The Book of Romans [4] The Bad News – 1:18-28

ColosseumPaul, in verses 16-17, has begun to declare the Gospel which defines and motivates his mission. It is the very “power of God”; it is universal, for Jew or Greek (i.e., non-Jewish pagans), and it manifests the righteousness and power of God given as a gift to man, who live by faith.

But there can be no need for the Good News until we come to terms with the Bad News: That man has rejected God, and as a consequence, has turned from righteousness to unrighteousness, with the moral depravity and divine judgement which are the inevitable and certain consequences:

For the wrath of God is revealed from heaven against all ungodliness and unrighteousness of men, who by their unrighteousness suppress the truth. For what can be known about God is plain to them, because God has shown it to them. For his invisible attributes, namely, his eternal power and divine nature, have been clearly perceived, ever since the creation of the world,fn in the things that have been made. So they are without excuse. For although they knew God, they did not honor him as God or give thanks to him, but they became futile in their thinking, and their foolish hearts were darkened. Claiming to be wise, they became fools, and exchanged the glory of the immortal God for images resembling mortal man and birds and animals and creeping things.

Therefore God gave them up in the lusts of their hearts to impurity, to the dishonoring of their bodies among themselves, because they exchanged the truth about God for a lie and worshiped and served the creature rather than the Creator, who is blessed forever! Amen.

Paul begins here with a statement of natural law: that man, by his reason, is capable of knowing God through the evidence of creation. The failure to know God is not one of insufficient knowledge or proof; it is rather a moral choice. Man refuses to acknowledge and submit to God because he, in spiritual darkness because of sin, has corrupted his reason, and now creates gods in his own image or in the image of the lesser creatures of creation.

For this reason God gave them up to dishonorable passions. For their women exchanged natural relations for those that are contrary to nature; and the men likewise gave up natural relations with women and were consumed with passion for one another, men committing shameless acts with men and receiving in themselves the due penalty for their error.

And since they did not see fit to acknowledge God, God gave them up to a debased mind to do what ought not to be done. They were filled with all manner of unrighteousness, evil, covetousness, malice. They are full of envy, murder, strife, deceit, maliciousness. They are gossips, slanderers, haters of God, insolent, haughty, boastful, inventors of evil, disobedient to parents, foolish, faithless, heartless, ruthless. Though they know God’s righteous decree that those who practice such things deserve to die, they not only do them but give approval to those who practice them.

Paul begins his depiction of man’s descent into moral depravity by his description of the impact on the most fundamental of human behaviors, reproduction and the relationship between men and women. But lest we think that sexual deviancy is the prime manifestation of the unrighteous man, he promptly lists virtually every vice of man. Furthermore, somewhat surprisingly, Paul points to the natural law knowledge of fallen man: they understand that such behavior merits God’s punishment, yet act in evil ways and encourage others to do so.

Key Words

Wrath (Greek:orge): anger, the natural disposition, temper, character; movement or agitation of the soul, impulse, desire, any violent emotion, but esp. anger; wrath, indignation; anger exhibited in punishment, hence used for punishment itself; punishments inflicted by magistrates

Suppress (Greek: katecho): to hold back, detain, retain from going away; to restrain, hinder (the course or progress of)that which hinders, e.g., of Antichrist from making his appearance; to check a ship’s headway i.e. to hold or head the ship; to hold fast, keep secure, keep firm possession of; to get possession of, take, to possess

Futile (Greek: mataioo): to render (passively, become) foolish, i.e. (morally) wicked or idolatrous, to become vain

Darkened (Greek: skotizo): to obscure; to cover with darkness, to darken; to be covered with darkness, be darkened; of heavenly bodies as deprived of light; metaphorically, of the eyes, of the understanding, of the mind

lust (Greek: epithymia): desire, craving, longing, desire for what is forbidden, lust

Gave them up (Greek: paradidomi):

  1. to give into the hands (of another)
  2. to give over into one’s power or use: to deliver to one something to keep, use, to take care of, or manage; to deliver up one to custody; to be judged, condemned, punished, scourged, tormented, put to death; to deliver up treacherously, by betrayal; to cause one to be taken, to deliver one to be taught, moulded
  3. to commit, to commend
  4. to deliver verbally: commands, rites, to deliver by narrating, to report
  5. to permit, allow: when the fruit will allow, that is when its ripeness permits; gives itself up, presents itself

Key Concepts

  • God has made known to man His nature, apart from divine revelation, through the evidence of creation
  • Man has made a moral decision to reject God and worship himself and the things of creation
  • The consequence of this choice is all manner of moral depravity, and ultimately the judgement and condemnation of God
  • That man in his nature understands the evil nature and consequences of his behavior, yet persists in it and encourages others to do so as well

Resources

The Descent

cliffsIt haunted him, without mercy.

Strong, athletic, handsome, and personable, he seemed at life’s outset to be unfairly advantaged. His friends were many; a ladies man, by reputation, the life of every party, the love of every woman who gazed on him.

He was, by nature, a generous and gentle soul, a gift he received from his parents, humble and devout. He himself found religion attractive, and attended synagogue regularly with them. He had little use for the priests and the lawyers––he found them legalistic, arrogant, and judgmental––but embodied in his faith he discovered a formula for living: obey the law of God, and your life will be healthy and prosperous. Did not the Proverbs promise, “By humility and fear of the Lord are riches, and honor, and length of days”? He would do his part, and God His, and all would be well in life.

The climb had been arduous. Stronger and more agile than his friends, he had reached the top of the cliffs before them. His best friend, struggling behind him, lost his footing, and he reached back to save him from falling. His friend was saved — and his own life changed forever.

When he came to, he felt no pain — in fact, no sensation whatsoever. He heard the shouts and the dislodged rocks of his friends scrambling down the cliff; he tried to get up, but could not. He had survived the fall — and lived to wish he had not.

Weeks and months passed, with no improvement; his paralyzed body remained lifeless, though his mind, now a tortured prisoner, remained fully alive. Most of his friends drifted away, their discomfort in his presence so palpable that their absence was more relief than regret. The Four remained, though he saw no reason for them to do so, other than guilt, or some pathetic sense of charity to the crippled. His limbs withered and shriveled, twisted like the branches of those ancient trees on the cliffs. Racked by fevers, festering pressure sores, and wallowing in the excrement he could no longer control, he no longer had a life, but only a slow, agonizing, and hopeless descent toward death.

The Four visited him daily, alone, in pairs, and on occasion collectively. They cleaned him, tended his wounds, and tried to encourage him in his deepening depression, to no avail. As shriveled and twisted as his body had become, his soul became far more foul and fetid in its unquenched and raging bitterness. Self-pity, self-loathing, and a hopeless despondency descended upon him, crushing and torturing his spirit in a personal living hell. His friends prayed, read Scripture, and feigned faith in some deliverance of spirit, if not body; this only increased his cynicism and the sputtering rage he spewed toward God. How could a good God allow such an evil fate? Had he not kept his part of the bargain, only to be betrayed by a deity he had once trusted? Why did his friends torment him with this utter nonsense?

Then there was the humiliation he suffered at the hands of healers, who prayed and pranced and called down Heaven’s power to heal him; he had too little faith, they accused, when their futile foolishness failed. In this, they were most surely correct. Then, the day his friends dragged him to the Temple, to the priests, as Moses had prescribed. His bondage arose from hidden sin, they said: his own, or his parents. What sin was this, he challenged? The sin of saving a friend’s life? His parents had more righteousness in their little fingers than these prattling and pretentious fools — where was their repentance? The self-righteous religious cast him out of the Temple, and the long journey home was silent, and awkward, and hopeless.

The crowds were immense, if the stories be true — this charlatan must have some slick magic up his sleeve, and there was no shortage of gullible fools in the world to follow along. His angry protests were to no avail — must he go through this humiliation once again? — as the Four lifted him onto the cart and began the dusty and agonizing ride to ridicule. See the Master? Not even close — they could barely see the house for the mob. The Four muscled their way through the grumbling crowd, and ignoring the shouting owner, climbing a fig tree by the house. Before he could protest yet again, they lifted him onto the roof, nearly dropping him in the process — what a fitting and ironic end to his pathetic life that would be! Now what? They began to claw at the straw and tiles; curses arose from below as mud and straw and shards of clay tumbled onto upturned faces. Then they lowered him into the darkness.

He saw their eyes first: seated above the crowd, dressed in fine linen robes, their phylacteries glittering with fiery jewels, their eyes blazing with hatred and contempt seemingly from the very depths of Sheol. Then, turning, he saw at last the healer’s eyes: strong, kind, penetrating to the depths of his spirit. To see them was to gaze into eternity, and see its joy. He felt utterly naked — but not ashamed.

He smiled: “Son, your sins are forgiven.”

There was no challenge this time — he knew the sins of which the healer spoke: bitterness, unforgiveness, cynicism, ingratitude, the hatred of God, of life, the despair over lost promise and shattered hopes. There befell then a lightness, an extraordinary peace, the lifting of a burden far heavier than that his friends had borne in bringing him here. A smile crossed his face, for the first time in many years: could this be joy?

Amazed at his inner awakening, he failed to hear the gasps, to notice the stunned silence of the once-noisy crowd. There was only the angry, strident whispers, hushed at first, then ever more intense, like the growl of a ravenous predator: Blasphemy. Blasphemy! BLASPHEMY!

He looked back at the healer: there was no fear, no anger; naught but an enormous strength, his eyes afire with the conviction of truth. “That you may know that the Son of Man has the power on earth to forgive sins…” He looked directly into his eyes: “Arise, pick up your mat, and walk.” It was far more invitation than command.

It lasted but an instant, but seemed an eternity. Great warmth seared through his withered flesh. Tendons tight as iron loosened and stretched; his shriveled muscles softened and fleshed out; his papyrus-thin skin pinked and plumped into a vibrant glow. He sat up — before realizing he could not do so. Swinging his legs free, he stood — he stood!! — bent over, and rolled up his mat.

The crowd gasped, and cried, and praised God; he heard none of it, not even the joyful shouts of his friends on the roof. As he bounded out the door, every hand reached out to touch him, as if he, the healed, had the power of the healer. As the sounds of the crowds faded into the distance, he touched his newborn limbs, still stunned in disbelief about what had just happened.

There was much work to do; relationships to repair, amends to make, and the endless telling of his story to the amazement of all who would listen. He followed the Master throughout Galilee wherever he preached. Sitting among the thousands, he nevertheless saw Jesus look directly at him each time, and smile. It seemed as though the Master had even more joy at the healing of his crippled heart than he himself did — and his own was indescribable.

Many months after his healing, he wandered again into the desert, alone. The storm clouds were gathering: the hatred he had seen in the eyes of the religious leaders was ever more intense, and he sensed something dark and foreboding ahead in his Master’s mission. His own journey led him back to the cliffs, where his life had changed forever. His eyes gazed upward at their great height, then slowly descended to the rocks of brokenness below. He recalled his Master’s words, spoken so prophetically: “Greater love than this no man has, than to lay down his life for his friends.”

And finally, at long last, he understood.

Healing Faith

 

A repost of an essay from several years ago on suffering and faith.

 
chainsA reader named Katherine recently e-mailed me. She had lost her husband, a man some years older than she, to multiple myeloma and Alzheimer’s disease. She is a Christian, and is struggling to make sense of his death, and the difficult questions of why God allows suffering. She writes, after giving me some details of his life, death, and fine character, and asks:

Why does God allow such terrible illnesses to such a kind person? I know there is really no answer as I know all about Job. The thing I am really afraid is that I prayed for his healing, and it did not happen. When I became a Christian back in the 80’s, the health and prosperity gospel was big at the time, and I guess it really influenced me more than I care to admit as I now know it is false. Even though I know it is false, I have become obsessed that God did not answer my prayer because of not being able to get rid of all the sin in my life (as if this were possible to do). One of the teachings of that movement was that if your prayer for healing went unanswered it was either because of lack of faith or sin in your life. I kept thinking that I don’t always put God first in my life, and that I spent more time reading secular magazines than reading my Bible and listening to more secular music than Christian music. These were my “main” sins, at least in my mind and thinking. Can you shed some light on this for me? I would be very appreciative.

The problem of suffering and evil is an ageless one. It poses a particular challenge for Judaism and Christianity, because of the seemingly insoluble tension between a world filled with suffering and evil, and the belief in a God who is good and all-powerful. Solutions to this dilemma, both adequate and inadequate, abound. It is the desperate hope of the atheist that this logical incompatibility proves beyond question the nonexistence of God. Others, less willing to ditch a Divine order, have concluded that God is good, but impotent; or that God is detached and uncaring, or capricious, or moody, or sadistic — and therefore not good.

It must be said plainly that answers to this paradox are neither simple nor entirely satisfactory. The dilemma as it stands may be solved in a global and satisfactory way — as has been done by both Judaism and Christianity — but invariably the lofty principles seem to break down at the moment when a solution is most needed: in the time of crisis when we ourselves experienced the depths, hopelessness, and irrationality of suffering in our own lives. CS Lewis, whose tightly reasoned treatise The Problem of Pain provides an extraordinarily deep and thorough discussion of this dilemna–later in life nearly repudiates his faith and sound theology after the death of his wife, a process painfully detailed in his diaries, A Grief Observed. It is indeed unsettling to watch Lewis discard all of his carefully reasoned and theological understandings of pain and suffering in the brutal crucible of unbearable pain and loss. Nonetheless, he ultimately comes to terms with the paradox, and undergoes an embracing of this profound dilemma far deeper than the intellectual by means of his own trial of fire.

At the heart of this difficult issue lies the human heart. God undertook a vast and dangerous experiment when creating man: He wanted, not merely another animal — of which there were countless — but an animal capable of something He alone understood: love. He gave this exalted animal vast intellect — but this was not sufficient to engender love. He gave His creation powerful emotions, the capacity for both creation and destruction, which He alone had possessed — but this also was not sufficient. For love — the utter, uninhibited emptying of self for another — required that most dangerous license of all: free will. Having created us thus, designed with the capacity to love, we must of necessity be utterly free to choose — for choice is the very heart, the very essence of love.

It was, by all visible measures, an experiment gone wildly awry. Having given this creature the extraordinary capabilities required to love fully — intellect, emotion, passion, empathy, the ability to feel intense pleasure and pain both physically and spiritually — he set this creature free to love — first of all Himself, and then others of like kind. And the first choice of this masterpiece of creation was the decision to turn away: to replace the intended objects of love with the sterile altar of self. Thus was unleashed the monstrous liability of a truly free creature: the ability to hate, to cause pain, to kill, to destroy.

A world in which God eliminated evil would by necessity be emptied of all mankind.

If we are to be honest, much of the pain and suffering which comprise the evil of the world is due to nothing more than this: that man, having been given the ability to choose, chooses wrongly, and uses the gifts and abilities given for the purpose of love to instead elevate himself at the expense of others, often in ways stunningly malicious and utterly wicked. Look around you, at the world both near and far: pride, selfishness, greed, lust, rage, jealousy — all these things manifest themselves in our lives and those of others, causing great pain and endless suffering. The child abused; the wife abandoned; the drive-by shooting; the greedy CEO who bankrupts the company and rapes the stockholders; the serial killer and the rapist; genocide; wars of conquest; torture; senseless massacres: these are the actions of men and women putting self above others — and each of us does it, to a greater or lesser degree, though we minimize our own roles to justify our own actions. We all wish for a world where God would eliminate evil — but all assume that we ourselves would be the only ones left standing when His judgment is delivered. A world in which God eliminated evil would by necessity be emptied of all mankind.

Yet there also exists those evils which have been called, in days past, somewhat ironically, “acts of God” — those circumstances or events which cause pain and suffering, not directly engendered by human evil. Thus the child is born with a severe birth defect; hurricanes, earthquakes, and tornadoes cause death and destruction; chronic and devastating diseases fall upon those who seemingly deserve a far better fate. It is with this, this seemingly capricious evil, with which we struggle most earnestly, straining to understand, yet to no avail.

Judaism and Christianity both imply that some such evil may be consequential, the result of punishment or predictable consequences for the malfeasance of man. A more robust theology is less accusatory and thereby more coarsely granular — maintaining that such evil has entered the world because of the fall of man. Under such design our divine divorce has corrupted not only behavior, but our very natures, and all of creation. Yet such theology is of little comfort to those who are the objects of such seemingly random evil; we demand to know of God, “Why?” — and in particular, “Why me?” Yet there is no answer forthcoming, and we are left assuming a God either powerless to stop such evil or unwilling to do so.

Yet the problem of a good God, an omnipotent God, and an evil world of His creation is not entirely insoluble. Much lies in our projection of human frailty onto the nature of the Divine, and the impreciseness of our definitions of good and omnipotent. When we say God is good, we tend to mean that God is “nice” — that he would never do anything to cause us pain or suffering. Yet even in our limited experience, we must acknowledge that pain and suffering, while not inherently good, may be a means to goodness. We choose to have surgery or chemotherapy, though painful and debilitating, that our cancer may be cured. The halls of Alcoholics Anonymous are filled with men and women who, having faced both personal and relational destruction, have used their former liabilities as a gateway to a new, more fulfilling life — one which could not have taken place apart from their harrowing journey through alcoholism. To a misbehaving child, the discipline of a loving father is not perceived as good, but such correction is essential for the development of personal integrity, social integration, and responsibility.

Our inability to discern the potential for good in pain and suffering does not by necessity deny its presence; there are many who, when asked, will point to painful, difficult, and unbearable times in life which have brought about profound, often unexpected good in their lives, unforeseeable in the midst of their dark days. There surely is much suffering which defies our capacity to understand, even through we strive with every fiber of our being to find the goodness therein. But the fact that such inexplicable suffering exists, and that answers are often lacking, does not preclude the possibility that God is good, or that such suffering may ultimately lead to something greater and more noble than the pain endured.

We are … not merely imperfect creatures that need improvement: we are rebels that need lay down their arms

In our egocentricity we often neglect to look for the benefit in our suffering which comes not to us, but rather to others. Caring for someone suffering unbearably provides an opportunity to the caretaker to experience selfless love, compassion, tenderness, patience and endurance — character traits sadly lacking in our selfish world, which routinely turns its back on suffering to pursue an untroubled life of self-fulfillment and self-gratification. It is not inherently evil to be called to give beyond our means and ability — as caring for someone suffering always demands — for in the exhaustion and inadequacy thus revealed, we may discover unknown inner strengths, and come to a richer, and more fulfilling dependence on God. We are, as CS Lewis so accurately described, “not merely imperfect creatures that need improvement: we are rebels that need lay down their arms” — and finding how shallow are our reserves of love, compassion, and strength, we may through this brokenness seek to acquire them, humbly, from their Source.

But surely an omnipotent God has the power to stop suffering — is He not either impotent or evil when failing to use such power to remove our suffering? The omnipotence of God, like His goodness, is but dimly perceived. For the power of God is in perfect harmony with the purpose of God, and is thus used to advance these purposes for the greater good. Thus, the good deed of creating man with free will — and thereby capable of love — by its very nature restrains the omnipotence of God to violate that free will. The evil of the world exists in large part, if not wholly, because this free will has been abused. Yet the abuse of free will must be permitted, that the proper use of free will — the laying down of arms, the surrender to the sovereignty of a wholly good God — may take place, freely and unfettered as required by love. God must tolerate the existence of suffering and evil, that all may have the freedom to choose the good — though many will refuse to do so.

Yet he does not merely tolerate the presence of suffering, but provides for its very redemption: that suffering, though itself evil, may ultimately produce good. Thus pain, suffering, death, and evil need not triumph: they may provide the means that some may turn toward the good, or bring forth further good for themselves or others. This is redemption: to buy back that which is destructive, worthless, of no value, evil, and make it worthwhile, valuable, even priceless.

Christianity, throughout its history, has struggled with and largely resolved the problem of pain, within the confines of the mystery of God. Yet Christianity in its many doctrinal eddies has sometimes chosen the wrong path and the wrong answers to this challenge. Such errors generally fall into two broad categories: the concept of suffering as punishment or retribution from God, and the manipulation of God for man’s gratification. The first of these runs counter to the core doctrine of the cross: that God has chosen to provide in Christ a sacrificial lamb — that Christ, through his suffering, may bear the justice of God, so that we may see the mercy of God. Our suffering is not a punishment for sin, as such punishment negates the purpose of the cross. Correction, it may be; discipline, it often is; opportunity, it always is; punishment, it never is.

The countering position — that of God as divine opiate, ever present to kill our pain — is a variant of the faith which has become perniciously widespread, feeding on a culture of ease and self-gratification which creates God in its own image. Thus God becomes a font of wealth, of health, of prosperity, of a trouble-free materialistic lifestyle, a divine vending machine whose coinage is faith. Faith, however, in such a worldview is no longer a profound trust in a God who is beyond understanding and infinitely wise, but becomes instead a means of buying from God all which we demand. Hence, we may be wealthy, if we only have enough faith; we may be healed, if our faith is sufficient; we will not suffer if we will but strengthen and enlarge our faith. Our faith must be prefect, lest our pleas go unheard. The strength of faith matters more than its verity; we charge the gates of heaven with the bludgeon of self-will.

The perniciousness and destructiveness of this perversion of historical Christian faith lies in removing from the hands of God decisions of life and death, health and illness, wholeness and suffering, while burdening us with the hopeless demand that we steel our faith to impossible heights to coerce and manipulate the will of God. That such efforts are typically fruitless seems self-evident: God most surely is capable of healing — and does indeed do so often, even dramatically at times — but most surely does so in accordance with his divine wisdom and will. Should His wisdom dictate that suffering, poverty, brokenness, even death and despair would better serve the purposes of drawing men to Himself, what measure of human obstinacy and recalcitrance will change this will? When such “faith” proves futile, it destroys trust in God, and not infrequently leads to utter loss of belief, a bitter agnosticism born in false expectations and misplaced hope.

We demand of God that which we alone deem to be good, then blame Him when He pursues a greater good beyond our understanding

Hence, we demand of God that which we alone deem to be good, then blame Him when He pursues a greater good beyond our understanding. This is the struggle to which Kathleen is alluding, as she questions the goodness of God in failing to heal her husband, blaming her own “sins” for his untimely demise. To us, such a healing seems only good — in so far as it mitigates our pain and loss, as well as that of those we love — but like the surgeon’s knife, sometimes such pain must not be withheld that evil may be conquered by the good. Were he healed, and restored to full health, would he not then face death on yet another day? Our lives have both purpose and a proper time: we live for that purpose, and we die when that purpose is fulfilled. That those who are left behind cannot grasp that purpose — and appropriately suffer profound pain and loss at this separation — does not negate that purpose nor impede its culmination.

We live in a time when our expectations of health, of prosperity, of a pain-free life are increasingly met in the physical realm, while we progressively become sickly, impoverished, and empty in the realm of the spirit. Despite our longer lives, we live in dread of death; despite our greater health, we obsess about our ills; despite our comfortable lives, we ache from an aimlessness and purposelessness which eats at our souls and deadens our spirits. Though we have at our command the means to kill our pain–to a degree never before seen in the history of the world–yet we have bargained away our peace in pursuit of our pleasure. The problem of pain has never been an easy one; in our day, it has not been solved, but rather worsened, by our delusions of perpetual comfort and expectations of a trouble-free life.

Until we come to terms with suffering, we will not have comfort; until we embrace our pain, peace will never be ours.

The Pornography of Barbarism

The following post was written several years ago. It seems apropos to revisit it, in light of the recent horror in Aurora.

 
visigoths
I am not easily shocked anymore.

Perhaps it is my profession, where the constant exposure to human suffering and pain harden the spirit and keep emotions at a safe distance. Perhaps it is the almost imperceptible but relentless inoculation brought about by the constant stream of violence and vice which pour forth from the dazzling screen faced daily from the comfort of cottage and couch. Perhaps it is the cynicism and callousness from one too many movies showing gratuitous sex; one too many art exhibits with fecal creativity or blasphemous pretension; one too many headlines of school shootings or child rape. It all seems to blend together, like some Clockwork Orange deprogramming script shimmering on screen as we sit with eyes held open against our will, the beauty of Beethoven lulling us into the normalization of depravity.

Each scene, more horrid than the last, flashes by, horrifying in the moment but soon forgotten, our calloused souls no longer responding, our eyes transfixed in cold determination on money and the material, routine and ritual. We have swum in the cesspool so long we no longer notice the smell.

This week, some things broke through the indifferent haze. Like some unheralded emetic, the cynical disdain for a culture gone corrupt turned instead to nausea — physical, to be sure, yet far more: a nausea of the soul, a dyspepsia so deep in the spirit that no hardened defense could mask its rolling waves of disgust and dismay.

There was, at the first, the video: a teenage girl, lured into a trap, then brutally beaten by six other girls her age for thirty minutes continually, carefully recorded on video for upload to YouTube.

Then came the Yale “artist” who repeatedly impregnated herself by artificial insemination, then aborted the fetus with drugs, carefully saving the results for display wrapped in plastic and Vaseline for her senior art exhibit.

Then this morning, in the local paper: a man — a school bus driver — convicted for sexually assaulting a 4-year-old girl left alone on his bus.

One could multiply such incidents, ad nauseum, on almost any given day, in any part of the world — beheadings and genocide, ghoulish scenes of body parts and bloodied walls from yet another heroic martyr seeking virgins through hyperviolence. Yet these events, small on such a savage scale, in some way troubled me more than most.

One wants to rail at a society gone mad, at a civilization which has lost its bearings and moral compass, at a decadence fed by materialism and secularism, force-fed with the rotgut wine of postmodern relativism, drunk with the notion that ideas have no consequence and idols worshiped bring no destruction.

Yet the time for such anguished mourning seems long past, its passing but a point in a pitiful past history. We have, it seems, entered the post-human age.

Our secular prophets have heralded the Good News: there is no God; we are but accidental apes. We have been liberated from the bondage of religion and morals; we are, at last, in this twenty-first century, at the pinnacle of human achievement and potential. The shackles of superstition are broken, the potential of man unbounded, his glory unlimited but by the constraints of his imagination.

Yet as we celebrate our exalted humanity, the technology we worship brings glimpses of a darker reality, flashed in some subliminal message quickly dismissed as aberration or sideshow.

We may reflexly think of those who partake in such ghastly exhibitionism to be but beasts — but to think thus insults the animals, whose nobility far exceeds our own. For the animal kingdom is violent, brutish, and predatory — but it is so with purpose, its violence constrained by the drive to survive, or mate, or protect its territory. It is only the human animal who ventures into the subhuman, in glorification and gleeful pursuit of perversion for pleasure, of violence as theater. It is this theatrics of barbarism so prevalent in our age which bespeaks something far darker, more sinister, more terrifying. For to be human is to share the beautiful and the good with the hideous and evil; it has been so since the dawn of history. But to celebrate perdition, to promulgate a pornography of barbarism, to cast it abroad over media and message seems the unique and chilling characteristic of our current reckless age.

Civilization has always withstood the barbarians with low walls lightly guarded. It has depended far less on strength of force than strength of character, a consensus among the civilized that certain behavior and unrestrained license threaten its very existence. Laws and the power of enforcement cannot long resist the dark demons of depravity unleashed from within; the power of Rome proved feeble when there became no difference between the citizens within and the barbarians without. The Dark Ages which thus ensued seem now long forgotten, even as we arrogate the privileges of freedom while destroying the self-control and restraint on which it depends.

Our own Dark Age seems soon upon us. The knowledge and technology which have brought us to such great heights will document in living color and HD the breaching of the walls and the slaughter of the children.

Don’t touch that remote — you will not want to miss the next episode. And be sure to post it on Facebook.

What Brilliant Darkness

tomb

What brilliant darkness now descends
To slay the weight which life doth rob
To bear the anguish undeserved
On frigid stone no glorious end.

The blazing lanterns light the night
As noble leaders drain the cup
To toast the end of ghost not known
And praise the triumph of blind sight.

What brilliant darkness now hangs deep
In hopeless end of fruitless dreams
In upper room no brightness cast
In lowered light a restless sleep.

The blazing lanterns light the night
As slumbered warriors wrap their cloaks
And starlight bathes the tethered beam
Where blood poured out in sacred rite.

What brilliant darkness now breaks bright
With light a sun can scarce reflect
To roll the stone which triumphs death
The lamps of countless souls to light.

Have a blessed and fruitful Easter. God bless.

Almost Cut My Hair…

Almost cut my hair,
Happened just the other day.
It was gettin’ kinda long,
Could’ve said it was in my way.

But I didn’t and I wonder why,
I feel like letting my freak flag fly,
And I feel like I owe it to someone…

I’m suffering from whiplash — perhaps I should call one of those attorneys whose ads I see at bus stops and on the back of grocery carts…

In a recent post, I waxed euphoric about a big transition in my professional life, wherein I would move from being a solo practitioner to a hospital group employee, working predominantly in an inpatient capacity, with a much reduced load of office paperwork and business responsibilities, with the expectation of significantly more free time. I was truly excited about these possibilities, and felt great relief at the promise of unloading the crushing burden of paperwork, compliance with endless government regulatory demands, intrusive and abusive audits, and a host of other ugly and unpleasant parasites which suck all the life out of the profession of medicine.

More pay, less work — what’s not to like?

That was yesterday. And this is today: I have decided not to pursue this course — or perhaps, more accurately, this is not the course chosen for me to pursue.

The decision is, in a way, rather shocking, a wrenching change of direction for which I was wholly unprepared, and which is still deeply unsettling. I feel in some ways like the shipwreck sailor, watching a passing ship — recently his only hope of salvation — sail slowly into the distance, as he floats, unseen and unsaved. At yet there is a certainty that this sudden change of course is the correct one — though I’m quite in the dark about what comes next.

So what changed?

Nothing whatsoever about my current situation: private solo practice, as it is now configured, has become an enormous burden in so many ways. It’s ugly — and getting uglier in a hurry.

Much of the non-medical world seems dimly aware, if at all, of the tectonic changes occurring in health care. Patients are beginning to notice that their doctor’s practice name has changed to something like “Big Hospital Medical Associates”, but otherwise see little change: they can still see their doctor, the staff is, by and large, the same familiar faces, no worries, carry on.

Behind the scenes, however, the changes are enormous. As of 2009, 65 percent of established doctors were in hospital-owned practices. That percentage is growing rapidly, as physicians and other providers, such as nurse practitioners, flock to the perceived safety and security of large groups and hospital-owned practice affiliations.

The attraction is undeniable: offloading the burden of burgeoning administrative and regulatory requirements; attractive first year salaries and sign-on bonuses, combined with the promise of more free time and predictable schedules; and the lure of better reimbursement for services due to a large organization’s greater heft in negotiating contracts with insurance companies. It’s easy to overlook the potential downsides when the eye candy is so attractive.

After much happy talk and eagerness from the hospital recruiters and medical administrators, the process of merging my practice with the hospital group moved like continental drift. Months passed with no action; emails and phone calls were answered slowly, if at all. My frustration was enormous, but the delay proved a blessing in disguise.

The bad news trickled in slowly, as I waited, impatiently. A large local hospital group announced layoffs of nearly 400 people, for starters — no administrators or middle managers, of course: only the clerical and support staff that keeps a practice running. A busy surgical practice with an incompetent scheduler could not fire her (her race guaranteed a discrimination lawsuit), so they simply eliminated her position — and now they have no permanent scheduler for a year. Other schedulers were moved offsite, far removed from the physicians and practices whose lives they controlled. A former associate, a true workaholic who routinely saw 50-60 patients a day, had his salary cut because he wasn’t productive enough(!!). Highly-trained support staff were told they could not perform certain procedures because the hospital legal department decided their license did not permit them to perform them — although the procedures themselves were not restricted under their state licensing privileges, and they were far more highly skilled and experienced at these procedures than those “credentialed” to do them.

Big picture insights also came into play:

Hospitals lose $150,000 to $250,000 per year over the first 3 years of employing a physician — owing in part to a slow ramp-up period as physicians establish themselves or transition their practices and adapt to management changes. The losses decrease by approximately 50% after 3 years but do persist thereafter. New primary care physicians (PCPs) contribute nearly $150,000 less to hospitals than their more-established counterparts; among specialists, the difference is $200,000. For hospitals to break even, newly hired PCPs must generate at least 30% more visits, and new specialists 25% more referrals, than they do at the outset.

Chained to the oar, the galley master pounding out the cadence…

After 3 years, hospitals expect to begin making money on employed physicians when they account for the value of all care, tests, and referrals. … Outpatient office practices of employed physicians seldom turn a profit for hospitals.

Interesting — most private outpatient office practices are profitable, although less and less so.

Hospitals are willing to take a loss employing PCPs in order to influence the flow of referrals to specialists who use their facilities. In the 1990s, hospitals usually guaranteed physicians nearly 100% of their previous year’s salary during their transition to hospital employment. This arrangement invariably led to losses, since drops in productivity were coupled with higher overhead expenses and less-effective revenue-cycle management. Today, aggressive hiring of PCPs is returning, in part because hospitals fear physicians’ becoming competitors by aggregating into larger integrated groups that direct referrals and utilization to their own advantage. Hospital-employed PCPs generally direct patients to their own hospitals and specialists affiliated with them. In addition, by employing physicians, hospitals retain maximum flexibility in the market, should health plans change their reimbursement structures to require providers to bear risk and manage population health…

Though hospital employment may offer physicians some protection from system reforms, it comes with more performance management than it once did, and the option of reverting to independent practice later may be far less attractive in the future. Employment choices that physicians make today may not be able to be undone.

The hospitals hope to make up for their physician employment losses by improvements in productivity and “performance management” [read: controlling physicians’ decision-making based not on quality, but on cost]. That these economic “efficiencies” are largely illusory — and will harm patient care — will become evident in time. This scenario played itself out in the early 90’s, when hospitals bought up practices in anticipation of Clinton Care. They proved financially untenable and ultimately imploded, after massive cuts in support staff and physician salaries made continued hospital group affiliation untenable. The enormous economic pressures soon forthcoming through ObamaCare and ACOs (more on these anon) will invariably result in similar scenarios — with far fewer escape hatches for increasingly unhappy physicians. They will be locked down by highly restrictive regulation and “care standards”; locked in by non-compete clauses and the insurmountable hurdles to starting or returning to practice; and locked out completely of the decision-making processes which control their lives and their profession. Expect a tsunami of early retirements and career changes when this is fully implemented.

And in the unlikely event the hospitals succeed economically at this venture, through the will to power, you may be assured that the vultures will soon descend to strip the pink flesh off their bones:

The consolidation wave [hospitals acquiring practices] is raising red flags among some regulators, researchers and health insurers, who warn that bigger health systems can use their leverage to push for higher rates. “We’ve always been concerned about combinations that are being done to increase prices,” said Karen Ignagni, chief executive of America’s Health Insurance Plans.

These factors made for a long and poignant pause in my rush to employment. But the final straw proved to be the realization that my reconstructive infertility specialization, built laboriously over 30 years with much hands-on care and effort, would die on the vine under hospital management. I would lose control over pricing; lose control over my superb supportive employees who are masters at communicating with patients an the many issues involved in these cases; and lose the freedom to provide discounted and charity care when the Spirit leads.

So my “Dear John” letter went out, two weeks ago. My employees were ecstatic at the news, my wife enormously supportive of the decision (she had previously been a major force prompting me to seek the security of hospital employment, and has now done a complete 180), and I have an enormous peace with the decision in my own soul. Perhaps, like Odysseus, I have been tied to the mast, lest the Sirens lure me onto the rocks of disaster.

Of course, the problems of sustaining and surviving in the hostile environment we now inhabit in health care remains; thus it becomes now a journey of faith.

Ah, faith: not the blind confidence in the unbelievable, but trust in the eminently Trustworthy, without the clarity of vision one might wish, but with the vision of hope based on experience. He has never let me down; He will not do so now.

It should be a most exciting journey.

Meditation on Good Friday

Today is Good Friday. It has been my custom, on this extraordinary day, to post an old meditation on the meaning of the cross, called Three Men on a Friday. Today, however, I feel led to meditate on something rather different, though not unrelated.

Good Friday, of course, is the Church’s remembrance of its most central truths: that God became man, was crucified to pay the price which we could not pay, and was raised victorious on the third day. Good Friday is a somber day, a day to remember that we individually are responsible for the torture and agony which befell Christ — that he hangs on the Cross in our stead.

Yet, in the deep sorrow and humility which we bring to mind on this profound day, there is also an extraordinary hope: that in our greatest disasters, in our biggest failures, in our most agonizing and painful moments, there is a purpose, a plan, a hope which is both utterly irrational, yet absolute and sure.

Good Friday teaches me that failure is not to be avoided at all costs, but instead embraced as a great opportunity. Good Friday teaches me that my lifelong struggle for perfection is doomed to failure, and is chasing after the wind. Good Friday teaches me that I have no idea what is best for me, that pain and suffering have a purpose which I need not, and often should not, understand. Good Friday teaches me that God can make sparkling diamonds out of filthy coal, that my worst attributes, my most painful failures, the most disastrous events which have befallen me beyond my control, are but the building blocks of a new and far better life in hands of God.

I have recently shared some of the struggles in my life, especially my professional trials, and these have indeed taken no small toll on my spirit. Beyond that, like many, I have watched as a country which I love, whose institutions and traditions have blessed and prospered millions, is undermined and corroded by greedy men lusting for power who serve only themselves. Like many, this has been most painful to watch, engendering much anger, frustration, dismay, and discouragement.

Yet I must not forget that I too am greedy, that I too seek to control others and manipulate my world for my own benefit and betterment. We hate most in others what we see in ourselves, and our instincts scream to return evil for evil. Yet by so doing, I enslave myself to those who would enslave and destroy me.

The Cross teaches me another way. It teaches me, quite simply, that God is in control of all things, and that His ways are not my ways. It teaches me that the darkest hour comes before dawn, that God can use evil for good, and that only by bending my will and my knee before Him, no matter what the cost, can my own victory and deliverance, and that of others, be purchased.

We are at war. This is a war, not merely of bombs and guns, nor of words and arguments, nor of politics and power. It is an ancient war, from the very beginning of time: a war between the will of man and the will of God. One way is the way of hatred, anger, revenge, and destruction, whose outcome, no matter how fleeting its seeming victories, will inevitably and invariably lead to defeat and destruction. The other way is that of submission, of self-crucifixion, of “not my will but Thine.” Every fiber of my being strains against this way; every inclination of my will and spirit runs contrary to such surrender. Yet on the Cross, surrender, humiliation, agony, and defeat became the very instruments used of God to reconcile man — stubborn, rebellious, hateful man — to Himself, and to bring new life, and new power, and new hope to those who would follow in the irrational ways of God. And this war must be fought and won, first and foremost, within me.

Yet in this way of submission, brokenness, and humility, we are not called to passivity nor defeat. We are called — each in our own way, using our own gifts — to do battle. For some this will be a way of persuasive words, or prophetic proclamation of the evil which surrounds us. For some it will be writing letters, contributing money, volunteering time and effort, running for office, becoming involved.

But for all, first and foremost, it must begin with prayer, with self-examination, with the submission of every aspect of our lives to the will and wisdom of God, for judgment begins with the house of God. It is time, quite literally, to be on our knees; it is time to fast, to repent, to make amends, and take hold of that joy and purpose which can only come by aligning our wills with that of Him who paid the ultimate price to make us whole.

We do not know — we cannot know — what the outcome will be; the ways of God are vastly higher than our capacity to understanding, and our efforts will come to naught if we try to bend the plans of God to the will of man. We must submit to crucifixion if we are to see the Resurrection.

There are many paths, the broad leading to destruction, the narrow to life. May God give us the will and the wisdom to follow that narrow path.

Thoughts on Thanksgiving

Before the joys and trials of family get-togethers, the bacchanalian consumption of endless pounds of poultry, and the weariness of holiday travel tempered only by the thrill of a TSA patdown, it is perhaps fitting to pause and reflect a moment on the reason for the season we celebrate this week: Thanksgiving.

Like most of our holidays, Thanksgiving has become commercialized, sterilized, and neutered, long ago detached from its original significance, its spiritual roots withered and wizened, lost in the ever-longer lead-in to the crass commercialism of Christmas. To be sure, we nod in its direction, with cursory platitudes of gratitude for material blessings and bountiful food. Yet our lives betray the truth behind the truisms: we are a most unhappy, ungrateful, ungracious, and resentful lot. We who reside amidst the greatest wealth ever accumulated, suffer from an acquisitive sickness, a deep and abiding unhappiness which even greater and ever more cannot heal. We live in expectation more than acceptance, revenge rather than reconciliation, greed not gratitude. For all we have, we have not peace, and thanksgiving is the farthest thing from our minds and hearts.

So what then of gratitude, of true thanksgiving? It is not the cheap grace of the smug acknowledgment of all we possess, lest we be seen by others as a selfish boor. Nor is it some warm emotion poured forth like spirits from a crystal decanter, transparently empty after its contents are spilt. It is indeed poorly expressed by words alone, which cost far too little to repay our debts.

It is, rather, a proper sense of perspective, grounded in a larger vision of purpose. It recognizes, first and foremost, that we are limited and flawed, not the pinnacle of evolution but the pride — and the problem — of creation. We are magnificently made but fatally flawed; we aspire to the stars but stumble in the mud. What we have is not what we have earned, but we we have been given — and far too often used not for glory but for gain.

Thanksgiving tells us that we have a higher purpose, a calling which draws us toward the divine, in order that His highest purposes are fully served. It tells us we are hopelessly handicapped in our pursuit of this noble calling, waylaid in wanton selfishness and frivolous foolishness, distracted from our goal by baubles and the banal. Indeed there is little hope of restoring our vision but by grace, by the gracious hand of God to guide, empower, and correct us. It is in this extraordinary reality that true gratitude is found, that we who have hated the good have, in spite of ourselves, been called back home, in forgiveness and with vision restored, to be made useful and purposeful again, to be made new.

This grace empowers gratitude, for it opens all things, both good and bad, to the possibility of redemption. For the good we may be grateful, not merely that it blesses us, but that it enables and empowers us to serve and give to others. Our trials and liabilities, too, become tools by which we may reassess and redirect our lives, growing in empathy for the suffering of others, and in trust in the inscrutable goodness and wisdom of God, who uses evil for good. Our thanksgiving is a celebration of freedom — the freedom to transform all things, whether good or evil, to the higher purposes of God.

A cynical and empty culture knows nothing of this miracle of grace, and thus has no gratitude, no graciousness, no humility or hope. We are called, in this season of Thanksgiving, to be a light shining in a dark and empty world, which by disowning transcendence has destroyed its hope.

Let us, then, be truly grateful this Thanksgiving, for the grace of redemption, the hope of transformation, and the mercy shown to us through Him who is most gracious.

Have a most blessed and fruitful Thanksgiving.