Why health is more than medical care

Why is health more than just medical care?  Here are some reasons:

  1. Medical care tends to address matters of the body but not of the spirit. As medical professionals we are trained to diagnose, treat and manage medical conditions. We seek to apply scientific evidence to our craft.  And yet health is something more than science, scopes and surgery.  The best doctors and nurses treat the person, not just the disease.  Illness is not just chemistry and biology; it includes the non-material aspects of existence, such as meaning, dignity and reconciliation.
  2. Health is an outcome of many complex factors, not just medicine. These include things like nurture, nutrition, good housing, healthy relationships.  The reduction in deaths from infectious diseases in the West, for example, was mostly due to non-medical factors, not antibiotics.  Again, the evidence is that the best correlation with worldwide infant mortality is the educational level of the mother. Those who want to improve health of populations must think beyond individual care to the social and enviornmental determinants of disease.  Health is more than just medical care.
  3. Ultimately health is not ‘controlled’ by any one discipline or profession. As health professionals we have a fairly narrow focus – to treat or manage conditions in individual patients.  But health — since is is more than the absence of disease but the well-being of people — results from more than our medical tools.  Smoking, gun violence, human traffiking, poverty, inadequate vitamin A in the soil, deforestation, natural disaster — all contribute to human suffering and poor health!
  4. Health is about dignity, not just treatment. While excellent medical treatment is essential, not all conditions are curable, and some remain fatal. Even when we can’t cure or treat, our work must sill say, “You are a person. You are made in the image of God!” Restoring dignity must be part our motivation.  We are not treating machines, but human beings. Too often in our bio-psycho-social disease model we think mostly about physical treatment.
  5. Ultimately, health is a blessing of God, who created the body and also gave it tremendous powers of healing.  The tagline at a mission hospital in Chiang Mai, Thailand reads, “We treat. Jesus heals.”  We have the privilege to serve in medicine in humble ways to alleviate suffering; but in the end it is our Lord and Creator who gets the glory.

I welcome hearing about your reasons for thinking beyond medical care to health.

A cheerful heart is good medicine

In medical school I learned that the death of a spouse is a risk factor for one’s death, and many times the surviving spouse dies near an anniversary of the sad event. The connection between our soul and body is closer than we can imagine. The book of Proverbs says it this way: “A cheerful heart is good medicine, but a crushed spirit dries up the bones.” (Proverbs 17:22).

Increasingly science is recognizing the intimate connections between the heart and the body. A crushed spirit dries up the bones. Brokeness can be emotional, relational or spiritual; whatever the cause, it impacts the body. It can a factor resulting in high blood pressure, anxiety, cardiovasular disease, autoimmune disorders, cancer, etc.  All of these things have multiple causes (genetic, environmental, and so on) but the condition of the spirit is a vital factor.

Modern medicine has brought us some marvelous physical interventions, from drugs to CT scans. And while we are grateful for these, we must not overlook the effect the heart can play.  All of us in general practice have seen cheerful hearts which bring healing, and crushed spirits that dry up bones.

I’ve seen nurses literally bring patients back to health by the care they demonstrated to the sick. On the other hand I have witnessed others who see their role as a job more than a service of love. Love becomes a powerful medium for healing. “A cheerful look brings joy to the heart, and good news brings health to the bones.” (Prov 15:30).  What a privilege to see health professionals who give not just technical help, but sacrificial love.

Where does one get such a cheerful heart? Ultimately the source is not in ourselves, but in knowing the sacrifice which God has made for us in history. The objective fact is that Jesus Christ came to earth to give His life for our sin and rebellion, rising to offer hope and new life.  This Easter week we are celebrating not just the idea of resurrection, but the historical fact of the resurrection of the Son of God.

That kind of cheer just doesn’t go away.

Too much to do? Time to re-examine our own assumptions!

Stress and burnout are recognized themes in medical missions.  One source of stress is the sheer magnitude of physical needs; one billion people in our world have no access to a trained health worker and healthcare workers often stand in the gap.

In the face of overwhelming need how do we maintain healthy margins?  Overextended, we lose our compassion, damage relationships, and often leave our fields of service early.  Yet, the pressure is there, since the patients show up, the children are literally dying, and there is often no alternative for those who are the most marginalized.  Wouldn’t Jesus have compassion on the sick and dying?

In the late 1980s I was in a similar situation in southern Ethiopia, where I was called to lead a small team to treat patients dying among the Mursi tribe; hundreds were dying around us from meningococcal meningitis.  While we had some effective antibiotics we couldn’t get ahead of the need – patients were dying faster than we could treat them.  In our case, the answer was not so difficult, as the Ethiopian ministry of health asked us to bring along their workers and meningitis vaccine; thus we were both able to save many who were ill, but also prevent new cases with vaccine.  Caring for the ill and prevention went hand in hand – with a team approach.

But what about a hospital or clinic where the people come each day and yet the facility and staff are still overwhelmed?

One approach has been to assign numbers to non-emergency patients to limit those who can be seen on a given day.  Other barriers have been erected, such as raising fees – although this limits care to those who are most vulnerable and thus tends to defeat our purpose.  Outpatient clinic hours can be trimmed.  Specialty clinics can be opened only certain days.  All these efforts are ways of establishing boundaries and limits.  Some are needed; some are painful.

Yet, our hearts as medical providers are driven by compassion; we want to see as many as possible.  Compassion is from the Lord, and our instincts may be noble. But unexamined assumptions may contribute to our own burnout and long term lack of fruitfulness.

As medical healthcare workers and missionaries, do we recognize our own limits and vulnerabilities?  Or are we driven by a “Savior” complex where we must be the answer to everyone’s need?  Do we allow the needs to constitute our call, or does Jesus Christ shape the call?  If we are called and empowered by Him (as the true vine) then we (as his branches) can only produce eternal fruit as we allow Him to work through us.  Yes, this kind of ministry can be overwhelming, even impossible.  Are we connected to Him as the vine well enough that the life-giving grace of God gives us wisdom and strength?  Or have we subtly become “the vine” ourselves in the midst of the needs?

We do want to give our lives for others.  Good.  But our own wisdom and strength quickly fades and we must come to Christ and His word.  We might have the desire to “burn out for Jesus” but taken to the extreme we will damage our family and other relationships.  Exhaustion and callousness on a chronic basis are not the ‘living stream of water’ that Jesus promised would come from our hearts!

What is our ultimate purpose in medical missions?  It is to glorify Jesus Christ.  We become like a seed which falls into the ground; it must die and spring up with new life.  My hospital, my program, my health teaching – these are all means God uses to show His character through suffering and healing, to make disciples, to enable others to connect to the vine – ultimately serving others by God’s grace.

We must reflect on this ‘Me-first’ mentality.  Do we assume that these health ministries are about us and our ability?  That’s a prescription for the prosperity gospel!  Let’s not promote a false gospel based on our works rather than grace.

The ultimate purpose is to establish God’s reign, God’s kingdom on earth – or some small signpost of the kingdom in a broken and twisted world. We can make a real difference. However it is not by our trying hard enough, but by abiding in the Vine. We don’t want to plant our program; we want to plant the mission of Jesus.

Health is not just about the physical needs of those who come to us, but about their social, economic and relational needs. I fear that too often we apply a Western mindset [think separation of physical from spiritual/non-physical reality].  One way of creating more helpful margins is to actually involve local staff and others from churches and community in the care of those who come to us – enabling them to connect with our programs as whole people, not just disease conditions.

This takes building leadership for healthcare missions, not just adding medical practitioners.

Eventually this means we work with local doctors, community, nurses, churches, believers – to build healing communities. Only through teamwork can we begin to meet the overwhelming needs of those around us in a deeper way.  And yet in this way – as we die to our own ambitions – we are enabling others to see and to know and to serve the Lord Jesus Christ.  He is the King and Savior and healer and He is building His kingdom. We get the privilege to be a small part of His work. He is worthy!

“…not merely a doctor”

“The doctor has so objectified himself that he never faces up to himself and his own life at all.”

“Somewhere in Pembrokshire a tombstone is said to bear the inscription, ‘John Jones, born a man, died a grocer.’ There are many whom I have had the privilege of meeting whose tombstone might well bear the grim epitath: ‘…. born a man, died a doctor’! The greatest danger which confronts the medical man is that he may become lost in his profession.”

D Martyn Lloyd Jones, in “Healing and the Scriptures.”

Dr. Martyn Lloyd Jones was a brilliant British physician and an outstanding preacher, and offers great medical wisdom and spiritual insight. This book was published in 1982 but still contains “a masterful view of the Christian physician’s calling, and of the dimensions of ministry to the whole man.” (Quote from J.I.Packer).

How often our identity is tied up with being medical professionals. Lloyd Jones challenges us to view success not merely as the accumulation of medical knowlege, reputatation and material wealth, but fruitfulness for Christ and His kingdom. The foundation of our identity must be in God, not ourselves; we are creatures made in the image of God and created for fellowship with God — all of which is only possible through the salvation obtained by Jesus at the cross.

Dr. Lloyd Jones says to us, “I beseech you not to allow the profession to make you forget yourself, that you are a man, and not merely a doctor.”  And to bring the vocabulary in the 21st century, we’d say, “you are a man or a woman, not merely a doctor!”