Some musings

It has now been acknowledged that the coronavirus can effect our sense of taste and smell, but it should also be recognised that it can effect our sense of perspective too, causing us to pay far too much attention to things that are not of sufficient importance to warrant it. Not that that is anything new.

In the preface to his book critiquing the effect of television on our culture, Neil Postman compares the concerns of George Orwell in ‘1984’ with those of Aldous Huxley in ‘Brave New World’. He writes:

‘What Orwell feared were those who would ban books. What Huxley feared was that there would be no reason to ban a book, for there would be no one who wanted to read one. Orwell feared those who would deprive us of information. Huxley feared those who would give us so much that we would be reduced to passivity and egoism. Orwell feared the truth would be concealed from us. Huxley feared the truth would be drowned in a sea of irrelevance. Orwell feared we would become a captive culture. Huxley feared we would become a trivial culture’

What is particularly astonishing is the fact that Postman’s book was written in 1985, long before the exponential rise in the number of TV channels and the dawn of Facebook and Twitter which together have only served to confirm Postman’s view that Huxley, not Orwell, was right. It is not religion, as Marx asserted in 1843, that has become the opium of the masses but rather it is entertainment that numbs us to what is real and valuable. It was for good reason that Postman’s book was entitled, ‘Amusing ourselves to Death’.

The truth is that we will all die as a consequence of our sin. The world seeks to distract us from that fact by filling our minds with things of negligible value compared to the infinite worth of a God who can save us from the very thing we long to forget.

A week does not go by without some new ‘must see’ televisual feast being presented before us to distract and lift us from our otherwise supposedly tedious lives. Of course there is, for example, nothing inherently wrong about watching the endeavours of a dozen amateur cooks but does ‘The Great British Bake Off’ really warrant the attention it generates in our newspapers each year when a new series begins. Thoroughly enjoyable though it is, our lives would not be so very diminished if we never saw another disappointing signature bake, another plucky attempt at a technical challenge, or another triumphant showstopper.

To be entertained is in danger of becoming our ‘raison d’ete‘. To simply be amused, a word, incidentally, that means to be devoid of thought, must not become the goal of our existence. The truth is that there is a God, one by whom we were created to both know and delight in, but, just as a world that doubts the goodness and ability of God to provide and protect his people looks elsewhere for their security, so a world that doubts the very presence of God looks elsewhere for satisfaction.

Increasingly sportsmen have become those we should all aspire to be like. And when sport and television combine, as they do for example during the Olympics, we are all too easily persuaded that there is nothing more important than how fast someone can pedal a pushbike, nothing more amazing than someone doing a head over heels, and nothing more thrilling than someone jumping into a pool of water. Now don’t get me wrong, though not as much as a day at the cricket, I have missed watching the Olympics this year as much as the next person, but we simply mustn’t buy into the assertion that it has any ultimate importance.

What we glory in reflects what we consider most important. And so we must all ask ourselves what or who it is that we glory in – what, or who, it is that absorbs our attention. The reality is that it is God who is of ultimate importance and we are to fix our eyes on Jesus, not the latest comings and goings on Strictly Come Dancing.

Jeremiah 9:23-24 reads:

‘Thus says the LORD: “Let not the wise man boast in his wisdom, let not the mighty man boast in his might, let not the rich man boast in his riches, but let him who boasts boast in this, that he understands and knows me, that I am the LORD who practices steadfast love, justice, and righteousness in the earth. For in these things I delight, declares the LORD.’

To ‘boast’ here does not mean to brag – it is not that we should brag about the fact we know something about God. On the contrary, if we know anything about God at all it is down to the graciousness of God in revealing himself to us. Rather to boast here is ‘to value’, ‘to consider important’, ‘to take delight in’. Here then is a warning to us as to what we should glory in.

Let not the wise man boast in his wisdom, let not the mighty man boast in his might, let not the rich man boast in his riches.

We could go on.

Let not the tennis player boast in the accuracy of their serve,

Let not the gymnast boast in their agility

Let not the sprinter boast in their speed.

And less you consider that none of this refers to us, or perhaps that I am jealous of those more athletic than me, let’s bring it a little closer to home.

Let not the clinician boast in their clinical acumen

Let not the craftsmen boast in the work of their hands

Let not the welfare advisor boast in the sensitivity of their counsel.

And neither let the Christian boast in the success of their ministry,

No, let him who boasts, boast in this

Let him who values anything, value this, delight in this, consider this important:

That he understands and knows God, that he understands and knows that He is the LORD, who practices steadfast love, justice and righteousness in the earth, and that in these things He delights.

We are to value the fact that we know God and delight in those aspects of his character that He himself delights in. To know God is the meaning of our lives, the true purpose of our existence. Praise God that it is so – for only knowing God can satisfy the longings of our hearts.

The sporting endeavours of ourselves or others will not satisfy our souls

The lightness of any Victoria Sponge ever baked will not satisfy our souls.

Even the joys we may experience at work or home will never ultimately satisfy our souls.

But knowing God will.

Augustine of Hippo wrote in his Confessions;

‘Thou hast made us for thyself, O Lord, and our heart is restless until it finds its rest in thee’

Augustine was right. This is no great surprise since his words were simply echoing those of Jesus who said in John 17:3

‘…this is eternal life, that they know you the only true God, and Jesus Christ whom you have sent.’

To know God then is to live – to truly exist – to have eternal life. It is the whole point of our existence. What a privilege it is, therefore, to have been brought into the family of the triune God through the death and resurrection of Jesus Christ. What an honour it is to be called by our Heavenly Father, the sovereign creator and sustainer of the universe. And what a joy it is to have his Spirit with us, speaking to us through his word. Oh that we might have ears to hear from Him, that we might know him better.

So in these days of pandemic let’s not spend too long attending to the news, God’s story really is bigger news than anything we’ll find reported there. And let’s not allow ourselves to be distracted from all the bad news by the ‘bread and circuses’ that are continually offered to us but which never succeed in satisfying. Rather than amusing ourselves to death with yet another box set on Netflix, endless amusing cat videos on Facebook or, even, one more work out with Jo Wicks in the mistaken belief that a healthier body will bring us ultimate satisfaction, let’s be as we ought, different from the world, and find instead contentment in the God who is there. Let’s not doubt his presence or his ability, not only to provide and protect us, but also to truly satisfy us.

For ‘some trust in chariots and some in horses, but we trust in the name of the LORD our God.’ [Psalm 20:7]. ‘[He] make[s] known to [us] the path of life; in [his] presence there is fullness of joy; at [his] right hand are pleasures forevermore’ [Psalm 16:11]. Therefore, let us fix, or even feast, our eyes on Jesus, ‘the founder and perfecter of our faith, who for the joy that was set before him endured the cross’ [Hebrews 12:2]. For he is ‘the image of the invisible God’ [Colossians 1:15]. In seeing and knowing Jesus we see and know the Father, and to know God, as already mentioned, is eternal life [John 17:3].

It is not in ourselves, therefore, that we should boast but rather in Jesus Christ, in his character and what he achieved on the cross. ‘God opposes the proud but gives grace to the humble.’ [James 4:6]. May it be, therefore, ‘far from [us] to boast except in the cross of our Lord Jesus Christ, by which the world has been crucified to [us], and [we] to the world’ [Galatians 6:14].

Because to know God really is enough. His grace is sufficient for us [2 Corinthians 12:9] and ‘godliness with contentment is great gain’. [1 Timothy 6:6].

So then, even in these days of great difficulty, may we grow in godliness. And, as we do, may we all know contentment, may we all know great gain, and may we all know his amazing grace.

O LORD, how many are my foes! Many are rising against me; many are saying of my soul, “There is no salvation for him in God.” Selah

But you, O LORD, are a shield about me, my glory, and the lifter of my head. I cried aloud to the LORD, and he answered me from his holy hill. Selah

I lay down and slept; I woke again, for the LORD sustained me.

I will not be afraid of many thousands of people who have set themselves against me all around.

Arise, O LORD! Save me, O my God! For you strike all my enemies on the cheek; you break the teeth of the wicked.

Salvation belongs to the LORD; your blessing be on your people! Selah

Psalm 3

How, I wonder, did you sleep last night. Did you sleep well?

It’s common for those who are anxious or under stress to find it difficult to get a good nights sleep, so it’s no surprise that some of us have found it difficult to sleep during the coronavirus pandemic. Unsettled by all that is changing about us, uncertain of what the future might hold and fearful perhaps even of death, the nights for some have on occasions been long.

In Psalm 3 David is under stress. His son Absalom has led an uprising against him and has even plotted to have him killed. David has had to flee and as he has done so he has had to listen to the taunts of those who oppose him, taunts which suggest that God is no longer for him. David however knows better. He knows God is his shield, the lifter of his head. Knowing that God will protect him and knowing he will not be put to shame, David cries out to God. And God answers.

And as a result, despite all his difficulties, David is able to sleep, knowing that God sustains him as he does so.

Because of the protection he is confident God will give, David will not fear his enemies. He doesn’t doubt that God will deal with them, that he will both shame them and disarm them. David knows salvation belongs to the Lord.

And so it is with us. Daily we face difficulties, especially in this time of pandemic. We may feel overwhelmed by them and struggle as others, perhaps, look on and question how we can still trust in a God who, from their point of view, seems to have abandoned us. But we know different. Because, as we too cry out to God, he answers us in the promises he has made, the promises we find in the Bible. And so, with the shield of faith, we can extinguish all the flaming darts of the evil one [Ephesians 6:16].

Because the truth is that, no matter what our circumstances might be, God is for us. And ‘if God is for us, who can be against us? He who did not spare his own Son but gave him up for us all, how will he not also with him graciously give us all things?’ [Romans 8:31-32] We can be absolutely confident ‘that neither death nor life, nor angels nor rulers, nor things present nor things to come, nor powers, nor height nor depth, nor anything else in all creation, will be able to separate us from the love of God in Christ Jesus our Lord. [Romans 8:38-39]

Knowing these things will help us, like David, to sleep at night. Like him, we can be sure that God will sustain us too.

But whilst Psalm 3 is a ‘Psalm of David’, written ‘when he fled from Absalom his son’, it is, at the same time, a psalm about another, greater, king. Like David, King Jesus was rejected by his own people and was taunted by those who saw him as one who was beyond salvation. As Jesus hung on the cross he was derided by those who passed by ‘wagging their heads and saying, “Aha! You who would destroy the temple and rebuild it in three days, save yourself, and come down from the cross!” [Mark 15:29-30]. Unlike David however, Jesus was not spared death – but, even so, death could not hold him. Though he laid down and died, God did not let his ‘holy one see corruption’ [Psalm 16:10]. God sustained him too, even in death, and on the third day Jesus rose again.

And the same will be true for us. As, for the time being at least, the death rate from coronavirus begins to fall, we may be beginning to feel a little more confident that these days will pass. No doubt, in time, they will. But, even if we do not succumb to Covid-19, we will all still one day die. Even so, as the verses above remind us, not even death can separate us from the love of God. On occasions in the New Testament Jesus describes those who are dead as merely sleeping. And no wonder. For when we do die, we can be confident that, to Jesus, it will be no more difficult to raise us as it would be to wake us from sleep. And so just as he did with the ruler’s daughter in Matthew 9, he will but take our hand or, perhaps, just as he did with Lazarus in John 11, he will but call our name, and we will be raised. God will sustain us, even in death.

And so, just as he did with David’s enemy, God has shamed and disarmed our enemies. And the last enemy to be destroyed is death. [1 Corinthians 15:26]. And because of the cross, ‘death has been swallowed up in victory’ [1 Corinthians 15:54]. We who were dead in our sin, God has ‘made alive together with him, having forgiven us all our trespasses, by canceling the record of debt that stood against us with its legal demands. This he set aside, nailing it to the cross.’ And in so doing ‘He disarmed the rulers and authorities and put them to open shame, by triumphing over them in him’. [Colossians 2:13-15]. With sin dealt with, death has indeed lost its sting. It has been disarmed and finally been rendered truly powerless.

So we can sleep soundly because the God who keeps us neither slumbers or sleeps [Psalm 121:2-3]. And when our time comes, we will be able to rest in peace because we are those who ‘rely not on ourselves but on the God who raises the dead’. [2 Corinthians 1:9]. Salvation really does belong to the LORD, and his blessing really is on his people.

So tonight, knowing all this, may we all know what it is to sleep well!

Recently I was struck by these words from 1 John.

‘Beloved, we are God’s children now, and what we will be has not yet appeared; but we know that when he appears we shall be like him, because we shall see him as he is. And everyone who thus hopes in him purifies himself as he is pure. [1 John 3:2-3]

These really are wonderful verses.

On account of God’s great love, we are his children now. That is what we ‘already’ are. Even so, we are ‘not yet’ what we should be – that is like Jesus. Even so ‘dear friends’ we should not despair, for we have a hope which purifies us.

For the more we look to Jesus, the more we will look like Jesus. And the more we see what Jesus is like, the more like Jesus we shall be seen to be. And when we finally see him fully, then we will finally be fully like him.

We are ‘already’ children of God but we are ‘not yet’ perfect.

Jesus appeared to take away our sins [1 John 3:5]. He did this by dying on the cross for us, paying the penalty for all our wrong doing. But, for now, indwelling sin continues to reside in each one of us. And so, we who are his must, by the power of the Holy Spirit, keep on putting to death the deeds of the body in order that we will live. [Romans 8:13]. The struggle continues – daily, and proves that we are spiritually alive because the Holy Spirit dwells in us.

But when he appears again, when he finally appears, he will complete the good work he has begun, and we will finally and forever be, what we were always meant to be without sin. We really will be just like Jesus.

So until then, rather than looking only at the world situation, let us instead fix our eyes on Jesus, who is not only the author, but also the perfecter of our faith. Because it is by looking to Jesus that we are saved.

Soli deo gloria.

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On Sunday evening we heard news of the first tentative steps that might be made towards an easing of the current lockdown restrictions. But there is a long way to go. We may be moving slowly in the right direction already, but we are not yet fully there.

The passage in 1 John above highlights for me the theological idea of the ‘already’ and the ‘not yet’, an idea that I have found hugely helpful in recent years.

We live in the tension between the ages – that is we are saved, we are being saved and we will be saved – the kingdom is coming, has come and will come. We are not yet fully what we will be, not yet fully where we are heading – but we are on our way.

But, unlike the national situation in which we are tentatively treading towards a complete lifting of restrictions, the fact that we will one day obtain the freedom of the glory of the children of God [Romans 8:21] is absolutely guaranteed. Indeed, so certain is it that, though we do not yet experience it, we can already consider it ours.

God works by his Spirit, through his word – he has the power to create by his command. When he speaks, reality changes. He created the universe by a word of command. ‘God said let there be light and there was light’. Jesus raised Lazarus by a word of command. ‘Lazarus, come out ‘and the dead man came out, alive.

God’s word is so powerful and his promises are so sure that, there is a sense in which, when God promises something it becomes an instant reality. The promise is ‘already’ true, even though the full realisation of that promise is still ‘not yet’.

In the Bible, this idea of ‘the already and the not yet’, is a recurring theme. It is a very helpful concept which explains how God can declare something as true even when the current experiences of those he says those things to, may seem very different. And because there is nothing more true than what God says, because God’s promises are so certain and because God creates through what he says, when God declares something to be so, there is a sense in which it is simultaneously both ‘already’ true, even when it is ‘not yet’ true.

Hence the ‘already and the not yet’.

Having decreed something, a process then begins by which what is true by God’s decree becomes true in actuality. A couple of examples may help.

Gideon for example is quivering in the wine press when God declares him to be a mighty warrior. Now if God says you are a mighty warrior you are a mighty warrior irrespective of how you feel. And yet Gideon is quivering in the wine press – he’s far from a mighty warrior. There then follows a process by which we see Gideon becoming just what God told him he was at the outset. At the time of God’s decree, Gideon was both already and not yet a mighty warrior – In time he became what he already was.

Similarly God renamed Abram as Abraham saying I have made you the father of a multitude of nations. Abraham, however, given he was childless at the time, was not the father of many nations when God said that he was. Once again however, there followed a process by which we see Abraham becoming what God had already declared him to be. Abraham became what he already was.

So why is this important for us?

Because the same is true for us.

God declares us to be a chosen race, a royal priesthood, a holy nation. And so we are – the only problem is that each and every one of us is also far from holy, we are all those who continue to sin. But if you are someone who, like me, is all too conscious of their indwelling sinfulness and oftentimes weak faith, someone who sometimes finds themselves asking ‘Can I really be a Christian?’, take heart, whilst not encouraging complacency, I would suggest that we are simply ‘not yet what we already are’!

God has declared us to be right with him. We are ‘justified’ solely because of what Jesus has done for us. And if God says you are not guilty, then you really are ‘Not guilty’. God treats us just as if we had never sinned and just as if we had always obeyed. We are righteous, acceptable before God now – because God says we are. And yet, at the same time, we are still sinners.

Martin Luther was right. He had an expression ‘simul Justus et peccator’ – meaning we are both just and sinful at the same time.

Counted righteous already, we are now in the process of becoming what God already declares us to be. That is the road map that we are on. We are being sanctified. Every one of us will die as a sinner, as one who sins – but if we are Christians, if our faith is in what Christ has done for us, we will die as justified sinners, those who, though they continue to sin, have, none the less, begun the process of sanctification – that process by which we become more like Jesus.

And God will complete the good work he has begun in us – because he has promised to – and one day, on the day of Jesus Christ we will rise again with a perfect resurrection body. Then, and only then, we will fully be what God already declares us to be today.

We will have become what we already are. All restrictions will then have been lifted and, since the Son will have set us free, we really will will be free indeed’ [John 8:36]

A few further reflections written in the days if Covid-19

MAGNIFYING THE LORD

Oh, magnify the LORD with me, and let us exalt his name together!’ [Psalm 34:3]

I wonder what it is that we are currently most preoccupied by, what it is that most fills our minds.

The majority of us, no doubt, will be all too aware of a certain virus that has been getting a lot of airtime recently. In contrast, it is significant how few column inches have been given over to the things of God.

For sure, over the Easter weekend, there was some reporting regarding how churches have responded to the current pandemic but, in terms of what God himself is actually doing, I don’t think it would be an exaggeration to say that the news channels have been completely silent.

Of course none of us are surprised by this but we too need to guard against making the same mistake as the media and allowing ourselves to think and read more about Coronavirus than we do about God.

The Bible not infrequently talks about magnifying the Lord. But how are we to do this? Are we really called to make God bigger than he already is?

John Piper helpfully guides our thinking when he points out that we can magnify things in two ways – with a microscope and a telescope.

A microscope is used to make something that is small look bigger than it really is. Whilst this has value when examining those things too small for us to see unassisted, this is not the way we should magnify God.

A telescope, on the other hand, brings into view things that, though they may appear small to the naked eye, are actually very big. They enable us to see things as they really are. This is how we should magnify God.

Many see God, if they acknowledge his existence at all, as of little importance in their daily lives. But the truth is very different. By magnifying God, drawing attention to him by the way we speak and act, continuing to trust and hope in Him even in times that are difficult, we play our part in helping others see him as the ‘great big God’ he really is.

The media magnifies the Covid-19 virus as with a microscope, making it all important. It is, of course, of some significance – after all it might, if it pleases God to do so, be the cause of our death. But it is, nonetheless, infinitesimally small, both in size and in significance when compared with God.

God however, the one who, if we do die in the coming weeks, will most certainly raise us to life, is infinitely large. And of infinite significance too. So let’s be preoccupied by him, let’s be ‘looking to Jesus, the founder and perfecter of our faith, who for the joy that was set before him endured the cross, despising the shame, and is seated at the right hand of the throne of God.’ [Hebrews 12:2].

Because that is the reality. Our Heavenly Father really is far more worthy of our attention, and that of all those with whom we interact, than anything else. Let’s make that apparent today.

So come, ‘magnify the LORD with me and let us exalt his name together!’

JESUS WEPT

‘Jesus wept’

John 11:35 is, famously, the shortest verse in the Bible. And yet these two words contain so much that is helpful in these days when daily we are told of far too many people dying. Here are just three things we can learn.

1. Jesus is somebody who cares. He weeps for the death of his friend Lazarus and, no doubt, at the sadness his loss has caused all those who also loved him. Jesus weeps with those who weep’ [Romans 12:15]. It’s good to know that our God is not a remote deity who lacks compassion but a loving Heavenly Father who comes alongside us in our sadness. Jesus, I believe, still weeps, daily at the news of all those who have died of Coronavirus.

2. Jesus’ tears reassure us that it’s right for us to weep too, that Christianity isn’t a religion of the stiff upper lip in which grief is dismissed with insensitive assertions that ‘all things work together for the good’ [Romans 8:28] even though that is gloriously true for those who love God and are called according to his purpose. In 1 Thessalonians 4:13 Paul writes in order that his readers ‘may not grieve as others do who have no hope.’ With these words he says we are to grieve, but that we should grieve hopefully. No doubt Jesus knew as he wept that he would soon raise Lazarus back to life. He grieved, but not as one who had no hope. As the Covid-19 death toll climbs we should weep, but weep with hope. Because there will be better days.

3. As Jesus weeps, not only did he know that he would raise Lazarus, but that he himself would soon die. He knew that his raising of Lazarus from the dead would be the act which would provoke those who opposed him so vehemently to start making their plans to put him to death. [John 11:53]. Their hardness of heart must also have saddened Jesus and, quite possibly, added to his tears. Jesus knew that the cost of raising Lazarus to life would be his own death. But it wasn’t just the cost of raising Lazarus to life that was paid for the day that Jesus was crucified. It was the price that had to be paid to guarantee our own resurrection too, even if that death occurs during this current pandemic.

Jesus said, “I am the resurrection and the life. Whoever believes in me, though he die, yet shall he live” [John 11:25]. This is wonderfully true, and it is this truth that will enable us to grieve hopefully, sustaining us, not only when those we love die but also as we approach our own death too.

Regardless of the cause of death, Coronavirus or cancer, old age or accident, there will still be a place for tears, our own, those who love us, and, if John 11:35 teaches us anything, those of Jesus too. But these tears will come to an end – because Jesus wept that we might know eternal joy – he died that we might have everlasting life.

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ON NOT NEGLECTING TO GATHER TOGETHER

One of the distinctive aspects of Christianity is the belief that, after death, we have more to look forward to than a merely spiritual existence.

To know that there will be a bodily resurrection, that, like Jesus himself, we will be made up of flesh and blood after we too are raised from the dead, is, in these days of social isolation, very good news. Because don’t we all miss that real life contact with others.

Whilst Skype, Zoom and the rest of the internet’s many ways of meeting virtually have their merits, merits for which we can all be grateful for allowing the degree of interaction they do, such interaction is, nonetheless, not the same as meeting together physically.

When one is finding life difficult it is good to know that someone is thinking about you, but it is better still to have someone physically with you, someone who is, literally, there for you. Similarly, whilst lovers who are separated may draw comfort from the letters they send each other, so much more precious, on account of their tangibility, than emails, bits of paper are nonetheless a poor substitute for being together in person.

In order for relationships to be all that they are supposed to be, there needs to be physical contact. That’s why we kiss, a physical act of love as well as a sign of that love. Even more so, the act of marriage, that sign and seal of the covenant relationship by which the Bible tells us two people unite to become one flesh, is an intensely physical act which cannot be undertaken whilst apart.

Which is why we must not get too used to virtual church. During the current lock down, most churches are currently offering some form of online service. This is a good and valuable endeavour, one which can offer much in difficult circumstances. But we must not mistake it for real church.

Real church, functioning as it should, involves the physical gathering together of God’s people. It’s not something that can be properly done apart. Like lovers who make weekly phone calls to one another, we should long to meet again on a Sunday morning, to know the intimacy that comes when we gather together as the body of Christ.

That’s why Hebrews 10:25 warns us to not neglect meeting together. Though we may not be able to do so at present, we should find ourselves missing that fellowship and eagerly looking forward to the day when we will once more be together. We should be longing to gather round the Lord’s table again, to participate in the physical act of the Lord’s supper. Breaking bread together and sharing the cup with one another, is a physical act. It is as we eat and drink the tangible that we experience the sign and seal of God’s love for us and together know intimate communion with Christ.

We were created to be in physical relationship with one another. No wonder then the depth of grief we feel when we are bereaved. But when we die, or when one who we love is taken, we can be comforted by the knowledge that the pain of separation that we will then feel so intensely, will be but temporary. One day we will be reunited and be able to physically hold one another once more.

‘Behold! I tell you a mystery. We shall not all sleep, but we shall all be changed, in a moment, in the twinkling of an eye, at the last trumpet. For the trumpet will sound, and the dead will be raised imperishable, and we shall be changed. [1 Corinthians 15:51-52]

Our eternal future does not consist of our floating around in some disembodied form of ourselves. Ours will not be some virtual existence, a simulation of what we know today, On the contrary, what will be will be more real than what we currently experience. Though, at present, our outer self is daily wasting away [2 Corinthians 4:16], when we are raised Jesus Christ ‘will transform our lowly body to be like his glorious body’ [Philippians 3:21]. We will have new bodies, bodies that are better than those we have at present and which, by virtue of their imperishability, will remain so for ever.

Just as when the current restrictions now preventing our meeting together are lifted, so too the restrictions imposed by death will only be temporarily. We will fellowship together once more. And so we look forward even now to gathering together, ‘a great multitude that no one [can] number, from every nation, from all tribes and peoples and languages’ [Revelation 7:9]

And what is more, not only will we be together, we will, on that great day, stand before the Lamb. We will forever be together with the Lord. [1 Thessalonians 4:17].

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WAITING PATIENTLY

Though the lockdown restrictions are now gradually beginning to be eased, it’s going to be a while longer before they are lifted completely. We’re just going to have to be patient.

What an encouragement it is then to read Psalm 40, especially for those who, despite knowing they are saved, continue to find life a struggle. Because, whilst it is a psalm of King David and, therefore, one that serves to point us forward to Christ, it is also a psalm that reflects our story too.

As Christians, even though we can rejoice that we have been lifted out of the miry pit and had our feet set on a rock (v2), even though we can sing that new song that has been put in our mouth (v3), and even though we are greatly blessed as a result of having put our trust in God (v4), even so, troubles without number still surround us (v12).

That they do so does not question the reality of the salvation that we already have. We have been saved but there is still a need for us to go on being saved. Furthermore God in his sovereignty is sometimes pleased to lovingly send difficulty to those who are his, even those whose walk with Him is the closest. Consider Job. It was precisely because there was ‘none like him on the earth, a blameless and upright man, who fear[ed] God and turn[ed] away from evil’ [Job 1:8] that he was singled out as the one that Satan was permitted to torment.

Though, like Job, we may not understand the difficulties we have to face, we can be sure that, because our loving Heavenly Father allows them to come our way, ultimately they are always for our good. And we need not doubt that one day we will know what it is to be fully saved because Jesus Christ is able to ‘save to the uttermost those who draw near to God through him, since he always lives to make intercession for them.’ [Hebrews 7:25] The truth is that, in addition to this pandemic eventually coming to an end, we can be sure that everything that is currently wrong will one day be made forever right. Because poor and needy though we may find ourselves this morning, the Lord still thinks of us (v17). Even as he prays those prayers that still we all so badly need.

And so, despite the difficulties we currently experience and the sadness we continue to know, let us, confident of our future, rejoice and be glad in him today (v16), let us speak of his righteousness, faithfulness and love (v10) and may he be exalted (v14) as we wait patiently for the LORD.

For he will hear our cry (v1).

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START SPREADING THE NEWS

One of the factors upon which great store is put by those seeking to advise on how best to manage the current coronavirus pandemic is the so called reproduction number, R. It is a measure of disease transmission that refers to the average number of secondary infections produced by a single infected person. When R is below 1, the number of people infected will reduce whilst, when it is above 1, that number will increase. The current requirement to self isolate when one has symptoms, and practice social distancing when one hasn’t, is an attempt to reduce the value of R and with it the number of coronavirus cases. Another factor is the existence of so called super spreaders, those folk who, for whatever reason, are particularly effective in passing on the virus, infecting more people than most.

Now, whilst none of us wish to be those who spread Covid-19, we should all be those who desire to spread the word of God and ‘infect’ others with the good news of Jesus. Because, compared to merely contracting the coronavirus, it is a far more dangerous thing for us not to hear God speak. Proverbs 29:18 tells us that, ‘Where there is no vision, the people perish’. The nature of the Hebraic parallelism employed in the rest of the verse makes clear that, by ‘vision’, the writer means God’s word, a view that is made clearer still by verses like 1 Samuel 3:1 where we read ‘And the word of the LORD was rare in those days; there was no frequent vision’.

When it comes to passing on the gospel, I wonder what the value of R is for us. In the early church it was certainly above 1. In the book of Acts we read that in those days there was a bold proclamation of the gospel. And as a result ‘the word of God continued to increase, and the number of the disciples multiplied greatly in Jerusalem’ [Acts 6:7].

A big part of the book of Acts is the story of how the word of God spread. We read of how ‘the word of God increased and multiplied’ [Acts 12:24], how ‘the word of the Lord was spreading throughout the whole region’ [Acts 13:49], and of how ‘the word of the Lord continued to increase and prevail mightily’. [Acts 19:20]. That same word must continue to spread, to increase and prevail mightily, today.

This week a government minister said that one of the reasons that churches needed to remain closed was because of the concern that the exhalation involved in the singing of hymns posed an increased risk of virus spread. If, then, the exhalation involved as we exalt the Lord as we sing on Sundays can spread the coronavirus, how much more can we spread the gospel if we exalt the Lord as we daily exhale in speech?

‘We are ambassadors for Christ, God making his appeal through us.’ [2 Corinthians 5:20]. What an amazing privilege! When we proclaim the gospel, God is speaking through us. And as we speak, God will, by his Holy Spirit, ensure that his word does not return to him void. ‘For as the rain and the snow come down from heaven and do not return there but water the earth, making it bring forth and sprout, giving seed to the sower and bread to the eater, so shall [God’s] word be that goes out from [his] mouth; it shall not return to [him] empty, but it shall accomplish that which [he] purpose[s], and shall succeed in the thing for which [he] sent it.’ [Isaiah 55:10-11].

God works by his Spirit through his word. As his word is spoken, God, by his spirit breaths new life into those he is pleased to give it. Just as when ‘the LORD God formed the man of dust from the ground and breathed into his nostrils the breath of life, and the man became a living creature’ [Genesis 2:7], so it is ‘with everyone who is born of the Spirit’ [John 3:8]. God breathes new life into those who were dead in their ‘trespasses and sins’ [Ephesians 2:1]. ‘In [Christ] you also, when you heard the word of truth, the gospel of your salvation, and believed in him, were sealed with the promised Holy Spirit’ [Ephesians 1:13]. If others are to experience the same new birth that Jesus says we all must, then it will be a result of the Holy Spirit bringing it about as the gospel is spoken.

Whether or not somebody ‘catches’ the word is up to the Holy Spirit but we are called to be “contagious’ by exposing others to that word. Wouldn’t it be wonderful if we were ‘super spreaders’?. But if we are going to be those who ‘infect’ others with the gospel, we are, like those in the early church, going to have to use words because it is through words that Jesus is seen today. His beauty is displayed when we hear his voice, when we read his word or hear it preached. In Corinthians 4:4 Paul tells of how the light of the gospel displays the glory of Christ. Whilst the world says that ‘seeing is believing’, since ‘faith comes from hearing, and hearing through the word of Christ.’ [Romans 10:17], and given that ‘faith is the assurance of things hoped for, the conviction of things not seen’ [Hebrews 11:1], the truth is that ‘hearing is believing’. ‘We walk by faith, not by sight’ [2 Corinthians 5:7].

So let’s speak so that others might see and walk by faith too. Let’s seek to be highly contagious, to be those super spreaders. And let’s look to get our reproduction number up and pray that we might see ‘the Lord [adding] to [our] number day by day those who [are] being saved.’ [Acts 2:47]

Jesus commissioned us to ‘Go into all the world and proclaim the gospel to the whole creation’ [Mark 16:15].

Let’s start spreading the news,

Let’s be leaving today.

Let’s be a part of it.

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For further reflections see ‘Faith in the time of Coronavirus – 1’ by clicking here

For ‘Faith in the time of Coronavirus – 3’ click herehttps://peteaird.org/2020/07/18/faith-in-the-time-of-coronavirus-3/

For ‘Faith in the time of Coronavirus – 4’, click here

A year or so ago I wrote a blog on the film ‘Stan and Ollie’ and what it had to say about how we practice medicine. It was entitled ‘I’ll miss this when we’re gone’. Two months into the coronavirus pandemic, as the sadness lingers on, much of it still rings true.

1. Not all good advice is good advice for all.

A global response to a global pandemic is always going to struggle to deliver care tailored to an individual’s specific needs and preferences, and a generic approach to Covid-19 has been, therefore, unavoidable. Nevertheless, whilst top down protocols have necessarily been put in place to deal with what is after all a new and deadly disease, and whilst we shouldn’t beat ourselves up on account of it, it needs to be acknowledged that what is best medical advice for populations is not always the best advice for individuals. Because individuals are more than just their physiological make up.

Furthermore, and inevitably when responding so rapidly to something so unknown, not all advice has turned out to be good. So many opinions have been expressed as to what should or should not be done in response to Covid-19 that it has sometimes been difficult to discern what should be taken on board immediately and what should be viewed with caution. This was especially true in those early days when advice was changing so rapidly. What is more, whilst it’s been hard enough to familiarise oneself to a novel disease whilst simultaneously adopting to new ways of working, its been harder still to apply all that to individuals according to their particular needs, especially when, as well as being concerned for those we are to care for, we have been concerned for our own and our family’s welfare.

We have all wanted to be purveyors of the best advice to our patients but some of what has been shouted loudest has been best ignored, or at least not attended to until a little more information has become available. Time, though, has not always been on our side, and decisions have had to be made at pace. And so, as a result, though there have been times when changes have of necessity been made wonderfully quickly, there have also been times when changes have best been avoided.

None of this should allow us to think that we no longer need to try to treat patients as the individuals they are, to do so is the one thing that general practice is genuinely ideally positioned to do. But, given all of the above, it is no surprise that in these exceptional circumstances this has had to be compromised a little. Even so, we have, I think, along with the overwhelmingly excellent support of our patients, managed to maintain personal care as well as has been humanly possible.

2. The main thing has been to keep the main thing the main thing.

But what the main thing is, has also been open to debate. Covid-19 is without doubt a thing, a huge thing, perhaps even, temporarily at least, the main thing. But it isn’t the only thing. And if it is the main thing, then it must not be allowed to remain the main thing for longer than it ought.

Furthermore, whilst we have all been concerned about minimising loss of life, we need to accept that, however strongly we hold our point of view, how that main thing is best achieved in the long run is still not entirely clear – and may not become so for some time yet.

What is certain though is that whilst there have been some who have been unduly cavalier in their attitude towards the pandemic, there are others who have massively overestimated their personal risk of coming to significant harm. Many, in their understandable desire to stay alive, have stopped living any sort of life at all and have found themselves isolated from everything that makes their lives meaningful. And that’s not good. I don’t suppose I’m the only one who has found themselves trying to help patients put coronavirus into some kind of perspective.

Life must, and will, go on, with or without coronavirus, and, as we all know, there is more to life than merely staying alive. And therein lies the thing that I believe will always truly be the genuinely main thing.

3. Contradicting emotions have been experienced simultaneously.

Who hasn’t managed, having felt overwhelmingly anxious one minute, to convince themselves the next that everything just might be OK after all? Who hasn’t felt distressed by all that has been going on, yet been cheered by working in teams made up of individuals who remain a joy to work with? And who hasn’t mourned the daily death toll, and our colleagues who have been lost to Covid-19, yet rejoiced at news of those who have survived?

I hope we have all known some happiness in all the sadness. Perhaps you’ve known what it is to smile, even as you’ve cried.

And finally,

4. We have all needed to hope.

Amazing though it is, working within the NHS causes one to see its limitations and the need for something greater in which to place one’s hope, something that really can carry us through this crises. Perhaps that’s why so many of us, though appreciative of the appreciation, are uneasy each Thursday evening as the country applauds us and other key workers. We know we’re not enough. Our hope is not simply that we’ll be up to the task, we know we may not be, but that all of this will come to an end and some semblance of normality will eventually be restored.

And when it does, as it surely one day will, my hope is that General Practice, though perhaps taking hold of some of the new ways of working developed over the last few weeks, won’t lose what has always been at its heart and makes family medicine the special thing it is. And that thing is, and will always remain, the doctor-patient relationship – the cornerstone on which the whole of general practice depends – built on trust, nurtured through adversity and established over time, significant amounts of time, spent together, in the same room.

Because, if I’m honest, despite how amazingly well general practice has contributed to the cause, I’m beginning to miss that, now that that’s beginning to go….

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For the original blog ‘I’ll miss this when we’re gone’ click here

Recently I went to see ‘Stan and Ollie’, the film about Laurel and Hardy. There’s a scene towards the end of the film, when Hardy says to Laurel ‘I’ll miss this when we’re gone’. He speaks the words, indicating his eagerness to finish the show with the dance routine that, due to his heart disease, he knows, from a solely medical point of view, he is unwise to perform.

Oliver Hardy knows it’s not just his career with Stan Laurel that is drawing to a close – it’s also his life. What he chooses to do though is not simply based upon the notion that one should live only for the moment. Mindful of the future, the sadness he will feel, and recalling the past, the joy he has known, he makes a decision in the present. Hoping not to be left with the sadness of regret – he dances.

It’s a bittersweet moment. The sadness is extenuated by the joy, the joy extenuated by the sadness. It made me smile – as I cried.

It reminded me of four things:

Not all good advice is good advice for all.

There are some things more important than one’s health – the value of a life is not measured by its length. In our efforts to extend life we must not deprive our patients the opportunity to live. Sometimes we need to say to our patients that they’d be well advised to pay no heed to what we doctors tell them And sometimes we have to be wise enough to interpret what conventional medical wisdom means for those to whom we pass it on. Because even good advice is sometimes best ignored.

The main thing is to keep the main thing the main thing.

Neither we, nor our patients, need yet more guidelines focusing in on every symptom that is experienced with the demand that each is managed perfectly. Though following guidelines may make us all feel safer, they risk leaving us trapped in a very small corner of the here and now. Too much attention to problems can give them undue prominence in our consciousness and risks diminishing our lives more than is necessary. This is even more true when the problems are only risk factors – that is, merely potential problems.

Similarly, neither we nor our patients need any more spurious health scares. Though, as a consequence, undertaking a precipitous and wholesale change to our medical practice may give us a momentary sense of satisfaction that current advice is being followed, we will be left too busy to alter the things that genuinely matter today and thus delay any movement towards a truly better tomorrow. We need to keep in mind the bigger picture and focus on what’s most important. Colluding with patients that with the right combination of pills and careful attention to lifestyle death will be avoided is dishonest and, as Oliver Hardy perhaps understood, detrimental to all our chances of enjoying the life we have now.

Contradictory emotions can be experienced simultaneously

We can not deny the existence of sadness – on the contrary it’s inevitability is universal. Furthermore, we cannot know what happiness really is without knowing the pain of sorrow – and sorrow requires the memory of the temporary nature of happiness. If, then, we are to be happy, it must be alongside our sadness. We dare not wait for the absence of sorrow before allowing ourselves to be happy. It is not that we can not be happy because we know sadness, nor that we can not be sad because there are things to be happy about. Paradoxically, we can be happy and sad at the same time. Life isn’t merely about being happy. We can smile – even as we cry.

Similarly we can have a healthy appreciation of life despite serious ill health. We can live well, maybe even dance, despite our approaching death. Life is not black or white, it’s a kaleidoscope of grey. We would do well to see the light in the darkness.

We need hope.

Unlike Oliver Hardy, too many people, won’t miss this life when they’re gone. Merely keeping people alive and healthy shouldn’t be our sole concern. Nobody for whom the highlight of their day is a bottle of scotch, a packet of fags and a happy meal will adopt healthy lifestyles no matter how much we bully them to do so. We need to consider the future rather than be obsessed with the present. Such patients need to be given the hope of better lives – lives that will be missed – lives which might just motivate the healthy living that will enable such lives to be more fully enjoyed.

Rather than offering answers that won’t work, and adding to the futility that all too many experience, medicine must stop trying to be the solution to the problems for which it is not the answer. Being encouraged to constantly look inward at ourselves is the opposite to what is needed if we are to enjoy the fulfilled lives we hope we’ll live. More than a fourth antihypertensive or a third line statin, to be happy we need to be valued as members of local communities, undertake worthwhile work and enjoy meaningful connections with others. We need to know what it is to love and be loved. That is all of society’s responsibility, and though that too may be a vain hope, it is at least preferable than hoping solely in ourselves. I for sure though need one that’s even better still,

At work, to keep us going in hard times, we need also the hope that our practices will continue to be communities which provide such opportunities. They need to remain small enough to allow relationships between both staff and patients to develop over time in ways that just aren’t possible in large anonymous organisations. Staying reasonably small enables us to notice and appreciate others even as we are noticed and appreciated ourselves. Lose this and we will find we have gotten’ ourselves into another nice mess. And so, for as long as I am privileged to be able to continue to practice in the way I do now, in a supportive partnership looking after personal lists, I’m not looking to leave or reduce my commitments any time soon.

Because, I guess, ‘I’ll miss this when we’re gone’

Now if only I could dance.

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‘Stan and Ollie’ is currently available to watch free to those with an Amazon Prime subscription.

For a related blog reflecting on the Covid-19 pandemic click here

For a more theological take on the film click here

‘Eleanor Rigby

Picks up the rice in the church where a wedding has been

Lives in a dream

Waits at the window

Wearing the face that she keeps in a jar by the door

Who is it for?’

Eleanor Oliphant may be perfectly fine – but Eleanor Rigby is not. Maybe you’re not either.

It’s no fun to be lonely. It’s no fun to live by yourself and spend each evening trying to keep yourself busy in the hope that you can somehow forget how alone you really are. Sometimes though, you just can’t forget and it’s a job then to do anything at all. The weekends don’t help. Rather than being something to look forward to, they serve only to heighten the sense of isolation that you feel as the long hours drag by with you seeing nobody from the end of one working week to the beginning of another.

Hopes of ever meeting somebody and settling down seem like an unattainable dream. And so, as the loneliness continues, the unhappiness grows. The more unhappy you become, the greater the anxiety you feel at what it would take for the sadness to end until you find, in time, that the more you long for the loneliness to end, the more you long to be alone. You wonder what the point of it all might be and conclude that there is no point at all.

Alone in your room, imagining the happiness of others, it’s easy to sing silently along to The Velvet Underground,

‘All the people are dancing

And they’re having such fun

I wish it could happen to me

But if you close the door

I’d never have to see the day again’

Antidepressants may be offered to you but they never really help. No substitute for friends, they’re not the answer – too often they just make you feel worse. Conceivably, talking therapy could help a little but, rather than the simple steps towards a better tomorrow that it was suggested they would be, each session becomes just one more thing to survive, just one more hurdle to overcome. It’s hard to know what to do in such circumstances, not because you lack intelligence, on the contrary you have learnt well what the world has too readily taught, that isolation is good and that we all have to make it on our own.

And so, as I talk to such people, I sense them whispering, ‘I don’t know what to do’. And too often, like them, I find myself stuck, not knowing how to answer. When we eventually part, as I too abandon them to their solitude, their sadness surrounds me and increasingly it becomes my own.

‘All the lonely people – where do they all come from?’

Loneliness, and the accompanying anxiety that is so often both its’ cause and effect, is a common problem and, to those who experienced it, it is both crippling and overwhelming. And the problem is getting worse and will, I suspect, continue to do so for as long as society persists in fragmenting and we carry on being encouraged to live too much of our lives online. Because a life lived virtually is a life that isn’t quite complete – and a life that isn’t quite complete will feel, to many, like a life that is no longer worth holding on to.

Something is missing from our all too virtual lives, something has been lost.

And that something is ourselves

We all so long to be found.

‘Will you search through the loamy earth for me

Climb through the briar and bramble

I will be your treasure’

So run the opening lines of Johnny Flynn’s theme song to the TV comedy series ‘Detectorists’. If you haven’t seen it then do yourself a favour and give it a go. It’s about two friends, Andy and Lance, who spend all their spare time metal detecting. To be honest, not a lot happens. But as what doesn’t happen unfolds, a wonderful friendship between two people is portrayed, one which one can’t help feeling is something that is precious beyond words. Something to be envied.

In one scene Lance is talking to another character about his years of metal detecting. He says,

‘This was our escape from the rude world, the madding crowd…Do you know how often we find gold? Never. We never find it. And that’s what we’re looking for. We don’t say that. We don’t say that we’re looking for gold. We pretend we’re happy finding buckles and buttons and crap, but what we’re hoping for is gold.’

But what Lance is forgetting is the gold he has already found in the friendship he shares with Andy. The truth is that, because of that friendship, he really can be happy ‘finding buckles and buttons and crap’. Likewise, we too all need to sometimes stop our searching for things that don’t really matter and see what of value lies right in front of us but which we so easily overlook. Good relationships are the basis for happiness – if we have them, we are fortunate indeed. We should not underestimate their worth.

Despite having no interest in angling, another program that I have enjoyed immensely is ‘Gone Fishing’. Like ‘Detectorists’, whilst precious little takes place, we see a genuine friendship in action, this time a real one, between Paul Whitehouse and Bob Mortimer. They are long standing friends who have known what it is to support one another through the difficulties they have each known in their lives. And again, it’s genuinely heart warming to watch. Good relationships enable us to carry on when life seems to be falling apart around us – if we have them, we need to be careful that we nurture them well.

I have often thought that it is less important what we do in life than who we do it with.

Friendships can and do make all the difference but they need time to develop, time that is spent together, time that our frenetic lifestyles too often don’t afford.

Given that humans are meant to live in community, it is no surprise to learn that loneliness is bad for us. It is of no surprise to anybody that individuals who experience prolonged loneliness are liable to suffer low mood and anxious thoughts but it is not solely in terms of our emotional wellbeing that loneliness has adverse effects. Less appreciated is the fact that loneliness is also bad for our physical health with those experiencing it having higher rates of cardiovascular and cerebrovascular disease as well as poorer cancer outcomes. It has even been suggested that loneliness is as bad for us as smoking 15 cigarettes a day. The truth is that loneliness is deadly.

And what’s true for our patients is also true for us – being a GP can be a lonely experience too. The early years of being a doctor generally consist of a series of jobs each lasting just a few months before it’s all change and new acquaintances need to be made. It’s hard to establish good working relationships with colleagues in such circumstances and, even when settled in a job, work can be just too busy to allow time for real friendships to develop. What is more, the constant demands of the job can too easily play havoc with our relationships outside of work.

To have friends, both inside and outside of work, is vital – it is simply too important to leave to chance. In work, therefore, we must find time to support each another. We need to genuinely care for one another as friends rather than simply existing alongside each other as colleagues. It is not without good reason that GP partnerships have often been likened to marriages. Healthy partnerships, whether formalised as such or not, are grounded in the commitment that is inherent in those partnerships. They grow as a result of individual members of the team spending time alongside those with whom they go through life and with whom they can honestly acknowledge their weaknesses and struggles. They will not develop where individuals stay chained all day to their desk, constantly battling their own problems, all the while oblivious to those being experienced by others. Keeping doors open when not consulting, regularly taking time for informal chat and not neglecting the all-important daily gathering around the coffee machine all serve to build the working friendships that go a long way towards protecting those within medical teams from falling by the wayside. Informal practice meetings over dinner, annual away days and regular social events, all characteristic of healthy partnerships, will go still further. I consider myself fortunate indeed to be in such a practice.

And maintaining our home life, protecting it from the ever present threat of our work encroaching there, must also be a priority if our relationships outside of medicine are to have any chance of thriving and becoming another source of much needed support.

But to finish, let’s consider again those whom we come into contact with who are lonely. Because there are a lot of them about. Loneliness in the UK is at epidemic levels with, according to the Office of National Statistics, 2.4 million adult British citizens knowing what it is to be lonely. So if there are so many lonely people, and if loneliness is so bad for our health, why don’t we give it the same attention that we give to such things as blood pressure, smoking and cholesterol levels? Part of the answer, perhaps, lies in the fact that, with no pill available that can take away the isolation, there is no money to be made from these individuals who live on the edge of society. And where there is no money to be made, there is no incentive for those who decide what our priorities should be to make loneliness one of things that is considered important enough to tackle.

But there is another reason.

And that is that lonely go unnoticed – unless we are forced to see, they are so easily overlooked.

‘Eleanor Rigby

Died in the church and was buried along with her name

Nobody came’

And so the lonely remain, and the sadness continues. For me at least, far more than the physical consequences of isolation, it is this, the enduring sadness that inevitably accompanies loneliness, that concerns me most. The problem of loneliness is not, of course, ours alone to solve, it is all of society’s responsibility, but even though most of those affected will never dare to ask us for our help, we should, I think, be conscious of both the problem and it’s invasive and malignant consequences. And so we must always keep asking the question,

‘All the lonely people – where do they all belong?’

Because, somehow a place for them has to be found. But how? Personally, faced with someone who is desperately lonely, I admit to sometimes hearing again the words. ‘I don’t know what to do’. Only this time it is me who is whispering them quietly to myself.

It isn’t easy to find ourselves not knowing what to do, it is part of what makes it difficult for us to break bad news to our patients, it’s part of what makes it hard for us to tell them that there is nothing more that medicine can offer. But telling someone that we can’t do anything more for them as doctors doesn’t mean that we can’t do more for them as individuals – we don’t have to leave them alone just because we can’t solve their problem.

In ‘Out of Solitude’, Henri Nouwen wrote,

‘When we honestly ask ourselves which persons in our lives mean the most to us, we often find that it is those who, instead of giving advice, solutions, or cures, have chosen rather to share our pain and touch our wounds with a warm and tender hand. The friend who can be silent with us in a moment of despair or confusion, who can stay with us in an hour of grief and bereavement, who can tolerate not knowing, not curing, not healing and face with us the reality of our powerlessness, that is a friend who cares.’

‘All the lonely people, where do they all belong?’ The answer, surely, is with friends.

Though it may be the case that sometimes we can do no more than be a friend who cares, a friend who cares may be all that we are needed to be. Because, when we do what may seem to be nothing very much, that is when we may actually be doing a very great deal indeed. Sometimes we need to stop being the doctors who disappear when they cannot help and become instead the individuals who, when they don’t know what to do, know how much it can help to simply stick around.

For as long as it takes for the one who is lonely to become, perhaps, somebody’s ’very special one’, to become, perhaps, somebody’s treasure.

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Related blogs:

To read ‘An Audience for Grief’, click here

To read ‘Life after Life’, click here

To read ‘On not remotely caring’, click here

To read ‘Contactless’ click here

To read ‘The Medical Condition or Hannah Arendt is completely fine’, click here

To read ‘A Lonely Heart’, click here

To read ‘She’s The Patient You Don’t Know You Have’, click here

To read ‘She’s The Patient You Still Don’t Know You Have’, click here

To read ‘together in line’ click here

To read ‘the wrong patient’, click here

To read ‘beaten’, click here

“Hope in reality is the worst of all evils because it prolongs the torments of man.”

So said Friedrich Nietzche. But was he right?

Promises change things – they give us hope.

Many of us, particular in these days of pandemic, want things to be better than they currently are, we want someone to change our future because our present is not to our liking. We all need hope. Hope keeps us going in the face of problems which seem insurmountable. Without it we become resigned to never ending difficulty and, like Nietzsche, tend towards depression and passivity.

Theologian Jurgen Moltmann writes, “Present and future, experience and hope, stand in contradiction to each other”. He suggests that “hope is directed to what is not yet visible… and brands the visible realm of present experience…as a transient reality that is to be left behind”.

But some are uncomfortable with our constantly living in the hope of a better tomorrow. ‘Mindfulness’, the psychological process of bringing ones attention to experiences occurring in the present, is increasingly advocated as the answer to all our problems. But whilst mindfulness may have its place when we are overwhelmed by unnecessary anxiety concerning the future, grounding us, as it does, in the here and now and helping us appreciate what we have and can currently enjoy, if we imagine we can sort out our very real problems by considering the intricacies of a tree, then surely we are mistaken.

T.S.Eliot penned, “The knowledge derived from experience…imposes a pattern, and falsifies”. What we know from what we encounter is not enough to understand fully. We need to draw from outside of ourselves if we are not to be misled. The present requires the context given it by the past and is tempered by what is expected in the future. A powerful illustration of this is provided by John Piper. He asks us to imagine that, whilst walking through a hospital, we hear the screams of somebody in pain. He suggests that how we feel about what we hear will differ greatly depending on whether we are on an oncology ward or a labour ward. The future matters – it changes our present.

As a doctor, there is a sense in which I am in the business of changing the future for my patients – offering a promise of a better tomorrow for those with whom I consult. I seek to envisage what currently can’t be seen and then endeavour to bring it into reality for them. Moltmann again: “Hope’s statements of promise…stand in contradiction to the reality which can at present be experienced. They do not result from experiences, but are the condition for the possibility of new experiences. They do not seek to illuminate the reality which exists, but the reality that is coming.” So, for example, when I issue a prescription for an antibiotic, it is the proffering of a hope, that the infection will come to an end. It’s a promise that what is not true now, will shortly be so.

But really changing the future is an act solely of the divine – although doctors can help us with an irritating cough, we need more than such trivial matters resolved. In particular, we can strive all we like to live in the moment but, as temporal creatures, we cannot escape the future. Not least, we cannot deny that we are cognisant of our own mortality. Death is a problem we all have to face and one which medicine, despite its best efforts, will never solve.

To quote Moltmann once more, “The pain of despair surely lies in the fact that a hope is there – but no way opens up towards its fulfilment”. What then can we do when faced with the problem of death. Must we, if we are to carry on at all, agree with L.M. Montgomery that ‘life is a perfect graveyard of buried hopes’? Should we, with Dylan Thomas, “rage, rage against the dying of the light” or comfort ourselves with mere mindfulness as we “go gentle into that good night”.

Death is not the only future problem we face that medicine cannot solve. Many people have lost hope of things ever being better – the future is something only to be feared. We live in an increasingly anxiety ridden society. Henry Thoreau wrote “The mass of men lead lives of quiet desperation, and go to the grave with the song still in them.” But Thoreau was wrong – the desperation is deafening.

Many of us will know what it is to have a difficulty which appears beyond us, which wears us down and threatens both our present happiness and the happiness we desire for tomorrow. If then we are to solve the problem of the future, we must either limit its’ importance and be content to be satisfied by the joy we can muster in the present, or struggle to find the antidote to despair that is the hope of something better. There is much that medicine can do but ultimately our hope would be better placed elsewhere – after all, a misplaced hope is a false hope, and a false hope is no hope at all.

We need to be directed towards a real hope that can lift us above the suffering of the here and now, something we can look forward to and which, despite everything, will keep us going; something which, even if it can’t immediately get us to the top of the mountain we face, manages to draw us up a little higher and puts us in a place where we are able to at least imagine what the view from the top might look like.

When life is hard, whether at work or elsewhere, we all want things to be better – it’s then, more than ever, that we need a hope for the future to keep us keeping on. And for that we need someone who can make, and keep, bigger promises than a mere doctors assurance that a rash will clear up.

Hannah Arendt (1906-1975) was a German born philosopher best known for ‘The Human Condition’ (1958) She identified two key behaviours for bringing about change – those of forgiveness and the making and keeping of promises. Forgiveness, she said, is the behaviour by which it is possible to nullify past actions, releasing others from what they have done and enabling them to change their minds and start again. ‘Forgiveness’, she writes, ‘is the key to action and freedom’ and ‘the only way to reverse the irreversible flow of history’. In contrast, the ability to make and keep promises is the key to make the future different from the past. ‘Promises are the…way of ordering the future, making it predictable and reliable’.

I think Arendt was right, but though she would have felt that these behaviours were possible for humans, in truth our efforts are often insufficient. We need a God who truly forgives, completely, and who can make and keep promises big enough to change our future in ways in which we can not. Promises that can assure us that our biggest problems can be solved. And that is exactly the kind of God we do have.

God is a God who makes promises, promises he keeps. He’s been making them from the early chapters of Genesis. Amazing promises – that he kept. And he has made amazing promises to us too, namely that, in Christ we are forgiven and our future is with him. And he will keep those promises too. Believe that and we will not lose hope, no matter our current circumstances.

Promised forgiveness – changes our past.

Promises believed – change our present

Promises made – change our future .

Nietzsche was wrong. Because, in reality, hope does not prolong the torments of man, rather it sustains us through them.

Promises change things – they give us hope. And all the more so when, based on promises we can absolutely trust, our hope is absolutely certain.

In the middle of a global pandemic, when all we seem to hear is bad news, it’s helpful to be reminded of some good. When we’re constantly being told what we need to do, it’s helpful to be reminded of what has already been done.

One Father’s Day a few years ago I went, along with the family, to visit my Dad. I was driving along the North Devon Relief Road, happily minding my own business when, all of a sudden, I noticed a police car following along behind me.

‘So what?’ you might ask. Well, the thing is, not only was it following along behind me, it was also flashing it’s lights at me – you know the ones – the rather striking blue ones. ‘I’d better stop’, I thought to myself, ‘and see if the police officer wants any help with his enquiries.’ And do you know what? He did. In fact, so keen was he to have my assistance, that he invited me to step out of my car, and join him in his.

Now I should point out that at this point I had no idea what he wanted to talk to me about. I hadn’t been speeding and, as far as I was aware, the car I was driving was in good condition. I was at a total loss. Perhaps, I thought to myself, it was simply because he was rather proud of his car and he therefore wanted to show me just how much better it was compared to mine!

Once I was seated comfortably, the police officer began. He started by asking me some rather easy warm up questions, my name, where had I come from, and where was I heading, all of which I answered without any great difficulty.

And then he told me two things:

The first thing that he told me was the law and how I was guilty of breaking it. He told me I was guilty, guilty of driving too close to the car in front of me and, what’s more, that I had been doing so for the previous four miles. He told me that ‘only a fool, breaks the two second rule’ and, in so doing, though I hadn’t realised it at the time, I now appreciate that, by implication, he was saying that that was exactly what I was – a fool. He went on to tell me that my crime of ‘driving without due care and attention’ was worthy of a court appearance and six points on my licence.

Gulp.! Now the law is the law and, having broken it, I realised that I had no complaint, no argument. And so I acknowledged that it was the proverbial fair cop, there being no point in my trying to argue my way out of it anyway since he had it all on film. His rather fancy car really was better than mine, it even had an built in camera! The truth could not be denied, I was guilty.

I was, of course, sorry for what I’d done but being sorry didn’t change the fact that he had me, as they say, bang to rights. And so I found myself hoping that he’d show me leniency, that he’d spare me the punishment the law required, that he’d treat me, not as one who’d broken the law but instead as one who’d been driving safely. That is I hoped he’d be gracious to me, that he’d show me mercy and not treat me in the way the law demanded, in the way that I deserved.

But before I had the chance to beg…or cry…he went on.

And he told me the second thing.

He told me some news – some good news. He told me that he had decided to let me off! I don’t know why he chose not to punish me, it certainly wasn’t because of anything in me. It wasn’t because there were other drivers who were driving even more dangerously than me that day, it wasn’t a result of a promise on my part to never do it again, it wasn’t even because I’d expressed sufficient remorse. It was simply because, though I was guilty, he had chosen to be forgiving.

And that news was good news – it was gospel.

As a result of the policeman’s kindness I kept a clean driving licence that day. Not because I wasn’t guilty of any driving offences – but rather because I wasn’t counted as having done so. And no record was kept!

And that, it seems to me, is a good illustration of Law and Gospel.

Recorded in the Bible there are many laws, the most famous of which are contained in the Ten Commandments. They can be summarised by the command that we should love God with all our heart, soul, strength and mind and our neighbour as ourselves.

However, like the Highway Code that I broke all those years ago, this is a command I have not kept. Over the years I have been repeatedly guilty of breaking God’s law and so, like that Sunday afternoon, because the law condemns me and declares me guilty before God, I am left conscious of my need for mercy.

But, as was the case from the lips of the police officer that day, God also has some good news for me to hear. The Christian gospel announces to me that I am acquitted. It tells me that I am forgiven – but not because of any good in me. It’s not because there may be people who have done worse things than I have, not because I’ve promised to do better in the future, not even because I’ve been sufficiently contrite. Rather I am forgiven simply because, despite my guilt, God has chosen to be gracious to me.

Because God is, by nature, gracious, that characteristic of his by which he decides to treat us better than we deserve. Rather than punishing us as the law demands, he chooses, by way of Jesus’ death on the cross, to pay our debt on our behalf and welcome us into his family as his adopted sons. He chooses to treat us as if we’d never done anything wrong, as obedient children who had always behaved the way we should.

The law tells us what we need to do to be acceptable to God. And it crushes us.

The gospel tells us what God has done to make us acceptable to God. And fills us with joy.

Now don’t misunderstand. The law is good, everything about it is right. The rule that says that we should not drive too close to the car in front is an excellent rule, one that I fully agree with. But as my actions proved, just as the rule itself didn’t stop me from breaking it, so too the very good command to ‘Love God’ does not cause me to do so.

But here’s the funny thing. Since that encounter with the policeman, I sometimes think of his kindness when I’m driving and, though my driving is still not perfect, it has, as a consequence, improved a little. I find myself wanting to drive better. The law didn’t change my behaviour, but the policeman’s kindness did.

And so it is with the gospel. God’s law does not have the power to change us, but the kindness of God revealed to us in the gospel can. Because that gospel is very good news indeed. You see, not only is Jesus counted as if he was guilty of all the wrong things we have done, but we are counted as if we had lived the perfect life that Jesus led. It’s a wonderful exchange by which Jesus dies for our sin and we become God’s adopted children. That’s what the Bible means when it tells us that, ‘For our sake [God] made [Christ] to be sin who knew no sin, so that in him we might become the righteousness of God.’ [Corinthians 5:21]. And the thankfulness we feel as a result of all that has been achieved by his kindness draws from us a love for God that the simple command to love Him could never do. We find ourselves wanting to be better.

Whether written, as is widely believed, by John Bunyan or, as is perhaps more likely by the English hymn writer John Berridge, the words of this short rhyme make the distinction between law and gospel clear.

‘Run and work the law commands

But gives us neither feet nor hands

Far better news the gospel brings

It bids us fly and gives us wings’

Inevitably, over the coming weeks there will be more bad news, and for some it may be particularly heavy to bear. Even so, we must not forget the good news, we must not be ashamed of the gospel ‘for it is the power of God for salvation to everyone who believes’ [Romans 1:16].

Whilst the coronavirus continues to affect us, there will be much that we will be told we need to continue to do both to protect ourself and others as well as to support those who continue to care for us. Even so, we must not forget what God has already done for us through the life, death and resurrection of Jesus.

Because, ‘when the cares of our hearts are many’, it is knowing that God is far, far kinder than even the most benevolent of police officers, ‘that will cheer our souls’. It is knowing that ‘in Christ, God was reconciling the world to himself, not counting [our] trespasses against [us]’ [2 Corinthians 5:19] that will allow us to ‘rejoice in our sufferings’. And it is knowing the good news of the gospel that will sustain us through the bad news of the coronavirus.

Let me ask you a question, ‘Have you a giant in your life that needs to be overcome?’

Many would say that the current global pandemic is a giant sized problem, without doubt it is one that is likely to continue, in one way or another, to effect all our lives for a good while yet. But even giant sized problems can be overcome.

The question posed above is one that is sometimes asked by motivational speakers encouraging those facing difficulty to look to the story of David and Goliath for the inspiration necessary to overcome their problems. Undoubtedly there are wonderful things to be learnt from this well known biblical passage, but the mistake that is often made is to imagine that in order to get anywhere in life we all just need to be a bit more like David. And the reason this is a mistake is that, if we are to identify with anyone in the story, it shouldn’t be with David but rather with the terrified Israelites who are quivering in their boots at the prospect of going out to battle the Philistines.

Because David, when he goes out, as Israel’s representative in battle, to fight the Philistine champion Goliath, is not a picture of who we should be but rather a picture of someone who would come after him and who would himself act as the representative of the children of God, somebody who would one day go out to battle their enemy on their behalf. Because David, the shepherd boy who became King is a picture of Jesus, the King of Kings who was, and is, the Good Shepherd who laid down his life for his sheep.

The coronavirus, of course, is not really the biggest problem we face, it is but a manifestation of our biggest problem. Because, although the vast majority of us will not succumb to Covid-19, we will, despite the media’s apparent belief that death is an anomaly, all one day die. Rather than the coronavirus, it is death itself that is our biggest problem.

Death is the last enemy, it is the giant in our life that needs to be defeated. But defeated it has been, not by us, but by Jesus.

Regardless of how it might come about, the reason we all die is because we are all by nature sinful. Just as the chickenpox rash is the evidence of that particular virus being present within us, so too our individual acts of wrongdoing are the evidence of our desperately sick hearts. For sure some of us are more spotty than others but it remains the case that all have sinned and fallen short of the glory of God [Romans 3:23]. And the wages of sin is death [Romans 6:23].

If death is to be defeated, if it’s power over us is to be taken away, then something has to be done regarding our sin. That is not something we can do ourselves and that is why we should, like those scared Israelites before Goliath, find ourselves quivering with fear before death. Unless of course we have one who can fight the battle for us, a Saviour who can secure the victory we could not. Wonderfully, in Jesus, that is exactly what we do have.

Since the sting of death is sin, if sin is dealt with then death loses its power. But until then, as those who sin, we are, as a consequence, doomed to die. Indeed, so inevitable is our death we could be considered to effectively be dead already.

But here’s the good news! We who were ‘dead in [our] trespasses…God made alive together with [Christ], having forgiven us all our trespasses, by canceling the record of debt that stood against us with its legal demands. This he set aside, nailing it to the cross. He disarmed the rulers and authorities and put them to open shame, by triumphing over them in him’ [Colossians 2:13-15]

When Jesus was crucified, he took the punishment for everything that we have done wrong. And with sin dealt with we can ask, as others have before us, ‘O death, where is your victory? O death, where is your sting?” [1 Corinthians 15:55].

Whilst the NHS is undoubtedly a means of God’s grace for which we are right to be grateful, it’s apparent deification and the nation’s weekly act of worship on a Thursday evening is somewhat disconcerting, and not a little concerning, not only for me but also a number of my colleagues in the medical profession. There is, of course, a place for a little quiet appreciation, but it seems to me that things have gone some way beyond that. Such ongoing acclaim adds a burden of expectation on the NHS that it simply can not meet. Because the reality is that the NHS has never saved a life, nor will it ever. At best, it has only ever prolonged some. And whilst the search for a vaccine for Covid-19 is a worthy endeavour, it’s development will not greatly perturb death who will continue to find novel ways of ending our lives. Furthermore I am not a #NHSHero, nor am I one who is fighting on the ‘front line’. All is quiet at the front since death is already in retreat, defeated by somebody far braver than I and who has already fought, alone, the decisive battle on our behalf.

So, the coronovirus, is it a giant sized problem? Without doubt it’s large in all our minds but the struggle that we are currently engaged in is in reality no more than a minor skirmish in a war that has already been won. Let’s not forget that God isn’t called the Almighty for nothing and, regardless of how well we might prepare for battle, ‘the victory belongs to the LORD.’ [Proverbs 21:31]

And neither let us be in any doubt, ‘Death [really has been] swallowed up in victory’ [1 Corinthians 15:54]. For whilst ‘the wages of sin is death…the free gift of God is eternal life in Christ Jesus our Lord. [Romans 6:23]. Jesus said ‘I am the resurrection and the life. Whoever believes in me, though he die, yet shall he live’ [John 11:25].

He wasn’t wrong.

Back in the days when it was still dark whilst I made my morning commute and Covid-19 was still something I’d never heard of, I found myself reflecting on three matters that I had noticed on my way to work.

The first was this – misinterpreted Sat Navs cause confusion.

One morning I was perplexed when midway to work my Sat Nav, for no apparent reason, added 18 minutes to my expected journey time to work. Initially I assumed that, in the darkness, I’d missed the motorway exit at Junction 23 and my extended travelling time was due to the fact that I’d now have to drive up to Junction 22 before heading back. But then I reached the Bridgwater exit that I thought I’d missed and thus came to the conclusion, in the absence of any other conceivable explanation, that I must have entered some kind of time warp and my whole understanding of the space-time continuum would needing rethinking. The truth though was more prosaic – it was simply that I had mistakenly set the Sat Nav for home rather than work. My confusion had resulted from misinterpreting what the Sat Nav was saying.

It strikes me that we can become similarly confused in our Christian walk if we set inappropriate expectations of how our lives will work out as a result of misinterpreting what the Bible tells us. If we expect a carefree life, devoid of difficulty, hardship and suffering, we are likely to be confused and unsettled when these unwelcome intruders turn up in our lives. And if we have believed that Christians are immune to such problems, if we have believed that Christians can expect to avoid suffering, we may run the risk of coming to incorrect assumptions when we find ourselves experiencing such difficulties. We may find ourselves falsely imagining that our difficulties are a result of our having put our trust in a God who does not love us enough, or is not powerful enough, to prevent us suffering. We may conclude we have brought the suffering upon ourselves by some personal shortcoming for which God is punishing us. Tragically, we may even come to the conclusion that God does not exist at all.

If we live life with false assumptions we will be in danger of coming to false conclusions. It is so important therefore that we have a right understanding of how we can expect our lives to play out – we need to have our spiritual sat navs set accurately. We must not be surprised when suffering comes because Jesus himself makes it plain that ‘in this world [we] will have tribulation’ [John 16:33]. Nonetheless we can take heart because, even in the throws of a pandemic, we know that Jesus has ‘overcome the world’.

Second observation – Mobile phones are presumptuous.

I had recently acquired a new phone and, after I had had it for a couple of weeks, I was surprised as I climbed into my car one morning when it informed me that my journey to Bridgwater would take 29 minutes. At first I found it a little unnerving to think it knew where I was going since I had not told it, and the information it offered had not been solicited. I soon realised it had simply learnt, by virtue of being in my trouser pocket for the previous couple of weeks, what my normal movements were. Though a remarkable piece of electronics, my phone was, however, being presumptuous. I say presumptuous because travelling around in my pocket for a few weeks did not give it the right to think it knew me. OK it got lucky that particular morning – and a number of mornings since if I’m honest – but, believe it or not, it takes more than a few weeks to get to know who I am.

I have known myself now for a little over 53 years and I’m still not sure I know myself terribly well. I continue to surprise and, not infrequently, disappoint myself – with who I am and what I think, do and say. Self help gurus may assure us that we’re ‘good enough’ but I don’t think they’re right. I, for sure, am not good enough – as a doctor, husband, father, or friend. It’d be terrific if I was so much better in each of these roles and be able to fix those seemingly unsolvable difficulties which continue to present themselves. But the truth is I’m not a good enough person because like everybody else I am a sinner.

The twin truths of:

‘The heart is deceitful above all things, and desperately sick’ [Jeremiah 17:9]

and

‘…man looks on the outward appearance, but the Lord look on the heart’ [1 Samuel 16:7]

do not make comfortable reading. Which is why, I continue to draw great consolation from the belief that I am known fully by one who is big enough to cope with those difficulties with which I can’t – not least my own sinfulness. One of the great things about being a Christian is that we are known – completely known – not by a jumped up piece of electronics but by a Heavenly Father who loves us even though we are sinful – not because we are lovely but because he is loving. He knows us intimately – better than we know ourselves.

‘O Lord, you have searched me and known me! You know when I sit down and when I rise up, you discern my thoughts from afar. You search out my path and my lying down and are acquainted with all my ways. Even before a word is on my tongue, behold O Lord, you know it altogether.’ [Psalm 139:1-4]

And even though our problems remain – inexplicable and troubling to ourselves and others – our hope remains outside ourselves – in one we believe knows, not only what we will do in the next 29 minutes or the next 29 years, but what we will do throughout the next 29 millennia – and beyond. More than that we also know that, even as we experience our most difficult days all that happens to us is designed by our loving Heavenly Father for our good – all of it ultimately with a view to conforming us to the likeness of Jesus.

Because our hope is not that God thinks we’re OK but rather that he loves us enough to complete the good work that he has begun of making us OK [Philippians 1:6]. It is not that we have loved God but rather that ‘he has loved us and sent his Son to be the propitiation for our sins’ [1 John 4:10]. What a joy it is to be drawn by a loving Heavenly Father who really does love us rather than being driven by our need to love ourselves. What a joy it is be held safely in God’s everlasting arms on account of his mercy and grace, on account of his worth, rather than forever striving to prove our own.

And the third thing I noticed on my way to work? Well simply this.

The sunrise is sometimes staggeringly beautiful. There were a few glorious ones when I was thinking about these things. It is good sometimes to get a little perspective by looking outward at something more impressive than oneself. Not only is it more satisfying to admire the admirable than it is to be admired, it’s good to be reminded that, after a period of darkness, the sun eventually rises.

Scripture assures us that ‘Weeping may tarry for the night, but joy comes with the morning’. [Psalm 30:5] What makes the difference is the arrival of the light. Light is a positive that can be switched on in a way that darkness can not. Turning on a lamp in a dark room dispels the darkness but darkness can never be switched on so that that it dispels the light. Light reveals the truth that darkness seeks to conceal.

In dark days we need the light, we need the truth, we need Jesus. We need Jesus of whom the apostle John once wrote, ‘In him was life, and the life was the light of men. The light shines in the darkness, and the darkness has not overcome it…The true light, which gives light to everyone, was coming into the world.’ [John 1:4-5,9]

And that really is something worth reflecting on.

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For some alternative medical reflections made in the darkness, click here

Life is frequently difficult, and living through a Coronavirus pandemic, a war in Eastern Europe and an economic downturn does not make things any easier. Consequently, every now and then a day comes along which is just too much – when the demands put upon us exceed that with which we are able to cope. There is just too much need and we simply can’t meet it. We can feel drained of every ounce of energy that we possess as a result of our work, the needs of our local community or even our home life where the problems we face and the struggles of those we love sometimes add to our burden regardless of how willingly that burden is borne.

We can be so overwhelmed that it can feel that our inability to deliver the impossible reflects negatively on us, that our failure to solve every problem suggests some moral failure on our part. But there is no shame in being asked for more than we have and only being able to give all that we’ve got. We are after all only human. Our mistake is to imagine that we could ever meet every need. To imagine that we could ever do that would, in truth, be the height of presumption.

Late one November, a year or two ago the good people of Amazon were kind enough to email me, informing me that here at last, on Black Friday, were the deals I had been waiting for. 40% off exclusive Le Creuset Cast Iron Round Casseroles, 45% off a Braun Cordless Epilator and 33% of a giant bar of Toblerone. Admittedly that last one did have some appeal, but Amazon didn’t offer me the thing that I’d really like. Rest. On the contrary, by trying to convince me that these are deals that I really didn’t want to miss out on, they succeeded only in adding to my stress by encouraging me to strive still further to avoid missing out.

It’d be good, wouldn’t it, really good, to get some rest?

The notion of rest is a highly significant one in the Bible. It speaks not so much of an absence of work but rather an end to struggle. It speaks of a state of affairs when all is as it should be. The language of Genesis Chapter 1 has God resting on the seventh day. Interestingly, to me a least, is the idea that God rests not from work but rather from the work of creation. God continues to work, [John 5:17], indeed he neither slumbers or sleeps, [Psalm 121:4] sustaining the creation that he has bought about. But, on the seventh day, he rested from creation because creation was complete – because everything was good, everything was very good.

The Bible also talks of a future rest – when things will once again be just as they should be. The creation account of Genesis 1 is followed by the fall in Genesis 3. Right now we exist in fallen world when all is not what it should be. Because of man’s rebellion against God, our lives are difficult, our work is a struggle.

‘Cursed is the ground because of you; in pain you shall eat of it all the days of your life; thorns and thistles it shall bring forth for you; and you shall eat the plants of the field. By the sweat of your face you shall eat bread, till you return to the ground, for out of it you were taken; for you are dust and to dust you will return’ [Genesis 3:17-19].

This is bad news but, equally, the gospel assures us that ‘the sufferings of this present time are not worth comparing with the glory that is to be revealed to us’ and ‘that the creation will be set free from its bondage to corruption’. [Romans 8:18,21]

This corruption is particularly evident to us today – but it will end.

So where does rest come from. Jesus said:

‘Come to me all who labour and are heavy laden, and I will give you rest. Take my yoke upon you and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light’ [Matthew 11:28-30].

We can not make everything right, we can’t make even ourselves right – but we can go to one who can. Accepting that we are not as we should be, giving up the pretence that we are good, is always the first step towards making things better.

Part of the solution then is to realise that we are not the answer. And neither are our man made philosophies. Rather we need to rest in the glorious truth that God does not love us because we are good, but rather that he loves us to make us good, relieves us of the heavy burden of constantly trying to prove our worth and replaces it with the easy yoke of his acceptance of us in Christ.

So when is this rest available. Now or in the future? The answer is both – that is both now and in the future. We are called to rest in Christ now. We are to trust in his completed work on our behalf, a work that took him to Calvary where he was ‘pierced for our transgressions, and crushed for our iniquities’ [Isaiah 53:5]. And, because of his resurrection three days later we can be assured that his work secures the future eternal rest that we all so long for.

Faith is not our believing that God will bring about what we would like to be true – rather it is believing that what God says is true, He will bring about. It ‘is the assurance of things hoped for, the conviction of things not seen’ [Hebrews 11:1] that comes from believing that God will keep his promises. Because we can be absolutely certain of this means that we can know a contentment today in our discontent, a rest in our restlessness. By faith we receive now what will one day be truly ours.

So today we are invited to come before God with nothing but our need and receive from him. ‘Come, everyone who thirsts, come to the waters; and he who has no money, come, buy and eat! Come, buy wine and milk, without money and without price.’ [Isaiah 55:1] Now that is a Black Friday offer that I don’t want to miss out on.

But this does not mean that we are not active, indeed we are called to work to make the world a better place, but that work results from us having first rested in someone greater than ourselves, someone from whom we draw our strength and who works through us for the good of others.

This notion of resting before we work is reflected in how the Bible speaks of how a day is structured. We tend to think that night follows day whereas in fact the Bible speaks of day following night. The language of Genesis 1 repeats the refrain ‘And there was evening and there was morning, the first day…And there was evening and there was morning the second day’. The Jewish sabbath began at sunset. Night comes before day – we rest before we work.

So we rest now in Christ and yet at the same time we struggle on. Right now there is a tension in our rest, a rest that is already present yet at the same time not yet consummated. There are more struggles ahead for us all. But there will come a time when that eternal rest is realised – when our struggles are over, and when our joy is complete. The seventh day in Genesis never ends – and nor will that future rest. Then ‘the dwelling place of God [will be] with man. He will dwell with them, and they will be his people, and God himself will be with them as their God. He will wipe away every tear from their eyes, and death shall be no more, neither shall there be mourning, nor crying, nor pain anymore, for the former things have passed away.’ [Revelation 21:3-4]

And that will be more satisfying that even an oversized bar of Swiss chocolate.

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Related blogs:

To read ‘Good Friday 2022’, click here

To read “Easter Sunday – 2021”, click here

To read ‘The Already and the Not Yet’, click here

To read ‘Faith in the time of Coronavirus’, click here

To read ‘Faith in the time of Coronavirus – 2’, click here

To read ‘Faith in the time of Coronavirus – 3’ click here

To read ‘Faith in the time of Coronavirus – 4’ click here

To read ‘Hope Comes From Believing The Promises of God’ , click here

To read “Waiting patiently for the Lord”, click here

To read ‘But this I call to mind and therefore I have hope’, click here

To read ‘Some trust in chariots’, click here

To read ‘Sleep Well’, click here

To read ‘Covid 19 – does it suggest we really did have the experience but miss the meaning?’, click here

To read ‘Why do bad things happen to good people? – a tentative suggestion’, click here

To read ‘Luther and the Global Pandemic’, click here

And for some more thoughts on suffering, click here

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Easter Morning. The tomb is empty and Jesus is raised. Obviously.

I say obviously because it never could have been any other way. Some people have a problem with that – they say irrational things like ‘Dead people don’t come back to life – that’s simply impossible’. But the Bible says just the opposite, the Bible says it was impossible for Jesus to stay dead!

‘God raised him up, loosing the pangs of death, because it was not possible for him to be held by it.’ (Acts 2:24)

Granted, the dead rising to life again is not a common occurrence. But if the rationale for you not believing in the resurrection of Jesus boils down to, ‘It can’t happen, so it didn’t happen’, then you are not being intellectually honest with yourself, drawing your conclusions on preconceived assumptions which are not based on fact. And it’d only take a resurrection to happen once for you to have to change your point of view.

At the end of a lecture he had given on the reasons for his atheism, noted philosopher Anthony Flew, was once asked the question, ‘But what if Jesus was raised from the dead?’. ‘Well,’ he replied ‘If Jesus was raised from the dead, that would change everything’. His response was consistent with his lifelong commitment to go where the evidence led, a commitment that would, a few years before his death in 2010, ultimately lead to him coauthoring a book which was entitled ‘There is a God’.

It was the apostle Peter who made the above statement regarding the impossibility of Jesus staying dead. It is interesting to note the change that had occurred in Peter since Good Friday. After Jesus’ arrest he had been running scared, denying to everyone that he had ever even known Jesus. But here, on the day of Pentecost, just seven weeks later, he stands and publicly proclaims, to a crowd of thousands, the reality of the resurrection. The reason for the change in Peter isn’t hard to find: ‘This Jesus, God raised up,’ he says, ‘and of that we all are witnesses.’ (Acts 2:32).

Like Anthony Flew, Peter had followed the evidence.

The evidence for the resurrection is well documented and a couple of links follow for those interested:

http://www.desiringgod.org/articles/historical-evidence-for-the-resurrection

https://biblicalstudies.org.uk/article_resurrection_anderson.html

But why was it not possible for Jesus to stay dead? This is a philosophical argument and is based on the nature of death and the underlying reason for it. We tend to think that death is normal – the inevitable end to the wearing out of our bodies after long years of use or, alternatively, the tragic result of some violent insult, overwhelming infection, or malignant growth, something that our bodies cannot withstand. But the Bible says that there is a more fundamental reason for why we die. And that, it says, is because of sin.

Death is not part of how things should be – rather it is a travesty, the consequence of the presence of the wrong that is in the universe, the penalty for the sin of which we are all guilty – myself more than anyone. An awareness of this opens the door to our being able to better understand how Peter can make his assertion that it was not possible for Jesus to stay dead.

It is because Jesus was sinless, that death could not hold him.

If we struggle to believe anything about the Easter story, it shouldn’t be the resurrection of Jesus – that bit stands to reason. The amazing part of the story is that he ever died at all. That the author of life should die is a great mystery – but die he unquestionably did. As it is for his resurrection, the evidence for Jesus’ death is overwhelming, even bein* attested to by a paper published in the Journal of the American Medical Association in 1986. You can read it here:

https://jamanetwork.com/journals/jama/article-abstract/403315

So what then was the reason for Jesus’ death? The answer to that can be given in one word: Love. The love he had for those he came to save, those he was willing to lay down his life for, [John 10:15], those for whom his death would bring eternal life.

The reason that Jesus’ was born in the first place was ‘to seek and save the lost’ [Luke 19:10]. As the apostle Paul once wrote, the ‘saying is trustworthy and deserving of full acceptance, that Christ Jesus came into the world to save sinners’ (1 Timothy 1:15).

Jesus knew this and understood that the salvation he had come to achieve would be realised through his death. ‘The Son of Man must suffer many things’ he said, ‘and be rejected by the elders and chief priests and scribes, and be killed, and on the third day be raised.’ (Luke 9:22). That is the reason why, when the time of his crucifixion drew near, Jesus ‘set his face to go to Jerusalem’. (Luke 9:51).

Jesus went to Jerusalem on purpose, with the expressed intention of dying there.

But why did he have to die? More than that, why did he have be killed? Why couldn’t he have simply slipped away quietly in his sleep at a ripe old age? The answer to that question is that ‘the wages of sin is death’ (Romans 6:23). If justice is to be upheld, sin must be punished, and the penalty for sin is death.

We all want to live in a just universe – we cry out for justice when we see others maltreated especially when that injustice is particularly great or when we are find that it is who are the ones who are experiencing the injustice. The only time we are unhappy with justice is when we are guilty! I believe speeding drivers should suffer a penalty but many were the excuses I had for why I shouldn’t have had to attend the speed awareness course I was invited a few years ago!

God is, by his very nature, holy. He is perfectly right, perfectly just. And if he is to remain just, His standards must be he upheld. We, on the other hand, are not what we should be. We know, if we are honest, that we don’t live up to even our own standards let alone those of a holy and righteous God. Therefore, since as has been already been said, the ‘wages of sin is death’, we have a problem. We all deserve death, myself included and, unless a suitable substitute can be found, we face the prospect of experiencing that punishment ourselves.

But this is where the bad news of the law of God becomes the good news of the gospel. Because, not only is God holy and rightly angry at injustice he is, at the same time, merciful and gracious. God gave his only son to be a penal substitute, one who would act as the wrath absorbing, justice satisfying, atoning sacrifice for our sins. One who would gladly take our place and suffer for us the punishment we deserve.

At this point it is important to remember the mystery of the Trinity. God, though one, is three persons. We are not, therefore, seeing here a loving Jesus who absorbs the wrath of an vengeful despotic God. On the contrary, Jesus is himself fully God even as he is fully man. And the Father and Son, along with the Holy Spirit are one. As the Father loves the son, so the son loves the Father. Therefore, the death of Jesus, planned and agreed by all three persons of the Godhead before time began, and pointed too throughout the Old Testament [see for example here and here] reveals a loving Father every bit as much as it reveals a loving son,

The Old Testament prophet Isaiah had, some 700 years prior to the crucifixion, prophesied how God would one day lay on Jesus our sin and punish him in our place: ‘But he was pierced for our transgressions;’ he wrote, ‘he was crushed for our iniquities; upon him was the chastisement that brought us peace, and with his wounds we are healed. All we like sheep have gone astray; we have turned, every one, to his own way; and the LORD has laid on him the iniquity of us all.’ (Isaiah 53:5-6).

Jesus, because of his love, both for his Father and for us, willingly took on our sin and died in our place so that we need not suffer that punishment ourselves. He was put to death so that ‘whoever believes in him should not perish but have eternal life.’ (John 3:16). For our sake [God] made [Jesus] to be sin who knew no sin, so that in him we might become the righteousness of God. (2 Corinthians 5:21).

That is, God treats Jesus as if he had lived like us so that he can justly treat us as if we had lived like Jesus. This is what it means to say that God loves us. It’s not that he thinks everything about us is just peachy, but rather that he treats us well despite how little we deserve his kindness. He loves us, not because we are lovely, but because he is loving.

And how great is that love with which he loves us. We cannot conceive how vast that love is. ‘For as high as the heavens are above the earth, so great is his steadfast love towards those who fear him; as far as the east is from the west, so far does he remove our transgressions from us’ [Psalm 103:11-12]

‘In this is love, not that we have loved God but that he loved us and sent his Son to be the propitiation for our sins.’ (1 John 4:10). ‘The wages of sin is [indeed] death, but the free gift of God is eternal life in Christ Jesus our Lord.’ (Romans 6:23). ‘And this is eternal life, that [we] know…the only true God, and Jesus Christ whom [he has] sent.’ (John 17:3).

This then is how God loves us. Jesus death is not just a sign of God’s love, it is an act of love too, one that achieves our salvation. One that achieves our rescue. If I’m walking along the river with my wife and I turn to her and say ‘Darling, I love you so much and because I want to show you how much I love you I’m going to throw myself into the river’, and then, having made my declaring, I promptly proceed to do just that and drown, I am, what is commonly known as, an idiot! If however, as we walk along the riverbank she falls in and begins to drown, and I jump in to rescue her but, in so doing, lose my own life, then I have acted out of love. I will have demonstrated my love by my actions, by what I have done, by what I have achieved. I will have done a loving thing, but one that is no where near as loving as that which was done by the son of God who, of infinitely greater worth than I, died for those who were only deserving of death.

God then, in the death of his beloved son, at great personal cost, rescues us from himself so that we might enjoy knowing him forever, no longer having to live in fear of his righteous anger towards us. God’s justice was satisfied by his wrath being directed toward another, toward Jesus, the one who willingly absorbed it all for us on the cross. So completely did Jesus’ death pay the penalty for our sin that there is now no longer any of God’s anger left over to be directed at us. That is what is meant by Jesus’ death atoning for the sins of those he died for. That is the meaning of ‘propitiation’ in the verse above. God hasn’t merely laid aside his anger at sin only for it to rise up again at some later date, on the contrary, it has gone for good, even as it was fully poured out on Jesus.

That is why Jesus, as he hung on the cross, cried out ‘My God, my God, why have you forsaken me?” (Mark 15:34). Remarkably God was turning his back on the son he loves so deeply in order to save we who have ourselves turned our back on God. And it why the apostle Paul can write that ‘There is therefore now no condemnation for those who are in Christ Jesus.’ (Romans 8:1). All condemnation towards those whose only hope for salvation lies in Christ is gone! The job of satisfying the requirements of the law and thereby maintaining God’s justice even as he forgives we who have sinned and deserve death is complete. As Jesus died he said ‘It is finished’ (John 19:30). He wasn’t talking about h8s life, rather he was talking about his work of atonement. And he was right, the resurrection on Easter morning proving that his sacrifice really was fully effective in paying the price for all that we have done wrong. God’s grace really is completely sufficient for even the chief of sinners.

Rest assured, knowing God for all eternity will not be dull like some people imagine. We have all had moments in our lives when we have experienced something truly beautiful – a glorious sunset perhaps, a magnificent mountain view maybe or perhaps waves crashing powerfully against a rocky coastline. These are awesome sights, ones to be fully enjoyed enjoyed. But they are mere a faint echo of what we will one day experience, they will pale into insignificance when we see God face to face, when heaven is on earth and the dwelling place of God is with man. ‘He will dwell with [us], and [we] will be his people, and God himself will be with [us] as [our] God. He will wipe away every tear from [our] eyes, and death shall be no more, neither shall there be mourning, nor crying, nor pain anymore, for the former things [will] have passed away.’ (Revelation 21:3-4).

Seeing God and experiencing that future new creation will be infinitely more satisfying than the happiest times this world has to offer, better even than Easter Day. And the prospect of that future joy might just be enough to sustain us through the saddest times this world affords – days like Good Friday.

Easter morning – the tomb is empty and Jesus is raised.That’s good news – but not unexpected. It was always going to happen.

It was Good Friday.

But now it is Easter Sunday.

Obviously.

Happy Easter.

Addendum:

If you have read thus far, I am (a) surprised [I believe the expression is TL:DR – Too long: didn’t read] and (b) grateful. Thank you.

I am aware that this has been long but some things need more than the length of a tweet if one is to have any chance of conveying their importance.

I am also aware that there will be some, perhaps many, who will consider what I have written as naive, irrelevant and perhaps even offensive. If that is you I trust you’ll accept my words as a genuine attempt to explain things I hold to be of first importance for us all to know and understand. If, as a doctor, I genuinely believed I had a life saving cure for your terminal illness, you’d consider it cruel of me if I withheld that treatment from you even if you didn’t share the belief in its effectiveness. So consider me foolish by all means, but I hope you’ll not consider me unkind in writing as I have. If one can not write of these things at Easter time, then when can one write of them?
For all that however, I hope that there may be others who will agree with what I have written and, rejoicing with me at the news of Jesus’ life death and resurrection know that this news is simply too good not to share.

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Related posts

To read, ‘Good Friday – 2021’, click here

To read, ‘The Resurrection – is it Rhubarb?’, click here

To read, ‘Real Love?’, click here

To read, ‘Hope comes from believing the promises of God’, click here

To read ‘John 3:16’, click here

To read ‘Water from a rock’, click here

To read ‘The Sacrifice of Isaac’, click here

One Maundy Thursday I wished a good friend of mine a happy Easter break. He hesitated however to return my good wishes because, he said, that he understood that Good Friday was a day for Christians like me to be miserable. It got me thinking to what extent he was he right.

Paul, writing in his second letter to the Corinthians, describes Christians as, ‘Sorrowful yet always rejoicing’ [2 Corinthians 6:10]. If such a paradoxical existence was the reality for Christians back in Paul’s day, it is surely no less true a reality for Christians living the 21st Century. ‘Good Friday’, the name we give today, is itself a paradox – for how can we apply the adjective ‘good’ to describe the day of Christ’s crucifixion? For sure, it is a day on which Christians should grieve over their sin and what it was that Jesus had to suffer in order to secure their redemption, but, at the same time, it is a day for rejoicing in the triumph of his sacrifice as we anticipate and remember his subsequent resurrection from the dead on Easter Sunday.

‘Sorrowful yet always rejoicing’ – it was the experience of Paul and it was also the experience of Jesus himself. For he was himself ‘a man of sorrows and acquainted with grief’ [Isaiah 53:5]. Matthew recalls the words of Jesus to Peter, James and John, in the Garden of Gethsemane:

“My soul is very sorrowful, even to death; remain here, and watch with me.” [Matthew 26:38].

And yet the writer to the Hebrews has it that Jesus, ‘for the joy that was set before him endured the cross’ [Hebrews 12:2].

Suffering, then, is not the end of joy – it can even be the passage to joy. Again this is not a contradiction – but it is a paradox! A paradox that the second thief, even as he was being crucified alongside Jesus, understood. There he was, in just about as bad a position as it is possible for a person to be in, minutes away from an excruciating death, when he, nonetheless, made his remarkable request:

‘Jesus,’, he said, ‘remember me when you come into your kingdom’ [Luke 23:42].

Like everybody else that day, the second thief saw Jesus suffering and dying on a cross. But unlike the religious rulers, the Roman soldiers and the other thief who was also being crucified that day, he didn’t see defeat. He continued to speak of Jesus as one who was coming into his kingdom. For him Jesus’ death didn’t mean an end to all the kingdom and salvation talk. Whilst all those others, those who mocked Jesus as they watched him die, were looking for a salvation FROM death, the second thief saw that the salvation Jesus was bringing about was a salvation THROUGH death.

Jesus’ death wasn’t the end of Christ kingdom, on the contrary, his death was its beginning.

This is a profound truth – one we do well to try and grasp some understanding of.

Far from a simple faith, the second thief’s faith was remarkable. And it is on account of his wonderful faith that we should not be surprised by Jesus when he responds to him with these words:

‘Truly, I say to you, today you will be with me in paradise’ [Luke 23:43].

Jesus saw in the second thief somebody who got it! Somebody who trusted the power of God despite seeing that which to unspiritual eyes was nothing but weakness. Somebody who saw victory where most saw only defeat. Somebody, indeed, who understood the paradox of Good Friday.

That suffering is not irredeemable,

That sorrow is not incompatible with joy,

That even the darkest nights can be followed by the brightest days.

‘Sorrowful yet always rejoicing’? It was the experience of Paul. It was the experience of Jesus. It was the experience of the second thief.
And it will be our experience too.

Some of us are sick? Some of us mourn the loss of loved ones? Some of us worry over our future? Some of us have experienced great tragedy in our lives – some recently, some longer ago but who nonetheless still feel the pain just as keenly as if it were yesterday.

There is indeed much today for us to be sorrowful over. Some Christian types can sometimes well meaningly suggest we should always be happy. ‘Smile’, they say, ‘Jesus loves you’. But though they are right to proclaim the truth that God really does love us, they are wrong to suggest that we should never be sad, for even the eternally happy God knows what it is to cry. [1 Timothy 1:11, Luke 22:62]. Even Jesus wept at the tomb of his friend Lazarus, his grief no less intense for knowing that he would soon bring him back to life. [John 11:35].

Perhaps, then, even God knows what it is to be sorrowful yet always rejoicing.

So it’s not wrong to be sad, it’s simply normal. The Bible never tells us to masochistically rejoice about our suffering. But it does tell us to rejoice in our suffering.

Because despite our sorrow – there is much to rejoice over! We truly are loved with an everlasting love, a love that transcends our current struggle, a love that means that we too can be sorrowful yet always rejoicing.

As we suffer we can rejoice because of the Gospel. The good news is that Good Friday was followed by Easter Day, that Jesus died for our sins, bearing the punishment we deserve, and that when he rose from the dead Jesus proved the sufficiency of his sacrifice. By it we are justified, counted righteous, declared to be ‘not guilty’.

Some of us grieve over our unrighteousness and can not even lift our eyes to heaven. We beat our breasts and cry out, ‘Have mercy on me, a sinner’ [Luke 18:13] But because of Jesus’ work on the cross on our behalf we are made right with God – regardless of our current situation.

Not because of our worth – but because of his grace.

Not because of what we do – but because of what he did.

Not because we are lovely – but because he is loving.

So, if you’re sorrowful today, remember you’re not alone, God weeps with you. And know that, because of Jesus, his life, death and resurrection, ‘Weeping may tarry for the night, but joy comes with the morning.’ [Psalm 30:5].

It’s Good Friday – but Easter Sunday is coming. Because of what took place over those two days nearly 2000 years ago, we can know real forgiveness for all those sins that we so bitterly regret, no matter how great they are.

But if that were not enough to rejoice over this Eastertide, we can also look to the future with a certain hope. Suffering is all too real today but the day is coming when God ‘will wipe away every tear form [our] eyes, and death shall be no more, neither shall there be mourning, nor crying, nor pain anymore, for the former things [will] have passed away.’ [Revelation 21:4]

‘So we do not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day. For this light momentary affliction is preparing for us an eternal weight of glory beyond all comparison, as we look not to the things that are seen but to the things that are unseen. For the things that are seen are transient, but the things that are unseen are eternal’. [2 Corinthians 4:16-18]

It’s Good Friday – but Easter Sunday is coming.

So may we all know happiness this Eastertide – even those of us who are sorrowful.

Especially those who are sorrowful.

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Related Blogs

To read, ‘Luther and the Global Pandemic – on becoming a theologian of the cross’, click here

To read, ‘T.S. Eliot, Jesus, and the paradox of the Christian Life’, click here

To read, ‘Why do bad things happen to good people? – a tentative suggestion’, click here

To read, ‘Suffering – a personal view’, click here

To read, ‘The “Already” and the “Not Yet”‘, click here

To read, ‘Hope comes from believing the promises of God’, click here

To read, ‘Faith in the time of Coronavirus 1’, click here

A few reflections written in the days of Covid-19

IN THIS TIME OF UNCERTAINTY

‘In this time of uncertainty’.

These are words I’ve heard several times over the last few weeks – indeed I’ve said them myself, on many occasions. But here’s a thought, are things really any more uncertain at the moment?

Well of course they are. Doh!

But then again, perhaps not.

How so? Because what we once imagined was certain about tomorrow was never as certain as we thought it was. Indeed James, never one to mince his words, tells us that we are arrogant and evil to ever imagine that we know what tomorrow will bring!

‘Come now, you who say, “Today or tomorrow we will go into such and such a town and spend a year there and trade and make a profit” – yet you do not know what tomorrow will bring. What is your life? For you are a mist that appears for a little time and then vanishes. Instead you ought to say, “If the Lord wills, we will live and do this or that.” As it is, you boast in your arrogance. All such boasting is evil. [James 4:13-16].

The only things that are seemingly more uncertain to us today are those things we are told we shouldn’t ever have considered as certain in the first place!

But that’s not the only reason why we shouldn’t unquestionably accept that everything is now uncertain. Because it is still wonderfully true that the things that really matter, those things that relate to the unchanging character of our loving Heavenly Father, are no less certain today than they were a month ago.

God remains totally in control and, as James implies, it is still true that what the Lord wills, that will be what happens. We can draw comfort from that can’t we?

Furthermore, the writer to the Hebrews also reassures us. ‘Jesus Christ is the same yesterday and today and forever.’ [Hebrews 13:8] And his steadfast love is therefore no less certain in these days. The truth is that His love will never cease. Likewise the Lord’s mercy – it too will never come to an end. Indeed it’s newness is as certain today as it proved to be yesterday, and will prove to be tomorrow. [Lamentations 3:22-23].

So, uncertain times? Well maybe, but then again, maybe not.

Now I am sure that there will be many other verses that we can think of that contain promises made by God. Each offers us certainty today because God’s promises, all of which find their ‘Yes’ in Jesus, [2 Corinthians 1:20] can be utterly depended upon. God is faithful.

So, if you’ve a mind to, why not add some of God’s promises that come to your mind in the comments below. They’ll be an encouragement to us all.

Go on…you know you want to! We could end up with quite a list.

That is, of course, God willing!

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SELF ISOLATING AND FEELING ALL SO ALONE?

Self isolating and feeling all so alone?

Wondering if anyone is thinking of you, if anyone knows what you’re doing – whether you’re standing, sitting or lying down?
Questioning if anyone knows, or cares, what you think?
Guessing that you’re talking to yourself – that nobody is listening?

Then know this: Our Heavenly Father sees our every move, knows our every thought. and, even now, surrounds us. He has His hand upon us.

‘O LORD, you have searched me and known me!
You know when I sit down and when I rise up; you discern my thoughts from afar.
You search out my path and my lying down and are acquainted with all my ways.
Even before a word is on my tongue, behold, O LORD, you know it altogether.
You hem me in, behind and before, and lay your hand upon me.
Such knowledge is too wonderful for me; it is high; I cannot attain it.’
[Psalm 139:1-6]

We are none of us, ever alone

‘The LORD is near to all who call on him, to all who call on him in truth.’ [Psalm 145:18]. ‘In Christ Jesus [we] who once were far off have been brought near by the blood of Christ.’ [Ephesians 2:13]

And to we who are His;

God the Father has said, ‘I will never leave you or forsake you’ [Hebrews 13:5];

Jesus the Son has said ‘I am with you always, to the end of the age’ [Matthew 28:20];

and the Holy Spirit is the one who dwells within us.
[2 Timothy 1:14]

May we all know that, today, the triune God is with us. He is near.

with thanks to my son-in-law, Dan Wallace, for the idea.

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JESUS DOESN’T NEED TO SELF ISOLATE

‘And [Jesus] told his disciples to have a boat ready for him because of the crowd, lest they crush him, for he had healed many, so that all who had diseases pressed around him to touch him. [Mark 3:9-10]

I read these verses this morning. What a contrast to these days of social isolation. The diseased press around Jesus to touch him in search of a healing.

When the diseased touch the clean the clean are made diseased – except when the one who is clean is Jesus, the only one who is truly clean. Then the diseased are made clean by his touch.

In these days let us draw comfort from the fact that he has cleansed us from our sin, a far more deadly thing than any coronavirus. We are clean in the sight of God because of Jesus. His death has bought us life. And may we touch others with the gospel. It is the good news we all need to hear today.

‘For our sake he made him to be sin who knew no sin, so that in him we might become the righteousness of God.’ [2 Corinthians 5:21]

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YOU’RE NOT AS LOST AS YOU MIGHT THINK

‘I am God, and there is no other; I am God, and there is none like me, declaring the end from the beginning and from ancient times things not yet done, saying, ‘My counsel shall stand, and I will accomplish all my purpose,’ [Isaiah 46:9-10]

Some years ago, whilst out on a walk, one of my children announced that they were lost. This was on account of said child not having a clue as to where they were. But the individual in question was wrong – they weren’t lost because the one who held their hand, [me], knew exactly where they were.

I knew the way home.

Perhaps you can’t see a way through all that’s going on just now. But be assured – you’re not lost because the one who holds your hand knows exactly where you are and, even in these particularly difficult days, that same loving Heavenly Father will ensure that we will all eventually make it safely home.

The one who really does know the end from the beginning holds us still.

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COMFORTING WORDS

‘Even though I walk through the valley of the shadow of death, I will fear no evil, for you are with me; your rod and your staff, they comfort me.’ [Psalm 23:4]

I don’t know about you but, with all this talk of death, I am in need of some comforting. But where can we find such a thing when daily there is so much bad news that unsettles us?

We could simply avoid listening to the news, try to ignore reality by refusing to live in the real world. But such comfort would not be genuine.

We could pour over the statistics which perhaps suggest that any individual’s chance of coming to serious harm remain small. But such comfort would not be complete.

We could lose ourselves in fictional dramas offered up by our Netflix subscriptions and try to simply forget. But such comfort would only be temporary.

But I for one need a greater comfort than that.

‘Blessed be the God and Father of our Lord Jesus Christ, the Father of mercies and God of all comfort, who comforts us in all our affliction, so that we may be able to comfort those who are in any affliction, with the comfort with which we ourselves are comforted by God.’ [2 Corinthians 1:3-4]

God is the God of ALL comfort. There is therefore no real comfort to be found elsewhere. He may not remove us from the difficulties we are experiencing, (the verses don’t promise that, only that He comforts us IN our affliction), but He none the less comforts us however great that affliction is. His is a complete comfort, one that comforts us in ALL our affliction.

So we would do well to stop trying to do things to comfort ourselves but instead allow God to comfort us with what He has already done.

How?

By hearing the most important news of all. ‘that Christ died for our sins in accordance with the Scriptures, that he was buried, that he was raised on the third day in accordance with the Scriptures’ [1 Corinthians 15:3-4]. This is not false news – on the contrary, ‘The saying is trustworthy and deserving of full acceptance, that Christ Jesus came into the world to save sinners.’ [1 Timothy 1:15]

By focusing on the statistics that are able to completely reassure, those that tell us that ‘EVERYONE who calls on the name of the Lord will be saved’ [Romans 10:13], that ‘ALL who come to [Jesus, He] will never cast out’ [John 6:37], that if ANYONE does sin we have an advocate with the Father, Jesus Christ the righteous [and] He is the propitiation, the ‘wrath absorbing, justice satisfying, atoning sacrifice’, for our sins [1 John 2:1-2] and that ‘if we confess our sins, he is faithful and just to forgive us our sins and to cleanse us from ALL unrighteousness.’ [1 John 1:9]

And by remembering the greatest drama that ever played out, the historically verifiable one in which ‘God so loved the world, that he gave his only Son, that whoever believes in him should not perish but have eternal life.’ [John 3:16].

The first question of the Heidelberg Catechism asks ‘What is your only comfort in life and death?’. It has a beautiful answer:

‘That I am not my own, but belong with body and soul, both in life and in death, to my faithful Saviour Jesus Christ. He has fully paid for all my sins with his precious blood, and has set me free from all the power of the devil. He also preserves me in such a way that without the will of my heavenly Father not a hair can fall from my head; indeed, all things must work together for my salvation. Therefore, by his Holy Spirit he also assures me of eternal life and makes me heartily willing and ready from now on to live for him.’

‘Comfort, comfort my people, says your God. Speak tenderly to Jerusalem, and cry to her that her warfare is ended, that her iniquity is pardoned’ [Isaiah 40:1-2]

Here then, in God’s true word, is found comfort indeed

May it be a comfort that is sufficient for each of us. One that, knowing that all that God says is true, enables us, regardless of whether we live or die, to confidently say with Paul that ‘to live is Christ, and to die is gain’ [Philippians 1:21]. Because even if we do die, we can be sure that, just as with the second thief at the crucifixion, Jesus will remember us and ensure that, on that day, we will be with him in paradise. [Luke 23:43]

Even though I walk through the valley of the shadow of death, I will fear no evil, for you are with me; your rod and your staff, they comfort me.’ [Psalm 23:4]

That is our hope – not that we will not die but rather that we will surely be raised, resurrected to eternal life, to dwell in the house of the Lord forever. [Psalm 23:6]

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THE FEAR OF THE LORD

Psalm 147:11 says,

“But the Lord takes pleasure in those who fear Him
In those who hope in his steadfast love”

This is a curious thing to say, suggesting as it does that we should hope in the one we fear. Generally speaking we run away from what we fear, hide from it, isolate ourselves from it, hoping as a result to find some safety.

But if we fear God – if we fear the consequence of all the wrong things we have done – then our only hope is to run NOT AWAY from God. But towards Him.

And most particularly we need to run to the cross – where God’s anger was poured out – not on us, but on his son Jesus who took the punishment we deserve. Think of some dreadful fire destroying all before it – the safest place to be is where the fire has already been and burned the ground before moving on. That ground can’t be burnt again. So it is with God – the safest place from God’s wrath is where it has already fallen and cannot fall again. Some of us may be wisely seeking a degree of safety today by isolating ourselves in our homes, but ultimately we are safe only in Christ.

“God is our refuge and strength, a very present help in trouble.’ [Psalm 46:1]

Though at first glance it seems crazy for sinners like us to run towards a holy, righteous God, the truth is that actually the only sensible thing for those who fear God is not to hide from Him but to run to Him for mercy – putting our trust in his steadfast love.

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WISHFUL THINKING?

As the news grows ever more concerning, are you, like me, longing for better days? Perhaps then you may be comforted by these words of Victor Hugo.

“Even the darkest night will end and the sun will rise”

Such is an encouraging and hope filled assertion, not dissimilar to those made by others in recent times who have expressed the view that ‘these days will pass’. But are such assurances merely wishful thinking?

Hugo’s words reminded me of a time last year when I found myself in what I believe these days is called a ‘space’. On the walls were a number of displays one of which caught my eye. Upon it were written these words:

‘There will be other times and better times’

Of course these words may also have been no more than wishful thinking. But what was unusual about them was where exactly they were inscribed. Because the space I was in was a church, and the display I was looking at was a memorial stone to somebody who had died.

To many people therefore, the words would have been nothing but foolishness for how can there be other, better times after death?

But to those who believe that what God says is true, the words are neither the consequence of foolishness nor the result of naive optimism. On the contrary, to those who trust God, the words are most certainly true because they are based on his promises.

They are the words of somebody with genuine faith, of somebody who is assured of the things which are hoped for, who is convinced of the things not yet seen. [Hebrews 11:1]

Because for the Christian, even in death there is hope, a certain hope – that of resurrection. It is not that we hope to avoid death and suffering but rather that, even as we do suffer and die we will still be able to confidently declare that ‘There will be other times and better times’.

David put it slightly differently:

‘Weeping may tarry for the night, but joy comes with the morning.’ [Psalm 30:5]

For some, of course, the night has already been long and the dawn is yet along way off. Even so, the sun will eventually rise.

But for now we wait. As we do, ‘May the God of hope fill [us] with all joy and peace in believing, so that by the power of the Holy Spirit [we] may abound in hope.’ [Romans 15:13]

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For ‘Faith in the time of Coronavirus – 2’, click https://peteaird.org/2020/05/19/faith-in-the-time-of-coronavirus-2/here

For ‘Faith in the time of Coronavirus – 3’ click here

For ‘Faith in the time of Coronavirus – 4’ click here

In 1957 Harold MacMillan told the British people that they’d never had it so good.

How though, things have changed. In these days of a coronavirus pandemic, our way of life is being threatened in a way not seen since WWII and the NHS, which we have come to expect will always be there for us when we need it, is being stretched to the point where medical care may not be as wholly available for some as we would like.

What are we to think? What if this were to become the new norm? What if the past 75 years were an anomaly?

Perhaps now would be a good time to ask ourselves if T.S. Eliot was right. Did we have the experience but miss the meaning?

The following is a reissue of a blog first written nearly two years ago under the title, ‘T.S. Eliot, Jesus and the Paradox of the Christian Life’.

WE HAD THE EXPERIENCE BUT MISSED THE MEANING

Recently I read ‘Histories’ by Sam Gugliani – It’s a very good read relating the stories of various individuals, clinical and non clinical, who work in a hospital, and gives their differing perspectives of what takes place there. To give you a flavour, here are a few quotes that stood out for me and got me thinking.

“Hospital words spun like stones across the still waters of people’s lives.

“We’re all victims, aren’t we, of medicine’s success.”, and

“Their voices change key when they speak to him, lengthening to a sing-song, as if his dying might be rendered in nursery rhymes.”

And then there was, “We had the experience but missed the meaning”. Those more literate than I will know without resorting to an internet search that it is a line from the third of T.S. Eliot’s ‘Four Quartets’ entitled ‘The Dry Salvages”. It has been on my mind since discovering this remarkable, if perhaps bleak, poem.

Drawing on a 2010 blog by Ben Myers which helped me understand the poem, Eliot seems to be saying that ‘as one becomes older’ our pasts reveal, if we will see it, a pattern in which moments of ‘sudden illumination’, those times when we are happy, are the temporary exception to the norm. They are like a ‘ragged rock in the restless waters’ which serve only to reveal that the true nature of our existence is one in which permanency is characterised by abiding ‘moments of agony’ – such is ‘the primitive terror’.

“And the ragged rock in the restless waters, Waves wash over it, fogs conceal it; On a halcyon day it is merely a monument, In navigable weather it is always a seamark To lay a course by: but in the somber season Or the sudden fury, is what it always was”

Eliot describes ‘Time’ as both our ‘destroyer’ and our ‘preserver’. The only thing that keeps us alive is the very thing that brings about our demise. Eliot is urging us to see this deeper truth that our moments of happiness display. We have these experiences, he says, but are want to miss their meaning.

So what do I take from this as a doctor? Like moments of happiness, health is but temporary. In due course normality will be restored and we will all succumb to the ravages of time. It will ultimately destroy us. I don’t mean that we should resign ourselves to a life of melancholic anticipation of death, but we should, I think, appreciate health for what it is – a state of being that we should value whilst we have it.

Furthermore, as doctors, we should be realistic in terms of what we can expect to achieve for our patients. We are, after all, only doctors. We should make every effort to tend the sick and whenever possible endeavour to effect a cure.

But just as important perhaps is how we encourage our patients to value their health as the fragile state it truly is and we would also do well to consider how we might prepare them for the inevitability of death. Colluding with patients that with the right combination of pills, and sufficient attention to lifestyle, death will be avoided is dishonest and, perhaps, detrimental to all our chances of enjoying the life that we have.

To continue on a more positive note, it should be remembered that ‘The Dry Salvages’ is but the third of Eliot’s ‘The Four Quartets’. The fourth, ‘Little Gidding‘ offers us some hope of redemption. Ironically perhaps, the reader is asked to reflect on their experience of what they have read earlier and understand that they may indeed have missed the meaning. There is redemption but it is a redemption not from, but through death.

What we call the beginning is often the end And to make an end is to make a beginning. The end is where we start from… We shall not cease from exploration And the end of all our exploring Will be to arrive where we started And know the place for the first time.

Similarly then, might we, and our patients, know happiness, not by the avoidance of all sadness but rather through experiencing sorrow in all its dreadful intensity? Too often I make the mistake of thinking that I can only be happy when I’m not sad, and so, when unhappiness steals its inevitable way into my life, I am left feeling that I can no longer know what it is to be happy. Foolishly, before allowing myself to smile again, I insist on striving to put an end to everything that reduces me to tears, on endeavouring to put everything right.

But I simply cannot do it. Whilst I hope for that time when all will be well, waiting until then before being happy only succeeds in leaving me a long time sad.

But, seemingly contradictory, happiness and sadness are not mutually exclusive. In some sense we cannot know what happiness really is without knowing the pain of sorrow – and sorrow requires the memory of the temporary nature of happiness.

To be truly happy then we cannot deny sadness – on the contrary we must embrace it. And we must learn that it is possible to know what it is to be ‘sorrowful yet always rejoicing’. It is not that we can not be happy because we know sadness, nor that we can not be sad because there are things to be happy about. Paradoxically, we can be happy and sad at the same time.

As Leonard Cohen sang, shortly before his death, ‘There is a lullaby for suffering and a paradox to blame’.

Understand this and we, and our patients, may experience life without missing its meaning.

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T.S. Eliot professed a Christian faith, converting to Anglicanism in 1927 and served as a warden at his local parish church of St. Stephen’s, Gloucester Road, London. The question arises then as to whether Eliot’s bleak view of a life, a life characterised by inherent sadness, all be it with the hope of redemption, is in contradiction to the joy that the Bible teaches results from the receiving of the gospel.

As with much in the Christian life there is a tension here, but the simultaneous experience of joy and sadness is better described as a paradox, one experienced by the apostle Paul himself who wrote of how he was ‘sorrowful, yet always rejoicing’ (2 Corinthians 6:10). Furthermore, Eliot’s line ‘We had the experience but missed the meaning’ is one that might have been used by Jesus himself.

John 6 recounts the feeding of the 5000. The following day the people come to Jesus again only to be rebuked by him when he said to them, “Truly, truly, I say to you, you are seeking me, not because you saw signs, but because you ate your fill of the loaves” (John 6:26). ‘You had the experience of eating the bread’, Jesus is saying, ‘but missed the meaning of what it meant to be fed’.

So what was the meaning? Undoubtedly the miracle was a sign and, as with all signs, what they point too is more important than the sign itself. Nobody on a trip to the seaside, sees a sign to the beach and stops and admires the sign rather than hurrying on to play in the sand.

The miracle of the feeding of the 5000 points to who Jesus is. By miraculously feeding so many people, Jesus is recreating God’s miraculous provision for the Israelites in the wilderness when he daily provided them with manna from heaven. In so doing Jesus is declaring himself to be God. But if Eliot is right then perhaps there is more here to be learnt.

Just as the experience of moments of happiness are meant to display our abiding sadness, might not the experience of being fed be meant to reveal our enduring hunger. Jesus’ words urging the people not to work for ‘the food that perishes’ suggests this might indeed be the case.

Being fed with bread one day leaves you hungry the next even when that bread is miraculously provided by Jesus. Hunger is the default position. As far as we know, Jesus did not feed the people when they came to him this second time. Instead he tells the people to work ‘for the food that endues to eternal life’ which, he says, will be given them by ‘the Son of Man’ (John 6:27).

Jesus then famously declares that he is ‘the bread of life’ and that ‘whoever comes to him shall not hunger’. Here is redemption – an end to all hunger – a redemption secured by looking on the Son and believing on him – a redemption that is all of God whose work it is that we should believe in the one he has sent. (John 6:29).

To have the experience of being temporary fed with physical bread and miss the meaning it points to of our perpetual hunger is to miss seeing our need for redemption by feeding on the everlastingly satisfying bread of heaven. That would be a disaster.

I think Eliot is saying something similar. Our moments of happiness are meant to point to our permanent sadness and our need for a redemption which will secure an eternal joy.

Not many of us today, in our comfortable middle class churches, know what it means to be genuinely hungry. But we do know what it is to be genuinely sick and genuinely have problems that leave us sad. Frequently, and very appropriately, we come to Jesus on account of these things to seek his help.

Now just as Jesus fed the 5000, he also healed many people, but just as the relief of the people’s hunger was temporary, so too the physical healings that Jesus performed were also only temporary. Just as the people he fed returned to him hungry the following day, so those he healed all eventually became sick again. Even Lazarus, who Jesus raised from the dead, in time knew what it was to become ill once more and ultimately die a second time.

I wonder if sometimes, just as he rebuked the people for coming to him for food, for their physical needs, Jesus might, when all we are concerned about is our health, sometimes rebuke us for our constant requests for healing.

This is not to say we shouldn’t pray for healing, the Bible clearly gives us warrant for this, but we must be careful that we don’t use Jesus as a spiritual circus pony who must perform tricks at our bidding. Might he not sometimes say to us, ‘Truly, truly, I say to you, you are seeking me, not because you saw signs, but because you want a healing’? Might he not urge us sometimes not to work for the healing that perishes, but the healing that endures to eternal life?

If so, when we are not healed the way we would like, when our problems are not resolved the way we would chose, just as the people were not fed the way they would have liked the day after the feeding of the 5000, might we be encouraged that the reason for this is that Jesus wants us to have something better than physical healing? Might he want us not to have had the experience but miss the meaning?

Our moments of health are but temporary and we should treasure them. But we must also see in them the meaning of our permanent sickness and our need for an eternal healing. Those who look on Jesus, who believe in him, will not spiritually die for, not only is Jesus the bread of life, he is also the resurrection and the life.

The idea that health is an aberrant exception to disease, mirroring Eliot’s suggestion that happiness is an aberrant exception to a life of unhappiness, has support from scripture. 2 Corinthians 4:16 reminds us that ‘our outer self is wasting away’. For our bodies to fail is the norm. Lately I met somebody who assured me that I would soon be out of a job on account of ‘a new wave of the Spirit’ that would, in this present age, see an end to all disease. Similarly we may have dreams of ‘making poverty history’ in the here and now but Jesus said we would always have the poor with us (John 12:8) – I suspect he could have also said we will always have the sad and the sick. But taking those words that speak of our outer self wasting away in context we again have a paradox, for it is by that wasting away that our inner self is being renewed day by day. It is this suffering, this ‘light and momentary affliction’ that is preparing for us an eternal weight of glory, beyond all comparison’. (2 Corinthians 4:17).

And ‘so we do not lose heart’. Temporarily being fed should remind us of our perpetual hunger and our need for spiritual food. Temporarily being healthy should remind us of our perpetual sickness and our need for spiritual healing. Temporarily being happy should remind us of our perpetual sadness and our need for spiritual joy. All of which we find in Jesus.

So yes we are hungry, yet always feeding, we are sick yet always being healed, and we are sorrowful yet always rejoicing. Such is the Christian life, not a contradiction but a mysterious and wonderful paradox. It is not that we can not be happy because we know sadness, nor that we can not be sad because there are things to be happy about. Rather we can be simultaneously happy and sad. It is a paradox, not a contradiction.

We may see in our lives hunger, sickness and unhappiness, things that sometimes may be ordained for our good by our loving Heavenly Father in order that we might ‘look not to the things that are seen, but to the things that are unseen’ namely spiritual food, life and joy. ‘For the things that are seen are transient, but the things that are unseen are eternal’ (2 Corinthians 4:18). We all experience health and happiness. When we do we must not have the experience but miss the meaning. And so too, when we suffer and are sad, as well as recognising how the longing for happiness whispers of the happiness that really does exist for us somewhere, we must also acknowledge that there is meaning in our experiences of suffering and sadness.

We can rejoice, then, when we are sorrowful and we can give thanks in every circumstance, for we have been, are being and will be redeemed – from sorrow, through sorrow, from suffering, through suffering and from death, through death.

As Covid-19 continues to dominate the headlines and stretch our health services like nothing before, it is, of course, a very concerning time for us all.

But now is not the first time that the people have found themselves unnerved. Nearly 3000 years ago King Uzziah died, and the future then seemed very uncertain for the people of Isaiah’s day. Isaiah, however, saw beyond the immediate uncertainty.

This is what he wrote:

‘In the year that King Uzziah died I saw the Lord sitting upon a throne, high and lifted up; and the train of his robe filled the temple. Above him stood the seraphim. Each had six wings: with two he covered his face, and with two he covered his feet, and with two he flew. And one called to another and said: “Holy, holy, holy is the LORD of hosts; the whole earth is full of his glory!” And the foundations of the thresholds shook at the voice of him who called, and the house was filled with smoke.’

[Isaiah 6:1-4]

There is an image of one who is utterly in command. Uzziah may have died but God was still on the throne. And, despite the difficulties and uncertainties we all are currently facing, I believe he still is today

As one who works in the NHS, it was heartening to hear the applause that rang out on Thursday night for those who work in it. But we do need to be careful that we don’t begin to misplace where we put our hope. Because if we hope only in the NHS we are lost. I don’t doubt the NHS will go above and beyond in the coming weeks, many will show huge devotion to the care of others, often at risk to themselves, and I pray that I may play my part well in that great effort too, but what we are facing is beyond the best efforts of even the worlds greatest health care system.

Furthermore, amazing though the NHS is and though we will rightly all be immensely grateful for the no doubt many many people who will be kept alive that might not otherwise have survived, it cannot save everyone. Indeed it can not, in eternal terms, save anyone. Whilst many will be preserved through this coronavirus pandemic, each of those whose deaths are thus delayed will still face that great enemy in time.

So whilst there is a place to applaud the NHS, and, really, thank you if you did, I don’t want to appear churlish, it really is appreciated, we must not allow it to become an idol in which we put our ultimate trust. Maybe it’s just me but this week I have found myself trusting in the statistics, the news of a 4000 bed coronavirus unit being provided in London and, in the absence of proper PPE, the sourcing of some suits designed for those working with asbestos to offer a little more protection than the flimsy plastic aprons we would otherwise have to rely on.

It was Martin Luther who described the human heart as an idol factory. In my case at least, he wasn’t wrong. Whilst it is right to be grateful for these things, and while I really should be striving to adhere to the government restrictions regarding social distancing, I am wrong to imagine my ultimate security is found in such things. Rather than drawing comfort from the degree of safety that these things provide, I should be trusting the one who truly holds my future in his hands. I should be on my knees crying out to the one who can secure for us the eternal salvation we require. So let’s appreciate the NHS by all means, it is after all undoubtedly a means of God’s grace to many, but let us not forget to honour the one who is truly worthy of all our praise

God has made promises, promises that there is a day coming when He will wipe away every tear from [our] eyes, and death shall be no more’, a day when ‘neither shall there be mourning, nor crying, nor pain anymore, for the former things [will] have passed away.”

[Revelation 21:3-4]

The NHS cannot deliver this – it simply isn’t up to the task. If we demand this of the NHS it will let us down, if not in the next few months then later in our lives. Expect the NHS to solve all of our problems and not only will we be disappointed but we will also put a burden on those who work in it way beyond that which they can bear.

I am part of a fantastic primary care team and I value each and every member of the team including those wonderful retired partners who are even now considering how they can help. I am fortunate indeed to have them around me but, for all that, I know they are all only human. And so, as well as being immensely grateful for them, I am currently praying for them daily – and please if you are minded to, join me in this. The NHS may be the greatest health organisation in the world but the truth is that there isn’t any organisation anywhere that can possibly deliver what we would really like it to.

But God can. The same God who has demonstrated His ability to keep his word most vividly in the life, death and resurrection of Jesus Christ. So let’s be grateful for the NHS, let’s applaud it, every week if we wish, but let’s not forget where our real hope must lie.

As I have said, God has has made promises – promises that he can and will keep.

Now there may be some that ask how I can be so confident in God when there is plainly so much suffering in the world and which some of those reading this will have had all too real experience. There is, of course no easy answer to that. But I trust in the God that entered into our suffering that He might redeem us through that suffering. It may not be the way that we’d have chosen to do it, but then we’re not God and his thoughts are not our thoughts, neither are our ways his ways. [Isaiah 55:8].

And I for one am very comfortable in accepting that God is wiser than I am – consider the arrogance it would take for me to think otherwise. And I believe that I can have every confidence in believing it when He assures me that ‘though weeping may tarry for the night, joy comes with the morning. [Psalm 30:5]

So we can rightly be very grateful for the NHS but we must put our hope ultimately in God, banking on his promises.

Rather than boast in man’s abilities, we need to humble ourselves. God is for those who know their weakness. He blesses the poor in spirit, blesses and comforts those who mourn. [Matthew 5:3]: a bruised reed he will not break and a faintly burning wick he will not quench, he will faithfully bring forth justice. [Isaiah 42:3] My God gives rest to all who labour and are heavy laden.[Matthew 11:28]

So, ‘shall not the Judge of all the earth do what is just? [Genesis 28:25] I believe He will and it’s what will get me to sleep tonight despite the world’s current uncertainties.

‘Some trust in chariots and some in horses, but we trust in the name of the LORD our God. ‘[Psalm 20:7]

And I for one am convinced that we are right to do so because He is one who can be trusted.

Addendum:

‘And [Jesus] told his disciples to have a boat ready for him because of the crowd, lest they crush him, for he had healed many, so that all who had diseases pressed around him to touch him. [Mark 3:9-10]

I read these verses recently. What a contrast to these days of social isolation. The diseased press around Jesus to touch him in search of a healing.

When the diseased touch the clean the clean are made diseased – except when the one who is clean is Jesus, the only one who is truly clean. Then the diseased are made clean by his touch.

In these days let us draw comfort from the fact that he has cleansed us from our sin, a far more deadly thing than any coronavirus. We are clean in the sight of God because of Jesus. His death, by paying the penalty for our wrongdoing, has bought us life. And may there be many who are touched by this gospel. It is the good news we all need to hear today.

‘For our sake he made him to be sin who knew no sin, so that in him we might become the righteousness of God.’ [2 Corinthians 5:21]

This was written in the first week of March when coronavirus was just beginning to make its presence felt in the UK.

This week, as coronavirus continues to spread and increasingly dominates our thinking, I have been reading the book of Lamentations. It can be a difficult book to read at times describing as it does the anguish of one who, seeing disaster all around him, recognises that it is God himself who has brought about the tragic events he is witnessing. He acknowledges those events to be the just consequence of the corruption that exists in a world that has rejected God. The book is a helpful reminder that as well as being a God of love, God is to be feared since, as a holy God, he is also a God who requires that justice be done.

Proverbs 9:10 tells us that ‘The fear of the LORD is the beginning of wisdom’ and yet, today, the fear of God is something we rarely feel, preferring other things to worry about instead. Currently many are concerned about the coronavirus, and the prospect of a world pandemic. This is wholly understandable but the threat posed by the virus pales into significance against the danger we all face before a righteous God. As the writer to the Hebrews put it, ‘It is a fearful thing to fall into the hands of the living God.’ [Hebrews 10:31].

Without presuming to imagine I know the mind of God by suggesting that the disease is a specific judgement from God for any specific sin, we would nonetheless do well to see the current spread of coronavirus, like any threat to our lives, as not only a call to action but also as call to repentance. I know it is for me. [See Luke 13:1-5]. As C.S. Lewis wrote, ‘Pain insists upon being attended to. God whispers to us in our pleasures, speaks in our conscience, but shouts in our pains: it is his megaphone to rouse a deaf world.’

What then are we to do in the face of Covid-19? Is it really sufficient to hope solely in the effectiveness of catching our unexpected sneezes in our elbows, preferring foot-taps to handshakes and repeatedly washing our hands whilst singing ‘Happy Birthday’? Now don’t get me wrong, these are all vitally important things that we should all be practicing, and no less so for those like me who have a high regard for the sovereignty of God and thus believe that He determines the moment when each of us will die – after all such people rightly take great care to look both ways before they cross the road. As a doctor, I fully recognise the value of good advice and the benefits of medical science, frequently the means of God’s wonderful grace but we all nonetheless need something even greater than these sensible measures in which to place our trust.

The writer of Lamentations thought so too. Despite being cast down by the trouble he saw all about him, he none the less called to mind that the steadfast love of the LORD never ceases, that His mercies never come to an end, that they are, in fact, new every morning. He recalled God’s great faithfulness and, therefore, on account of what he knew to be true, had good cause to have hope. [Lamentations 3:21-23].

Even as a Christian I can sometimes find myself forgetting this. Sometimes I can find myself drawing more comfort from the survival statistics that suggest that if infected with coronavirus I am likely to come through it alive, than the more certain truths that I profess as a believer. This is unwise of me since the reality is that I cannot tell whether God will allow me to become infected, and, if infected, whether he will allow me to live or die. But, like the writer of Lamentations, this I know for certain – that God’s steadfast love for me will never cease and that, whether I live or die, his mercy towards me will never come to an end.

As it happens I have next week off and I am planning, God willing, to spend it in a holiday cottage in Eyam in Derbyshire. This seems strangely fitting since Eyam is remembered as the plague village. The first death from bubonic plague occurred there in September 1665 and by the Spring of 1666, 42 villagers had died. As a result there were understandably many residents who were at that time planning on fleeing the village but the recently appointed rector, William Mompesson, with the help of the previous incumbent Thomas Stanley, called a meeting and managed to persuade the villagers to stay with him and face death rather than put the lives of those outside the village at risk. As a consequence many residents died. Elizabeth Hancock buried six of her children along with her husband over an eight day period and by November 1666, when the last death occurred, a total of 260 people, at least a third of Eyam’s total population, had died. But their sacrifice had, by containing the disease, spared thousands of others who lived outside the area that had been cordoned off.

What enabled the villagers to act in the way they did must surely have been that in their distress they were, like the writer of Lamentations, able to call to mind that the steadfast love of the Lord never ceases, that his mercy never comes to an end. Despite the pain and sorrow of the sickness and death that they experienced and witnessed all around them, they continued to hope in God, whose own beloved son, Jesus Christ, had himself given his own life to save others. They knew that Jesus’ sacrifice on the cross, that place where God’s justice and mercy met, had paid the penalty for all their sin and that they could, therefore, as forgiven people, look confidently forward to a day when God would ‘wipe away every tear from their eyes, and death [would] be no more’ [Revelation 21:4]. They knew that though ‘weeping may tarry for the night, joy [would come] with the morning’ [Psalm 30:5]. As such they could hold the things of this world lightly.

May we also know what it is to hope in that same God as we, like them, recall His steadfast love and mercy. And rather than being more concerned about the amount of toilet roll we can stockpile, may we, as we seek to look after both ourselves and others, be strengthened by that hope so that we are able to serve those who are in need of help in these difficult days, putting their welfare before our own as we too look ahead to that time when there will there be neither ‘mourning, nor crying, nor pain anymore, for the former things [will] have passed away.’ [Revelation 21:4].

For ‘The LORD is my portion,” says my soul, “therefore I will hope in him.’ [Lamentations 3:24]

Addendum:

A couple of quotes, now that Covid-19 has been declared a global pandemic.

Firstly from C.S. Lewis, writing 72 years ago with reference to the atomic bomb. Replace atomic bomb with ‘coronavirus’ and the words have some relevance to us today.

‘In one way we think a great deal too much of the atomic bomb. “How are we to live in an atomic age?” I am tempted to reply: “Why, as you would have lived in the sixteenth century when the plague visited London almost every year, or as you would have lived in a Viking age when raiders from Scandinavia might land and cut your throat any night; or indeed, as you are already living in an age of cancer, an age of syphilis, an age of paralysis, an age of air raids, an age of railway accidents, an age of motor accidents.

In other words, do not let us begin by exaggerating the novelty of our situation. Believe me, dear sir or madam, you and all whom you love were already sentenced to death before the atomic bomb was invented: and quite a high percentage of us were going to die in unpleasant ways. We had, indeed, one very great advantage over our ancestors—anesthetics; but we have that still. It is perfectly ridiculous to go about whimpering and drawing long faces because the scientists have added one more chance of painful and premature death to a world which already bristled with such chances and in which death itself was not a chance at all, but a certainty.

This is the first point to be made: and the first action to be taken is to pull ourselves together. If we are all going to be destroyed by an atomic bomb, let that bomb when it comes find us doing sensible and human things—praying, working, teaching, reading, listening to music, bathing the children, playing tennis, chatting to our friends over a pint and a game of darts—not huddled together like frightened sheep and thinking about bombs. They may break our bodies (a microbe can do that) but they need not dominate our minds.’

Of course, when social distancing measures are fully introduced not all of this will be possible but the point is, nonetheless, well made. And secondly a quote from Augustine, the great theologian and Bishop of Hippo, writing in the 4th century,

‘What does it matter by what kind of death life is bought to an end? When man’s life is ended he does not have to die again. Among the daily chances of this life every man on earth is threatened in the same way by innumerable deaths, and it is uncertain which of them will come to him. And so the question is whether it is better to suffer once in dying or to fear them all in living.’

The threat of death that we face today is real, but not new.
But the ‘God of all comfort’ [2 Corinthians 1:3] who, through the centuries, has comforted our brothers and sisters in Christ who faced that same threat, has not changed. He is the same ‘yesterday today and forever’ [Hebrews 13:8].

Whether we live or die, he is always to be relied on.

This week I did something reckless. I put a patient at risk of potential harm without informing them of the fact. I purposefully denied them of their right to weigh the pros and cons of the treatment I was offering and thus make up their own mind as to whether they wanted to accept it. It was crazy of me I know, but I paid no heed to the high severity warning that EMIS flashed at me when I prescribed some flucloxacillin to a patient already taking paracetamol and thus wilfully exposed my patient to the increased risk of high anion gap metabolic acidosis associated with that combination of drugs. I did not practice caution in my prescribing in the way that the manufacturers of paracetamol advise.

It seems to me that one can barely prescribe anything these days without receiving a warning of the potential harm one may be causing a patient such that it is a wonder that anyone ever leaves my consulting room alive. Perhaps I am the only one who for years has prescribed flucloxacillin with paracetamol with ne’er a care, perhaps I am the only one who has been fortunate enough never to have run into trouble with the associated high anion gap metabolic acidosis, but I rather suspect that the high severity alert I received was a tad exaggerated. Correct me if I’m wrong but I rather expect I may not be the only one who, as well as struggling to explain what high anion gap metabolic acidosis actually is, had never heard of its association with what I previously had considered a pretty benign combination of drugs.

Why then the marked increase in these alerts which, apart from anything else, make it more likely that we will fail to notice appropriate warnings for genuine prescribing errors that we may be at risk of making? Part of the answer to that question no doubt relates to the desire of all and sundry to cover their backs in the belief that, if a warning has been given, they will no longer be culpable for any harm that may result from their product. This is understandable to a point but the consequence will be that, with nobody else being prepared to take responsibility for a management plan, in order for a patient to decide to accept a proposed treatment they will require a higher medical qualification than their doctor who is is somewhat unsure of the finer details of the warnings that they are passing on.

I wonder, however, if another reason for the explosion of warnings that we are currently being exposed to might lie in the belief that if we simply have enough information we will always be able to make the right decisions and thus always ensure a happy outcome – that if we are well enough informed, the means for success will surely lie entirely within us. To believe as such is however, not only a mistake but one that puts an ever increasing burden on us to be what it is, in reality, not possible for us to be – that is perfect.

We have, I think, adopted what might be called a ‘Philosophy of Victory’ – a philosophy which results in us believing that our goals are always attainable. We are essentially invincible – if we will only try hard enough we are always sure to win. Health, wealth and prosperity, can all be ours and we have only ourselves to blame if they are not. But our excessive desire for these things, and our belief that they are ours for the taking, has resulted in a society where the strong succeed and the weak can go to the wall. Ours is a culture where pride and self advancement are heralded as virtues and humility and self effacement are seen as weakness.

But if I have learnt anything this week from the existence of high anion gap metabolic acidosis it is not so much the dangers of simultaneously prescribing paracetamol and flucloxacillin but rather that, the more we learn the less certain everything becomes.

In his book ‘The Uses of Pessimism and the Danger of False Hope’, Roger Scruton warns against what he calls ‘the best case fallacy’, the illusion that we are prone to believe that progress will inevitably bring about a future state of affairs when all will be well. ‘There is’, he writes, ‘a kind of addiction to unreality that informs the most destructive forms of optimism: a desire to cross out reality…and to replace it with a system of compliant illusions.’ Scruton advises that we act as a ‘scrupulous optimist’ might. Alongside other characteristics, Scruton suggests that a scrupulous optimist ‘knows the uses of pessimism’, that conscious awareness that things may well go wrong, and that we ‘live in a world of constraints’. Scrupulous optimists, he says, ‘like all rational beings’ take risks ‘as part of their desire to improve things’ but do so ‘always counting the cost of failure and evaluating the worst case scenario.’ They know that things sometimes go wrong and that they, and those around them, are limited. Was this ever more evident than this weekend when, uncertainty around Covid-19 abounds and we find ourselves anxiously wondering what the coming weeks will bring?

Both those who are ill and those working in the health service to support them in their sickness need to have this healthy dose of pessimism. We aren’t always as clever as we would like to be and it can’t always be assumed that we’ll get things right. We need to take risks, even go ahead and prescribe that flucloxacillin to our paracetamol taking patient, but, at the same time, be aware that things may go wrong.

Because sometime bad things happen – and they always will. That is, sadly, inevitable.

Rather then than a ‘Philosophy of Victory’ perhaps we’d be better off adopting a ‘Philosophy of Defeat’, a philosophy which acknowledges our weakness and, therefore, the inevitability of suffering, pain and sadness. This is not to suggest that happiness is not something to be had, or indeed that good outcomes should not be desired or sought after, but rather to acknowledge that there is a gap between what we might hope for and what we may actually experience. Accepting this may just serve to leave us less discontent than when we deny the fact and so continue to constantly strive to attain the unattainable.

As Leonard Cohen once said,

“Everybody has experienced the defeat of their lives. Nobody has a life that worked out the way they wanted it to. We all begin as the hero of our own dramas in centre stage and inevitably life moves us out of centre stage, defeats the hero, overturns the plot and the strategy and we’re left on the side-lines wondering why we no longer have a part – or want a part – in the whole damn thing. Everybody’s experienced this, and when it’s presented to us sweetly, the feeling moves from heart to heart and we feel less isolated and we feel part of the great human chain which is really involved with the recognition of defeat”.

The result of accepting such a ‘Philosophy of Defeat’ would, as Cohen suggests, leave us less isolated. Instead of finding ourselves all alone as we seek to promote ourselves as unique and special, seeking to advance ourselves to the potential detriment of others, we may find that, by losing sight of ourselves and our need to be something we may just end up finding out who we really are and being content with who we already are. Accepting our ordinariness and seeking to serve others despite our weakness may result in our finding ourselves happier and more connected with those with whom we come into contact even if we come to harm ourselves. What is certainly true is that if faced with a full blown pandemic, we will not be well served by an ethos of every man for himself.

We need to walk through this thing called life together, the strong supporting the weak, and all the more so when times are hard. Manage to do this and we may just find that the distance between us, far more dangerous than any high anion gap, will be considerably narrowed.

And that would be very good medicine indeed because some of us have been self isolating for far too long already.

“Moon hanging low over my window

Shoebox of dreams hid under my bed

Follow the bright light city of gold

I had to leave to realise all I needed was here”*

[This post contains spoilers for the film ‘Wild Rose’]

Not so long ago I watched ‘Wild Rose’, the film for which the wonderfully talented Jessie Buckley received a BAFTA nomination for best actress. She plays the part of Rose-Lynn, a young Scottish woman who has made some poor choices in life but who, on being released from prison, starts to pursue her dream of becoming a country singer. Her desire to make it to Nashville, Tennessee is, however, somewhat hindered by her being a single mother to two young children and having a mother who, having looked after the children whilst she was in jail, not unreasonably believes her daughter’s responsibility towards her little boy and girl take precedent over her ambitions of making it in the music industry.

Rose-Lynn however is set on succeeding and despite having it pointed out to her by her mother that there is ‘no shortage of folk who can sing’ eventually makes it to Nashville only to discover when she arrives there that there are no end of young hopefuls, all of whom are trying to do the same thing that she is. On a visit to the legendary country music venue, the Ryman Auditorium, Rose-Lynn slips away from the tour guide and finds herself on the stage where she sings an impromptu song to the empty auditorium, accompanied only by a few members of the band who are there rehearsing. At this point in the film one might have expected her to have been overheard by a music promoter who would then have offered her a recording contract. But no industry mover and shaker is listening, only a security guard who remarks how ‘you would not believe how many people do what [she] has just done’. Shortly after Rose-Lynn returns home to her family and a year later is seen performing at her local country music club, content not to have made it big.

In a world where we are constantly promised that our dreams will come true if we only want them to enough, it was refreshing to watch a film where this was not the case. Despite some bad language and a scene or two that you may not want to have watched alongside your grandmother, it seemed to me that this was a more suitable message for our children to hear than those contained in many films that are specifically aimed at them.

Rather than being told that everyone is awesome and that whatever we dream of can be ours if only we would believe it enough, Rose-Lynn discovers the truth; that though she can undoubtedly sing, not only is she not so very different to many others, not so very special, but also that she doesn’t have to travel far from home to find the satisfaction she desires in life. She learns that, rather than trying to earn the admiration of strangers on account of her striving to be someone she isn’t, it is better to be loved by those who will continue to do so despite her being who she actually is. Because, though to be lauded by others may have some temporary appeal, the constant demand to perform beyond your capabilities is unsustainable and will eventually lead to your downfall whereas, those who are unconditionally loved for who they are know the security that enables them to become better than they would otherwise have been. Sometimes we all just have to simply accept who we are – even if to do so is, at times, impossibly hard.

Perhaps there is a message in there, for both our patients and ourselves.

Discontent – there’s a lot of it about these days and much of it is, of course, both wholly understandable and entirely appropriate. Even so, without suggesting that no one should ever seek to better themselves but instead simply accept one’s lot in life regardless of how poor the deal they have been dealt in life might be, perhaps if we were all to have more modest ambitions of what to expect in life we would all be less disillusioned and unhappy than we sometimes find ourselves. Endlessly striving for levels of awesomeness that are simply beyond most of us, constantly being told we can and should be better, fuels our unhappiness and stops us appreciating what of value we already have.

Because by sowing the seeds of discontent, we reap a harvest of disillusion.

And it’s not only in the area of our emotional well-being that we might benefit from more realistic goals. In my work as a doctor I wonder how many people I have told that they aren’t good enough – that they need to exercise more, eat better, and have a lower cholesterol, blood pressure or BMI. For sure, to suggest such things, is not bad advice but we should ask ourselves whether a 11% chance of developing heart disease in the next 10 years is really so bad when related to a 75 year old, whether a cholesterol of 5.2 is something that is inherently something to be dissatisfied about, and whether a BMI above 25 needs as urgent attention as we sometimes suggest. Surely these things are only tantamount to disaster to the degree to which our dream is to never die. Sadly, however, such a dream is not ours to have, however much we may want it.

But what of we medical professionals we who so often find ourselves defined by who we are at work. Too often we are told we are required to be better than we know ourselves to be, not only by a system that demands that we be without fault but which still insists that we show year on year improvement, but also by our own, frequently too critical, internal systems of self judgement. Perhaps our inherent ordinariness needs to be accepted a little more by both ourself and others if we are to be both happier and, consequently, ultimately more effective.

Some of us may even need to give up the notion that the only way to be happy is by being a doctor. Some dreams only fail to come true – some, however, become nightmares. Whilst medicine can be a very rewarding career, the truth is that for many it is simply not. For some happiness lies elsewhere.

Of course it is not just medics who can sometimes feel out of their depth in the career they find themselves in. Regardless of what job we may do, for those of us who are ‘tired and weak and worn’ the answer isn’t to simply ‘keep on keeping on, to keep on being strong’. Instead, when it all becomes too much, we, like Rose-Lynn, need perhaps to stop and rest in the acceptance of those who love us, however weak we may be. ‘Keep your loved ones near’ is always good advice but particular so when times are hard.

Though it may be a cause of sadness, there is no shame in being unable to give what you do not have and can not attain. It is a shame however when we imagine that there is.

Another thing that struck me in ‘Wild Rose’ was when Rose-Lynn’s mother says to her “I wanted you to learn responsibility. I didn’t want to take away your hope.”

The line stood out for me and raised the question in my mind as to whether the two need to be at odds with one another. For Rose-Lynn it seems at first that the responsibility she has towards her children, the duty she has to look after them, is the end of all hope of her ever being truly happy. But that isn’t necessarily so, as is made clear in the film. Though a struggle at times, doing what is right has its own rewards, not for any associated acclaim but for the satisfaction that comes simply from doing what needs to be done for others.

Some years ago I finished work particularly late on account of being caught up with a patient I’d visited after evening surgery. I’d been invited to a gathering that evening for a friends 70th birthday but as a result of my having to manage and admit the patient I was visiting, the celebrations were all but over by the time I arrived. Those at the party commented on how I must have had a bad day given how long the day had been but in truth they were mistaken. On the contrary it had been a good day because, on that occasion at least, doing what was required of me, was both worthwhile and satisfying.

What I’d done wasn’t anything particularly amazing, there were no QoF points attached to my actions, nor was a box ticked that day that would, at some later date, satisfy my appraiser. Instead it was just a small thing that made a difference, something that mattered to the individual concerned. Sometimes it’s the ‘sweet little nothings that add up to some things that we can’t do without’.

Acting responsibly then can be rewarding especially if we remember that, first and foremost, those to whom we should act responsibly towards are not those who seek only to regulate us but those who come to us for help. Contrary to popular belief, success is not all about personal development, we were not ‘born to run, to get ahead of the rest’, it’s not good to always want, or need, ‘to be the best’.

The truth is that sometimes ‘it’s alright to be all wrong.’, that ‘you’ve got to be weak, if you want to be strong’. We all want to be needed which means of course that somebody has to be the one who has needs. On occasions that somebody will have to be us. And that is something we all need to be OK about.

Furthermore, there is more joy to be had in seeing someone other than oneself flourish and enjoy what passes as success than there is in insisting on our having that success oneself. We none of us need to be loved by everyone and, in a world where some do not know what it is to be loved by anybody, what kind of person would require that they were?

And so we need to resist the constant demand that we must always be improving in the mistaken belief that what we have and what we are is not enough. But if it’s true that others need to be content with who we are, then perhaps we need to learn what it is to be more content with who we are too. Happiness lies more in the acceptance of our ordinariness than in a pursuit of an impossible perfection that will drain us of any joy we may otherwise have had.

In my recent appraisal I was asked what I thought I needed to improve in the coming year. I answered, and yes I was subsequently revalidated, ‘nothing much’. This was not because I am foolish enough to think that I am without fault, far from it, but because, conscious of my limits, I can’t help thinking that, rather than loading myself down with the burden of having to do what in all probability I will not be able to, I, and everybody else, would be bettered served if I concentrate on doing the things I can. And in a years time, if ‘progress’ doesn’t spoil things, I hope that you’ll find me, not singing in a local club, I’ll spare you that, but contentedly plying my trade in the local GP practice where I work, among and alongside the people of the local community of whom I am very fond. Because after 23 years my practice feels a bit like home and, as we all know, ‘there’s no place like home’.

So let’s accept who we are a little more, enjoy doing the little things we can that help others, because the little things matter enormously. A few weeks ago I reflected on the fact the things that I did that most made a difference included my knocking on the door of somebody whose mental state was concerning his wife, showing somebody what I considered an amusing 40 second film that I’d made of my dog, and reassuring an elderly lady newly diagnosed with coeliacs disease that of course she could ‘cheat’ occasionally and so have the gluten rich curry she wanted at a special family gathering she was looking forward to attending. Such seemingly insignificant actions are important even if their effect is unmeasurable. They can be, and often are, enough.

Not all of life is special and not every story has a happy ending. None of us are all that special either. But it needn’t matter if we can find enjoyment in the ordinary and satisfaction in the every day. Not everything that is important is big, and the notion that we can only know happiness if our wildest dreams come true is not one that comes close to according with the truth.

---

[*all unattributed quotes are lines from songs in the film]

For anyone interested, here’s a link to hear Jessie Buckley singing ‘Glasgow (No Place Like Home)’ from the film ‘Wild Rose’

https://youtu.be/E-l-Ly0ly4M

Better still, the whole film is available on Amazon Prime and Netflix.

‘I went to the woods because I wanted to live deliberately, I wanted to live deep and suck out all the marrow of life; to put to rout all that was not life and not, when I had come to die, discover that I had not lived.’

Henry Thoreau

Benjamin Franklin was wrong – as well as death and taxes, there is, in this world, at least a third thing that can be said to be certain – and, in case you’re wondering, I’m not thinking of the defecatory habits of ursine mammals in areas with a healthy tree population. Instead, the certainty to which I’m referring is the notion that the NHS will continually be asked to deliver more than it can reasonably be expected to in the mistaken belief that it is the conduit to perfect health.

A few years ago now, a new health initiative to improve patient health by means of personalised care plans was introduced. It generated some interest. Doctors were encouraged to sit down with patients and generate individualised advice on how those patients should go about their day to day lives so that they might maximise their health. It was patient centre health care – with bells on.

Now nobody would deny that suggesting patients stop smoking, eat healthily and take more exercise is anything other than good advice but, no matter how good that advice is, there will be no benefit in giving it to those who are not motivated enough to follow it.

With apologies to Henry Thoreau:

‘I went to the health centre because I wanted to lower my BMI, I wanted to live to 103 and maintain a blood pressure of 130/70; to reduce my serum cholesterol below 5.0 and not, when I had come to die, discover that I really should have switched to a low fat spread.’

Somehow it doesn’t have the same ring to it. Working to achieve targets is not what life is about – not at work, nor indeed in our personal lives. But in a world obsessed by what can be measured, data is increasingly becoming more important than the people to whom that data relates.

And that’s not healthy.

Encouraging people to be too focused on improving their health parameters is to do them a disservice. Furthermore, it is never going to work. Instead, in order to motivate people to live healthily, they will first need to lead lives about which they are motivated enough to go on living. If, the best part of 2000 years ago, Juvenal was dismayed by the people being superficially appeased by ‘bread and circuses’, he’d be no less frustrated at our being far too easily satisfied by a packet of chocolate hobnobs and a Netflix subscription. Without, for one minute, denying the joys inherent in such things, you get my point – if that is all life holds out for you, if the biggest thrill you get in a day is the momentary pleasure of a fag, a bottle of scotch or a Happy Meal, you will continue to seek your pleasure in these things.

But if life is rich and rewarding, then people just might be motivated enough to give up these lesser pleasures and thereby improve their health. There is more to life than being alive and a preoccupation with health can become little more than a distraction to the important matter of actually living.

Furthermore, drawing people into ever more complex care pathways, even if it did produce improved health indices, may only serve to bring about a more healthy population of ‘dead’ people whose health becomes the sole goal of their lives.

We need to be less interested in health. Rather than it being the end in itself, we need to see it simply as the servant which enables us to live. The nation’s demand for health has steadily increased as medical science has made medical interventions possible that once could only ever have been dreamed about.

Health provision has risen hugely but, we must ask, are we any healthier? We may be living longer, but our sedentary lifestyle and epidemic levels of obesity suggest that the best efforts of healthcare professionals have failed to achieve the healthier population for which we would have hoped. Indeed medical advances may even be considered to have encouraged unhealthy practices by their promise of sorting the problems that such practices inevitably cause.

Now don’t misunderstand me. If one is suffering from appendicitis, then a doctor is undoubtedly a handy person to have about. But, if we are to be healthier as a nation, we are going to have to want to be healthier because the lives we are living are worth being healthy for. We’ll need to be drawn towards health rather than driven, cajoled and bullied towards it. If happiness promotes healthiness then might nor our current unhealthy lifestyles be explained by the fall that has been seen in the nation’s happiness in past years even if that downward trend may now be turning a corner. Addressing that unhappiness may, therefore, be a more effective way to improve our health.

And this makes me consider whether there is an arrogance about health care provision. Have we doctors got ideas above our station? Do we overestimate our significance, imagining we are the most important factor in bringing about health in our patients as we go on constantly about their cholesterol, blood pressure and smoking status? Do we set ourselves up as the high priests of the god of health – laying down the laws of wellbeing and threatening terrible consequences to those who contravene that law? The way we often talk about health advances suggest perhaps we do. How often do we hear of some new medical advance promising to save any number of lives when, in truth, such advances will, at best, only prolong some and save none.

Albert Einstein once said, ‘The only thing more dangerous than ignorance is arrogance’. He was right. And not only is an arrogance on the part of medicine bad for patients, it is bad for doctors as well.

An exaggerated sense of our own importance increases the responsibility we feel in our dealings with patients and with that sense of responsibility, the anxiety we feel also increases. Everyone who deals with patients will know the anxiety that results from that sense of responsibility coupled with the uncertainty that is so often intrinsic to such interactions. Dealing with this uncertainty is one of the challenges that I and every doctor has to learn to cope with. The problem, of course, is that none of us are quite as able as we’d like to think we are – we can not know what we can not know. Could it be then that our anxiety is another form of arrogance?

Now hold on a minute, you might think, that can’t be right. After all doesn’t anxiety convey feelings of uncertainty and inadequacy – hardly the characteristics of the proud? But think again. Could it be that my anxiety is bourn out of a belief that, once again, it all depends on me – that the outcome is entirely down to my interventions, that in some way I have the power to determine the future if only I could do the right thing guided by my god-like qualities of omniscience and omnipotence with which I must save the world or at least my little corner of it? Now that would be arrogance.

An example may help. Take that patient who attended the other day with a headache. For all the world it seemed like a common or garden tension headache with no sinister sounding features whatsoever. The advice to take two paracetamol and call me in the morning was never more apt. Yet as the patient left my anxiety began to grow. What if the patient has a brain tumour, what if they die, what if it’s my fault? Now the truth of the matter is that if the patient has a brain tumour then, though sad, there was no way that that could have been determined from taking a history and performing an examination. Sad to say I do not have the god like quality of an MRI built into my forehead enabling me to notice what is otherwise impossible to see. I have to accept that I am only a doctor.

All doctors have to learn to acknowledge the fact that that is all we are. We are limited in what we can do. Now that is not to say we shouldn’t do our best – of course we should but we would all, I think, be a lot less anxious if we realised it didn’t all depend on us.

Our patients’ health does not depend wholly on us, and what’s more, believing it does often serves to make us defensive when things don’t end well, more concerned to justify our actions rather than showing the compassion we would do well to express in such circumstances. Doctors can’t make everyone healthy any more than they can make everyone happy. Perhaps we should, at times, allow ourselves to step back as doctors and, rather than killing our patients with health advice, somehow encourage patients to look away from health as the source of their happiness to something bigger and better – something really worth living for.

Then we might see an increase in health flow from a reduced concern about health.

At general election time, our politicians promise a utopia that is way beyond what they have the ability to bring about and, though they should be encouraged in their efforts and we should be responsible with our vote, they, and we, must be realistic in what they can truly deliver. Politicians are no more solely responsible for the health of the nation than we are but, having said that, they could adopt policies that better promote happiness.

Finland has recently been voted the worlds happiest nation scoring highly on levels of healthy life expectancy whilst the US, despite it having the world’s largest economy is increasingly unhappy and struggles with an epidemic of obesity, substance abuse and depression. Why the difference? One answer seems to be that Finland, along with the other Nordic countries that sit alongside Finland at top the happiest countries list, has one of the highest tax bills in the world, one that limits the wealth gap and encourages equality. And that tax bill is one that is happily paid by a people who see it as necessary for delivering quality of life for all with free health care and university education for everyone.

Medicine is important but the causes, and the causes of the causes, of ill health need to be addressed if we are to become a healthier society. A little honesty about who we are and what we can do as a profession would go a long way. And individually too. We’re all pretty average, all pretty ordinary. Rather than pretending we’re more than we really are, let’s have a little humility. As Harry Callahan used to say: ‘A man’s gotta know his limitations’. We might just feel a little better by acknowledging them.

Furthermore, such an attitude may, as a result, help us to stop the constant berating of ourselves, and others, for not being what we, and they, could never be.

So what makes life rewarding? Certainly not the hitting of health targets so often imposed on us by ourselves and others, regardless of whether those targets be optimal blood pressure, BMI or cholesterol levels. Though all desirable in their way, a life that is genuinely rewarding is surely more than that and has something to do with experiencing life with all its ups and downs alongside others who, regardless of how close they come to some arbitrary notion of what is ideal, we love unreservedly and who love us equally despite our frailties, despite our failure to reach the mark. It’s acknowledging each other as equal and valuing each other accordingly, connecting with others, appreciating them for who they are and what they bring to the world, that makes life worthwhile.

And a rewarding life is also something to do with living in the hope that however hard, however difficult life is today, someday things can and will be better. If we are to live abundantly, experience life in all its fullness, we’ll need to stop constantly setting health targets and endlessly striving to achieve them imagining that they alone will bring about the better world we desire. Of course we can each make our small contribution to making our society a better place, good health care is part of that, but we’ll need to appreciate that we aren’t the most important people in the world, upon whom the whole fabric of the universe depends. We’ll need to acknowledge that we all need more help and to be shown more kindness than a mere doctor can offer.

Understand these things and we might live a little more happier, a little more deep – whether we take a trip to the woods or not.

‘No one to follow

And nothing to teach

Except that the goal

Falls short of the reach’

Leonard Cohen

A few weeks ago I made it to London’s Guilgud Theatre to see ‘The Girl from the North Country’. It’s a play by Connor McPherson which incorporates the music of Bob Dylan and, though on the face of it having nothing to do with medicine, nonetheless touches on a number of issues which relate to general practice.

The first was pretty obvious. Set in 1934 during The Great Depression, the play charts the fortunes of those staying in a rundown guesthouse in Duluth, Minnesota. Nobody is finding it easy. The various residents have each suffered some downturn or other be that the heartache of a broken relationship, the financial hardship of a failed business venture or the disappointment of a dream that has failed to materialise. And so they find themselves endeavouring together to eek out an existence at a time when hope is in short supply. As such they are not so very different to the folk we find sitting in our waiting rooms each day.

And then there is the plays’ portrayal of those with problems in relation to their mental health. The son of one couple staying in the guesthouse has learning difficulties and the wife of the owner of the hostel suffers from a form of dementia which makes her behaviour erratic and difficult to manage. Neither can find their difficulties easy to live with but it is equally apparent that neither is it easy for those who are close to them.

To love those who are distressed can be extremely painful. When supporting patients with mental health problems it’s easy for us to forget how hard it is for those they live alongside.

Inevitably there are times when those we love make life more difficult for us, but it is a measure of the depth of the love that we feel for them that we are prepared to accept and live with that difficulty. After all, to love is to bear the pain that the love brings with it.

To abandon someone when the cost is too high has nothing to do with love, and yet, because we are all still human, it should not surprise us too much when, like the characters in the play, we find ourselves struggling with conflicting emotions and frustrated by those we love the most. Sometimes we may even find part of ourself longing to be free from those to whom we are most closely bound. True love, however, does not cut itself free, no matter how strong that desire sometimes becomes.

Thinking about this I found myself wondering about my relationship with the world of medicine. It too can drive me to distraction. At times it can make my life both difficult and frustrating, all on account of the way that it sometimes behaves, ways that seem irrational, demanding from me as it does what is not only undeliverable but also that which seems nonsensical. And yet, despite all this there is something that holds me to the profession, a profession which continues to remain dear to me.

Which brings me to the final thought that I had in relation to the play, one that follows on from what I have just said. And it’s this – that the love I have for the job that I have had now for nearly 30 years often goes unrequited, not by the colleagues I work with, nor by the patients I see each day, but by the system that I work within.

For me the most powerful song in the play comes early in the first act and is sung by a character who finds herself pregnant. The father is nowhere in sight. A load is born on account of one who offers no support. The song she sings is bittersweet. Full of longing for the one who has deserted her she repeatedly pleads, ‘Has anyone seen my love?’ And yet she is honest about the hurt that she has been caused. The song, ‘Tight Connection to my Heart’, contains words that seem particularly appropriate for those of us for whom medicine remains dear, despite the fact that, as the years go by, we are forced to bear an ever increasing burden with little encouragement from those who ask us to carry it.

Isn’t our love affair with medicine sometimes like a dysfunctional one sided relationship where one individual is taken advantage of by the other?

Think about it. How often do you feel anxious before the day gets started at the mere prospect of being on call, how often could you sing along with ‘my hands are sweaty and we haven’t even started yet’. How often do we feel overwhelmed by the demands of a job that forces us to work at a speed with which we are uncomfortable and yet find ourselves tied down by the requirements of the very system that demands we practice at the rate we do. I for one this week could have readily sung, ‘I had to move fast, and I couldn’t with you around my neck’.

We all know that there’s something seriously wrong with the system and yet we struggle to find a way to change it. And so we find ourselves having to go ‘along with the charade until [we] can think [our] way out’. The ridiculousness of so much of what we do bothers us constantly, it seems sometimes like ‘a big joke’, one that ‘sometime, maybe, [we’ll] remember to forget’. Our working conditions are often far from ideal but still the work has to be done and so we press on, ‘[We’re] gonna get [our] coat[s], [we] feel the breath of a storm, there’s something [we’ve] got to do tonight’. The policy makers however, they can ‘go inside and stay warm’.

But despite our best efforts the powers that be are never satisfied with us. They ‘want to talk to [us]’. Well they can ‘go ahead and talk, whatever [they’ve] got to say to [us] won’t come as any shock.’ We’ve familiar with the constant implication we could and should do better. ‘[We] must’, it seems, ‘be guilty of something, [they] just whisper it into our ears’.

Deep down though, we believe, or at least want to believe, that General Practice remains ‘the one [we’ve] been looking for, the one that’s got the key’. Nonetheless, we not infrequently find ourselves wondering if we’re up to the task whilst, at the same time, questioning why we continue to put up with what we are asked to. And so we feel unable to ‘figure out whether [we’re] too good for [the job] or [it’s] too good for [us]’.

‘Oh but it’s sad when a love affair dies but’ as Tim Rice penned, ‘we have pretended enough’. But about our relationship with medicine in this way might just help us to understand why we find ourselves where we are. So why do relationships sometimes fail?

One reason perhaps is that the one who was loved was originally viewed through rose tinted spectacles, perceived far most positively than was ever warranted. This may largely be because the idealised version of the beloved was the one that the person who once loved wanted to believe. In time though, the true nature of the beloved becomes apparent and, with the truth no longer deniable, love grows cold. How many of us I wonder went into medicine encouraged by a careers advisor who promised us that it was the best of all possible jobs and how many of us imagined that our working lives would look like something out of the ‘Doctor at Large’ films. I doubt I’m the only one who went into medicine with my eyes firmly closed and subsequently found the reality somewhat different.

Another, and far more important, reason why relationships fail is that the one who was loved changes. Somebody who once genuinely promised good things to another changes and becomes somebody who now takes advantage of the one who loves them and demands from them only what they themselves desire. Might not medicine have been a little like that?

Where once medicine promised secure employment along with plenty of opportunity to genuinely help people, it has now become, for many, a cruel task master who, as well as demanding we act in ways that we are not always sure are in the best interests of our patients, constantly threatens us with severe reprimand if we ever fall short of its definition of perfection.

And finally, of course, relationships can fail because the one who once loved changes, perhaps as a result of the very relationship they entered into so enthusiastically. Over time, the one who once loved no longer wants the things that the beloved once offered. Broken by the system, I wonder how many of us now realise what we should have appreciated long ago, that the financial reward and degree of social status that medicine offers, comes, for some, at too high a price.

Of course it’s not just medicine. We live in a world where too many people are treated as commodities to be consumed. The media uses individuals for as long as they are useful and individuals are exploited by those who are only out to make a quick buck. And it also seems to me that increasingly many of our patients, regardless of the genuineness of their illness, are unaccountably facing ‘disciplinary meeerings’ when, on account of their sickness record, they are not as productive as their employers would like.

A wise old counsellor once said to me that when we find ourselves in a unhealthy relationship we have three options. We can put up and shut up, we can get out or we can change.

Whilst the first of these options is undoubtedly the worst, and the second, though understandable, is frequently a cause for sadness, the third, if it is at all possible, is the most preferable option. My counsellor friend may have missed an option however because, of course, sometimes, getting out or change simply isn’t possible, not immediately at least. And when that’s the case, better than ‘putting up and shutting up’ it’s far better to voice ones struggles to a friend who can be with you through the pain even if they can’t take it away.

That said, positive change, making good what currently is not, is, undoubtedly the ideal and therefore, what we need to try to bring about. But it’s not our colleagues that continue to support us and who are a joy to work alongside that need to change, and nor is it our patients who are generally a pleasure to interact with day by day. Rather it is the system that needs to change, a system on whose behalf we must no longer make excuses.

Rosa Parks was the woman who, in 1955, lit the spark that ignited the civil rights movement when she was asked to give up her seat on a Montgomery bus for a person with white skin. She simply said ‘No’. Our problems are comparatively trivial, but I can’t help thinking that we would do well to say a quiet yet determined ‘No’ to the ‘general practice’ that is being forced upon us. Not only is it unsustainable, it is also, for all its frenetic earnestness, threatening to have as its goal something that falls short of what it could be reaching. Medicine needs to stop sacrificing its soul on the alter of algorithm driven protocols and seek, instead, to retain its heart and mind and remember how to think and feel. Although we may have to accept the consequences, it may just have the effect of maintaining the profession which we chose to become a part of and mean that, when our time comes to retire, we are genuinely sad to leave.

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For anyone interested, you can listen to Sheila Atim’s wonderful rendition of ‘Tight Connection to my Heart’ from the Original London Cast Recording of ‘The Girl from the North Country’ here. Do have a listen, it’s well worth it even if, unaccountably, you’ve no interest in Bob Dylan himself.

I’m 53 now and due something of a midlife crisis, so you’ll forgive me for looking back on my career in general practice and asking how worthwhile it has been. No doubt I’m not the only doctor in the country that looks critically at their performance and sees their weaknesses rather more readily than their strengths. And yet, as the years go by, there seems to be an ever greater requirement to justify myself, to prove my value.

Paradoxically this leaves less time to do valuable things. The need to look inward and prove myself, as well as being a crushing burden personally, is detrimental to my patients since the pressure to tick boxes all day renders me content to have ticked those boxes rather than to do something that would actually make a difference.

Once, when things didn’t go as we would have hoped, we talked about the event of significance, as professionals. Then such discussions became formalised as significant event audits (SEAs) and in time they became a requirement, necessary for revalidation. But with the addition of a list of situations that the SEA meeting had to cover, they largely lost their value. Once when we came across something we didn’t know, we looked it up, as professionals. Now we have to document our learning and reflect on the process. Once training was an apprenticeship, now it is a tiresome collecting of CBDs, COTs, DOPs, PSQs, and MSFs. Once we sought to advise, help, and treat patients who were sick, now we have to chase QOF points and are rewarded for them regardless of how meaningless the chase for them actually is.

What have you done this last week that you felt was particularly worthwhile? I’d wager a small coin it wasn’t starting someone on a statin.

And the result of all of this is, I think, a devaluation of general practice, such that it is in danger of becoming a profession of which I am no longer proud to be a part. Medicine as a whole is becoming a job not a vocation. We need to wise up to the fact that general practice is being dumbed down as we are forced to focus on the minutiae at the expense of the whole.

Others have remarked that wisdom is being lost for the sake of knowledge, which in turn is being lost for the sake of facts. And now facts are losing out for the sake of data. The fact that our computers urge us to consider lowering the blood pressure of the patient consulting with on account of their recently having suffered the death of their spouse, proves the point.

Computers can process data, they may even be able to carry out a form of thinking, but I’m pretty sure that they can not feel. If we allow them to, computers will ensure that we will find ourselves moving toward an ever greater validation of the sacredness of a patient’s clinical parameters at the expense of our capacity to consider the individual as a whole

There is a place for data, of course there is, but I want to be wise, not merely accurate. Do we really want our legacy to be successfully filling the local nursing home with the next generation of older mentally infirm patients who really may have been better served staying away from our life-prolonging medicines? The point of living is not a long life. It may not be wise to strive for it.

A while back I filled out my appraisal forms and, for my plans for the coming year, I put down that I wanted to approach the problems that would be presented to me with a degree of medical know-how, mixed with a healthy measure of common sense, pragmatism, and good fortune. I wondered if that would satisfy my appraiser? Or would I just have to prove I’m ok, by producing the ‘evidence’ that would prove no such thing?

As I say, I want to do things more wisely, and that just may mean my doing less.

Those of you still reading this post and who are of a similar age to myself may recall the television series that first aired in 1973 entitled ‘Why Don’t You Just Turn Off Your Television Set And Go And Do Something Less Boring Instead’. Amazingly the series ran until 1995 when, presumably, the producers realised they were losing the argument. There is of course an irony inherent in the fact that the only medium through which the message to stop watching television stood a chance of being listened to was the very medium the producers were reacting against.

They were not the only ones to be concerned by the influence television has on us. In the preface to his book, ‘Amusing Ourselves to Death’, a critique of the effect of television on our culture, Neil Postman compared the concerns of George Orwell in ‘1984’ to those of Aldous Huxley in ‘Brave New World’. He wrote:

“What Orwell feared were those who would ban books. What Huxley feared was that there would be no reason to ban a book, for there would be no one who wanted to read one. Orwell feared those who would deprive us of information. Huxley feared those who would give us so much that we would be reduced to passivity and egoism. Orwell feared that the truth would be concealed from us. Huxley feared the truth would be drowned in a sea of irrelevance. Orwell feared we would become a captive culture. Huxley feared we would become a trivial culture.”

What is particularly astonishing is the fact that Postman’s book was published in 1985, long before the exponential rise in the number of TV channels and the dawn of Facebook, Twitter and the like which has only served to confirm Postman’s view that Huxley, not Orwell, was right.

The point is well made that the very presence of the medium demands that it be filled regardless of whether there is anything worthwhile to be said. Trivia thus reigns. One only needs to compare the number of ‘likes’ attracted by my Facebook post of Dorothy L. Sayers’ admittedly lengthy article ‘The Lost Tools of Learning’ to that of a friend who posted a picture of a dog balancing biscuits on it’s nose to see my point. And yes I am too narcissistic not to care. Having said that, to be fair, the picture did amuse – by which I mean ‘a-muse’ in it’s literal sense of requiring no thought. But then maybe I’m just a grumpy old man, guilty of ‘triste supercillium’ – intellectual snobbery!

And it’s not just Facebook where there is too much information.

The same could be said of medicine and, no doubt, many other professions. Every day, countless new periodicals pour through our letterboxes, both real and virtual. None of us can pretend to consider all that even the most respected journals offer up for our delectation – what chance then the legion of lesser publications that are produced each week?

And it doesn’t end there. The media presents its own view of ‘what’s what’ in medicine and feeds it to patients as fact. And this, in turn, is mixed with the opinion of all and sundry with the result that, as the juggernaut of medical opinion lumbers on to the next medical hot potato, seeking its own 15 minutes of infamy, nobody left in its wake knows what to believe. But then, everybody’s entitled to their opinion aren’t they? What do you reckon?

Without doubt, it is all too easy to miss the significant in the tidal wave of trivia.

So why do we find ourselves so inundated with information and opinion? And why do so many of us insist on adding to the noise?

Undoubtedly the internet and improved communications systems have made it possible to disseminate information faster and more efficiently than ever before, but that doesn’t fully answer the question. To understand how and why we use that technology we need to appreciate how we have been changed by it. For all our on-line connectivity, we are, perhaps, lonelier than ever before and are, therefore, increasingly desperate to be noticed. We are becoming increasingly narcissistic as we insist on our opinions being heard, considered important and approved of. The irony of my saying so here does not go unnoticed, but the truth is that, for many of us, we need to be ‘liked’.

Because, with apologies to Orwell: ‘Many likes good, few likes bad’.

However popularity does not define what is good and truth is not determined by how many assent to a point of view. Furthermore, if the important is lost in a sea of trivia, might not our adding to that ocean be an attempt, all be it a subconscious one, to deny that there is anything important at all. Because, as the important goes by unnoticed amidst the trivial, so also, with all our incessant comment, does not the important itself become trivial?

Which brings me to the thorny issue of our being patient centred. Is it all it’s cracked up to be? Of course we should seek to understand where a patient is coming from but there is a difference between respecting a patient and respecting what that patients tells us. As with our reading of the medical press, we need to discern just how meaningful what a patient says is on a personal level. And be professional enough to disagree. As a patient said to me ‘It’s all very well you saying that the mark on my head is nothing serious doctor, but my hair dresser says it’s cancer’. Perhaps I should have offered to cut her hair!

Yes we should understand our patients’ ideas, concerns and expectations, but that doesn’t mean we should surrender to them any more than our politicians should surrender to the patients expectation of GPs being open seven days a week. Of course the difference there is that the politicians need votes, GP’s don’t, or at least shouldn’t – except at patient satisfaction survey time of course. We really do need to be motivated by a desire to be good doctors – whatever that might be – not just doctors who are liked as a result of giving patients what they want. But with all the information out there it is becoming increasingly difficult to know just what the good doctor should do.

As well as questioning what the system demands of us, we need to become more discerning of what we hear. Just because a thing is said confidently, repeatedly or passionately, doesn’t make it true or worth listening to – and that includes, of course, these words. A thing is true because it’s true – not because its popular or ‘true for me’. The problem is that discerning what is true is increasingly difficult as the tidal wave of information crashes over us each day, the sources of which are often far from clear, and opinions are continuously shouted by those with questionable authority to pass comment on the matters they profess expertise.

So what should we do?

Well here’s the thing – perhaps we should do nothing. Or at least nothing new until we really, really know what is worthwhile.

Medicine needs to take a long hard look at itself and question the validity of the information that is inexorably presented if it is to avoid jumping between successive bandwagons, each promising to deliver us to the promised land where perfect health is enjoyed by all. Rather than more, we need less information – information that is more considered and reliable. Medical journals shouldn’t publish information just because they have pages left to be filled, study days shouldn’t include sessions run just to fill the hours required, and educational activity shouldn’t be undertaken simply to satisfy our appraiser. Before ticking the box, we need to ask whether the box is necessary at all.

As Christopher Hitchins warns us, we should ‘not take refuge in the false security of consensus’ because as George S. Paton reminds us ‘If everyone is thinking alike, then someone isn’t thinking’.

And so we need to think, but in a way that leaves us free to feel as well. We need to ask the questions which matter – and attend to the answers that will really make a difference to our patients and not simply burden them with a load more anxiety as we admire the ‘emperor’s new clothes’ of medical certainty. It’ll take time but anything that is worthwhile needs just that – be it a relationship, an education or a fine bottle of wine. Nothing of worth can be said in 280 characters, and wisdom is not immediate.

So we need to take some real time to consider the wisdom of what we do. Let’s have jam tomorrow rather than yeast extract today. That way we may avoid imposing on our patients all our self important interventions, along with all of their adverse effects and dubious benefits, before, confusing them, and ourselves, when the medical consensus changes again next week.

Ancient wisdom calls us to ‘Be still’ – such a phrase doesn’t refer just to the absence of movement – it’s a call to be quiet and realise that we make too much noise and that much of what we say and listen to would have been better left unsaid.

Wouldn’t it be great then if we could just ignore it all? If we could be that wise! But of course we couldn’t…could we? We have to be seen to be learning to comply with revalidation regardless of whether that learning is helpful. And just to make sure that we’re doing it, we must reflect on how that learning has helped us lest we conclude that it hasn’t. It all seems just a little bit, dare I say it, Big Brother. There seems to me an irony in the fact that the very educationalists who, not so long ago, encouraged us to understand our learning style and play to our strengths, are the very same educationalists who now insist that reflection is king.

All learning styles are equal, but, it seems, some learning styles are more equal than others.

Is it just me or has anybody else noticed that those of us who actually are more reflective by nature, aren’t activist enough to record the process of doing so and those of us who are activist enough to record their reflections aren’t reflective enough to have anything to reflect upon!

So let’s at least spend less time reflecting on ourselves. We’re really not that interesting you know. Narcissus, from whose name we get the words ‘sleep’ and ‘numbness’, came to a soggy end. So let’s wake up and feel something other than the sense of being drowned by the information bombarding us.

So why don’t you just stop reading this medically related post and go and do something less boring instead? Come on – who’s up for doing less?. Who’s ready for such a brave new world? Because something really does need to change.

And with that, I think I’ll take my own advice and shut up for a bit because I suspect I’ve said far too much already.

Shadows are falling and I been here all day

It’s too hot to sleep and time is running away’

I’m 13 years old, only a youngster, and I’ve cycled into the back of a stationary lorry opposite Chelston Chapel on the way home from school. I’m still lying unconscious on the floor when the ambulance arrives but I eventually begin to come round and, thinking for some reason that it is what one does in such circumstances, I start repeating my telephone number over and over again to anyone who’ll listen. The upshot of my carelessness is two weeks spent in Musgrove Park Hospital on an ENT ward where I fall in love with a nurse for the first but not last time. I’m the only child on the ward and I imagine the nursing staff find me kind of cute in a way that nobody does anymore. I end up having two operations on my nose, and suffer as a consequence that most serious of surgical complications, that first fledgling desire to be a doctor. A few weeks later, at an outpatient review, my mother tells the consultant of my new career intentions. He smiles to himself having, no doubt, heard such an ambition voiced many times before. But years later, as he reviews a child under my care, he looks at me and, with an inkling of recognition asks, ‘Didn’t you once cycle into the back of a lorry?’

A little over thirty years later, now comfortably middle aged, I’m back in the same hospital, this time in a bed on Fielding Ward.

‘It’s the act of a desperate man’, says the cautious consultant’s in response to my asking why I’m to have a PET scan. His attempt at humour is not reassuring, abnormal results from such investigations rarely being associated with happy endings. But it seems it’s not just GPs who have a differing tolerance to uncertainty. He’s not as confident as his colleague that we’re dealing with endocarditis. Not all criteria for that particular diagnosis have been satisfactorily fulfilled and, apparently, ‘we’ve all got a dodgy mitral valve’. He’s decided that further investigations for my night sweats, back pain and impressive CRP are in order. He’s probably right – after all I’d been admitted on a Sunday so, if some are to be believed, it was always likely that I wouldn’t leave hospital alive.

The next day, too weak to walk, I’m wheeled to the scanner, a blanket over my knees like a frail elderly man. The mouths of some in the waiting room drop open, their heads turning to follow me as I pass by. They’ve not seen their GP like this before. Nor, back on the ward, has the bank HCA, herself my patient. She seems to gain just a little too much enjoyment asking her doctor whether or not he’s managed to open his bowels yet today.

And then the waiting, and worrying, begins. How will I tell the children that I don’t have long? The inevitable bad prognosis will, when it comes, give a whole new meaning to the extended leave I’m anticipating later in the year. Reassuringly, confident cardiologist, no longer responsible for my care, seems surprised that a PET scan has been requested when he leans over my bed that evening. ‘It’s definitely SBE’ he tells me and I’m happy to believe him until, a little later, I’m passed a phone. It’s my GP. She’s rung the ward asking how I am. ‘So you’ve back pain?’ she asks me. Unquestionably she must know something I don’t, has surely learnt of some retroperitoneal malignancy by accessing my scan result online. However, it seems that that is not the case since, the following morning, after a long dark night of existential soul searching, the ST3 assures me the report is not yet available. But by midday it is. Cautious consultant will be along to discuss it soon. I can’t, it seems, just be told it’s normal.

Visitors arrive and, finding me just a little distracted, later leave with still no consultant stopping by. Who said ‘No news is good news’? I’ve decided that no news means that he’s waiting till the end of the day, to talk to me when he’ll not be interrupted. Then he’ll have the time to unhurriedly tell it to me straight. Doctor to doctor? Hardly – I’m no doctor now, just ordinary anxious patient.

‘You OK?’ asks Sister, as the evening meals are served.

‘Yes…fine, thank you. Just waiting for, you know, the scan report. It’s back…apparently.’

‘I’ll see what I can find out’

A few minutes later, she’s back – with a plate and a cheery ‘All normal’. Hospital food never tasted better.

And I promise myself to remember, when I eventually recover and get back to the job I long to continue to do, that good news isn’t good until it’s told.

And now another episode. I’d only stood up to put the dog to bed when I fainted. And no it wasn’t because I should have taken more water with it. I chose to come down hard, my head striking the corner of a wall. I’m unconscious for a time and behaving oddly enough to concern everyone who is at home with me, not least the dog whose night time routine has been aborted before the provision of his bedtime snack. And so an ambulance is called and before long I’m laid up in casualty waiting for my results. Eventually of course they’re all shown to be normal and I turn down the kind offer of a head injury advice sheet as I’m discharged and, in the early hours of the morning, make my way home.

A few hours later I’m at work thankful for an additional significant event I can add to my appraisal folder but reluctantly agree with my kind and considerate colleagues who insist I shouldn’t be at work. I don’t like not being up to it but I allow myself to be taken home. It’s the day before my birthday – perhaps I need to accept I’m beginning to get old.

Three times a patient, each difficult in varying degrees, but each, in their way, formative and, therefore, helpful. Looking back I’d not have had it any other way.

Behind every beautiful thing, there’s been some kind of pain’

One the stimulus to becoming a doctor, one a help in understanding more of what it’s like to be a patient, and one, perhaps, the first hint that one cannot remain a doctor forever.

In a world that glories in the strong and heralds the individual, it’s good to be reminded of one’s weakness and one’s dependence on others. Even the strongest will one day grow week – even the youngest will one day grow old. None of us will always be able to do what we once could and each of us will soon enough have to accept our increasing limitations, our increasing dependence on others. To value ourselves and each other only by what we can achieve will, therefore, inevitably result in increasing disappointment.

Rarely does a month go by without somebody I have known, perhaps for over two decades, reaching the point beyond which they can continue no longer. And so they stop. One day their experience will be mine and someone like me will draw my family aside and speak quietly to them.

In 1997 Bob Dylan, then 56, sang ‘It’s not dark yet, but it’s getting there’. In the succeeding twenty three years he has produced arguably some of his best work and even today he still continues to tour. I am now just a few years younger than Dylan was in 1997 but I am, perhaps, just beginning to realise for myself what he knew then. Like Dylan, I hope that there are still a good few years left in me too but it does me no harm to remember that, however much I may dislike it, there will come a time when I will have to call it a day too.

‘I was born here and I’ll die here, against my will

I know it looks like I’m movin’ but I’m standin’ still’

*All quotes in italics from ‘Not Dark Yet’ by Bob Dylan. Have a listen by clicking on the link below.

https://youtu.be/5fGYWAVw2zg

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To read ‘Reflections on the death of Leonard Cohen’, click here.

It’s New Year’s Day, traditionally the time for making resolutions. This year there is, perhaps, one particularly bad habit that we should all resolve to give up. You know the one – being a GP. In recent years it’s been increasingly accepted that GPs are to blame for most of the problems in the NHS and being a GP is now seen as something for which we all ought to be ashamed. Surely then it’s time we considered getting ourselves some help.

Whether it be our delayed diagnoses, our inappropriate admissions or our failure to offer enough appointments, it’s time to face up to the uncomfortable truth, GPs are the problem. It’s not as though we haven’t been told enough times by enough people. Finally it’s time we listened. The facts, as they say, speak for themselves – it really is all the fault of we GPs.

We must deny it no longer. We must stop trying to convince ourselves we’re OK and instead acknowledge our failings. After all, if we don’t, how can we expect anything to be done to help us. We will just go on making our own life, and everyone else’s, miserable.

Everyone’s aware of how embarrassing GP behaviour can be. You know the kind of thing, how we spoil everything for everybody on Christmas Day by turning up at family gatherings rather than opening our surgeries as normal. Without a doubt it is selfishness such as this that, at this time of year, leads to A&E departments being inundated with patients who are then forced to waste precious hours of their time in waiting rooms burdened by their sore throats and itchy toes. And then, of course, there is our wilful ignoring of patients whose symptoms clearly suggest that they have cancer but who we deliberately neglect to refer preferring instead to put an unnecessary burden on secondary care services by recklessly admitting patients to hospital just for the fun of it.

So let’s all face up to our problem. I’ll go first by introducing myself:

My name is Peter – and I’m a General Practitioner.

If you’re similarly afflicted, come and join me – I’m setting up ‘GPs Anonymous’ in the hope that together we can support all those who are stricken with the affliction that is ‘being a GP’.

But perhaps you’re still not convinced that you have a problem. If so, can I urge you to ask yourselves these four screening questions? Answer two in the affirmative and you may have a problem – answer ‘Yes’ to all four and you’re in real trouble.

C – have you ever felt you wanted to cut down how much general practice you do?

A – have you ever been annoyed by criticism of your actions as a GP?

G – have you ever felt guilty for what you have done as a GP?

E – have you ever started doing your ‘GP thing’ early in the morning?

Extra phone lines will be installed should demand for this new service prove overwhelming.

But why do people fall into the destructive behaviour patterns that are characteristic of general practitioners? Some have suggested that in some cases there may be a genetic component – seeing your parents behaving as GPs seems to predispose some to follow a similar path. Mercifully, however, this is becoming less common. Others experience a little bit of general practice early on in their medical career and naively imagine that it’s a good thing – something that they can control. After all, just one attempt at a ten minute consultation can’t hurt can it? But before long they’re out of control – only in it for the extortionate pay, the long hours of ‘off duty’ and the kicks one gets from the systematic mismanagement of those who thought they were there to help.

It’s a tragic condition but this year, with the arrival of ‘GPs Anonymous’, there is at last some real hope for change. So please give generously, together with your help, this year we can rid the country of the blight that GP’s have become.

And then won’t everyone be happy?

HAPPY NEW YEAR!

[This is a reworking of something I wrote back in January 2015. Apologies to those who may have seen it before but sadly it seems it is no less relevant today.]