal employees) and Medicare/Medicaid, managed (more or less) by CMS. These lst three might be called “hubrids,” but are certainly not in the same camp as private health insurance outfits that spend as much money and effort denying claims as honoring them in pursuit of shareholder profits.

    Naive me, I was and continue to be an enthusiastic supporter of Barack Obama, partly (but not entirely) because he was on board with the notion of universal health care. This has been a seeping wound in our country since before Hillary Clinton first failed to get Congress to do anything about it during the first Clinton administration. Since that time the number of uninsured Americans has continued to swell as insurance companies and their executives (like executives all across the economic landscape) received ever-larger golden parachutes funded by shareholder profits fed by premiums paid by employers and employees together in a never-enough effort to satisfy what might be called a national economic trend to corporate profit obesity.

    Drilling into the links, I found that Ms. Chesler penned a second part to the essay you linked which says plainly in the third paragraph, “For years, politicians have been talking about universal health care–which I agree, we must have in America. According to one estimate, about 18,000 Americans may die each year because they are uninsured.” Even she is on board with the notion. (Incidentally, this essay has a few more mentions of “insurance” but still not many. My impression of Pajamas Media is that it is the Internets equivalent of Fox News. Where else does one find reference to “right-roots”?) (Sorry ’bout that. I couldn’t resist.)

    There is much to be said about reforming health care and we won’t resolve the issue in a comments thread. But this is a very important conversation. I don’t recall where I heard it, but the best one-liner I have heard is “We have the best health care system in the world and the worst way imaginable to pay for it.” Or as Chruchill famously said, You can always depend on the Yanks to do the right thing after first trying everything else.

    Before I end, I need to note that my post-retirement employment has been in the retirement community, five years in a facility owned by a health care system. I was shocked when I first started there after a forty-year career in the private sector (food service) scrambling for hard-earned profits). I encountered a wholesale waste of material and human resources that in the private sector I never dreamed possible. I realized soon it was because the place was “not-for-profit,” and therefore not dependent on paying shareholders over and above the operational profits that truly “private” companies must have to survive and succeed.

    (There are two levels of “private.” The first is truly private, typically, but not always, family-owned. The second is what happens when a private company “goes public.” inviting stockholders into the operation. Clearly profits are easier to divide among a small number of “owners” that a large number. So the pressure to produce ever larger profits is much greater. Also, the pressure to “grow” is correspondingly greater. The price of the stock becomes more important than operational profits. See Enron. Or GM Or Goldman-Sachs. But don’t get me started…)

    There is a symbiotic, incestuous relationship between health care “providers,” (both for-profit and non-profit) and the insurance industry.. This relationship is enabled by so-called “not for profit” outfits who must pick up the social pieces (uninsured people who by law and good public relations must receive at least life-saving emergency treatment) and pay for them by “writing off” unpaid expenses by overcharging insured patients enough to generate at least a little black ink for operational profits The tax accounting rules also help by allowing breaks for charitable contributions to non-profits for individuals and institutions who for business or tax purposes seek to improve their public image (tax-subsidized institutional advertising) or offset otherwise taxable gains. There are many ways to skin the tax cat.

    I think I’ve said enough at the keyboard to get me through another day.

    Let us go forth into the world to serve and please the Lord! Hallelujah, hallelujah!.

  8. John Ballard:

    When you wrote: ‘Before I end, I need to note that my post-retirement employment has been in the retirement community, five years in a facility owned by a health care system. I was shocked when I first started there after a forty-year career in the private sector (food service) scrambling for hard-earned profits). I encountered a wholesale waste of material and human resources that in the private sector I never dreamed possible. I realized soon it was because the place was “not-for-profit,” and therefore not dependent on paying shareholders over and above the operational profits that truly “private” companies must have to survive and succeed.’

    . . . you just made a massive point.

    You know: Governmental Healthcare, all served up with the same considered and measured courtesy, efficiency, veracity, motivation, goodness, logic and concern of one’s local DMV.


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