Lepers

This is the first of a series of posts centered around the Biblically recorded healings by Jesus, and what applications they may have in healing today.

Matthew describes the beginning ministry of Jesus with two specific markers. The first thing Jesus did was to preach, “Repent for the kingdom of heaven has come near.” Matt. 4:17. (NIV)

Then, in the next scene after calling the first four disciples, Jesus resumes proclaiming the good news about the kingdom of heaven, but with one added twist: “…healing every disease and sickness among the people.” Matt. 4:23 (NIV)

I find it easy to brush by this, partly because I’ve heard it so often that it’s only Muzak to my ears. But familiarity shouldn’t let me slide by the important implications of the intimate connection between repentance, the good news about the kingdom of heaven, and physical healing. Lots of religions are big on repentance and some version of heaven, but outside of Christianity, few make such a direct connection to healing. And Jesus’ “good news” about the kingdom of heaven is not that it is there in some far off future or after death, but that it has “come near;” it is at hand for anyone who is willing to turn and look. The same seems to be true about healing. Jesus’ healing is physical relief here and now, not a mind-over-matter exercise, or spiritual acceptance of suffering.

Matthew unpacks this in a measured approach. He doesn’t try to explain; he only tries to report. He starts with the Sermon on the Mount, a long look at what Jesus means by, “Repent, the kingdom of heaven is at hand,” which is totally life changing and turns the common values of the world upside down. But then Matthew immediately continues with what happened when Jesus stopped talking and started walking:

A man with leprosy came and knelt before him and said, “Lord, if you are willing, you can make me clean.”

Jesus reached out his hand and touched the man. “I am willing,” he said. “Be clean.”  Immediately the man was cured of his leprosy. Then Jesus said to him, “See that you don’t tell anyone. But go show yourself to the priest and offer the gift Moses commanded, as a testimony to them.” ( Matt. 8: 2-4, NIV)

This leper wasn’t supposed to be kneeling in front of Jesus. He didn’t have the right. He was supposed to be standing at least ten paces away and shouting, “Unclean,” to anyone who came near.

And Jesus wasn’t supposed to touch him. Leprosy was the one clear contagion of the age. Though the germ theory of disease was still a couple of millennia in the future, society recognized that at least this one disease could be transmitted from person-to-person. Once he touched the leper, Jesus was contaminated. He was at risk, and he became a risk to the people around him. He became “unclean.”

I imagine the outrage from the disciples when the leper kneeled within arm’s reach. I see them flinching when Jesus reached out his hand, maybe taking a step back themselves. Maybe this was where the promising ministry about hope and the love of God would end.

But the healing worked one more time. Then Jesus said something else surprising: don’t tell anyone. There was a legal process for the outcast leper to be returned to society, and it involved going to the priest and offering a thanksgiving sacrifice. Just do that and keep quiet, He told him.

Around eighteen centuries later, in the summer of 1857 a yellow fever epidemic broke out in Jacksonville, Florida. Yellow fever was the contagion of the age. The city population numbered under two thousand, and six hundred contacted the disease. Over the course of only a few weeks, 127 people had died, nearly 10% of the population. Businesses closed, steamships no longer stopped at the wharves, and those who were able abandoned the city. Grass grew in the streets.

Imagine if an epidemic with similar impact broke out in Jacksonville today. Three hundred thousand critically ill with a single disease. Eighty thousand dead. Hospitals overwhelmed, the airport and railroads shut down, the streets deserted. We would look like the set of a post-apocalyptic movie.

Five physicians practiced in Duval County in 1857. Some of them may have stayed, along with some brave nurses and caregivers. Dr. E.P Webster’s drug store remained open, dispensing medicines to those in need regardless of the ability to pay.

There were no hospitals. It would be another twenty years before St. Luke’s opened its doors to provide twenty-one in-patient beds. During the epidemic, people were cared for in homes, hotel rooms, meeting halls, and churches.

That summer found the most prominent Jacksonville doctor, Abel S. Baldwin, in New York visiting family and friends. Dr. Baldwin had come to Jacksonville in 1838. He was a charter member of the Florida’s first county medical society, and by all reports a bright, young man with connections and multiple interests. He obtained a charter for a railroad line that led from Jacksonville to Lake City in 1850, a project that remained incomplete at the time of the epidemic. He kept meticulous weather records, and the Smithsonian Institution in Washington, D.C., appointed him their official meteorologist in 1852.

While still in New York, Dr. Baldwin and his wife received news of the epidemic in Jacksonville, and faced a simple choice: to go, or to stay.

There were good reasons to stay in New York. Without steamship or rail service, travel would be expensive and uncertain. Medical care for yellow fever victims was then largely symptomatic. His presence may not make a difference. The epidemic may be over, or the town completely deserted by the time he got back.

Then there was the risk. The germ theory of disease had still not yet been formulated. The “wee little beesties” seen under Von Leeuwenhoek’s microscope were curious findings, but no one had made the connection to disease. Still, doctors were no fools. They knew that more than leprosy spread from person to person. Some of these, like plague, typhus, smallpox, and yellow fever were fatal.

I imagine Dr. Baldwin’s family and friends urged him to stay in New York with his wife until the situation clarified itself. He could start a practice there. He could go to Washington to work full time for the Smithsonian where he already had the meteorologist title. He could manage his railroad from a distance or sell it.

But he, along with his wife, returned to Jacksonville, to the town occupied only by doctors, nurses, one pharmacist, the jaundiced patients, and those who buried the dead. It is difficult to imagine the chaos, uncertainty, deprivations, isolation, suffering and sorrow. He did what he could, his wife serving at his side.

By autumn, the contagion had burned itself out. Those susceptible had died, and those who survived had immunity. Expatriates started to trickle back, businesses re-opened, the steamship resumed service. The railroad was completed. Horses and wagons trampled the grass that had grown in the streets.

Dr. Baldwin survived. He lived and practiced in Jacksonville until his death in 1898. But his wife did not. The epidemic claimed her as one of its last victims.

Every age has its leprosy. AIDS is ours. Public awareness of the means of transmission, and currently available effective treatments now blunt our fears, so the isolation of victims in the eighties and nineties is hard to remember now. Houses were burned, sick men and women were turned out into the streets, and even doctors backed away from contact. The medical profession adopted “universal precautions” because of AIDS, but the measures are really more effective for common in-hospital bacterial cross-contamination and for hepatitis, both of which are much more easily transmitted than the HIV virus. Forever afterward, doctors and nurses did their jobs with their hands sheathed in a thin layer of protective latex gloves.

Three times I operated on AIDS patients when other surgeons turned them away. One was a young man with hemophilia who had undoubtably contacted the virus through transfusions. Another was a gay man with a previous spinal fusion that had failed; his surgeon recognized the need for another operation but feared for his own health. The last was a female inmate who was positive not only for the HIV virus but also for hepatitis C.

I knew about physicians like Dr. Baldwin who had risked their lives for their patients. I figured it came with the tradition of medicine, and for myself I did not see an honorable alternative. Other doctors did. The fact that I believed the risks were quite low bolstered my self-righteous courage.

I once thought that the tradition of accepting personal risk for the benefit of the patient goes back to Hippocrates. But neither the Hippocratic Oath nor the Oath of Maimonides deals with risk to the physician provider. Plenty of physicians over the centuries chose self-protection, and for very good personal reasons. Perhaps the tradition of the provider taking personal risk goes back to the Gospel story of Jesus and the leper.

Jesus may have known the risk to Himself would be low, Him being God and all. But it is not at all clear from the Gospels that He knew everything that would happen next. In the Garden of Gethsemane, He begged His Father to allow a different future than the one He was facing. He had to at least imagined other possibilities. Perhaps the same thing was true three years earlier when the leper kneeled in front of Him. Maybe He didn’t know what would happen; He only knew what His Father would have Him do. He may have held in His human mind the very possibility that He would touch the leper and become a leper.

On my last noted case, the woman positive for the HIV virus and hepatitis C, I needed to do an injection with a syringe and long needle during the course of the operation, something I had done literally thousands of times without incident. But on that day, for whatever quirky reason, I stuck my own hand right up to the hilt with the contaminated needle. I don’t recall ever suffering a similar injury on any patient, much less this one that carried a double risk.

Now, really for the first time, personal risk had gone from being theoretical to being real. I took anti-retroviral drugs for six weeks, refrained from blood donations, and did repeated blood tests for a year before I considered myself safe. During that year, I feared the results after each blood test. Each time I could receive news that would change my life, and the life of my family, forever. There may be a cost to conviction. Dr. Baldwin lost his wife. What would I lose? And if I got sick, or worse, sickened one of my family, would I look back and say that I took a risk that needed to be taken?

I think Jesus took the risk long before He met the leper, when He decided to give up his divinity and curb his existence into a narrow time-space continuum as a frail human in order to save one broken species. Once He gave in to that plan, one more broken man with leprosy kneeling in front of Him was only a microcosm of His purpose, even if He didn’t know what would happen next.

Matthew probably didn’t include this healing account for the sole benefit of future health care providers. Everyone faces lepers.

It is hard to reach out to some people; they frighten us. The homeless, the dirty, the criminals, the mentally ill, the drug addicts and the alcoholics–all are lepers of the twenty-first century. There is reason to be afraid. They can hurt us. But they are also human beings in need.

I can’t fix them all. I might not be able to fix any of them. Even Jesus didn’t try to fix them all during His brief material stay on this planet. But when that one guy with leprosy knelt down in front of Him, He reached out and touched him.

I can only hope to do the same.