I've chosen to believe

December 16, 2005

Here's one doctor's response to those who have struggled to find a balance between suffering and faith.

In our emergency department recently, I saw a family hovering around the bed of a shriveled little man. I wasn't caring for him, but I knew his story. He was in the hospital with pneumonia, was probably septic, and had a grave prognosis. The man's medical history was remarkable especially for one other thing: He was born with only half of a cerebrum, so that for his entire life up to this point, 55 years, he'd been in an infantile state. An amazing, tragic situation. But more amazing still, during all this time his mother and father had kept him at home. This was, in fact, his first hospitalization.

Over those 55 years, they had watched him transform from an infant, to a child, to an adolescent, to an adult-without his functional abilities ever changing or maturing. They never had the hope, even the false hope, that he would someday be complete.

It was easy to understand how their son's situation might cause them to lose faith in a higher power. I could see how their son's confinement to a lifetime of bed and diapers and liquid meals might make them say, "God? You must be joking!" And yet here, in the rural South, it's rare to hear that kind of bitterness. Faith, for better or worse, is dyed into the fabric of the culture, inseparable from all other beliefs and customs.

Looking past the easy answers

After 12 years as an emergency physician, I understand why the practice of medicine sometimes undermines doctors' faith.

I understood it the night I stared down at my partner's shattered, swollen face, while his wife prayed for him, tears streaming down her own face, and their two fine sons gathered around his bed. During his years of practice, I wondered, how many drug addicts and dealers, drunks, wife beaters, murderers, and assorted liars and losers had this good man served and saved? Where was God when his servant wrecked his car that night and the swelling in his brain took his life?

I understood it the night when, with no pulmonary surgeon present, and no medevac helicopter available, I opened the chest of a young woman who'd been stabbed by her sister. After working in vain to save her, I was the one to bring the news of her death to her mother, who slid to the floor screaming. She would bury one child and see the other sent to prison.

And I understood it as I looked into the vacant eyes of a young girl whose sister had been decapitated after their car was side-swiped. As she waited for her family to arrive, we offered her sodas and snacks, and futile pats on the shoulder to comfort her.

In all these cases, the degree of pain and suffering was so great that God seemed absent, no longer part of the equation. If he were, he wouldn't let such things happen.

But that answer is too easy. Indeed, in medicine, it's our job to look past easy, apparent answers to hard solutions. And if that weren't the case, we'd still be using poultices and bleeding everyone. We'd know little about the body, and we'd believe that diseases had more to do with foul air and evil spirits than with bacteria and viruses, tobacco and obesity.

In the same way, when I witness pain and loss, I realize something that isn't at first apparent: Even in our moments of despair, we believe that people shouldn't suffer and that, as much as humanly possible, we should keep them from it. And it's this desire for something better for our patients that should strengthen our faith.