Monday, October 19, 2015

St. Luke, Physician and Evangelist

On October 18th our regular "Third Sunday of the Month" service of Choral Evensong observed the Feast of St. Luke.  Our Guest Preacher was the Rev. Daniel Hall, M.D.  Dan is Episcopal Priest in Residence at the First Lutheran Church of Pittsburgh, Grant Street, Downtown, and has a practice of General Surgery at the University of Pittsburgh Medical Center and the Hospital of the Veterans' Administration.

Evensong, St. Andrew's, Highland Park
Feast of St. Luke
The Rev. Daniel E. Hall, MD

Ecclesiasticus 38:1-4,6-10,12-14

Honor physicians for their services,
for the Lord created them;
for their gift of healing comes from the Most High,
and they are rewarded by the king.
The skill of physicians makes them distinguished,
and in the presence of the great they are admired.
The Lord created medicines out of the earth,
and the sensible will not despise them.
And he gave skill to human beings
that he might be glorified in his marvelous works.
By them the physician heals and takes away pain;
the pharmacist makes a mixture from them.
God's works will never be finished;
and from him health spreads over all the earth.
My child, when you are ill, do not delay,
but pray to the Lord, and he will heal you.
Give up your faults and direct your hands rightly,
and cleanse your heart from all sin.
Then give the physician his place, for the Lord created him;
do not let him leave you, for you need him.
There may come a time when recovery lies in the hands of physicians,
for they too pray to the Lord
that he grant them success in diagnosis
and in healing, for the sake of preserving life.

2 Timothy 4:5-13

As for you, always be sober, endure suffering, do the work of an evangelist, carry out your ministry fully.

As for me, I am already being poured out as a libation, and the time of my departure has come. I have fought the good fight, I have finished the race, I have kept the faith. From now on there is reserved for me the crown of righteousness, which the Lord, the righteous judge, will give me on that day, and not only to me but also to all who have longed for his appearing.

Do your best to come to me soon, for Demas, in love with this present world, has deserted me and gone to Thessalonica; Crescens has gone to Galatia, Titus to Dalmatia. Only Luke is with me. Get Mark and bring him with you, for he is useful in my ministry. I have sent Tychicus to Ephesus. When you come, bring the cloak that I left with Carpus at Troas, also the books, and above all the parchments.

Don’t you just love evensong? Great music. Great scripture.  Perhaps great preaching?….but at least a chance to bust out the cassock, surplice, tippet and academic hoods.  And I’m delighted that at least up here in the choir, it’s not just the clergy wearing their hoods, but a whole range of colors representing your various degrees.  If you really wanted to double down, everybody out their in the nave could show up with their black robe and hood and we could all live into a lovely dream that this corner of Highland Park was just a step away from Edwardian Oxbridge—our own little taste Downton Abbey with Lord Grantchester sitting right over there. This is the stuff that makes the Anglican ship in which we are sailing so beautiful and compelling. It is good to be with you this evening.  Thank you for the invitation.

You may have noticed that my own hood here is green rather than red.  That is because it is the hood I received on graduation from medical school.  As some of you know, I am surgeon as well as a priest.  And that was Bruce Robison’s clever twist in inviting me to preach today with these texts appointed for the feast of St. Luke, sometimes remembered as “The Physician.”

You see, the tradition holds that in addition to being the author of the eponymous Gospel and the Book of Acts, Luke was first trained as a Greek Physician.  The evidence is pretty thin, but in his letter to the Colossians, St. Paul names a Luke who he also identifies as a doctor.  And scholars have noted that the composition of Luke and Acts betrays a man of education—the vocabulary and syntax is substantially more sophisticated than the rest of the New Testament.  And since Luke’s writing employs a preponderance of medical and nautical metaphors, scholars have thought that he might have been either a physician or a sailor before meeting Jesus, but there is controversy about which one is more likely. When my New Testament professor explained this for the first time, I spoke with him after class with my tongue in cheek saying, “I don’t understand the controversy. It seems pretty obvious that Luke was a Doctor sailing his yacht around the Med!”

Joking aside, the tradition of St. Luke the Physician and the texts appointed for this occasion give us an opportunity to reflect on the practice of medicine, and its proper place in our common life as Christians.  And to the extent that I’m a physician myself, perhaps I can bring a fresh perspective. So what do we learn?

At first glance, things seem to be particularly good for physicians according to Ecclesiasticus. (As if we needed any more air pumped into our overly-filled heads!):

Honor physicians for their services,
for the Lord hath created them;
for their gift of healing cometh from the Most High…
The skill of physicians makes them distinguished,
and in the presence of the great they art admired.

So far so good.  Ecclesiasticus sounds like a proud Jewish grandmother.

And then Ecclesiasticus outlines a very sensible position on the proper place and use of medicine.  It acknowledges that God is the source of healing, and that our first impulse should always be to confess our faults and pray to God for healing.  And having done so, to turn ourselves over to the care of a physician, because God created medicine, and gave the physician skill, and even though miracles can and do happen, sensible people will not despise the skilled care and effective medicines that God has seen fit to bless us with through the practice of medicine.

The position of Ecclesiasticus seems to mirror the common sense of the old joke about the man stranded on a desert island who prays to God to save him, and in his fervent faith, turns away first a fishing boat, and then a cruise ship and finally a helicopter because he is confident that God’s miracle if salvation will be supernatural.  And when he finally perishes, he asks God why he didn’t answer his prayer, and God says “I did.  I sent you a fishing boat, a cruise ship and a helicopter.  What more were you looking for?”

So on one level, this passage from Ecclesiasticus is important counterpoint for those among us with Pentecostal or Charismatic tendencies—those who would rather pray that God spare them of cancer than submit to the indignity of a colonoscopy or mammogram. This kind of wisdom certainly applies to our contemporary setting. We shouldn’t ignore Jewish grandmothers. I’ve had my colonoscopy…and I hope you’ve had yours!

But I’m not sure that is the end of the story.  Although there are some who resist modern medicine in favor of miraculous cures, I think it is much more common in this day and age to find those who turn to medicine itself for the miracle.  We follow the advice of our physicians. We stop smoking. We eat better.  We exercise. We take the pills they prescribe. We supplement our food with multivitamins. We eat local.  We eat organic. We expose our children to Bach while they are still in the womb. We follow with interest the nightly news that reports the next advance in cell biology, immunology or genetics that promise to unlock the key to aging, cancer and mental illness. And the commercials between those reports sell the promise of salvation through pharmacology. No symptom is too small to manage. No experience is too trivial to ignore. If only we knew enough, we could efficiently and effectively relieve human suffering, and preserve our autonomous control over our unruly bodies. Medicine promises not only to treat disease, but to enhance our lives, making us better than well.  And although only a few technological futurists like Ray Kurzweil explicitly claim that technology will transcend all human limitation (including death), I think than many of us are captivated by the alluring proposition that medical technology might one day show us how to get out of life alive.

And in this context, the sick become morally culpable for their illness.  If only they hadn’t smoked.  If only they didn’t eat refined carbohydrates to the point of Type II diabetes. If only they ate lower on food chain or adopted the Asian diet or exercised more, or exercised better.  If only they had submitted to that mammogram, or PSA test or that whole body PET-CT scan. If only they had made any number of the countless choices that we hope will mitigate the existential threat comes to us all in illness and death. If only….

I think that this is the more common posture toward medicine and its promises. But in doing so, we forget the more fundamental counsel of Ecclesiasticus when it says:
My child, when thou art ill, do not delay,
but first pray unto the Lord, and he will make thee whole.
Give up thy faults and direct thy hands rightly,
and cleanse thy heart from all sin.
Then (and only then) give place to the physician…

Giving place to physicians and our medicine without first giving place to God makes of medicine an idol. We put our trust in the technology itself rather than in the God who supplies the genius that generates the technology. We begin to think that we can eliminate suffering from human experience rather than remembering that God himself chose to enter that suffering rather waving his hand and making it go away.  We begin to fall for the age-old temptation to believe that by hook or by crook, we can save ourselves through the choices we make and the deeds we accomplish.

The point I’m trying to make is that we have distorted the wisdom of Ecclesiasticus. We have taken the advice of our Jewish grandmother too literally. We give too much honor to physicians and the medicine they provide.  Our hopes for what hospitals, doctors and pharmacies can offer are unrealistic. As much as I want you to trust me as your surgeon—as much as I want our hospital to be worthy of your faith—we do not have the power to save you. 

That power belongs to Jesus, and him alone.  And it is precisely this point that Luke is trying to make in this passage when Jesus walks into his home synagogue, proclaims the year of the Lord’s favor, sits down and says: Today, this scripture has been fulfilled in your hearing. The promise of the Gospel sets us free from the ultimately futile attempts of working out our own salvation through wise and prudent choices.

You know this.  Yet despite that knowledge, it is altogether too easy to slip back into thinking that the Gospel is about doing the right thing or being the right kind of person.  We tend to think that Christianity is about values and ethics; about doing right and living well.  And so it is, and therefore, we expect our sermons to have clear application for what it is we are to do in life. Tell the truth. Practice random acts of kindness. Raise your kids in nurturing environments. Honor physicians.  Take their medicine. Stop smoking. Go to the farmers market. Do these things and God will bless you.

But the point made by the Luke and the point often left out of our sermons is that the Gospel is not primarily prescriptive, but descriptive.  The Gospel is about reality first and action second.  Only after de-scribing the reality of the way things are does the Gospel go on to pre-scribe specific action.  When Jesus says, “Blessed are the meek” he doesn’t mean that we’re all supposed to be meek.  Instead, it’s about getting the record straight by stating that, contrary to all appearances, the meek are, in fact, blessed.  When Jesus says, “The person who seeks to save his life will lose it; but the one who is willing to lose his life for my sake will find it” he doesn’t intend it as an ethical exhortation.  It isn’t an ought statement so much as it is a description of what is real—the way things really are.

When Jesus says “strive for the kingdom of God”, he compares it to a small mustard seed that grew into a large tree. He compared it to the sprinkle of yeast that leavened the entire batch of bread. The kingdom of God is that tiny, almost immeasurable thing that when added to the rest, transforms the grist of everyday living into something different and more wonderful.  The kingdom of God is the gift of conversion, the pulling away of the veil, the illumination of the way things really are.  The kingdom of God is the assurance of things hoped for, the conviction of things not seen. 

Let me try to be less abstract and more concrete.  Who we are and what we do depends entirely on why we do it.  Exhortations to holy or healthy living may make sense to the world.  Exhortations for “values” and “hope” make sense in the political rhetoric of Republicans and Democrats alike.  But these exhortations to right action are meaningless if they are not integrally and explicitly connected to Christ Jesus.  We can’t be holy unless we know holy, and we can’t know holy until we know Jesus.  And when we know Jesus, we know that we can do nothing good apart from him.  So that any good work, if it is truly good, is not ours, but the work of Christ who lives within us. 

Apart from the love of God in Christ Jesus, all our work and toil is but vanity and chasing after wind. I can stay up all night operating on perforated diverticulitis.  You can spend five days a week volunteering in a soup kitchen.    And you can volunteer time on a church committee.  And you can teach the glories of the English Choral Tradition. And you can revel in that most tasteful of liturgical vesture, the cassock, surplice, hood and tippet. And you can give money away to the poor.  But if we do these things for their own sake—if we do them to punch our ticket—then they are but vanity and chasing after wind.

So what are we to do?  We are called to be a holy and sanctified people, set apart, living in the world, but not of the world.  We are called to be witnesses to the truth of the way things really are, exposing idolatry in whatever form it may arise.  We are called to be witnesses to the truth that God, himself, became flesh, dwelled among us, died and was raised again so that we might become heirs to his kingdom.  And yes, we are called to do not just good works, but great and magnificent works.  And the technologies of medicine do accomplish some of the most great and magnificent works.

But even the most magnificent works are powerless to save. Yet salvation has already been accomplished because in Jesus, the words of the prophets have been fulfilled, and he has proclaimed the year of the Lord’s favor. What we need are eyes to see and ears to hear this leavening truth about the kingdom of God. Those eyes and ears are not ours by right, but gifts from God—given to us in baptism and nurtured through disciplines of prayer, worship and service. With those eyes and ears, we can see through the hollow threat of bodily illness and recognize that whether we live or die, we belong ever and always to the Lord. With those eyes and ears, we can approach our own death in the confidence that death will not have the last word.  With those eyes and ears we can even now hear and see that great getting up day when all will be raised—not as disembodied spirits, but as flesh and blood in our own bodies—and with those eyes and ears we will see our Lord face to face and hear him call us to take our place with him at the Supper of the Lamb. It is this hope that frees us from fear.  It is this promise that enables us to seek God above all things. May God grant to us these eyes and these ears so that with our mouths, we might proclaim with St. Luke the Physician, the unimaginable goodness of the Great Physician, the lover of souls, the salvation of the world, the holy and undivided Trinity: Father, Son and Holy Ghost.  Amen.

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