As a part of Zondervan’s Ordinary Theology series, The Scalpel and the Cross recounts New Testament professor Gene Green’s encounter with open-heart surgery and carefully examines the many ways in which Christian doctrine spoke into the experience. The result is a short book that avoids shallow explanations and glib promises, instead guiding readers to deeper understanding and enduring hope in the face of one of modern life’s necessary traumas.
As a part of Zondervan’s Ordinary Theology series, The Scalpel and the Cross recounts New Testament professor Gene Green’s encounter with open-heart surgery and carefully examines the many ways in which Christian doctrine spoke into the experience. The result is a short book that avoids shallow explanations and glib promises, instead guiding readers to deeper understanding and enduring hope in the face of one of modern life’s necessary traumas.
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Overview
As a part of Zondervan’s Ordinary Theology series, The Scalpel and the Cross recounts New Testament professor Gene Green’s encounter with open-heart surgery and carefully examines the many ways in which Christian doctrine spoke into the experience. The result is a short book that avoids shallow explanations and glib promises, instead guiding readers to deeper understanding and enduring hope in the face of one of modern life’s necessary traumas.
Product Details
| ISBN-13: | 9780310516057 |
|---|---|
| Publisher: | Zondervan |
| Publication date: | 05/05/2015 |
| Series: | Ordinary Theology |
| Pages: | 96 |
| Product dimensions: | 5.20(w) x 7.80(h) x 0.20(d) |
| Age Range: | 18 Years |
About the Author
Read an Excerpt
The Scalpel and the Cross
A Theology of Surgery
By Gene L. Green
ZONDERVAN
Copyright © 2014 Gene L. GreenAll rights reserved.
ISBN: 978-0-310-51605-7
CHAPTER 1
REFLECTIONS FROM THE DAY BEFORE
Tomorrow they cut.
A few years ago my cardiologist informed me that the echocardiogram showed a buildup of calcium on my aortic valve. Someday the valve would need to be replaced since the blood flow through it would become severely restricted. I had been in the battle against high cholesterol for a couple of decades and enjoyed good success through adjusting my diet, exercise, and modern pharmacology. I imagined that staving off open-heart surgery would be possible as well. Ten, fifteen, or twenty years were the projections I had in mind before the surgeon would need to install a mechanical or bio-engineered prosthetic in place of my native valve. My calculations were off significantly. A mere two years passed before I found myself short of breath after a short ride on my titanium road bike. Pains in the upper chest forced me to stop for rest. The same pain came when I ran my customary programs on the treadmill. Even trimming the hedges became disconcertingly difficult. This twice-yearly project had never brought much joy, but it never sent me to my seat either, short of breath, at least until now.
I made an appointment with my trusted GP, Mark Nelson. After hearing that I had become symptomatic, he submitted a referral that allowed me to make an appointment with my cardiologist, Jim Carroll, and Robin Fortman, my PA (physician's assistant) whose specialization is cardiology. Carroll ordered an angiogram after seeing the results from the echocardiogram Fortman had ordered. Both exams, along with my symptoms, clearly indicated that the time for surgery had come. He also discovered a blocked coronary artery that would need to be bypassed using a vein taken from my leg and grafted onto my heart. Surgery was imminent. The instructions were simple: No food or water after midnight; take morning medications with a sip of water; scrub down thoroughly with antibacterial cloths in the morning; put on freshly cleaned clothes for the trip to the hospital. Tomorrow they cut.
During the days of preparation, I read countless journal articles about aortic valve replacement as part of the decision to opt for a mechanical valve fabricated from carbon or a biological valve donated by a fellow creature. Porcine, bovine, or equine were the options, all of which echoed myths of satyrs, minotaurs, and centaurs. Other techniques are under development such as the Ross procedure, which uses a person's own pulmonary valve in the place of the aortic valve, necessitating the graft of a replacement pulmonary valve harvested from a cadaver. The technology involved to assure good hemodynamics and to maintain structural integrity of the biological valves inspires awe. On the other hand, the fabrication and installation of a small, carbon valve brings science fiction straight into the heart as the procedure transforms a person into a cyborg. I had an embarrassment of technology at my disposal to help assure an extended lifespan. Without the operation I was looking at two to five years of life left. Not good.
But through all the literature I discovered nothing written that could be called a theology of surgery. How should I be thinking about the forthcoming surgery in relation to my faith in Christ, my theology? The medical journals were not the place to look for such reflection, and I did not expect the surgeon to discuss this matter with me. Though I was filled full with good medical understanding about this necessary surgery and had numerous technological questions occupying my mind, there was no theological river running through it. The prayers of the saints were going up across the world, and I knew God heard them and would answer. God is the Physician and all physicians receive their calling from him. Only he, in the end, can heal. But beyond these basic theological pillars, I had not inherited clear and wise guidance on how to reflect more broadly on the place of surgery within God's plan and purpose. I had no theology of surgery, only a doctor's black bag of technology. Theology shapes our understanding of God, his world, his societies, and ourselves. The theological support for surgery was not there, however. The framing was absent. Curious, indeed.
In the book Philosophie de la Chirurgie, René Leriche observed, "Surgery is an act of human authority on destiny." Surgeons impose their will upon the human body in an attempt to correct that which destiny dictated with the hope that this intervention will help restore the person to better functionality. The surgeon faces off against malformation and deterioration, broken body parts and malignant growths, in a strong man's bid to bring the offending body part under control. Something has gone wrong, and the surgeon musters the best of knowledge, skill, and art to correct it and restore the person. Cutting the body is a violent yet noble business, an imposition of authority upon a destiny that boasts an absolute claim of sovereignty. In this wrestling match, there are victories through the pain, as well as casualties and tears. But despite the way both surgeon and patient may limp away on inglorious days, both reassemble on the line to wrest the outcomes of destiny once again from her hand.
The audacity and violence of the surgical act stand up even under Hippocrates' dictum to "never do harm." The surgeon does not administer the controlled violence of the scalpel with harmful intent or destructive force but sharply cuts with care and precision. The surgeon and their patient accept the wounds as part of the price when saying "No!" Restoration, not harm, is the goal of this agonizing engagement.
The act of surgery finds its archetype in the art and skill of Jesus whose healings resembled the surgeon's work more than any other branch of medicine. He imposed his authority on the deformations that surrounded everyone from Galilee to Judea, and he even healed the wounded. When Peter sought to do harm by cutting off the ear of Malchus, the high priest's slave (John 18:10), Luke the Physician notes that Jesus "touched the man's ear and healed him" (Luke 22:51). We do not know whether he picked the whole ear up off the ground or reattached the ear that hung by a piece of flesh from Malchus's head. He acted as a surgeon in either case, divinely suturing the wound without further loss of blood or any malformation. Luke does not stop long enough to let us know if a scar remained. Jesus imposed a higher order on this moment of destiny, both for Malchus and himself, as he was being arrested. Peter acted as someone entangled by the plans laid out by others to do Jesus harm, but Jesus stepped up to take control, commanding Peter to put up his sword and adding, "No more of this!"
Earlier in Jesus' ministry, those gathered around the pool of Bethsaida in Jerusalem saw that Jesus could take authority over deformations in the human body (John 5:2–15). The blind, the lame, and the paralyzed all gathered at this pool, which at other times in its history became associated with the Greek god of healing, Asclepius. Myth and superstition surround the scene as people apparently expected healing if they could get into the water when it stirred by some mysterious power (John 5:6–7). A man who was lame for thirty-eight years waited by the pool. His case was hopeless. He had never walked and never would walk. But Jesus simply commanded, "Get up! Pick up your mat and walk" and "At once the man was cured." He did as Jesus commanded, picking up his mat and walking. The Surgeon intervened where time and destiny had stamped their mark of defeat. The patient's task was simply to believe and obey the Surgeon's instructions.
Not everyone received healing from Jesus, though there are numerous scenes throughout the gospel records that report the remarkable efficacy of Jesus' work as the Physician (Luke 6:9; 9:11). The news spread and the crowds swelled, even to the point that Jesus could no longer walk openly (Mark 2:4, 13; 3:9, 20; 5:24, 27; 6:34; 7:33). Compassion for the crowds motivated all his actions (Mark 8:2). In Jesus' day physicians were available and Luke, Paul's travel companion, was one of them by training and trade (Col. 4:14). Healing centers such as Epidaurus celebrated the cult of Asclepius, and many who slept in the abaton within the precincts of his temple, the Asclepion, sought healing. But no physician was ever as effective and no god ever generated as much acclaim as Jesus, the Healer.
Yet even with great numbers healed, some did not receive his benefaction. A man lame from birth, who lay daily at a busy gate of the Temple in Jerusalem, had seen Jesus walk by on numerous occasions yet he remained lame. Jesus passed on his healing ministry to his disciples. We know that after his resurrection and ascension Peter and John passed by and caught the lame man's gaze. Peter said to him, "'In the name of Jesus Christ of Nazareth, walk.' Taking him by the right hand, he helped him up, and instantly the man's feet and ankles became strong" (Acts 3:6–7). The Great Surgeon acted again through the one he had called and commissioned in this work. Peter acted with faith in the Surgeon and believed fully that a lifetime of destiny could be overruled by Jesus Christ of Nazareth's authority. The surgery was a stellar success since the man went away "walking, and leaping, and praising God." He had recognized an outstretched hand that was not Peter's. But this man for years had seen Jesus walk by and was not touched by him. Jesus healed, but sometimes people did not receive this grace.
When Jesus explained to the disciples of John the Baptist that he was indeed the one who was promised by the prophets, Jesus answered by referring to Isaiah 35, "Go back and report to John what you hear and see: The blind receive sight, the lame walk, those who have leprosy are cleansed, the deaf hear, the dead are raised, and the good news is proclaimed to the poor" (Matt. 11:4–5). The words come from one of the chapters in Isaiah that describes Yahweh's victory on behalf of his people:
Be strong, do not fear;
your God will come,
he will come with vengeance;
with divine retribution
he will come to save you. (Isa. 35:4)
The announcement of the liberation of God's people rushes in behind the promise of restoration of creation, even in the most desolate places:
The desert and the parched land will be glad;
the wilderness will rejoice and blossom.
Like the crocus, it will burst into bloom;
it will rejoice greatly and shout for joy. (Isa. 35:1–2)
Waters in the wilderness and streams in the desert (35:6) accompany the promise that
the eyes of the blind be opened
and the ears of the deaf unstopped.
Then will the lame leap like a deer,
and the mute tongue shout for joy. (Isa. 35:5–6)
The chapter anticipates the complete restoration of God's creation and those who live in it, both sullied by sin. The prophecy looks forward to the return to God's Promised Land with singing and joy when "sorrow and sighing will flee away" (35:10).
Jesus' work as the Great Surgeon begins that renewal. His acts, and those he accomplishes through his servants, mark the beginning of God's final and full restoration of all that is wrong in our world and in ourselves. Within the healings of the lame and the reattachment of an ear we see the future, the restoration of all creation sparking in a small and very personal act. The surgeon participates in this process of renewal. Surgery is the rainbow reminder that the broken world as we know it need not and shall not remain as it is. Surgeons offer hope that does not belong to fools but has its roots sunk firmly in the soil of God's promise, which comes to life now and will fully blossom upon the advent of the one who makes all things right and new. God enables the surgeons' work. Technology, skill, and art do not work apart from God's work.
Surgery is a violent act carried out in compassion as it challenges the destiny stamped upon a broken human frame—a frame that needs restoration. The surgeon intervenes with the hope of renewing functionality and health to the patient. Surgery offers a glimmer of the good things to come with the final advent of his kingdom that rules over all creation. Indeed, it is a present taste of that future glory, operating in the space between the fallen world and the hope of God's final redemption. The scalpel is sharp with hope, glinting brightly in the operating room and heralding the future era when God will restore all of his creation. In an imperfect way, our future hope is brought into the midst of the present agonies of our sick and broken world. The surgeon acts as the Surgeon acted.
The arrival time at the hospital is 5:00 a.m. with surgery at 7:00. The surgeon has set the schedule and arranged all the preparations. I walk forward toward tomorrow with assurance that the outcomes will be good since God is skilled as the one who fashioned and heals my body, and as the one who will restore it truly for all eternity. The surgeon and the other medical staff will be there to carry out a divine calling.
CHAPTER 2THE SURGERY, THE SYMPHONY, AND SURVIVAL
Code Blue!"
While in the Intensive Care Unit after surgery, things came completely apart. I awoke from the anesthesia but could not talk since I was still intubated. Deb, my wife, was there along with my youngest daughter, Christi, and son-in-law, Josh. I was becoming distressed and over and again tapped out "• • • – – – • • •" in my wife's hand (Morse code for SOS). The multiple monitors behind my bed all displayed normal readings at first, but then the alarm sounded at the nurse's station as my heart went into ventricular tachycardia. Lying there, I could not breathe and felt that things were crashing in as my heart beat an extreme rhythm. I knew that I was dying. The medications pulsing through my system made the frightening experience seem like being in the middle of a Picasso painting, reality distorted. The room filled with doctors and nurses, and, the next thing I knew, they shocked my heart into regular rhythm with a defibrillator. I bounced up from the bed, just like in the movies, as the painful electric shock coursed through my body. Deb and Christi were outside watching as the voltage plastered a "deer-in-the-headlights" look on my face. The doctors and nurses stood there, still and silent. In that pause, all eyes fixed on the monitors to see if a regular heart rate would return. When it did, the room relaxed, the code was cleared over the public address system, and normal recovery treatment continued. One of my physicians, a specialist in cardiac electrophysiology, told me that after open-heart surgery such occurrences are rare.
Before the surgery I believed that I would survive, but I also had a sense that at some point things would go wrong. God had assured me that I'd reach my destination safely, but he also warned me how difficult and dangerous the road was going to be. While grace brings us home, we're not exempt from dangers, toils, and snares. Before the operation, I discussed the virtues of various valves, having read numerous medical journal articles and listened to the orientation my surgeon, George Kuzycz, offered me. But not once had I considered the wider circle of people who would care for me before, during, and after surgery. Everyone who prepped me for the event, explained what was going to happen, and assisted in the operating room, were specialists in their own area. They worked together collaboratively, assisting the surgeon and me as we were brought together to install a new aortic valve through open-heart surgery. Each performed a vital role in the operating theater, in ICU, and on the cardiac floor. I am alive today not only due to the skilled collaboration of the operating room staff but because of the prompt professional response of medical personnel who were not present during my surgery. They were on duty when I went into V-Tach, and in concert they brought me back from imminent death. I did not meet all the professionals who attended me, but Deborah kept a running list of everyone she met who participated in my care before and after the surgery. The bill from the hospital listed fifteen physicians who contributed in some capacity or another. The nephrologist kept close track of my kidney function, the pulmonologists worked to assure that my lung capacity would return to normal, and, when my blood platelets fell, a hematologist joined the team. My primary care physician, Mark Nelson, set the process in motion, which began with a cardiac examination and ended in the surgery. After discharge from the hospital, he once again oversaw my care as I moved forward toward a renewed future.
(Continues...)
Excerpted from The Scalpel and the Cross by Gene L. Green. Copyright © 2014 Gene L. Green. Excerpted by permission of ZONDERVAN.
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