Reflections of a Neurologist

by Lynne O. Geweke, MD

Let me introduce myself to you. Although it is true that I specialize in the treatment of headaches, by training and practice I am a neurologist. I learned long ago that lots of people are not sure what a neurologist is or does — which is probably a good sign. As much as I enjoy neurology, I am not crazy about the idea of needing a neurologist myself. Neurologists treat disorders of the brain and the nervous system — things like strokes, seizures, multiple sclerosis, and, yes, migraines. Just to set the record straight, I do not operate; I am not a brain surgeon.

When I was asked to talk to you today, I was told that I was to speak as “a person of faith in the healing arts.” Well, I sort of choked on the “person of faith,” but I’ll get to that later. Many doctors would be embarrassed by the “healing arts” designation. As for neurologists, we are known for our medical impotence — we know everything and can do nothing. Most diseases we deal with are hopeless. But, like other doctors, we try. To try, we must know about the brain. I have been engaged in learning about the brain for a long time. My learning began the first time I held a human brain in my hands in anatomy lab, and it continues through the books I read and every patient I see.

Because of my study, I know lots of strange little things about how your brain works and how it controls your body. I know what part of your brain is working when you wiggle your left little finger or when you smell a rose. I know what parts of your brain do the understanding, the speaking, and the reading. I know about the areas where some of your memory is processed and at least a bit about where your brain processes sleeping, breathing, appetite, and emotion. It is very fascinating. Picture this: you pick up a book and a tiny little area of your left brain begins to work. Little lines and curves on a page become knowledge, memory, and meaning to your life.

But there is a darker side to this. “What the Lord giveth, the Lord taketh away,” as they say. And it seems that the “taking away” can be done without the Lord. I know where a little injury will leave you unable to wiggle your left little finger or where a bit of nerve damage will take away your sense of smell. I know where I could put a little lesion with the result that your ability to speak, see, and hear may continue but the book will never make sense to you again. I know how to “ding” that brain just so and suddenly you won’t ever remember anything again, not even what you ate two seconds ago. I know about changes that would make you laugh at funerals, cry bitterly at nothing, and, to the great embarrassment of your family, swear with every sentence you utter. In short, I can take away what you think is “you.” It is real and it is not that hard to do. I’ve seen every one of these conditions and, without previous contact, there are no clues as to what the person was like “before.”

This, frankly, has been hard on the concept of what I was once taught was my “soul.” Being raised Catholic, I was taught about the soul, and I think most people have a somewhat similar concept of a soul. I have thought of my soul as the essence of me-ness, some sort of heavenly reflection of what I am on earth. When I go to heaven, so it seemed, I would certainly recognize my own soul in a crowd. It’s gonna be me, right? And for sure, it can’t be destroyed!

But now I know that what I once thought was me can be destroyed or radically changed, and that my personality is almost a whim. In a second, or a minute, because of a bad blood vessel, or a bullet, or a car, I may look like I’m here, but it’s not the ME I know. Is this scary? What I know and have seen convinces me absolutely that there are fates worse than death.

It seems cruel, doesn’t it? You can spend the first part of your life trying really hard, loving your family, going to church, holding wonderful intellectual discussions, and creating beautiful artworks, and then suddenly you are someone else. I can assure you that, unlike the movies, that “someone else” is never better than the old you. As a result of a sudden change, you may no longer think straight or walk straight, and you may suddenly be the social equivalent of Job covered with sores.

And what would you have done to deserve this? Nothing. NOTHING. No one knows this better than doctors. Unlike Job’s friends, who tell him that God must be punishing him for something, we doctors perversely believe the opposite. It is almost as if we firmly know that to get an awful disease, you have to be a really nice person. Only the good die young. The sweet young mothers get multiple sclerosis; the smelly old alcoholics clutter up the emergency rooms forever.

This is a doctor’s classic dark sense of humor. We need some way of dealing with the pain and, even more, the uncertainty. I’m not surprised that many doctors drop away from religion. In what are we supposed to have faith? How can you plug away, day after day, in what seems like the world’s biggest poker game and have faith in a God who seems the source of utter disorder? How can you make sense of the senseless and believe that a destroyed life is meaningful? Are you not supposed to get what you deserve in life?

Apparently not.

Recently I had a lovely, middle-aged patient with cerebral palsy. A person is born with cerebral palsy. She had learned to live with what she had and to do what she could, which is about all that can be done. With some help from caretakers, despite very little use of her limbs, she was somewhat independent. Unfortunately, a lifetime of wear on already weakened limbs had taken its toll, so, despite some heavy-duty surgical effort, she had reached the point of losing these modest capabilities, also.

Her very religious caretakers were overheard telling this patient that she was suffering God’s righteous judgment in her physical affliction. They told her she deserved this fate!

I can’t fully express the rage I feel at this. God knows that, as a doctor, I try to be charitable and broadminded and try to see the caretaker’s point of view, but I could not in this case.

There are many platitudes.

“God has a special purpose for you, to give you this suffering.”

This seems to mean, “Shut up, don’t complain.” As a doctor, I say, “Forget that! If I can do anything about suffering, I will! Please complain so I know what needs doing!”

“God never gives you more than you can bear.”

I say, “Oh yeah? Do you mean that despair and suicide do not exist? Do you mean to say that the person who cannot “bear” it is a religious wimp? I’m sorry, but the truly awful and unbearable does exist in our world.”

“If you had more faith, God would cure you.”

In other words: “You’re a moral failure. You haven’t got what it takes. Clearly you’re not cut out for the God Team.”

This has always struck me as the height of arrogance. “If you had more faith, God would cure you.” Why should God suspend the rules of physics and nature? Everyone dies. Do people who say this mean that if a person has enough religion, that person is exempt from the laws of nature?

If this is religion, I don’t want it. I don’t want a faith that is not in my world right here. I can’t accept an image of God that flies in the face of the earthly knowledge we have struggled so hard to gain. Did God give me a mind as some sort of joke? This world that I know of medicine and science is so real, and I love it very much. When I study the brain, diagnose a case, or make sense out of something obscure, I am elated. This is my real world: I live in it; I think in it; I love it.

But I struggle to reconcile the real world and my faith. How on earth do I cope, when my knowledge of science and reality doesn’t agree with what I’ve been told about God? How does a good doctor deal with this? Is there a division between reality and faith?

Wait a minute. Whose problem is this anyway?

It must be mine. It can’t be God’s. This is God’s world, and it doesn’t exist apart from God. If I can’t reconcile reality and faith, I have to look at my faith. The laws of nature aren’t going to change and God isn’t going to change. My search, my route to God, is through seeing and knowing about what happens on earth, whatever it may be. It is my faith that both this world is and God is, and if I cannot reconcile the two, it is my problem, not God’s. God is greater; God is the greatest.

There is a verse in Corinthians I particularly like: “What am I to do? I will pray with the spirit and I will pray with the mind also; I will sing with the spirit and I will sing with the mind also” (14:15).

I don’t pray much for favors. I don’t think God will change the world for me. But sometimes I laugh at the sheer chance that I even exist in this world, and sometimes I say “Thanks.”

Maybe the real meaning of Easter — the whole God-and-Humanity thing — is that as Jesus lived and died, he wasn’t merely like us, he really was one of us! Yes, a person with brain cells and wiggling fingers who could smell roses and all the rest! When he died, his body shut down in the same way that I have seen happen so many times. And if there really was an Easter . . . .

Maybe we have been too dumb to hear just how close this world is to God. We have made grand and obscure mysteries out of the most fundamental truth that God is with us and that we stare at God day in and day out. Our faith must agree with the real world which is beautiful and ugly; it is ordered and it is unruly; it is soothing and it is frightening. But, it is here. We have it, we have each other, and we have God, both in it and in each other.

So, even though I could cry at my own minuscule powers, I love being a healer because I am with you, you are with me, and there is life in our physical touch and emotional contact. Where there is life and where there is suffering and death, God is there, somewhere. I don’t believe in miracles. If I don’t see God immediately and your need calls God out, maybe you are healing me as much as I am healing you.

This is better than a miracle!