Health and Religion

Medical Priorities and the Nature of Man. A surgeon says doctors have accepted society's evaluation of man's needs.

Denis P. Burkitt, M.D., eminent British surgeon, is a former member of the External Scientific Staff of the Medical Research Council.
I have had more opportunities than most to visit hospitals in all the five continents. I continue to be impressed by the elaborate extravagance and advanced technology so markedly evident in Western medical centers. The superbly, scientifically efficient and technically sophisticated intensive-care unit is usually shown with particular pride to visitors. As a surgeon, I am given access to the outstandingly excellent operating suites. The wards provide patients with all they could require, from television sets to cardiac monitoring. I find my attention throughout is directed to increasingly costly, and to a lesser degree increasingly successful, provisions made and measures adopted to cater to the physical needs of the biological component of man. High on the priority list are the research laboratories, usually sup ported by animal houses. Animal experiments further enhance the monopoly accorded to biological man, for extrapolation of results presupposes that man is merely an advanced animal, differing from inferior species only in degree and not in kind.

Occasionally incorporated within—or more usually adjacent to and sometimes more distant from—the main hospital building may be found one or more wards designated for the treatment (and just possibly research into the cause) of disease of the mind. This unit tends to be relegated to the older parts of the hospital.

When I wander around on my own, I not infrequently discover a room set aside as a chapel, which is used not only for church services but also for consultations with the chaplains. I can seldom remember my attention being drawn to the chapel as I with a group of clinicians sweep past its door. It is assumed, and regrettably rightly, that the chapel or the approach to life that its presence symbolizes is unlikely to be of interest to visiting doctors, particularly if they are known to be research oriented.

I in no way wish to disparage the utmost efforts to provide, within prevailing limitations, the most efficient care possible for the bodily needs of every patient. I merely use this obvious example of relative priorities to emphasize what I believe to be a distorted concept and false evaluation of the true nature of man.

With all its creditable achievements, the overscientific approach to man and to medicine can all too easily turn pathetic patients into consecutive cases, and care-ridden mothers into clinical material. Seeming progress must be questioned when demonstrations of courtesy, consideration, and compassion give way to emphasis on electronics, economics, and equipment. This need not be so, but there is a tendency for personal interrelationships to be inversely related to the size of an institution.

Doctors in their assessment of priorities almost inevitably accept the standards of values adopted by their environment, the society in which they live. It demands a deliberate act of reassessment in the light of God's revealed will and laws to do otherwise.

There can be no doubt whatever that maximal emphasis is being placed on the purely biological component of man, his physical body. The key requirements for a happy life, which is understood to mean a fulfilled life, are portrayed with devastating emphasis as food, fitness, and fun. When one browses through brochures, in American hotels, that set out the amenities offered in any particular city, it is common to find more than three quarters of the total pages listing various and multitudinous opportunities for eating every type of food in every kind of surroundings. This is assumed to be the great priority, exceeding all others in the visitor's needs. Sex is a close second, provided for by tantalizing invitations under the umbrella cover of night life.

Relegated to a very subordinate position of priority are notices about art or other cultural exhibitions. There may be a reference to an odd museum or possibly a concert or play. Sometimes, but not always, if one looks carefully, announcements of church services can be found, probably inserted in small print.

This is the undisputed order of priority presented to the visitor body, mind, spirit. Those are the three parts of man that Paul refers to in his prayer, but in the opposite order: "May God . . . keep you sound in spirit, soul [mind], and body" (1 Thess. 5:23, N.E.B.).* In all walks of life the wrong order is being retained. In massive advertising campaigns, manufacturers vie with one an other to proffer their ever-increasing commodities. These must be made to appear essential for the attainment of the golden goals of pleasure, fitness, and fun. The first is almost inseparable from the primary priority, food; and the last is closely intertwined with sex, with all its current concepts. These so often divorce pleasure and privilege from resulting responsibility.

Physical beauty is linked with health as one of the highest of goals, and perhaps no other quality is so exploited by the massive advertising of industrial enterprise. By roadside billboard, cinema, radio, television play, and poster, the real, and to a much greater extent the imagined and artificially created, needs of man as a purely biological creature are brilliantly portrayed and incessantly proclaimed. Miss World competitions foster the unrealistic concept that a woman can be valued and assessed by means of tape measurements and facial expression.

The scientific enterprise that has characterized the past two centuries has led to an acclaim for scientific achievement that is almost tantamount to worship. Yet nurture and training of the mind still take second place to providing for and pampering the body. Beauty in women and athletic achievement in men are more highly acclaimed than intellectual achievement and the capacity for deductive reasoning. Once again it is the former, rather than the latter, that can be massively exploited for financial gain. In the field of medicine, academic achievement not unnaturally takes pride of place, but for the most part it is achievement directed to repairing physical faults and defects in men and women. And it is open to question whether the rows of diplomas adorning the walls of doctors' offices (in countries where this is the customary practice) relate more to a doctor's performance than to the less assessable qualities of compassion, integrity, perseverance, unselfishness, and determination.

So far has scientific achievement progressively taken the place of God in the Western world that man's spiritual nature has been relegated to a position of trivial insignificance; in many circles its very existence is questioned. Any serious attention to man's spiritual dimension is viewed as an optional extra for obvious eccentrics. It is widely assumed that scientific achievement, which has hitherto showered upon us so many blessings, will eventually solve all our problems. At least, it is suggested that it is the only reliable source to which we can hopefully turn for valid solutions.

Yet, in spite of all this, we are inwardly aware that the major problems besetting our profession, overshadowing our hospitals, and troubling our homes are seldom related to academic inadequacy. These problems are outside the realm that is amenable to scientific exploration or even financial rescue. The basic ones are seldom deficient in ability and resources, but relate to the deeper problems of attitudes and relationships. Few problems arise with regard to techniques for procuring abortion or the mechanics of initiating or terminating resuscitation. Reducing alcoholism or drug addiction involves moral and spiritual, rather than scientific, resources. Science cannot judicate in such matters. It has nothing to say on the true nature of man, the sanctity of life, or moral standards.

What head of a department or other leader of a team would question the assertion that attitudes take precedence over ability, character over cleverness, and motives over methods? This is not to decry in any sense the second of each of these paired attributes. It is "both . . . and . . . ," not "either . . . or," that should be demanded.

Superb physical strength is a poor asset if coupled with deficient mentality. On the other hand, the reverse, a brilliant intellect with a partly paralyzed body, can reach great pinnacles of achievement—witness Franklin D. Roosevelt and Helen Keller. But a brilliant mind devoid of moral principles can characterize the most dangerous and destructive of criminals. Evil is less efficient if not coupled with genius.

Almost all who are parents, if given the choice, would rather their children display such characteristics as caring, courtesy, and consideration than that they be selfish geniuses or morally delinquent athletic stars. This remains true in spite of the emphasis placed on physical and mental training at home and at school, often with barely a reference to God-imposed values.

Our attitude to many of the problems facing the medical profession today must be profoundly influenced by our view of the nature of man. Whether man is viewed as merely or as considerably more than the most advanced form of biological existence will inevitably affect our decisions, for example, on the justification or otherwise of a liberal abortion policy or the introduction of euthanasia.

The Bible's view is that man is much more than a merely biological creature, and that he is distinguished from the rest of the animal kingdom not only in degree but also in kind. He is at the head of the animal kingdom, but he has also been endowed with another dimension that is peculiar to man, a spiritual propensity that provides the potential for a Godward awareness and relationship. This is clearly portrayed in the Creation story in the early chapters of the book of Gene sis. Man is made, at the end of a sequence of creation, from "the dust of the ground" (chap. 2:7). This is exactly what we are composed of biologically, and it is that to which we inevitably and eventually return.

Then comes the pronouncement of the Creator, "Let us make man in our image" (chap. 1:26). This cannot be a biological concept, and must depict the bestowal on the biological framework of a suprabiological nature and dimension that provides the potentiality for communion with and relationship to God the Creator. The message throughout the Bible is that this potential can either be realized or neglected and consequently lost. The former course confers life to the essential inner man, and the latter ensures his death.

The message throughout is that the life that results from establishing this relationship is of such importance that all else in human existence is of relative insignificance. The sacrificial and propitiatory death of Christ on the cross was to bridge the gap between God and man. Christ, "the just, suffered for the unjust, to bring us to God" (1 Peter 3:18, N.E.B.). This supreme event in history categorically underlines the preeminent value, in God's sight, of man's spiritual dimension as contrasted with his bodily or mental dimension. To Paul, the former (when one is redeemed) is a price less treasure; the latter merely an earthen vessel.

The Bible introduces the word life in an entirely different context from that which the medical profession is dedicated to maintain and prolong, some times with measures of questionable desirability. In the Creation story Adam and Eve were warned that on the day that they willfully disobeyed and disregarded God they would die. Following their rebellion, however, there is no suggestion in the record of their biological death. It was estrangement from God that befell them. Christ constantly stated as the reason for His coming "'that they may have life,'" and He also said, " 'You refuse to come to me that you may have life'" (John 10:10; 5:40, R.S.V.). On both occasions He was addressing people fully endowed with biological life. The life He was talking of was the life of the Spirit, and this so far transcended mere biological existence that He was able to say that " 'he who believes in me, though he die [biologically], yet shall he live [spiritually], and whoever lives and believes in me shall never die [spiritually]' " (chap. 11:25, 26, R.S.V.). Paul similarly contrasted the biological and spiritual natures of man in his assertion that "though our outer nature [biological] is wasting away, our inner nature [spiritual] is being renewed every day" (2 Cor. 4:16, R.S.V.).

Tragically today the reverse is all too often true. The inward man is perishing as the outward is pampered and consequently flourishing. When we enquire after the welfare of our friends or patients, we almost invariably refer to their outward man. We hesitate ever to show interest in, let alone concern for, the inward man.

Our attitude to man, inward or out ward, may be likened to the relative emphasis that we place on various types of containers and their contents. A box may contain precious jewels. It would naturally be regarded as ludicrous were someone to boast of the box, admire its design, and care for its paintwork while ignoring its contents, the preservation of which is the only reason for the box's existence. The same attitudes apply to an eggshell containing a developing chick, or a chrysalis temporarily housing the makings of a beautiful butterfly. But are these illustrations any less inappropriate than the disproportionate attention that is paid by man to his temporary container in which he dwells, and through which he expresses himself, while neglecting to the point of extinction his inward man?

Even on a purely scientific level we have probably grossly overestimated the achievements of medical science; yet when one considers man in his true pro portions, it is humbling to realize (and more so to acknowledge) how relatively little we have really benefited many of our patients. Admittedly, maintaining or restoring health is, in the material realm, one of the greatest benefits one can be stow on another. But it is no less than shattering to consider Christ's challenging question, "'What does it profit a man, to gain the whole world and forfeit his life?'" (Mark 8:36, R.S.V.). Presumably this refers to his inner man, his spirit. This question inevitably poses the even more penetrating one, "To what extent do I profit my patients or others if I treat them exceedingly well but do nothing whatever to improve the welfare of their true selves?"

On one occasion during the life of Christ, several men were desperate to seize any chance of helping their friend who was suffering from one of the worst of disabilities, paralysis. They had heard that Jesus was able to cure disease. In their ingenuity, born of desperation, they dismantled the roof of a building in order to place their sick friend at Jesus' feet. They must have been completely flabbergasted when Jesus appeared to tally to ignore the very disability that had prompted their action. Instead He dealt with something that was to them quite irrelevant. He, in fact, saw the man's deepest need—his separation from God and all that it deprived him of. An all-pervading theme in the Bible is that sin separates. This life-depriving situation Jesus first remedied. In so doing He did more for the man than gaining him the whole world. Then, seeing the consternation of his friends, He cured, almost as an afterthought, an incidental, the physical disability for which the paralyzed man had been brought to Jesus. In fact, in the record of this incident the main value of the physical cure was expressly stated to be that of a demonstration that Jesus had the power to heal the real man within. What a total reversal of our values and concepts of the nature of man!

The inevitable superiority in true values of a spiritual versus a materialistic approach to life is well expressed by Malcolm Muggeridge in his autobiography, Chronicles of Wasted Time. He writes, "I have always had an inner and unaccountable conviction that any religious expression of truth, however bizarre and uncouth, is more sufficing than any secular one, however elegant and intellectually brilliant."

As one considers these things, a verse written long ago, but still relevant to all, comes to mind. "The loss of wealth is much. The loss of health is more. The loss of the soul is such that nothing can restore."

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Denis P. Burkitt, M.D., eminent British surgeon, is a former member of the External Scientific Staff of the Medical Research Council.

April 1979

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