By LeRoy Lawson
Being Mortal: Medicine and What Matters in the End
Atul Gawked
New York: Metropolitan, 2014
The Arsenal of Democracy: FDR, Detroit, and an Epic Questto Arm an America at War
A. J. Jaime
Boston: Houghton Mifflin, 2014
There”s a Sheep in My Bathtub: Birth of a Mongolian Church Planting Movement
Brian Hogan
Bayside: Asteroidea Books, 2008
Atul Gawande”s Being Mortal is a book for everyone. But everyone won”t like it.
It”s for everyone because it”s about dying and dying is for everyone. Everyone won”t like it because it”s about honestly accepting dying, even if you”re a doctor and you”re supposed to be against it.
Dr. Gawande is the surgeon son of physician parents. He is proud of his heritage and his calling. After 20 years in his own medical practice, however, he concludes that in many ways, especially when it comes to caring for the dying, doctors get it wrong. Committed to extending life as long as possible and by every possible means, they refuse to accept the fact that in the end, “we just fall apart.”
As we disintegrate, we run to our doctors to fix the failing parts. And the doctors comply: pills for this, canes or prostheses or wheelchairs for that, surgery for the other, with a covering of narcotics to mask the pain. What they don”t do is speak to the real issues of well-being for the patient, and that is “about the reasons one wishes to be alive.”
The seldom-asked question is why? Why take chemotherapy if the best it can offer is a few more months? Why use more desperate measures if the falling off of the quality of life can”t be stopped? Why incarcerate in nursing homes and hospitals where the top priority is the patient”s safety when the patient”s top desire is autonomy, even when that means taking risks? “One has to decide whether one”s fears or one”s hopes are what should matter most.”
The debate over the best care for the terminally ill, he says, “is about what mistakes we fear most””the mistake of prolonging suffering or the mistake of shortening valued life.” Tough call.
Here is where one of my own nagging questions comes in: Why is it we Christians, who say we believe in a Heaven where things are better than they are here, call for the latest extraordinary measures (chemotherapy, surgery, radiation) to bargain for a few more months even if these measures engender increased suffering and loss of autonomy? What are we afraid of? If it”s true there are worse things than death, and there are, then is it possible that turning our life decisions over to the medical profession may not be in our best interests? Just asking.
Dr. Gawande, of the medical profession, is asking the same questions.
Full of eye-opening research and riveting storytelling, Being Mortal asserts that medicine can comfort and enhance our lives even to the end, providing not only a good life but also a good end. It”s just that what it can do it often doesn”t do, thus bringing about the worst of results with the best of intentions.
This book held me spellbound in part because of the author”s depictions of several patients whom he has guided (or, he confesses, misguided) through their final days. One of them was his own father. The other reason for my appreciation: between us (counting our stepparents), Joy and I have walked through the final stages with seven parents. We have lived these pages. Before long our children will be faced with what to do with us. I hope they read this book.
A Complex Tale
When I started reading A. J. Baime”s The Arsenal of Democracy, I didn”t intend to review it in this column. It wasn”t that long ago I wrote a few words about David Halberstam”s The Reckoning, his retelling of the American automakers” nearly disastrous slide toward obsolescence before Japan”s wake-up call in the 1970s and 1980s. I thought that was enough about Detroit for awhile. But then I got caught up in Baime”s book, which takes us to an earlier, more muscular Detroit””back when a worried President Franklin D. Roosevelt, eyeing the seemingly unstoppable Nazi juggernaut, challenged America”s industrial giants to harness their enormous potential to stop Hitler and save the allied nations.
This is a complex tale. There are good guys and bad guys, of course, but sometimes they are the same guys. Take Henry Ford, for example, indisputably one of the greatest industrial leaders in our history. A good guy. But he”s also the same Henry Ford who hated Jews, who hired thugs to run his company, who humiliated and very likely drove his son Edsel to his early grave, and who stood against anything Roosevelt wanted just because Roosevelt wanted it.
And there is Henry”s Ford Motor Company”s herculean efforts to build bombers (the famed B-29, the “Liberator”), a result of Edsel”s determination to convince his father to do the right thing even if it was what Roosevelt wanted. But this same company had plants in Europe that cranked out war materiel for the Nazis. A complex story.
I was equally fascinated by the two focal points in the book. First, the stunning transformation of our sleepy, isolationist American-first-and-only, still-climbing-out-of-the-depths-of-the-Depression nation into the world”s leading superpower in just a few short years; and second, the primordial contest between generations, in this case between an aging, slipping-into-dementia titan of industry and his gentler, more-in-touch, long-suffering son. It”s a drama worthy of Greek tragedy.
Missionary to Mongolia
A friend passionate about church growth pointed me to Brian Hogan”s There”s a Sheep in My Bathtub, which addresses two of my longtime questions: (1) What is the best way to grow a church; and (2) What kind of leader is required to get the job done? Don”t let me mislead you though. This isn”t a how-to treatise. Rather, it”s a gripping tale of an intrepid, faith-filled family who followed God”s call from a comfortable American life to Mongolia (yes, Mongolia!), where there was no church and where the nationals assumed that all white-skinned visitors were Russians, which did nothing to help their evangelistic endeavors.
Against incredible odds, the Hogans shivered through subzero temperatures (outside and inside), battled corrupt government officials, learned the real meaning of spiritual warfare, overcame the hostility of distrusting fellow missionaries who looked askance at these youngsters with their newfangled techniques, and ate foods their untutored digestive systems rebelled against. These and many more were the challenges they had to overcome. And they did.
Theirs is a gripping story. But it is also a case study in what happens when you take the New Testament seriously as the model for church planting. The Hogans rightly believed they should not simply recreate an American church (with all the cultural adaptations that make it distinctly American). It had to be Mongolian. So they leaned heavily on the earliest church as described in Acts.
They applied the basics: the apostles” teaching and fellowship, the breaking of bread and prayer, amazing generosity, reliance on the Holy Spirit, and discipling native leaders. So simple. So powerful.
What the earliest church lacked was as important as what it had. It had no buildings, no ecclesiastical structure, no extra-biblical manual of instructions, no seminaries or artificial educational standards for the leaders. But it did have the guidance of the Holy Spirit, signs and wonders that left people in awe, a deep commitment not only to Jesus but to one another. And it had the flexibility to be adapted and adopted by cultures as different as, say, middle-class America and rural Mongolia.
Hogan recounts with heart-wrenching honesty the birth and death of their son Jedidiah, the first American born””and just weeks later buried””in Mongolia. Reading this story reminded me of other missionaries I”ve known who buried a child on the field.
The sacrifice of a child is not required by missionary manuals; it is a reminder, though, of what price may have to be paid by anyone who sings with conviction, “I”ll go where you want me to go, dear Lord, I”ll do what you want me to do.”
LeRoy Lawson serves as international consultant with CMF International.
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