Before the Big Fall
Reason suggests that Humpty Dumpty took his lumps, falling several times before the big one. Let’s consider a few of his other accidents. First, it was because of his imperfect genes. He was born a little lopsided—not a perfect oval—though he would never admit it, which required him to pay attention when he got up to do his daily exercise on the wall. One day, he got distracted, forgot to compensate, and fell. Another time, it was just bad luck—a gust of wind at the wrong time. And what about that time he got in an argument with his resentful neighbor—not a Grade A Jumbo egg like Humpty but only medium grade—who came up behind and pushed him.
Each time the damage was reparable, thanks to the advances of medical science. The orthopedic doctors pinned the broken bones in his arm after the first fall. The second time he fell on his side and lacerated his kidney, but the surgeons were able to stop the bleeding. It was more dangerous when he hit his head after being pushed by his neighbor; fortunately it was only a subdural hematoma, and the neurosurgeons drained it. Each time he recovered under the watchful eye of the highly skilled medical team. It was particularly difficult after his brain injury; he was getting older, after all, and he had been recently diagnosed with diabetes. But after two weeks in the intensive care unit and two more weeks in a regular unit, he was able to go back to his wall. Each time they sent him back, he was a little more wobbly than before—until that final fall when, no matter how hard they tried, they couldn’t put him back together.
Medicine’s Failure, or Recalcitrant Realities
If we experience repeated successes after we fall, success becomes routine, and our expectations rise that every time we fall, we will get better; we even convince ourselves that what people died from yesterday won’t be fatal tomorrow, as medical science continues to advance, conquering new territory every day. William Osler was right—with enough time and energy and money, we will eventually “relieve the human condition of the human condition,” realizing the biblical promises here and now.
But then the day comes when the incurable happens. It could be cancer, it could be heart disease, it could be a simple fall but at an older age—this time the pieces just won’t go back together. In almost every case, at some point there is a sense of failure—for the patient, for the family, and for the health care team.
Not long ago a journalist for the Los Angeles Times died after a long struggle with breast cancer. She wrote of her journey with particular poignancy, contributing installments until her last days. She had lived for many years with cancer. But as the days wound down, with all known therapies exhausted, she was understandably frustrated as the disease progressed. Not unusually, she blamed the system. In an op-ed, published after her death, she wrote, “The medical establishment tells me I have ‘failed’ a number of therapies. That’s not right: The establishment and its therapies have failed me.”
Feeling that the medical system has failed is an increasingly common reaction when problems aren’t fixed or diseases aren’t cured. No area of medicine can escape this sense of failure. Most obvious is oncology, when it involves incurable cancer. But rheumatologists cannot cure lupus, cardiologists still lose patients after a heart attack, neurologists must help people live with disability after a stroke, and even dermatologists see some patients die from melanoma. In every case there is a sense of failure, for both the patient and the profession. I remember a young couple who were distraught after enduring their third miscarriage. How is it, the husband asked, that the medical profession can do so little to prevent this from happening? All I could do was share their sense of impotence.
We cannot help but be discomforted by these tragic experiences. At the very least they remind us we are vulnerable, despite the best efforts of our buffered selves to assure us we are not. At times we are angry and feel that the promise of medicine has failed us. But science and technology are bound to fail if we ask them to fulfill promises of biblical proportions. What we often miss are the downsides of our delusion: a corruption of the very science we depend on to achieve our grandiose goals, the narrowing of reality to solvable problems, and an increasing fear of what remains uncertain, no matter how small that is.
Content taken from Pursuing Health in an Anxious Age by Bob Cutillo, MD, ©2016. Used by permission of Crossway, a publishing ministry of Good News Publishers, Wheaton, Il 60187, www.crossway.org.
photo by TatianaB