Nov 2 - White Coat Mass for St. Luke's Physicians' Guild (31st Sunday Ordinary Time)

Good evening, brothers and sisters.

I want to thank the St Luke’s Guild for inviting me… but perhaps you’ll rethink your choice in the future, based on the length of this homily.  But I think it may be a fitting penance for all of us physicians who often keep our patients waiting for us.

Our readings for this anticipatory Mass coincide beautifully with today’s White Coat Mass for the Feast of St. Luke.

The First reading is echoed in our Gospel. When the scribe comes to ask Jesus which is the first of the Commandments, he gives the answer straight from Deuteronomy:

"Hear, O Israel! The LORD is our God, the LORD alone!

You shall love the LORD, your God,

with all your heart, and with all your soul, and with all your strength.”

This is the Shema Yisrael – which means hear o Israel -  this is the central Jewish prayer, recited by Jews twice daily, and written down and placed inside little boxes called phylacteries over their foreheads and upper arms… in obedience to what is written in the next verses in Deuteronomy: “Recite them when you are at home and when you are away, when you lie down and when you get up. Bind them on your arm as a sign and let them be as a pendant on your forehead.”

Jesus affirms the primacy of this commandment of love of God, and then adds that the second greatest commandment is this: “You shall love your neighbor as yourself.”  The word used for love is agape – which is selfless love, doing good for another without expecting anything in return.

Then the scribe repeats the 2 greatest commandments, adding that they are greater than all burnt offerings and sacrifices. "You are not far from the kingdom of God." – Jesus responds.

These two commandments offer the key to the Kingdom of God, the key to Heaven, because God is love.

Love of God, Love of neighbor – these are the central dictates of our faith, and what we as healthcare professionals – as healers – should be practicing par excellence.

We’re finishing the beautiful feasts of All Saints and All Souls. So I’d like to spend some time reflecting on Catholic history: on the saints and good souls who have gone before us, the physicians who have embodied love of God and neighbor. Then I’ll end with a challenge for all of us. Fittingly for this guild, we can begin with St Luke. He is called the ‘beloved physician’ by his comrade Paul – and the word for beloved is ‘agapetos’. As one of the 4 evangelists, Luke alone gives us the parable of the Good Samaritan, that beautiful model of the love of neighbor.  Luke shows us how to love the forgotten ones in our midst, regardless of personal cost.  Luke is also the only Evangelist to give us the Annunciation – that sublimest moment of the Love of God – of Mary’s ‘fiat’ as the handmaid of the Lord.  Luke himself showed his love of God in his act of writing his gospel, of preaching.

We can turn next to two of the most famous physicians in the early Church – Sts Cosmas and Damian. These Syrian brothers were called the ‘silverless ones’ because they treated the poor free of charge– which was unheard of in those days. Here was love of neighbor – love of the forgotten. Apparently, their charitable work helped to convince many pagans to convert to Christianity. Around 300AD they were arrested for being Christian, and then tied up to be burned at the stake.             And we thought that physician burnout was a recent problem!

Tradition tells us they miraculously survived the fire and ultimately were beheaded. If you’ll pardon another pun, we could say they were killed for sticking their necks out for Christ. Cosmas and Damian fearlessly showed love of God and love of neighbor.  Fast forward a bit to 370AD, and you have St Basil the Great. As a bishop, showed his love of God, including suffering persecution for defending the true faith. He also lived love of neighbor. Although not a physician, Basil did study medicine in Athens. And when a severe famine hit Caesarea, he started the world’s first public hospital, staffed by physicians and monks. The hospital treated lepers and orphans – the outcasts of those days. And so began the Catholic tradition of founding hospitals – which has continued to this day in places like St Jude’s and the Mayo clinic– indeed, the Catholic Church remains the largest non-governmental provider of healthcare in the world.

We’ll zoom forward a 1000 years so our dinner doesn’t get cold. We can thank medieval monasticism during that millennium for preserving all of the classical texts of medicine and ancient learning. And we can thank the late medievals for founding the first universities in Europe, which of course were Catholic. Some notable university scholars include two Franciscan friars. Roger Bacon in the 13th century is credited as the ‘father of the scientific method’, and William of Ockham gave us ‘Ockham’s razor’, which we use in medicine to this day.

 Other Catholics helped bring medicine into the modern era.

For example, Fr. Dr. Thomas Linacre was a priest and physician in the 15th C. who founded the Royal College of Physicians. If he had lived only 20 years later, he likely would have suffered the fate of Catholics like St Thomas More or St Edmund Campion – the latter of whom was dragged, hung, and quartered.  St Edmund was literally eviscerated for his faith; if you’ll pardon another medical pun – it took real guts to be a Catholic in England in those days.

Turning to the 16th century, we can point to men like Fr Fallopio or Bishop Steno, esteemed anatomists after whom the Fallopian tubes and Stensen duct were named.

The list goes on and on: the founders of modern anatomy, histology, anatomical pathology, mycology, bacteriology, and genetics were all devout Catholics. To list their names: Vesalius, Malpighi, Morgangi, Fr Micheli, Pasteur, Fr Mendel. Catholicism has left its stamp on the very heart of medicine: think of the mitral valve, named after the miter that bishops wear, which have 2 parts or leaflets. Think of Aspergillus, that tricky fungus that, under Fr Micheli’s microscope, looked like the aspergillum or holy water sprinkler we use at Mass.

Or think of the rachitic rosary or the rosary-bead esophagus, or even the term ‘cells’, which looked like monastery cells under the microscope.

One could argue that it was these scientists’ belief in the human body as “fearfully and wonderfully made” – that compelled them to study medicine so dutifully… so that they could imitate Christ in love of neighbor.

One of my favorite examples is Rene Laennec. He’s remembered for coining the terms cirrhosis, melanoma, Pectoriloquy, and Egophony.

 He lived through times of great turbulence: including the ultra-secular French Revolution, which included the guillotining of Carmelite nuns. Yet Laennec clung to his Catholic faith: in fact, once he was praying the rosary while riding in a carriage with his wife…. and there was an accident and they were thrown from the carriage. Once they got back into the carriage, Laennec simply said: “well, we were on the 3rd decade.”

It was precisely Laennec’s Catholic faith which prompted him to his greatest medical achievement—inventing the stethoscope. He was on a house call one day to examine a buxom young woman, but – being a man of Catholic modesty, he did not want to follow the usual technique of putting his ear directly on the patient’s chest.  So instead he devised to roll up a piece of paper to put to his ear, and voila, he discovered he could hear the lungs better this way.

So we can rightly say that the stethoscope is a Catholic invention – just like universities and public hospitals.

And yet how many today tell us that we Catholics are the backwards ones, fighting medical progress?

I love the quote from Dr Joseph Murray, who was a surgeon at Brigham Hospital and the first person to successfully perform an organ transplant in 1954 – a feat that won him the Nobel prize.

He wrote: “Is the Church inimical to science? Growing up as a Catholic and a scientist – I don’t see it. … The more we learn about creation … it just adds to the glory of God.”

Again, love of God assists with love of neighbor.

Ok, so I’ve finished our sprint through Catholic medical history, and I’m hoping that we’re all feeling inspired by the Catholics who have preceded us, with their love of God and neighbor. 

Ok… So what? How will this affect us today?

I’d like to give some homework… something we all did plenty of in medical school. These are two challenges for how we can all try to love God and neighbor a bit better.

First, I want to encourage all of us to continue to be the advocates for the forgotten ones.

Let’s be like Dr Jerome Lejeune, who cared for thousands of children with Down Syndrome, and ultimately discovered Trisomy 21 as the genetic cause. He was aghast that his discovery led to an explosion in selective abortion, and fought hard against this.  This unpopular pro-life position lost him the Nobel prize and even led to people painting ‘Death to Lejeune’ on the walls of the Sorbonne University.

I think Lejeune would say: “What does it profit a man to gain [the Nobel Prize], but lose his soul?” I have no doubt that Dr Lejeune, when he died, was greeted by myriad upon myriad souls of unborn children at the gates of Heaven – ‘St Peter, let him in – he’s with us!’

I know many of you here have followed Dr Lejeune’s lead, advocating for proper care of the vulnerable – the unborn and people with terminal illnesses.  Keep it up!

I hope the saints inspire us to be bold: to be willing to stick our necks out, to have guts, to risk getting burned. 

We live in difficult times, but many of the saints lived in far more difficult times.  St Luke continued to preach, even when he saw fellow evangelists like Paul get martyred.

‘Preach always, when necessary, use words’, is what many of us have been taught, but this is a false dichotomy. We should preach with actions yes, but also with words. To be like Christ the physician, we need more than kind actions.

In the days of Cosmas and Damian, to treat the poor was itself remarkable. But fast forward to today, and Christianity no longer has a monopoly on care for the poor. Christian agape for the poor has permeated the world. Look at countless safety-net hospitals; look at Doctors without Borders. This is the norm: this is what’s expected of doctors now.

If I’m honest, I don’t think that I’m much nicer or more compassionate than many of my non-Christian colleagues.  Being nice isn’t enough.

What we can bring, especially in this corner of the U.S. soaked in secularism and wounded by clerical sex abuse, is the light of Christ.

When we die, it will matter less how many Whipples we completed or how many cataracts we fixed, compared to how many people we helped come to Christ.  Yes – good patient care is important. Of course.

But spiritual care , care of the soul, is part of good patient care, and all Christians have a mandate to evangelize - to bring Good News - as we can.  

I know this is not the message I heard from the pulpit growing up, and it’s something we Catholics feel very uncomfortable about. I only first learned about praying with patients from Southern Baptist doctors at my med school.

But then I saw it practiced by a couple of heroic individuals during my residency at MGH.  I think of Dr XXXX, now a palliative care doc in California. When she was admitting a patient to the hospital, at the end of her visit she sometimes offered to pray for the patient. More often than not, the patient would say yes, and she would kneel at the patient bedside to pray with them. Patients loved it. Or I think of Dr ZZZZ, one of my colleagues. She is a palliative care physician who walks around with small bottles of water from Lourdes in her white coat pocket. She has bottles in her exam room too. Thus, not infrequently, she finds situations when she could prudently offer a bottle to a patient, telling about the story of Lourdes and healings.  The patients love it, even many non-Catholic patients.

Once, one of her bosses approached her and asked, ‘Is it true you have this holy water in your office?’ Tepidly, she responded, ‘Yes’, and he said, ‘I’d love to have a bottle, if you don’t mind.’

The devil wants us to cower in fear. But we need not fear: we have Christ on our side. We never proselytize, we never force anything on anyone. But we can certainly invite a patient to prayer, or we can offer to give them a prayer card, or we can ask if they’d like to see a chaplain. Indeed, we have studies showing that many patients feel their spiritual needs are not being met… yet less than 1% of physicians ever ask patients about their spiritual needs.

In prepping for this homily over the last week, I stepped out of my comfort zone, and offered to pray with 3  different patients. I’ll admit I was pretty nervous at first – It’s been a while since I’ve done this. But lo and behold, the patients all really appreciated the prayer. Tears were shed.

And even if they had said, ‘no thanks’, I could have simply replied: ‘Ok, but do you mind if I keep you in my prayers when I’m at home?’ In my experience, everyone says yes. Everyone appreciates prayer.

In the days in which patients are increasingly treated as numbers, what patient wouldn’t want their clinician to see them as a beloved child of God, with value and purpose even in their suffering? Who doesn’t want reassurance “that, even though I walk in the dark valley, that Thou art with me?” So here is my challenge: to myself and to all of you.

This evening, I’ve brought a stack of small bookmarks, with Psalm 23 on them. A beautiful prayer, relatively ecumenical. 

If you feel so called, I’d encourage you to take a pack of 10 of them home, and then try to offer them to 10 patients over the next several months, if the situation seems right. 

I promise you that you won’t be burned at the stake or eviscerated. Nobody will paint ‘Death to Dr. XXX' on your clinic walls.

But yes, it will require courage, to love God with our whole heart.  Recall that some of our Jewish brothers wear this Greatest Commandment literally on their sleeve.  So I pray that all of us have the courage to wear our faith on our sleeves, to live these greatest commands of love of God and neighbor.

Through the intercession of St Luke and all the saints, may it be so.

Amen.