Top Posts of 2014

In case you missed them, here are the top 5 posts of 2014:

1) How a Christian doctor treated one patient's depression: Testimony from Depression

2) Do people have A "Right" to Health Care?

3) The idea of physical agency for medical complaints has pushed the spirit of mankind out of its proper claim: Germ Theory and the Spirit

4) We carry the germs of deadly spiritual ideas from a misbegotten medical orthodoxy... and bring those wrong ideas into our examination rooms: Connecting Physicians and Pastors

5) What is a Free Economy?

Seized Authority

[T]o read the New Testament letters is to read about the same common concerns that psychologists are charged with handling. God, however, charged the Church with these problems. Secular psychology initially was seizing authority from the Church. Now the evangelical church is actively foisting off these "psychological" problems onto psychology, having accepted the whole renaming bit that comes with the false dichotomy of mind-spirit. The Church is abdicating its responsibility.


Excerpt from a private letter

How the Government Killed the Medical Profession

Government interventions over the past four decades have yielded a cascade of perverse incentives, bureaucratic diktats, and economic pressures that together are forcing doctors to sacrifice their independent professional medical judgment, and their integrity. The consequence is clear: Many doctors from my generation are exiting the field. Others are seeing their private practices threatened with bankruptcy, or are giving up their autonomy for the life of a shift-working hospital employee. Governments and hospital administrators hold all the power, while doctors—and worse still, patients—hold none.

-- An excerpt from "How the Government Killed the Medical Profession" by Jeffrey A. Singer, an article Dr. Terrell would have liked.

Read the rest of the article here.

Original Sin

We are condemned not merely because of our sins but positionally, from conception, we are in sin, until we accept Christ. (Gen. 8:21, Psalm 51:5, 14:1-3). There is a universal moral law that reveals our sin state even if we have never heard the Gospel. True, it may be twisted and blunted and obscured in a few (usually weird and backward) societies, but it is there.


Excerpt from a private letter

Long-view Optimism

[T]hough the battles I am involved in are going the wrong way, the essential victory to secure the war has already been won. Short-view pessimism, long-view optimism.


An excerpt from a private letter

The Privilege of Self-Medication

We are set to think of self-medication as bad, because we see so many problems with it. We should pause and consider a couple of other things, however.

First, the bad outcomes we see do not necessarily mean that the privilege of self-medication should be restricted. To restrict that privilege means that we think of ourselves as more than advisers and assistants. It means that we think of ourselves as controlling authorities. Where in Scripture has God authorized us as having any controlling authority over our patients?

Second, we have no good denominator for the dangers of self-medication. That is, we see those who have problems, but we are not nearly as aware of those who do not have problems. Every treatment has a certain failure rate. That is, we have a numerator of failures sitting over a denominator of all treatments. Unless we know the denominator we cannot know the fraction. If we do not know the fraction, we cannot know the rate. If we do not know failure rates, complication rates, and success rates, we are presumptuous to deny people by law the ability to decide for themselves.

We tend in medicine to practice on the numerator kind of information. We make decisions based on partial information. Patients need to be able to "vote with their feet." It is a check on us "experts." We, too, have fallen natures, with pride and desires for power and money. We want to have our way.


Excerpt from "Pharmacy and Medical Interventions"

Extending Life Expectancy?

I don’t think it’s been shown that the medical profession has had anything positive to do with extended life expectancies in the United States. It’s a definitional matter. It’s an epistemological matter -- how do you know what you know. You start with presuppositions about your view of a human being: a human being is a person conceived. The medical profession, alone, is accountable for a decrease in average life expectancy. From around fifty years around the turn of the century in this country, to around forty-five years today -- probably having passed through a time of greater life expectancy in the mid-forties to early sixties, after which abortion became commonplace. Definitional issues aside, for those people who were allowed to make it to birth, there has been a very substantial increase in life expectancy, which might in part be due to some of the things we do in medicine. It was just done at too high a cost, as we took the resources of those who were not allowed to live and diverted them into many things, one of which was vast medical establishment that now exists.


Excerpt from an interview with Dr. Terrell

The Mistake of Medical Licensure

[Medical licensure] is a mistake. It is only about a hundred and three years old where I live, and similarly, about a hundred years old in other states. So its a very new idea when placed against the backdrop of medicine as a whole. As usual, it was promoted with the idea of the public good. But if you look at it, as usual, it was the physicians who wanted to remove certain kinds of competition that they had disdain for. It is one of the reason for higher costs. It is one of the reasons that orthodoxy has been able to be so militant and stamp out of so much of unconventional treatment by calling it quackery -- and I indeed believe that there is much quackery out there -- and pushing it off the playing field without being able to show that what they do is all that bad, or all that different from what we do. It’s a form of state-granted monopoly which Caesar has granted to certain privileged people such as ourselves.

This authority really resides in God in the family, not in the “experts.” We are tyrannized by the experts. The profession as a whole is a tyranny of experts. Physicians are able to enact their own agenda without sufficient proof that what they do is all that splendid. Licensure is a mistake and it is one that I expect will be remedied, perhaps within my lifetime. It is very radical to propose that licensure is wrong, but there are strong pragmatic reasons for it. In my own state we are seeing an expansion of who is able to do certain things -- there are nurse practitioners who can now prescribe, chiropractors are moving in on the medical turf, and there are physician assistants of various sorts. I am in favor of that, basically, because it is expanding the number of people who are able to do what I do without being arrested for it. And the ultimate end is that after awhile so many people will be empowered to do so many things, that after a while licensure will simply die, and will be of no use to those who promoted it for personal gain.


Excerpt from an interview with Dr. Terrell

Viewing the Broader Outcome

The means [in medicine] are very impressive. But the outcomes sometimes aren’t. Part of that is nature of reductionistic science itself. When we narrow our focus of view to, “Did the patience die of heart disease after this bypass surgery?”, you may get one set of figures that looks really good. But when you look at all causes of mortality after a treatment, you may find that others may increase to balance out the benefit that you got. But the person in the profession who is focusing on the outcome in their little particular part of the world of medicine didn’t choose to look at that because it was outside their field of view. As a generalist, I am one of those who are supposed to called upon to look at a wider array of potential outcomes. When you look at that, you find that medicine, even in some of our cherished areas, has fallen short.


Excerpt from an interview with Dr. Terrell

Facts vs. Wisdom

Doctors are concerned about keeping up with the literature, which is absurd on its face. There are millions of articles published in English alone relevant to medicine every year. If you are so aware that you could hone them down to one percent of what is published, you would have a daily reading load so heavy that you could never keep up. We have confused data with understanding, and the acquisition of massed of so called facts with wisdom. It is particularly telling that the fear of the Lord is the beginning of wisdom. Medical schools never mention the Lord in any positive contexts, whatever. We have grown away from the wisdom that was, perhaps, once there in medicine. Once we dropped the integrating capacity of Scripture, the data no longer makes any sense.


Excerpt from an interview with Dr. Terrell

Presuppositional Medicine

Medicine itself is an empirical endeavor; we look at how things are. We look at the natural man. Yet medicine cannot tell us how things should be. Medicine is empirical in a lot of ways -- in its application -- but in its formation and its fundaments it is presuppositional. And the only proper presuppositions are those of Scripture, which are best stated in the Westminster Confession of Faith and the Larger and Shorter Catechisms, or documents like that, such as the Heidelberg Catechism.


Excerpt from an interview with Dr. Terrell

A Passive Teacher

A father tells his four year old to go into the house. The four year old hesitates, then trundles off in another direction. The father does nothing. Mistake not. Learning has just taken place, and the learning is contrary to good health. Multiplied episodes of that sort have far more to do with the ultimate health of that child than eating meals laden with cholesterol or devoid of fiber.


Excerpt from "Pharmacy and Medical Interventions"

Recapturing Supervision

How may overarching supervision of the medical care by Christians be recaptured by the Church?

1. Church discipline of physicians who are practicing gross sins. So you have no abortionists in your congregation? Do you have those who refer for abortion?

2. Church discipline of members who are practicing gross sins. It is neither kind nor healthy to overlook gross sin.

3. Preaching the Word to the Church, with applications to health where they are present. This is not the same as locating biblical "support" for current medical practice.

4. Teaching the word to the Church, with applications to health where they are present.

5. For #3 & 4 above, the issues which relate to health taught in Scripture include: "parenting," marital relations, indebtedness, work habits, Sabbath-keeping, addictionism, education, etc.

6. A diaconal ministry instructed and involved in helping Church members ask the right questions of physicians during illnesses, politely but persistently.

7. Visitation of the sick. For the hospitalized ill, seeing to it that appropriate visitation is taken seriously by the hospital staff.

8. Anointing with oil and prayer for the sick.

9. Developing a working relationship between physicians and pastors in which the pastor is not the junior partner, for the identification of the source(s) or patients problems.

10. Nouthetic counseling for Church members. De-medicalize the management of problems-in-living through the use of cooperation with a physician who appreciates the proper position of medicine in the health equation. Not everything felt in the body is originating from the body.

11. Escape the straightjacket. The medical profession's viewpoint on health and disease is very narrowly conceived.

12. Physicians at every level of the system need to have an appreciation of the prior probabilities of disease, and to use it in helping patients prioritize their health issues among the other issues of life.


Excerpts from Physician and Pastor: Co-Laborers

Treasure of the Heart

[C]hurches need to talk about money. Not only the kind that members give, but how the portion that members retain is spent. Church members give something on the order of 2% or so of income. Medical care is consuming 13% of the gross national product. There is an idolatrous disproportion here. The gospel message has competition in the world, and it is measurable at a pocketbook level. Where a man's treasure is, there will his heart be also. Some of the other places in which money can be spent than on services labeled “medical care” may have as much or more actual productivity for health.


Excerpts from Physician and Pastor: Co-Laborers

Family Assistance

Often an ill person will need some sort of assistance that is not strictly medical -- financial, nutritional, transportation, information, etc. I have noted a reflex has developed within medicine to turn first to civil governmental agencies of a social service nature. While not necessarily implying that the family or church should duplicate services needlessly, I have found it illuminating to ask a patient who expresses such a need, "Does your family know about this need?" Most commonly, the answer is, "No." If I ask why not, a common response is, "They have their own lives to live. I don't want to bother them." I restrain myself, usually, from saying, "You don't seem to mind bothering anonymous taxpayers with your request that they underwrite what God gave families the privilege and duty of providing." Sometimes I discover that the reason the patient is reluctant to let their family know is some unresolved family conflict. What an opportunity! I recommend that the family be notified of the need and offer to be the one to do so. In almost every case, when I have notified a family, they have responded -- either out of love, duty, or perhaps merely because they would be embarrassed to say 'no' to a doctor.

Not only is the need met, the family is strengthened by doing what it is designed to do. The family has been instructed by the very asking of the question. We physicians are so consequentialist in our practice. If we know it won't "work" to accomplish a given end, we economize by not bothering. The problem comes when our focus is sometimes on too narrow a set of consequences. Both pastors and physicians can teach by maneuvers of this sort. We need to see if there is some way to diaconally institute it.


Excerpts from Physician and Pastor: Co-Laborers

The Parents' Job

Habits for life may be established early, for good or for bad. Are your church's parents abandoning their responsibility? Don't trust the schools to do the parents’ job. “A paternalistic state has no room for fathers.” (David Chilton) Neither leave part of it up to physicians. The orthodox practice in medicine now, including, of all things family medicine, is to hold what dependent young people say to their doctors confidential from their parents! This tenet has it that the value of that confidentiality with a doctor exceeds in health value the value of having informed parents. Explain not that parents often do not care. Of course, many do not. For those outside the church, the physician will not be able to make much of a parent. For those inside the church, the chore for such children begins with holding the parents accountable for their responsibilities.


Excerpts from Physician and Pastor: Co-Laborers

At the Deathbed

When a person knows that he is near death, there may be some final business to transact, such as those seeking reconciliation or a final word of encouragement or instruction. When nothing else physically speaking can be retrieved in a case of someone dying, sometimes something spiritual can. Teaching at the end can be potent. Thomas Hooker, a formerly well-known Puritan pastor of Connecticut, on his death bed was asked, "Sir, you are going to receive the reward of all your labours." He answered, "Brother, I am going to receive mercy." At his death, my father's last words were, "My cup runneth over." A summary for the entire family, who knows it to be true, to reflect on for ourselves. For the likes of that, in pursuit sometimes of the last full second of life, we have notably unmemorable deathbed scenes from the ICU: "Is that a flat line?" "Set it at 300 joules." "Another amp of bicarb." "Let's check the ET tube placement."


Excerpts from Physician and Pastor: Co-Laborers

Pastoral Counsel on Death

The issues of “living wills” or (the preferred) durable power of attorney for health care should not be left to the medical profession alone… Until the 1950's, the majority of deaths in the U.S. occurred in the home. Since that time dying has largely been an institutional phenomenon. Why should dying be inevitably medicalized? (It is clearly a metaphysical event. The enfolded spirit leaves the body. [James 2:26] Inasmuch as the spirit is by definition beyond the method of natural science to measure, we depend only upon indirect measures.)

Pastoral counselors, prepare your church members for the inevitability of death. Prepare them in detail. Prepare in grisly detail. The techno-wonders of medicine so capture families that the hard, needful questions never get asked:
(a) what are the prospects for recovery without treatment?
(b) what are the prospects for recovery with treatment?
(c) what is the treatment like?
(d) what is life like with treatment?
(e) What is life like without treatment?
(f) how much does it cost?
(g) what kind of treatments are available to maintain function as long as possible?
(h) what kind of treatments are available to relieve suffering?
(i) why do I have to go into a hospital? what can be done there that can't be done somewhere else?
(j) will the family and close friends be allowed access if the patient wants it?
(k) bring up the issue of “CPR” or “Code status.”


Excerpts from Physician and Pastor: Co-Laborers

The Key to Health

While it is generally believed that the day of the Renaissance man -- the one who could by dint of intelligence and hard effort still encompass all the branches of knowledge adequately -- is gone due to the explosion in knowledge, there needs to be at least a collusion between physician and pastors over the matter of the spirit and body in health and illness. If no one can encompass it individually, then the Church with its gifts should try to do it corporately.

Christianity is the only key to full health and the best key to health even in a limited, physical sense. Medicine needs help of the gospel ministry in accomplishing this. Medicine is under the Gospel. It functions too often as though it were apart or parallel. The pastor and physician are ideally co-laborers, not adversaries. We exist in a hierarchical relationship. The pastor represents to us the overarching Word of God. The physician is under the gospel -- both the natural science aspect and the spiritual aspect. The gospel applies to all of life. Medicine is not excluded. The special problems of the relationship of spirit and body, their sometimes unfathomable blend, require that we work together, both under the Word of God.


Excerpts from Physician and Pastor: Co-Laborers

Tyranny of the Expert

Christian teaching for the denominator population is a powerful force for health. If Churches were more obedient, it would be an even more powerful force. The medical profession needs the input from the Church to clean up its act, to put its powerful tools into the right perspective, to make sure that our methods are harnessed to the right questions. While science pretends to abhor the method of authority, and tells tales about the bad old days in which medicine kow-towed to authorities who did not do experiments, we still live in an authoritarian system. The authorities tell us not only that the only method of any real use is the "scientific method," they also insist on casting the questions in materialistic terms only, throwing revelational epistemology off the playing field.

They are applying their epistemology where it does not legitimately apply, to normative issues. We have a "tyranny of the expert," who knows much more than we do, yet who does not see that the depth of vision has been gained at the substantial cost of a breadth of vision. The Church can restore the breadth of view to illness and health, can reclaim the validity of the method of revelation, and pitch out the method of natural science from its stolen territory.

Medicine has become somewhat like the man who knows the cost of everything and the value of nothing. There is a need for a generalist -- not speaking here of a medical generalist, which I am, though that is true, -- but of someone who has the whole person in view, -- in the context of the family, church and society, as well as a time span that extends beyond a six year follow-up study. We need someone to have a view all the way to the deathbed and to eternity beyond. Medicine demands now an illegitimate thing of its practitioners -- that we give up our general office of believer and priest in order to become a body mechanic. The body mechanic image is a very dangerous one for medicine.


Excerpts from Physician and Pastor: Co-Laborers

Testimony from Depression

Given the recent celebrity suicide, it seems appropriate to post a letter Mrs. Terrell received following Dr. Terrell's death:

I just wanted to let you know that Hilton Terrell saved my life.... I had been feeling bad (not sick), and extremely anxious, and it proceeded to get progressively worse over time. I hardly slept or ate and had lost down to approximately 130 pounds. I had no idea what was happening to me, and I felt like I had no control over anything, but I had too much pride to tell anyone what was going on. 

What I did not know was that I was spiraling down into deep depression. I never even knew anything like that was possible. It was worse than any physical pain I had ever endured. I finally broke down and went to see [my pastor]. It was he who recommended that I contact Hilton. 

At that point in time I had not considered suicide, but I had reached the point where I fully understood how someone could do it. I knew that if something could not be done for me I probably would reach the point of considering suicide, or, at the very least, my body would stop functioning due to lack of sleep and food. 

Out of desperation I called Hilton at home on a Saturday to let him know of my situation, and to ask if he could help me. I was wondering how I would survive until whenever he would set the appointment. To my surprise he asked me to come to his office the next day (Sunday). I made it through that Saturday night and drove to [see him] on Sunday hoping and praying for a miracle. 

Hilton spent hours with me and only charged me $25.00 (he told me that was his normal fee). To this day I have known only one other doctor ... that I believe was in the profession for the sole purpose of helping people. 

Hilton stayed there with me until he was sure I had nothing else to say. During our continuous conversation I kept telling him how I felt, what I wanted to happen, what I did not want to happen, what had happened to me, etc. Hilton, in his wisdom, kept asking me, but continuously phrasing it differently, what had I done for others? 

In essence, what Hilton was continuously telling me was that I needed to get my focus off of myself and on to others. He gave me a prescription for some kind of antidepressant, and told me it might take a few days to get into my system. Fortunately for me it allowed me to get a full night's sleep that very first night for the first time in months (I had been sleeping an hour or two each night). 

Hilton told me that he fully believed that there was a physical side to peoples' problems because why else would God have placed things on this earth to be used as medicine. Hilton also told me, though, that he believed that there was a spiritual side to peoples' problems. I learned a lot from him that day. 

I began putting into practice what Hilton taught me, and was able to take myself off of the antidepressant within a couple of months. At that time I still did not feel "normal," but over time, and with practicing what I learned from Hilton, I gradually got better. I have not had any more trouble with depression since. Hilton saved my life, and I will never forget that.

Healthy Work

To be employed is health-promoting. Counseling from Eph. 4:28 ("He who has been stealing must steal no longer, but must work, doing something useful with his own hands, that he may have something to share with those in need.") will have healing and preventive qualities. We have too much, "I can't work because I'm too sick." We have too little, "You're sick so much because you are not employed."


Excerpts from Physician and Pastor: Co-Laborers

Healthy Marriage

As has long been known, being married is a healthy estate.

Can doctors in today's regime encourage this? Not without strident criticism. Can the Church? Yes. On the grounds of evidence such as these researchers accumulated? No, rather because the Bible commends it as the norm for most people. Yet the general consistency with what biblical counseling might at times recommend is illustrative. In his “catalog of risks,” Bernard Cohen, mentioned earlier, found that poor social connections -- living a relatively isolated life -- ranked fourth among the causes of loss of life expectancy, after smoking, alcoholism, and poverty. He estimated a loss of about 3 years of life expectancy for such persons, exceeding suicide, murder, AIDS, drowning, electrocution, natural hazards such as floods and earthquakes, and many other things that we get all worked up about.


Excerpts from Physician and Pastor: Co-Laborers

The Need for Pastoral Counseling

Physicians deal mainly with sick numerators, persons who have presented their bodies a living sacrifice for us -- our community is the sick. There have been efforts within medicine to deal with the whole community, and public health medicine is its best expression, but for most practicing physicians, the community is more or less out of reach. As far as sickness is concerned churches deal with denominators -- both the sick and the well within the community of faith. The Church also deals with the “fields white unto harvest,” the pagans, both sick and the well in those fields. While medicine has incorrectly restricted itself to empirical, evidential data, it has also drawn its data too often from numerators only. The Church has the opportunity to see these sick numerators in the illuminating context of their spiritual denominators -- how sickness relates to spiritual condition. Furthermore, medicine has cut off revelational data -- input from the Bible. Pastoral counseling can restore this missing feature of revelation to its powerful role in maintaining and regaining health.


Excerpts from Physician and Pastor: Co-Laborers

Neglect of the Heart

Our priorities in medicine are badly skewed. The heart is the neglected sine qua non of health in the U.S. today. Jesus said, “For from within, out of the heart of men, proceed evil thoughts, adulteries, fornications, murders, thefts, covetousness, wickedness, deceit, licentiousness, an evil eye, blasphemy, pride, and foolishness. All of these things come from within and defile a man. (Mark 7:21-23) We need this kind of “kardiology” for our spiritual and physical health.


Excerpts from Physician and Pastor: Co-Laborers

Godliness is Greater

1 Tim. 4:8 "For bodily exercise profits a little, but godliness is profitable for all things, having promise of the life that now is and of that which is to come."

Physical elements have a place. Godliness has a greater place, not only for the here and now, but for the hereafter, also.

Limitations on the Disease Model

The medical profession's perception has become so limited to the theoretical constructs known as “disease entities,” by which is meant only the physical causes and manifestations of disease, that it is unable and unwilling to see that mankind is a living, breathing spirit folded into a body. Pastoral counseling offers one major avenue to instruct the medical profession and other onlookers, as it instructs the direct recipients.

Of the many possible examples, one of my favorites is a two-page ad for the anti-viral drug Zovirax appearing in many medical journals. Page one of the ad shows a downcast young woman seated alone in a sidewalk cafe lamenting that genital herpes has put her into “solitary confinement.” Page two shows the same girl smiling and in the convivial company of another young woman and two very nice-looking young men. The girl was in “solitary confinement” only in that she could not fornicate. Better living through chemistry “solves” the problem by enabling her to fornicate somewhat more freely. The ad treats of the issue of genital herpes as though it is merely a matter of viruses, their DNA structure, and chemically substituting a different base in the thymine, guanine, etc., pairs. The acceleration of this kind of narrow thinking is traceable to about 1960. Since that time, all of our venereal diseases have increased in frequency, greatly, with the addition of new diseases such as AIDS.


Excerpts from Physician and Pastor: Co-Laborers

Flee Immorality

I Corinthians 6:15-18 "Do you not know that your bodies are members of Christ? Shall I then take the members of Christ and make them members of a harlot? Certainly not! Or do you not know that he who is joined to a harlot is one body with her? For, 'the two,' He says, 'shall become one flesh.' But he who is joined to the Lord is one spirit with Him. Flee sexual immorality. Every sin that a man does is outside the body, but he who commits sexual immorality sins against his own body."

The anemic Church of Common Morality feebly recommends fleeing sexual immorality, then counsels that you approach it with a condom in hand, tacitly teaching that flight from that immorality is not possible.

Medicine Without the Word

Matthew 4:4 "...It is written, 'Man shall not live by bread alone, but by every word that proceeds from the mouth of God."

Medicine is sustenance of the same sort (though of lesser necessity) as is bread. To try to live by medicine without the Word of God is destined for frustration and failure.

The Longevity of Righteousness

Prov. 16:31 "The silver-haired head is a crown of glory, If it is found in a way of righteousness."

Longevity is related to righteousness.

Pursue Wisdom

Prov. 9:10 - 11 "The fear of the Lord is the beginning of wisdom, And the knowledge of the Holy One is understanding. For by me your days will be multiplied, And years of life will be added to you."

Do not send young people off to college to pursue a degree if they do not have the beginning of wisdom. Is a fool in possession of a degree and much data more useful than one without?

Saving Life

Bernard Cohen produced what he calls a “catalog of risks” [found here] in which he tries to put the various risks life has to offer into order according to their “riskiness.” He uses the method of years of potential life lost which he terms “lost life expectancy.” The results of his work are eye-opening, revealing the narrow mindset medicine has developed. For example, a person who lives an alcoholic lifestyle on the average lops 4 thousand days (about 11 years) off of his life. If a counselor were successful only 5% of the time in seeing an alcoholic changed, he would save as many years of life as would the medical profession if the medical profession were able to save all burn victims, or all poisoning victims. If the counseling were an effective instrument in getting people out of poverty by means of getting them back to work, and was effective only 3% of the time, the counseling would save as many years of potential life as would be saved by eliminating all deaths by motor vehicle accidents if the relationship that poverty has with mortality is causal.


Excerpts from Physician and Pastor: Co-Laborers

Giving Away Years

Prov. 5:7-13 "Therefore hear me now, my children, And do not depart from the words of my mouth. Remove your way far from her, And do not go near the door of her house, Lest you give your honor to others, And your years to the cruel one; Lest aliens be filled with your wealth, And your labors go to the house of a foreigner; And you mourn at last, When your flesh and your body are consumed, And say; 'How I have hated instruction, And my heart despised reproof! I have not obeyed the voice of my teachers, Nor inclined my ear to those who instructed me!"'

It is a mark of our departure from the authority of Scripture that we think we need "evidence" such as that provided by "medical research" to tell people to be sexually pure.

Healthy Parenting

Pastors and teachers who teach God's law are promoting preventive medicine when they teach what are now called “parenting” skills from Scripture. The number of medical contacts resulting from unbiblical parent-child relationships is large, including: preventable accidents, drug abuse, venereal disease, functional abdominal pain, tension headaches, illegitimate pregnancy and more. Small children whose parents, for example, tolerate “sass” or disobedience, as in a church nursery, can be provided with inexpensive, powerful health maintenance without any physician involvement whatsoever. Nouthetic counselors can admonish the parents on the fifth commandment and its applicability in the present life and in the life to come.


Excerpts from Physician and Pastor: Co-Laborers

Healthy Memorization

Prov. 3:1, 2 "My son, do not forget my law, But let your heart keep my commands; For length of days and long life And peace they will add to you."

Why has catechizing and memorization fallen onto such hard times? When we do memorize, do we choose those passages that are more of a "pick-me-up" for momentary use and discard than deeper study?

The Questionable Link Between Saturated Fat and Heart Disease

Here's another current article that Dr. Terrell would have loved:

The Questionable Link Between Saturated Fat and Heart Disease


"Saturated fat does not cause heart disease"—or so concluded a big study published in March in the journal Annals of Internal Medicine. How could this be? The very cornerstone of dietary advice for generations has been that the saturated fats in butter, cheese and red meat should be avoided because they clog our arteries. For many diet-conscious Americans, it is simply second nature to opt for chicken over sirloin, canola oil over butter."

Read the rest of the Wall Street Journal article here.

Unhealthy Day Care

[T]he widespread use of group day care facilities needs to be challenged. While it seems reasonable that a family may delegate at times portions of its child care duties to others, the family retains the responsibility for what occurs. Day care just cannot be as healthy as a biblical family. A toddler enrolled in day care can expect to be bitten by another child within an average of 73 days. While siblings within homes also bite one another, the toddler at home is not going to be surrounded by 20 other toddlers who are in the prime "biting age." One mother just cannot give birth to that many children in a short period of time. It requires collecting them from many households.

The risk of infectious disease in day care is two to four times greater than for children cared for at home. This includes gastrointestinal infections, which are also carried to other family members at home. Otitis media also is increased in day care children.

You would expect such information would impel reasonable people toward a view that small children, if possible, are better cared for in homes than in group day care, and that policies to support that end would be the best ones. Instead, as example of the narrow way medicine has of conceiving of problems and their solutions, listen to the "answer" of the researchers of a major review of illness and day care, persons at the Bush Institute for Child and Family Policy at the University of North Carolina at Chapel Hill. "... government intervention is justified when a market fails to measure adequately the true costs or benefits of a given market transaction. ... It seems reasonable ... to recommend specific regulatory provisions ... regulations requiring parents to demonstrate that they have been following a schedule of health visits for their child, (such as that recommended by the American Academy of Pediatrics.)"

That government policies encouraging two-parent wage earner families built into the tax structure and otherwise is the problem is not even considered. That changing policies to reduce the demand for group day care is a better approach is ignored.


Excerpts from Physician and Pastor: Co-Laborers

The Health of the Family Structure

We [should] consider the power for health that intact families which have biblical authority structures possess. "Children in single-parent families are 20 percent to 40 percent more likely to suffer health problems." Pastoral counselors who work to sustain marriages are also very powerfully engaged in the physical health of the household. You are strengthening a locus of government which is far more powerful to maintain health than is medical care. Would we in medicine not dream to be able to reduce health problems by 20% to 40%? ...

Pastoral counseling which points out the family's primary responsibility to care for its own has health power.


Excerpts from Physician and Pastor: Co-Laborers

A Fraction of the Picture

The prior probabilities of disease profoundly influence the decisions of the practitioner in making diagnostic decisions. Generalists look at subspecialists and are tempted to conclude that they are always seeking zebras. Subspecialists are tempted to look back at generalists and conclude that they are always missing things. Our denominator populations are different. Our error rates are not necessarily different…

Rather than pursue medical internecine warfare, consider that we in medicine as a whole have been turning to the entire population and telling it how it ought to function for health. The estimates of patient self-selection prior to seeking medical attention is probably an underestimation of the self-selection that takes place before any of us in medicine see the patient. Other studies estimate that physicians see patients in only 6% of all episodes of illness. Not only are we prone to be mechanistically disease-oriented, we see only a fraction of the whole picture!


Excerpts from Physician and Pastor: Co-Laborers

Spiritually Sick

We collect and categorize physical ailments, using the medical model. Our field is differentiated largely by disease microorganisms (infectious disease), organs (cardiology), tissues (neurology), age groups (geriatrics), physiological events (obstetrics), and procedures (coronary artery bypass teams).

The whole of medicine is now categorized by reference to these physical features. Imagine a hospital in which the ill were categorized according to spiritual features. There might be a wing in which covetousness was the underlying spiritual feature by which a person came to illness, a ward for idol-worshippers, isolation rooms for those in whom stealing was the spiritual genesis of their problem, whole hospitals for the sexually immoral.


Excerpts from Physician and Pastor: Co-Laborers

Ignoring Denominator Populations

Today, physicians initially learn about sickness from the sickest of the sick… “Tertiary care” hospitals collect the rarest of the rare. We have “zebra farms.”… Hospitals are remarkably efficient for displaying diseases in several stages of development or varying manifestations as well as for studying their response to treatments. On one ward may be collected all manner of cancer or infection or genetic diseases. The benefits we have enjoyed in medical understanding from such collections is not to be underestimated. However, along the way, these collections have helped us to ignore the denominator populations from which they were drawn, as well as the possibility of taxonomies based upon other features than bodily diseases.


Excerpts from Physician and Pastor: Co-Laborers

No Need for Mammograms?

As noted earlier, Dr. Terrell was not a fan of mammograms. More evidence is coming out that he was right. See this article from today's Wall Street Journal.

"A large study published Tuesday adds to the growing body of research concluding that screening mammograms save relatively few lives from breast cancer while discovering many cancers that wouldn’t have caused problems if left alone." Read more...

Forgetting Wisdom

We let ourselves be tyrannized by data, by information, and have forgotten wisdom. Good science requires good questions.


Excerpt from "Pharmacy and Medical Interventions"

Ignoring the Monster Inside

Science in medicine has become master instead of servant. We have viewed health and illness as an alien something that leaps upon our backs in the dark and fastens to our flesh. This model of sickness suggests that all that is needed is to peel the monster off of our outside. We can leave what we are inside, in our spirit, alone. Indeed, there is plenty of therapy which fits that model quite well. Yet, illness is more often substantially subjective.


Excerpt from "Pharmacy and Medical Interventions"

Free Economy

The opposite of a controlled, monopolistic economy is a free economy, in which the marketplace allows people to assign values to the various products and services which are available. Value is, remember, subjective, not objective. In a truly free economic exchange, both buyer and seller come away winners. If value were objective rather than subjective, every economic transaction would produce a winner and a loser. Someone would have traded something of more value for something of less value. The best that could be expected would be a tie. But, since value is subjective, the value to me of my $20 is not as great as the bottle of medicine sitting on your shelf. To you, my $20 is more valuable than that bottle. We exchange, and both are winners.


Excerpt from "Pharmacy and Medical Interventions"

Sovereign God in Medicine

I have confidence... in a Provident God, who exerts His will in ways that are partly comprehensible to us by means of principles. Our present system [of medicine] in many ways is trying to overrule God. Have no fear. It won't.


Excerpt from "Pharmacy and Medical Interventions"

Bearer of Justice, Not Compassion

A requirement by the state that a certain privileged group (doctors) be inserted into the patient's decision is accepted by us as natural, but it is only about a hundred years old. Were things so awful before? Even if they were, has God set up civil rulers to govern the health of individuals, or has He set up the individuals as the ones who are responsible? If you think the former, what is your Biblical grounds for thinking that? Government is for the punishment of evildoers. It is an instrument of justice, the bearer of the sword. It is incongruous to see the compassion and care of the injured and ill as a part of a ministry of justice and coercion.


Excerpt from "Pharmacy and Medical Interventions"

A "Right" to Health Care?

How would you deal with the more fundamental statist argument that underlies this socialized approach to medicine? The argument goes that “Everyone has a right to health care, and it is the duty of the federal government to provide health care.”

I’d question on a presuppositional basis, first, where does this right emanate, and how do we know that we have it. I don’t think I could get an adequate Biblical answer. Secondly, it treats health care as something that is applied to people, like clothing to our backs, or roofs over our heads. Health is something that is intimately tied up with what we think, and therefore what we do. It is not something to be applied to people as a stamp is applied to an envelope. And the system we are headed for treats health care as some sort of commodity, which it is absolutely not, and cannot be…. It can’t be provided like a commodity. People that say they have a right to health care could say that they have a right to a certain amount of money, without engaging in any of the activities to acquire and preserve and increase it. It’s preposterous. It’s not going to be handed out that way. Which is why I am confident it is going to fail. A lot earlier in this country than in the more cohesive countries of Europe.


Excerpt from an interview with Dr. Terrell

Unecessary Mammograms?

Dr. Terrell was not a fan of mammograms, and it seems that a larger medical community may now agree with him. Recently, The American Conservative posted an article stating,

"In a randomized controlled study (the gold standard of medical research), women who received regular mammograms were no less likely to die of breast cancer than those who went without. Although they received no additional protection, women who were screened paid an additional price. One in five of the cancers or abnormalities identified by mammography were ultimately harmless, but the women went through biopsies in order to be sure. Even worse, one out of every 424 women who were screened received treatment for a nonexistent cancer, enduring needless and debilitating radiation, chemotherapy, or surgery."

Read the rest of The American Conservative article here.

The Population vs. the Patient

Just as we [physicians] cannot serve two masters in the form of multiple [clinical practice] guidelines covering the same issues, so also we cannot serve the "population" in the abstract instead of the patient before us. It is Doublespeak to maintain otherwise.


Excerpt from "Practice Guidelines"

Unknown Risks

Dr. Terrell used to say that the danger in medicine was not always what we know, but what we don't know. What we don't know can get us. For a current example, read the recent news regarding Europe's Pandemrix swine flu shot.

A Personal Religion

Our Christian religion is a personal one.  The Bible may be described as a book of tragedies, which it is, though victory is woven all through it and triumphs at the end. It may also be described as a book of names. It is not abstract principles only, it is flesh.


Excerpt from "Notes on Ephesians"

Good Ends and Good Means

Our duty is to discover His will and to do it and to let Him take care of the outcomes. He is trustworthy.

Americans are characterized by a “can do” attitude. We are performance oriented. While there are many advantages to this there are also characteristic faults. We are prone to seek control beyond our rightful sphere, to take over from someone else [by unjust means]... Don’t like the employer? Just sue him. Don’t like your neighbor’s trashy yard? Get a zoning ordinance passed. Don’t like the way your acquaintance is raising her child? Anonymously report her for child abuse. Don’t think people should use echinacea for their ailments? Use the FDA to have it prohibited.

One characteristic all of these approaches use is their ends-justify-the-means assumption. God wants us to seek good ends. He also wants us to use good means. Respecting His division of authority is basic.


Excerpt from "Trusting God or Trusting Ourselves"

Patient-Oriented View

[Clinical practice] guidelines are disease-oriented rather than patient-oriented. This orientation to disease is an affliction of modern medicine which the guidelines did not originate, but which they will aggravate. The context in which problems occur, the beliefs of the patient, coexisting disease, financial issues, malpractice liabilities, and so forth, are not sufficiently in view.


Excerpt from "Practice Guidelines"

Germ Theory and the Spirit

[The germ theory] is a powerful concept. Great things have been accomplished in medicine by application of this theory. Ask today what the cause of pulmonary tuberculosis is, and nearly every physician will answer, “Mycobacterium TB” or one of the other Mycobacteriaceae. More than just for infectious disease, the germ theory is typical of a set of models which posit a material cause for each disease.

Common to these models is the idea that each disease is caused by an unbidden, alien, and usually unseen agent which invades a person against his will. The job of medicine is to find the alien and cut it out surgically or poison it out medically. Preventive medicine is supposed to lock out the alien substance or to lock it up harmlessly -- be it cholesterol, elevated blood glucose, uric acid, or a developing nest of malignant cells. The patient's job is rather passive in all of this. The patient is basically to hold still while the doctor identifies and destroys the invader. The whole idea of prevention or therapy is to change as little of the person as possible. Only the invader needs to be destroyed. The person's attitudes, beliefs, motives, loyalties, or character are largely incidental to the process.

The germ theory has worked!

One and a half centuries later, we have become victims of our success in exploiting these models of disease which feature a "physical causative agent" that comes in willy-nilly on a gene or a germ. Thus planted and matured, this model of physical causation of disease has borne such fruit that people are trying to grow it well outside of its natural range.

Physical causation for presenting complaints of patients has been transplanted to problems which do not have a physical cause, though they may have a physical consequence in the body. In addition, though multifactorial models for disease are now in ascendance, all of the multitude of factors examined are physical factors. The spirit of the suffering person is neglected as a factor, let alone as a key factor. The idea of physical agency for medical complaints has pushed the spirit of mankind out of its proper claim.

I wish to maintain that the spirit of mankind is actually the primary factor in determining health or sickness in the United States, and that the "basic science," as it were, of spiritual matters is Biblical theology. It follows then that Medicine should be functioning from a biblical framework that makes the natural science methodology subsidiary to theology.


Excerpt from "Physician and Pastor: Co-Laborers"

Connecting Physicians and Pastors

We wash our hands so as not to infect patients with physical germs. Yet we carry the germs of deadly spiritual ideas from a misbegotten medical orthodoxy -- wrong ideas about the nature of people and their complaints -- and bring those wrong ideas into our examination rooms. We are infecting our patients with these wrong notions. We are harming our patients both physically and spiritually by the infectious ideas we bring with us into the medical encounter. We are also harming them by keeping biblically correct beliefs out of the medical encounter….

Consider, however, a household I have encountered that is not all that unusual. A divorced woman in her forties heads the house, one of only two employed persons in the house. Her ex-husband contributes nothing to the support of his one surviving child, who is disabled. The other child died in infancy. The mother has three daughters by other men whom she never married. Two of these three already have illegitimate children of their own, out of numerous sexual liaisons, and the third adolescent is already quite sexually experienced. Educational and vocational aspirations find little encouragement or example in the house.

Out of this household has emanated sexually-transmitted diseases galore, depression, one murder, a person with a seizure disorder possibly related to childhood head injuries, severe visual impairment, numerous infections, premature childbirth, and so forth. Into this maelstrom of medical problems, our profession has hurled, modern obstetrics, Dilantin, antibiotics galore, surgery, tricyclic antidepressants, and vitamins. Not admitted to this arena of suffering, however, is any investigation, let alone challenge, of the erroneous belief systems. What is proper sexual behavior? What is a good basis for marriage? What is the right way to handle anger? Is it right not to work, when you are able to do so, and live off the means of others? These kinds of questions are begging to be asked and answered. Yet, with a vengeance, the medical profession is refusing even to consider them. All lifestyles are now being created equal. The Scriptures have answers to these questions. They are not rhetorical questions. Medicine, however, is halted well short of the etiologies contained in values and beliefs. By means of working connections between physicians and pastoral counseling, we need to make these answers available to patients.


Excerpt from "Physician and Pastor: Co-Laborers"