Gray Matter

by Kilpatrick, Joel;Levy,David

  Nothing had changed about how I performed surgery. I still strove to be the best and took great satisfaction in complex cases that required high-level skills and performance. Nevertheless, the way I related to patients had changed forever—with consequences I could never have expected.

  Chapter 3

  Introducing Spiritual Care

  One day the receptionist at my practice came back to my office looking puzzled and a bit uncertain.

  “There’s a woman here to see you,” she said. “She doesn’t have an appointment, but she says you operated on her a year ago.”

  This was unusual—most people don’t just drop in on their neurosurgeon—but I had a few moments to spare in my schedule.

  “Send her back,” I replied, wondering who this woman might be and what was so urgent that would make her come by unannounced.

  Moments later a former patient entered my office. I immediately recognized the confident woman and remembered her case. Her name was Joan. She was petite with dark hair and looked much younger than her advanced years. She had taken good care of herself, and she had the appearance of someone in control and perfectly put together. She had been referred to me because a dangerous aneurysm had been discovered in her brain. Instead of being a single round ball, the aneurysm was multilobed with a wide neck. This type is harder and riskier to repair, and you never know if you can do the surgery without blocking the main blood vessel. We had spent a lot of time going over the pros and cons of doing the procedure, in light of her age and ability to endure and recover from it. With nearly eighty-year-old vessels, she could easily have had a stroke if devices were maneuvered through them.

  The aneurysm looked ugly, as though it could bleed at any time, and I did feel she should have it fixed. But given her age, I could not suggest one course of action more strongly than another. I could only provide the statistics and let her decide. She had brought her family in to help her make the decision. After deliberating, they decided to go forward with surgery. I prayed with her before and after the procedure. At that time, she let me know rather firmly that she didn’t believe in God but that she did not mind if I prayed for her.

  The surgery went well. Joan’s follow-up examination had indicated no lingering complications. There was no reason to see me again. Yet there she stood in my office, one year later, looking a little out of place but self-possessed, as I remembered her. Her words were unexpected.

  “I came here without any makeup and without an appointment because I just needed to see you,” she said. I had no idea what to make of her urgency, so I did what most smart doctors do: I leaned back against my desk, put my head to one side, and listened.

  “At my last appointment after the surgery, I asked you a question,” she continued. “I asked why most educated people don’t believe in God, and you said you thought it was because they were arrogant.”

  I nodded and smiled. That did not sound like something I would have said, although I did remember her asking the provocative question. Whatever I had said, this was her interpretation of it.

  “I can’t get what you said out of my head,” she exclaimed, glaring at me with irritation. I didn’t quite know how to respond, so I decided to take a safe path by eliciting some general information.

  “Tell me how things are going in your life,” I asked.

  “Not very well,” she sighed. “My husband had a stroke recently. It’s been causing us trouble. He’s not recovering like we hoped he would. Life seems to have taken a turn for the worse for both of us. We don’t know where to find answers.”

  She paused.

  “I needed to talk to someone about faith,” she said, in a tone of embarrassment.

  The irony of this conversation did not escape me. I had not seen her for a year and didn’t expect to ever see her again. Yet when Joan needed someone to turn to in her time of deepest need, she chose to confide in me—her neurosurgeon. Without her makeup, no less.

  “Tell me about your faith,” I said, giving her an open door to talk about her concerns.

  “I don’t think I can believe in the Bible,” she replied, charging right into the crux of her dilemma. “I don’t see how I can believe in Jesus. So many highly educated and intelligent people think it’s simply a myth.”

  Realizing that this conversation would probably need to go beyond the five minutes I had to spare, I knew I had to postpone it while I took care of a patient who actually had an appointment.

  “Joan, I need to meet with another patient. That should take about thirty minutes, and then I have a break for lunch,” I said. “In the meantime, take this pad of paper into the waiting room and write down all the reasons you don’t believe in God. Write down anything standing between you and God: people who have hurt you, people who were supposed to represent God and did it poorly, things you prayed about but didn’t get, painful experiences, and anything you feel guilty about.”

  Something else occurred to me. Joan’s resistance to faith might stem from valuing too highly the opinions of educated people, many of whom considered faith to be a fairy tale, something only the unsophisticated would believe. Based on our previous conversation, I knew she had such people in her family.

  “I want you to do one more thing too,” I added. “Ask yourself whether, if the story of Jesus were true, you would want to believe it. You may find many reasons why, even if it is true, you wouldn’t want to believe it. You may not want to be ‘one of those people.’ You may not want to lose the respect of people you love. Maybe you don’t want to be religiously or politically stereotyped. Maybe you think that to believe God came to earth would be to deny your intellect. Whether it’s true or not may not be the issue. You may not want to believe it.”

  Startled, Joan looked at me as if this question had never occurred to her. It was as if I had switched on a light in a room she had never seen in her own house. I also sensed fear that if she came to believe, she might be the only one in her marriage, family, or social circle who had faith. She was wisely counting the cost, and it appeared steep. She took the paper and walked out. Part of me wondered if I would ever see her again.

  When I was finished with my other patient, I walked out to the waiting room. Joan was sitting there with the piece of paper covered in her handwriting. She handed it to me. At the top of the page it read, somewhat momentously, “My List.” We walked back to my office and I began to read. First on her list of objections were her parents, particularly her mother, who had been unkind to her throughout her childhood. Joan saw hypocrisy in the church they attended, where many people, including her parents, kept up appearances while acting badly at home. When she was fourteen, Joan decided her parents’ view of God couldn’t be correct and went on a spiritual journey to find God, attending several churches. She then found a boy she liked who didn’t go to church, and she stopped searching for God. She felt that she had made a reasonable effort and had come up empty. Besides, this boy seemed like a better deal.

  The boy Joan met would become her husband. She was only fifteen when they began a physical relationship. She felt justified rebelling against her parents’ rules and morals because of her failure to find God and because of her parents’ hypocrisy. Even so, deep down she felt ashamed and guilty, which pushed her further from God. That was sixty-five years ago. She had never again searched for God, until now. She had noted at least one affair on the list, with her family doctor, who had told her sex would help her depression. It worked for a while, until he shot himself.

  For some reason, I felt free to speak openly with Joan. After all, this time she had come to me not as her physician but as a spiritual counselor.

  “Did you feel guilty?” I asked.

  She had obviously been thinking about what started her on this godless journey and answered quickly, “Oh, it was terrible. I would see my mother in the kitchen and I could have just died, I felt so guilty.”

  “The reason we feel guilty is usually because we are guilty,” I said, not knowing how she would respo
nd. Perhaps she would storm out of my office. I continued, “We are guilty of going against what we know is right, even if we justify it because of what others do or say. God calls it sin. The good news is that there is a cure for guilt and sin. It is confession and forgiveness.”

  She shook her head rather violently.

  “I won’t do that,” she said. “I don’t see sin that way.”

  Joan’s resistance was vehement. I have learned from doing surgery that when you meet resistance, you can’t keep pushing harder. Instead, you try to understand what is blocking your way. When operating in the brain, pushing harder can burst a blood vessel and kill the patient. Regarding spiritual matters, also, I believe that pushing when you meet resistance causes more harm than good.

  I scaled back our conversation. Looking at her, I thought about how in control she wanted to be. Many people would have envied her had they seen her in public or met her at a social function. She had an elegant demeanor and exuded a quiet inner confidence. Nobody could see the hidden turmoil raging inside.

  “I think the reason you’re here,” I responded after a quiet moment, “is that you’ve been able to control everything in your life up to now. You’ve made things work. You have been able to keep God out of your life because your health has been good and your marriage has been good. Even your aneurysm treatment went perfectly. Everything has been working for you. But that facade is falling apart. Now that your husband is debilitated, you are asking whether there could be anything more to life. I imagine you came to me because you are asking yourself when you last saw someone with hope.”

  She agreed with me in her silence. After a few moments she responded.

  “I know I haven’t lived a perfect life,” she said. This was a familiar phrase to me. In essence sin is simply missing the mark or not being perfect. People prefer to think of it as an honest mistake, instead of a willing choice. They often cannot tolerate the word sin because it implies that someone is judging their actions. Instead, they use softer, more palatable euphemisms, as Joan was doing.

  “To get rid of the guilty feelings, I bet you shut down whatever faith you had,” I continued. “You stopped looking for God. You didn’t want it to be true.”

  I seemed to have told the story of her life, and she seemed to be listening.

  “So, what do I do?” she finally inquired.

  My reply was heartfelt: “I would love to help you with your sin, but I can’t, because I have my own. What you need is someone who has no sin, someone who lived a perfect life. Then he would be able to pay for your sin because he has none of his own. That is why Jesus came to earth, lived a perfect life, and died—to get rid of whatever sins and guilt are blocking you from being in relationship with God. He actually wants to take your guilt from you and leave you free from shame. Guilt comes naturally when we sin, and you can try to pay for sin yourself by feeling shame, or you can let Jesus pay for it and be forgiven. I believe that he really wants to forgive you, but it requires confession.”

  She thought a moment, looking doubtful, but then seemed to conclude that she wasn’t going to leave without trying something. After all, desperation had driven her to my office in the first place.

  “Do I have to?” she asked.

  “No, not at all,” I replied, “but I don’t know any other way to get rid of guilt. I can help you find excuses for what you did to try to make you feel better, but I can’t forgive you. The fact is you have already spent years justifying what you did—including trying to convince yourself that there is no God—and claiming that you are not guilty. But here you are, still feeling guilty.”

  “What about other religions?” she asked, and I was not about to push her into something she was not ready to do.

  “You are welcome to investigate other religions,” I said. “Take all the time you need. The questions I think you need to ask of each one are, ‘How do I get forgiveness?’ and ‘How do I know I am forgiven?’”

  “Okay,” she said softly.

  “Would you like Jesus to pay for your sins?” I asked.

  “Yes,” she said.

  “Do you need more time to think about it?” I asked.

  She shook her head and replied, “No.”

  “Do you want me to help you talk to God?” I asked.

  “Yes,” she said.

  I began to pray on her behalf while Joan looked out my office window, deep in consideration.

  “God, you know everything about Joan,” I said. “You know the good and the bad. Only you have the power to take away our guilt and to forgive us. Joan would like to do that now.”

  “Joan, think about what I am saying, and if you agree with it, you say it. ‘God, I have sinned.’”

  After a moment she said, “God, I have sinned. I knew what I was doing was wrong, but I did it anyway.”

  She paused, contemplating carefully, and then said again, with conviction, “I knew what I was doing was wrong, but I did it anyway. Forgive my rebellion.”

  We continued, with me offering suggestions and Joan stating them in her own words: “Jesus, thank you for paying for my sins so I can be free of my guilt. Thank you for forgiving me like you promised. Amen.”

  She was still staring out the window. She did not look any different. She showed no sign of emotion. There was not even a hint of tears. She remained stiff, prim, unflappable. Still, I marveled at this intelligent woman who, decades earlier, had walked away from God for a boy who didn’t want God. Disbelief had left her unfulfilled. Now she was searching for God again and was ready to give faith another chance.

  “I feel a lightness,” she finally said, “like I have a cloud inside me.”

  She stood there experiencing this euphoric, peaceful feeling, seeming to analyze and enjoy it at the same time.

  “You are feeling some of the joy that God feels now that you two are talking again,” I said with a smile. “Sin is God’s least favorite subject. He must deal with it to remove your guilt and convince you that nothing is blocking the relationship between you. But he really wants to hear you speak to him about what matters to you. That’s what prayer is.”

  “How do I . . . start?” she asked.

  “I usually start with gratitude,” I said. “It helps my mood and stops me from focusing on negative things. Just tell him what you are thankful for.”

  She shifted in her seat. “Well, God, . . . thank you that I’ve been healthy most of my life. And my aneurysm surgery went well; I’m thankful for that.”

  “That’s a great start,” I said. “There is so much that we take for granted. What else? If I get stuck, I start with my eyes. There are a lot of people who cannot see.”

  “Yes, thank you, God, that I can see and hear and walk,” she said.

  “Don’t forget your mind. Not everyone has a sharp mind at your age,” I added.

  She went on giving thanks for a few minutes, becoming more joyful as she realized all that she had been taking for granted.

  “My granddaughter, the apple of my eye—I am thankful for her.”

  “You know,” I said, “the way you think about your granddaughter is the way God thinks about you. He adores you.”

  “Really? I never thought of God like that.”

  “He would also love to hear about anything that concerns you, like your husband’s illness,” I said.

  Joan then spoke to God with confidence about her concerns for her husband.

  Finally, I said, “Any good relationship requires both talking and listening. I think you already know how to listen to God.”

  “I do?” She sat up straight, surprised.

  “Why else would you rush in to see your neurosurgeon to talk about faith, with no appointment—and no makeup?” I smiled. “Who do you think gave you that idea?”

  She raised her eyebrows. Indeed, this had not been like her.

  I felt deeply thankful. I had witnessed something priceless. My day had taken an unexpected but wonderful turn. Joan stepped forward and hugged me somewhat fo
rmally. Then I walked her to the door. As difficult as she was to read, I could tell she was a different woman from the one who had barged into my office earlier. Her presence felt easier, fresh and new. The lines in her face were softer. I don’t often get to see the results of my providential encounters with patients, but I had just watched a woman move toward the One who, out of his great love, could forgive any sin and free her from the guilt and shame she carried. I cannot think of a better way to use my lunch hour than to help someone talk to God—because once the two of them are talking, the possibilities for healing go way beyond me.9

  * * *

  Once I began praying with patients, it didn’t take long to realize that I would not actually get to observe a change or difference in the lives of most of them because our interactions were necessarily brief. There was no reasonable way to follow up with them even for medical reasons. I rarely got a bird’s-eye view of their faith journeys—I was privy to only a small snapshot along the way that took place during extraordinary circumstances. All I could do was offer some semblance of peace during a time of crisis and perform the procedure to the best of my ability; most went their own way to recover. No one could blame them for wanting to stay away from hospitals after what they had been through. If they were impacted by our interactions, I had no way to know unless they sent me a card or note in the months after surgery. Enough people thanked me that I felt encouraged to keep going, but I assumed that I was making little difference in the day-to-day lives of most people. I rested in the knowledge that I had given them all I could to make their lives better, even if some might find it odd that their doctor would pray.

  Occasionally, patients did come back to the hospital to share their stories. One kind woman in her sixties, Gloria, came by my office to review a follow-up scan. I had last seen her six months earlier and had counseled her about a benign tangle of extraneous vessels in the back of her head, as well as some small aneurysms we were following with scans. Her follow-up scan showed no change in the aneurysms, and we decided not to pursue surgery.