Arriving at the meeting late, I was immediately attentive as the new resident was describing his feelings about a dying patient he had been caring for. Though not in a great deal of pain, the patient was tormented with a hole in his trachea--placed there to ease his labored breathing, it also rendered him unable to speak.
With blood samples drawn several times daily, a catheter in his bladder, a catheter in his arm vein, unable to eat, and isolated from knowledge of day or night in his intensive care cubicle, Mr. Beck had been undergoing exquisite torture for more than a month. Relatives called at rare intervals.
Now it was plain, the new resident said, that Mr. Beck would not recover but would die of his unusual lung disease in days or weeks. It had become harder for the young doctor to enter Mr. Beck's cubicle. So little could be done. Conversation was so one-sided, so frustrating for both as he tried to decipher words formed by Mr. Beck's trembling lips.
Further "therapy" usually meant adding to his already considerable discomfort. A suction tube could be put into his tracheostomy more often in a vain attempt to keep up with the pneumonia that was dealing the final blows to his lungs. Again, more torment for Mr. Beck from the spasms this induced.
Because of our practice of sharing night and weekend call, all of the other residents present at the meeting had come to know Mr. Beck. We all knew his torment and his prognosis. We also knew how the new resident was feeling.
There were no helpful suggestions for the patient's or the resident's plight. There were no measures being carried out in Mr. Beck's care that are considered "extraordinary medical care," no dramatic respirator with its controversial plug. Yet it is also true that the ordinary care being provided to Mr. Beck is extraordinary when compared with what was available a few years ago.
He was alive this far only because of the ability to monitor and correct subtle imbalances in his blood acidity and levels of various dissolved salts and gases. This "ordinary" care was also extraordinary in its ability to prolong his dying. At the moment, no one present was particularly proud of this medical prowess.
The meeting was a teaching conference on the topic of death and dying. As the guest speaker, a Christian minister, began to address himself to Mr. Beck's suffering, I began to be turned off by what he was saying. It was, disappointingly, the usual: Don't avoid the patient. Allow him to express his feelings, to vent his anger. Death is a part of life. The steps of dying as described by Kubler-Ross. How trite!
I began to yearn for him to address himself to the crucial issue--death as the gateway into the hereafter. Please, you are a Christian minister. Your expertise is not psychology.
Mr. Beck is dying. The issue is what is to become of him after he dies and this is what you can effectively speak to. This is, after all, your calling. You could add a dimension to this conference that is almost uniformly neglected in such conference. Saved and unsaved residents here could benefit by a consideration of Christ's offer of eternal life in Him.
Very shortly after my thoughts took this trend, I was convicted in my heart of hypocrisy. I, least of all, had the right to criticize anyone on this point, for Mr. Beck had been my patient before his care was assumed by the new resident when I rotated to the hospital's obstetrical service. I had known him when he cold talk. And talk he did. He had been an obstreperous patient, difficult to deal with.
Mr. Beck had known he was dying before I had. It wasn't plain to me until the last day he had been my patient, just before the new resident assumed his care. By that time he had withered in body and spirit.
I had continued to visit him daily after it was no longer my responsibility to care for him, but my visits had become more and more sporadic as I felt the same helplessness that the new resident had expressed. I could get out of seeing Mr. Beck in the situation I had had a hand in creating. The new resident could not.
Throughout all the weeks I had seen Mr. Beck, I had not witnessed to him about Christ, although I strongly suspected he was not a Christian. I knew that the long-term outlook for Mr. Beck was grim, but death was not pressing at the moment, so I let it slide. I had talked to patients before about Christ's answer to their problems, especially to alcoholics, but never yet to someone with a terminal illness. I had yielded to subtle pressures.
One pressure was the precept of "not taking advantage of my position and the patient's physical and mental weakness to push my religion." People are especially vulnerable when they are ill. Physicians are in a unique position to take advantage of this weakness in many ways, if they choose.
I had disagreed with this precept mentally, but not often enough in action. When questions of our eternal existence and judgment for our life's actions are forced into our awareness by the threat of death, we are indeed weak. But man's weakness is no reason to withhold the Gospel. It is rather the reason to present it. There may not be another opportunity.
Another precept was "Never take away hope!" My supervising physician had once told me this in regard to terminal patients. A frank discussion of the hereafter with Mr. Beck would have strongly implied to him that I thought there was no hope for him medically.
I would not have been taking away hope had I presented the Gospel to Mr. Beck. I would have been replacing a vain hope in this life and its strengths and pleasures (obviously a slight hope in this case) with the hope of eternal life. That is hardly taking away hope.
Perhaps the strongest and most dependable pressure I had yielded to was "What will the others think?" The others were the nurses, orderlies, nurses' aides, technicians and doctors. There is little privacy in intensive care units. To present the Gospel to Mr. Beck would have to be public profession of a type I haven't often practiced.
To make it worse, Mr. Beck was slightly hard of hearing. I would have had to raise my voice. So I let it slide. And I had been critical in my heart of a Christian minister because in my opinion he wasn't living up to the name Christian. Then I realized that I, too, bear that name, and my responsibility was greater because my opportunity had been greater.
The minister was at the moment offering his services to the new resident to visit Mr. Beck. If that resident wanted him to, he would be glad to do so. I could sense that the new resident would assent to this.
Fearing that the minister might play psychologist and ease Mr. Beck out of this life with a listening ear and sympathetic touch rather than telling him the good news of Christ's atonement, I offered my services instead. I don't know that the minister would have played the role of death therapist rather than doorman to the way of life; however, the possibility that he might subject to the same pressures I had yielded to seemed real.
The reason for my being the one to "spend time with" Mr. Beck was the thin one that I had known him longer and had known him when he could converse well; therefore, I should have better rapport with him.
Within the hour, I was at Mr. Beck's bedside. If Abraham could arise up early in the morning to fulfill his unpleasant task of sacrificing Isaac, surely I could afford to put it off no longer. That I regarded sharing the Gospel of Christ with a dying man as such a chore rather than a privilege shows how much of a hold the gods of this world had on me yet. Relief! Mr. Beck was asleep, a rare privilege for him.
Two hours later I again entered the intensive care unit, this time after some prayer. As I came in the door a nurse told me, "Mr. Beck has been asking to see a doctor, any doctor."
To his cubicle I went, being careful to close the double glass doors behind me. Some privacy at least, though I was keenly aware of the partition behind his bed. It did not reach to the ceiling and the passageway on the other side frequently had visitors or hospital staff members standing around, easily within earshot of my voice.
"Hello, Mr. Beck." He immediately began to struggle to mouth words. He was too shaky to write. It was very clear what he was mouthing, but to be certain, I let him say it twice before I said it aloud to let him know I understood. He said, "Let me go."
"Mr. Beck, we're trying to. But it's hard for us."
Weakly, he nodded assent, then weakly shook a couple of the tubes leading from his body, in frustration at being held prisoner in life by them. I ask him if he knows what will happen to him once he dies. He indicated, "No." I asked him if he believed in God. Yes. Was he a Christian? No. Would he like to hear? Yes.
As simply as I could, I told him: Our sinfulness. God's righteousness. Christ, the way of salvation, by whom we become righteous because He paid the penalty we richly deserve. If we accept Him as God's Son, as the one who has paid our penalty, then we are received into God's presence at death. No one earns it. It is a gift.
As ineloquent as I have ever been, but all the elements were there. Would he like to pray with me? Yes. Aloud I prayed, laying out before God Mr. Beck's situation and suffering and our helplessness to help him. Briefly, it crossed my mind that some nurse or visitor might be looking or listening. The answer was swift: I must serve God, not man. If someone was listening, fine. Perhaps they needed to.
I asked Mr. Beck if he would like to receive Christ into his heart as his Savior. Yes. He closed his eyes in prayer. When he opened them a minute later, he was weeping. At least I think so, for so was I. Later, I left him and asked the nurses to please give him a half hour's respite from their routine of care. They understandingly assented. Obviously, Mr. Beck had been a trial to them as well as to us.
I visited Mr. Beck several times before his death eight days later. His suffering continued unabated. Satan extracts his pound of flesh. Mr. Beck certainly had been a help to me, and I tried to explain to him why and thank him. Will we meet again in heaven? Was it genuine? I hope so.
This article was originally published in The Presbyterian Journal in February 1976. The "Mr. Beck" of this story is not the patient's real name.
Showing posts with label Medical Care. Show all posts
Showing posts with label Medical Care. Show all posts
Wednesday, January 18, 2017
Monday, February 16, 2015
Euthanasia and Economics: A Doctor's Formative Experience
She weighed, I supposed, about 65 pounds. All of her limbs were withered and fixed into what is commonly called a fetal position. She was only in her early sixties. As a hospital resident doctor I had been called down to the emergency department to see her. She had been referred in from a nearby nursing home where she had been a long-time resident. It seems that the catheter that drained her bladder had become caught somehow during the process of routine removal for changing. It was my duty to discover a way to remove it.
She was a victim of a rare, incurable disease that causes the brain gradually to deteriorate over a period of years, usually beginning in middle age and always fatal. The judgment and intellect diminish along with the personality and control over the body. She lost control of bladder and bowel. She had not uttered a word in several years. Nor moved much. Nor seemed to understand. Nor swallowed food. She had been fed by a plastic nasogastric tube. Even now it protruded from her nose with the capped end taped to her skin.
I will never forget her. It was one of those experiences that I regard as formative in my personal medical ethic. The Word of God should determine what is right and wrong. Yet experience serves to bring the issues to my attention and allows a focus on the Scripture. The Bible instructs my experience. I am in the world. The Bible helps me be not of the world.
I discussed her plight with a urologist. He recommended a procedure from freeing the stuck catheter. It was the least painful we could think of. But it was not without pain. As I carried out the procedure, I discovered that she could still understand pain. She could grimace. At least, that is how I interpreted the contorted expression on her hollow face behind the tube and tape.
Her life had intrinsic value because she was human. She was formed in the image of God. I knew that the image of God did not refer to her physical appearance, whether or not it was marred by the consequences of Adam's sin. Yet was she still alive because we valued her or because we value our pretended omnipotence in the world? The technology that had preserved her physical existence is all commonplace nursing skill today. Special air mattresses do not qualify as extraordinary care. Nor does the practice of turning and positioning her frequently to prevent bedsores. Nor do catheters, nor plastic nasogastric tubes.
Yet plastic itself is so new my father recalls it as a novelty in college chemistry. Balanced liquid nutritional formulas were new when I was a baby. I remember easily the development of several types of air mattresses. Because we can, we muss. Because it is not extraordinary, we do it. Because someone else can be made to pay for it, we aren't even forced to think about is Scripturally. Even then her care was costing $18,000 a year. Had she lived another generation, she would have died when she was no longer able to swallow. Would she have wanted it this way? I never knew. There were no living wills then. I wish there weren't now. No family member evidenced interest or awareness. Opposition was rising at that time to the horror of abortion and its close relative euthanasia. At last evangelical Christians were becoming vocal against these evils. With interest heightened by this index experience and bolstered by numerous like ones since then, I have read our journals, newsletters, and publications. There is a persistent blind side in the anti-euthanasia effort. On this blind side are two errors.
One error is a failure to consider money. We are acting as if we are omnipotent when we pretend that we have the resources to provide what has come to be considered ordinary care. Those who would actively kill a sufferer are sinfully "playing God." Also "playing God" are those who believe that even sacrificial giving will satisfy the technological idols we serve, hoping to receive from them a prolonged material existence. The other error is that we overlook simple kindness of the Golden Rule variety. Would I have wanted to be treated as this patient was, even if no one had to be extorted to pay for it? No. Despite the simplicity of a nasogastric tube, I see it as no kindness as all, as prolonging death. As a human being with intrinsic value, the image-bearer of God, she had a right to expect of us bread. We gave her instead a stone.
Originally published in The Presbyterian Journal, February 12, 1986
Monday, February 2, 2015
Death with Dignity
Discernment is needed by conservative Christians concerned about the value of human life lest we become like the experts in the law described in Luke 11:46.
Medical efforts are not neatly divisible into heroic vs. non-heroic. Hope is a statistical probability in medicine which is almost never a zero. Hope to a Christian is never a probability and always 100 percent.
The use of complex machines or dangerous surgery highlight the issue but simpler measures are often where we need discernment. On occasions I have seen a $3.00 plastic IV tube transformed into cruel punishment of the dying.
It is true that there is no such thing as a life not worthy to be lived. It is equally true that there are treatments not worthy to be inflicted.
Excerpt from a letter to The Presbyterian Journal, August 18, 1982
Medical efforts are not neatly divisible into heroic vs. non-heroic. Hope is a statistical probability in medicine which is almost never a zero. Hope to a Christian is never a probability and always 100 percent.
The use of complex machines or dangerous surgery highlight the issue but simpler measures are often where we need discernment. On occasions I have seen a $3.00 plastic IV tube transformed into cruel punishment of the dying.
It is true that there is no such thing as a life not worthy to be lived. It is equally true that there are treatments not worthy to be inflicted.
Excerpt from a letter to The Presbyterian Journal, August 18, 1982
Monday, January 12, 2015
Spiritual Roots
To gently confront a young, single woman who is requesting birth control pills for reasons of contraception (marriage not imminent) and see the reaction change from puzzlement to astonishment and finally to admitted concern for her errant "lifestyle" [that marvelous euphemism now for sin] is rewarding. Rather than being morally uninvolved or professionally detached, it seems essential to offer to get nearer to the root of such problems. The root is spiritual. Rather than acquiescing to the blunted sense of sin which our culture inculcates, it is rewarding to sharpen it. The trick is to do it gently, by example and by the Word, allowing the Holy Spirit to do any convicting that is to be done.
Excerpt from a private letter
Excerpt from a private letter
Monday, November 24, 2014
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"
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"
Monday, October 6, 2014
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
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
Monday, September 22, 2014
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
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
Monday, September 15, 2014
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
Excerpts from Physician and Pastor: Co-Laborers
Monday, September 8, 2014
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
Excerpts from Physician and Pastor: Co-Laborers
Monday, September 1, 2014
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
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
Monday, August 25, 2014
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
Monday, August 18, 2014
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
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
Monday, August 11, 2014
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
Excerpts from Physician and Pastor: Co-Laborers
Monday, August 4, 2014
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
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
Monday, July 28, 2014
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
Excerpts from Physician and Pastor: Co-Laborers
Monday, July 21, 2014
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
Excerpts from Physician and Pastor: Co-Laborers
Monday, July 14, 2014
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.
Monday, July 7, 2014
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
Monday, June 30, 2014
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.
Monday, June 16, 2014
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.
Subscribe to:
Posts (Atom)