Month: April 2016

Five years ago, a hail of bullets ended the life of a remarkable man in Pakistan. Shabaz Bhatti, aged 42, was a cabinet member, the only Christian elevated to such status in the Pakistani government. As minister for minorities, he spoke out against religious persecution, and particularly the misuse of Pakistan’s blasphemy laws. He was prominent among the defenders of Asia Bibi, a Christian mother of five who was sentenced to death for blasphemy against Mohammed, and currently languishes in prison.

Prior to his death Bhatti had made a video to be released upon the occasion of his death. More on this, including the video footage, can be found in Christianity Today:

“I’m ready to die for a cause,” Bhatti said. “I’m living for my community and suffering people, and I will die to defend their rights. So these threats and these warnings cannot change my opinions and principles.”

“…I want to share that I believe in Jesus Christ, who has given his own life for us. I know what is the meaning of ‘cross’ and I follow Him to the cross. Pray for me and for my life.”

As the fifth year anniversary of his martyrdom is marked, an effort is underway to elevate him to greater recognition within his own church. The Catholic Herald reports:

“He spoke with faith and demonstrated courage. Thanks to him the voice of Pakistan’s Christians was heard. He paved the way for us. He was a good Catholic and gave his life for his mission,” Archbishop Joseph Coutts of Karachi said at a March 2 ceremony marking the anniversary of Bhatti’s death.

The Diocese of Islamabad-Rawalpindi has begun collecting testimonies about Bhatti to enquire into his martyrdom and sanctity.

CBS News recently reported a story of faith and forgiveness, with a fascinating twist of fate. In 2005, in Benton Harbor, Michigan, Jameel McGee was arrested on false charges of drug dealing. He spent four years in jail before he was exonerated. While in prison, Jamal found God.

His arresting officer had his own “come to Jesus” moment (figuratively as well as literally). His misdeeds were discovered, he was fired, and he had to do his own stint of jail time for a year and a half. While in prison, he, too, became a Christian. Looking back on his former life he says, “I was the lowest of the low.”

Today, by chance (give or take a dose of divine intervention) they have found themselve working alongside each other at the same faith-based cafe. Jamal McGee confronted the former policeman, Andrew Collins, who apologized. Jamal McGee, who is vocal about his Christian faith, forgave Collins, and says that today they are very good friends.

Today they’re not only cordial, they’re friends. Such close friends, not long ago McGee actually told Collins he loved him.

“And I just started weeping because he doesn’t owe me that. I don’t deserve that,” Collins said.

You may read more at CBS.

There is also an article at Huffington Post.

It should not shock or surprise that an occasion of great malfeasance on the part of one may be the impetus to heroism in another. I was recently informed of a situation that shows both the darkness and light that resides within us.

First, let us examine the darkness. More tha 117 patients were enrolled in clinical trials at Duke University, conducted by Dr. Anil Potti. His work had offered the hope of using cDNA microarrays to individualize cancer treatments. Sadly, it has turned out that much of the work by Dr. Potti was falsified. After investigations by the Institute of Medicine, Potti’s collaborator, Dr. Joseph Nevins was forced to take a closer look at the data. CBS News reported in a “60 Minutes” segment:

Fearing that reality, Joseph Nevins, whose own reputation was at stake, reviewed the original data which had justified the clinical trials for 112 patients. Dr. Nevins discovered that when the underlying data disproved Dr. Potti’s theory, the data were changed.

Nevins: “It became clear that there was no explanation other than there was a manipulation. A manipulation of the data, a manipulation of somebody’s credentials and a manipulation of a lot of people’s trust.”

The bright spot in this story is the courage of a young man who stood up for the truth. In 2008 a medical student named Bradford Perez, who was doing research in Potti’s lab exposed these misdeeds in a report that he presented to administrators at Duke University Medical School. He decided to take his name off all papers published by Potti, and repeat his research year at Duke in a different lab. His concerns apparently were initially covered up, and it took two additional years before the clinical trials were halted.

An outside reviewer had high praise for Perez:

“The medical student was very brave,” said Arthur Caplan, director of the Division of Medical Ethics at the NYU Langone Medical Center, who was asked to review the materials cited in this story. “That was quite an act of courage.

“I have a feeling his lowly status made him someone that they would be able to hope would just go away,” Caplan said. “There was a little bit of don’t-let-the-door-hit-you-on-the-way-out.

“Perez can look at himself in the mirror. Every day. But he paid the price.”

You can read more about Anil Potti and Bradford Petez at Cancer Letter.

(Dr. Walter Freeman, left, and Dr. James W. Watts study an X ray before a psychosurgical operation, in public domain image by photographer Harry Ewing).

On a memorably pleasant spring day day some years ago I was privileged to be given a tour of an old mental health institution in the Midwest. The hulking and late Victorian era stone building (complete with mansard roof and turrets) looked like something straight out of a horror movie. Once housing thousands of patients, this facility is now home to little over a hundred severely mentally ill individuals, along with some offices and outpatient clinics. Most of the remaining space sits vacant, full of dust and memories. Of these memory-filled spaces perhaps the creepiest on the tour were the surgical suites, once used for a variety of “psychosurgeries”. The most popular and notorious of these was the prefrontal lobotomy.1

The lobotomy is a prime example of the hubris of mid 20th century medicine. It is estimated that this technique was performed on over 40,000 Americans, mostly in the 1940s and 50s, although it persisted even into the late 1970s. A crude and imprecise surgery, the lobotomy had a high mortality rate, and caused such complications as seizures and behavior changes–it left many people drooling and docile. The procedure was sometimes performed by non-surgeons, and even by non-physicians. In that era of paternalism in medicine, informed consent was not always obtained. Often the procedure was done for what we would now say is no very good reason. A man named Howard Dully has the distinction of being among the youngest of patients to receive this procedure, when he was only twelve, essentially for being unruly and hostile toward his abusive stepmother. His story has been recounted in a book called My Lobotomy, and also in this article from The Guardian.

One aspect of the lobotomy story that has piqued my interest is the personal and professional rise and fall of the lobotomy’s most enthusiastic proponent, Dr. Walter Freeman. A Yale grad and University of Pennsylvania trained Neurologist, hailing from a prominent family, he was present at the 1930s international meeting where Portuguese Neurologist (and future Nobel Prize winner) Egas Moniz described the earliest cases of lobotomy performed on humans. Freeman soon modified the procedure so that the brain could be entered by hammering an ice pick into the medial aspect of the orbits. A natural showman, he toured the country in a van he called “the lobotomobile”; It is said that he performed 3500 lobotomies in his lifetime.

An Ohio physician, Dr. Wolfgang Baumgartel, later recounted to NPR his recollection of a 1956 visit by Walter Freeman to his facility:

As far as I remember, he probably did between 15 or 20 on that particular day. Dr. Freeman did not leave the operating room after each procedure — the patient went out, the next patient was ready to come in, had his procedure done, went out again, and then the next patient came in…

I remember that he was relaxed. He was very calm while he was operating. He made it look easy to do it. I think he had an extremely self-confident personality. He didn’t have any qualms. He wanted to prove that he was right, he was convinced that he was right. I thought, “How can a man be relaxed just going blindly into a brain ?!” But of course, I didn’t have the authority to say, “Stop that!”

Even in its heyday, the procedure was not without its detractors. His own partner, Dr. James Watts, disapproved of the new “icepick” procedure, and parted ways with him in 1950. Other physicians were appalled as well. As the Wall Street Journal reported: In 1948, one senior VA psychiatrist wrote a memo mocking Dr. Freeman for using lobotomies to treat “practically everything from delinquency to a pain in the neck.”

Dr. Freeman could be reckless. Elizabeth Day wrote, He had a buccaneering disregard for the usual medical formalities – he chewed gum while he operated and displayed impatience with what he called ‘all that germ crap’, routinely failing to sterilise his hands or wear rubber gloves.

From the earlier cited WSJ article: One patient in Iowa in 1951 died when the doctor chose an inopportune moment to stop for a photo and the surgical instrument penetrated too far into the patient’s brain, Freeman biographer Jack El-Hai wrote.

Freeman famously lobotomized Rosemary Kennedy, leaving her in a permanently infantile state. According to Lisa Waller Rogers, lobotomized patients often had to be retaught how to eat and use a toilet.

Although the discovery of Thorazine and a growing public horror of the effects of the procedure pushed the lobotomy out of vogue, Walter Freeman continued to perform them. Jack El-Hai states:

He refused to stop his support of lobotomy when common sense and medical expediency demanded that he do so. His stubborn advocacy of lobotomy during the 1950s and 1960s, and the many patients who were drawn in by his championing of the procedure, is a large part of the tragedy of the first era of psychosurgery.
(Jack El-Hai (2008), p. 138)

His personal life unravelled in tandem with his professional life, or perhaps drove his strange zeal. It is reported that he had a terrible relationship with his mother, and his marriage was troubled as well. Youngson and Schott related the following in an article for The Independent:

All emotion, all anger, and the blind, black rage that many suspected was within Freeman were turned inwards, and when they emerged, it was in strange and grotesque fashion. … Twelve years earlier, Freeman had experienced a nervous breakdown, brought on by overwork. He had been particularly scared by this experience, and ever since had taken at least three capsules of Nembutal every night to guarantee sleep. Nembutal also gave him a dreamless sleep. Freeman did not like his dreams.

Dr. Freeman was forced to retire in 1967, when his last patient died of a brain hemorrhage, and he was banned from operating. He had already become a bit of a pariah in the medical community, operating out of a private clinic because he had been pushed out of the hospitals. He remained defensive, writing bitter limericks about his professional enemies. His last years were spent touring the country on a quest to interview his former patients and revive his legacy. He died of cancer in 1972.

I used the word hubris” earlier, which well fits the good doctor Freeman’s refusal to turn aside from the procedure he loved. As the Good Book says: “Pride goeth before a fall.”

For further reading:

  • Mashour, Walker, and Martuza. “Psychosurgery: Past, Present, and Future”, Brain Research Reviews, 45 (2005): pp 409-419; Accessed online at Stanford University site.
  • Elizabeth Day (2008), “He was bad, so they put an ice pick in his brain…” accessed online at
  • “Top Ten Fascinating and Notable Lobotomies”, at listverse.
  • NPR, “Walter Freeman’s Lobotomies: An Oral History”; accessed online at
  • Wall Street Journal, “The Lobotomy Files”, accessed at
  • Jack El-Hai, “Lessons of the First Era of Psychosurgery.” Clinical Neurosurgery, 55 (2008): 138-139, online here.
  • Youngson and Schott, (1996) “Adventures With an Ice Pick”, in The Independent, available online here.


1. In my remembrance, although the lights were off and the doors locked, these suites appeared sterile, clean, and stocked; They seemed almost as if they had just been closed up for the day, rather than abandoned decades ago. They gave an eerie impression of being ready to go back into service if needed by a new crop of doctors.

(Two athletes, Greece, 4th century BC; From decorative vase in the Kunsthistorisches museum, Vienna)

The Olympic Torch relay is the event that traditionally marks the start of the Olympic Games. Over the years, the flame has been transported in some interesting ways. For example, in 1976, the flame was sent by radio signal between Greece and Canada. The flame was detected by heat sensors in Athens, and a signal was sent to Ottawa, where it triggered a laser beam to relight the torch. You can read about some of the other interesting methods of transporting the flame here.

In ancient times, the “lampadedromia” or “torch race” was a relay race, in which several teams of athletes ran through the city, bearing aloft torches. This kind of race took place at various times in Athens, Corinth, Ceos, Byzantium, and elsewhere. Initially there were religious overtones; the first person to reach the designated altar with flame still alight was granted the honor of relighting the sacred flame. All members of the winning team were considered equally honorable, and shared the glory of the victory. More about this event can be read at Harry Thurston Peck, Harpers Dictionary of Classical Antiquities (New York: Harper and Brothers, 1898); accessed online at this Tufts University site.

In some of the earliest of Christian writings, the Saint Paul the apostle borrowed from Greek culture for a metaphor of the Christian life. For example, in his first letter to the Corinthians, he urged them:

Do you not know that in a race all the runners run, but only one receives the prize? So run that you may obtain it. Every athlete exercises self-control in all things. They do it to receive a perishable wreath, but we an imperishable.

Here and in a famous passage from 2nd Timothy, Paul emphasizes running hard, being focused on the prize, and finishing the race. In the Timothy passage he looks back upon his efforts:

I have fought the good fight, I have finished the race, I have kept the faith. Henceforth there is laid up for me the crown of righteousness, which the Lord, the righteous judge, will award to me on that Day, and not only to me but also to all who have loved his appearing.

I don’t know if Paul was invoking “lampadedromia” specifically, or some other kind of race. The torch race was run in Corinth, to whose resident Christians his earlier passage was addressed. Some interesting things about that early torch race do come to mind.

1. Bearing a torch is both a joyous honor and a solemn responsibility. The sacred light that we bear aloft is no votive offering to pagan gods; in Christianity light is the symbol of God’s presence. Jesus declared himself to be the “Light of the World”. At Pentecost, as recorded in the book of Acts, the Holy Spirit manifested to the early disciples in the form of “tongues as of fire”. Even today we see that Christian literature, buildings, and denominational logos sometimes use the image of a flame to represent the Holy Spirit.

2. Being a relay race, the contest is a team effort. This isn’t a case where one guy runs and everyone else gets to sip beer and eat brats on the sidelines. We are all runners. All of us must do our part for team Christianity. We must strain and get sweaty, but we don’t do it alone. We help each other out, and we all share in the glory of the final victory.

3. As in the torch races of old, if we run well but don’t tend to the flame, allowing it to burn out, then we lose the race. May we run in such a way that we reach the end with torch alight, with God’s spirit still blazing forth in our lives. May we, with Paul, be able to say “I have finished the race. I have kept the faith.”

It appears that the British health system and the U.S. Veterans Administration, have been plagued with the same kind of institutional corruption. The venerable New England Journal of Medicine printed an editorial entitled “Scandal as a sentinel event: Recognizing Hidden Cost–Quality Trade-offs.”

A government-commissioned inquiry by Sir Robert Francis revealed how these circumstances combined to create a major health care scandal.4 Francis’s report describes how Mid-Staffordshire’s leaders imposed cuts without assessing risks, then intimidated staff into suppressing their concerns. Overwhelmed clinicians, Francis concluded, couldn’t remain conscientious and still keep up. Receptionists performed emergency department triage. Meals were left out of reach of bedridden patients. Drug doses were missed. Incontinent patients weren’t cleaned. And impossibility engendered emotional disconnection. One physician told Francis, “What happens is you become immune to the sound of pain” — or “you walk away. You cannot . . . continue to want to do the best you possibly can when the system says no to you.”

Meanwhile, management insisted that NHS performance targets be met, punishing breaches even when compliance did more harm than good. Emergency department nurses told of delaying the start of antibiotics, pain medication, and other needed treatment to attend to less-needy patients within the 4-hour wait-time limit. Staff who missed targets feared being fired. This fear, Francis found, led to premature discharges and falsification of records.

caregivers will move from frustration to insensitivity to corruption when put in an impossible bind between demands for frugality and demands for excellence.

A bit further on we get to the really interesting quote:

“There’s a defined pot of money,” Francis told me last year. “But there’s a public expectation — there’s also a professional expectation — I should be allowed to do everything that’s in my patient’s interest . . . . Politicians promise the same. When that doesn’t work, it’s the fault of the [institution’s] leadership.” The result is a “toxic atmosphere” that “prevents those who are running the show from telling the truth” — and signals caregivers to keep quiet.

This analysis doesn’t let clinicians off the hook for dishonesty or neglect. But it underscores that these scandals are sentinel events — indicators of the risk that caregivers will move from frustration to insensitivity to corruption when put in an impossible bind between demands for frugality and demands for excellence.

Filed under “Reflections of the Fall”.