Wednesday, January 26, 2011

Seeing the Light

When we first moved to the Keys, you could tell when hurricane season was near because all of the stores would stock up on big flashlights and C and D batteries. And you needed a lot of batteries because the ones in the flashlights always seemed to be dead when you were groping for them in the dark. And it was dark a lot. The electricity was much less reliable 20 years ago. It was not uncommon for the Keys to have a blackout once or twice a month. And after hurricane Georges some of us were without power for a whole month. We went through a lot of batteries. It’s too bad we didn’t have today’s technology. LED lights burn brighter and require a lot less power. Their light is whiter as well, without the yellowish tinge and wedge of shadow the older flashlights often cast. Today there’s no excuse not to have an affordable bright light on your key chain or in your pocket. I bet our ancestors would literally kill to have one.

For most of history, humans were understandably afraid of the dark. Until we mastered fire, we were at the mercy of predators with exceptional night vision. On a moonless night, you couldn’t see the dangers around you and you couldn’t see well enough to run away from them. Even with campfires, torches and lamps, the light was limited and flickering. It could easily burn out or be extinguished. So much of what happened intentionally at night was the kind of stuff you didn’t tell your parents or your spouse about.

Small wonder the Bible is full of imagery about light. In the days before light pollution, nobody took light for granted. Light meant safety. And so what more appropriate metaphor was there for God and for his Word, by which he enlightens us.

The ancient Hebrews did not confuse God with the sun but they did see it and its light as his gift. As it says in Ecclesiastes, “light is sweet and it is pleasant for the eyes to behold the sun.“ In Genesis light is the first thing created. Then, on the fourth day, God creates the sun and moon, one to rule the day and one to rule the night. The stars are signs for seasons and days and years. In fact, most of what God creates in Genesis is either a form of light or a form of life.

We now know about photosynthesis and the role of sunlight in helping our bodies create vitamin D. And yet our ancestors intuited the connection between light and life. Perhaps they noticed how poorly plants grew in the shade. Perhaps it was the fact that it was just safer getting around by daylight. But they knew that light was essential for life and that God was the source of both.

The chief thing about light is that it allows us to see. Even in familiar surroundings, light is vital to navigating safely. I've lived in our present home for 15 years and I still occasionally whack my shins or stub my toes trying to get around in my darkened bedroom. And when you are in a new environment, you really need illumination to find your way around. So it’s easy to see how the metaphor of God being light arose, even before he appeared to Moses in a burning bush and to the Israelites as a pillar of fire in the night. In morally murky situations, whether at home or elsewhere, the light of God is essential for assessing where we are.

The other morning at 6 am I was putting fluid into my car engine. I cleaned my hands with wet wipes and was, I thought, rather thorough about it. But when I went into a lighted building I realized I'd missed a few spots and had to re-wash with soap and water. The light of God has the same effect on us. We might think our lives are clean in comparison to the rest of this darkened world. But when viewed in the radiance of God, we can see that we still have some areas that need attention.

Light helps us see dangers around us. One of the tropes one often sees in suspense or horror films is the flash of lightning that reveals the person on screen is in a precarious situation or that the monster or serial killer is right behind her. Or the hero and villain are frantically groping for a weapon that falls to the floor just as the lights begin to flicker or go out. Few films are brave enough to have more than a few seconds of pitch black and so they tease us with glimpses of light between several frightening frames of darkness.

The light of God also reveals spiritual and moral dangers we often don’t see. It warns us of keeping the wrong sort of company to which our friendship or romantic attraction might blind us. It reminds us that the seed of our actions can be found in angry or careless or foolish thoughts and words. It points out that we can get so caught up in the rituals or trivia of religion than we forget the essentials of following Jesus.

Light can also guide us. Before there were telescopes, sailors realized that the stars could tell them where they were and guide them to their destinations. During the day, the sun travels from east to west. And a lamp or a flashlight can show us the path to follow.

The light of God shows us the way to live. It turns its spotlight not only on the pitfalls along the way but also the proper way to respond to situations. It highlights the importance of justice, peace and forgiveness in our lives. It picks out those who, while not perfect, are heading in the right direction. And it points clearly to Jesus.

In John’s Gospel, Jesus is called the Word of God, and the Light and the Life of the world. He is the beacon we should be following, the radiant example of God’s love that we should strive to reflect in every area of our life. In First John, it says, “God is light and in him is no darkness at all. If we say we have fellowship with him while we continue to walk in darkness, we lie and do not act in truth. But if we walk in the light as he himself is in the light, then we have fellowship with one another, and the blood of Jesus his son cleanses us from all sin.”

Darkness hides reality but light reveals the truth. At a Halloween party, children might pass off peeled grapes as eyeballs but they have to let you feel them in the dark. The light would destroy the illusion. And Jesus destroys the illusion that evil is just a matter of things external to us that we can control, or that calling him “Lord” is sufficient even if we don’t obey him, or that we can serve him without taking care of the needs of others.

Light destroys darkness. In the original novel, Dracula does come out during the day. His powers are weakened but sunlight doesn’t destroy him. But when the story was first filmed, in an unauthorized adaptation called “Nosferatu,” Dracula is not staked and beheaded as he is in the novel. Rather the heroine entices the vampire to overstay his nightly visitation so that the rays of dawn can kill him. It’s such a powerful visual that most films still feature vampires who evaporate in sunlight.

And since light does banish darkness, the Book of Revelation pictures a new heaven and a new earth where night is no more. The sun reigns supreme in the sky and the Son of God is the light of the City of God. He not only wipes away all tears but chases away all that would overshadow the joy of his presence.

Lest we get too dualistic, remember that light does not cast everything into black and white. Rather it is light that allows us to see colors. Black is the absence of all color. Only in the light can we see the multi-hued beauty of God’s creation. Rainbows are in fact light itself revealed in its constituent colors and in all its glory.

Light is God’s first gift. It gives us life, warmth, truth and a whole spectrum of colors to appreciate. As C. S. Lewis said, “I believe in Christianity as I believe that the sun has risen; not only because I see it, but because by it I see everything else.” And just as everyone can carry a small but powerful source of light these days, so we Christians carry in our hearts the light of God and whenever darkness threatens we can call upon his light that we might see our way out of the night that seeks to envelope us and emerge into the radiance of God’s Son.

Monday, January 17, 2011

A House Divided

“Thank God Jared Lee Loughner was crazy.” I’m sure that thought, however politically incorrect, went through the minds of some of the members of our political parties. Because had he been a follower of the right or the left, it would have given the other side an endless supply of “ammunition.” As it was, both sides still thought it might be time to tone down the rhetoric. It’s one thing to put a gunsight over the district of a political opponent; it’s quite another to have someone actually use a gun to try to assassinate that person. Yes, I know a few on the fringe haven’t gotten the memo to stop blaming the other side. And one pundit really needs to study his history. When someone in an incoherent rant on You Tube says his favorite books are “The Communist Manifesto” and “Mein Kamph,” you can’t say he is a tool of one party. “The Communist Manifesto” is way left wing and “Mein Kamph” was fascist, which is an extreme right wing position. To say you embrace both puts you off the bird completely. That alone should tell you that the speaker is at the very least confused.

I’m not here to speak about which political party is right or wrong. That’s not my job. But I do think this is a perfect illustration of something that afflicts all groups when differing opinions become so rigid that no compromise is possible and each side demonizes the other. We’re starting into several week’s lectionary readings from Paul’s First Letter to the Corinthians. That was a church that had a lot of sides and controversies. And Paul was be trying his darnedest to keep them from coming apart at the seams.

Corinth was situated on the narrow isthmus between southern and northern Greece and between 2 gulfs that served as a portage site for boat traffic between the western and eastern Mediterranean. It was a very wealthy city, a Roman colony and the capital for most of Greece. It was also corrupt. The town’s name was turned into a Greek word that meant “living a very debauched life.” On the acropolis above the city was a temple to Aphrodite, known to the Romans as Venus. A thousand temple prostitutes served there, coming down the mountain in procession to procure “worshipers” and lead them up to the temple. On the bottom of their sandals were embossed letters that left footprints which read “follow me.”

Except for Ephesus, Paul spent more time in Corinth than any other city. When he left after 18 months, he left a vibrant church that included Crispus, the ruler of the local synagogue. So when at Ephesus he got word that the Corinthian Christians were divided on a number of issues, he was distressed. He sent a letter telling them not to tolerate immorality in the church. A number of questions were raised which Paul handled in what is now called 1st Corinthians. The situation did not get better so apparently Paul paid them a visit. Things only got worse and so Paul wrote a very stern letter. The church finally straightened up and Paul wrote a conciliatory letter. Some scholars think that 2nd Corinthians, with its awkward shifts in tone, contains the 3 other letters.

The situation at Corinth has given us a peek at an important church in the 1st century. It is not always pretty. But we see a couple of principles for dealing with human divisiveness.

The first problem that Paul deals with is that the Corinthians Christians were divided along the lines of which spiritual leader they followed. They were saying “I belong to Paul,” “I belong to Apollos,” “I belong to Cephas,” and “I belong to Christ.” Paul isn’t even complemented that he has a faction. He is outraged. “Was Paul crucified for you?” he asks.

Paul gets to the heart of the matter. The church wouldn’t exist without Jesus and his sacrifice. While it may be impossible for us not to prefer one particular person’s take on the gospel, it is the gospel itself, the good news about Jesus, that should be our focus, our common ground.

We see this in any group, whatever its mission. Despite overall agreement on the essentials, people gravitate to a certain emphasis or interpretation and suddenly you have blue dog Democrats, or social conservatives, or Tea Partiers, or progressives. These factions often have their biggest disagreements with those they are closest to in ideology. In the church alone there are 33,830 denominations. Some of the differences are minor, some are major. Still, the vast majority could join in affirming the Apostles Creed. Yet we let our non-essential differences divide us, despite the fact that Jesus‘ prayer on the night he was betrayed was for our unity.

Interestingly, after stressing the centrality of Jesus, Paul concludes by saying, “So let no one boast of human leaders. For all things are yours, whether Paul or Apollos, or Cephas, or the world or life or death or the present or the future--all belong to you, and you belong to Christ and Christ belongs to God.” They don’t belong to their teachers. Their teachers belong to them. They are part of the riches in Christ. In other words, all their perspectives are valuable; just don’t become captive to any one of them. They are yours. And don’t forget, you are Christ’s.

Paul deals with several issues in that church: sexual immorality, lawsuits, marriage, food offered to idols, the Eucharist, spiritual gifts, and more. I’m not going to deal with those today. But finally he gets to the other essential element of the church: love. We read 1st Corinthians 13 at weddings but in the original context Paul is talking about the church. He knows he can’t resolve every problem that can or will arise. But one thing that can keep the church from splitting is love.

Paul isn’t talking about mere sentimentality. He is talking about "agape," the Greek word for the kind of love God is. Human love is often impatient; divine love is not. Humans can be cruel to those they love; divine love is kind. Human love can be tinged with envy and arrogance. Humans in love can be boastful and rude. Not so divine love. Humans can be irritable, resentful, and insist on their own way. Not divine love. Human love does not prevent people from rejoicing in injustice, especially if it favors them. Divine love finds its joy when the truth wins out. Human love may fade or fail but divine love continues to bear up, to trust, to hope and to endure no matter what comes. It never quits.

No group will hold together if there is no love for each other and for their mission. Fear of a common enemy can bring people together for a while. Then the threat passes, like our alliance with the Soviet Union against Nazi Germany, or the parties involved turn on each other, like the alliance between the Soviet Union and Nazi Germany, and it’s over. Love binds people into a team, a family. If the love is unselfish and unconditional, the group can survive and even thrive, whatever it faces.

So the two essential things needed for the church to survive and even grow is a commitment to Christ, over and above individual leaders and emphases, and Christ-like love. Without those two, all the gimmicks, programs, and marketing techniques in the world can’t save a church.

For one thing, love means being willing to make sacrifices for the good of the church. One of the problems facing Christians in the Roman empire was buying meat. Butcher shops were attached to pagan temples and would sell the excess meat offered to the idols. Some Christians became vegetarians rather than eat food offered to idols. Others, reasoning that there is only one God, felt that meat offered to idols was offered to nothing real. So they had no problem eating the meat. Paul obviously agrees with the latter position, seeing as he calls those who hold the former position “weaker brothers.” Nevertheless, he is concerned that their faith not be damaged by the example of those not bothered by the problem. So he suggests that those whose faith is stronger not show up those whose faith might stumble over the matter. Specifically, they should refrain from eating meat. That’s right. Instead of telling those whose faith was affected by this issue to grow up, he told the more mature Christians to make concessions on the matter. It goes against what most people would feel is just. But it was done out of love for those troubled by the issue and to preserve the unity of the church.

It reminds me of something that happened early in the history of this country. The Continental Congress was considering the Declaration of Independence, penned by Thomas Jefferson. All of the previous problems with the text paled next to the paragraph criticizing the British crown for the slave trade. The southern colonies did not like it. They threatened to vote down the Declaration were the paragraph not removed. John Adams was vehemently for its inclusion. He wrote Ben Franklin that if slavery was allowed to remain in the U.S., a war would be fought over it in 100 years time. But finally Jefferson himself took out the paragraph, something he really resented. The Declaration of Independence eventually passed unanimously.

Who was right, Adams or Jefferson? Both. Adams’ prediction of the Civil War was only off by 15 years. It remains the war that cost more American lives than any other. But if Jefferson hadn’t removed the paragraph, there wouldn’t have been a Civil War because there wouldn’t have been a United States of America.

Imagine the political fallout of making such a decision today, when compromise on any position is considered unforgivable. And Paul’s weaker brother doctrine isn’t that popular in the church either. But Jesus never said that the world would know his disciples by how we agree on everything but by how we love each other. And as any couple knows, love means, in the real world, making compromises. The abolitionists, primarily Christians, did not give up on ridding the United States of slavery. And even after the Civil War it took another hundred years to get legislation passed that actually secured the civil rights of African Americans.

The church no longer fights over eating meat offered to idols. There have been many conflicts since. And oddly enough, outside of Paul’s letters there is little reference to the controversy. It seems Paul’s method worked, whereas the issues on which Christians could not reach a compromise on have left lasting scars on the church. And the world sees just another bunch of people arguing over non-essentials. Wouldn’t it be better if those Christians arguing over things not covered in the Apostle’s Creed could say to one another: “I totally disagree with you on this matter…but I love you anyway.”

There is no requirement that citizens of our country love one another but the Declaration of Independence ends by saying, “for the support of this declaration, with a firm reliance on the protection of Divine Providence, we mutually pledge to each other our lives, our fortunes and our sacred honor.” Our constitution lists among its purposes is “to promote the general welfare.” So we are not to act as a random collection of individuals but as a nation with a common mission that is meant to help all. Our freedom of speech was secured by the Bill of Rights not so that we indulge ourselves in achieving new depths of invective but so that by bringing everyone’s perspective to the table we can craft the best solutions to the problems that threaten us.

Facing the might of the greatest empire of their time, Ben Franklin, one of the last to give up on reconciliation with Great Britain, pointed out that “we must hang together, gentlemen,…else we shall most assuredly hang separately.” More straightforwardly, Jesus said that a house divided against itself cannot stand. Substitute “country” or “church” and the truth of that statement remains. And we must ask ourselves if we wish to take that as the final verdict on our ourselves or the words of Psalm 133: “Behold how good and pleasant it is for brothers to dwell together in unity.”

Friday, January 14, 2011

Lord of All

When I was a kid, I was an avid reader of Mad magazine. I was aware of Cracked magazine but it seemed to me a pale imitation. The art wasn’t as good, the humor wasn’t as funny nor the satire as sharp. So it’s odd that one of my favorite websites is But it’s nothing like the magazine. The website specializes in lists, like “5 Ridiculous Things You Probably Believe About Islam,” “6 Absurd Gender Stereotypes (That Science Says Are True),” and “5 Horrible Life Lessons Learned From Teen Movies.” The articles are factual; the humor is in the outrageous truths offered and the often hilarious way they are presented, although the language isn’t always appropriate for church. What I like is that the writers really do their research. So when they write an article entitled “6 Supervillains From History That Make The Joker Look Subtle,” they’ve got the facts to make their case.

One list that caught my attention recently was “5 Real Deleted Bible Scenes In Which Jesus Kicks Some [you know what].” Brian Thompson is actually writing not about the Bible but about the pseudepigrapha, works by people purporting to be apostles or other biblical folks. These were never seriously conidered during the 200 years that Christians debated which books to include in the New Testament. These books read like bad fanfic. The incidents to which Thompson refers include one in the "Gospel of Pseudo-Matthew." The Holy Family encounters a cave full of dragons (!) on their flight to Egypt. They are terrified until the baby Jesus hops down from Mary’s breast and cows the dragons into worshiping him. The "Infancy Gospel of Thomas" is full of more disturbing incidents. Jesus is making birds out of clay and bringing them to life when another boy splashes in the pool he’s using. Jesus causes him to age and wither away. Then there’s the time a kid bumps into Jesus, who pronounces a death curse on him. When the townspeople go to his parents to report Jesus’ reign of terror, he strikes them all blind.

Not to worry! Joseph grabs Jesus by the ear and makes him undo all the harm he’s done and resurrect those he‘s killed. Thereafter, Jesus chills and goes straight.

As you can see the reason the church didn’t include these fake gospels has nothing to do with censorship and everything to do with their quality and fanciful nature. For the same reason that fans of the first “Highlander” movie reject the second one, Christians saw that these pseudo-gospels blatantly contradicted the content and spirit of the original four. In trying to emphasize Jesus' divinity, they went way too far. And since we know these were written a hundred years or more after Christ’s earthly life, there’s no good reason to consider them valid sources for information about the historical Jesus.

In fact the earliest writings about Jesus are Paul’s letters, which date from the 50s A.D. And since most scholars date the gospels later, you’d think they would say our best source for data about Jesus was Paul. Oddly enough, they don’t. Part of that is due to a bias against Paul’s Christology, his theology of Jesus Christ. Even biblical scholars like to be seen as objective, which they interpret as meaning not inclined towards the supernatural. So they really have problems with Paul’s portrait of Jesus as Christ, Lord, Savior, the last Adam, the Son of God, and the Wisdom of God. Ironically, they hope to find a more primitive, less developed picture of Jesus in the gospels despite their later dates.

Of course the problem is that Mark, the first gospel, usually dated in the mid to late 60s A.D., starts out with the words “the beginning of the gospel of Jesus Christ, the Son of God.” So his Christology seems to be as high as Paul’s. One finds the same situation whichever gospel one turns to. In Matthew’s first chapter, he links Jesus with Isaiah’s prophesy of child named “Emmanuel: God with us.” In Luke’s first chapter the angel Gabriel tells Mary that her child will be called “the Son of the Most High.” In Luke’s sequel to his gospel, the Book of Acts, Peter on the first Pentecost calls Jesus “both Lord and Christ.” And John starts out telling us Jesus was the Word who is God. You will not find Jesus portrayed as mere Jewish sage anywhere in the New Testament. The only way to take the deity out of the earliest writings about Jesus is to deliberately edit it out.

Why is this important? Because when we are dealing with Jesus, we are dealing with God. If Jesus was born a human being, it means God became a human being. If Jesus lived as a poor man, then God lived in poverty and want. If Jesus touched the sick and deformed and outcast, then God touched those considered unclean. If Jesus wept at the tomb of Lazarus, then God wept at the grave of a friend. If Jesus did not resist when arrested, then God did not smite down those who treated him unjustly but endured the beating, the spitting and the lash. If Jesus went to the cross, then God suffered the most horrific and unrelieved pain we can imagine. If Jesus died, then God underwent the transition we most fear. If Jesus rose from the dead, then God has defeated death and is master over all that seeks to destroy and degrade us.

The earliest Christian creed was simply “Jesus is Lord.” In Sunday’s passage from Acts, Peter says, “he is Lord of all.” All is the most inclusive term possible. If we believe it, two conclusions follow from it.

First, if Jesus is Lord of all, then ultimately Jesus is in charge of everything. We can have peace of mind that Jesus has, in the words of the old spiritual, “the whole world in his hands.” At no time, in no place, under no circumstances, are we beyond his love and protection. We can have confidence and courage in any situation because Jesus is Lord of all.

The second conclusion is that, if Jesus is Lord of all, then we must obey him in everything. If Jesus were merely a moral teacher, we could nevertheless pick and choose among which of his teachings to follow. I'm a huge fan of C.S. Lewis but I disagree with his opinions on certain things. But it would be a contradiction to call Jesus master of all, if we do not obey him as our master in every situation. In fact, though some critics think the chief problem with Christianity is that Christians do not reject some of its teachings, it is a bigger problem when we opt out of various commandments. Because we are more likely to skip the things that are hard. Like the commandment to love others as we do ourselves. Or to love our enemies. Or to turn the other cheek. When Christians get into trouble it is usually because they have not followed Jesus commands to forgive, to be compassionate, and to be generous to those who cannot repay us.

It was when heresies arose, when people started writing down distortions of the truths of Jesus, even misguided attempts to make him more awesome, that Christians began to discuss which books were inspired by God and which weren’t. If you read what they rejected, it’s hard not to agree they did a good job. The capricious and violent Jesus depicted in the pseudepigrapha was not even a candidate. It wasn’t consistent with the radically loving and forgiving Jesus found in the oldest and best attested writings about him. If that is the Jesus who is Lord of all, what have we to fear? And if Jesus is truly Lord of all, why should we balk to obey his gracious words?

Monday, January 10, 2011

Mental Illness: the Facts

I have to admit that when I heard of the shooting of a District Judge and a Democratic Representative who had narrowly defeated a Tea Party candidate in Arizona, my first reaction was fear that it was done by a political extremist. But as the story of the shooter, Jared Lee Loughner, has come out, it looks more and more as if mental illness may be involved. Because of his behavior, the young man had been removed from his college algebra class, had several run-ins with the campus cops, and was prohibited from returning to college without a doctor's note to the effect that he was not a danger to others. One Walmart refused to sell him ammo for his 9 mm Glock because of his behavior; unfortunately, another Walmart was not so discriminating. His political videos on You Tube have been described as rambling and lacking coherence. There is a very good possibility that this man, accused of wounding more than a dozen people and killing 6, has a severe mental illness.

Now I am worried that instead of jumping to conclusions about certain people's politics, the conclusions leaped to will concern the mentally ill. My first job as a nurse was working on a psychiatric floor. Later I worked on a neurosurgery floor. I have stayed interested and informed on the growing research on the brain and so I would like to separate fact from fiction on this topic.

The mentally ill are no more likely to be violent than those who are well. Studies have shown that the rate of violence among the mentally ill is no higher than among the general population. An analysis of violent rampages, in which at least one person was killed, found that a little less than half were committed by mentally ill individuals. The other half were committed by people with no previous indication of mental illness. Only about 3% of the violence in this country is committed by the mentally ill.

Mental illnesses are brain illnesses.
Now that we have PET scans and other imagining technology, we are discovering key differences in the way the brains of mentally ill people work and sometimes in the structure of their brains. Mentally ill people are no more responsible for their sickness than someone with sickle cell anemia is. Mental illnesses have physical causes and are physical illnesses of the brain. The puzzling or disturbing behavior they cause are really the symptoms of the illnesses, just as fever is a symptom of infection.

Because of the illness that affects his or her brain, a person with a mental illness classified as a psychosis often has problems perceiving or interpreting reality. These manifest themselves in delusions or even hallucinations. A delusion is the false belief of an individual that persists despite overwhelming evidence to the contrary. The person may perceive himself to be Jesus Christ, or the President, or some other highly exalted or important person. These delusions of grandeur can lead to paranoia. If you are so obviously and superlatively special and others don't perceive or treat you that way, there must be a reason. It could be jealousy, envy, hostility or a massive conspiracy. Such feeling are intensified if the mentally ill person is also suffering from hallucinations. He or she may see or hear things that aren't there. Usually hallucinations are disturbing to the person perceiving them. They may see grotesque monsters, inexplicable or sinister objects, or ordinary things in bizarre contexts, such as babies crawling on the ceiling. They may hear voices that tell them they are special or, more often, which torment them with accusations, denunciations, or insults. The voices may frighten or depress them. And yet others do not acknowledge these voices. Either they are telling the truth and this reinforces the hallucinating person's idea that he is special. Or other people are lying about not hearing the voices and so are part of the conspiracy against them.

There are many effective treatments and medications for the mentally ill. The reason why some mentally ill people do not get treatment is because either they have no health insurance, or the health insurance doesn't provide coverage equal to that provided for "physical illnesses," or the person, because of his illness, is non-compliant with or refusing his treatment.

A high proportion of the mentally ill are unemployed and thus less likely to have health insurance. Even those with health insurance may find that their policy offers limited coverage for mental health treatment. The number of days per year they can be hospitalized for a mental illness may be inadequate. There might even be a lifetime cap. Their medications may not be on their plan's formulary or the number of refills may be limited. George Bush once announced parity in the coverage for mental and physical illnesses but it has yet to become reality in most health care plans.

Then there is the problem of non-compliance. A mentally ill person suffering paranoia is obviously going to be skeptical of drugs prescribed by those who very well could be part of the conspiracy against him or her. Or he may hate the side-effects so much that he stops taking the drugs. When I worked as a psych nurse, I often saw the same people come in again and again. We would get them on their meds, they would improve and be discharged home. But the side effects would bother them. They might feel sleepy or slowed down. And they might convince themselves that their hospitalization and first round of drugs had cured them and so they didn't need to keep taking them. Then their symptoms would return and they would have to be readmitted to the hospital to get back on their medications.

There are acute conditions that can cause mental symptoms, such as kidney or urinary tract infections, high or low blood sugar in a diabetic, exposure to toxic substances, or reaction to recreational drugs. But illnesses like schizophrenia or bipolar disorder are usually chronic and the person may need to be treated for life.

A major part of the problem is the stigma attached to mental illness. It causes people to fear and isolate the mentally ill. Let's face it: when a person you know begins acting or speaking in a bizarre fashion, it is unsettling. When it's someone you don't know, the temptation is to avoid him or her. Yet if you saw someone with a broken leg, you would probably get them help. Our fear and lack of understanding of mental illnesses clouds our compassion for those suffering.

The effect of untreated mental illness can be a descent into poverty and even homelessness. The wholesale emptying of mental institutions under Ronald Reagan also added to the number of homeless mentally ill. The stigma kept many of the community mental health treatment centers that were supposed to complement this de-institutionalization from being built. People didn't want "crazy" people coming into their neighborhoods. Yet these illnesses can strike people of any socio-economic class and any ethnicity. Add depression into the mix and it is estimated that 1 in 5 Americans will suffer from a major mental illness some time during their life.

The stigma also keeps some people from getting a diagnosis and treatment. Many still see mental illness as a failure of the will or an embarrassing weakness. A lot of that is the belief that mental illnesses are radically different from "physical" illness. But as we've seen that's a fallacy.

I hope that this horrific incident doesn't further stigmatize the mentally ill. Remember, we were perfectly willing to see this as the action of a person just swayed by extreme political rhetoric. I hope that it does alert us to the importance of recognizing and treating mental illness. And I hope more bloggers and reporters spread the facts about mental illness rather than repeat the fallacies.

Wednesday, January 5, 2011

Timeless Principles for New Beginnings

“You’re not going to stick me with needles, are you? I hate needles!”

I looked at the young woman sitting next to me, covered in tattoos, and pointed to the rather prominent ring hanging from the septum of her nose. “What about that?” I asked.

“That’s different,” she said, marinating my nose in whaffs of alcoholic fumes.

It was 5 am, New Year’s Day at intake in the county jail. I was doing the medical screening on new inmates. Most were drunk. This thin young lady was a "Marchman," meaning the officers brought her in to sleep it off. Once she was awake and sober, she would be released without an arrest on her record, rather like Otis in “Andy of Mayberry.” But I had asked enough questions to know she would be back. Big tip off: she said at one point, “I’m an alcoholic.” She was barely in her 20s. Sad way to start the new year.

As a nurse, I’ve worked neurosurgery, psych, med/surg, rehab, chronic care, home health, private duty, correctional medicine, geriatrics, and pediatrics. As a priest, I’ve baptized, married and buried people. I’ve seen human beings at every point in life, including the end. But while there’s just one end to this life, there are multiple beginnings. Which is a good topic for the new year.

The most obvious beginning is birth, though it’s not actually the beginning. It’s at conception that genetic material from 2 individuals combine. Even those 2 are recipients of DNA from their ancestors. The result is a unique individual, although how much of who she or he is comes from inheritance and how much comes from experience is a matter of debate.

But there are other beginnings: when you first walk, when you first talk, when you go to school, when you first fall in love, when you make a decision about God, when you start your career, when you marry, when you become a parent.

Endings also beget beginnings. The end of high school or college is usually seen as the beginning of one’s life as an adult. The end of one’s single life is the beginning of one’s life as part of a married couple. Or when one ends one career and starts a new one. In these endings, what begins could be seen as a progression in life.

Then there are those changes in which there is a disconnect between what ends and what starts. Such as when one ends a life of crime and goes straight. Or when one ends an active addiction and starts a life as a recovering addict. Or when one ends a life lived for one’s self, and starts a life following Jesus. In such cases, what’s new is the direction of one’s life.

Are there general principles for a beginning? I think there are. And I’ll be drawing at least some of them from my observations of my everyday patient, an infant. For him, just about everything is brand-new.

I wasn’t at the birth of my patient. But I have been at others, most importantly my children’s. And from the standpoint of the newborn, the first step is getting acclimated. A new beginning means a new environment. Actor Stephen Tobolowsky remembers when his son was born. He looked like an angry thousand-year old man. He realized the baby was having trouble with the brightness of the delivery room. He shielded his firstborn’s eyes with his hand and swore he read a “thank you” in his son’s expression.

A new beginning takes us into new territory. And that takes adjusting. You need to get the lay of the land--new people, new powers, new principles at work. Babies have to adjust to the light, the noise, the cold of the world outside the womb. New employees have to adjust to new priorities, new procedures, new responsibilities. New parents have to adjust to the same sort of things. So getting oriented is one of the first things you have to do when beginning.

Next you need a source of energy. You know how when you start a new job or a new school, you’re exhausted at the end of each day. Even if all you did was read manuals, watch videos, take notes and fill out forms, you feel as if you’d been digging ditches or running a race. And while the temptation is to just chow down on junk food, full of calories and little else, you need proper nourishment, full of good stuff.

You also need rest, time to recover and recoup. That’s why babies sleep a lot. In fact, one of the best theories of why sleep is necessary is that our brains are reviewing, prioritizing and storing what we’ve experienced. Which may, by the way, explain dreams. We know that memories are not stored whole but broken down and stored in bits: smells here, sounds there, visions elsewhere. They are recombined when we remember. Dreams may be the surreal experience having one’s life disassembled before one’s eyes: sometimes disturbing but sometimes instructive, as we see combinations and juxtapositions we might not have come to logically.

Next you need to inventory your assets. You need to assess your strengths, your talents, your equipment. I watched my patient as he stared at his own hand. You could see him taking it in, wondering what it was. And eventually, he started seeing what it could do. Through trial and error, he is working out how to do grab things better. The same with sitting up. He can now do so for several minutes without toppling. At first, he was twitching and shifting, trying to adjust his body so he would stay upright. Now he sits like a rock. At first, when he achieved balance, he was almost paralyzed. If he dropped a toy, he would look at it and whimper. Reaching for it would throw him off balance. Now he is working out how to put his weight on one hand while reaching with the other. He hasn’t gone so far as to crawl for something out of his reach but we expect that soon. I am no longer retrieving and returning dropped toys. “Go and get it,” I tell him. “You can do it.”

That’s something you also need: drive, a motive to go forward. It isn’t a beginning if you don’t move. You need to plunge ahead. Find out what it is you’re after and go for it. I remember hearing the story of a gang member who went straight. What motivated him was the birth of his child. It made him reevaluate his life. He didn’t want her to have the same kind of childhood he did. He wanted her to have what he didn’t: a father. That’s what made him take the dangerous but necessary step of getting out of the gang, out of the life and beginning a new life, with new goals and a new way of achieving them.

There are new things to learn, of course. And things to unlearn. One of the hardest things for me to learn working at the jail is that, unlike a hospital, I can refuse to accept someone if they need major medical attention first. We can do detox; we can treat for TB and Hep B and C and HIV; we can maintain people on medication; but we don’t do surgery or deliver babies. And I had to learn that, as a correctional nurse, I could give a patient Tylenol or a laxative or start him on antibiotics when he needs it, before waiting to get the doctor’s order. There are guidelines but they recognize that in jail, preventing infection and pain in clear cut cases is a high priority. New beginnings mean new things to learn and old things to unlearn.

Finally, when you begin a new phase of life, you need a mentor. Babies need parents. Students need teachers. New employees need someone to show them the ropes. Recovering addicts need someone to help them start over. Beginnings can be bewildering. It really helps to have someone tell you the rules, give you tips, show you around. Because of his rough start and handicap, my patient has a physical therapist. She is helping him catch up with the developmental milestones he missed being in the hospital so many months. Things like lifting his head, learning to grasp intentionally, crawling--the stuff that he should have achieved earlier--she is helping him with. She can’t do it for him. She can’t tell him how to do it. So she shows and nudges and challenges him. And he is catching up.

It’s a nice and symbolic, but you don’t need a new year to start something new. You do need the other things, though. You need to adapt to the new environment, learn what it is and how it works. And as scary as that can be, never forget that there are certain things that always apply in this world. No matter where you are, there is always a true north, there is always an up and a down, and there is always right and wrong. And you can never be somewhere that God can’t find you.

You need nourishment, and not just physically. Whatever your new endeavor, you need to feed your spirit. New situations can be overwhelming. They can be a real drain. You need the spiritual food found in Jesus. We need the daily bread that he offers, the living water that only he can provide. We need to, as we say at the Eucharist, “feed on him in our hearts by faith with thanksgiving.” When starting something new, don’t skip meals and don’t try to live by bread alone.

You need rest. God gives us the sabbath because he knows we require it. We need to break from the routines of life. And yet we humans have engineered a 24/7 world. The commandment to remember the sabbath and keep it holy is probably the one most heedlessly violated. Most people don’t even see it as important. But the soul-killing pace of the world is beginning to take a toll. Stress makes us sick, mentally and physically. Jesus said the sabbath was made for humans. Let us observe it.

Take an inventory of your assets. Or in Bible-speak, count your blessings. God gives us gifts. He didn’t lavish them on us so we could abuse or misuse them. But neither does he want us to neglect them. Before going on an expedition, experienced explorers check their equipment to find out what they have and if it is in working condition. A periodic personal inventory, that includes one’s spiritual resources, is vital.

You need a motive to move ahead. It can be self-improvement, curiosity, love or necessity. Make sure it is not fear or rage or greed or arrogance. Not all motives are good, even if they do drive people towards noble goals. Make sure what drives you is holy, set apart for God’s use. When you do your personal inventory, it’s good to check on your motivation. Why are you doing what you do and how does that affect how you do it?

Don’t forget as you learn new things, you may have to unlearn others. Make sure you know which is which. When my patient learns to walk some of the skills he learned when crawling will still apply, like maintaining a dynamic balance. But some things that may once have been useful will be left behind. A lot of the problems that keep people returning to jail are the result of not unlearning bad habits and old ways of thinking. One man in intake had never been in jail before. He overindulged on New Year’s Eve. I hope he’s learned never to do that again. And if there’s a deeper reason for his drinking, I hope he learns to get help. There are lots of support groups that help those who let them and that teach principles for living a good life.

Finally, you need a mentor, be it parent, teacher, or helper. God is all three. Human mentors are valuable but always put God and his principles first. Never let yourself be talked into cutting corners, or cheating or taking advantage of others, even if it seems to be part of the culture. Of course, if you can, find a mentor who is honest and moral. Or become one. God knows the world needs mentors who are good in every sense of the word.

Sometimes we get in a rut and life seems stale. We are just doing the same thing over and over. At such times, certain people seek out the new. New can be good, like a new life or a new way of helping people. But new can be bad, like the new kind of mortgage investing Wall Street engineered. But you know what’s always new and different? Following Jesus, making a concerted effort to really live like him and according to his principles. Few people try it and even fewer keep at it. But it’s seldom boring. Of course, we’ll never know unless we begin.