September

There’s a question that runs like contagion through schools and neighborhoods. The question came to my sons and may have visited yours.

The question plagued me during my work as an ER physician and internist. I’ve seen many innocent people suffer, watched personally (at the bedside) over 1,000 people die and then come home to a house with children who that day saw only friends with full stomachs and air-conditioned houses cluttered with toys, to a wife who saw only friends with new cars and stores with pretty sales people and un-scuffed merchandise; come home to kiss them goodnight and then lie in bed to feel the question "why?" creep into the room and keep me awake while others slept.

But now, after coming home from a recent trip to Mississippi and the aftermath of hurricane Katrina, I came home to something different. This time, instead of finding three sons completely content, I heard my middle son, William, tell me of the new class mate who came from New Orleans, who was introduced to his class, and who cried when introduced: cried not with the bashfulness of a school child staring at strangers but cried from heaviness deeper and more confusing than embarrassment.

At a time when many suffer with loss of home and life at no fault of their own (due to natural disaster), the following question seems more commonly in the thought of people: "If there is a God, then why do people suffer?" Everyone, occasionally grapples for a reason for suffering (when passing through a time of personal torment, like lunging for a solid buoy that will float them through a sea of pain (discontent with ephemeral philosophy that lets them sink). But in times of war and natural disaster (like these present times), even those blessed with good health and material comforts and family harmony simultaneously turn to see the sudden suffering of a city of people and ask in chorus "Why?"

For us to understand the present world is like a dog on the porch to understand the most simple concepts. Try to explain the most simple workings of your job to your dog or cat. Do you think that our present scientists have a good understanding of the universe? Try the three "whys" rule. Most experts, I’ve found (including myself in the area of medicine) cannot answer three "why’s" in a row. For example:

2. Why? Answer: Because two objects are attracted to each other with a force proportional to their mass and inversely proportional to the distance between the two objects (Gravity can be written as math formula that seems to explain).

3. Why? Answer: No one knows why two objects are attracted in this way! (so the math formula is not explanation; the math is description)

Try this rule in your own area of expertise. Three whys in a row and you’re probably out of answers. So, in every area of knowledge, we can explain down to about two levels. But, our explanations are really only descriptions and names! What is "gravity" but a name and not really an explanation. What is the definition of gravity but a description of the behavior of objects and not really an explanation. Stay with me...I promise this relates to Katrina.

When I went off to college to obtain a degree in the sciences, I really had to face much disappointment. I remember coming back to the dorm room one fall day and telling my roommate that I thought the explanation about electrons orbiting around a nucleus was bull and he looking at me like I was crazy. I learned to keep that one to myself until later in advanced chemistry classes when I learned that electrons don’t really orbit around a nucleus (as school children and college freshman are taught), the picture is simply a model that helps describe the behavior of chemical reactions. More advanced mathematical models (that are more nebulous in their construction) become necessary later where electrons sometimes act like particles and sometimes act like pure energy and the student is left wondering about true causes.

Einstein asked his students once how much they thought we know about the universe. One student answered 5%. Einstein answered, "I think that we know less than 5% of all there is to know about the universe. But, assuming the 5% estimate correct, what are the chances that God exists in the other 95%?"

I’ve found that people educated in areas other than the sciences assume that scientists have explained more than we have explained. Having worked as a research chemist, it seems to me that scientists have described the universe in useful ways that allow predictions and harnessing of natural laws for our benefit. But, we’ve explained very little. I can describe a car and what it does and use it to go to the grocery store without understanding how it works. So, it is with our descriptions of the universe.

And so it is with our understanding of suffering and death. When it comes to death, we’re like the child that cries when his father steps onto the elevator, the door shuts, and the child fears his father has gone forever because the father can’t be seen anymore.

I don’t expect people to rejoice at heart ache and death with some mountain of faith at what lies on the other side of pain and death. I’ve seen kind and pious people feel guilt about not having enough faith to rejoice at death and accept pain with peacefulness. Yet, I read of Christ’s tears when Lazarus died and read of Christ's plea seasoned with blood and sweat when facing the prospect of pain.

I don’t claim to have a view point that allows the removal of pain, tears, and occasionally confusion. But, I think that there’s much comfort in knowing that we don’t know it all...knowing the certain fact that the human mind knows very little of what can be known. Aristotle said, "I know only one thing...that I know nothing." Perhaps in the vast body of the unknown, there might be waiting comfort and explanation for those who’ve suffered pain that appears to be unjustified.

So, the comfort that the non-scientist misses (as does the proud scientist who confuses his description with understanding) is this: because we know very little about the spirit, the mind, the soul and the forces that create matter and energy, there is much hope in the vastness of what we don’t know.

Philosophers and prophets who seem to have seen into this unknown with vision not supported by logic but by inspiration, have testified of the eternity of the soul and of reward for virtue. But, what if there is nothing on the other side of pain and death but oblivion?

Dr. Victor Frankl, known for his book On Man’s Search for Meaning, was the physician who survived a German prison camp and testified to the variation of response of those who lived there. His opinion (while in the middle of the tragic slaughter of 6 million Jewish people and the wicked torture of even more) was that even in the worst of situations people have the choice to give the situation meaning. His book was chosen by the Library of Congress as one of the 10 most influential books ever written; his book has been of help to me.

Job and Paul both spoke of 3 causes of pain: pain for doing good, pain for doing evil, and pain for no reason we can see but explained by something in the vastness that is yet unseen by us. The best description that I’ve seen for this explanation of pain can be found in Oswald Chamber’s book, The Christian Disciplines.

The first time I came home from seeing an innocent person die from a drunken driver (over 100 per day according to a recent study by the CDC), the first time I saw a 2-year-old girl dead from an infection, I half expected the whole community to grieve and ask the question with me–but of course most didn’t see what I saw that day and so didn’t need to ask the question...that day.

But, now every child in my son’s class, and anyone on my block in my neighborhood, when still at night can feel that question try to creep into the room, "why is there suffering?" All in chorus, all dumped at once into that emotional sea. With war and natural disaster in the news, the question seems to spread.

I don’t offer you the counsel of a religious leader, I don’t claim the logical deep counsel of the philosopher, I’m only offering a thought on which to hang the question when it creeps into the room. I don’t offer a beautiful philosophical ship to rescue the race, just a solid buoy that I’ve held at night.

Fist, some suffer for doing bad. This seems to be the most acceptable reason for suffering and many will try to push all suffering somehow into this category. They’ll even go so far as to say that the innocent child who suffers must have been evil in a previous life. Though I would never wish for suffering, it seems more acceptable that I’ve crashed my bike while riding with no hands than it does for just having an unexplained blow-out of one tire. Though it hurts, I can at least see a reason under my control for the liver disease in the person who drinks alcohol daily.

I would never wish for the tight-rope walker to fall. But, when he walks across the deep gorge in socked feet holding his long balancing pole, he and I both know that he gains the thrill of walking only by accepting the risk of falling. And though I may define "bad" in a way that differs from you, "bad" often translates into physical or emotional risk. Things are bad because they are bad for us.

When I fall from the tight rope while doing "bad" I'm usually not cursing God on the way to the canyon floor.

The next reason for suffering is for doing good. This is the prophet stoned for speaking needed truth. This is the physician who lost his license to practice medicine for being the first to suggest that obstetricians should wash their hands and wear a clean jacket (at that time a bloody jacket was a badge of experience and a source of pride). He would later be proven right, of course, but his new thought though good and right brought him suffering during his life.

But, even suffering for doing good seems acceptable in a way. When I propose a new idea or do medical research or offer a patient a new therapy (even if proven but only recently proven) I recognize that the path represents stepping on to the tight rope.

When I first started treating women in my community with testosterone replacement, there were no other physicians in this area doing so. I knew some of my colleagues would raise eyebrows, but the reaction from some was even more aggressive than I suspected. Now, even though the practice of replacing testosterone in women has become common, some local physicians still black-ball me from their list of respected physicians loyal to the accepted dogma.

As an ER physician, while stitching the face of a drunken man that was known by me to have HIV (from previous medical records), I recognized that I was stepping onto the rope. I didn’t contract the disease by an accidental needle stick, but I’ve know of others who have. Doing good and speaking truth so commonly involves risk that the idea is almost cliche and the resultant suffering from the good action becomes a badge and a trophy.

Suffering for bad and suffering for good seem acceptable. The problem, the confusion, the sea in which most flail for support is in the 3^rd reason for suffering–suffering for no known reason. This is the child with cystic fibrosis who gasps for air or the child with sickle cell disease crying for pain or the child separated from parents or friends by hurricane Katrina. These are the situations that send the question into the room to wake you.

So, here are the simple ideas that have helped me deal with this third type of suffering and from where they’ve come:

1. There is a huge part of the universe about which we have no knowledge or understanding. We’re like dog’s on the porch with great battles being fought in the spiritual plane of which we have no awareness or understanding. (from William James the great Harvard psychologist in his book Pragmatism and from the writings of Einstein and Job.)

2. Within this vast unknown there may live God and the explanation of pain that seems without meaning now. This God is beyond our understanding but He/She knows the part about pain and has a plan that is good: (from Oswald Cambers, the Christian Disciplines; from the book of Job; from Einstein’s writing, from the notebooks of Leonardo da Vinci; from the New Testament writings of Paul, from Boethius' writings while in prison, and from Stephen King in an interview on "Fresh Air" while explaining why he was hit by a Van)

3. Within this vast unknown part of the universe, there may happily live those who have stepped onto the elevator. Perhaps, in the future, they will greet us and explain a few things.

Please don’t think I’m trying to be preacher or philosopher; I’m only offering a few suggested ideas and writings that have helped me go to sleep when the question creeps though my bedroom door.