Christ and Other Sheep: Reading the Gospel in Iraq

Most journalists I meet in the Middle East are disenchanted with religion. They are spiritually cynical, agnostic at best. Many are unusually humane, intently aware of our world’s wounds, yet invariably critical and distant from any organized faith.

I can see why. I’ve just spent 6 weeks reporting from Iraq, where faith seems saturated in hatred and blood. “Christians are not Arabs. Arabs cannot be Christians,” a displaced Chaldean from Mosul tells me. “We can never live with Muslims,” a widowed Yazidi cries. “Watch these Shi’a bastards,” a Kurd says as he sends me videos of elite militias abusing Sunni civilians. “You dog,” the soldiers in the videos laugh as they kick and beat a cowering man.

Religion starts to hurt. “In the name of God” becomes the sound of sectarianism, the anthem of a thousand gleaming daggers cutting lines and boundaries across the broken earth: I’m in, you’re out. I’m a believer, you’re not. I am good, you are bad. You dog. I could never live with you. You could never be like me. In the name of God, the merciful, the beneficent, you heretic! You infidel, in the name of God, go to hell. In the name of God, the merciful, burn.

As a reporter, I tread the lines between Kurds, Arabs, Yazidis, Christians, Sunnis and Shias. I see giant crosses and green flags demarcating different neighborhoods of Beirut. I see Jewish stars graffiti-ed on the staircases of Amman with “Al-Mot, Death” scribbled underneath. I see overflowing refugee camps in Jordan, Lebanon, Palestine and Iraq, and I am seized with an urge to damn religion. To hell with this hell, I want to say. To hell with the institutions and social constructs that give men self-justified license to rip other human beings apart. To hell with the lines, the walls, the moral police and everyone judging everyone else as unrighteous. To hell with God, I almost think.

But LORD have mercy, I cannot pray this. I almost curse the name of God, but then I stop, I cannot, I don’t.

I read the Bible in Iraq out of desperation. I needed to know that God is good and understand how that could be true when our world is as poisoned as it is. I couldn’t understand how God could be loving and exclusive at the same time. “Christ is the only Way,” I thought, “But what does that mean for all those who don’t know Him? Shall I condemn them, as other religions will condemn me?” Deuteronomy reads like an instruction manual for ISIS, I thought[1]. I spent my days collecting testimonies of genocide and my nights fearing that God was pleased to see this happen. I reported on violent religious extremism and feared: what if God actually condones this?

This fear paralyzed me for a while. Then I picked up the Gospel and read.

It’s much easier to picture Christ now that I live in His neighborhood. I picture Him coming to a land under oppression and celebrating life. Jesus goes to a wedding and turns water into wine.[2] He walks around healing, casting out spirits, multiplying food and telling tantalizing parables. He shows Martha that being with God is better than doing anything for Him. He weeps with Mary when she tells Him, My brother has died, and if you were there, it wouldn’t have happened. But she still calls him Lord as she says this. Jesus weeps- and raises Lazarus from the dead.[3] The next day, Mary pours expensive perfume on Him, worshipping, and small-hearted Judas says, “What a waste.” Think of the food distributions, cash programming, and hygiene projects that money could have funded. But Judas is a thief who’s been helping himself to the disciples’ moneybag. He’s really thinking of himself, selfishness twisted with self-righteousness, and Jesus sees right through him.[4]

I picture Jesus coming to historic Palestine, where the Israelites are under Roman occupation. Surely our LORD will save, his disciples must have thought. Our people worship the One True God and now the Messiah will break these chains of oppression, they must have hoped. FREEDOM, I imagine them whispering to one another, the way my Syrian friends tell me they spoke in 2011 for the first, daring, dangerous time. The word tingled on your tongue, they say, then grew until it grabbed your whole being, flung you into the street and had you yelling, roaring, electrified in sudden exultation with brothers and sisters and countrymen: FREEDOM, we stand and claim our humanity. Freedom, we protest and demand.

Surely Jesus’ followers thought this way as he entered Jerusalem on a donkey. Hosanna, they cried, save us now.[5]
Surely they thought he would lead them to social and political release.

I imagine how the earth must have shattered beneath the disciples’ feet when they found their leader had no intent of rebellion. No uprising, no overthrow, no victory – rather, death. I see photos of ISIS crucifying people in Raqqa and I picture Christ, then I picture his dearly beloved wracked with heartbreak and fear. So injustice continues. The world wins. All things are broken and we thought you’d fix them, but you’re gone, we’re lost, LORD -[6]

What the hell is this Gospel? Why would the disciples believe it, as Jesus died and Roman rule continued? Why should I believe it, as I stand in front of a Yazidi woman whose daughter is enslaved, counting atrocities in Syria, Iraq, Lebanon, Egypt, Israel and Sudan, feeling like the smallest person in the world, taking notes and knowing they’ll do nothing but elicit some fleeting public sympathy and exert a featherweight bit of pressure on military and political powers?

In Iraq, I consider this unlikely message: Jesus did not end suffering and injustice, but He will end them. He did not fight the way the world fights, with swords and guns and drones and jingoistic anthems. He did not win an ethno-nationalist victory for the Jews. He did not stop Lazarus from dying, nor did he heal every person or raise every Beloved from the dead.

Christ rejected Pharisees and went to the sinners, even to the Gentiles. He was like a Palestinian going to the Israelis, a Sunni going to the Shia, a Kurd going to an Arab, a Yazidi going to an ISIS fighter. He crossed all the lines.[7] He didn’t form a new club to supersede all the others. He said, being in a club won’t save you. Nothing you do will ever save you. Stop trying to be good. Seek God, repent and ask to be saved.

He washed feet.
Then He died.

There’s a trick of the devil that says, God hates the world because it’s sinful, so prove that you’re righteous and maybe you can be saved. Everyone else will burn.

The Liar whispers poison-thoughts of revenge, fear and self-pity in our heads. They bleed into systems of greed, power and money that rip the world apart. Then he stands at our ear and sneers, “The world is damned and you are damned with it. God hates you. Hate Him back.”

But the Gospel speaks the opposite. “God did not send his Son into the world to condemn the world, but to save the world through him. Whoever believes in him is not condemned,” Jesus told Nicodemus.

I read headlines from Kobane, Jerusalem and Darfur, and turn this over in my mind. We are not condemned. The world is burning, but those who believe are not condemned. “The prince of this world stands condemned,” Jesus says in John 16 – then He goes to the cross. He dies, then rises again. The Liar is condemned, Christ said, so don’t despair or bow before him. He is the condemned one, not you, Beloved.

There’s a secret message in Christianity that doesn’t make sense unless you believe in Christ not just as a teacher and moral example, but really as God giving Himself for Man: life comes through death. Everyone thought Christ was losing, but He won through loving sacrifice. His shocking call is this: “Follow me,” not to kill unbelievers, but to die for them.[10]

Lay down your life, Christ said: love those who hate you, pray for those who hurt you, do nothing out of selfish ambition or vain conceit, and speak Jesus’ name.[12] Follow Him, not toward comfort, privilege or resettlement to suburban America, but to wash feet and tell people that God loves the world. We may be killed in the process. But He is victorious. We are not condemned, darkness is. Nothing can separate us from our Father’s love.[13]

I don’t want to be religious anymore, I prayed in Iraq, recoiling from the vortex of exclusion, revenge and sanctimonious hate. At the same time, I feared the real cost of following Christ. I didn’t want to burn. I didn’t want to see any more of our world’s self-destruction. I’ll vomit, I cried. God, I’ll fall apart.

Religious people are like candles who don’t want to be lit. We’re adorned with gems and carvings, standing high and proud. We think our decorations make us good. Christ says, Forget your self-righteousness. The smallest scrap of paper that blazes from my Presence is more useful than a thousand pieces of regal unlit wax. I’m going to set you on fire and send you into the dark. You’ll melt, Beloved, but do not fear. You’re surrendering to a Light that will never go out.

The Gospel does not ask its followers to form a club and hate everyone else. The Gospel is a feast in a refugee camp, a banqueting table set before our enemies, an engagement party as the world breaks. It says: by the grace of God and faith in Jesus Christ, come to our Father’s table. Eat, drink and be filled. Don’t kill for the Gospel! Die for the Gospel. As you die, you live. Your Shepherd has loved the hell out of this earth.[14] Follow Him, and invite others to do the same. [15]
[1] Deuteronomy 20.
[2] John 2.
[3] John 11.
[4] John 12.
[5] John 12:12-19.
[6] “They asked her, ‘Woman, why are you crying?’ ‘They have taken my Lord away,’ she said, ‘and I don’t know where they have put him.’” – John 20:13, Mary Magdalene at the tomb.
[7] John 4: Jesus talks with a Samaritan woman.
[9] Romans 3:23, John 3:16-21.
[10] Matthew 10:38-39.
[11] “I tell you the truth, unless a kernel of wheat falls to the ground and dies, it remains only a single seed. But if it dies, it produces many seeds. The man who loves his life will lose it, while the man who hates his life in this world will keep it for eternal life. Whoever serves me must follow me; and where I am, my servant also will be. My Father will honor the one who serves me.” – John 12:24-26.
[12] Matthew 5.
[13] Romans 8.
[14] “He tends his flocks like a shepherd: He gathers the lambs in his arms and carries them close to his heart; he gently leads those that have young.” – Isaiah 40:11
[15] John 10.

Christianity, Journalism and Gaza: I do not know it all; I know very little at all.

“When I finally began to spend time in the place about which I had pontificated for so long, I discovered that I was much more interested in what the people I met had to say than in my own views. It dawned on me that I could only be a good writer on the Middle East to the extent that I was a good listener… The brash young man I was could write with a sense of mission in large part because he had never spent any time in the region; he was intoxicated by the sound of his own voice, the power that he felt it gave him.
—-

I wanted to give an account of their suffering, but I had to do so with a measure of humility, without pretending that I knew more than I did – or, more to the point, more than they did… Reporting on Algeria, I was forced to own up to my own uncertainty and to make it a part of my writing.”

I loved reading this piece today by Adam Shatz, long-time reporter in the Middle East. Partly because he is an eloquent writer full of insight, and partly because the brash, youthful presumption he describes is so familiar to me. One year ago, I thought I had answers to all the hard questions, from “What’s going on in the Middle East?” to “Whose fault is it?” to the biggest of all, “Who is God?”

Graduating from Princeton, I was confidently groomed to analyze, critique and defend political and religious views. I had the perfect blend of sureness, urgency and occasional condescension. I’d only studied the Middle East for four years, mostly from outside the region, but felt justifiably self-righteous, often indignant, and obliged to jump into punditry and political debate.

That changed this year. It doesn’t matter how hard I studied at Princeton or Oxford, how many books I read on Islamism, Zionism or Orientalism, how well I presented at the State Department or how many drafts I wrote of my thesis. I did not know the sound of church bells and calls to prayer in the mornings of Jerusalem, the scorch of beating sun on your 400th day in a refugee camp, the jostling of bodies as soldiers herd you like cattle through a checkpoint, or the rush of Mediterranean blue along Beirut’s Corniche as you pass old men smoking argileh and toasting kaakeh on its coals.

Journalism is humbling, especially from abroad, because I realize that I do not know it all; I know very little at all. Thankfully, reporting is not about projecting my own opinions but gathering knowledge, walking the streets, drinking tea, making friends, asking questions, and most importantly, listening.

My best friends now are from Syria, Palestine and Sudan. I’ve never felt my heart swell with an entire region’s revolutionary promise, then break as my heroes were killed, arrested or forced to flee. I’ve never fled across a border. I’ve never watched anyone that I love die. I don’t know what it’s like to live through war, occupation or genocide. I barely dare to imagine. But I can ask.

As a journalist in the Middle East, the most foolish thing I can do is to assume I know what’s going on. As a Christian, the same mistake applies. I am reminded of 1 Corinthians 13:9-12:

“For we know in part and we prophesy in part, but when perfection comes, the imperfect disappears. When I was a child, I talked like a child, I thought like a child, I reasoned like a child. When I became a man, I put childish ways behind me. Now we see but a poor reflection as in a mirror; then we shall see face to face. Now I know in part; then I shall know fully, even as I am fully known.”

This passage used to confuse me. So am I a child or a man? Surely I’m a ‘man’ by now, I’d think. But the longer I’m a Christian, the clearer it becomes that I am but a child.

This year, God is suddenly very real. I talk to Him, ask questions, seek Him hungrily, because I find that I do not know. My quiet times of repeating religious adages to self have been replaced by what I call “faith like a crazy person.” It includes tumultuous emotion, exuberant bouts of joy, really cheesy moments and a lot of me just sitting on the floor yelling WTF ARE YOU DOING? Who ARE You!?

In journalism as in faith, we must listen humbly and ask hard questions. That includes “What’s going on in the Middle East?” “Why?” “Who is God?” and one more: “What would He have me do about it?”

In Gaza, for example, more than 2,000 people have been injured and 268 people killed from Israeli attacks this week. 70% of them were civilians. 1 in 4 were children. Human Rights Watch, Amnesty International, the United Nations have all condemned the strikes as illegal human rights violations, but the killing continues.

Hard questions: Why is this happening? What role are America and Christian church playing in it? Who told me so? Why do I believe them? Could I be wrong?

Harder questions for Christians: What is justice? God, how am I to seek it?

Usual side question from me: Can we just avoid this topic? It’s so sensitive and contentious. Also I hate oppression and it’s easier to just pretend this isn’t happening.

Steady answer from Christ: No.

I bring up Israel specifically and intentionally because it’s a vortex of all the hardest questions of all. But dear friends, we must ask them.

People often ask me how to help refugees in Jordan and the Middle East. Donate to UNHCR and pray, I say, but also ask questions about the region’s current crises. Too often do we feel sad for innocent victims without realizing that our states and institutions are involved in ongoing injustices, ones that depend on constituents’ apathy and ignorance to continue.

Accountability is harder than charity because it demands our effort to seek out truth, and then strength to acknowledge that we might have been wrong. But we needn’t be defensive or afraid of admitting mistake, because God is for us, not against us. He is gracious and ready to show us who He is – as long as we ask genuinely, surrendered, willing to drop our comfort and assumed righteousness.

I ask a lot of questions. I don’t have answers for all of them. Re: Israel and Christian Zionism, for example, I do not know what will happen in the “end times” with the Israelites, the state, the temple, etc. Based on Jesus’ words in the Bible, I don’t think I’m supposed to know. But I do know this:

“And now these three remain: faith, hope and love. But the greatest of these is love.”

– 1 Corinthians 13:13

Faith and hope can be difficult. Last night I stayed up late writing about the refugee crisis in Jordan, thinking about the Syrians begging here in Beirut, scrolling through my Twitter feed to read about the plane shot down in Ukraine, fascist racism in Tel Aviv and children killed on the beach in Gaza. My mom sent me a text at one point: “I wish I can be next to you and hug you right now. Grieve the loss of a child’s innocent dream about the beautiful world.”

I closed my laptop and cried.

If I weren’t Christian, I would be scoffing at all the soft-hearted fools who believe in humanity and kindness and people’s rights. Obviously they haven’t read history or even current affairs. Obviously they don’t know that people just hate each other. In Darfur the paler Arabs hate the darker Africans, just like in Israel the Jews hate the Arabs, just like in Germany the Nazis hated the Jews, just like in America the whites hated the blacks, and so on. I’d be a skeptic and a realist, attributing everything to power and interests and safely removed from the foolishness of belief in compassion.

But I am a Christian, which means by the Holy Spirit and God’s grace I have this lunatic faith and hope that God is just, He is sovereign, He is for us, not against us, and He wins.

Meanwhile, I ask questions. I listen humbly. I pray for Christ-like love, which means to consider others above myself, resist violence and to seek the good of people that hurt me.

It means to keep my Twitter feed open, to look, read, listen and think long and hard, crying and feeling for children who play in the sand and dream of a beautiful world that suddenly stops.

It means ignoring the cynic that cries, “Fool!” in my head, insisting until the day I die that every human being is a human, Holy and Beloved, regardless of their color, race or religion.

We do not have all the answers. But we can and must ask the questions. In the meantime, we know enough to love.

”Some of what Jeremy’s been reading and thinking about.”

For a while, I’ve wanted to share with other Christians, especially Manna people, about some of the books I’ve read recently. But I’ve been demotivated because 1) there’s so many books I’ve wanted to share it’s been hard to decide where to start, and 2) I felt like I wouldn’t do justice to any of the books unless I gave an in-depth review of them, and I just haven’t had the time or patience to sit down and write one of those kinds of essays.

Well, to get past those hurdles, I decided to just flat out ignore both those hindrances here. Instead of choosing one book, I’m going to write about several books. And instead of writing in-depth about each of them, I’ll make my comments highly summarized – just enough to get the gist for someone not super interested in the topic. But also, perhaps, just enough to whet the appetite of a more interested person to perhaps read the book. Think of this as a sort of pseudo-bibliographic essay, but also a window into my mind recently. I’m going to call this “Some of what Jeremy’s been reading and thinking about.” So here goes.

 

 

”Some of what Jeremy’s been reading and thinking about”

“Existential Reasons for Belief in God” by Clifford Williams

The reason I read it this summer was that the title caught my attention. Esoteric book about God? COOL. I WANT IT. But also, it got to something I’ve always wondered about: Is it OK for a person’s reason for believing in God to be simply that they feel a need for God? Is trusting in Jesus without having thought deeply through rational arguments for or against God’s existence foolish or even sinfully irresponsible? Feuerbach said that God is simply the longing of the human soul personified; Freud said human beings project their repressed desire for an exalted father onto the idea of a personal, Heavenly Father. Religion is wish-fulfillment. Marx: it’s a crutch, an opiate for the needy masses. Are they right?

Clifford Williams, I think, makes a very convincing case for the legitimacy of even some of the most seemingly illogical (or at least the embarrassing ones that we Christians would usually blush at) existential reasons for faith. He argues that not only is paying attention to our feelings of need for God an important part of making sense of Christianity, but that having merely “rational” reasons for believing in God doesn’t make sense. The ideal (and, I would add, the only authentic) way of acquiring faith in God, he says, is through both need and reason – a faith that consists of both emotions and intellectual assent. In other words, we should definitely use our mental faculties to weigh the evidence to make sure that our belief in God isn’t merely a crutch, but we should also recognize that if God has indeed created us with a need for him in our inner being (Pascal’s famous/infamous “God-shaped” hole), our existential needs are something we’re supposed to pay attention to! I know I didn’t do the book justice here, because reading over what I just wrote it doesn’t seem that awesome. But it is. You should just read it. (I have it on kindle if you want to borrow it for 2 weeks!)

“Heart and Soul: A Christian View of Psychology” by William Ouweneel

Speaking of our inner feelings, I’ve been fascinated with thinking through how our heart-relationship with God/spirituality relates to our psychology. There’s a lot of complex, difficult questions that arise when you open up this can of worms. To what extent do psychological problems originate in our spiritual relationship with God? How do we tell when a psychological issue is a presenting problem arising from physiological imbalances? How do we tell when it originates in improper spiritual relationship to God? How do our thoughts relate to our emotions, and our thoughts to our beliefs? What about psychosomatic disorders? While this book (free PDF here!) didn’t provide a clear-cut answer to all these questions, it did give me some tools to start with, beginning with its treatment of how the different levels of our human functioning relates to our psychology. He explained how our human psychology arises as a composite of our physical (relationship between sensory stimulation and perception, psychopharmacology, etc.), biological (neuropsychology, physiological psychology), perceptive (psychology of sensation/perception/conditioning), sensitive (psychology of our feelings), and cognitive (psychology of thinking, deliberation) structures, but also touched on social, economic, ethical, and even religious psychology as other interrelated fields. What I found the most helpful in reading this was that it gave me a starting point to see how interconnected our psychological functioning is and to recognize that helping someone who is suffering from psychological dysfunction requires a multi-faceted approach. Even if Christians may rely on truth from God’s Word to give us wisdom for living psychologically faithful lives, it’s also important to recognize the way our psychology is interconnected with the many layers of our human existence so that we don’t naively think that helping people focus on truths about Jesus will fix all of their psychological issues. Our human brokenness and frailty extends deep into all of the structures of our human existence; while we are called to help each other live as faithfully as we can with whatever psychological constitution we’ve each been given, short of a miracle, many people will only finally experience full psychological healing when Christ finally arrives to renew all things. Thank God he is coming again. How awesome will it be when we’re no longer beset with this constant struggle in inner self? How awesome will it be when our intentions, thoughts, motivations, desires, impulses, fears, loves all work properly for God’s glory?

“Christian philosophy: A Systematic and Narrative Introduction” by Craig Bartholomew and Michael Goheen 

Zooming out a bit, let’s talk about GOSPEL WORLDVIEW. Do you remember when you first got the expansiveness of Manna’s Gospel Worldview? When you became excited about how God cares about everything, not just only our individual spirituality? Well in a way, the shift that was happening there was a philosophical shift – from viewing Christianity through some implicit form of dualism (e.g. viewing the “Spiritual” as more holy than the “material” world) to seeing that the Gospel opens us up to a more holistic way of seeing everything – a way that is consistent with the idea that Jesus is the one in whom all creation holds together – things in heaven and on earth visible and invisible, etc. etc. (Colossians 1:15-23!)

Well, this book tells a sort of history of philosophical thought unashamedly out of this very gospel worldview. The authors are forthright that their history is not unbiased; they intentionally are telling the story in a way that highlights how philosophical thinking throughout history has reflected more and less faithful articulations (in their view) of what we at Manna call this “Gospel Worldview.” For the more theologically inclined, you could say that this book is a tracing of philosophical thought as a historical examination of the relationship between common grace and idolatry in the world of…ideas. Not for everyone, but I think anyone who wants a better picture of how philosophical ideas are embedded in our worldview, this was helpful for me in sorting through that. I would put it above Creation Regained on difficulty level, but below Kuyper’s Lectures on Calvinism.

 

I wanted to write about a bunch of other books, but I think I wrote too much already. So I guess I’ll have to do a second installment! For all you nerds out there (and let’s be honest…we’re Princeton grads…all of us are), be looking forward to..

“Books Jeremy owes library fines for: Recommended Christian books, Part Deux.”

And to whet your appetite:

• Purpose in the Living World by Jacob Klapwijk (Evolution, Creation, Emergence theory, Intelligent Design, etc.)
• The Economy of Desire by Daniel Bell (Spiritual disciplines + Economics, Spiritual evaluation of Capitalism)
• Reading Revelation Responsibly by Michael Gorman (How the heck are we supposed to understand all that bizarre imagery? And what’s with the Kill Bill-esque violence?)
• Loves me, Loves me not: The ethics of unrequited love by Laura Smit (Think: God as our pursuing lover…etc.)
• Theirs is the Kingdom: Celebrating the Gospel in Urban America by Robert Lupton (Urban ministry is where it’s at. I’m learning about all this stuff more through my church in North Philly. Poverty, justice, God’s Kingdom, all that jazz.)

Until then, read more! And love Jesus. And love the poor.

Why doctors (and doctor wanna-be’s) should read

I want to challenge my fellow pre-meds and aspiring physicians to read more. I want to suggest that a passage in Plato’s Dialogues, or a verse in a T. S. Eliot poem, is as important for our future medical careers as a chapter in Biochemistry, 6^th edition. We are human beings before we are physicians, and the community of human beings of ages past demands our attention.

This past weekend, I got a chance to attend the 3^rd annual Medicine & Religion Conference, hosted by the University of Chicago’s Pritzker School of Medicine. Philosophers, theologians, and healthcare professionals huddled to commiserate and pontificate, with the singular goal of pursuing a more harmonious relationship between (duh) medicine and religion. The Conference was mostly smart-talk – distant babble of academics – but I did come away with one conviction: in medicine, science is not enough.

The same phrase, oddly enough, appears in an address given in 1968 at the convocation ceremony of the American College of Surgeons. Then-President Dr. Preston A. Wade is, I like to imagine, speaking before a room full of recently initiated surgical fellows – eager to prove to the world (and their patients) their hard-earned prowess – only to urge them to undo what years of medical training had sculpted into the marble of their souls. He tells them, no less, to abandon their hardline devotion to science and technique.

I will quote at length from his address, because I think his words are worth noting:

“Today’s medical student makes his choice of profession, in a large measure, because of involvement in varying degrees with human suffering and his desire to alleviate it…Somewhere in the course of his medical education, the student becomes indoctrinated in pure science, or hard science philosophy, and tends to change his outlook, at least as he expresses it to his colleagues and his teachers, and adopts a much more hardened attitude toward medicine. It is obvious to him that anyone who continues to talk about studying medicine to alleviate human suffering may not always be popular with his colleagues. It is sometimes considered weak and rather childish to continue this attitude when one is struggling with intricacies of chemistry, biology, and physiology.”

It’s as if Caesar tells his army before a momentous battle that they’ve readied the wrong weapon (or, more accurately, not enough weapons).

The problem with a merely scientific or merely technical view of medicine is that it fails to recognize medicine as a human art, in which realities transcend neatly bounded categories and predictable outcomes. Even the routine prescription of statins for someone with high cholesterol can veer into the chaotic realm of emotions, spirit, and morality. As much as we would like to think, we – physicians or patients – are not merely material bodies.

To believe this is one thing, but to act on it is another. I have heard many medical students say, “I have to study right now – it’s for my future patients,” to justify why they are staying in with their science textbooks, rather than doing something else. Then there’s the system of ‘rotations’ in which the medical student becomes a nomad, jumping from clinic to clinic, field to field, with little time and space to be human themselves. Medical schools have a powerful set of rituals, and those rituals act as a ceramist, shaping his clay in very particular ways. After all, the decline of “empathy” among medical students by their third year of school is a well-documented phenomenon.

In the end, that is what I’m warning myself and others against: not the dedication of students to learning medical science, but the subtle transformation of that dedication into idolatry, a new religion, complete with its own rituals, merciless to its heretics. Refusing to bow to this new religion, perhaps, is no easier task than the holy defiance of Shadrach, Meshach, and Abednego against King Nebuchadnezzar. For the brave, the fiery furnace awaits, except that fiery furnace is a niggling and pernicious feeling that you aren’t doing enough compared to the others, that you will not make a good doctor.

What, then, does reading have to do with it?

Sherwin Nuland, a surgeon-writer who taught at Yale, famously said “You cannot forget too much science at the bedside.” When patients do not react the way we foresaw, or suddenly begin to cry at being told their diagnoses, or when, despite all of your attempts, they die, physicians will be clawing in the caverns of their souls for resources – for the words to describe what’s really going on, for the words to say back to patients to help them heal. Is a dying patient an impending code blue, or, as poet Dylan Thomas put, a fire, “rag[ing] against that good night”? Physicians must choose their words carefully.

Medicine, as I said, is a human art, and reading is an act of participation in the human community. As human beings, our community is not simply our contemporaries – those with whom we share a common time and space, and, therefore common limitations in perception. God has graced us with History, and the experience of those who have gone before us can color our vague outlines with paints we do not possess.

Every man falls under the cycle of birth, life, sickness, and death. Medicine deals with all of those things, and if we’re not careful to reflect on them and to seek the guidance of others (both present and past) during that reflection, we will very quickly find ourselves helpless to help others. I am not suggesting that reading (and engagement in the arts in general) will negate all of the tendencies in medical education towards disenchantment, jadedness, and science-worship, but it’s a very good place to start.

Daniel Song is attending medical school in the fall, and currently working as an intern at an inner-city primary care center in Chicago.

P.S.: For more details on the 2014 conference mentioned in the post, visit medicineandreligion.com/schedule.html

Reflection on Presence: Part 2

Once, on a flight, I met an elderly woman who had the misfortune of needing a liver transplant when she was in her early thirties. She had just gotten married. Her husband (sitting next to her) recounted how their attending nurse, in a hurry to move onto other patients, had brazenly told the couple to “clean up their own bedsheets.” Then there were the annoyingly bright lights, the constant whirring of the machines, and the frequent noise disruptions from the 5, 6 other neighbors who were crammed into their room, that made it almost impossible to sleep. 

Meanwhile:

“Research over the last 10 years has shown that burnout – the particular constellation of emotional exhaustion, detachment and a low sense of accomplishment – is widespread among medical students and doctors-in-training. Nearly half of these aspiring doctors end up becoming burned out over the course of their schooling, quickly losing their sense of empathy for others and succumbing to unprofessional behavior like lying and cheating.” “The Widespread Problem of Physician Burnout.”

If these stories of patients and physicians count for anything,  there seems to be something  awry with the picture of medicine nowadays. That is to say, there is very little healing in medicine.

The central question is, why are doctors so bad at being present? Why is there so little opportunity for relationship, a space that not only allows physicians to give patients human care (that is, a kind of care that fights against the mechanizing, fragmenting tendencies of the modern healthcare system), but also allows the doctors to receive from their patients, becoming, in the process, more human themselves?

I wonder, though, whether we’re setting ourselves up for just that failure. I wonder whether medical education (and even before that, the premedical environment) is a tremendous bait-and-switch, preparing students for one thing, only to leave them, decades later, to find that medicine is entirely another.

Browse through any brochure or marketing material from the top medical schools and you will quickly see what I mean. They are full of language that I find disingenuous – a language that points to a technological utopia in which human will no longer have to suffer or die.

That is not all. The entire preparation process for medical schools trains students to think of medicine not as an endeavor greater than themselves, but to subjugate the field to the confines of their private ambitions. To attract the attention of premedical students, medical schools must now offer ample research opportunities (backed up by endless stores of NIH grant money), opportunities for leadership activities, opportunities to see the greatest diversity or extremities of clinical cases, opportunities to be placed into the best residency programs (whatever “best” means).  It is a continuation of what premeds have done all of their lives, which is to push forward a carefully crafted, highly individualized story that makes them a unique candidate for the medical profession. I am not merely finger-pointing here, because I am guilty of the same. And when faced with the decisions on which schools to apply to, or which school to ultimately attend, I admit I have very little guidance other than something like the US News & World Report rankings. God help me.

This has consequences. I once eavesdropped on a conversation a premed student was having with a stranger while waiting for his flight home from a medical school interview. The stranger asked him what he might want to specialize in. He replied, “Surgery. Because I worked at an animal lab and I really liked dissecting.” This student may have been an extreme, but the sentiment underlining the comment is surprisingly representative of the premedical mindset – we are more driven by the process and the tools than people. Surgery is a very popular specialty among premeds. And at the end of medical school, the list of students who join the ranks of primary care is short, and the list of those entering care for the underserved, even shorter. I do not mean to elevate primary care or care for the underserved above all other specialties. I simply mean that the sickest and the poorest will pay for our moral wandering.

I’m not sure what can be done about this at a systemic level, or, for that matter, whether something can be done (largely because not everybody agrees this is something that needs addressing). For now, it will be the fight of individual students and doctors making the conscious choice for presence, and against what I call the ‘elevator mindset.’ Medicine is not an elevator that gets us somewhere; the end of medicine is embodied precisely in the stranger we so often ignore on our way to false goals. Christ’s call to ‘love your neighbor’ has never been so needed.

-jds

Reflection on Presence: Part 1

My parents moved back to Korea 5 years ago. They live now with my grandparents (on my dad’s side) on a farm in a dinky little down called Chuncheon that has nothing going for itself besides maybe the fact that it now boasts a subway stop leading to the capital city. So now people don’t have to move out of that town for good.

Anyway, my grandfather has something like Alzheimer’s disease. His debilitating stroke a few years back left him with such a compromised memory function that he can remember my name and not much else. Not being able to remember can be lonely. So when I go back home for vacations, and when my mom sees me doing nothing, she cuts up some fruit, puts it on a table and tells me go eat some fruit with my grandfather.

I sit there, talk about myself, eat some fruit. Silence for maybe 5 minutes, whereby my grandfather has forgot everything I just said. So I say it again, eat some fruit, and if I feel especially loving that day, maybe ask him a few questions about his life. He’ll mutter something – but nothing I don’t already know. I return the plates to my mom, and I ask myself, ‘what was the point of that?’ Nothing happened.

“When Job’s three friends, Eliphaz the Temanite, Bildad the Shuhite and Zophar the Naamathite, heard about all the troubles that had come upon him, they set out from their homes and met together by agreement to go and sympathize with him and comfort him. When they saw him from a distance, they could hardly recognize him; they began to weep aloud, and they tore their robes and sprinkled dust on their heads. Then they sat on the ground with him for seven days and seven nights. No one said a word to him, because they saw how great his suffering was.” (Job 2:11-13).

In ‘Salvation and Healing; why medicine needs the church,’ Hauerwas talks about the idea of presence, and how we have so little of it, both in medicine and the church. Consider Job’s friends, he says. You may think whatever you want about their well-meaning but vacuous consolations, but at least they stayed with Job for 7 days. And no one said a word.

That’s exactly what makes people uncomfortable. Everybody loves to help – everybody shows up when they have a chance to be a hero, no matter how small that heroism may be. But how many are willing to be present when not just the helped are helpless, but they are as well? Will you show up, even when there’s nothing you can actually do?

So then we return to my grandfather. Medically, the doctors have done everything in their power to fix him up, but where’s the healing? If what Wendell Berry says is true, then disease is not just the presence of a pathological condition; disease is fundamentally alienation – alienation from our bodies (we are no longer ourselves), alienation from other people (people don’t like to be around other people that might get them sick, or worse, remind them of their own mortality), and alienation from God (as in, Oh God, I’m sick as hell, where are you?).

If that is true, than healing is much more than what modern medicine is. If that is true, modern medicine is not only ‘missing the point,’ but predicated on an illusion, operating in a universe that lacks real moral meaning (which one can say is a universe that doesn’t exist). My grandfather can walk, talk, and live in ways he couldn’t in the days immediately following the stroke – and at that point modern medicine waves its banners high and declares success!, but I am left with a feeling that that is not all there is…

In the world of medical technology, the illusion of control prevails, and with that, the urge to fix. What if all of the medical shindig is but a cloud that blinds us from seeing the truth, which is simply that we belong to each other? And what if the greatest thing we could do (physicians and others) for sick people was simply to be present with them, rather than suggest a million cures for their physical and psychological condition. It’s hard to sit still when there’s all these toys we could tinker with.

In the end, though, being present is what we will all have to do. Because some day my grandfather will die. So will I. In death, we can do little but to hold the hands of the dying, and then, we no longer wear the masks of power, but become who we were meant to be: the recipients of a beautiful gift that we neither understand, or control.