Half-Pint Heroes

This week’s news brought the remarkable story of Wesley Autrey, a 50 year-old Vietnam veteran who jumped in front of a subway train to save a man who had fallen onto the tracks while having a seizure.

18-year-old Cameron Hollowpeter suffered a seizure while Autrey, accompanied by his two daughters, was waiting on the platform for the subway. Hollowpeter fell to the tracks after losing his balance, as an incoming train approached the platform. Autrey jumped down to save him — as his daughters looked on — initially attempting to pull him out, but realizing with split-second judgment that there was insufficient time to extract the still-seizing man from the tracks. He threw himself over Hollowpeter, wrapping him in his body to protect his flailing arms, in the shallow ditch between the electrified rails. The train screeched to a halt after passing overhead with but inches to spare, miraculously leaving both men without serious injury.

True acts of heroism are of course newsworthy, and at once both extraordinary and sobering (would you or I have done what Wes Autrey did?) — and draw a sharp and unflattering contrast with what often passes for heroism in our modern culture.

We hear of heroes daily in the papers and on TV: the fireman who rescues a child from a burning building; the policeman shot in the line of duty; the soldier who throws himself on a grenade to save the lives of his buddies. Such acts are heroism indeed, comprised of its core virtue: the willingness to sacrifice one’s life or well-being for another. We say this although we expect such things of these men and women, for this is their chosen calling and career, one which by its nature places them in harm’s way for the benefit of others.

Cheap heroism seeps deeply into our culture like some toxic effluent, poisoning even simple principled acts with a pretension of greatness.

Yet there is increasingly a class of acts now painted as “heroism” which deserves no such depiction. Such cheap heroes — the civic equivalent of Dietrich Bonhoeffer’s cheap grace Christians — seem to grow in number daily. They make no sacrifices, take no risks, suffer no losses when their “heroic” deeds are done. In a society increasing bereft of moral standards and the simplest traits of noble character and integrity, we paint a heroic stamp of approval on increasingly pathetic gestures, gilding our self-serving deeds with a thin gloss of glory.
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Libertarianism & Morality

This essay was originally posted in November 2004.
 
nebulaOn April 25th 1990, the long-awaited Hubble space telescope was launched. In the planning stages since 1967, delayed in deployment for 4 years by the Space Shuttle Challenger disaster, scientists were ecstatic at its potential to view deep space as never before from above the atmosphere’s distorting optical envelope. Within days their excitement turned to dismay, as pictures from Hubble returned out of focus.

The giant mirror, 94 inches in diameter, had a spherical aberration. When the mirror was being polished to its correct shape, the device used to test its curvature–called a null corrector–had been made to the wrong specifications. Thus, when the null corrector indicated that the mirror was perfect, it was in fact slightly aspherical. The extremely faint light of distant celestial objects could not therefore be sharply directed to the focal point, resulting in a halo effect and a fuzzy image. Upon investigation, the problem was found to be due to the interchange of metric and English measurements when engineering the testing device. Subsequent space shuttle repairs rendered the optics perfect again, giving rise to the spectacular photographs which the Hubble telescope has since obtained.

In the case of Hubble’s mirror, an inadvertent change of standards, resulting in an aberration 1/50th the diameter of a human hair, nearly doomed a multi-million dollar space project. Consider the likelihood of success if each of the engineers on the project had been allowed to use their own set of standards. Yet in the realm of human behavior and morality, an idea preposterous to a scientist is widely accepted as legitimate, even desirable.
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The Engine of Shame – Pt II

This essay, the second of a two-part series, was originally posted in October 2005.
 
DRGWIn my previous post on guilt and shame, I discussed their nature and differences, their impact on personal and social life, and their instrumentality in much of our individual unhappiness and communal dysfunction. If indeed shame is the common thread of the human condition–fraught as it is with pain, suffering, and evil–it must be mastered and overcome if we are to bring a measure of joy to life and peace to our spirits and our social interactions.

Shame is the most private of personal emotions, thriving in the dark, secluded lairs of our souls. It is the secret never told, the fears never revealed, the dread of exposure and abandonment, our harshest judge and most merciless prosecutor. Yet like the Wizard of Oz, the man behind the curtain is far less intimidating than his booming voice in our subconscious mind.

The power of shame is the secret; its antidote, transparency and grace. Shame thrives in the dark recesses of the mind, where its accusations are amplified by repetition without external reference. Shame becomes self-verifying, as each new negative thought or emotion reinforces the theme that we are rejected and without worth. It is only by allowing the light of openness, trust, and honesty that this vicious cycle may be broken.
 
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The Engine of Shame – Part I

This essay, the first of a two-part series, was originally posted in October 2005.
 

Steam locomotiveA wise friend–a man who helped me emerge from a period of considerable difficulty in my life–once taught me a simple lesson. In less than a minute, he handed me a gift which I have spent years only beginning to understand, integrating it into my life with agonizing slowness. It is a lesson which intellect cannot grasp or resolve, which faith only begins to illuminate–a simple principle which I believe lies close to the root of the human condition.

My friend taught me a simple distinction: the difference between guilt and shame.

While you no doubt think I am devolving into the linguistic morass of terminal psychobabble, I ask you to stick with me for a few moments. What you may discover is a key to understanding religion, terrorism, social ills such as crime and violence–and why the jerk in the next cubicle pushes your buttons so often.
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The Law of Rules

This is a repost of an essay from 2004.
 

In contemporary political discourse, we often discuss the Rule of Law, especially in our postmodern culture where bad behavior is often justified (and excused) by situation, upbringing, or historical injustice. But no one ever talks about the Law of Rules.

Today in the office I reviewed one of Medicare’s bulletins, clarifying (at least in intent, if not in practice) their regulations in some arcane area of reimbursement for surgical procedures. Few outside of the health care field have any idea of the complexity of regulations governing medicine. When last I checked several years ago, Medicare had about 150,000 pages of regulations in the Federal Register, approximately 3 times of the volume of the IRS tax code. American medicine is more highly regulated than Soviet state industry ever was, and getting more so by the day.

Without launching into a diatribe on the evils of government-funded and regulated medicine (perhaps another time), it strikes me that the explosive growth of rules, laws, and regulations in society as a whole is a reflection of an underlying shift in our culture, values, and individual moral integrity.
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Moving the Ancient Boundaries – I

Do not move the ancient boundary stone set up
    by your forefathers.
        — Proverbs 22:28 —

 
old houseAncient wisdom: a sage injunction uttered in a time when simple shepherds and farmers parsed out land for grazing and grain, speaking to the prudence of respecting contracts, negotiated agreements with those with whom we live, to abide in a measure of peace. Be honest; respect the property and possessions of those with whom you must abide; do not trade peaceful relations for parcels of land.

Yet like so much of this ancient book of Proverbs, its well runs far deeper than it appears, with ageless wisdom waiting for the discerning, those open to its application in different days and other ages. And so it seems that we, as a culture, have been hard at work for decades, if not longer, moving the boundary stones set up by our forefathers. These markers today are not simple rocks in fields or walls on hills to mark water rights or restrain wandering sheep, but are rather the cultural and moral underpinnings of that which we call Western civilization. We are busy cutting wood from the pilings to add garlands to the gables, and wondering why the house leans so far off vertical.
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A Life Not Long

sunset

I’ve been working on several posts, which had been taking longer than expected — especially a post on euthanasia, which is beginning to look like another multi-part series. I hope to start getting some of these up in the near future.

In the meantime, a link from Glenn Reynolds hooked into something I’ve been ruminating on in recent days: the endless pursuit of longer life.

Here’s the question I’ve been pondering: is it an absolute good to be continually striving for a longer life span? Such a question may seem a bit odd coming from a physician, whose mission it is to restore and maintain health and prolong life. But the article which Glenn linked to, describing the striking changes in health and longevity of our present age, seemingly presents this achievement as an absolute good, and thereby left me a tad uneasy–perhaps because I find myself increasingly ambivalent about this unceasing pursuit of longer life.

Of course, long life and good health have always been considered blessings, as indeed they are. But long life in particular seems to have become a goal unto itself–and from where I stand is most decidedly a mixed blessing.

Many of the most difficult health problems with which we battle, which drain our resources struggling to overcome, are largely a function of our longer life spans. Pick a problem: cancer, heart disease, dementia, crippling arthritis, stroke — all of these increase significantly with age, and can result in profound physical and mental disability. In many cases, we are living longer, but doing so restricted by physical or mental limitations which make such a longer life burdensome both to ourselves and to others. Is it a positive good to live to age 90, spending the last 10 or more years with dementia, not knowing who you are nor recognizing your own friends or family? Is it a positive good to be kept alive by aggressive medical therapy for heart failure or emphysema, yet barely able to function physically? Is it worthwhile undergoing highly toxic chemotherapy or disfiguring surgery to cure cancer, thereby sparing a life then severely impaired by the treatment which saved that life?

These questions, in some way, cut to the very heart of what it means to be human. Is our humanity enriched simply by living longer? Does longer life automatically imply more happiness–or are we simply adding years of pain, disability, unhappiness, burden? The breathlessness with which authors often speak of greater longevity, or the cure or solution to these intractable health problems, seems to imply a naive optimism, both from the standpoint of likely outcomes, and from the assumption that a vastly longer life will be a vastly better life. Ignored in such rosy projections are key elements of the human condition–those of moral fiber and spiritual health, those of character and spirit. For we who live longer in such an idyllic world may not live better: we may indeed live far worse. Should we somehow master these illnesses which cripple us in our old age, and thereby live beyond our years, will we then encounter new, even more frightening illnesses and disabilities? And what of the spirit? Will a man who lives longer thereby have a longer opportunity to do good, or rather to do evil? Will longevity increase our wisdom, or augment our depravity? Will we, like Dorian Gray, awake to find our ageless beauty but a shell for our monstrous souls?

Such ruminations bring to mind a friend, a good man who died young. Matt was a physician, a tall, lanky man with sharp bony features and deep, intense eyes. He was possessed of a brilliant mind, a superb physician, but left his mark on life not solely through medicine nor merely by intellect. A convert to Christianity as a young adult, Matt embraced his new faith with a passion and province rarely seen. His medical practice became a mission field. His flame burned so brightly it was uncomfortable to draw near: he was as likely to diagnose your festering spiritual condition as your daunting medical illness–and had no compunction about drilling to the core of what he perceived to be the root of the problem. Such men make you uneasy, for they sweep away the veneer of polite correction and diplomatic encouragement which we physicians are trained to deliver. Like some gifted surgeon of the soul, he cast sharp shadows rather than soft blurs, brandishing his brilliant insight on your now-naked condition. The polished conventions of medicine were never his strength–a characteristic which endeared him not at all to many in his profession. But his patients–those who could endure his honesty and strength of character–were passionate in their devotion to him, personally and professionally. For he was a man of extraordinary compassion and generosity, seeing countless patients at no charge, giving generously of his time and finances far beyond the modest means earned from his always-struggling practice.

The call I received from another friend, a general surgeon, requesting an assist at his surgery, was an unsettling one: Matt had developed a growth in his left adrenal gland. His surgery went deftly, with much confidence that the lesion had been fully excised. The pathology proved otherwise: Matt had an extremely rare, highly aggressive form of adrenal cancer. Fewer than 100 cases had been reported worldwide, and there was no known successful treatment. Nevertheless, as much for his wife and two boys as for himself, he underwent highly toxic chemotherapy, which sapped his strength and left him enfeebled. In spite of this, the tumor grew rapidly, causing extreme pain and rapid deterioration, bulging like some loathsome demon seeking to burst forth from his frail body. I saw him regularly, although in retrospect not nearly often enough, and never heard him complain; his waning energies were spent with his family, and he never lost the intense flame of faith. Indeed, as his weakened body increasingly became no more than life support for his cancer, wasting him physically and leaving him pale and sallow, there grew in him a spirit so remarkable that one was drawn to him despite the natural repulsion of watching death’s demonic march.

Matt died at age 38, alert and joyful to the end. His funeral was a most remarkable event: at an age in life where most would be happy to have sufficient friends to bear one’s casket, his funeral service at a large church was filled to overflowing–thousands of friends, patients, and professional peers paying their respects in a ceremony far more celebration than mourning. There was an open time for testimony–and such a time it was, as one after another took to the lectern to speak through tears of how Matt had touched their lives; of services rendered, small and large, unknown before that day; of funny anecdotes and sad remembrances which left not one soul of that large crowd untouched or unmoved.

A journey such as his casts critical light on our mindless pursuit of life lived only to live long. In Matt’s short life he brought more good into the world, touched more people, changed more lives, than I could ever hope to do were I to live a century more. It boils down to purpose: mere years are no substitute for a life lived with passion, striving for some goal greater than self, with transcendent purpose multiplying and compounding each waking moment. This is a life well-lived, whether long or short, whether weakened or well.

Like all, I trust, I hope to live life long, and seek a journey lived in good health and sound mind. But even more–far more indeed–do I desire that those days yet remaining–be they long or short–be rich in purpose, wise in time spent, and graced by love.

Euthanasia Investigation in New Orleans

hospital bed

In the aftermath of hurricane Katrina, there were some scattered reports–in an admittedly questionable media source (a British tabloid)–of euthanasia of patients trapped in a New Orleans hospital. I discussed the initial media report here, and did a follow up post here which expanded on the questionable nature of the sources and some of the comments in response. In brief, there was widespread skepticism from some commenters on the veracity of this report, which was, in their opinion, pure urban legend–and I was castigated for lending credence to such an outrageous myth.

Apparently they never got the word to the Louisiana Attorney General.

CNN is now reporting that a very active investigation is currently underway of Memorial Hospital–where 45 patients were found dead–by the Attorney General’s office. This investigation to date has uncovered additional testimony that euthanasia was actively discussed and may well have been performed:

The Louisiana attorney general’s office is investigating allegations that mercy killings occurred and has requested that autopsies be performed on all 45 bodies taken from the hospital after the storm.Orleans Parish coroner Frank Minyard said investigators have told him they think euthanasia may have been committed.

“They thought someone was going around injecting people with some sort of lethal medication,” Minyard said.

A nurse manager, Fran Butler, is quoted as saying:

“My nurses wanted to know what was the plan? Did they say to put people out of their misery? Yes. … They wanted to know how to get them out of their misery,” she said.

Butler also told CNN that a doctor approached her at one point and discussed the subject of putting patients to sleep, and “made the comment to me on how she was totally against it and wouldn’t do it.”

Dr. Bryant King, a physician who was present at the hospital, was also interviewed by the AG’s office, and recounts his story:

But King said he is convinced the discussion of euthanasia was more than talk. He said another doctor came to him at 9 a.m. Thursday and recounted a conversation with a hospital administrator and a third doctor who suggested patients be put out of their misery.

King said that the second physician — who opposed mercy killing — told him that “this other [third] doctor said she’d be willing to do it.”

About three hours later, King said, the second-floor triage area where he was working was cleared of everyone except patients, a second hospital administrator and two doctors, including the physician who had first raised the question of mercy killing…

One of the physicians then produced a handful of syringes, King said.

“I don’t know what’s in the syringes. … The only thing I heard the physician say was, ‘I’m going to give you something to make you feel better,’ ” King said….

King said he decided he would have no part of what he believed was about to happen.

Time will tell how this investigation turns out–and it may ultimately be very difficult to prove what happened at Memorial Hospital, given the poor condition of the bodies and the difficulty in distinguishing therapeutic pain management and sedation versus the same drugs used in doses sufficient to kill. One suspects that those involved in such actions–if they occurred–will be loath to admit it–and likely would have been careful to avoid witnesses, if at all possible.

And I’m sure those who so vehemently argued the absurdity of this story will belly up to the bar and confess they may have overreacted just a bit–but I’m not holding my breath waiting.

Update 10-27-2005: CNN is reporting that dozens of subpoenas have been issued to find out what happened at Memorial:

The subpoenas were served on employees of all levels at Memorial Medical Center, which is owned by Tenet Healthcare, because “cooperation, lately, has not been as good as I had hoped,” Foti said.

The subpoenas require that people appear before investigators for questioning.

“Some people were not coming forward. We learned Tenet sent out a letter that had a chilling effect,” Foti said. “We had no choice but to issue these subpoenas.”

“They [Tenet] seem to be in a position of protecting themselves, while we are just trying to get to the facts of what happened at the hospital,” the attorney general said.

Stay tuned–this may begin to get very interesting…