I recently took a course at the Johns Hopkins School of Public Health. There is a phrase that is printed on all of their correspondence and official documents. It is, “Protecting Health, Saving Lives –Millions at a Time.” It is an ambitious slogan and it exemplifies the philosophy behind this outstanding institution. The course dealt with public health implications of disaster and it covered the basics of large scale programs for populations in need. The focus was on delivering the highest impact intervention, getting the most bang for the buck for the most amount of people. Surgery does not fit in so well to this philosophy. It is a costly, labor-intensive endeavor, requiring highly skilled practitioners. In contrast to Public Health, surgery only helps one person at a time. During the course I found myself wondering if I had made the right career choice. On a purely practical level, I should probably abandon surgery and devote myself to providing clean water, sanitation, nutritional support and vaccination programs for people. In a setting of limited
resources, this is certainly more cost-effective. As a clinician, one can start to wonder what the practical significance of treating one person is. There are so many people out there. One person is only a drop in the bucket, a speck in the sea of misery.
When I look at the life of Christ, I am struck by the fact that he dealt with people one at a time. He was fully involved with the person who was in front of him, and he dealt with them as if they were the whole world. The Bible is full of these stories, but the one I want to mention is found in Mark 5. In this story Jesus is dealing with a medical emergency. An important synagogue leader comes for help with a sick child. She is critically ill and needs help fast! They are rushing to get there when Jesus suddenly stops and says “Who touched my clothes?” On the way to an emergency, Jesus stops to deal with an old poor woman who has a chronic disease. He interrupts the care of a sick child (many potential years) to care for an old woman (few). From a Public Health perspective, it is simply a wrong decision. The potential to lessen the
global disease burden and maximize DALY’s (disability-adjusted life years) would be much greater by directing available resources toward the care of the child. It would be like stopping an ambulance to help someone in a wheelchair.
Jesus did not see things that way. He saw before him, in this bundle of rags, a person of inestimable value. He saw not only a body, but a soul that had suffered and was in need of healing. In reality, the physical healing had already taken place. He could have been content that she was healed in her body, and rushed on to the real emergency, but he stops and makes contact. The disciples were annoyed. The synagogue leader was probably beside himself. Everyone was wondering why he was wasting his time, but Jesus stops and talks with the woman. He treats her with compassion and offers her the spiritual healing which she needed the most of all. In the meantime, the unthinkable happens. The child dies, perhaps as a result of the delay. It is a tragic outcome, but even then we see that God has the ability to work through the situation. When everyone has given up, He goes to the house of mourning and brings the dead girl back to life. It is a healing of unbelief as much as a physical healing. Even when there is no reason to hope, we see that miracles happen and that God can work through the most terrible tragedy to bring glory to Himself.
So how do we balance the demands that are placed upon us as clinicians? I only know how to help one person at a time. If there are three emergencies how do we choose which one comes first? How can we maximize our clinical efforts to provide the greatest benefit for the greatest number of people with the limited resources that are available to us? These are not theoretical questions. They are questions that you face every day in the clinics and wards. I do not have the answer, but I know that Jesus saw every person in front of him as the most important person in the world. He desired not only to heal
them physically but to touch their spiritual needs. He didn’t try to heal everybody. He also knew when it was time to just disappear for a while. Perhaps my work makes little difference from a Public Health perspective. I don’t help people “millions at a time.” For every person that I can save, there are thousands that I cannot, but I know that the person in front of me is valuable and is loved by God. All I can do is reach out and try to help them. That person is an eternal soul in need of grace and
forgiveness. This thought can give perspective as you look out at the impossible operative schedule, the ward full of disasters or the jam-packed clinic that you’ll never get through. The person in front of you is everything.