Pain: The Tool of the Wounded Surgeon

Christianity Today March 24, 1978

We are not abandoned.

I am sitting in an airplane returning from a trip to the Pacific Northwest. In four days, I interviewed three people. One woman was in an auto accident. As she was driving across a desert with her best friend, a drunken driver missed a stop sign and rammed her car. Her friend and the drunk died instantly; the woman survived with a shattered jaw, broken arm, collapsed lung, lacerated face, and various internal injuries. She is recovered now, except for haunting memories and the prospect of plastic surgery.

A young man had a story with a happier ending. He and his fiancee were hiking in a ravine of the Cascade Mountains when an ice bridge collapsed, burying them under tons of ice. The boy chipped his way out with a rock and went for rescuers. A helicopter lifted the girl out and, after spending five months in a body cast, she healed perfectly.

The third victim was an eighteen-year-old athlete from Anchorage, Alaska. In high school he lettered in football, basketball, and baseball. But during his junior year he noticed a bothersome lump above his ankle and had it diagnosed. Cancer. He lost his leg below the knee.

In the past seven years I’ve interviewed scores of people like these. All have undergone severe pain. A grandmother in a nursing home with two weeks to live. A race car driver in a burn ward. Every time I return from such a trip, I mull over their stories and their responses to pain. I can often read their reaction with one look into their piercing, sunken eyes. Each victim plods through similar stages: questioning, anger, self-pity, adjustment, gratitude, hope, more anger. Some wear this pain like a badge of courage. Others spend years wrestling with God.

These encounters have led me on a personal quest into the problem of pain. When asked what was the greatest problem he had observed in the United States, Helmut Thielicke replied, “They have an inadequate view of suffering.” I have come to agree with him. We elaborately prepare for many life changes—a new house, a wedding, a grandchild’s birth, a move. But how many of us prepare to cope with sudden, extreme pain? How many know how to respond to suffering friends?

After several years of talking with the suffering and of reading books on the problem of pain, I readily confess that I don’t have a hermetically-sealed envelope full of answers. I can’t say to each sufferer, “Praise God anyhow!” or “Pray for healing and it will come.” The perspectives that I have gained are less sweeping and perhaps less satisfying.

Some religions, such as Buddhism or Christian Science, deal with pain by denying its existence or by overcoming it. Islam accepts pain as the will of Allah. But Christianity walks a tightrope, affirming the loving concern of a benevolent God but facing squarely the cries of a pain-wracked world. I have found comfort in the Christian perspective because it does face up to the problem so honestly. “How can a good God permit such a world?” is the perennial question rustling through the pages of theology. I believe that Christianity offers substantial help for coping with this messy problem.

Why Pain?

I have never read a poem extolling the virtues of pain, nor seen a statue erected in its honor, nor heard a hymn dedicated to it. Pain is usually defined as “unpleasantness.” Christians don’t really know how to interpret pain. If you pinned them against the wall, or in a dark, secret moment, many Christians would probably concede that pain was God’s mistake. He really should have worked harder and invented a better way of alerting us to the world’s dangers. I am convinced that pain gets a bad press. Perhaps we should see statues, hymns, and poems to pain. Up close, under a microscope, the pain network is seen in an entirely different dimension.

I was most impressed with the amazing effectiveness of the pain network when I visited Dr. Paul Brand of Carville, Louisiana, the only man I’ve met who crusades on behalf of pain. Without hesitation, Brand announces, “Thank God for inventing pain! It’s the paragon of his creative genius.” Dr. Brand is well-qualified to make such a judgment, since he is one of the world’s foremost experts on leprosy, which attacks the nervous system. Leprosy patients lose their fingers and toes, not because the disease can cause decay, but precisely because they lack pain sensations. Nothing warns them when water is too hot or a hammer handle is splintered. Accidental self-abuse destroys their bodies.

Brand’s appreciation for pain climaxed after he was given a substantial grant to design an artificial pain system to help people with diseases that destroyed pain sensors. Brand had to think like the Creator, anticipating the needs of the body. After signing on three professors of electronic engineering, a bioengineer, and several research biochemists, he began.

First, the team developed an artificial nerve that could be placed on the fingertip like a glove. The nerve responded to pressure with an electric current that stimulated a warning signal. For five years Brand and his assistants tackled the technical problems. The more they studied nerves, the more complex their task appeared. At what level should the sensor sound a warning? How could a sensor distinguish between the normal pressure of gripping a railing and the pressure of gripping a thornbush? How could they allow for rigorous activities such as tennis-playing and yet warn of danger?

Brand also noticed that nerve cells change their perception of pain to meet the body’s needs. When inflamed with an infection, a fingertip may become ten times more sensitive to pain. A swollen finger seems awkward and in the way, because nerve cells “turn up the volume,” magnifying bumps and scrapes that are usually ignored. In no way could these well-funded scientists duplicate that feat with current technology. All the artificial sensors proved fragile and would rupture or deteriorate from metal fatigue or corrosion after a few hundred uses.

Almost everyone who studies the body will admit that the nervous system is well-engineered. But one could naturally ask, “Does pain have to be unpleasant? A protective system is, of course, necessary, but must it hurt? Piercing streaks of pain race to the brain, doubling up a patient—couldn’t God have found another way?”

Brand’s team contemplated these questions as they worked on an artificial nerve cell. For a long time they used an audible signal coming through a hearing aid, a signal that would hum when the tissues were receiving normal pressures and buzz loudly when the tissues were actually in danger. But the signal was not unpleasant enough. A patient would tolerate a loud noise if, for example, he wanted to turn a screwdriver too hard, even though the signal told him it could be harmful. Blinking lights were tried and eliminated for the same reason. Brand finally resorted to electric shock to make people let go of something that might hurt them. People had to be forced to remove their hands; being alerted to the danger was insufficient. The stimulus had to be unpleasant, just as pain is unpleasant.

“We also found out that the signal had to be out of the patient’s reach,” Brand said. “For even intelligent people, if they wished to do something which they were afraid would activate the shock, would switch off the signal, do what they had in mind to do, and then switch it on again when there was no danger of receiving an unpleasant signal. I remember thinking how wise God had been in putting pain out of reach.”

After five years of work, thousands of man hours, and over a million dollars, Brand and his associates abandoned the entire project. A warning system suitable for just one hand was exorbitantly expensive, subject to frequent mechanical breakdown and hopelessly inadequate to interpret the mass of sensations the hand encounters. The system sometimes called “God’s great mistake” was far too complex for even the most sophisticated technology to mimic.

Brand thus discovered one of the most basic—but overlooked—facts about pain: it is well-suited for this fallen world. Without pain, simple acts like shoveling snow, taking a bath, and turning a screwdriver become dangerous. They can destroy our cells unless the warning system imposes its limits on us. For someone with crippling arthritis or terminal cancer, pain rages out of control, and any relief, especially a painless world, would seem like heaven itself. But for the majority of us, the pain network performs daily protective service.

God’s Megaphone

Christianity asserts that besides adapting us to a fallen physical world, pain perfectly expresses the nature of our morally fallen world. Suffering is consistent with the Bible’s view of planet earth. It is a stained planet, and suffering reminds us of that. C.S. Lewis introduced the phrase “pain, the megaphone of God.” It’s an apt phrase, because pain does shout. When I stub my toe or twist an ankle, pain tells my brain that something is wrong. Similarly, the existence of suffering on this earth is, I believe, a scream to all of us that something is wrong. It makes us consider other values.

We could (some people do) believe that the purpose of life here is to be comfortable. Enjoy yourself, build a nice home, engorge good food, have sex, live the good life. That’s all there is. But the presence of suffering complicates that philosophy. It’s much harder to believe that the world is here for my hedonistic fulfillment when a third of its people go to bed starving each night. It’s much harder to believe that the purpose of life is to feel good when I see people smashed on the freeway. If I try to escape the idea and merely enjoy life, suffering is there, haunting me, reminding me of how hollow life would be if this world were all I’d ever know.

Sometimes murmuring, sometimes shouting, suffering is a “rumor of transcendence” that the entire human condition is out of whack. Something is wrong with a life of wars and violence and insults. We need help. He who wants to be satisfied with this world, who wants to think the only reason for living is to enjoy a good life, must do so with cotton in his ears; the megaphone of pain is a loud one.

It is this aspect of Christianity that made G.K. Chesterton say, “The modern philosopher had told me again and again that I was in the right place, and I had still felt depressed even in acquiescence. But I had heard that I was in the wrong place, and my soul sang for joy, like a bird in spring” (Orthodoxy, Doubleday, 1959, p. 80). Optimists had told him the world was the best of all possible worlds, but he couldn’t accept that. Christianity made sense to him because it freely admitted that this is a stained planet. One may accuse the Christian doctrine of the origin of suffering of being weak and unsatisfying—that it came as a result of man’s aborted freedom. But at least, as Chesterton notes, the concept of a great but fallen world squares with what we know of reality.

Pain, God’s megaphone, can drive me away from him. I can hate God for allowing such misery. Or, on the other hand, it can drive me to him. I can believe him when he says this world is not all there, and take the chance that he is making a perfect place for those who follow him on pain-wracked earth. If you once doubt the megaphone value of suffering, visit the intensive-care ward of a hospital. It’s unlike any other place in the world. All sorts of people will pace the lobby floors. Some rich, some poor. There are beautiful, plain, black, white, smart, dull, spiritual, atheistic, white-collar, and blue-collar people. But the intensive-care ward is the one place in the world where none of those divisions makes a speck of difference, for all those people are united by a single awful thread—their love for a dying relative or friend. You don’t see sparks of racial tension there. Economic differences, even religious differences fade away. Often they’ll be consoling one another or crying quietly. All of them are facing the rock-bottom emotions of life, and many of them call for a pastor or priest for the first time ever. Only the megaphone of pain is strong enough to bring these people to their knees and make them reconsider life.

The Wounded Surgeon’s Promise

Almost all the suffering people I have talked to deal with God at some level. When the natural world of doctors and drugs doesn’t seem to be working well, they try the supernatural world. A few find miraculous answers: healings, cessation of pain, supernatural faith. Others do not.

There are, however, two contributions to the problem of pain that hold true in any circumstance, whether healing or death ensues. The first is the simple fact of Jesus’ coming. God entered humanity, and saw and felt for himself what this world is like. Jesus took on the same kind of body you and I have. His nerve fibers were not bionic—they screamed with pain when they were misused. And, above all, Jesus was surely misused. This fact of history can have a large effect on the fear and helpless despair of sufferers.

The scene of Christ’s death, with the sharp spikes and the wrenching thud as the cross was dropped in the ground, has been told so often that we, who shrink from a news story on the death of a race horse or of baby seals, do not flinch at its retelling. It was a bloody death, an execution quite unlike the quick, sterile ones we know today: gas chambers, electric chairs, hangings. This one stretched on for hours in front of a jeering crowd.

Jesus’ death is the cornerstone of the Christian faith, the most important fact of his coming. You can’t follow Jesus without confronting his death; the Gospels bulge with its details. He laid out a trail of hints and bald predictions about it throughout his ministry, predictions that were only understood after the thing had been done, when to the disciples the dream looked shattered. His life seemed prematurely wasted. His triumphant words from the night before surely must have cruelly haunted his followers as they watched him groan and twitch on the cross.

What possible contribution to the problem of pain could come from a religion based on an event like the crucifixion? Simply, we are not abandoned. The Alaskan boy with an amputated foot, grieving Ugandan Christians, the Toccoa Falls survivors—none has to suffer alone. Because God came and took a place besides us, he fully understands. Dorothy Sayers says:

“For whatever reason God chose to make man as he is—limited and suffering and subject to sorrows and death—He had the honesty and courage to take His own medicine. Whatever game He is playing with His creation, He has kept His own rules and played fair. He can exact nothing from man that He has not exacted from Himself. He has Himself gone through the whole of human experience, from the trivial irritations of family life and the cramping restrictions of hard work and lack of money to the worst horrors of pain and humiliation, defeat, despair and death. When He was a man, He played the man. He was born in poverty and died in disgrace and thought it well worthwhile” (Christian Letters to a Post-Christian World, Eerdmans, 1969, p. 14).

By taking it on himself, Jesus in a sense dignified pain. Of all the kinds of lives he could have lived, he chose a suffering one. Because of Jesus, I can never say about a person, “He must be suffering because of some sin he committed.” Jesus, who did not sin, also felt pain. And I cannot say, “Suffering and death must mean God has forsaken us; he’s left us alone to self-destruct.” Because even though Jesus died, his death became the great victory of history, pulling man and God together. God made a supreme good out of that day. T. S. Eliot wrote in his “Four Quartets”:

The wounded surgeon plies the steel

That questions the distempered part;

Beneath the bleeding hands we feel

The sharp compassion of the healer’s art

Resolving the enigma of the fever chart (Collected Poems 1904–1962, Harcourt Brace World, 1965, p. 187).

The uniquely Christian contribution is a memory. But there is another one—a hope. To the person with unrequited suffering, it is the most important contribution of all. Christ did not stay on the cross. After three days in a dark tomb, he was seen alive again. Alive! Could it be? His disciples couldn’t believe it at first. But he came to them, letting them feel his new body. Christ brought us the possibility of an afterlife without pain and suffering. All our hurts are temporary.

How to imagine eternity? It’s so much larger than our short life here that it’s difficult even to visualize. You can go to a ten-foot blackboard and draw a line from one side to another. Then, make a one-inch dot in that line. To a microscopic germ cell, sitting in the midst of that one-inch dot, it would look enormous. The cell could spend its lifetime exploring its length and breadth. But you’re a human, and by stepping back to view the whole blackboard you’re suddenly struck with how large that ten-foot line is compared to the tiny dot that germ calls home.

Eternity compared to this life is that way. In seventy years we can develop a host of ideas about God and how indifferent he appears to be about suffering. But is it reasonable to judge God and his plan for the universe by the swatch of time we spend on earth? No more reasonable than for that germ cell to judge a whole blackboard by the tiny smudge of chalk where he spends his life. Have we missed the perspective of the timelessness of the universe?

Who would complain if God allowed one hour of suffering in an entire lifetime of comfort? Why complain about a lifetime that includes suffering when that lifetime is a mere hour of eternity?

In the Christian scheme of things, this world and the time spent here are not all there is. Earth is a proving ground, a dot in eternity—but a very important dot, for Jesus said our destiny depends on our obedience here. Next time you want to cry out to God in anguished despair, blaming him for a miserable world, remember: less than one-millionth of the evidence has been presented, and that is being worked out under a rebel flag.

Let me use another analogy to illustrate the effect of this truth. Ironically, the one event that probably causes more emotional suffering than any other—death—is in reality a translation, a time for great joy when Christ’s victory will be appropriated to each of us. Describing the effect of his own death, Jesus used the simile of a woman in travail, full of pain and agony until all is replaced by ecstasy.

Your world is dark, safe, secure. You are bathed in warm liquid, cushioned from shock. You do nothing for yourself; you are fed automatically, and a murmuring heartbeat assures you that someone larger than you fills all your needs. Your life consists of simple waiting. You’re not sure what to wait for, but any change seems far away and scary. You meet no sharp objects, no pain, no threatening adventures. A fine existence.

One day you feel a tug. The walls are falling in on you. Those soft cushions are now pulsing and beating against you, crushing you downwards. Your body is bent double, your limbs twisted and wrenched. You’re falling, upside down. For the first time in your life you feel pain. You’re in a sea of rolling matter. There is more pressure, almost too intense to bear. Your head is squeezed flat, and you are pushed harder, harder into a dark tunnel. Oh, the pain. Noise. More pressure.

You’re hurting all over. You hear a groaning sound and an awful sudden fear rushes in on you. It is happening-your world is collapsing. You’re sure it’s the end. You see a piercing, blinding light. Cold, rough hands pull at you. A painful slap. A loud cry.

You have just experienced birth.

Death is like that. On this end of the birth canal, it seems fiercesome, portentous, and full of pain. Death is a scary tunnel and we are being sucked toward it by a powerful force. We’re afraid. It’s full of pressure, pain, darkness—the unknown. But beyond the darkness and the pain there’s a whole new world outside. When we wake up after death in that bright new world, our tears and hurts will be mere memories. And though the new world is so much better than this one, we have no categories to really understand what it will be like. The best the Bible writers can tell us is that then, instead of the silence of God, we will have the presence of God and see him face to face. At that time we will be given a stone, and upon it will be written a new name, which no one else knows. Our birth into new creatures will be complete (Rev. 2:17).

Do you sometimes think God does not hear? God is not deaf. He is as grieved by the world’s trauma as you are. His only son died here. But he has promised to set things right.

Let history finish. Let the symphony scratch out its last mournful note of discord before it bursts into song. As Paul said, “In my opinion whatever we may have to go through now is less than nothing compared with the magnificent future God has planned for us. The whole creation is on tiptoe to see the wonderful sight of the sons of God coming into their own.…

“It is plain to anyone with eyes to see that at the present time all created life groans in sort of a universal travail. And it is plain, too, that we who have a foretaste of the Spirit are in a state of painful tension, while we wait for that redemption of our bodies which will mean that at last we have realized our full sonship in Him” (Rom. 8:18, 19, 22, 23).

As we look back on the speck of eternity that was the history of this planet, we will be impressed not by its importance, but by its diminutiveness. From the viewpoint of the Andromeda galaxy, the holocaustic destruction of our entire solar system would be barely visible, a match flaring faintly in the distance, then imploding in permanent darkness. Yet for this burnt-out match, God sacrificed himself. Pain can be seen, as Berkouwer puts it, as the great “not yet” of eternity. It reminds us of where we are, and creates in us a thirst for where we will someday be.

D. Bruce Lockerbie is chairman of the Fine Arts department at The Stony Brook School, Stony Brook, New York. This article is taken from his 1976 lectures on Christian Life and Thought, delivered at Conservative Baptist Theological Seminary in Denver, Colorado.

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