"Life's Challanges and the Power of Faith" by Dr. Peter Levine
On May 21, 2006, Worship was led by Dr. Peter Levine. His inspirational sermon has been reprinted numerous times, and is, still, frequently requested. Get the MP3 here.
Pastoral Reflection for Youth
In the house where I grew up as a kid was an old windup phonograph. It was called a “Victrola.” It had belonged to my grandparents, and it had a collection of 78 rpm records with it. One was a recording of poetry read by the American poet, Edgar A. Guest, known as the poet of the people during the 1930s. Some of my colleagues here at the church on a Monday night session of poetry reading heard me mention that I was going to read something by him, and in unison, said, “Eewwww”. But I’m not going to stand here and disgrace the pulpit by reading such things as, “Wait Till Your Pa Comes Home.” You remember that poem:
“Look what you’ve done you little tramp
you soiled the wall with your fingers damp,
you tracked the floor with your muddy feet,
you fought with the boy across the street,
you’ve torn your clothes and you look a sight,
but wait till your Pa comes home tonight.”
I wouldn’t do that.
Today most of the children are at a separate service for children, as the Religious Education season draws to a close. And when I learned that, I was disappointed because I wanted to read this poem that influenced me when I was a kid and had listened to the poet in his own words reading the poem I am about to read. So Diane Mirick is reading it now, this minute, to the kids. He wrote this poem called, “It Couldn’t Be Done.” It doesn’t apply to all situations, but what an interesting, starting point-of-view for life.
It Couldn’t Be Done
Somebody said that it couldn't be done,
But he with a chuckle replied
That “maybe it couldn't," but he would be one
Who wouldn't say so till he'd tried.
So he buckled right in with the trace of a grin
On his face. If he worried he hid it.
He started to sing as he tackled the thing
That couldn't be done…….. and he did it.
Somebody scoffed: "Oh, you'll never do that.
At least no one ever has done it";
But she took off her coat and she took off her hat,
And the first thing we knew she'd begun it.
With a lift of her chin and a bit of a grin,
Without any doubting or quiddit,
She started to sing as she tackled the thing
That couldn't be done…….. and she did it.
There are thousands to tell you it cannot be done,
There are thousands to prophesy failure;
There are thousands to point out to you, one by one,
The dangers that wait to assail you.
But just buckle in with a bit of a grin,
Just take off your coat and go to it;
Just start to sing as you tackle the thing
That "cannot be done, "and you'll do it.
–Edgar A. Guest
Would any children who are left in the congregation and any of their teachers please thunderously head for the doors and join their programs.
And for those of you who are new to the church; one of the great joys for my wife and I every Sunday during this period of the service is to watch what is normally a thunderous group of children and teachers rush to both side doors. If you want to know, “What can I do about all the horrible troubles in the world,” support a program of Religious Education that is as good as this one. There is the hope for the future.
Pastoral Reflection for Grownups: A True Story
A physician with a form of leukemia had been sent to see me from out of town several years earlier and was doing beautifully on a gentle maintenance program of daily oral chemotherapy. I saw him on a routine follow-up visit and he suddenly was feeling badly. He had lost a lot of weight. He had severe fatigue. He was pale. He had tremor. His skin was cold and a little bit clammy. His usual good humor was replaced with the demeanor of a man who was about to die. And his blood counts from the hematology lab were unchanged. His physical exam was unchanged. There was nothing else in the history that suggested what was going on. And so I began looking for a second illness. I scheduled him for x-rays and other studies and asked him to come back and see me in a week. The studies were all normal. When he came back to see me, the light bulb finally went off….boing! Why wasn’t I thinking? So I said, “Jerry, what did they tell you, the physicians in the north county who sent you down to see me?” “Well, they said I had chronic lymphocytic leukemia.” And I said, “Well what did they tell you about what would happen?” He said, “They told me the average survival was five and a half years.” And I said, “How long have I been seeing you?” And he replied, “Five and a half years.”
This is not an unusual story, even though the patient is a physician. He had also read about it and confirmed that average survival was five and a half years, and so he “knew” it was time to die. He had forgotten, as so many people do, about the bell-shaped curve of averages. There are some people who will die at five and a half years, and there are some people who will die in weeks or months and others who will live for decades. And oh, incidentally, the bell-shaped curve for most illnesses is not a bell shape; it’s a big wide curve with long tails. Some people with most forms of leukemia are going to die soon after diagnosis, because they’ve got other things going on, because they’re extremely old and sick, or they’ve got two diseases, or they’ve got a really rare form of leukemia that’s very aggressive, or something. But other people are going to be there twenty years from now doing just fine. It took me several visits to talk him into that, and out of the idea that he was dying. He wasn’t dying. The mind/body connection is unbelievably powerful. At the 11-year point he came back to see me to remind me of the episode of his almost premature death and to thank me.
FIRST READING
-Isaiah 33: 15-16
He who walks righteously and speaks uprightly; who despises the gain of oppressions, who shakes his hands lest they hold a bribe, who stops his ears from hearing of bloodshed, and shuts his eyes from looking upon evil.
SECOND READING
—from “The Passing Arthur” by Alfred Lord Tennyson
Then loudly cried the bold Sir Bedivere:
"Ah! my Lord Arthur, whither shall I go?
Where shall I hide my forehead and my eyes?
For now I see the true old times are dead,
When every morning brought a noble chance,
And every chance brought out a noble knight.
Such times have been not since the light that led
The holy Elders with the gift of myrrh.
But now the whole Round Table is dissolved
Which was an image of the mighty world,
And I, the last, go forth companionless,
And the days darken round me, and the years,
Among new men, strange faces, other minds."
And slowly answered Arthur:
"The old order changeth, yielding place to new,
And God fulfils himself in many ways,
Lest one good custom should corrupt the world.
“Life’s Challenges and the Power of Faith”
Dr. Peter H. Levine
This morning’s sermon is entitled, “The Role of the Blood Platelet in Hemostasis and Thrombosis.” Oh no… I’m sorry…that was a different talk.
Tom Schade asked me if I would turn a talk that I gave at an Advent service on “hope” last December into a sermon and present it here this morning. And I was happy to do so. It will involve talking a bit about some of my own experience with adversity. I’ll draw heavily from what I’ve learned, not just in medical school, but more importantly, what I’ve learned from my patients. I will also change the examples I use enough so that the 25 people who attended that Advent service won’t be bored to tears by hearing it a second time, although you’ll recognize a few common themes.
First, I want to be sure you understand what I am talking about in terms of life challenges. Life challenges to me include such things as marital problems, problems with your children, job discord, losses of all sorts, financial difficulties, illness. Life throws these things at us. Sometimes these challenges are tough and seem unbearable, and the best antidote we have is hope for a better tomorrow.
(Let me assure you that this talk will not be a downer!) I spent most of my career in hematology because I wanted to treat patients with serious, potentially fatal, blood diseases. I was quite sure of what I, myself, would die of. I would die of heart disease. I’d have a heart attack, as did my father, and as do so many other Americans, and I do have some risk factors for heart disease. And so I never dreamed that I would have a disease in my own specialty, or two diseases in my own specialty, as I subsequently did.
One of the questions I’d like to pose to you at the outset is, “Who deals best with the kinds of major challenges that life can throw at you, men or women?” And I’d like to ask you all to go along with me by doing the following. I’m going to ask you to put up your hand as to which it is, and keep it up long enough for everyone to look around and see how you voted. I’d like to see how the men vote. I’d like to see how the women vote. And let’s see how many people are horribly embarrassed by this exercise. Who handles life’s major challenges better? For example, a major family issue or being told you have a fatal disease. (Wait till I ask…wait!) I’m going to ask you to vote for either (a) Men handle it better, or (b) Women handle it better. How many votes for (a) Men? Put your hands up. (This choice got a smattering of votes by both sexes.) How many votes for (b) Women? Put your hands up. (This choice got a very large majority of votes, and not just by the women.) This is not a vote along party lines, you will note! The scientifically correct answer, and I have to tell you I am very dismayed by the outcome of your vote, is: (c) No one has the vaguest idea!
It would be impossible to do a study like this in true randomized fashion, given how many different stresses there are, and how different men and women are. This is lumping to a degree that’s ridiculous. Then why did I put you through this nonsensical exercise? We know a lot more now about how brains work through a variety of good scientific studies, including positron emission tomography scanning (PET scanning), of the brain in which we can watch while people are confronted with a variety of situations to observe what their brain does to deal with that situation. Many of you have read recently of excellent studies done on homosexual men and women that show us that the brain “wiring” of homosexual men and women is a variant of normal in 10% of us that causes them to react differently to stimuli. We thus now understand that it is a variant of normal to be homosexual for about 10% of the human population, just as it is a variant of normal for some of us to have red hair or blue eyes.
Well, what about the issue of confronting people with stressful impulses? The data for PET scanning says when you confront men with a stressful situation, a severe one of the sort of examples I gave you, a part of the brain that has to do with motor activity, the muscles used for fight or flight, lights right up. When you confront women with that sort of stress, the motor activity in those areas of the brain tamps down. In women, the area of the brain that has to do with higher thought integration and speech lights up bright red. In men, it goes out!! It goes completely dark. There is virtually no wiring for discourse during severe stress in most men. Why do women get so infuriated when it’s time to argue a tough issue and men go silent, and in fact, leave? They flee. It’s because they’re wired that way. It’s because evolution has caused those changes to occur in most people, and luckily that particular anomaly can be relearned or unlearned in the face of life’s severe challenges.
What I have seen among men and women who are confronted with a diagnosis of severe, potentially fatal, blood disease, is that initially the response among the women is remarkably better. But sooner or later, the men learn, often from some of the women, either family members or friends or people who are taking care of them, about the benefits of reaching out and accepting discourse, discussion, advice, solace, etc.
Now at the Advent series, I talked at some length about aplastic anemia, a rare disease which I acquired nine years ago. I’m going to spend two minutes only on it now. It’s a rare form of auto-immune disease. Your immune system mistakenly attacks your bone marrow stem cells and stops them from making blood cells. There was no effective established treatment for it when I developed it nine years ago, unless you were young enough for a marrow transplant, which I was not. About 6-8 months before I developed it some experimental treatments began to be done with a new way to suppress severely the immune system, to stop it from attacking the bone marrow and to let the bone marrow work again. I tried the new experiment and it worked. But at first, I knew I was going to die. I knew it because I had treated hundreds of older patients with severe aplastic anemia as had all of my colleagues and they’d all died. I was too old for a marrow transplant. Older patients with severe aplastic anemia all die. I “knew” it. So I needed to put in place a series of prescriptions that I had seen my patients use to maintain hope. I’m going to tell you about that prescription in a minute. But first, I want to tell you about my second problem. I’m going to use a few examples from that to illustrate some of the points in the “Hope Prescription.”
When you’re severely immune-suppressed as I was from the treatment of my disease, you are susceptible to other illnesses, and there are two cancers in particular that are common in people who are severely immune-suppressed. One of them is melanoma, the skin cancer. And I developed a melanoma on my scalp, and because it was a rare melanoma with no pigment in it, nobody could see it. By the time it was diagnosed, it was large and deep. I underwent multiple surgeries. I had a radical lymph node dissection of my neck, then I went back and had some of my parotid gland taken out, and (remember this talk is not going to be a downer!) we chased it for a number of months. Then I went back for a routine follow-up and the CAT scan showed I had 6 metastastic lesions in my lungs. Melanoma with lung metastases has an anticipated average survival of a few months. So, I said to myself, “Well better now start working, instead of on the “Hope Prescription,” on the “Get Ready To Die Prescription.” Among the many things I needed to think about was, where would I have the funeral? I had been a Unitarian but didn’t currently belong to a congregation. Dr Harvey Kowaloff, a good friend of mine, introduced me to Barbara Merritt, about whom I had heard wonderful things. My wife and I came and spent an hour with Barbara, and told her my story. When it was over, after asking me a few questions, Barbara said to me that she didn’t think that God was ready for me to die yet because I was still doing a lot of useful things, and I still looked pretty good. I went home and thought about that and I said, “I have just been given the license to hope. What’s wrong with me? I’ve forgotten one of the things I had learned from all those patients. I might know what will kill me, but I certainly don’t know when. So I’d better go back and reapply the “Hope prescription” with a vengeance.” And that’s what I did.
Here are the elements of the “Prescription for Hope.” First, live normally. Live. Do the things you always did to the extent that you can. Sounds simple, but when confronted with major stress, lots of people stop doing those things they normally do. Living normally, especially when confronted with stress, a severe one like being told you have a fatal illness, might mean; “I am going to France. I’ve always wanted to see Paris. Here’s my excuse to do so. I’m going on a trip to France.” NO! Don’t do that. Why? I can’t tell you how many times I’ve seen patients of mine use that as a piece of their defense. And this also applies to people with other kinds of severe life stress. I’m going to go to Paris. Or I’m going to make it to the Christmas holidays. I’m going to make my grandson’s graduation. Those are all wrong. Because what happens is that you go take the trip to France, you go to your grandson’s graduation, you make it to Christmas, and then…die. How many times have I seen that? Patients who kept themselves going beautifully with their illness, nothing changed, except when the holiday passed or the graduation passed, they died. The mind/body connection is unbelievably powerful. OR in the case of another type of severe stress, you reach that milestone (Paris, Christmas or the graduation) and then you go into a deep depression. The milestone is over. Don’t do that. Do this when confronted with a severe stress: “I’ve got a multiple point plan. I’m going to France, and when I get back, I’m going to do….” And then follow some other pieces of the prescription I’m about to give you please, because that’s the way life is.
Do something new. I don’t care what it is. Start writing letters to your Congressman. Ever done that before? Think it’s hopeless? You’re wrong. They do pay attention to the letters they get. I’ve seen multiple examples that they do. Yes, it’s true, you are going to get a phone call or two looking for a donation …ignore that! They will pay attention to the letters whether you are a donor or not. Their office staff will be collating these and saying to the senator or local representative, “We’ve had six letters now on the problem of hunger in the Worcester area. We need to be active in helping the volunteer efforts that are going on. We have to do something about this.” Letters really work, having spent a lot of time in Washington, I assure you, they really work. Do something new. Put a bird feeder in your backyard. Join a committee. It doesn’t matter what it is. Do something new that you can control.
Next, plan a series of powerful conversations. One of the biggest regrets I have in my life is waking up in the middle of the night to a midnight phone call from a policeman. I’d get lots of middle-of-the-night phone calls when I was in practice. But this one was different. It was from a policeman who said, “Dr. Levine?” I said, “Yes.” “Your mother wants you to come home. Your father’s had a heart attack.” And I said, “Is he alright?” And the policeman said, “Your mother wants you to come home.” That’s how I learned that my father had suddenly and unexpectedly died. And I went home. My father and I had a great relationship. He was a super guy. He knew I loved him. He knew all the things he meant to me. But I didn’t have a chance to say that to him because I’m wired wrong. I’m a male. Have some powerful conversations with people around you. Pretend you’re going to die, now. (Don’t do it, just pretend!) Or say “I heard some geek with a hat say that we ought to be having powerful conversations with each other,” and go have some. Say to people in your family and maybe a few close friends, even though you know they know it, that you love them and appreciate them, and why. You will be amazed at how good it feels, and how important it is to give them the opportunity to say things back to you.
So far we’ve done: Live Normally, have a Long-term Plan, Do Something New, Have Powerful Conversations. Next comes extend help to other people. Do something that helps other people or other things. Participate in the Plant Sale. Dig up some plants and bring them to the church for sale or help to sell them. Go to the sign-up tables upstairs after church this morning and find some interesting new things to do that can contribute to the well-being of other folks. It’s unbelievably gratifying. This may be the most powerful element of the prescription for hope.
In addition to helping others, be willing to ask for help. Reach out. Talk to the ministers of this church. Talk to members of your family. Ask their opinion and listen. My secret weapon through all these travails has been my wife, who is wonderful about listening and reflecting good advice and caring and being supportive. And hopefully, I help support her with what she has to go through with watching me deal with this. Incidentally, periodically, she walks into the room, seizes me by the throat and says “Get out of bed and get going!” Actually, she’s never done that. It’s just that it feels like that to me on some days because she can read me, and knows when I’ve forgotten my prescription and that I need to just start applying it again.
One of the last things I’ll tell you is that, of course, I’ve wound up getting my aplastic anemia back because Dr Doreen Brettler, my hematologist at the Levine Cancer Center at Memorial and I, said we’re going to design a new, never before attempted treatment for melanoma that happened in the face of immune-suppression: we’re going to abruptly stop the immune-suppression (that’s malpractice) and let your immune system come back to fight off the melanoma. And we’re going to give you chemotherapy…you never give chemotherapy in aplastic anemia, that’s malpractice, too. So we did as an experiment two forms of medical malpractice that were totally contra indicated. That plus the whole hope prescription, and help from a lot of my friends here, and the melanoma all went away. It disappeared almost three years ago. Maybe it’ll come back sometime, but if it does, I’m ready with the next experiment and the whole hope prescription.
And what about prayer? Does prayer work? There was a study published last month showing absolutely no effect of prayer. I’ve had thirty years worth of serving as consulting editor to 8 medical journals, including the New England Journal of Medicine the Annals of Internal Medicine, and all of the blood journals, the Journal for Public Health, etc. I’ve never seen a worse piece of human research. Time doesn’t permit me to tell you the incredible flaws in that piece of garbage. But it should not have been published. It was awful. Does prayer work? I don’t know. But it sure makes you a more thoughtful person and makes you feel better.
One last story, and then I’ll sit down. Some of you know I don’t believe in coincidence, especially when it’s preposterous. The scientific method tells us to doubt such coincidences. I had a really unusual complication of my aplastic anemia last September and found myself at a care unit in the hospital that I would never ordinarily require. I woke up wide awake in the middle of the night. I’m going to be careful about confidentiality here. A man/woman walked into that unit to which I would normally never go and said, “Aren’t you a hematologist?” I said, “Yup.” And he/she said, “I have something kind of rare, can I tell you about it?” I said, “Sure.” (I’m complimented when people do that, as most doctors are.) And he/she went on to describe an illness, a genetic illness that he/she had that would kill him or her at about age 45. And it’s very, very rare. There are expected to be three people with this illness in the Commonwealth of Massachusetts now. He or she was one of them. “Do you know anything about this?” he/she said. I replied, “Yes, when I first began doing bench research in hematology, I worked on this. I am one of the three hematologists in Massachusetts who knows about this disease in some detail and therefore knows that a new medicine has been invented that will be released two weeks from now that will cure it. That’s got to be just a coincidence. No! When one of three people in the Commonwealth who has it, meets one of the three hematologists in the Commonwealth who knows lots about it, and when the meeting occurs just as the first new cure is about to be released, does not constitute random occurrence.
Two or three of the very thoughtful people here who attend Monday Night at the Church regularly are going to give me hell for telling this story and we’re going to debate it over the weeks to come. If you’ve never had a letter from Ken Waugh, who has one of the best minds I’ve ever encountered and really thinks about these things and writes beautifully, you’ve missed something. I’m saving a letter he wrote me the last time I talked that’s unbelievable. If you’ve never attended Monday Night at the Church and had the meals that he and Carmen and their helpers prepare, and listened to the programs that Jeff Bailey puts on, you’ve missed something. They are terrific.
It is time for us to close this sermon and to sing a hymn. Hymn #29, gray. “Joyful, Joyful We Adore Thee.”
Benediction:
Sad but true:
Life will confront all of us from time to time
with stress and adversity.
Some will seem unbearable.
May all of us find the way to retain our hope
and to regain enjoyment in life,
And may we do so, at least in part
by both giving and receiving support from our fellow man.
Key Elements of Dr Levine’s Hope Prescription
1. Keep on living, as normally as possible, and with as much vigor as possible. Set both short and long term goals.
2. Do something that’s new. Make it something you can control, and make it worthwhile.
3. Have some powerful conversations.
4. Reach out and give some support to a person or persons who are in need.
5. Reach out and ask for and dare to accept the support of others.
6. Get active at the First Unitarian Church of Worcester (or equivalent institution), and be inspired by its many attributes, its worthwhile activities, and its potential to be a site for some of the above-mentioned prescription elements.
posted by First U | 10:38 AM
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