Today my brother Arthur helped someone stay alive a little bit longer. He wouldn’t be happy with how I used his story, but he’s dead enough to not hear it.
Art had an enormous IQ which helped him dance through school, standardized testing, and academic awards like a hot knife through butter. But life requires many skill sets, genius being just one. My brother’s biography in many ways mirrors that of the Unabomber’s — move for move — until one decisive moment when Jesus walked into Art’s life.
Forever and irrevocably from that moment forward, Art became God’s logic pugilist. Heretofore, all of his training in science and math was used to prove that the truth in the Bible could be found only in literal interpretation.
Two years ago, at his memorial service held at a large evangelical congregation with all seats filled, his brother-in-law gave my favorite eulogy. “The best way to describe Art’s 40 years of service to God is with these two demonstrations:
I would like to see a show of hands from anyone in this room who knew Arthur Dappen, who at one time or another did not have a serious disagreement with him?” The entire congregation in mass was a sea of lifted arms. Art’s brother-in-law asked them to put down their arms.
“Now,” he went on, “I’d like to see a show of hands for anyone who thinks they ever won an argument against Art.” The room murmured a soft chuckle en masse. Not one hand was lifted.
This is the background I give as I find myself driving this week to meet a woman for the first time who is lodging at a Christian Science nursing facility. I had no idea there were such places. What I did know was that she hadn’t seen in doctor in 30 years, she had become completely bedridden. Her larger family disagreed with her on her approach of solving medical issues with prayer and meditation alone and wanted a “second opinion.” Her son was resigned to her decisions but asked if I might provide a medical opinion about her condition and perhaps render advice about options she might choose.
The facility’s administrative director met me at the door, concerned about bringing medical science into Christian Science place. I was escorted to the patient’s room and in it waited the patient and her family.
I sat down and started as I always do with a new patient: gathering her medical history and her story. The patient participated, and, although in obvious distress from a chronic medical condition, was lucid and relatively cooperative. She asked the family to leave so that she could then give me information that she didn’t want the family to know. However, I doubted that much of what she told me could have been much of a secret.
When I was ready to offer a diagnosis and course of action, I invited the family back in and reviewed my findings. There was no doubt she was suffering from anemia and that this was a chronic condition. I did not know the cause but suggested some simple labs and a transfusion could help the condition immensely while trying to develop a longer term plan. She declined on the transfusion that frankly would make her better. Her refusal harkened back to a similar struggle I had had with my brother. I found myself once again on familiar terrain, except only this time the dance wasn’t with my brother.
You see, my brother did not believe in the science of medicine and in his final struggle developed severe shortness of breath from a progressive pneumonia. He had ignored all medical care for 40 years. I can remember him clearly at the last family reunion struggling to breathe, a 62-year-old man confined to a wheelchair from shortness of breath, sitting next to his 87-year-old father who had advancing dementia. I was struck that they looked like twins sitting side by side, both failing.
My dad knew enough to say to my brother, “Why don’t you get some help?” I gladly offered this help. “No, Alan,” he said, “My body is the battle ground between God and Satan. It’s all up to God.” “Great,” I had thought. “He tried to save me and I refused and now I try to save him and he refuses.”
I am brought back to the present by a question from the patient’s family, “How can we help her?” I realized that I had been invited to the Christian Science group home in hopes that I might be able to dance with her. Could I find common ground between a salsa and a waltz? With these dynamically opposing views of the world about to square off again, I was aware that history might repeat itself and that I would sit out yet another dance. I can hear my brother now, “Don’t listen. He’s not my brother’s keeper, just Satan’s messenger.”
With this type of obstacle, I doubt that I would ever get the chance to dance.
Until next week, I remain yours in primary care,
Alan Dappen, M.D.