Monday, January 12, 2009

washing your hands (mark 1. 4-11)

I visit in the hospitals, on average, a couple of days a week. The same is true for Bill Jeffries. Tara Bain visits one day a week, and the Stephen Ministers visit on the weekends. Over the past years visiting in hospitals has changed. For one thing, people do not stay in the hospital for very long. When I began in the ministry, twenty-five years ago, people would stay 3, 4 or 5 days; now they are in and out in 24 hours.

There is also a great deal more privacy for a person who is hospitalized, which is good. Again, I can remember walking into the hospital and going down the list of everyone who was a patient. Federal laws prevent that from happening now. Years ago people—preachers, Sunday School teachers, would report in great detail about a person’s hospitalization; what stage of cancer is it? where in the body is the illness located in? Now, and again to the good, there is greater privacy. No one really has a right to know why anyone else is in the hospital, or even that they are a patient. It is enough simply to pray for someone and their recovery.

Another change, more subtle but just as significant, is the presence of hand sanitizers on the door of every hospital room. This has become the norm, I realize, although, until recently I had never given it much thought. That changed when a read an essay in the New Yorker on “washing your hands”. It later became a part of a book by a young man who is a physician in Boston, a professor at Harvard and a writer. Some people, I have come to believe, are too talented for their own good. This guy, Atul Gawande, obviously is.

Last year two million Americans were infected with viruses in hospitals; 90,000 died. Can you guess what might be the single most powerful factor in preventing the spread of infections? Getting people who work in hospitals to wash their hands. Studies show that people who work in hospitals wash their hands about one-third or one-half as often as they need to. There are people who are employed and whose mission is to change this behavior: rewarding teams that reduce infection, punishing people who do not, placing sinks in different locations, the list goes on. And yet people are resistant to change. Gawande acknowledges that on a recent day he realized that of seven hundred patients in his hospital, sixty-three were infected or colonized with Mersa. That is almost 10%.

This is a problem that calls for a response. The solution turns out to grounded not in a major scientific breakthrough, or a profound intellectual idea. It is a simple, everyday ritual practice: washing your hands.

Christians believe that we live in a world that is infected, and the root issue is human sin. Theologians have argued about whether the infection is passed genetically from parent to child, or whether we are socialized into the environment of sinful world. And Christians differ about particular kinds of sins. The early church fathers even came up with seven deadly sins. But most agree that sin is a reality. Reinhold Niebuhr once remarked that “sin is the only empirically verifiable Christian doctrine”.

And because we are aware of the sin that is out there and the sin that is in here, we have worked on this problem in a variety of ways. Monks and nuns have been sequestered in cloistered environments to keep them away from the sins of money, sex and power. But sin makes its way into the monastery. Protestants have put their clergy on a pedestal, the laity get their hands dirty in the kingdom of the world, the clergy live in the kingdom of God. But scandal after scandal reminds us that this is not quite truthful.

Sometimes we think we are the good people and others are the problem. Early in my ministry I was sitting with a couple whose teenage daughter was in a crisis. The parents were overachievers, one very involved in a public political role. Their daughter had fallen in with “the wrong crowd”. The solution they arrived at was to move to an adjacent county, to start over: new school, new friends, new behaviors. A year later the couple were in my office again. They were moving home. After some adjustment they realized that their daughter had simply found a new “wrong crowd” in a new place! And so they were returning home, to work on things as a family, to get the core of it all. The environment did not need to change. They---we---needed to change.

We are all sinners, the Apostle Paul tells us. But like those doctors and nurses who work in Brigham and Women’s Hospital in Boston, we resist change. And yet, we are human beings, we as Christians have a deep need to change. The discipline of washing ourselves, cleansing ourselves found its way in our most basic and fundamental practice: baptism.

Each year we remember the baptism of Jesus, and its implications for our own baptisms. The baptism of Jesus is recorded in each of the four gospels, and there are slight variations in each telling of the story. Matthew gives more of the details surrounding the baptism---John’s sense of unworthiness, for example, but also John’s conflict with the other religious leaders. John’s gospel links the baptism of Jesus to the confession that he is the lamb of God who takes away the sin of the world. Luke seems to connect the baptism of Jesus with his genealogy, traced back to Adam, as if to associate baptism and our need for cleansing with our common humanity. Characteristically, Mark’s telling of the story is the briefest. John baptizes Jesus, in the Jordan river. The heavens open, the light shines, the dove descends, the voice of the Father speaks, “This is my beloved son; I am pleased with him”.

And so even the story of Jesus, which is what a gospel is, begins with a need to tell a story about a washing, a cleansing. Of course Christians have also believed that Jesus was the One who was without sin, and this led to an appropriate question: “why be baptized?” Well, he was baptized for our sake, as he passed through the waters he stands with us, he identifies with us. He is fully divine but he is also fully human, the creeds affirmed. In his baptism, he gives us a practice, and in his entire life he responds to one of our greatest needs: to be washed, cleansed, renewed, all for the flourishing of life.

And so what helps us most may not be a tremendous breakthrough in research or the grasping of a complex insight, but a simple spiritual practice. This practice of washing our hands, of remembering our baptisms can be profoundly helpful.

It can also be threatening. We are, all of us, in need of the cleansing grace of God. Christians around the world differ about who can eat at the Lord’s table, who can be married, who can be a minister or a priest, and so on. Baptism is the one act that seems to place us, every one of us, on a level place. In our baptisms we are the same. In our baptisms we are not given the name Methodist or Catholic or Baptist or Episcopalian. In our baptisms we are given the name Christian.

This was a powerful reality for the first Christians. And it really is what makes us different; not our spiritual superiority in relation to others, but our need for grace, our own ongoing need to be renewed. Christians have always believed that we only need to be baptized once----this is the act of God on our behalf, our inclusion in the family----but it does help to be reminded of this, because we forget, we lost touch with the habits of grace.

And so each year on this Sunday we remember the baptism of the Lord and we renew our own baptisms. as simple and profound a ritual practice as washing our hands. We come forward and to be touched again with the waters of baptism, with the sign of the cross on our foreheads. The sign of the cross represents the saving power of Jesus Christ over the reality of sin in our lives, and the water connects us with thousands of years of the story of God, from creation to flood to the crossing of the sea on the way to the promised land to the womb of Mary to the baptism of Jesus to our own baptisms.

At each point along the way God uses water to create us, to recreate us, and to sustain us. And even now, if we listen, we will hear the voice of the FATHER, speaking to us, you are my beloved son, you my beloved daughter, I am pleased with you; we will notice that standing beside us is the SON, who does not need to stand alongside us but is there nonetheless; and resting upon our shoulders is the SPIRIT, holy dove and heart’s delight.

Atul Gawande in the essay speaks of washing our hands in relation to diligence, and that has meaning for us as well. As Christians, in a new calendar year, it is good for us to be cleansed of our pride and our pretense, it is good for us to be washed of the guilt that we can leave in the past and to be renewed with the grace that awaits us in the future. But we need a way to do this, a simple, profound way that is as ancient as a man standing in a river, 2000 years ago, and as relevant as our need to start all over again, to stand with Jesus in the shower of blessing, to “remember that we have been baptized, and to be thankful”.

Source: Atul Gawande, Better: A Surgeon's Notes on Performance.


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