Saturday, February 20, 2010

Mentors in Missions: A Tribute to Henry Farrar

I was about 14 and had decided I would be a physician. My seventh grade science teacher (and my Sunday school teacher) Margaret Beene had told us about her aunt who had a strange, little-understood disease called scleroderma in which the skin, inside and out, hardened to make the affected organs barely functional. In one form fingers could be resorbed from the tips due to the pressure of the skin on the bones, and internal organs such as the digestive tract and heart had major functional problems as their own “skins” hardened. Then Mrs. Beene got the disease, and I was going to find a cure for it: I was going to be a doctor.

We had traveled 50 miles from our small town to Tyler, the closest thing to a city nearby, to attend a service of an evangelistic meeting at the Omen Road Church of Christ. We met some friends, Howard and Betty Waldrip, there and were going to their home for a bit after the service. My parents had split up to assist in finding the Waldrip home, and I had ridden with the ladies. We were sitting in the parking lot about to head for their house when Sister Waldrip turned to me in the back seat:

“What are you going to be when you grow up, Bruce?”

“I’m going to be a doctor,” I answered from the back seat.

“And be a medical missionary like Henry Farrar?” she queried.

I thought, “No way! I’m going to do research and find a cure for Mrs. Beene’s scleroderma.” I had no idea who Henry Farrar was, but I was pretty sure that the kind of research I wanted to do and medical missions didn’t go hand in hand. But a seed had been planted.

A few years later my older sister married a latino evangelist, Victor Rodriguez, and the idea of missions came a little closer to home as they discussed possible work in Spain or Latin America. The seed had been watered just a little, and was ready for the warm sun of the missions youth rally which my dad organized. David Gatewood, already working through forays behind the “iron curtain”, spoke along with Kenny Sinclair who was finishing graduate work toward a long life of service in Malaysia, as well as a young lady whose name now escapes me. On a card that bares David’s name, along with that of Maurice Hall, I pledged a life of medical mission service to Spanish-speaking people. The seed planted with the name of “Henry Farrar” was germinating.

Dr. Farrar continued to appear in my life. First, on arriving at Harding and discovering the library, I read about him in the Christian Chronicle, his establishment of the Nigerian Christian Hospital, and the troubles that institution had during the Biafran war. I heard stories of his making his way through war lines to check on the hospital and serve the people he loved, of slipping an old, invalid passport with an otherwise valid visa inside a new passport that lacked those stamps and signatures and by God’s grace making it work, getting through to do God’s work.

Most recently I’ve been impressed that Dr. Farrar has read and can discuss in detail or is even teaching from every book that I’ve read or been recommended on spiritual growth and development. His mind is still racing to know and to live under the lordship and teaching of Jesus Christ. The arthritis that has bent his tall frame in recent years belies the sharp mind that operates behind eyes keen once again after cataract surgery and under the blooming almond tree of white hair that foretells the wisdom to come from his lips. But his intelligence, sharp as it is and has always been, and his wisdom pale beside this man’s most marked characteristic, his faithfulness, the incredible trust that Henry Farrar has in his God, the Father of us all, and in Jesus Christ, our model as God’s only son, himself a medical missionary, as Henry has always reminded us.

I’m pretty sure Dr. Farrar was present at the first Medical Missions Seminar held by Churches of Christ in the fall of 1968 or the spring of ‘69 at Harding, though his quiet demeanor pales in my memory beside Joe Cannon’s more bombastic faithfulness and charges to physicians on that occasion: “You don’t go to the mission field because you’re worried about your 401K’s and your retirement funds. Why don’t you work until you’re done and then just die and go to heaven?” If it was Joe who said it, Henry Farrar has lived it. The closest to a word of complaint I ever heard from Doctor Farrar was that he was “underworked and overpayed” when he returned to practice in the States. I know nothing of his financial affairs, but he educated several children, one a surgeon, one a doctoral level RN, and one a missionary, and he has continued to give liberally to others who work faithfully in Nigeria and other places. Money never seemed to be a concern of his: the Lord cared for him and for others through him.

At other medical missions seminars that unfolded over the years Henry encouraged successive generations of candidates to just finish medical school and get on the boat, go to the mission field. He seemed to disdain the urging of others to study culture and language, which they said was necessary so that inter-personal ministry on the field could be enhanced. But when my wife and I spent a few weeks at his hospital during my senior year in medical school, staying in what had been his home, I was pleasantly surprised to see an Ibo grammar as one of only two or three books remaining on the bookshelf of the mostly empty house. And he was not just respected in that part of Nigeria where he worked, but truly loved by the people there. He had not ignored language or culture, but his gentle servant spirit, his personal sensitivity, had been the primary catalyst for developing close cross-cultural sensitivity and relationships.

I think Dr. Farrar’s “get with it” advice may have been motivated by the fact that more than 90% of those who said during pre-med years that they were going to do medical mission work ended up in a private practice in the U.S., never doing any long-term work. The acculturation to American private practice and its seemingly intractable pull on mission candidates was probably discouraging to Dr. Farrar, and it remains a challenge to the needs of medical missions around the world. Henry’s practical answer was “just do it”, the sooner the better.

When various circumstances suggested that the Farrar family return to the States for an indefinite period, Dr. Farrar flexibly “reinvented missions”, leading a wave of itinerant service by multitudes of physicians and surgeons, beginning at Nigerian Christian Hospital and expanding to numerous other facilities, a growth that continues today among some perhaps ignorant of its original inspiration. It is probably not an overstatement to say that these methodologies, itinerant surgical missions, owe their practice in Churches of Christ to Henry’s need to be here and be there, a need he has heeded up until the present. Thus he was able to not only continue to meet his own family’s needs and serve in Nigeria, but also to involve many of those who had said they would go, only to find themselves somehow unable or in some way unsuited after finishing their residencies. At least in some sense, a sense that has been a blessing on both sides of the service, the seemingly betrayed intentions of many have been fulfilled through imitation of the latter part of Dr. Farrar’s life, and not uncommonly through his personal invitation.

The influence of Dr. Henry Farrar in medical missions in Churches of Christ would be difficult to overstate. Though he is probably too humble to say the words, what he has done and the Christ-like spirit with which he has done everything cry in the words of the apostle for us to “follow me as I follow Christ”. It is at least fair to say that none of the rest of us might have ever been there had he not gone, so that Sunday school teachers, visiting missionaries, and Bible professors across the nation could invite those of us considering the practice of medicine to be medical missionaries “like Henry Farrar”, and thus like Jesus Christ.

P.S. Dr. Farrar fell Tuesday morning on arriving at his work, suffering a concussion and a fracture of his first cervical vertebra. He has awakened and is lucid and communicating, but is paralyzed from the neck down and is unable to breathe on his own. The family appreciates your prayers.

Any errors in the above stories are mine, as I remember them.

Margaret Beene lived to be 90 years old by the grace of God and the good care of many able physicians, some of whom she surely outlived. She always encouraged my decision to be a medical missionary, to the last years of her life.

Saturday, February 6, 2010

Shame: HIV, Death, and the Body of Christ

He glided behind me as he passed the front desk. I didn't have to be there, and he didn't need to stop there, but he seemed to avoid being seen. Somehow I knew he was my last patient of the day. We hadn't met, but as I perused his slim chart, it was evident there were problems. We'll call him Mr. P. The amount of HIV virus in Mr. P's blood had dropped, but not nearly as fast or far as it should have. There were suggestions that he had been on several medications since his infection was discovered, but the documentation was not all there. Then there were his current meds. All of them, nearly a month's worth in most of the bottles, had been last filled seven weeks ago: one bottle was nearly full, another was dosed at half the amount it should have been, and there was only one pill left of one of the meds. "And I don't get paid until Friday," he said from under the bill of his cap. "That's when I can refill it." Three more days. Missing a single dose of your HIV meds each month can increase the risk of resistance developing over the year by 10-15 percentage points. This man, like many of our patients, needed help taking his meds.

He looked to be in his 60's or 70's, but he said he was only 45. As we talked about his disease and what was going on, he wouldn't look at me. On several occasions I asked him to, and he did. Briefly. And then the head was down again, the bill on the cap shading his eyes, hiding his face from my attempt to know him.

"How has this disease affected your life?"

"It's affected me a lot. I'm angry. Angry a lot. I don't know how I got it," the voice spoke from behind the cap.

"Does anyone else know about your disease?"
"My sisters. They know."

"And they've handled that OK?"

"Uuuuh-húh. Oh-Kay. One of them is ok. One of them, she has me drink out of a plastic cup." There was a silence.

"And then . . . she throws it away?"

"Uuuuh-húh," the voice swung up in affirmation.

"But my other sister, she's ok. She feeds me. Lives across the road from me."

His brother-in-law had brought him to the clinic, the husband of the sister "across the road". Without lifting his face Mr. P affirmed that the in-law knew of his disease and that he would sign a release for me to talk with the brother-in-law and sister. I went over a number of things with them, separately, in person with the brother-in-law in Mr. P's presence, and then on the phone with his sister after he'd left. We talked about the CD4 lymphocyte, what that white blood cell normally does, how HIV infects it, then destroys it while diverting the CD4 from its primary mission of protecting us to the role of producing more HIV viruses. We talked about resistance, and the need for adherence to the medication regimen, the need to use a pill box, and possibly for someone to assist him. Then I mentioned to Mr. P's sister his hidden eyes.

"He won't look at me," I began.
"No. He won't look at anybody. Me neither."

"Has he always been this way, or just since he knew he was infected?"

"Just since he's been infected."

Then it hit me! He's ashamed! He's ashamed to be infected with HIV. He's so ashamed that he can't look at anyone. For those who don't know, he's afraid they'll learn, as if by looking into his eyes they would see deep within his brain the "HIV" in red letters, stenciled on the gray matter of his mind. For those who do know, he's ashamed. I was almost overcome with anger and sadness at this man's situation, this man who is now almost Gollum-like, shriveled and be-deviled, his "image-of-God" humanity defaced more than usual because of this disease, the way others deal with him because of the disease, and his fears of what he might receive. Head down he tries to hide in his own dark cave between the bill of his cap and the flaps of his partially zippered jacket. It may be that some of his shame is due to his guilt for how he caught the disease, but that is not my impression. Yes, few know, but of those who do, only two treat him well, treat him . . . normally. And he is overcome with anger, fear, and shame.

This shame, and the fear of it, immobilizes people around the world, keeping them from getting tested in a timely fashion when treatment is most affective and complications are least likely, driving them into caves of despair when they know they are infected, afraid of rejection, loneliness and death, not the stopping of that pumping muscle in their chests, but the death of their spirits through loss of interaction with the rest of us who've been imparted spirits from the One who is Spirit. These fearful ones have not known Him, except through those whom He has created, those He seems to have given life, and now the "living" will, thinks Mr. P, withdraw and leave him absolutely alone, dead. Those who claim to live forget that it is their privilege, their responsibility, at precisely this moment to offer life.

I praised Mr. P's sister and praised God in her presence because she is accepting him, affirming him, loving him, she and her husband. When I see him again I will inquire about shame and if it is confirmed I'll discuss the possible why's of it. If he is guilty, I will offer him the forgiveness that God has given me. "Your sins are forgiven you." "Neither do I condemn you. Go, and cease your life of sin." That is how the Lord dealt with shame. And he has sent us to do the same.

Meanwhile, I am saddened and angered by the way we are, "we" being what too often passes for church, community, and even family in this man's life. That which should be gracious, loving, offering forgiveness, even at the cost of its own life, but rather is too often, especially in this situation, proud, exclusive, condemning: polished, beautifully painted gift boxes full of dead men's bones. "If you were blind, you would not be guilty of sin; but now that you claim you can see, your guilt remains."

Lord, do what is necessary to open eyes, minds and hearts, to impart fear where it needs to be, and courage where it needs to be, so that this disease may be stopped not just in its destruction of bodies, but in its destruction of souls, its defacing of your image in those you made to bear it. Teach the church to be your body, courageous not only in righteous living but also in gracious offering of forgiveness, love and hope, that men and women may know they are loved by you, and can truly live in you.