Credo: Chapter 3

“I believe in God, the father almighty, creator of heaven and earth.”

Held in secret for over half a century, here is the confession of a true nerd: Reading the genetics section of the Biology 101 textbook, I came to the part about the discovery of the DNA molecular structure and I cried tears of joy. It was so beautiful, so intricate, so unexpected…and so perfect.

I know, it seems like a nutty response. Me, sitting in a corner of the Wilson Library at the University of Minnesota, sniffling over a textbook. That’s why I never mentioned it until now. But today maybe some of us should remember that the world around us is all those things–beautiful, intricate, unexpected, perfect–in a word, miraculous.

And this is important, why?

Because if you understand the world as miraculous, you understand yourself as a miracle, a creature of destiny and purpose. If you are content to limit your understanding of the universe to the description of the mechanical moving parts and deny the spiritual forces that created those moving parts, you will understand yourself as a random being in a purposeless universe. You may call yourself a scientist of sorts, but you will have given up the greatest purpose of science, which is to understand the miraculous. And you may have given up on your own destiny.

Our best science has always come from people seeking the truth about creation and, therefore, the truth about God. Copernicus, a Catholic scholar in the sixteenth century, is the scientist who demonstrated that the Earth revolved around the Sun, leading to our future understanding of our solar system, our place in the galaxy and our galaxy’s place in the universe. Georges LeMaître, another Catholic scholar, working in the twentieth century, was the first to formulate the theory he called “The Beginning of the World,” and what we now commonly call “The Big Bang Theory.” (Edwin Hubble confirmed his calculations two years later.) And in modern times we can look to Frances Collins, MD, PhD, who led the Human Genome Project and was director of the National Institute of Health from 2009 to 2021 (for a full review of his faith journey, read his book “The Language of God”).

The Bible, in Genesis 1:1, tells us that “In the beginning God created the heavens and the earth.”

The phrase is so familiar that it is easy to skim over with a “Yeah, yeah. Everybody knows that. Let’s get to the good part.”. But the verse says two important things that are not givens. The first is that there is a beginning. A beginning to time and a beginning to space and a beginning to matter. Alternatively, some religions propose that time is circular, that we are on a “wheel of time.” Other religions skip a true origin of time and space, apparently making an assumption that these things have always been around, then go on to start on origin story with the creatures or gods that populate the earth. This verse clearly says there is a beginning.

The second thing this verse says is “God created…”

Compare this first verse of the Bible with what creation science tells us. The Big Bang Theory proposes that time and space and matter indeed had a very specific beginning, and a power beyond our comprehension brought an ordered universe into being out of nothing. Because Science tells us about the How, never about the Why. Science describes what the power beyond our comprehension did, but doesn’t call that power God. The Bible doesn’t have to limit itself to description; it can go on to the Why, to the Truth.

Then galaxies formed, our own Milky Way formed, our own earth formed. The first verse of Genesis doesn’t give a timeline, but our best scientific guesses are that the “Big Bang” occurred fourteen-and-a-half-billion years ago. After the Big Bang, say about a billion years or so, galaxies like our Milky Way started to form. After another eight-and-a-half billion years, our own Sun took shape. Another three billion years later, the Earth was formed. That would be about four and a half billion years ago. The Biblical first day had not yet occurred.

Then Genesis 1:2 tells us that “Now the Earth was formless and empty, darkness was over the surface of the deep, and the Spirit of God was hovering over the waters.”

Creation science describes the primordial Earth less poetically, but only a little imagination is required to envision the same thing Genesis 1:2 describes. Our atmosphere was primarily water in the form of steam and the surface was an ocean of liquid magma (molten rock), e.g. “darkness over the surface of the deep.”

Genesis 1:3 tells us “God said, ‘let there be light,’ and there was light.” Science tells us that the earth cooled, the steam atmosphere condensed to water and clouds and sunshine reached the surface. In other words, there was light.

Genesis 1:4 tells us “God saw that the light was good, and he separated the light from the darkness.” Science tells us that the Earth rotated, perhaps at the same rate that it does today, perhaps not, but clearly in a rotating pattern of light and darkness. This is not true of our moon and not true for all planets; it is true specifically for Earth.

Genesis 1:5 tells us that “God called the light ‘day’ and the darkness ‘night.’ And there was evening, and there was morning—the first day.” From this point on we can argue what the term “day” might have meant in prehistory. Is a day a prescribed twenty-four hour period? Was it a single rotation of our planet, and if so, did our planet rotate at the same interval a billion years ago as it does now? Or is a day a metaphor for an era or an eon?

I personally don’t feel the need to argue about the definition of day in this context. But what is inarguable is the sequence of events described in Genesis 1:1-27. The waters separate from land, vegetation appears, the sun and the moon and the stars become visible, sea creatures populate the oceans, then birds appear, then land animals, and then lastly, man. 

And this fact is in itself amazing: that our most ancient record of our creation in the Book of Genesis outlines exactly the sequence of events that modern science confirms, the same separation of waters and land, vegetation, then sea creatures, then birds, then land animals and then, at last, homo sapiens, mankind. In other words, science confirms what the Book of Genesis has already told us.

I like to imagine God the Father conveying a vision of His creation to an individual or group of individuals before they had the mathematics and the telescopes and the language to figure it out for themselves. Because it was important. Because each individual was created in the image of God with purpose and destiny, and they should know that first. And if God wanted to convey a vision of His creation that looks like modern creation science has envisioned, it would look a lot like the first chapter of Genesis.

There is more, of course. I want to rant on about the creation of life on earth, abiogenesis, the miraculous transformation of primordial elements in prehistoric Earth coming together to form proteins and nucleic acids and cell walls and mitochondria—something about as likely as putting chunks of aluminum, copper, plastic and silicon in a bag, zapping it with a bolt of lightening and expecting a MacBook to appear.

I want to rant about evolution, the miraculous continuing creation of life in its various forms, the miracle of DNA and the miracle of every single species created.

I want to rant about the limits of physics, dark matter and dark energy, the unknown other end of the universe that will always remain unknown, the huge question of the Higgs field that all matter must pass though to gain mass and the mystery of what lies beyond the Higgs field.

But I’ve ranted enough. Those are knowledge-based arguments. Creation is also a personal thing, an experienced thing.

I haven’t gotten too emotional about molecular structures lately, but I have been awestruck by quiet, northern lakes at dusk, raging ocean waves on the edge of hurricanes, and the sky on a clear, moonless night in the wilderness. These are mysteries and miracles. They strike me with awe. If I ponder them for a moment, I am driven to humility. I am a speck made up of billions of delicate and intricately designed molecules. I am able to be conscious of a universe that is huge and beautiful. I believe in the creator of heaven and earth.

Credo II

Chapter 2

“…the Father almighty…”

My dad jingled. He would take the bus to work downtown each morning and come home predictably at the same time each afternoon to the same bus stop. The stop was three blocks away, so too far to meet him there. But my brother and I were allowed to watch on the front sidewalk and when he came into view on the other end of the block, about two hundred yards away, we could run to meet him. This probably served my mother well; she could have us out of the house, attention fixed on something not likely to cause harm to ourselves or others, and reasonably safe.

Sometimes on a good day he would let us take turns and ride on his shoulders the rest of the way home. But since it was an uphill climb and there were two of us, usually he would convince us to walk by his side and hold his hand. The top of my head came to about his waist so my ear was right next to his pocket. What I remember most about those walks was the the jingling of change and keys in his pockets. It sounded like little silver bells. Only dads jingled. Not moms, not kids, only dads. My dad.

My creed identifies God as “the Father.” God is the Father, but so is the priest, so is the rote beginning of the Lord’s Prayer, and so is my dad. What can “God, the Father…” possibly mean?

In religions other than Christianity, and even in our own Old Testament, God’s title is some variation on “Ruler of the Universe” or “Lord and Master.” The Man Upstairs, the Big Boss. Not Dad.

“Dad” implies something much different than “Ruler of the Universe,” does it not? The Ruler is almighty certainly, but he rules over the nameless masses with the threat of punishment or even complete annihilation for disobedience, and the less well-defined benefit of obedience is continued existence. This is understandable. A Being as powerful and universal as we imagine God wouldn’t, to our human way of thinking, be capable of being personal. I mean, He’s got over six billion living souls on this planet alone, not to mention the ones already in heaven and hell. And we are not even talking about managing the couple hundred billion galaxies in the observable universe and all the living creatures great, small, and microscopic. It’s a helluva job and no reason to think He would pay any attention to me (unless maybe I stepped out of line).

Dad, on the other hand, knows exactly who I am. He created me with his own DNA through his passion and his love. He knew me as a baby before I could know myself. He protected me and guided me until I could take care of myself. And every now and then he punished me for being violent or disrespectful or putting myself or others in danger.

Jesus shocked the world when He referred to God as “Abba,” an informal and familiar term in Aramaic meaning something close to “Dad.” God is personal, He is loving, and, after understanding that He really exists, this is the most important thing we need to know about Him: He’s Dad. He created you with His own DNA through His passion and His love. He knew you before before you knew yourself. He protects you and guides you.

And, yeah, sure, He’s almighty. We kinda expect that out of God; otherwise, He wouldn’t be God. But when we put father together with almighty, I think the most amazing thing about all the powers He displays is to be Dad. Not just to me, but to every human being born since the beginning of time. The father almighty. Dad.

Now I’m an old man and I’ve lived a life far less than perfect. I don’t want to label myself a sinful man, but I can’t claim to be righteous either. When I’ve drifted, I’ve felt myself struggling, unsettled, lonely and lost. On other days, my best days, I wait for Dad, looking for him in the distance, and when I see Him coming I run as fast as I can and we walk together, holding hands, a jingle like silver bells in my ear, because only He sounds like that. And together we walk toward home.


Core beliefs are a “creed.” In Christianity that would be the Nicene Creed dating from 325 A.D. and the derivative Apostle’s Creed dating from about one hundred years later. These Creeds, nearly identical in content, define Christianity, both Roman Catholic and Protestant. Christians, like myself, have memorized these lines and recited them in liturgy for nearly 1,800 years, but this familiarity may have bred a certain thoughtlessness about the implications of each word and phrase.

Over the next several weeks I hope to go through each phrase of the Apostle’s Creed with a personal reflection to claim, along with my spiritual forebears, the essence of my faith. I invite you to share with me.

The Apostle’s Creed

I believe in God, the Father almighty,
      creator of heaven and earth.

I believe in Jesus Christ, his only Son, our Lord,
      who was conceived by the Holy Spirit
      and born of the virgin Mary.
      He suffered under Pontius Pilate,
      was crucified, died, and was buried;
      he descended to hell.
      The third day he rose again from the dead.
      He ascended to heaven
      and is seated at the right hand of God the Father almighty.
      From there he will come to judge the living and the dead.

I believe in the Holy Spirit,
      the holy catholic church,
      the communion of saints,
      the forgiveness of sins,
      the resurrection of the body,
      and the life everlasting. Amen.

“I Believe in God…”

My father’s father never went to church. I did not know him very well. He died when I was nine and his last years were marked by hearing loss, which made it hard for him to understand, and Parkinson’s disease which, made it hard for him to be understood. But by all reports he was a good man: hard-working, honest, loyal to family and friends, a good husband, a good father, a good farmer. I don’t know exactly what he believed, probably nobody did. He never complained and he never explained. He lived as if he believed that a small corner of a cold, unfeeling world could be brought to heel with diligence and luck, and a better world would be left behind for his wife and children.

And yet on his death bed, after his wife and children had gathered and prayed, he had a few moments alone with his son, my father, and he said, “Do you think there could be something to all that?”

It’s a good question, better asked earlier in a lifetime, because it might make a difference not only in how you spend eternity but in how you live your life. Yet, the belief in God is often difficult for highly practical, self-reliant men like my grandfather who distrusted superstition. So, men like my grandfather don’t talk about it. They let others (like my grandmother) worship and pray while they go about their business, possibly entertaining but never answering that deathbed question. Could there be anything to all that?

The answer is Yes. I want you to know that I know and that and you can, too.

I want to tell you about the logic and evidence behind a belief in God. I want to point out that superstition is belief in something without evidence and faith is belief in something with evidence. I want to point out that our most cherished ideals–Beauty, Justice, Truth, for example–must come from holy source; they are not something that can be proven, but we all know them and treat them as self-evident and real. I want to point out that every culture known to history had a religion that believed in God; we are at the end of a chain of wisdom tens of thousands of years old that believes in God. I want to point out the transcendent experience we all have when we witness any one of the three big life events: falling in love, the birth of your own child, the death of a loved one.

All those things are true and I could go into great detail about each sentence, and you may believe me and you may ponder what I say and you may think of counter arguments because there are always counter arguments. But the most important answer to “Could there be anything to all that? is Yes, I have experienced the Something, I have tested it in my life and found it to be true; it is good, and I want that Something for you, too.

Knowledge is a tool, something that can grow or be modified by new information. On its own, knowledge is not personal, not foundational. It is used to solve a problem, or answer a question, or a way to ask another question, but knowledge only defines a framework in which we interpret reality. Experience defines reality.

My first experience with God was when I was fourteen. I say “experience” because I had already a “knowledge” of God in the Protestant Christian tradition through Sunday School, the Bible Story Book read to me by my mother before I could read myself, and confirmation classes that took three hours of every Saturday morning for two years before the ceremony to confirm my baptism vows and take responsibility for my own soul. Lots of knowledge; not much experience.

By this time in my young life I already knew enough to be skeptical, and it was then and it is now in my nature to be skeptical. The entire Christian tradition could be a myth no different from the myths of the Romans and the Greeks, and for that matter the myth of Santa Claus–constructs created by society to control the behavior of small children and gullible adults. Karl Marx called religion the “opiate of the masses.” Sigmund Freud speculated that God was a construct of our unconsciousness that represented our inner father figure, that part of our unconscious that makes us behave.

Maybe, maybe not, I thought. But on the other hand, all of those I loved and respected–with the exception of my grandfather–believed in this Christian myth.

Then I found myself walking alone in a cold, October rain on a deserted city street, severely underdressed in a tee shirt and blue jeans, wet through to my underwear. I still had a long way to go before I got home. I decided to put God to the test. I asked the Creator of the Universe to make me warm and dry, and since the request was de novo I thought it only fair that He should get a full ten seconds to fulfill my request. If He could do that, I told Him, I would believe the whole God, Jesus, Resurrection thing as true. If it didn’t happen, I would remain skeptical.

I counted down from ten to zero, and was about to embrace the life of an agnostic cynic. I had even formed the words in my mind, “See? There is no God.” At that moment, before I could embrace the words as a thought, much less speak them aloud, the family car pulled around the corner, driven by my brother who didn’t actually have a driver’s license. He popped open the door and yelled at me to get in, which I did, and found the car had already been warmed to about 900 F with the heater still blasting away. In a few minutes I was home, changing into dry clothes and eating fresh-baked bread at the kitchen table.

It seems like a trivial incident, a coincidence perhaps. But the unlikely circumstance of my “salvation” occurring at the exact moment I requested it, puts the experience beyond coincidental into miraculous. A small and very personal miracle perhaps, but still a miracle.

I would like to say that this experience made me a good person, but that would be a lie on so many levels. What it did do was convince me that whatever else I might be cynical about and whatever decisions I made or actions I took, I could not tell myself that God was not real. As I have looked back on this watershed experience, my personal testimony, I think that God may have been laughing at how trivial my request had been.

But now when I think about this story–a kid being alone, cold, wet, and a long way from home, I see it as a metaphor. That’s where God finds us, or more accurately since He hasn’t lost track of any of us at all, where we are open to finding God. Like my grandfather. In pain, certain he would not be going home, and uncertain of what lay ahead. 

My dad told my grandfather, “Yes, there is something to all that.” And my grandfather listened, and a few hours later he died.

For months afterward, my dad grieved over the loss of his father. He sat with his own mother every night for several weeks then called her every evening for the next six months or more. But he remained troubled, slept poorly, and grieved until one night he saw his father in a dream. Grandfather didn’t say anything that Dad could repeat later, but only indicated that everything was all right, he was at peace and my dad could be at peace, too.

So…I believe in God…for lots of reasons, but mostly because He shows Himself to lonely, cold, wet boys a long way from home, and old men on their deathbeds.

Mountains and Mustard Seeds

Number Thirteen in the Healing Miracle Series

When they came to the crowd, a man approached Jesus and knelt before him. Lord, have mercy on my son,” he said. “He has seizures and is suffering greatly. He often falls into the fire or into the water. I brought him to your disciples, but they could not heal him.”

“You unbelieving and perverse generation,” Jesus replied, “how long shall I stay with you? How long shall I put up with you? Bring the boy here to me.” Jesus rebuked the demon and it came out of the boy, and he was healed at that moment. (Matt. 17:14-18, NIV)

Jesus had been coy with patients before, taking his time before responding to their requests, calling them out when they touched his robe, forgiving sins instead of commanding healing, casting out demons from the violent men of the Gadarenes without being asked–all unexpected responses to human suffering. But never had he been impatient, even rude, as he was now to a father with an epileptic son.

Or maybe his comments about the “unbelieving and perverse generation” had been directed elsewhere. Maybe to the disciples, because of their failure to cure the child in his absence? But even this seems unfair, and out of character, for the Jesus we have come to know in the previous chapters. Or maybe he’s human–not just human, but still human like you and me.

He had just come down from the mountain. He had been in the presence of Moses and Elijah, the great leaders and prophets, both of whom the world thought to be long dead. And God Himself spoke to them, and Jesus, in the presence of three witnesses: This is my Son, whom I love; with him I am well pleased. Listen to him! (Matt. 17:5, NIV)

How many of us wouldn’t love to hear those same words from our earthly fathers! Or if we were lucky enough to hear them, don’t we treasure those moments among the best in our lives? Imagine hearing the clear voice of God the Father while communing with the saints of the past. This had to be the pinnacle of his life on earth so far–what he had meant when he talked about “The Kingdom of God,” a place he knew in faith and in hope but had yet to experience in earthly life.

Then he came down from the mountain and found the same kind of problems he had left behind the day before, along with disciples that couldn’t seem make any headway without his presence. No doubt the disciples looked sheepish. After Jesus had his little outburst, he did what Jesus does; he cast out the demon.

“How long shall I stay with you?” he cried out, but maybe he was really questioning his Father whom he had just left: How long until I can come home? How long until every soul has unity with You? How long will our created world be filled with diseases and demons?

The Kingdom to Come

Our internship class inherited a man named Archibald, or “Archie” as everyone quickly came to know him. About a week before our internship started, he had suffered a shotgun wound to the abdomen when a heroin deal went south, and had his first of many operations to save his life. Any abdominal wound can be fatal, but a shotgun is particularly nasty because of the multiple intestinal perforations each of which can be the source of infection–peritonitis–and potentially life-threatening sepsis. Some of the intestine can be sacrificed, but if too much intestine is taken, the body cannot absorb adequate nutrition to survive.

Archie survived his first operation, but had recurring bouts of peritonitis and sepsis. At one point his respirations failed and he needed a ventilator for nearly a month. To “rest” his intestine and minimize further infection he required total parenteral nutrition, TPN, through central intravenous lines. Over the next few months, he underwent several more operations to find and repair damaged intestines or drain abscesses. Every one of our surgical interns rotating through general surgery took care of Archie.

He was a likable guy. We–all eighteen interns–suffered with him, and never lost hope for his eventual healing, even though every week seemed to bring a new complication, and the months dragged on. In all those months, no friends or family members visited. We had the feeling that he had become part of our family at the hospital–the pseudo-family that comes together when dedicated people work together for a common purpose.

Finally, one day in early Spring, word spread throughout the interns scattered through the hospital: after nine months, Archie had made it out of the ICU! Then a few days later–miracle of miracles–he was released from the hospital. The interns and ICU nurses actually had a party for him. With cake!

Three days later, he was back in the ER with a new abdominal problem. This time he had been stabbed.

He actually looked sheepish. He knew how much literal blood, sweat, and tears had poured into his care. Then we did what we do; we took care of him. But we were deeply disappointed.

The care was simpler this time. Knife wounds are ever so much easier than shotgun wounds. A few weeks later, Archie was discharged again and we never saw him again. Maybe he mended his ways. Or maybe he moved, or maybe he died after the next injury. I don’t know.

What I know is the change in us, his caregivers. We lost a certain enthusiasm for our unbridled altruism, recognizing that sometimes we care more and work harder at fixing our patient’s injuries than they work at saving their own lives.

Or that’s the way it seems. Another way of saying this is that we could fix complicated abdominal injuries, but we couldn’t fix addictions and broken neighborhoods and broken relationships, and if those things don’t get fixed, all our other efforts are in vain.

Maybe that’s something like what Jesus felt. Every effort falls short unless “the Kingdom comes.”

A few months ago I went hiking in the Smoky Mountains with my friend Gee. We experienced wilderness solitude and a healing miracle. We tested our physical endurance and renewed our appreciation for simple things like food, water, shelter, and rest, and explored a fast from all the other things we liked but didn’t need: TV, electricity, cars, hot showers, cell phones…No, wait, maybe we did need cell phones.

The fourth and last day should have been the easiest, and it started out that way. We got up, ate breakfast, and walked about five miles on mostly flat trails. The several stream crossings were very doable, and we reached a campsite at the edge of Lake Fontana around 2pm, well ahead of schedule. I had arranged for a motor launch to meet us there at 4pm and bring us to the marina where the truck was parked. If all went according to plan, by 5pm we should be on the road home.

We ate the last of our food, took off our boots, and stretched out–resting, meditating, enjoying the sunshine and blue sky under the shade of a giant sycamore tree at the edge of a calm lake. We prayed thanks for a great trip, and for guidance in our future steps. This seemed like the perfect end to a renewal in the wilderness–a real “mountain top experience.”

Around 4PM, I put on my boots and packed away the sleeping pad that had given me comfort. I started listening for the sound of a boat motor. Around 4:15, I decided I had misunderstood, and the pick up time was really 4:30. Around 4:45, I realized the boat wasn’t coming. In other places, a cell phone call would fix the problem in a minute, but Fontana Lake, we discovered, is a blessed and cursed by cellular silence. We would have to walk out.

The Lakeside trail to the top of the Fontana dam has no net elevation gain or loss, but the five plus miles from Eagle Creek are marked by steep ups and downs. Fast hiking would be impossible for two senior citizens with packs. Sunset would be at 6:45, but here on the east side of the ridge, darkness in the forest would come earlier.

We walked the last thirty minutes in complete darkness, our headlights giving us just enough illumination to stay on the trail. Antique auto body shells, crashed in the woods ninety years ago when the trail was still a road, eerily appeared in the shadows. At last we made it to the parking lot that marks the junction to the Appalachian Trail and the gravel road spur to the Fontana dam. We stashed our packs off the road behind a tree, hiding them from opportunistic thieves, but we needn’t have troubled. The parking lot was deserted, as was the gravel road, the Fontana dam, and the remaining three miles of paved road to the marina parking lot. Not one person, not one moving vehicle. And, except for the streetlights on the dam, the night remained pitch black.

We made it to the truck and returned to retrieved our packs, then started driving toward home. By now we were about three hours overdue check-in with our families. We knew they would worry, and soon the Park Service would be called to report us as missing hikers. But the cell phone black hole continued for nearly an hour after we left Fontana.

Finally, around 10 PM we reported ourselves to be alive and well. Shortly afterward we found a reputable chain hotel with a vacancy, and immediately after that started looking for food.

I’m always hungry after four days of hiking, and especially so after missing dinner and hiking an extra eight miles or so in the dark. The only place open was the local Waffle House.

A Waffle House at a rural crossroads in eastern Carolina around midnight on a Friday can be a scary place, a dive with unhealthy food and dangerous people, and nothing like how the day started–walking along a sunny stream in the Smokies. We found a rusted pick-up truck in the parking lot with a caged and howling hunting dog, an Elvis impersonator at the counter inside, a middle-aged couple dressed like teenagers and carrying motorcycle helmets, and a very short and very round elderly waitress with a short pencil and shorter attention span. Nobody we met lacked visible tattoos.

The mountain top experience was gone. I got the cheeseburger with fries and a malt, and cleaned my plate. Gee got the “Big Breakfast”–eggs, bacon, pancakes, grits–and at least had the good sense to leave some of it uneaten. We could have been mugged in the parking lot, or died of coronaries before we got back to our hotel. But this time, the Waffle House wasn’t scary. It was a place filled with people who, like us, a little dirty, a little desperate, and a little lonely, found food and fellowship and light in the darkness. An outpost for the Kingdom to Come. 

A Little Faith

Then the disciples came to Jesus in private and asked, “Why couldn’t we drive it out?”

He replied, “Because you have so little faith. Truly I tell you, if you have faith as small as a mustard seed, you can say to this mountain, ‘Move from here to there,’ and it will move. Nothing will be impossible for you.” (Matt. 17:19-20, NIV)

Jesus had previously commissioned the disciples to “Heal the sick, raise the dead, cleanse those who have leprosy, drive out demons.” (Matt. 10:5, NIV). When Jesus returned, they couldn’t understand their failure. They had to know.

One of the most common spinal conditions I cared for was a herniated lumbar disc. The results in a typical case were gratifying–90% of patients felt improved and returned to normal activities. But 10% didn’t, descending into a nightmare of chronic pain and disability, and the reasons for failure were often obscure. Sometimes I felt the failures were my own–misdiagnosis, clumsy handling of the delicate nerve, failure to remove enough of the disc, or even removing too much disk or too much bone during the exposure. More often, I could tell no difference between the operation I would do on a successful case from the operation on a failed case. Nevertheless, failure was always personal. I wanted desperately to know why this time I couldn’t drive out the demons of pain and disability.

Jesus gave the disciples a cryptic answer: Because you have such little faith.

Whatever could that mean? They had apparently faced similar problems before quite successfully. They had given up their jobs and homes to follow Jesus. What did more faith look like?

I don’t know. But I think the mountain he was talking about was the mountain he has just come from–the Kingdom of God mountaintop experience of being united with our Father and the saints. If you have faith like a mustard seed, you can move this mountain of misery to the mountain of the Kingdom.

One of the most difficult things for a surgeon to do after a failure is to see the next patient. When I walk out of the room of one patient still in pain weeks after what should have been a successful operation and go to the next room of a patient in pain after weeks of non-operative treatment for the same condition, sometimes it’s hard to turn the doorknob. I know what is most likely to give the patient relief and I know it is an operation that I am trained to do–as well as anyone in the world–and I know what the patient wants and what medical science recommends and what I am going to say. But sometimes it’s hard. Because after the doorknob is turned, and I step into the room, everything else will happen, and the results will be on me, and at those moments I have little faith, no bigger than a mustard seed, and I don’t want to do it.

Then I turn the knob, take a step into the room, hold out my hand to theirs, and listen. We do the examination and look at the images, and we work out a plan together. And, most of the time, the mountain of pain and disability moves from here to there. Then, to one more little corner of creation, the Kingdom comes.

Big Man Down and the Procession of Life

There was a man in New Haven known for his size, his vast appetite for food and drink, his violence, and he feared not man nor God.  He stood six-foot-six and weighed an estimated 400 pounds.

One night he angered his girlfriend.  She revved his car, a sizable 1970’s style sedan, and threatened to run him down on Howard Avenue.  He stood in the middle of the street and dared her to do it.  She made one pass and swerved at the last minute narrowly missing him.  She turned the car around, and he laughed, daring her to try again.  This time she didn’t swerve and she didn’t miss.  After the impact he was dragged another full city block before falling free in front of the ER entrance at Yale-New Haven Hospital.  An ambulance still had to be called because none of the hospital personnel who rushed out could lift his massive frame onto a hospital gurney.

Once in the emergency room, he proved equally difficult to evaluate.  He was too large for the CT scanner, and X-Rays penetrated his thick flesh poorly leaving blurry images and much guessing about internal injuries. Cervical spine x-rays had been able to penetrate only as low as C-3.  Normally all seven cervical vertebrae can be seen on x-ray, or in very large individuals perhaps only five or six, but in his case the lower four vertebrae were completely obscured by his massive shoulders.

One thing that was clear: he was paralyzed from the waist down from a fracture at the lower thoracic/upper lumbar spine.  Surgery was scheduled for the following day.

The operation was long and difficult with much blood loss. Whether it was successful or not became quickly irrelevant when he woke in the recovery room now paralyzed from the neck  down.  Further efforts at x-rays of his cervical spine determined that he had a fracture at C-4 and now a new cervical spinal cord injury.  Unable to breathe adequately, he was left on the respirator, an endotracheal tube placed during surgery remaining as his airway.

Up until this point I had little involvement in his care.  My primary responsibilities were in the research labs, and I covered the clinical patients only one night per week and one weekend per month.  But when Saturday rolled around, he was still intubated, and dependent on the respirator in the Neuro ICU, and I was the sole resident on-call for the weekend.

On Saturday morning rounds, the staff neurosurgeon, also covering for the weekend, told me the patient needed a tracheostomy and we should do it that day.  I had done enough tracheostomies–the procedure itself didn’t intimidate me–but this case frightened me.  I argued that the procedure would be difficult, and ENT consult should be considered, and it wasn’t an emergency.  The procedure could be done the following week when plenty of back-up help was available, perhaps even in the OR where adequate light and and equipment would be available.

The surgeon would have none of it.  Back then, neurosurgeons did tracheostomies on their own patients.  To consult ENT or another surgical service would a sign of weakness, and neurosurgeons never admit to weakness.  Why mess up a busy operating room schedule with an annoying procedure like a tracheostomy that could be done off hours in the ICU?

I argued my other responsibilities to the seventy-odd patients under my care.  He simply said to call him as soon as my routine work was done.

My routine work was not done until six PM.  I called the staff physician, hoping the late hour would put him off, but he remained undeterred.  He showed up a the NICU at eight PM determined to help.

A trachea is normally immediately beneath the surface of the skin at the throat, often less than a quarter inch from the surface.  In this patient the trachea was a good four inches deep in the neck.  The standard retractors and indeed the tracheostomy tubes themselves were too small.  The light was poor, and we struggled for two hours over a procedure that normally takes thirty minutes.

At last he had an airway in the trachea.  I sutured it in place and tied it around his neck for good measure.  The staff physician went home, and after fielding the calls and tasks that had accumulated during the time I was involved in the procedure, I went to bed.

At two AM, the phone rang.  The patient had coughed out his airway and was now in respiratory distress.  I ran to the NICU and tried to replace the tube, but after the recent procedure the path from the skin to the trachea is no longer easy.  All the recently dissected tissue planes provide false passageways even in normal individuals.

I struggled to find the trachea and a tube large enough to reach it, but working alone and with poor light, I was frustrated and unsuccessful.  His breathing became more and more labored.  I called the resuscitation team, but they too were unable to re-intube him in the conventional manner.  His heart rate slowed and he lost consciousness as I struggled to find his trachea.

Then he died.

It’s a great thing to do a good tracheostomy.  Lives are saved in hospitals (and sometimes restaurants) frequently.  But sometimes it doesn’t work.  It’s been over forty years.  I stood between the big man and his death, and I failed.

I didn’t kill him exactly.  His girlfriend in her fury bore the legal responsibility.  Alcohol intoxication, lust, anger, and hubris (standing in front of a speeding car twice!) had a lot to do with it.  And I was only the last person in a line of medical providers who failed to stand between him and the hereafter, and between the girlfriend and a murder charge.

There is a poignant story in the Luke 7:11-16 in which Jesus and his followers are entering the town of Nain just as a funeral procession meets them on the road.  The dead man is the only son of a widow. Jesus, against all common sense and against the Jewish tradition that to touch the dead that renders one ritually unclean, stops the procession, touches the body, and raises the young man to life.

It’s an easy story to slide over.  Jesus was healing people all the time; now he stepped up the game and healed a dead kid, a widow’s son no less.

And it is all of that.

But Jeff Hoy in his Words of Faith (Stopping the Procession. Words of Faith.5-11-18.Dr.Jeffrey D. Hoy © 2018 draws attention to the metaphor.  Normal life in the world is a procession toward death.  It’s where we’re all headed.  We fear it, we avoid thinking about it–we don’t touch it.

We handle our despair in different ways.  Some of us party–eat, drink and be merry, for tomorrow we die.  Some of us exercise, diet, take vitamins, avoid germs, obsess about safety, putting off for today the looming disaster of our end.  Some of us become religious, earning our place in heaven so we don’t have to worry about our end on earth.

Some of us, for example, me, learn about medicine and how to cheat disease and death, and, as we win daily battles, we hold onto the illusion that we will win the war.  But sooner or later, we meet the procession of death.

Backed by 2500 years of medical tradition, a 500 year history of surgery, an armamentarium of drugs and surgical procedures, my medical procession is powerful against impending death.  I put out my hand, I touch the corpse, the boy rises, the procession stops.

Sometimes.  This time I put up my hand, I touched the corpse, and the procession rolled over me.

Because I’m not Jesus.

In reality, the death procession never stops.  The medical procession can only slow it down.  The death procession only stops when the people weeping and wailing and those carrying the coffin stop believing in chaos and death and start believing in purpose and life.  Believe you are a child of God, believe you are loved, believe you are made for a purpose, believe that when your body dies you will exist on a new plane of experience–even when all that belief is beyond your intellect and your sensory experience.  Then the procession stops.  Then you can turn around and join the procession of life.  You can walk with Jesus.

The death of the big man with the failed tracheostomy is but one of many experiences that haunt me after forty years in medicine.  The sense of failure is pretty big when someone dies and you feel like you could have, should have, done something better to prevent that death.  It is easy to slip into despair camouflaged as a supposed “realism,” which is only cynicism after all.  One learns to go on, live in the moment, do the good one can do, and let the rest go.  It’s possible to live like that.

But if I want to live with joy instead of despair, I have to turn around and join the procession of life.  I have to walk with Jesus.