Faith & Religion

The Call

Dr Bob

The Call

cancer Damn!, I hate these calls… Lying on my desk, clipped to a yellow manila binder, is a single sheet of paper. Its pleasant color format and sampled photomicrograph belie the gravity of its content:

Adenocarcinoma, Gleason grade 9, involving 60% of the specimen.

How do you deliver a death sentence?

Your first impression of Charlie is his sheer mass: 50 years young, healthy as a horse, built like a tank, a former football player turned popular coach at a local high school. He arrived at my office after seeing his family physician for an acute illness, with fever, chills, and problems urinating. His doctor had diagnosed a urinary tract infection, placed him on an antibiotic, and drew a PSA–a screening test for prostate cancer. It was markedly elevated: over 100, with normal being less than 4. I grumbled to myself as I reviewed his chart: Those damned primary care docs shouldn’t draw PSAs when patients have prostate infections–it just muddies the waters.

PSA (prostate specific antigen) is a test which measures a protein in the blood stream released by prostate tissue. It has greatly improved early detection of prostate cancer in the 20 years it has been in widespread use–but it is not, strictly speaking, a cancer test. It is noisy–often abnormal in other conditions, including benign prostate enlargement (BPH), inflammation, and prostate infection. It is virtually always elevated in the presence of an acute prostate infection–often markedly so–and can take months to return to normal. The high PSA alarms the patient, however, who is told he may have cancer. But most do not–and Charlie looked like a classic case of infection.

His history was typical, and his response to antibiotics appropriate, so this seemed at first glance like so many other similar cases I had seen. His prostate exam was alarming, however: rock-hard and irregular, unlike the typical soft, boggy texture of an infected gland. Experience and training kicked in, and I knew exactly what we were dealing with: a relatively uncommon form of prostate infection called granulomatous prostatitis. I had seen dozens of cases–always alarming on first exam, with very high PSA values–and always responding to long-term antibiotics. Charlie was started on a one-month course of high-powered, high-priced bug exterminator, and came back for follow-up after its completion.

He was feeling better, and his PSA had dropped markedly, to 45. His prostate exam also seemed improved, but still quite abnormal. I remained quite confident in my diagnosis–after all, cancer doesn’t get better on antibiotics–but was unwilling to wait much longer to know for sure. I scheduled a prostate biopsy, reassuring him after its completion of my optimisim that the results would show only infection.

The report was a blow to the gut. I sat silently, staring at it, in stunned disbelief.

In the age of PSA screening, most prostate cancers are detected at an early, curable stage–although their slow-growing nature makes treatment less important in very elderly patients. The chances for cure at diagnosis are determined by an estimate of the size and aggressiveness of the tumor. Size is determined by exam, ultrasound findings, and total PSA values; aggressiveness by the Gleason score–a value indicator (between 2 and 10) of the aggressive appearance of the cancer cells under the microscope. Higher is not better: Gleason scores of 9 and 10 indicate rapidly growing cancers which tend to spread early and are difficult–if not impossible–to cure. Charlie had drawn a pair of deuces in a high-stakes poker game: large volume, high-Gleason score cancer. The statistics were dismal: he would likely be dead of cancer in 5 years, regardless of treatment. And as cancer deaths go, this one’s not pretty: pain is a huge management problem in many, as the cancer infests and erodes the spine and long bones, breaking even the strongest of men. One learns to hate this disease before very many such cases have been seen.

And now I had to call him with his biopsy results.

The actual call will be brief: I will inform him that, unfortunately, the biopsy has shown cancer, that additional tests will be needed to determine its extent and the best way to manage it, and arrange for a follow-up visit in the office. The real bad news will be transmitted then, face-to-face, with more than enough information for its gravity to sink in. To do this–without robbing hope–will require more inner strength than is readily at hand.

But for now, I simply need to tell him he has cancer.

The word cancer encapsulates the deepest fears and anxieties of man, embodying in one small word pain, suffering, loss of control, hopelessness, dependency, death, the fragility of our dreams and hopes, and our uncertainty about the hereafter. To inform a patient that he has cancer is to shatter the illusion, the daily denial that death may yet be outmaneuvered, forestalled, kept on hold for some future date of our own determining. It is an illusion which dies hard–surprisingly so, as we alone among all creation are cognizant of its inevitability and certainty.

Perhaps the cruelest wish a man might be granted–were there some bottled genie passing out such favors–is knowledge of his own future. Yet, in some small measure, that power has been granted to me, and others of my profession. Not in any specific manner, of course–not of days or years, details or circumstances–but in knowledge deep enough to see the broad strokes: shadowy figures through rippled glass, of pain, and loss, and shattered dreams, of desperate grasping at the frail straws of fading hope, as the drumbeat of mortality pounds ever louder toward its dark crescendo.

Patients receive the call in different ways. Most accept it with seeming stoicism, and little expressed emotion–yet it is not hard to imagine–and sometimes to sense–the tight grasp of fear that grabs the throat and grips the heart. When wives are listening, the fear is more immediate, more palpable, as voices tremble with panic despite every effort to control it. A million questions will arise–but almost never on the initial call. On rare occasion, there is a casual indifference to the news–prompting reflection on what strength of spirit–or dense denial –such men possess.

I often wonder how I would receive the call. As a Christian, I am confident of a life hereafter, eternal, spent in the presence of Him who loves me. Some call that arrogance, or self-righteous; it is not. God alone knows better than I the darkness of my heart, the depravity that makes me uniquely unsuited to be in the presence of the Holy One but for one moment, much less eternity. But I have been adopted–an unwanted child by an unspeakably loving and merciful Father, who only asks submission to His tender guidance and direction, and transforms a lost fool into something useful, something cherished, someone with purposes aligned–though poorly so–with His own.

But the call of death–so confidently faced from the comfortable vantage of good health and cheap grace–will strike fear into my heart when it arrives, for far smaller challenges have brought dread in larger measure. There will be the fear of the ordeal, the journey of suffering, the loss of things now treasured but instantly made worthless. There will be the pain of watching the loss of those close to me, struggling to make sense of a relationship, undervalued while unthreatened, yet now more precious while counting down inexorably to its end. I know–by the tutor of past and bitter experience–that faith will sustain me and mine through it all. But one cannot know what that day will be like–nor should we wish to ever know.

But for Charlie, the battle will now be enjoined–the weapons and werewithall of modern medicine in all-out war against its implacable foe. Perhaps by some miracle or unexpected grace he will be given a reprieve, a window to revalue and reassess life’s course, its priorities, its purpose. For even when we are cured, we are healed to face death again: Lazarus, once risen, will revisit the stony crypt. Yet the Voice which called him forth calls us also, beckoning toward a painful light from the cold terrors of death.

How difficult to be the herald of another’s mortality–it is a burden no man should have to bear. Some will deliver it through the steely detachment hammered hard by years of training; some avoid it altogether where possible, through choice of profession or abdication of responsibility. But for those who must speak this hard truth, may there be grace and wisdom, empathy and compassion. May it be also for me.

The Prayer of Java

Dr Bob

The Prayer of Java

Recently, an e-mail exchange with a friend brought up the issue of prayer, and how it was a difficult learning experience for him. Like so much in the world of the web, a seed gets planted which starts you thinking. It has taken some time to sprout, but here it is…

The subject of prayer is a fascinating one for me in many ways, not only because of its effect on my life, but because — as a logical-sequential scientist by profession and disposition, I want to understand how it works — and I don’t, and I can’t. But it does. And that cognitive dissonance drives me a little nuts.

Billions of words have been written on prayer, by foolish and wise, scholarly and simple. For the secular skeptic, baptized into the random meaninglessness of a life accidental, it must seem odd — if they stop to think of it, which I suspect they rarely do — that mankind throughout eons and cultures has devoted so much time and energy to a pointless litany of words directed to the non-existent. Even among we who confess to the existence and significance of a Being higher than ourselves, prayer confounds and frustrates us, as we search for some formula, some talisman to garner the attention and blessing of the invisible, inscrutable deity.

But this does not keep us from trying. The drunk asks God to help him out of this jam, promising not to drink again. The agnostic pleads with God that the biopsy not show cancer. The unhappy spouse prays that her husband change to her liking. We pray for money, for success, for jobs, for relief from emotional agony and physical pain. We pray ritualistically, hoping that by repetition an indifferent or annoyed God will throw some crumb our way to get us off His case.

Prayer, perhaps more than anything else, reveals what we think about God and about ourselves in relationship to such deity. If our God is remote, abstract, indifferent, then our prayers will have the character of whistling through the graveyard — hoping against hope that the very act of addressing this unknown force will ward off fear of some greater evil closer at hand. If we serve an angry, judgmental power — vengeful and quick to accuse — then we will pray from fear, pleading nervously for mercy while recommitting ourselves to the required perfection we have no hope of achieving. If we worship Santa Claus, then endless lists of self-gratifying demands will appear, as we hope we have been less naughty than nice.

Like nothing else, prayer reveals the smallness of our god and the poverty of our souls. It lays forth the preconceptions which rule our lives and the limits which bind us — if we will but take the time to examine them. My friend, in his thoughtful meditation, says the following:

In fact, whole elements of religion are centered around having you find and keep a personal relationship with God. But just because you have a personal relationship with God (and you should), doesn’t mean God has to have a personal relationship with you. He is, after all, God and He’s got a whole universe to run. It’s a big place and He’s just one God and He’s busy.
Far be it from me to disparage a friend’s worldview or theology (and this is most certainly not my intent) — my own will likely be the standing joke at the Pearly Gates. But his depiction — intended to be humorous, if I read correctly (in risio, veritas?) — nevertheless strikes me as a nearly-universal presumption, a governor principle on the engine of God. This understanding of God — called theism by those who put names to God-ideas — has just never made a lot of sense to me.

God — whose presumed job is to handle very big enterprises — sets out to create a spectacular universe of unspeakable complexity and beauty. At the high point of His craftsmanship, He creates a being a lot like Himself — capable of thought, reason, passion, beauty, love, creativity — and gives this creature a spark of the spiritual, of that which is beyond time, place, and limits, beyond the physical, in a universe without dimensions. He endows this being with a relational spirit, made whole through interaction both with Himself and with others of like kind. Having crafted such an extraordinary masterpiece, the blind watchmaker then supposedly just walks away — too busy polishing the instruments and arranging the sheet music to listen to the symphony He has created.

I for one find this concept of God implausible, unfulfilling and even cruel — to say the least. A God who can craft a universe of unspeakable vastness and beauty with but a word, who designs galaxies and gamma particles, black holes and hummingbirds, is not stressed out by its administration. We have no grasp of the infinite — after endless accomplishments, there are endless more yet to come: there is no exhausting the infinite. There is only one limit on His limitlessness: the limits I place by believing He can’t, or won’t, or is too busy, or not interested.

So what then of prayer? Is it the missing nucleotide in the DNA of evolution, as my friend postulates? A cosmic post-it note? Perhaps, although I prefer to think of it rather differently — it is, to my mind, the coffee house of another, non-dimensional world, the spiritual world. A world not bounded by time or space, limits or liabilities. It is friends — not equals, mind you, but close, trusted friends — sitting together over too-strong brew, sharing odd thoughts, mulling questions, venting frustrations, angry, remorseful, laughing, weeping — melding hearts, two into one.

It is in many ways an odd but satisfying conversation: I speak, He listens — yet somehow I know what He is thinking, and He most surely knows my thoughts. It is decidedly non-linear. The questions I ask, the problems I present, are answered — always. But not in words, almost never at the time I speak or ask. But I know they have been answered — although the fruition, the language, the form of the answer may be hours, months, years away. It may arrive as circumstances, or in a conversation with a complete stranger in another time and place, or in an entirely unexpected — even unwanted — change of heart or inner peace about some deeply troubling or puzzling dilemma. Yet I know it is God’s answer — the answer He gave me back at that table, shootin’ the breeze and guzzling joe. It is a conversation freed from time and space — bizarre, but strangely more real than that which we unwisely and hastily call “reality.”

Now the skeptic will ask — including the skeptic in my own head — how do you know? What proof do you have that these occurrences, these thoughts, these conversations and situations, have anything to do with God? Are they not mere chance, wishful thinking, psychological crutches, neuro-endocrine surges that my highly-evolved cerebrum maps into culturally-molded thought patterns?

Of course, the skeptic’s challenge contains a presumption — one rarely recognized, in fact: that everything which exists, all that is real, can be measured, tested, analyzed, proven, and recorded. But much which is human — perhaps all which makes us uniquely human — is beyond such simple means of measurement and proof. How much does love weigh? What are the dimensions of courage? What is the deceleration velocity of a failing marriage? What color is hope? What formula predicts despair? Why does a rose smell exquisite, but a rotten egg horrendous? Sure, we can speak of neurotransmitters and aromatic organic compounds, but such things touch on the spirit, and the tools of the physical realm are wholly inadequate as inquisitors. The disciplines which come closest to addressing these matters — psychology and social science — are at best mediocre observers — and miserable failures at repairing the damaged spirit. Don’t believe this? Ask your friendly secular psychologist to explain the phenomenon of evil — then sit back and enjoy the blubbering blather of psychobabble which results. Evil will be alive and well — and wholly uncomprehended — when he finishes.

I do not point this out to dodge the question of proof, or disparage a profession, but simply to illustrate the inadequacy of physical science — or reason handcuffed by concrete presumptions — to measure the real yet intangible realm of the spirit: you cannot measure your shoe size with a Geiger counter. But the evidence is there, in abundance, if you know where to look. Medicine is near-miraculous at healing the body — and miserable at healing the spirit. We can cure cancer, but not save marriages; give you new kidneys, but not flush the impurities from your mind or the hatred from your heart. But prayer can — and does — do just that, a work far more miraculous than a wonder drug or robotic surgery. When a hopeless drunk, an avowed atheist, starts to pray out of desperation to a god he doesn’t believe in, and loses the compulsion to drink, it is an aberration; when it happens to two drunks, a coincidence; when it happens to tens of thousands, it begins to look a lot like evidence. What cure will you seek for unhappiness? (Hint: it’s not a new car, a younger, trade-in wife, or a diamond-shaped blue pill). Medicine can kill the pain, but not cure the spirit; prayer can do both.

Of course, it is not the prayer itself, but the power it unleashes, which accomplishes such things. Gravity worked the same for Cro-Magnon man as it does for a modern physicist; understanding the force changes it not one wit. But you say: I prayed for this or that — many times, even — and it did not happen: prayer does not work. And here’s the rub: the power behind prayer is not an inert physical force, but an infinitely wise and caring God. Whether you believe in Him or not, He exists, He listens — and amazingly (given our reprobate nature), always has our best interest at heart. As I look back at my own life, were I to have received a tenth of the things I asked for in prayer, my life would be an unmitigated disaster. God knows when to say “no”, where to say “wait”; He knows how to listen to what I ask for and give me instead what I really need, and truly want.

There is one secret ingredient to make prayer work: trust. Gotta have it. Can God work without your trust? Sure — the rain falls on the just and the unjust, as the proverb says. Our problem is we want to understand God before we trust Him. We want Him to strut His stuff, lightning bolts and miracles and the like, before we’ll acquiesce and maybe give Him a break. Sorry, that’s not trust — just the opposite. But God cannot be understood — even in a limited way with our most enfeebled minds — until we first trust Him. Sounds like a bum deal, a Catch-22, but that’s just the way it works. Get over it — you won’t regret it.

And one last thought in this long-winded essay: If you’re new to this prayer thing (or even not so new), start small. Praying for world peace or a cure for your cancer is fine, but a bit grandiose for starters. Pray about your misplaced car keys, finding a parking spot, the wisdom to deal with that difficult patient, or co-worker, or child, or situation. Then open your eyes, your ears, your heart for the response. You won’t hear it every time — but I bet you’ll be surprised how often you do, and you’ll learn something about God, about yourself, and in some small way about how this spiritual world works.

And set aside a little time for a cup o’ joe with God — good news is, He’s already picked up the tab.

God of Loss and Grace

Dr Bob

God of Loss & Grace

The Anchoress tells of receiving heartbreaking news: the prospect of losing her hearing:

Yesterday morning, though, came a straw I have dreaded my whole life, and I finally drew it: the “you are losing your hearing” straw… The loss was discovered, of course, due to that dismal ear infection of the past two weeks, but the hearing in that afflicted ear is only slightly worse than the other. Upon reading my test results the doctor asked if I had worked around airplanes for the past 20 years, or if I had fronted a rock band. “Severe degeneration! hearing aids!”
The pain of such a loss is real, and it is deep — it can neither be trivialized nor ignored. Some will deaden the pain by drink, others by denial or depression, or one of a host of other means whereby we mitigate the pain while refusing to embrace it. We live with sense of entitlement: we should be free of pain and suffering. For most, such dire news — particularly about health and well-being — is a devastating blow, devoid of meaning and justice, a cruel trick of fate, perhaps, or some sort of karmic retribution for evil done in this life or one prior. It is at best random misfortune, at worst a cruel robbery, a brutal injustice. There is no making sense of it — it is without reason or purpose.

Yet for the Christian, things are supposed to be different. We serve — as an article of faith — a God of love, and when one has committed their life to such service, the reward of such a severe trial raises a host of uncomfortable questions: Is God unfair? Is this punishment for sin? Is He capricious, toying with me, playing me for the fool, demanding my obedience then rewarding me with pain and loss?

The Anchoress responds as many would — with rage:

“I drove home pounding the steering wheel and telling God I thought He was pretty damned unfair, after all. I demanded that He listen to me and make me a sensible answer about why things were going as they were, why at only 46 years of age I was increasingly debilitated, increasingly arthritic, increasingly feeling like a 65 year old.

It’s not enough that I must sometimes use a cane, or that I wear glasses, not enough that I am constantly bruised, often fatigued into stupidity and inarticulate, stammering aphasia, not enough that my body is scarred all over and that my skin is under siege simply because I am Irish! now I am going to need hearing aids? Now I am going to be deaf? What has my husband ever done to you, that you need to inflict this sort of wife upon him?

Oh, I howled. I ranted.

And it was so out of character for me to do so – this has not been my way, to shake an angry fist at God and make demands. I didn’t like doing it – it felt so wrong. So wrong, not to simply be thankful for my blessings – for all the good things, and all the “not too bad” things.

But I was so angry.
Anger at God — a frightening, even terrifying thought. At worst it presents images of lightning strikes, fire and brimstone, judgment, destruction. Better to pretend you’re not angry, hide it from God lest He send another, more awful plague in retribution.
(more…)

Deep Waters

Dr Bob

Deep Waters

Lake ClarkThey say that hell is hot. Sometimes, though, it is very, very cold.

Jim loved Alaska–it had been his home since birth. God’s country: wild, unpredictable, spectacular in beauty–there was no place like it on earth. Cities were a necessary evil, with their services and surliness, but out in the wild was where life could be found. Out among the glaciers, the ragged mountains framing the endless blue sky like jagged, broken glass, out where grizzlies snatched salmon from raging rapids, shortening their march to death as they fought wild currents to reach their spawning grounds. Out where eagles graced the sky, soaring above green fir spires and spotless snow fields. Out where God lived, where a man could see His hand, and hear His voice.

Jim lived a simple life of simple faith. He loved his wife as he loved the land, and together they were blessed with six children–three older girls, the twin boys, and a baby son their most recent gift. Each was a treasure greater than the next. Their lives were story book: The lodge they owned nestled near the shores of Lake Clark, a large inland glacial sea, mirroring the snow-peaked mountains surrounding it. Summers were busy–hunting and fishing tours, visitors from afar seeking trophies and photographs, decked in newly-purchased gear from REI in the lower 48. Jim loved to fly–the float planes lifted gracefully from the lake, carrying their awestruck passengers over endless miles of breathtaking beauty to some far-away stream where tied flies touched water and fish broke airborne for their last meal.

Out in the bush, relationships were few in number but rich and deep. Church was more than a Sunday obligation–it was a place where life was shared, joys celebrated, suffering consoled–a place where faith begot works, where love put on snowshoes and helped stack the winter’s wood. Family life was alive, ripe with blueberries picked, hikes to the falls, and quiet nights beside campfires. Summers passed quickly at Bible camp, concentric ripples of cannonballs and giggles of joy rolling across the lake from the old dock. Dates with dad and high tea with mom found no competition from mindless cartoons, and bedtime prayers thanked Jesus for His goodness and God for His gifts.

Winter was time for quiet reflection, as the short days and deep snows kept sportsmen far away, and school and indoor chores made the time pass slowly but with purpose. The plane was their lifeline: what few roads there were became impassible in deep snow, and flights to Anchorage a necessity for supplies and health care. The girls came along often, although the younger boys stayed with friends and relatives for lack of space.

Jim had tens of thousands of hours of flying experience, a skill which paid rich dividends in the harsh, capricious winters of south Alaska–there was little in the way of flying conditions he had not challenged and mastered. So this flight to Anchorage in February was a pleasant surprise: the low gray skies broke open to display the rare winter glory of sunshine on pristine snowfields, the glorious tinted rim of Alaska Range peaks and deep seas of Cook Inlet. The supplies garnered and the girls’ dental care completed, they took off for the return flight to home and hearth.

The storm struck without warning, a white she-devil blown in from the Gulf, the Cessna buffeted by sharp, hard winds as visibility and ceiling dropped precipitously. The instruments held true, and countless hours of difficult flying forged Jim’s nerves steely and his focus intent. Mom held the girls’ hands, distracting them from natural fears with songs and stories and heads held to breast, her own pounding heart betraying her calm demeanor. “Will we be OK, mommy?” “Jesus will bring us home, honey.”

The GPS told Jim they were indeed near home–the lighthouse in space beaconing safety and rest. By reckoning they should be near the lake, just a few miles out from the landing strip. But Nature had not finished yet, her rage reserved for one final blow.

A whiteout in a small plane is dreadful beyond imagining. Suspended between earth and sky, with no point of reference, no sense of up or down, sensory deprivation in a aluminum rocket. Your training trusts your instruments, but instinct and eyes scream for visual confirmation. There! On the right! Through a brief window in the suffocating white blindfold, a dark line: the outline of the lake shore. Jim banked the plane toward this beacon of hope. “Are we home yet, daddy?” “Almost there, honey.”

But wild Nature held one last vengeance: an atypical winter thaw had opened a long dark crack in the ice, normally frozen solid in February. The line Jim saw was not the airstrip. The plane hit water at airspeed.

The prop and windshield exploded. The cabin filled instantly with icy water, as Jim craned his neck to reach the fast-retreating air, still restrained by his harness. Years of wilderness training sprung to life, as without a thought he grabbed his Bowie and cut free the webbing. He struggled with the girls’ restraints, hopelessly locked between seats crumpled by the impact. His wife was nowhere to be seen. Time was up–the air was gone. He broke from the cabin, gasping for air at the surface, hoping to dive and try again to free his treasures. It was not to be: the plane sank like a millstone, 600 feet to the bottom of the frozen fjord, entombing the family he worshiped.

In shock, he looked around. His wife, by some miracle, thrown from the plane at impact, had struggled to the surface and clung to a floating berg. Spared from a frigid tomb, they stood on a fragile shelf of thin and breaking ice. Over two miles from the shore, clothing soaked through in sub-zero temperatures, their survival was still a loser’s bet. Slowly they worked their way shoreward, breaking through the ice at times, body temperatures dropping despite their exhausting physical efforts. Guided by some hand unseen, they finally fell exhausted on shore, finding shelter in an empty lodge. Blinded by cold and head trauma sustained in the crash, Jim was led into the cabin by his wife, who cut off his frozen clothes and started a fire.

Friends awaiting their arrival grew anxious, and the Air National Guard was called. A rescue helicopter–braving the same merciless weather–located the crash site, and ultimately reached them at the cabin. Even then, they could not be evacuated, as conditions grounded the helicopter until morning. A friend flew a Piper cub–braving the same horrendous weather–to bring arctic sleeping bags and warm food. Bravery, love, and duty had spared their lives.

Months passed. Physical healing came quickly, but the rawness of heart wept like an open sore, gently salved by friends and faith, prayers and potlucks, tears and thankfulness. The boys were precious as never before, but the emptiness of heart left by a lost child cannot be filled. The rage at God passes–slowly–as strength flows from trust born of countless old decisions to set aside self and act in faith. But the memories remain–the laughter lost, the peace of a sleeping child, the love of a flower picked, the hug unexpected. There is no answer to “why?“–only time, and trust, and talk, and the tender whispering of a gentle Spirit. Yet one haunting regret refused to die: the vasectomy Jim had undergone after their last son–expeditious at the time, financially prudent–was now a self-imposed prison in a home filled with family, yet achingly empty.

And so they sat in my office, seeking my skills to restore what no man should be asked to provide–hope and happiness. And they told their story, my heart aching with each small detail disclosed. Jim was a man of enormous character and strength, his wife still bearing the unspeakable pain on her face–yet there was no shame in the tears that welled up in their eyes. As I gently probed deeper with almost unseemly curiosity, I was drawn in by the most remarkable revelation: these two would stand. Theirs was a strength not merely of hardiness, or training, or steely denial hiding a dying heart, but of power beyond the means of any mortal. They had faced the hell that men fear even to consider, and conquered it. There was glory in their weeping, victory in their agony. They would never be alone, and never be defeated. I, the proud expert, felt strangely insignificant in their presence.

The surgery went well, and early recovery smoothly. As I spoke with Jim before he left for home, he talked about the girls who had loved their daddy and whom he still loved so deeply. “You know, if I could fly to heaven and bring them back, they would not want to come. Their happiness is complete, ours still unfulfilled. Jesus has indeed brought them home.”

Reply to Wendy

Dr Bob

A Reply to Wendy

In one of my early posts, I wrote an essay called Liberalism and Gnosticism, reflecting on the similarities which I found between the current Progressive movement in America and this rather ancient religious movement. I have been interested in the history of early Christianity and its contemporaries for some time, and have been increasingly struck by the parallels between much contemporary political discourse and conduct, and the detachment between intellect and behavior so common in the Gnostics. When I moved the site to it’s current location, it was one of the essays I relocated, as I saw some value in its persistence. I then set it aside, like some dusty old high school track trophy, to cite when annoying my children with my meager achievements in advanced age, creeping toward senility.

So it was with some surprise that I received a comment on this post recently, from a nurse named Wendy, which I will take the liberty of citing here:

I don’t understand. Why does liberalism have to be about religion. I find it very offensive. I am liberal because I think that everyone should have an opinion and that other people’s opinions should not be pushed onto others. If you want to believe in Jesus, good for you, but that doesn’t mean I should. And it doesn’t mean I am an evil person because I don’t believe in him. Why must Christians spend so much time figuring out why others aren’t Christian? Why can’t they spend more time on listening to others and finding tangible solutions to the problems that face this country. I am a nurse who cares for patients day in and day out with loving care and I don’t care if they are Christian or Hindu or anything else. They are humans who need to be respected and listened to. If they tell me about a man in the sky that they talk to and it helps them get through the day, good for them. I sit and listen and I do not judge. If Christians spent as much time looking for solutions to make this world a better place and less judging of other this world would be a better place.
In roaming the new world of online journalism, there are many who seem energized by controversy and dispute, anxiously awaiting each fiery arrow to skillfully deflect it with a witty or biting retort. Others seem merely to have hides of Kevlar–if I received just a smattering of the vile attacks many conservative pundits receive, I’d pack up my browser and take up lawn bowling. You see, I don’t do criticism, because a) I know everything, and b) I just knew you hated me. I remember sparring with Jehovah’s Witness back in the old Compuserve forum days, and dreading–dreading!–the modem’s screech, that dreadful hiss a coiled snake rearing to strike, downloading my messages.

Blogging, of course, is even more exposed, an emotional skinny-dip in piranha-infested waters, but fortunately, I am a cuddly cockroach in the TTLB Ecosphere, so my burden has been light. And Wendy’s note hardly qualifies as an attack, but rather a diplomatic difference, the sort of opinion sharing too rarely seen on the web. And I appreciate that.

So I am motivated to respond to her thoughts with a soon-forgotten post rather than a never-seen comment–after all, that’s what blogging is all about.

I am surprised–and a little puzzled–that this post proved so offensive to you, Wendy. Of course, someone of liberal leanings might find offense at being painted with any characteristic they dislike (as would conservatives, or anyone else for that matter). But the issue seems to be not simply a comparison deemed negative, but rather that I likened liberalism to religion. Actually, if I read my own essay correctly (others will be better judges), I was drawing a comparison between some of our more vocal friends on the left–who appear to value what one believes (or perhaps better, what one professes), over how one acts–with the rather striking similarity evident in the dualism of the ancient Gnostics. No more, no less, really–I wasn’t maintaining that liberals are a secret religion, or occult group, or anything similar. Is this the worst thing one can be called as a liberal–religious? Perhaps, as it appears to be the very worst thing you can be as a conservative.

But what is religion, really? If you view it as smells and bells, hymns and hypocrisy, rules and restrictions, churches and chastity belts, then yes–there are many who are not religious, who shun and oppose it–rather rationally in fact. But if you view religion rather as a worldview, as a set of beliefs about who we are, why we are here, our relation to the physical and the spiritual (or the immaterial, the soul, the life-force, the unseen, if you prefer–and if you believe such exists)–in other words, the meaning of life–then religion becomes a far broader thing, universal in scope, for we all have beliefs and opinions about such things. And these opinions mold and motivate how we act. So in a sense, we are all religious.

You define your liberalism as the freedom to hold opinions and your dislike of having others force their opinions on you, if I paraphrase you correctly. Do you read the newspapers? TV news? blogs? Vanity Fair, Architectural Digest, Sports Illustrated, People magazine, Cosmopolitan? They all force their opinions on all of us, although force is perhaps too strong a word–persuasion, overt or occult, is more accurate. They all hope to change the way you think about yourself, others, and the world around you–that’s exactly why we read and listen to them. You personally do the same, when you share the best cookie recipe ever, or how awful that movie was last night–you are attempting to influence someone else, to change the way they think or act. Religion (narrowly defined) is in reality just one more worldview, one more opinion attempting to influence how you think, how you perceive, how you act.

With so many opinions out there, it can be overwhelming to sort them out. We humans use a process called abstraction: we summarize complex information, forming opinions about the general from a few specifics. In software development, this is a good thing: you don’t care about TCP/IP stacks and protocols, document object models, CSS, or javascript–you click a link, and a web page comes up (hopefully “The Doctor Is In”, if my agents on the internet are following their orders). In human behavior, this leads to assimilation of information: complex but familiar external objects are simplified to fit preexisting categories in your mind–the link becomes the web page. The other mechanism we use is accomodation: when unable to resolve conflicting opinions or information, we basically say they are all the same or it makes no difference which you believe–we change our thinking, our pre-existing categories, to reduce or eliminate cognitive dissonance. So if this religion believes A, and another B (directly contradictory), rather than do the hard work of evaluating both, we default to “all religions are the same”, or “there are many paths to God”, or similar rationalization. Or we assume they both are wrong–which, of course, may be objectively true, or not.

But in day to day life, opinions do matter–ideas have consequences. An alcoholic’s opinion that his drinking doesn’t bother anyone else collides head-on with the front of your minivan full of children. You will not be non-judgmental about a man in NAMBLA having your 9-year-old son visit for a sleepover: you will force your opinion on him, and emphatically so.

What bothers people most about religion, I think, is that the opinions of religion often come with a little bonus: a loaded gun. If you do not serve Allah, you will be slaughtered in jihad; if you do not accept Jesus, you are going to hell; if you do not become a Jehovah’s Witness, you will be destroyed in Armageddon; if you live a bad life, you’ll come back in the next life as a cow, a beetle, or–God forbid–a Republican. This, I suspect, is what you mean by people forcing their opinions on you. “Believe it, or else” is not a message I want to hear–nor anyone else, I suspect.

But not all opinions with warnings are intimidation. If your young daughter picks up a sharp knife, or tries to drink the bleach, you will issue an opinion with a threat attached: “That knife could hurt you–drop it, or else!” She will be disciplined for a reason: the danger is real, and love demands action, even if it is not what your daughter wants to hear. She will hate you for your love–but survive to appreciate it later.

You are, I have no doubt, a fine, compassionate nurse. I have enormous respect for nurses–they are the heart and soul of medicine. We physicians breeze in, in our white coats, see patients for mere moments, snap out some orders, and move on to our next divinely-ordained task, leaving the nurses to pick up the pieces and fill in the gaps. You get no thanks, only rebuke for misreading our illegible scrawls. Your skills of observation and listening are unmatched by any other profession, medical or otherwise. And I agree wholeheartedly with you: there is far too much judging of others by Christians (and others)–the redwood in our eye sure looks like a speck in yours.

But let me suggest something, if I may: “I sit and listen and I do not judge.” The first two are excellent, but consider the third: sit and listen, and judge. Not the words, not the personality, not the belief system, not the theology. Don’t worry about the “man in the sky”–look at the man or woman in the bed. Judge the character of your patient–how do they look? Is there any sense of inner peace, a strength inappropriate to the dire news, a joy in dire circumstances, a comfort inexplicable by opiates and well-rehearsed platitudes? You have the eyes and ears, the heart, to see it–if you will open your mind and your spirit to do so.

We are scientists by training–hammered by merciless hours studying, following, learning, assessing, doing. We know how to measure, to infer, to test, to draw logical conclusions. But not all in medicine, in our care for human beings, is measured in kilograms, or milliliters, or mm. of mercury: there are things–spiritual, immaterial, nebulous, unexplainable–which can only be measured by the heart, but are nevertheless real and tangible. Look for them, Wendy–and be prepared for a wonderful journey when you find them.

Three Men on a Friday

Dr Bob

Three Men on a Friday

CalvaryThree men on a Friday, condemned to die. Ensnared by Roman justice, convicted, and sentenced to a lingering death of profound cruelty and excruciating agony.

The Romans knew how to do it right: execution designed to utterly humiliate its victims, and maximize their suffering–a public spectacle and object lesson to others about the foolishness of defying Roman authority. First used by the Persians in the time of Alexander the Great, and adopted by Rome from Carthage, crucifixion was so horrible and debasing a fate that it was not permitted for citizens of Rome. Victims hung for days, their corpses consumed by carrion.

Our knowledge of these three men is incomplete. Two are described in ancient texts as thieves, the other a preacher run afoul of religious leaders, delivered to the Romans under pretense of imperial threat. There should have been nothing unusual about this event: the Romans crucified criminals often, sometimes hundreds at a time. Yet these men, in this spectacle, were different: on these crosses hung all of mankind.

Two thieves and a preacher–an odd picture indeed. And even more peculiar: the most hated was the preacher. Taunted, insulted, ridiculed, reviled. A miracle worker, he, a man who supposedly healed the sick and raised the dead, yet now hung naked in humiliation and agony, unable to extricate himself from his dire circumstance. Even those convicted with him–themselves dying in unbearable pain and mortification–join the fray. Insulting the rabbi, demanding he set himself–and naturally, themselves as well–free. They know his reputation, yet selfish to the end, desire only their own deliverance.

But one thief is slowly transformed, in frailty considering his fate and the foolishness of demanding release when his punishment is just. And he marvels at the man hung nearby — why? Why does this preacher, unjustly executed, not proclaim innocence nor demand justice or vengeance? Why does he — amazingly — ask God to forgive those who have so cruelly and unjustly punished him? Why, in the extraordinary agony only crucifixion can bring, does he seem to have peace, acceptance, perhaps even joy?

The thief’s revulsion at the baying crowd, at the arrogance of his fellow convict reviling this man of character and grace, bursts forth in rebuke at him who ridicules: “This man has done no wrong!” Turning to the preacher, he makes a simple, yet humble, request: to be remembered. Only that. No deliverance from agony, no sparing of death, no wealth, prosperity, or glory, no miracles — only to be remembered.

The reply reverberates throughout history: “This day you shall be with me in Paradise.” A promise of hope, a promise of relationship, a promise of forgiveness, a promise of comfort, joy, healing, peace.

Three men on a cross. In these three men are all who have lived: two are guilty, one innocent. Two are justly executed, one unjustly. All three have chosen their fate: one thief to revile, ridicule, hate, blaspheme; one criminal to trust, to seek consideration and mercy from one greater; one man to submit to brutal and humiliating torture and death, willingly, for no crime committed — or for all crimes committed, everywhere and for all time. Yet only one promise given — to the one who, though guilty, trusted and turned.

Who was this man in the middle, this preacher? A charlatan, perhaps – but an imposter abandons his schemes when such consequences appear. Delusional, deceived zealot, or presumptuous fool? Such grace in agonal death is inconceivable were he any such man. What power did he have to make such a promise? What proof that the promise was delivered?

An empty grave. A promise delivered by a cavern abandoned, a stone rolled away. A gruesome death transformed into a life of hope, meaning and purpose for those who also trust.

Faith & Reason

Dr Bob

Faith & Reason

RoseRon Suskind, in an article in the NY Times Magazine during the Bush vs. Gore election, Without a Doubt, addressed the issue of the faith of George W. Bush, and began as follows:

Bruce Bartlett, a domestic policy adviser to Ronald Reagan and a treasury official for the first President Bush, told me recently that if Bush wins, there will be a civil war in the Republican Party starting on Nov. 3. The nature of that conflict, as Bartlett sees it? Essentially, the same as the one raging across much of the world: a battle between modernists and fundamentalists, pragmatists and true believers, reason and religion.

Just in the past few months, Bartlett said, I think a light has gone off for people who’ve spent time up close to Bush: that this instinct he’s always talking about is this sort of weird, Messianic idea of what he thinks God has told him to do. Bartlett, a 53-year-old columnist and self-described libertarian Republican who has lately been a champion for traditional Republicans concerned about Bush’s governance, went on to say: This is why George W. Bush is so clear-eyed about Al Qaeda and the Islamic fundamentalist enemy. He believes you have to kill them all. They can’t be persuaded, that they’re extremists, driven by a dark vision. He understands them, because he’s just like them . . .

This is why he dispenses with people who confront him with inconvenient facts, Bartlett went on to say. He truly believes he’s on a mission from God. Absolute faith like that overwhelms a need for analysis. The whole thing about faith is to believe things for which there is no empirical evidence. Bartlett paused, then said, But you can’t run the world on faith.
There is much to address and analyze in this lengthy article, and no doubt others better versed on the credibility of its sources, the speciousness of its evidence, and its use of unconfirmed hearsay and biased sources will rise to the debate. But I was particularly struck by one line which I believe embodies the heart of the article’s core thesis:

He truly believes he’s on a mission from God. Absolute faith like that overwhelms a need for analysis. The whole thing about faith is to believe things for which there is no empirical evidence…

There is a name for someone who believes things for which there is no evidence: a fool.
Listening to the secular fundamentalists at the NY Times expound on the mind and heart of a man of the Christian faith is akin to a man blind from birth describing a rose: you are far more likely to hear about the thorns than the subtle colors and beauty of its petals.

“The whole thing about faith is to believe things for which there is no empirical evidence.”

Really??

The tension between faith and reason (or “reality”, as Suskind calls it) is hardly a new issue, reaching back centuries to such philosophers and theologians as Augustine, Thomas Aquinas, and even Plato and Aristotle. Aquinas has the most fully developed exposition on the seeming dichotomy between that which is discernible to the senses or by logical deduction, and that which is revelation and mystery. Far greater minds than ours have taken–and mastered–this challenge.

“There is a name for someone who believes things for which there is no evidence: a fool.”

And I suspect most journalists for the NY Times would find this an apt assessment of President Bush–and by inference, his religious supporters, lumped together under the tattered banner of the “religious right”. As a believing Christian, therefore, I am a proxy target for this accusation. And as a blogger, it is my duty to reply.

So, is this thing called faith really a fantasy, a trust and hope in some unseen, unprovable philosophy or myth? Most definitely not. There are, from my perspective, quite a few objective reality-based foundations for that which I believe. Among these are:

  • Historical: The Christian faith is a historical faith. It is based on an individual, Jesus Christ, who lived in history, verified as real not only by His followers (and enemies) but by detached historians with no agenda to promote. The core convictions of this faith are easily demonstrable, not only in its sacred texts, the Scripture, but in writings and teachings of men from many cultures and times, from the earliest years following the death of Christ continuously to the present. The accuracy of its ancient sacred texts is nothing short of stunning, supported by an exponentially greater volume of manuscripts and archaeological evidence than any other ancient writings. If the Old and New Testament were not religious texts, there would be no academic dispute about their veracity and reliability. They are challenged because they shine a light on the darkness of the human heart, and make uncomfortable demands on human behavior and belief. If you can prove the judge is a corrupt impersonator, you dodge the sentence for your crimes; if he is unimpeachable, you’re busted.

  • Relational: There are several aspects to the relational nature of Christianity which serve as evidence for its reality. People do not arrive at Christian conviction by lightning bolt or holy vision, but rather by their relationship with others who hold the faith. We witness the effects of Christianity on the lives of others, and are led to consider it not only because of what they say, but far more by what we observe. Few of us would buy a car without talking to other car owners, reading reviews, and taking it for a drive. While not a guarantee of a good car, we consider such information valuable evidence in making our decision. While such evidence can be misleading–people are often seduced into cults by an appealing but deceptive attractiveness, for example–it is nevertheless evidence of the veracity of faith when carefully considered and weighed against other facts and observations.

  • The evidence of Christianity is … revealed in its ability to transform relationships. The evidence of Christianity is also revealed in its ability to transform relationships. Many Christians can testify to the healing and restoration of relationships with spouses, children, employers, between races, class and ethnic groups. Are all Christians so transformed? Not by any means, unfortunately. But the evidence of those who have been–often resolving seemingly hopeless situations and personal divisions–should not be dismissed outright because of the incompleteness of its scope. Do we do abandon chemotherapy because not all survive?

  • Experiential: Christianity is both doctrinal and experiential: it is comprised of a series of assertions to truth, but is not simply a belief system; it affects–often profoundly–the lives, convictions and experiences of those who follow it. While this is easy to challenge with claims of a purely emotional or psychological basis for such experience, in reality it is not so lightly dismissed. While short-term behavioral change can occur as a result of emotional experiences, and delusional thinking in mental illness can result in bizarre behavior, the vast majority of practicing Christians do not fit this mold. When people from all walks of life–responsible, sane citizens whose behavior is ordinary in every other way–profess their ability to overcome profound personal shortcomings, relationship disasters, personal tragedy or devastating misfortune with a peace and inner strength not available to them apart from their faith, is it not reasonable to conclude that something profound has happened, not attributable to the impotency of pop psychology? Might there not be a plausible explanation involving a Being greater, wiser, and more gracious and loving than ourselves from which such resources come? Scientific proof, no, but certainly evidence not to be dismissed out of hand.

    John Edwards is right: there are two Americas–just not the two he imagines. The divide places secular and liberal religious (often no more than thinly-disguised socialism, with little connection to historical Judeo-Christian belief) on one side, and people of faith on the other, with lives quietly transformed by God and a vision expanded beyond the tight constraints of materialistic or political thinking. For the secular, religion is like borrowing a sports coat at a fancy restaurant when you’ve forgotten yours: you use it to get your meal and drink wine with your friends, then shed the ill-fitting garment at the earliest possible time. There is a deep discomfort with and mistrust among the secular of anyone who claims such superficial window dressing could actually guide, direct or empower the lives of others.

    I cannot presume to speak for the mind or spirit of the President. But many of us who have experienced the inner transformation which faith alone brings, sense in the man a like mind and heart, which despite sometimes strong differences in policy or politics gives us confidence in his inner compass and core principles. Such conviction in our experience leads to discernment, rejecting well-intentioned but misguided advice, and pursuing goals judged to be noble and right despite the high costs of doing so. Faith does not overwhelm analysis; it sharpens and directs it. This is something that political speeches in churches or talk of boyhood altar boy service can imitate, but cannot replicate.

    The jacket just doesn’t fit the man.

Cult of Death or Heart of Man?

Dr Bob

Cult of Death or Heart of Man

BeslanDavid Brooks, in a NY Times Op-Ed piece after the Beslen school massacre, in 2016, said the following about the Muslim terrorists:

We should be used to this pathological mass movement by now. We should be able to talk about such things. Yet when you look at the Western reaction to the Beslan massacres, you see people quick to divert their attention away from the core horror of this act, as if to say: We don’t want to stare into this abyss. We don’t want to acknowledge those parts of human nature that were on display in Beslan. Something here, if thought about too deeply, undermines the categories we use to live our lives, undermines our faith in the essential goodness of human beings.
It should come as no surprise to me — yet it still does — that people have any confidence remaining in idea of the “essential goodness of human beings.” Yet this is perhaps one of the most durable myths of our modern secular age. It underlies both public policy and private perception, and forms the basis of many failed government and social programs. If you have the stomach for it and the honesty to look objectively, even a brief glance at human history both ancient and modern reveals vastly more evidence of the depravity of man than his essential goodness. Consider briefly the following examples: the Inquisition, slavery, Ghengis Kahn, the Holocaust, the Bataan Death March, the Cambodian killing fields, Rwanda, Idi Amin, Columbine, Saddam’s rape rooms and shredders, suicide bombers on school buses and in pizza parlors, the rape of Nanking, the gulags, and Wounded Knee. And these are only the large historical events, easy to bring to mind. Left unmentioned but vastly outnumbering these are the countless murders, rapes, child molesters, serial killings, drug dealing, and any number of other smaller – but still profoundly evil – events which now barely if ever make the news.

I am not a misanthrope, and am fully aware of the potential for man to achieve great goodness and nobility. From the selfless volunteer at an inner city school to Mother Theresa, countless examples of such goodness and nobility exist, often hidden and far less noticed than deeds of evil. The issue is about the natural inclination, the deep inner nature of man – is it toward good, or rather toward evil? Your answer to this question profoundly affects your worldview.

By taking the position that man is essentially good, you are left with the problem of understanding inexplicable evil, such as torturing school children and shooting them in the back as they flee, as occurred at Beslan. In evil of lesser scope, psychology and social theory are often recruited for this task: the child molester or rapist was abused as a child; inner city crime is a result of racism; the root of terrorism is poverty, injustice, and the oppression of the Palestinians by the Jews. Even there the answers fall short. But could any such combination of social liabilities give rise to such extreme evil, as seen at Beslan or Auschwitz – particularly in beings whose natural bent is toward goodness?

The Judeo-Christian viewpoint on man’s essential nature is that man is fallen: created by a good God to be by nature good, but given free will either to submit to the good or to choose evil. Having rejected the good for personal autonomy independent of God, the natural gravity of the soul is away from God, not toward Him. In God is an unspeakable and unimaginable goodness; in His rejection is the potential for equally unimaginable evil. The Judeo-Christian solution is redemption, not psychology; inner transformation, not social programs.

To resist evil, you must know the face of evil, and recognize the face of good. The secularist denies the existence of God (or counts Him or it irrelevant), and therefore all goodness must have its source within man. The religious liberal believes God is good, but impotent, and therefore man is responsible to do the heavy lifting of all good works. The traditional Christian or Jew understands that man, created by God with enormous potential for good, but corrupted by failure to submit to God and therefore by nature far more prone to evil than good.

Religious affiliation is an unreliable indicator of good or evil behavior. The combination of evil motives with the compulsion of legalistic religion is a potent and dangerous mix, where men pursue their evil goals under the lash of and laboring for an angry god of their own making.

Man’s tendency to evil can be restrained, either by force of law, by force of arms, or ideally by inner transformation, repentence and submission to the power of humility and service. Wishful thinking and false assumptions about the goodness of man will prove woefully inadequate for the encroaching and fearsome evil of our current century.