PUTTING PAIN TO WORK
by Paul Brand and Philip Yancey
Christianity Today, IL
Nov 16 2006
Healthy bodies know how to make use of pain. A healthy church does too.
I admit, a professional career devoted to people with leprosy, whose
main defect is an absence of pain, has biased me on the subject. And
yet numbness, too, is a form of suffering. In the case of leprosy
patients it can lead to a life of acute suffering.
When I reflect on pain I prefer not to think in a detached way of
a hypothetical sum of the world’s suffering; instead I focus on one
individual with a face and body. At such moments my mind often flashes
back to the refined, upper-caste features of my friend Sadagopan,
whom we called Sadan. Readers of Fearfully and Wonderfully Made know
him as the forbearing subject of my early experiments with proper
footwear for leprosy patients.
When Sadan first came to Vellore, his feet had shrunk to half their
normal length and his fingers were shortened and paralyzed. It
took us nearly two years of unflagging effort to stop the pattern
of destruction in his feet. Meanwhile we began reconstructing
his hands, a finger at a time, attaching the most useful tendons
to the most useful digits and retraining his mind to control the
new set of connections. In all, Sadan spent four years with me in
rehabilitation. He personified the soft-spoken, gentle Indian spirit.
Together, we wept at our failures and rejoiced at the gradual
successes. I came to love Sadan as a dear friend.
At last Sadan decided he should return home to his family in Madras
for a trial weekend. He had come to us with badly ulcerated hands and
feet. Now his hands were more flexible, and with a specially designed
rocker type shoe he could walk without damage. "I want to go back to
where I was rejected before," he said proudly, referring to the cafes
that had turned him away and the buses that had denied him service.
"Now that I am not so deformed I want to try my way in the great city
of Madras."
Before Sadan left, we reviewed all the dangers he might encounter.
Since he had no warning system of pain, any sharp or hot object
could harm him. Having learned to care for himself in our hospital
and workshop, he felt confident. He boarded a train to Madras.
On Saturday night, after an exuberant reunion dinner with his family,
Sadan went to his old room where he had not slept for four years. He
lay down on the woven pallet on the floor and drifted off to sleep
in great peace and contentment. At last he was home, fully accepted
once again.
The next morning when Sadan awoke and examined himself, as he had
been trained to do at the hospital, he recoiled in horror. Part of
the back of his left index finger was mangled. He knew the culprit
because he had seen many such injuries on other patients. Evidence was
clear: telltale drops of blood, marks in the dust, and, of course,
the decimated clump of tendon and flesh that had been so carefully
reconstructed some months before. A rat had visited him during the
night and gnawed his finger.
Immediately he thought, What will Dr. Brand say? All that day he
agonized. He considered coming back to Vellore early, but finally
decided he must keep his promise to stay the weekend. He looked in
vain for a rat trap to protect him that last night at home-shops
were closed for a festival. He concluded he must stay awake to guard
against further injury.
(To prevent such tragedies, we later tried to maintain a rule at the
hospital: all released patients must take a cat home to protect them
from rats during the night.)
All Sunday night Sadan sat cross-legged on his pallet, his back
against the wall, studying an accounting book by the light of a
kerosene lantern. About four o’clock in the morning the subject grew
dull and his eyes felt heavy and he could no longer fight off sleep.
The book fell forward onto his knees and his hand slid over to one
side against the hot glass of the hurricane lamp.
When Sadan awoke the next morning he saw instantly that a large patch
of skin had burned off the back of his right hand. He sat trembling
in bed, despair growing like a tumor inside him, and stared at his
two hands-one gnawed by a rat, the other melted down to the tendons.
He had learned the dangers and difficulties of leprosy, in fact had
taught them to others. Now he was devastated by the sight of his two
damaged hands. Again he thought, How can I face Dr. Brand, who worked
so hard on these hands?
Sadan returned to Vellore that day with both hands swathed in
bandages. When he met me and I began to unroll the bandages, he wept.
I must confess that I wept with him. As he poured out his misery
to me, he said, "I feel as if I’ve lost all my freedom." And then,
a question that has stayed with me, "How can I be free without pain?"
As I turn from the network of pain in biology to its analogy in the
Body of Christ, comprising all believers, again I am struck by the
importance of such a communicative system. Pain serves as vital a
role in protecting and uniting that corporate membership as it does
in guarding the cells of my own body.
Deep emotional connections link human beings as certainly as
dendrites link cells in our bodies, evident even in such relative
trivialities as sporting events. Watch the face of a wife sitting in
the stands at Wimbledon as her husband plays in the championship tennis
match. Strands of concern and affection unite them so intensely that
every on-court success or failure can be read on the wife’s face. She
winces at every missed shot and smiles at each minor triumph. What
affects him affects her. Or, visit a Jewish household in Miami,
San Francisco, or Chicago around election time in Israel.
Many Jews know more about the campaign ten thousand miles away than
about their local elections. An invisible web, a plexus of human
connections, links them with a tiny nation of strangers far away.
Or, recall the effect on a nation when a great leader dies. I
experienced the unifying effect of pain most profoundly in 1963 when
I came to the United States to address the student chapel at Stanford
University. As it happened, the chapel service occurred just two days
after the assassination of President John Kennedy. I spoke on pain that
day, for I could read nothing but pain on the faces of hundreds of
students jammed into that building. I described for them scenes from
around the world, where I knew clusters of people would be gathering
together in prayer and mourning to share the pain of a grieving
nation. I have never felt such unity of spirit in a worship service.
Something like those sympathetic connections should link us to members
of Christ’s Body all over the globe. When South Africa jails courageous
black Christians, when a government systematically destroys the church
in Cambodia, when Central American death squads murder Christians,
when Muslims drive a person from town for the crime of converting,
when more of my neighbors lose their jobs, a part of my Body suffers
and I should sense the loss. Pain also comes to our attention in
whispered signals of loneliness, despair, discrimination, physical
suffering, self-hatred.
"How can a man who is warm understand one who is cold?" asks Alexander
Solzhenitsyn as he tries to fathom the apathy toward millions of Gulag
inmates. In response, he has devoted his life to perform the work of a
"nerve cell," alerting us to pain we may have overlooked. In a Body
composed of millions of cells, the comfortable ones must consciously
attend to the messages of pain. We must develop a lower threshold
of pain by listening, truly listening, to those who suffer. The word
compassion itself comes from Latin words cum and pati, together meaning
"to suffer with."
Today our world has shrunk, and as a Body we live in awareness of
all cells: persecuted Russian believers, starving Africans, oppressed
South Africans and Indochinese and Central Americans … the litany
fills our newspapers. Do we fully attend? Do we hear their cries as
unmistakably as our brains hear the complaints of a strained back
or broken arm? Or do we instead turn down the volume, filtering out
annoying sounds of distress?
And closer, within the confines of our own local membership of Christ’s
Body-how do we respond? Tragically, the divorced, the alcoholics,
the introverted, the rebellious, the unemployed often report that the
church is the last body to show them compassion. Like a person who
takes aspirin at the first sign of headache, we want to silence them,
to "cure" them without addressing the underlying causes.
Someone once asked John Wesley’s mother, "Which one of your eleven
children do you love the most?" Her answer was as wise as the question
foolish: "I love the one who’s sick until he’s well, and the one who’s
away until he comes home." That, I believe, is God’s attitude toward
our suffering planet. He feels the pain of the suffering; do we?
God gave this succinct summary of the life of King Josiah: "He
defended the cause of the poor and needy, and so all went well." And
then this profound postscript: "Is that not what it means to know
me?" (Jer. 22:16).
I hear many cries for unity in the church today; a watching world
sees divisiveness as our greatest failure. Calls go out exhorting one
denomination to merge with another, or for many denominations to join
hands in a national or worldwide campaign. Out of my experience with
the nervous system in the human body I would propose another kind of
unity: one based on pain.
I can read the health of a physical body by noting how well it
"listens" to pain-most of the diagnostic tools we use, after all
(fever, pulse, blood cell count), measure the body’s healing
response. Analogously, the corporate Body’s health depends on how
the stronger parts attend to the weaker.
Some cries of pain in the Body come to us loudly and persistently. We
cannot help but acknowledge them. I am more concerned with the distant
outposts of pain, the extremities of limb in His Body that we have
somehow silenced. I have performed many amputations in my life,
most of them because the hand or foot has gone silent and no longer
reports pain. There are members of Christ’s Body, too, whose pain we
never sense, for we have denervated or cut whatever link would carry
an awareness of them to us. They suffer, but silently, unnoticed by
the rest of the Body.
I think of my Lebanese friends, for example. In Beirut, children
have grown up knowing nothing but war. They carry submachine guns
as nonchalantly as American children carry water pistols. They play,
not in parks, but in crumbling skyscrapers gutted by bombs. Christians
in Lebanon, especially the Armenians, feel utterly abandoned by the
church in the West, which focuses so much attention on Israel and
assumes all non-Israelis in the Middle East to be Arab and Muslim.
Spokesmen for Christians in Lebanon eloquently plead for compassion
or some token of understanding by their brothers and sisters in the
West, but we act as though the neural connections have been cut, the
synapses blocked. Few hear their pain and respond with Christian love.
Or I think of the homosexual population scattered throughout our
churches and colleges. Some surveys show that as many as 20 percent
of males in Christian colleges struggle with homosexual tendencies.
The reality is so abhorrent to Christian leaders, though, that
the church may simply pretend they do not exist. They are left to
flounder, cut off from the balance and diversity of the larger Body
and the compassion that might help them.
Or I think of the elderly, often put away out of sight behind
institutional walls that hold in all sounds of loneliness and
mourning. Or of battered children who grow up troubled, unwelcomed
into foster homes. Or of races who feel cut off from participation
in the Body. Or of prisoners sealed off behind huge fences. Or of
foreign students who live tucked away in cheap lodging, isolated and
afraid. Even those within the church judged for some minor doctrinal
disagreement can feel cut off, severed.
In modern society we tend to isolate these problems by forming
organizations and appointing social workers to deal with them. If
we are not careful, a form of institutionalized charity will grow up
that effectively isolates hurting members from close personal contact
with healthy ones. In such an event, both groups atrophy: the charity
recipients who are cut off from human touch and compassion and the
charity donors who think of love as a kind of material transaction.
In the human body, when an area loses sensory contact with the rest of
the body, even when its nourishment system remains intact, that part
begins to wither and atrophy. In the vast majority of cases-95 of
100 insensitive hands I have examined-severe injury or deformation
results. The body poorly protects what it does not feel. In the
spiritual Body, also, loss of feeling inevitably leads to atrophy
and inner deterioration. So much of the sorrow in the world is due
to the selfishness of one living organism that simply does not care
when another suffers. In Christ’s Body we suffer because we do not
suffer enough.
I must also mention one further service that members of Christ’s
Body perform by embracing others’ suffering. I say this carefully:
we can show love when God seems not to.
The great accounts of Christians who have suffered, beginning with the
Book of Job and the Psalms and continuing through the writings of and
about the saints, speak of a "dark night of the soul" when God seems
strangely absent. When we need Him most, He is most inaccessible. At
this moment of apparent abandonment, the Body can rise to perhaps its
highest calling; we become in fact Christ’s Body, the enfleshment of
His reality in the world.
When God seems unreal, we can demonstrate His reality to others by
modeling His love and character. Some may see this as God’s failure
to respond to our deepest needs: "My God, why have You forsaken me?"
I see it as a calling for the rest of the Body to push through
loneliness and isolation and to embody physically the love of God.
Praise be to the God and Father of our Lord Jesus Christ, the Father
of compassion and the God of all comfort, who comforts us in all our
troubles, so that we can comfort those in any trouble with the comfort
we ourselves have received from God. For just as the sufferings of
Christ flow over into our lives, so also through Christ our comfort
overflows. If we are distressed, it is for your comfort and salvation;
if we are comforted, it is for your comfort, which produces in you
patient endurance of the same suffering we suffer.
And our hope for you is firm, because we know that just as you share
in our sufferings, so also you share in our comfort (2 Cor. 1:3-7).
As I reflect on the need to develop greater sensitivity to pain,
I think of one of my favorite patients at Carville, a man named Pedro.
For fifteen years he had lived without pain sensation in his left hand,
yet somehow the hand had suffered no damage. Of all the patients
we monitored, only Pedro showed no signs of scarring or loss of
fingertip. My associate went over Pedro’s hand with great care and
came up with a surprise. One tiny spot on the edge of his palm still
had normal sensitivity so that he could feel the lightest touch of
a pin, even a stiff hair. Elsewhere on the hand he could feel nothing.
We also found on a thermograph that the sensitive spot was at least
six degrees hotter than the rest of Pedro’s hand (which supported our
theory, still being formulated, that warm areas of the body resist
nerve damage from leprosy).
Pedro’s hand became for us an object of great curiosity, and he
graciously obliged without protest as we conducted our tests and
observed his activities. We noticed that he approached things with the
edge of his hand, much as a dog approaches an object with a searching
nose. He picked up a cup of coffee only after testing its temperature
with his feeling spot.
Finally Pedro tired of our endless fascination with his hand. He said,
"You know, I was born with a birthmark on my hand. The doctors said it
was a hemangioma and froze it with dry ice. But they never fully got
rid of it, because I can still feel it pulsing." Somewhat embarrassed
that we had not considered that option, we verified that indeed the
arteries in his hand were abnormal. A tangle of arteries brought an
extra amount of blood and short-circuited some of it straight back to
the veins without sending it through all the fine capillaries. As a
result, the blood flowed very swiftly through that part of his hand,
keeping its temperature close to that of the heart, too warm for the
leprosy bacilli to flourish.
That single warm spot, the size of a nickel, which Pedro had previously
viewed as a defect, had become a wonderful advantage to him when he
contracted leprosy. That one remaining patch of sensitivity protected
his entire hand.
In a church that has grown large and institutional, I pray for similar
small patches of sensitivity. We must look to prophets, whether in
speech, sermon, or art form, who will call attention to the needy by
eloquently voicing their pain.
"Since my people are crushed, I am crushed," cried Jeremiah (8:21).
And elsewhere, "Oh, my anguish, my anguish! I writhe in pain. Oh, the
agony of my heart! My heart pounds within me, I cannot keep silent"
(4:19). Prophets like Jeremiah and Micah stand in great contrast to
an insensitive one like Jonah, who cared more about his comfort than
about an entire city’s destruction.
The prophets of Israel tried to warn an entire nation of social and
spiritual numbness. We need to encourage modern Jeremiahs and Micahs
and to value our compassionate, pain-sensitive members as much as Pedro
valued his tiny spot of sensitivity. By shutting off sensitivity to
pain, we risk forfeiting the wonderful privileges of being part of
a Body. A living organism is only as strong as its weakest part.
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