Life and Death, Racism, and Responsibility
By LeRoy Lawson
Do No Harm: Stories of Life, Death, and Brain Surgery
New York: Thomas Dunne, 2015
The Warmth of Other Suns: The Epic Story of America’s Great Migration
New York: Random House, 2010
To Heal a Fractured World: The Ethics of Responsibility
New York: Schocken Books, 2007
So what do you think of Obamacare? Has any topic in recent years generated more sound and fury, or more heat and less light than America’s medical care? (OK, maybe immigration policies, or same-sex marriage, or. . . . You get my point, though, don’t you?) For years my medical friends railed against dictatorial insurance companies that were wresting away doctors’ independence, overriding their best judgment so the insurers can save a few bucks. Now Obamacare is the heavy, and these same folks have turned their guns on the government.
Some patients, on the other hand, want more government involvement in medicine, not less. Look at England, they say. Socialized medicine really works there: medical care is more readily available, much cheaper, much more patient sensitive—in general, much better than America’s commercial system.
But is it? These advocates of “socialized medicine” must not have read Henry Marsh’s Do No Harm. One of England’s foremost neurosurgeons, Mr. Marsh (it’s not “Dr.” in the United Kingdom) doesn’t directly address America’s medical scene, but if you can read his tales without making comparisons between the two delivery systems, you are more focused than I am.
In both countries, truth to tell, medicine battles against illogical rules, administrative nightmares, inept doctors, grumpy nurses, impossible patients, and interminable waiting lines. But you can also find sensitive caregivers (nurses, in particular), highly skilled practitioners, and genuine heroism.
A consummate storyteller, Marsh may occasionally bog down in technicalities—he employs the almost unintelligible jargon of his trade—but he quickly retrieves your wandering attention with yet another tale of real people in genuine crises. As a neurosurgeon, he doesn’t have much to say about rashes and backaches, but he explores with relish the inner recesses of the brain, where a surgeon’s slip of a millimeter can burst a blood vessel or snip a nerve and permanently disable or kill the patient.
Even the most talented and experienced surgeon is often at the mercy of chance. A successful surgery? Lucky. A disastrous failure? Unlucky. (There’s no room for prayer or providence in his worldview.) He does not claim credit where credit is not due.
Often Marsh sounds dispassionate, treating the body as a mere object. But he’s not uncaring. He admits his discomfort in meeting his patients before surgery. “I prefer not to be reminded of their humanity and their fear, and I do not want them to suspect that I, too, am anxious.”
Many of his most difficult moments occur not in the operating room but in these pre- and post-operative conversations. How do you tell your patient that the case is hopeless and death is inevitable; that there is nothing more to be done? Or tell the family a mistake was made on the operating table, or the surgery proved their hopes were in vain?
Where they see professional competence, he feels his inadequacy. He does in fact make the occasional mistake. His patients have to live with the consequences. So does he.
Neurosurgery is more than slicing back the scalp, cutting through the skull to expose the brain, clipping an aneurysm, freeing and sucking out the tumor, staunching the bleeding. It’s about restoring hope. It’s about going into battle against an enemy of maddening resourcefulness. “I often have to cut into the brain and it is something I hate doing.” Hateful, but necessary.
There are bits of the comedic on these pages, mostly at the expense of the National Health Service. The chronic bed shortage, botched paperwork, ridiculous orders handed down by insensitive administrators who go by the book and who keep adding to the book—more and more rules and regulations that have precious little to do with curing patients.
Mr. Marsh does not suffer such fools gladly. But complain as he might, and he does, he still manages to restore your faith in the basic decency of devoted medical professionals: physicians, surgeons and, especially, nurses.
He is surely listening to America’s politicians yelling at each other about the terrible state of our nation’s medical industry. I wonder how he would vote.
It’s been so long since I first heard it said that I can’t remember who said it. The Lawson family had moved from the West Coast to the South in the mid-1960s, when the civil rights struggle was at the height of its intensity. My hometown was all white. I was not prepared for the racial tensions we experienced in Nashville. We weren’t far from Birmingham.
We probably felt a little smug, given our upbringing far from the scenes of battle. But someone cut me off, lest as a Northerner I should boast. “In the South we say to Negroes [sic], come as close as you want. Just don’t go too high. But you people in the North, you say, “you can go as high as you want. Just don’t come too close.”
I hadn’t thought of this quip for years until I read Isabel Wilkerson’s The Warmth of Other Suns: The Epic Story of America’s Great Migration. The migration she speaks of is the huge population shift that began just after the end of World War I and kept moving until the late ’60s, when Richard Nixon tried (and mostly failed) to keep the races from each other’s throats.
Black Americans moved north in great numbers—6 million of them in all—without any central organization. It was unplanned, the inchoate uprising of sharecroppers and fruit pickers and citizens of color without rights or safety who, one at a time just started disappearing, then reappearing out of harm’s way.
No, not out of harm’s way. That’s the heartache of their story. They arrived in such numbers that they inadvertently threatened other migrants who got there before them—Italians and Irish and Hispanics, all fighting to make ends meet and deeply resenting this latest wave of competitors for scarce jobs.
Wilkerson is an African-American, a writer/researcher of consummate skill. She earlier received a Pulitzer Prize for journalism. For this book, after interviewing 1,200 people she selected three who represent three stages of the migration. We get well acquainted with a sharecropper’s illiterate wife, a fruit picker who fled for his life after trying to organize a strike for a livable wage, and a poor schoolteacher’s son who married above himself and became a successful California doctor.
All three are flawed individuals; all three fight for a chance. And all three earn our respect. Interwoven with their stories are those of countless others driven by a variety of motives but united in their hope of finding a better life. Their experiences are proof that the Civil War didn’t end at Appomattox in 1865.
Neither did racism.
Jonathan Sacks’s To Heal a Fractured World deserves a more complete review than I can give it, especially after discussing The Warmth of Other Suns with its sorry proof of human appetite for the inhuman. Sacks (chief rabbi of Great Britain) pleads for a lifting up of religion’s role (its real purpose, in his view) in reconciling a human race at war with itself. Peace can come only, he argues, when we turn from a morality based on “I want my rights” to one that declares, “I will do my duty,” thus embracing the ethics of responsibility.
Basing his appeal on Scripture and theology (from his Jewish perspective) and lessons gleaned from the greatest minds of history, his words parallel James’s letter, “It is by our deeds that we express our faith and make it real in the lives of others and the world.”
If you are as weary as I am of clamoring power groups yelling for their rights without regard to others’, then you’ll appreciate Sacks’s old-fashioned, commonsense-filled counsel. His call for a righteousness that is not self-righteous, a holiness that benefits others, and a modest kindness in place of looking out for number one, is inspiring.
LeRoy Lawson is international consultant with CMF International and professor of Christian ministries at Emmanuel Christian Seminary, Johnson City, Tennessee. He has served as a CHRISTIAN STANDARD contributing editor and member of the Publishing Committee.