Monday, June 14, 2010

The Beloved Physician


St. Luke's Day Sermon
by The Rev. Dr. Carlos Sandoval, MD, psychiatrist and Episcopal priest in the diocese of Southeast Florida. 

I swear by Apollo, the healer, Asclepius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath and agreement: I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone. I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan. But I will preserve the purity of my life and my arts. In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill doing. If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot.

This is an excerpt from the Oath of Hippocrates, written around 400 B.C. I only recently have been reciting a modernized version of it as part of my morning prayers. This is the oath that Lucanus, a Greek physician, swore by when he graduated from medical school in Tarsus or maybe its rival school in Alexandria. Today Lucanus is known as Saint Luke, and today the church honors St. Luke, whom Saint Paul called most dear physician. Luke fascinates me because I see that my steps have followed his, though I did not realize it at the time I was heading into the field of medicine, and afterwards into the priesthood.

What do we know of Luke the physician, a native of the Greek city of Antioch? Some think he may have been a former slave or the son of a freedman. It is also believed he was a ship’s physician, as he seems to have known in detail many of the coastlines of his part of the Mediterranean. Why would this Gentile become a Christian? Perhaps, as the years went by and he witnessed all manner of human suffering, he realized that the gods of the ancient world were nothing more than petty super-heroes, with their multiple affairs, jealousies, and squabbles - gods who cared nothing for the welfare of humankind. Perhaps Luke questioned the very existence of any of the gods, or of the idea of one God. I know that I have questioned God’s existence many times, and still continue to have my own struggles in faith.

But the Greeks also had a belief in the unknown God, and perhaps Luke sought him as he questioned the meaning of life itself. Somehow, he learned of the life and death of Jesus the Christ and saw in him the God he was seeking. Perhaps this occurred when he met Saint Paul in Tarsus. Then, to find out all he could about the life and teachings of Jesus, whom he never saw, Luke must have visited all the places where Jesus had been, questioning everyone who had known Him or heard Him preach, including His mother, Mary. At last, when he had gathered all information possible, he wrote down what we now know as the Gospel according to St. Luke.

How could anyone not love Luke, the only Gentile author in the Bible? Luke wrote not one, but two books in the Bible – his gospel and also the Acts of the Apostles. Acts is the story of how the apostles began to teach the message of Jesus after his ascension. A good part of it is his eyewitness account, for Luke became Saint Paul’s travel companion and stayed with him until Paul was martyred. Luke tells us how the Church began to grow and spread. Luke alone reports the Annunciation, the Birth of Jesus, and the Flight of the Holy Family into Egypt. Only Luke records the Song of Mary and the Song of Simeon, which I now sing in the Cathedral’s Anglican Chorale.

Imagine Luke meeting Mary for the first time, kneeling before her and kissing her work-worn hands. “I am Lucanus, a Greek physician, Lady. I have come a long way to see you, for I love and serve your Son, though I have never seen him except in my dreams. Please tell me about your son!” These are Luke’s first words to Mary in Taylor Caldwell’s book, “Dear and Glorious Physician.” Imagine the talks Luke had with the Blessed mother as she told him about her son, as she showed him a chair or table that Jesus had made, as she told him how happy he was as a little boy, and as she became very still and serious when she recalled his suffering and her own. I can imagine Luke’s final meeting with Mary, touching her feet with his lips, and weeping in reverence and love. Perhaps he saw in Mary his own mother, she who is mother to us all, and the most blessed of women.

Luke is unique in his attention to children and women, whom he treats with the greatest respect – and to the poor, the outcast, the marginalized, the disadvantaged, and the suffering. As I read his gospel I know what he is talking about. Like Luke, I have traveled to many places and have seen the plight of people in the many parts of the world where I have lived and traveled, including our own country, and this city of Miami. To think that we, the United States, one of the most powerful countries in the world, are squabbling to come up with some sort of universal health care coverage is shameful. Luke is unique among the gospel writers because he has the keen eye of a physician, and sees the wounded of the world every day.

As a physician and as a priest I tell you that Luke has taught me a lot. Luke understands that illness is more than being sick. Illness marginalizes the individual from the community. The individual who is ill has something that those surrounding him do not have. Many of my patients have told me that they feel abandoned and isolated from their family and friends because of their illness. Abandonment and isolation are among the worst conditions that one can suffer. That is why Luke recounts the story of how the only person who is willing to help a wounded Jewish traveler, abandoned on the side of a dusty road and ignored by his own people, is a Samaritan.

Though the Samaritans were also of Hebrew extraction, believed in the same God of Abraham, and had the same books of the Torah, they were considered half-breeds and inferiors by their Jewish neighbors. But it is this outcast, the Good Samaritan, who helps a Jewish man in need. Luke the Gentile tells us this story to let the world know that the gospel of Christ is for everyone – Gentiles, Samaritans, Jews and non-Jews – no one is excluded.

Luke teaches me what my goal as a physician, priest, and Christian should be. It is to help reintegrate into society those who feel outcast and marginalized. This may be due to physical or mental illness, or due to other factors such as prejudice, ignorance, language or cultural barriers. I have been a physician 26 years, and I was ordained a deacon 21 years ago. I have seen how we humans treat each other poorly because of our differences. I do know what it is to be marginalized and also be untouchable. When my father, a captain in the US Air Force, retired and we moved to Miami, I was called a spic, and told I should return to Cuba, even though I was born in the United States, and on an Air Force base, no less! As a medical student I contracted tuberculosis from my patients, was put into isolation and quarantine for several weeks, and still have a scar on my lung to prove it. When I was discharged from the hospital, and considered “safe,” my food was still brought to me on paper plates, and some relatives completely avoided me for weeks.

When I worked as a missionary for the Episcopal Church in Ecuador, I contracted Hepatitis A, and was so sick that I lost twenty pounds in a couple of weeks. I was hallucinating and wanted to die. Not even my bishop would visit me. But he did tell me that if after two weeks I did not recover fully, he would dock half of my pay. At a hundred dollars a month, I could not afford to get only fifty! Many in the church have told me that I was not worthy of God’s love because I am gay. Earlier this year, when I was a candidate for Bishop of Ecuador, I was told that as well. A few years ago I applied to the Air Force Reserve and they told me they would love to have me either as a physician or a chaplain, as long as I signed a document swearing I wasn’t gay, and hid it. Some well-meaning relatives and parishioners still feel that way. How do you hide a six foot two man who weighs 220 pounds – excuse me, 223 pounds?

I share my personal life with you because I want you to know that when a patient or a parishioner shares with me what troubles them, I can honestly say I understand. I understand what it is to be an outcast, not good enough for this country nor the church. I have been told both, and at one time believed it. I understand how illness can marginalize you. It has happened to me. I have been bitter at times and have cried in dejection. I suppose that along with the scar on my lung, I also have several invisible scars I am not even aware of. Aeschylus, the Greek playwright, reminds us that if we would learn we must suffer.

The Jesus that Luke reveals to me in his gospel teaches me to always love in return. “Father, forgive, them for they know not what they do!” While I cannot say that I am always successful in this endeavor, I do try. What Aeschylus does not mention is that humor and laughter can bring learning as well. Luke tells us the story of Zacchaeus, a very short tax collector, who really wanted to see Jesus when he came to the town of Jericho, so he climbed up a sycamore tree. Jesus did see him in the tree, and shouted: “Zacchaeus, make haste to come down; for I must stay at your house today.” That was a happy day for this very short tax collector whom everyone hated. Perhaps he was actually a kindly and generous man. After his invitation to be the host for Jesus, we know that he must have become a more gracious man.

There have been happy and funny incidents in my life. When I was an exhausted intern at the Labor and Delivery department at Jackson Memorial Hospital, as I awaited the afterbirth after having safely delivered a woman’s baby, I fell asleep on her thigh. Can you imagine her reaching over and touching my head, saying: “Doctor, doctor, please wake up!” One of the reasons I switched to psychiatry was due to the fact that I do not do well with all-nighters!

There have been incredible advances in medicine since the time of Luke, but we still don’t have a cure for all maladies. I have witnessed several healings, which one could regard as miraculous. But in many cases all we can do is to treat the illness, delay its progression, and add years to a patient’s life. For ten years I worked as a psychiatrist among people living with terminal illness such as cancer and AIDS. I frequently became disheartened at the long-term prognosis, lying awake at night, wondering why these things happen, and questioning the apparent futility of my ministrations. The insomnia was getting worse, and one day, when I was having a real crisis of faith, I called Bishop Schofield and told him what was happening to me. “I don’t know if I believe in God anymore, Bishop, what do I do?” So Bishop Schofield took me sailing, gave me a couple of beers, and while he gave me no answer, I felt a lot better after the sailing trip. Sometimes in life all you can do is catch the wind and go sailing! We cannot cure every illness, but if we can give the sick comfort and a sense of purpose and belonging to the community, then we have given them healing. This is a wonderful thing!

Luke teaches, however, that there is something else we can offer. Luke tells us the story of ten lepers who approach Jesus on his way to Jerusalem seeking a cure. All ten were cured of leprosy, and could reintegrate themselves to their community, but only one, the Samaritan, a gentile and therefore an outcast, had a change in heart. “When he saw that he was healed, he turned back; praising God with a loud voice, he prostrated himself at Jesus’ feet and thanked him.” Jesus replied, “Your faith has made you well!” Jesus had offered him the gift of salvation. He was not only reintegrated to the community, but was reconciled with God. This is a state of total wellbeing, in body, mind and spirit. This is what the World Health Organization defines as health. This truly encompasses what it is to be human, and to be made in the image and likeness of God. This is the fullness of being that accepting God into our lives offers.

Luke’s gospel has taught me not only to restore the isolated individual to the community, but also to offer the dimension of faith. Faith is to be known and loved as Christ’s own forever, just as our baptism states. Dear and Glorious physician you have taught me much. Thank you for showing me how to find Christ in all those I minister to.

I would end with a hymn that the Orthodox Church uses for the Feast of Saint Luke.

Let us praise with sacred songs the Holy Apostle Luke,
The recorder of the joyous Gospel of Christ,
And the scribe of the Acts of the Apostles.
Luke’s writings are a testimony of the Church of Christ:
He is the Physician of human weaknesses and infirmities.
He heals the wounds of our souls,
And constantly intercedes for our salvation!
Luke, you became a disciple of God the Word,
With Paul you enlightened the entire world,
Casting out its darkness by composing the Holy Gospel of Christ.
Let us praise the godly Luke: He is the true preacher of piety,
He is the orator of ineffable mysteries And the star of the Church,
Jesus who is the Word, and who alone knows our hearts,
Chose Luke, with the wise Paul, to be a teacher of the gentiles!