Sunday, January 04, 2009

The Citadel

     I just saw a great movie called "The Citadel."  It was made in 1938, and it follows the career of a medical man, a pulmonologist.  He begins his work as a lowly apprentice to a bedridden doctor.  His one medical friend is a fellow (oft drunken) apprentice who spurs him on, even when everything is bleak.  Together, they fight endemic typhoid by blasting out the source: a deteriorating sewage system that leaks into the water supply.  The man cares most about helping people.  At his first delivery, it looks like the child is stillborn.  Even as the midwife covers her head and begins to mutter that this is the Lord's will, he gets a sudden idea, and stimulates the child and breathes into his mouth until he cries aloud.
     After this stint, he works as a doctor to coal miners.  Things become rocky as he thoroughly examines men before he issues "certificates," or papers that document a man unfit to work.  But then he starts to investigate a racking cough that many of the mine drillers present with.  With his wife's help and with a microscope from his old friend from the apprenticeship days, he finds the cause for this disease: silicon released from the coal the men are pulverizing is causing silicosis in the men.  Drummed out of the mine doctoring business for exposing an occupational hazard that the mines didn't want to pay for, he finds what looks like his first lucky break.  An old class friend invites him into the shady business of ripping off rich hypochondriacs.  With a steady stream of fictitious cases and exorbitant fees, all he has to do is play the system: recommend patients only to his circle of specialists wise to the crockery, hinting at what the patient's fictitious or exaggerated malady is.  Slowly at first, then steadily, the man changes.  He no longer values his patients, and he no longer cares about their wellbeing. 
Then his old friend looks him up.  The friend has given up drinking for two years now, and he's got a grand idea of starting a dues-based practice where patients pay a monthly fee and are able to see their physician or specialist as often as they need.  Our man poo-poos the idea, especially when he finds that his friend is only interested in making enough from the practice to live on.
      His reaction makes it abundantly clear just how deeply he's changed.  Later that evening, the friend shows up, stinking drunk.  The friend confronts the man again, saying he couldn't say these words sober, so he had to go get drunk.  He can't believe how he's forsaken his first clear idea of what it meant to be a doctor.  The friend stumbles down the hallway, falls, then boards the elevator as the "good doctor" looks on, silently.  A few minutes later, the man and his wife hear tires squeal and look outside at an accident that's just happened.  The friend has been hit by a car.
     For the first time in years, our man shows some interest in a patient.  He has a police officer call up a surgeon from his circle of crocks, and his best friend is rushed into the operating room at the swank nursing home which is rarely used for actual, serious cases.  On the operating table, it's obvious that the friend has sustained quite a few internal injuries.  These are serious, but not life-threatening.  What really needs to be done is to stop the internal bleeding.  Our man assists at the surgery, but trusts the surgeon to do his work.  Then a change comes over his face: What are you doing?  We need to get this bleeding to stop!  The surgeon is ho-hum; all in good time, all in good time.  Our man is getting more and more agitated, and decides to intervene.  He asks about performing a blood transfusion because his friend's pulse is so weak.  No good, the surgeon says: there's no time for that.  What about adrenaline?  The pulmonologist injects his friend with adrenaline, but looks on with horror as the friend's pulse slackens and stops.
    He stumbles out of the operating room, eyes staring.  He distractedly takes off his operating gown.  Then he turns on the surgeon: you killed him!  The surgeon tries to defend himself, that in these accident cases you never know what you're up against.  But the other man says, it was a simple technique, and you botched it.  You aren't truly a surgeon!  Every case I referred to you was child's play, and yet I trusted that you actually knew how to do surgery.  You've murdered my best friend.
    This is our man's awakening.  He wanders the streets in a daze, and once again sees the people in need all around him: the toddler with a babystroller waiting for their parents outside a bar, a man holding a cardboard sign reading "BLIND," the boy playing near the street dangerously close to traffic, and a hungry father and son digging through a trashcan and eating whatever they can find. 
     He remembers a case where a poor woman had asked him to see her little daughter who had a serious lung condition.  At the time, he'd barely listened.  He'd been more interested in the selection of cheese he was having for dinner, and he absentmindedly told her that he was sure her daughter would be fine.  Now he intervenes, and treats the daughter, taking her to a biologist who has a new treatment for cases such as hers.
     When he's hauled up in front of a medical ethics board, and asked how he could allow a patient to be treated by a non medically-licenses biologist, he stands up.  Was Louis Pasteur a registered doctor?  He names name after name of men who had no formal medical training, but whose guiding purpose was to help patients with the knowledge they had gained.  He went on to say that true medical ethics is just this: to act in the patient's best interest.
      Compare to this to one from the Great Doctor, who does not require referrals, and whose office is open 24/7:
"One Sabbath, when Jesus went to eat in the house of a prominent Pharisee, he was being carefully watched.  There in front of him was a man suffering from dropsy.  Jesus asked the Pharisees and experts in the law, 'Is it lawful to heal on the Sabbath or not?'  But they remained silent.  So taking hold of the man, He healed him and sent him away.  Then He asked them, 'If one of you has a son or an oxthat falls into a well on the Sabbath day, will you not immediately pull him out?'  And they had nothing to say." (Luke 14:1-6).
     The letter of the law, and the Spirit of the law.  The casual observer might think that Jesus was contradicting Himself when He healed on the Sabbath day.  And yet, He wasn't.  His life is an example of living a fulfilled life, a life filled with the Spirit so that he lived out the fulfilled law.  Without the Spirit, the law can be like the manacles of death.  Evil men can even self-righteously live out the letter of the law, but totally disregard the Spirit of the law.  With the Spirit, living is about knowing God, and getting to know Him so that obeying Him becomes as lifegiving as breathing.
    I saw a glimpse of this in The Citadel today.  It might sound melodramatic, and maybe it was.  But it showed me a man who was learning to live.

So if the Son sets you free, you will be free indeed.

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