Fearfully and Wonderfully Read online

  FEARFULLY and

  WONDERFULLY

  The MARVEL of BEARING

  GOD’S IMAGE

  DR. PAUL BRAND and

  PHILIP YANCEY

  UPDATED AND COMBINED EDITION

  You created my inmost being;

  you knit me together in my mother’s womb.

  I praise you because I am fearfully and wonderfully made.

  PSALM 139:13-14

  CONTENTS

  PREFACE: A New Edition for a New Time

  PART ONE: IMAGE BEARERS

  1 Invisible Made Visible

  2 Human Mirrors

  PART TWO: ONE AND MANY

  3 A Role in the Body

  4 Diversity: The Richness of Life

  5 Unity: The Sense of Belonging

  6 The Ecstasy of Community

  PART THREE: OUTSIDE AND INSIDE

  7 Skin: The Organ of Sensitivity

  8 The Visible You

  9 The Most Trustworthy Sense

  10 Bone: A Necessary Frame

  11 How Bones Grow

  PART FOUR: PROOF OF LIFE

  12 Blood: Life’s Source

  13 Wise Blood

  14 Breath: Inspiration and Expiration

  15 Body in Motion

  PART FIVE: THE LANGUAGE OF PAIN

  16 A Sense of Protection

  17 The Unifier

  18 Chronic Pain

  PART SIX: THE BODY'S CEO

  19 Brain: The Enchanted Loom

  20 Image Restored

  21 Levels of Guidance

  22 God’s Likeness

  23 A Presence

  DISCUSSION GUIDE

  PRAISE FOR THE FIRST EDITIONS

  PRAISE FOR FEARFULLY AND WONDERFULLY

  ABOUT THE AUTHORS

  MORE TITLES FROM INTERVARSITY PRESS

  PREFACE

  A NEW EDITION for a NEW TIME

  Philip Yancey

  I FIRST LEARNED ABOUT DR. PAUL BRAND in 1976 while writing my book Where Is God When It Hurts. As I was pondering the problem of pain, my wife found in the closet of a medical-supply house an intriguing essay he had written on “The Gift of Pain.” Dr. Brand had a unique point of view: while most people seek to escape pain, he had spent several million dollars in an effort to create a pain system. “Thank God for pain!” he wrote. “I cannot think of a more valuable gift for my leprosy patients.”

  After training as an orthopedic surgeon in England, Dr. Brand spent most of his medical career in India, where he made a dramatic discovery about leprosy, one of the oldest and most feared diseases. Careful research convinced him that the terrible manifestations of that cruel disease—missing toes and fingers, blindness, skin ulcers, facial deformities—all trace back to the single cause of painlessness. Leprosy silences nerve cells, and as a result its victims unwittingly destroy themselves, bit by bit, because they cannot feel pain.

  When Dr. Brand moved from India to a high-tech laboratory in Louisiana, he applied what he had learned about insensitivity and painlessness to diseases such as diabetes. Former Surgeon General C. Everett Koop later told me that Dr. Brand’s findings revolutionized the treatment of diabetic feet, helping prevent tens of thousands of amputations each year.

  Dr. Brand’s work earned accolades on several continents. Queen Elizabeth II appointed him Commander of the Order of the British Empire, India’s Mahatma Gandhi Foundation selected him as the only Westerner to serve on that board, and the US Public Health Service gave him their highest award. Despite such international recognition, humility struck me as his strongest attribute.

  When I met him, Dr. Brand was still adjusting to life in the United States. Everyday luxuries made him nervous, and he longed for a simple life close to the soil. He preferred going barefoot and spent his spare time bird-watching and tending his garden. Although he knew people such as Gandhi, Mother Teresa, Albert Schweitzer, and Prince Philip, he rarely mentioned them. He talked openly about his failures and always tried to deflect credit for his successes to his colleagues. Most impressively to me, the wisest and most brilliant man I have ever known devoted much of his life to some of the lowliest people on the planet: members of India’s Untouchable caste (now called Dalits) afflicted with leprosy.

  Continuing the Legacy

  The conversations that stand out sharpest to me now are those in which Dr. Brand recalled individual patients, “nobodies” on whom he had lavished medical care. When he began his pioneering work, he was the only orthopedic surgeon in the world working among fifteen million victims of leprosy. He and his wife, Margaret, performed several dozen surgical procedures on some of these patients, transforming rigid claws into usable hands through innovative tendon transfers, remaking feet, forestalling blindness, transplanting eyebrows, fashioning new noses.

  He told me of the patients’ family histories, the awful rejection they had experienced as the disease presented itself, the trial-and-error treatments of doctor and patient experimenting together. Almost always his eyes would moisten and he would wipe away tears as he remembered their suffering. To him these people, among the most neglected on earth, were not nobodies but persons made in the image of God, and he dedicated himself to honor and help restore that image.

  As I got to know him, Dr. Brand admitted to me somewhat shyly that he had once attempted a book. After hearing him deliver a series of talks to the Christian Medical College in India, other faculty members urged him to write them down for publication. The result filled only ninety pages, not enough for a book. Twenty years had passed, and he had not touched the manuscript since. I persuaded him to dig through closets and bureau drawers until he located the badly smudged third carbon copy of those chapel talks, and that night I sat up long past midnight reading his remarkable meditations on the human body.

  Dr. Brand described his goal in writing:

  In a sense we doctors are like employees at the complaint desk of a large department store. We tend to get a biased view of the quality of the product when we hear about its aches and pains all day. In this little manuscript, I tried instead to pause and wonder at what God made: the human body.

  In a further step, Dr. Brand lifted an analogy from the New Testament, the Body of Christ, and updated it with his knowledge from modern science.

  I asked for, and graciously received, the freedom to take his original manuscript and develop it, adding many stories from his life while expanding the medical and spiritual insights. For nearly a decade I followed Dr. Brand around the world, retracing the steps of his medical training in England and observing him with patients at leprosariums in India and Louisiana. Sitting under a tamarind tree, watching him at work in a laboratory, bouncing along in a Land Rover, screeching through the London “tube” (subway), I asked him every question I could think of.

  Even after forty years of medical practice, he retained a boyish enthusiasm for the grandeur of the human body. Our conversations roamed wide, yet every topic I brought up, he had already thought about in some depth. He quoted Shakespeare and discussed the derivation of Greek, Hebrew, and Latin words. During breaks he taught me such things as how to select a ripe fig (watch the butterflies) and how weaver birds build their elaborate nests using only one foot and a beak. As a young writer, I greedily absorbed his wisdom.

  In the years since, some 700,000 readers have bought copies of Fearfully and Wonderfully Made or its sequel, In His Image. I have heard from many: pregnant women thanking us for helping them appreciate the miracle of life and birth, medical students crediting these books for drawing them toward a career in medicine, high school and college biology teachers who use excerpts in their classes, and other readers grateful for a reminder of the marvels of the human body. />
  Eminent physicians have also written in praise of Dr. Brand’s legacy: Joseph Murray, the Nobel Laureate who performed the first kidney transplant; the medical authors Richard Selzer and Abraham Verghese; the neurosurgeon Oliver Sacks; Dame Cicely Saunders, founder of the modern hospice movement. Although not all of them shared his Christian faith, they found wisdom in his words and inspiration in his humane style of medicine.

  Updated and Revised

  Both books remained in print for more than three decades, and their age was beginning to show. After hearing from so many enthusiastic readers over the years, I wanted to introduce Dr. Paul Brand to a new generation. Since medicine and science have advanced greatly, I have made editorial revisions and updated relevant details, in the process condensing the text to create this new, combined edition.

  Although Dr. Brand died in 2003, I have retained his first-person voice from the days when he lived in India and in Louisiana. He reflects on his life from the rich vantage point of scientist, missionary, surgeon, storyteller, and theologian.

  We live in divided times. Politically, racially, and religiously, the United States is experiencing a severe strain on its unity, and a similar factiousness has spread around the world. We have much to learn from a man who studied medicine during the blitz of World War II, when virtually the entire world was at arms, and who began his medical career during the Partition of India, a cataclysmic event that caused more than a million deaths and created fourteen million refugees.

  The modern world depends on institutions—global alliances, corporations, church denominations, government bureaucracies—many of which seem to be failing. Perhaps it is time to take a look at a different kind of community, not an organization but rather an organism, best illustrated in the human body.

  Modern culture has also become reductionistic. We reduce music, movies, and knowledge to blips of data that can be stored on a handheld smartphone. Science, medicine, and other endeavors exist in professional silos with little cross-fertilization. Dr. Brand had the rare ability to bring fields together. An avid scientist, bird-watcher, mountain climber, and organic gardener, he strove to integrate the natural order with the spiritual order. As a Christian, he delighted in discovering echoes of the Creator within the world of nature.

  If you train a telescope on the galaxies, stars, and planets of the universe, and then look through a powerful microscope at tiny molecules and atoms and electrons, you will notice an unmistakable similarity in structure and pattern. The same Creator designed both levels of reality. So too the same Creator designed the human body and then inspired New Testament authors to look there for a model of spiritual truth. Dr. Brand’s insights come not as sermons but as observations of how cells work together in community and what we can learn from them.

  I hope that this book will help span the chasm that for too long has separated the created world from its Source. God invented matter, investing great creativity in this world and especially in the design of our bodies. The least we can do is be grateful.

  I look back with nostalgia on the decade of our collaboration when my own writing career was just beginning. I had splendid subjects to work with: the realm of nature and specifically the magnificent human body; the exotic life of a surgeon who brought healing to people who knew no physical pain and therefore much suffering; and the mystery of Christ’s Body, surely the most perilous venture ever made by God, entrusting the divine reputation to the likes of us, God’s fickle followers.

  A Personal Note

  True friends get their measure, over time, in their effect on you. As I compare the person I was on our first meeting and the person I am now, I realize that large changes have occurred within me, with Paul Brand responsible for many of them.

  Elsewhere, I have written honestly about my early struggles with faith, due in large part to exposure to toxic churches. I can imagine God gently steering me to Dr. Brand (through my wife’s serendipitous discovery in a closet, of course) at a critical time in my spiritual journey. OK, Philip, you’ve seen some of the worst the church has to offer. Now I’ll show you one of the best.

  Paul Brand was both a good and a great man, and I am forever grateful for the time we spent together. My faith grew as I observed with a journalist’s critical eye a person enhanced in every way by his faith. No one has affected me more, and I know no one who better illustrates Jesus’ most-quoted statement in the Gospels, that “whoever loses his life for my sake will find it.” From the perspective of a success-obsessed culture, an orthopedic surgeon devoting his career to some of the poorest and most oppressed people on the planet is an example of “losing his life.” Yet Dr. Brand lived as full and rich a life as anyone I know, one that combined professional achievement with enduring qualities of humility and a grand sense of adventure.

  As much as anyone, he helped set my course in outlook, spirit, and ideals. I look at the natural world and environmental issues largely through his eyes. From him I also gained assurance that the Christian life I had heard in theory can actually work out in practice. It is indeed possible to live in modern society, achieve success without forfeiting humility, serve others sacrificially, and yet emerge with joy and contentment. Whenever I doubt that, I think back on my time with Paul Brand.

  There was an exchange at work in our writing collaboration, I now see. Wounded by the church, plagued by doubts, I had neither the maturity nor the ability to express much of my own fledgling faith. Yet I could write with utter integrity about Dr. Brand’s faith, and through that process his words and thoughts became mine too. I now view the ten years I spent working with him as an important chrysalis stage. As a journalist, I gave words to his faith. In exchange, he gave faith to my words.

  Simone Weil once said, “Imaginary evil [such as that portrayed in books and movies] is romantic and varied; real evil is gloomy, monotonous, barren, boring. Imaginary good is boring; real good is always new, marvelous, intoxicating.” I saw real goodness in Paul Brand and found it indeed marvelous and intoxicating. I feel privileged, as his coauthor, to have had some role in shining a light on his life.

  Chapter One

  INVISIBLE MADE VISIBLE

  A CURTAIN SCREENED MY GROUP of interns and medical students from the rest of the forty-bed ward at a training hospital in Vellore, India. Activity throbbed in the ward: nurses tending to other patients, families bringing in home-cooked food. Inside the curtain, though, we were giving full attention to our young colleague as he made a diagnosis.

  He was half-kneeling, in the posture I had taught him, with his warm hand slipped under the sheet and resting on the female patient’s bare abdomen. While his fingers probed gently for telltale signs of distress, he pursued a line of questioning that showed he was weighing the possibility of appendicitis against an ovarian infection. Suddenly something caught my eye—a slight twitch of movement on the intern’s face. Was it the eyebrow arching upward? A vague memory stirred in my mind, but one I could not fully recall.

  The intern’s questions were leading into a delicate area, especially for demure Hindu society. Had she ever been exposed to a venereal infection? He looked straight into the woman’s eyes as he questioned her in a soothing tone of voice. Somehow his facial expression combined sympathy, inquisitiveness, and warmth. His very countenance coaxed the woman to put aside the awkwardness and tell us the truth.

  At that moment my memory snapped into place. Of course! The left eyebrow cocked up and the right one trailing down, the head tilted to one side, the twinkling eyes, the wry, enticing smile—these were unmistakably the features of Professor Robin Pilcher, my old chief surgeon in London. I sharply sucked in my breath.

  Startled by my reaction, the students all looked up. I could not help it, for it seemed as if the intern had studied Professor Pilcher’s mannerisms and was now replicating them in an acting audition. I had to explain myself. “That is the face of my old chief! What a coincidence—you have exactly the same facial expression even though you’ve never been to England an
d Pilcher has never visited India.”

  At first the students stared at me in confused silence. Finally, two or three of them grinned. “We don’t know any Professor Pilcher,” one said. “But, Dr. Brand, that was your expression he was wearing.”

  Later that evening, alone in my office, I reviewed my time under Pilcher. I had learned from him many techniques of surgery and diagnostic procedures. Evidently, he had also imprinted his instincts, his expression, his very smile, in a way that could be passed down to others. It was a kindly smile, perfect for disarming a patient’s embarrassment in order to tease out important clues.

  Now I, Pilcher’s student, had become a link in the human chain, a carrier of his wisdom to students some nine thousand miles away. The Indian intern, young and brown-skinned, speaking in Tamil, had no obvious resemblance to Pilcher or to me. Yet he had conveyed the likeness of my old chief so precisely that it had transported me back to university days with a start. The experience in that ward gave me a crystalline insight into the concept of “image.”

  A Mysterious Phrase

  In modern times the word image may connote nearly the opposite of its original meaning. Today, a politician hires an image-maker, a job applicant dresses to present an image of confidence and success, a corporation seeks just the right image in the marketplace. I wish to return to the word’s original meaning: a true likeness, not a deceptive illusion.

  Think of a ten-pound bundle of protoplasm squirming fitfully in a blanket. The baby’s father weighs twenty times as much, with his body parts in different proportions. Yet the mother announces proudly that the baby is the “spitting image” of his father. A visitor peers closely. Yes, a resemblance does exist, evident now in a dimple, slightly flared nostrils, a peculiar earlobe. Before long, mannerisms of speech and posture and a thousand other mimetic traits will bring the father unmistakably to mind.