My Relationship with My Healthcare Provider

I.

The only way you could have missed information about healthcare in the United States for the last several months would be if you locked yourself up in a remote cabin without any connection to the outside world. There are citizens of our country who believe that only those who can pay for it deserve the highest quality health care--or any health care at all. If services for the indigent aren’t available, well, suffering is a part of life and so is death. Providentialists in that number, those who believe that God has willed everything good and bad, go so far as to say that those who die way before they have lived a full life, because healthcare was unavailable to them when they were ill, die because it is God’s will that they die. That’s an easy way to get off the hook huh?

Then there are those US Americans who believe that health care is something every human being deserves--every human being, I said; not just citizens of the United States. These folks tend to believe, further, that levels of healthcare are not acceptable. In other words, people with cheapie health insurance can’t be denied a major, potentially lifesaving procedure, because they have a maroon plan instead of a gold or silver plan. Researchers giving their lives to try to find ways to save people’s lives aren’t slaving away in their laboratories thinking, “If we just work hard enough and long enough, the rich people can be healthier than they have been in the past.”

When medical care became a bedfellow to big business, healthcare went in the wrong direction, lost its bearings, and it’s never recovered. My friend, Ricky Grisson, Dr. Ricky Grisson, who is nearing the end of his residency in pathology at Mass General, got to Harvard to begin work on his M.D. credentials, and what he saw there, built on a year’s internship he did with Merk Pharmaceuticals, between university study and med school, convinced him that he would never be able to do what he hoped to do medically unless he understood how big business influences and, sometimes, controls decisions that should be entirely medically based. Thus, he interrupted the pursuit of his M.D. for eighteen months so that he could move to Emory University and complete an M.B.A.

In these last months of bitter political debate about who deserves what in terms of healthcare, who should pay for it, and should healthcare be one of the highest achievers in profitability in our country’s economy, we’ve seen businesses and politicians who’ve been making big bucks along with some of the highly specialized physicians resist most vigorously the notion that the processes of making people well must take a back seat to cash flow. We all knew that’s how it worked, but it was disconcerting to have it all laid out so clearly, so unmistakably.

This week, healthcare companies complaining about how broke they’ll be if all aspects of healthcare reform passed are implemented have been shown to be sitting around whining with record profits--in this economy, record profits. Chairperson Stark said:

Wellpoint and Aetna are on track for great years with multi-billion dollar profits. Now it’s time for them to return those windfalls to their enrollees in the form of reduced premiums. With business booming there is no excuse for any premium hikes of benefit cuts next year by Wellpoint or Aetna in their private sector or Medicare Advantage plans.

A few movies have stirred me during and beyond viewing them. The better movies, don’t you think, are those we can’t get out of our minds--even as years pass? One of those movies for me was “John Q.” Denzel Washington played a hard working family man who in a lay off situation found himself without adequate healthcare coverage for his son who needed a serious procedure performed. It was heart related as I recall, and the transitional insurance offered to laid off employees would not cover major procedures. Literally, the option left to the parents was to stand by and watch their son die because there was no health insurance available to cover the astronomical costs of the only shot the boy had at living--a surgery the health insurance company refused to cover and, which the hospital itself would not provide on a gratis or compassion basis.

Washington’s character and his wife sold everything they had to get a pool of money at least to make a dent in the staggering surgery fee. Friends were running fund raising efforts for them. Still, at the end of the day not enough money to get an OK from either the HMO or the hospital itself.

In desperation, and fully understanding the consequences of his behavior from a legal perspective, John Q. took a surgeon and a surgical stuff hostage and forced them to perform the necessary surgery. The captive surgeon couldn’t claim the needed surgery as his specialty, but when a gun is pointed at you, you can remember so much more from your medical school rotations than you thought you could.

The tension of the film was magnificent. It would have been impossible for a viewer to see the film and miss out on the parents’ angst, the nearness of the little boy to death, and the tornness medical professionals felt who were puppets in the hands of the insurance company and the hospital--not unwilling to help the little boy, but forbidden to do so. The gun changed that.

All through this healthcare debate, I kept thinking about this movie. The haves cannot without hold anything lifegiving--water, basic food, shelter in dangerous weather, or healthcare--from the havenots. History has shown repeatedly that eventually the havenots will revolt in order to try for their shot at life.

I remember how shocking it was to me during Jesse Jackson’s run for the White House when he was making a point about the reality of racism as still alive and well in this country. He said, “If affluent white people are in the hospital so sick they can’t get out of bed or even raise their heads off their pillows, a person of color will likely be the one to put a cool cloth on their foreheads to ease the fever and will likely be the person to get their bedpan and then clean them up and carry the bedpan away.” But when that person of color becomes ill, her or his chances of getting a hospital for treatment are slim at best. I was a seminarian back in those days, and things probably did improve a little bit for some few poor people of color, but there certainly has never been an across the board improvement.

I heard of people in my Baltimore years who had health insurance coverage for some of the hospitals, but not for Johns Hopkins and were therefore denied the super-specialized care available only there. The finest specialist in a field can’t treat everyone, after all, so who deserves the creme de la creme of medical specialists? People with the best insurance and/or cold hard cash are at the top of the list. Next come people who are famous; they may be rich, but not filthy rich so the fame counts for something. Next come cases that may make the news because of the doctor’s presumed success. That leaves someone with an entry level health insurance policy or a student policy or someone without a policy and without a stash of cash on the fast train to glory--you know, that train that most people don’t want to board while life is still worth living in this realm?

II.

Jesus’ concern for the sick cannot be overstated. He gave the most of his time in ministry trying to heal those who were sick physically and emotionally in a context where there were lots of sick people and more than a few faith healers like Jesus. Still, illness abounded--illness and untimely death. Obviously, Jesus affirmed wholeness as a highly suitable personal goal and seeking ways to rid oneself of illness as an appropriate investment of time.

It is obvious that Jesus expected those who could to take the initiative in seeking their own healing, but if they could not--if they were children or were too sick or impaired to seek out healing for themselves--then, Jesus embraced those who sought healing for those who could not.

Menstrual bleeding in ancient Jewish reckoning was unclean. A monthly purification was required before a pre-menopausal woman could resume her duties and her interactions with her family. Women who had additional similar bleeding--say a chronic discharge of blood--remained unclean according to the ancient religious law and would, thus, have been ostracized from their families, their friends, and members of the community at large.

One unfortunate woman who once crossed Jesus’ pathway had been hemorrhaging for twelve years. She’d spent everything she had on doctors’ fees and alternative medicines; nothing had done a bit of good. Nothing had stopped the flow of blood, which to make matters worse, she’d been taught to believe that God had willed as a punishment to her. She was rejected. She hated herself and wondered day in and day out why God had it in for her. Why had she not been able to make peace with God in twelve long, hard years of trying?

Jesus wasn’t her highest hope or her only hope; he was just one more healer along the way who MIGHT have some way to make the bleeding stop and who MIGHT deal with her on an intimate basis even though she was unclean due to incessant blood flow. Flowing blood, living blood was highly revered, but blood outside the body was dead blood and highly unclean whether it came from natural blood flow or an exterior wound. Animals killed for food and those killed to have their coats used by humans were considered unclean until purified and so were the tanners who dealt with making animal hides usable for humans. It was all about dried blood, blood that had stopped flowing. Death itself was considered unclean.

This is why the priest and the associate priest, in the story of the Good Samaritan, passed by their fellow Jew who’d been beaten up and left for dead by the side of the road. They were both on their way to the great Temple in Jerusalem for Temple duty. Had they stopped and attended to the man--if he were dead or if he were bleeding but still alive--that would have put them into contact with what was considered unclean, and they wouldn’t have been pure enough to do their scheduled Temple service. Some long series of rituals and some required passing of time would have been necessary in order for them to be suitable for ministering through prayer and ritual.

Twelve years of bleeding had probably cost this woman her family. A woman wouldn’t have been meandering around in public alone unless she were a widow, a divorcee, or a beggar. It was improper for a woman to be seen in public without the man to whom she was officially connected--her husband, her father, her son. This woman was alone, and she was darting through the crowds surrounding Jesus, head and face covered lest someone recognize her as the woman with the issue of blood who’d gone to every healer she could find--never, however, finding relief or healing. She wouldn’t have been able to travel far from where she lived so the chances of being recognized and then condemned for being in a public place ran high. For not knowing her place, she risked the fate of lepers and the mentally ill--being castigated to the edges of town and formally ostracized from the mainstream of her society where most people in public weren’t unclean.

Still, she was taking the risk of going out in search of Jesus as she was certain he wouldn’t or couldn’t come to her since she was unclean. She reasoned that she didn’t actually need him to touch her, thereby making himself unclean; she believed that all she needed to do was to inch close enough to him in the crowd just to be able to touch them hem of his toga, which she did. And as she suspected, she was healed.

Lots of people were brushing up against Jesus in a crowd like that; yet, Jesus felt the healing energy flow out of his body. And he wanted to know to whom that healing energy had gone. “Who touched me?” he asked his disciples.

“Who didn’t, Jesus? Like everyone here. You know better than anybody how crowds work. What kind of question is that?”

Evidently, Jesus essentially ignored the disciples and demanded to know who had touched him seeking healing, receiving the healing energy that God was sometimes able to put to work through Jesus. The woman feared she had done wrong, and she decided to ‘fess up knowing there could be any number of negative consequences coming her way. She begs Jesus to forgive her for her bold overstepping of boundaries; much to her surprise and the surprise of many others including his disciples, he commends her and blesses her for her faith and her courage.

Some of you have relived this woman’s life. Illness has dogged you, and you have spent your energy seeking healers to make you completely well once and for all. You know what it is to have spent all the money you have on doctors’ bills and payments to other health care practitioners. This story encourages you not to give up; perhaps there’s that healthcare provider somewhere, and only a brief encounter is needed to get the healing you need.

My dad had horrible back problems most of his life--up until he was nearly 50 years of age. There were pain pills. There was traction. There were constant conversations with doctors pushing him to have back surgery, promising a grand 50/50 chance of recovery. Dad was a mountain man who never did have much confidence in conventional medicine; he rarely saw a doctor until his later years except at the annual physical required by his employer since he worked around nuclear energy sources.

In pain though he often was, he rarely missed work or church, and he happily turned over back straining work to his first-born son. That was me. Mowing the yard became my job at the age of 9. Spreading gravel on our driveway became my job at the age of 12.

Just before my wedding day in 1980, Dad found a really old naturopath who heard his concerns then told him to bend forward. Dad said the naturopath moved his hand over the place where the pain was most intense and then pinched his spine. He said there was popping sensation and sound, and there ended his back problems for the most part for the rest of his life.

One of my favorite Bible stories as a kid growing up in the Sunday School program of the Beaver Dam Baptist Church in Halls Crossroads was another story from the life and ministry of Jesus. There was a man who was an invalid; he couldn’t get himself to Jesus so four of his friends put him on a stretcher and took him to Jesus. Jesus was working inside someone’s house, and there was no way they could stand in line with this man on a stretcher so they climbed some steps to the top of the house where many people had rooftop patios and openings into the house that could be covered or uncovered depending on the season. At the time of year in question, the opening was uncovered, and these great friends to the man who was sick showed additional intelligence by lowering the man on his stretcher down through the opening where he happened to end up right under Jesus’ nose.

The man ends up getting healed, and Jesus praises the concern of the man’s friends and framed their assistance as a part of what ultimately made the man whole. This story was told not just as another instance where a sick person was able to receive God’s healing energy through Jesus, but to praise friends who help friends who are ill.

Most of us know people who need some encouragement from us to move toward healing. Maybe all they need from us is a ride to the doctor’s office and a willingness to sit in the waiting room with them while they see the physician or the physical therapist or the nurse practitioner or the chiropractor or the acupuncturist or the naturopath. I’ve heard that actress Cloris Leachman began, a few years ago, telling people, strangers, whom she encountered in restaurants and grocery stores and department stores that they needed to lose weight. I’m not recommending that you try this, even with people you know and certainly not with your pastor. I think the way we go about encouraging those whom we love to seek optimal health should be gentle, caring, kind, and practical--like lowering the man who couldn’t walk at all down through the roof into the presence of the healer.

III.

The relationship with one’s healthcare provider is a very emotionally intimate one, and often a physically intimate one too. I remember the first time this dawned on me as an adult. I’d gone out in search of a new doc. I was out of college, no longer could I rely on Mrs. Dereberry, the college night nurse who once offered me two Mylanta tablets to treat a stomach ache; she didn’t take her eyes off her soap opera playing on the little black and white television as she reached into her big white pocket and fished around for the loose tablets. I declined.

Anyway, the new doc’s office at least allowed patients to keep on their underwear; some don’t allow even that modicum of dignity. The doc walked in, my first time ever seeing him, so being the southern gentleman I am, I naturally stood up to shake his hand, and it suddenly dawned on me how inappropriate that should be. Yet, there I stood in my skivvies shaking hands with an absolute stranger. A few minutes later, I’d have felt perfectly proud to have been able to hang onto even that sliver of cloth. Oh, well. My acupuncturist showed me recently a chart of all the possible places he could stick a needle to keep me healthy. Talk about humiliating! I made sure I learned what disorders were treated with that needle and pled with my body never to fail me in any of those places.

Have you ever wondered why Jesus could preach to the masses about how to be healed spiritually, but when it came to physical and emotional healing, he worked one on one? Healing is an intensely intimate art.

My late father used to occasionally watch faith healers on television for entertainment. He once called me when I still lived in the Knoxville area and said, “Turn on your TV now. You’ve got to watch this nut, Dr. Thea Jones,” so I did. This faith healer was going around through the audience asking people what ailed them, and when they told him he would lay his hands on the ailing body part, the person would be “slain in the spirit”--something like fainting, and come to presumably healed. His assistants were always in the right place to catch the ones who’d been healed as they fell backwards. Someone had migraine headaches; Dr. Thea Jones put his hands on the man’s head. He fell out, and when he came to his headache, which had been with him for weeks, was gone. This was live television mind you so it was rather dramatic.

Another man was having pain in his knee, which made it hard for him to walk at all. Dr. Thea Jones laid his hands on the man’s knee. The man, as we’d come to expect, was slain in the spirit and fell out. When his consciousness returned he stood up and walked and ran and jumped--no pain at all.

Next, a woman came up to Dr. Jones and said she was having pain in one of her breasts. She opened her blouse, and Dr. Thea Jones laid his hands on her head.

One of my church members in the little church where I first served as a pastor, called one of the other members and asked her to phone me to request that I come and lay hands on his diseased prostate gland. I sent back my response: “No, but I’ll beef up my distance prayers starting now!”

I had no idea when I planned this sermon series, this topic, or this date for this topic that it would be preached right at the 45th anniversary of the law President Johnson signed bringing Medicare and Medicaid into existence. On that important date, July 30, 1965, millions of Americans and about half of all senior adults had no heath care at all. Who said that nothing good could come out of Texas? Oh! That might have been me. Never mind.

Some important lessons about health and healthcare. Since we are more than just physical entities, healing often engages us at the physical level and beyond; our emotional selves and our spiritual selves contribute to the possibilities for our healing. Very simply stating the obvious, most people who don’t want to get well don’t.

In this discussion, we have to face the fact that not all the sick get well. Jesus didn’t heal every sick person he encountered or tried to heal. The stories we have are just a handful of his “success” stories.

Disease is not divine punishment for sin. People who are sick are not being punished by God because of moral failures or for refusing to do God’s will. Blaming God for illness is one of the top three worst theological positions ever taken. Some illness is certainly the result of our bad personal and corporate choices; and some disease just happens in a random universe, but some people believe that every sickness that comes to them and/or to their loved ones and their enemies has been willed by God.

Someone in the healthcare orbit must deal with the emotional side of illness for the patient and often for her or his family members. There are clinicians who can deal only with the biology or the chemistry of the situation, and perhaps that is needed by some professionals to try to maintain as much objectivity as they can. The patient, however, must not be treated as a specimen in a gargantuan petri dish. The emotions of the patient must be taken into consideration and dealt with--if not by the physician then by someone on her or his team or by a mental health professional.

Human beings also have a spiritual dimension that is affected by disease, and spirituality may indeed be a part of healing processes. This shouldn’t be overlooked in the processes of diagnosis and treatment; and certainly not in the consideration of prognosis.

Several years ago, when I was still living in Baltimore, I got the news that I needed to have sinus surgery, and I thought long and hard about it before agreeing to it. Of course, I wanted a skilled surgeon and a perfectionistic anesthesiologist working on me at the best hospital my health insurance would provide, and it wasn’t Johns Hopkins. I didn’t want a religious fundamentalist as a surgeon because fundamentalists are unlikely to take responsibility for a negative outcome--calling it “God’s will,” rather than their own responsibility.

I did, though, think a person with some openness to God wouldn’t be a bad idea since God’s love energies are at the heart of all human wholeness, I believe. So, with all due respect to my agnostic and atheist friends, they were out too.

The obvious choice was a Reform Jew who figured God was in the picture somehow, but not to the degree that if he had killed me or sliced off my nose he would have passed the buck to God; he’d had to have owned it himself. And he thought it would be very bad for his career and his self-image--not to mention his ability to sleep at night--to kill off a Protestant clergyperson. So Dr. Ira Papel was just the right surgeon. And I wrote to the Greater Baltimore Medical Center to request as my anesthesiologist a Seventh Day Adventist, Dr. Mark Ottley, who was always trying to goad me into theological debate at the gym where we worked out and who had so much commitment to health as a religious foundation that he couldn’t bear to let me go under forever. It all worked out beautifully.

There has been ongoing research for years about the place of prayer in contributing to the healing of those who are ill. Opponents of such research are critical of any possible positive findings, but the research continues with enough possibly positive results to keep looking into the dynamic.

Going back to 1988, San Francisco cardiologist, Dr. Randolph Byrd, conducted an experiment in which he asked born-again Christians to pray for 192 people hospitalized for heart problems, comparing them with 201 not targeted for prayer by any group known to Dr. Byrd. None of the patients knew whether they were in the group bring prayed for or not, but those who were prayed for needed fewer drugs and less help breathing.

Numerous other studies have yielded similar findings; not all have, of course. But there’s enough evidence of something positive going on with prayer and health that we shouldn’t discount the possible power of prayer as an adjunct to what may make someone well.

I don’t want to get into theology with my doctor, but I hope someone holds me up in prayer when I am sick and struggling because I will for sure be wanting to be whole.

Amen.