Anatomy of a Blind Spot
Seven years ago my partners and I opened an inner city Christian medical clinic in Memphis, Tennessee. The four of us were friends from LSU medical school, fresh out of residency training and brimming with idealism. While students in New Orleans, we worked with a local church in a housing project, running Saturday Bible clubs and summer Vacation Bible Schools.
The idea for our ministry grew from our experiences in New Orleans and From several other influences. For myself, those influences included my involvement in Campus Crusade For Christ as an undergraduate, CMDA in medical school, and the writings of men like Ron Sidcr and Tony Campolo. The logical basis for our work went as Follows: 1) There are many in our country who lack access to primary health care and who suffer disproportionately from illnesses. 2) Many of those same people have not heard the gospel of Jesus Christ, and also suffer spiritual illnesses. 3) The teachings of Jesus direct us to serve the needs of the poor and to proclaim his saving Lordship. 4) Therefore, we should create an evangelical Christian medical clinic that serves the medical and spiritual needs of the poor.
At the time, the logic seemed valid and straightforward. Despite what follows below, I still believe: it is. What I didn't know and am still learning now, is that my logical and theological ideas were true, but inadequate. They failed to take into account crucial issues, including race, culture, and, most importantly, my own sinfulness.
Memphis has several neighborhoods that lack adequate primary health care. In our city of over one million people, nearly four hundred thousand are poor enough to qualify For Medicaid or have no health insurance. The majority of these patients receive care from hospital ERs, county health department clinics. or university clinics staffed by residents. Again, it just seemed logical: find the most medically underserved part of town, put a clinic there, and prepare for the deluge of grateful patients. I'm embarrassed to admit it now, but that's exactly what I expected. Furthermore, I assumed that the patients, being thankful For this new service, would be immediately open to spiritual discussions and even conversion to my brand of evangelical Christianity.
As you might guess, I was disappointed. In the first Few months of operation we saw relatively few patients, not nearly enough to keep four doctors occupied. It became clear that if things didn’t improve, we would financially collapse. We tried advertising through posters at local businesses and churches. We did a radio ad on two African American stations. We got a big billboard on the neighborhood’s main street. We sent direct mail advertising to every household in the two zip codes surrounding the clinic. It helped a little. In truth, we were strangers to the community and strangers to the black medical establishment that had big influence on where Medicaid patients received their care. We lacked credibility with people who had previously seen well meaning but naive white folks march into their neighborhood with solutions to the black community’s problems. At the time I was angry. Why were we struggling to get patients when we were so obviously well trained and rightly motivated to serve the neighborhood?
As time went on, our patient visits greatly increased. By God’s grace we successfully convinced two of the African American managed care organizations to begin assigning larger numbers of patients to our clinic. We avoided financial failure. We began to see forty or fifty patients a day, and then even more. But we noticed something else. Many of the patients weren’t very thankful for the care we provided. Some remained suspicious of us. A few tried to manipulate us for various purposes: a disability claim, a narcotic addiction, or a prolonged absence from work. Even some of the people we hired to work at the clinic, who we thought understood the purpose of our ministry, seemed distant and distrustful. We distributed countless bibles and tracts. We had morning devotions. We tried to engage patients with spiritual issues, but made seemingly little progress. I wouldn’t have admitted it openly, but these things also frustrated me. Didn’t the patients see that I was there to help them? Didn’t the employees appreciate the job? Didn’t they all realize that I could comfortably make more money working somewhere else?
THE BLIND SPOTS
The human eye is obvious testimony to God’s creative wisdom. The complexity of design allows us to take in light and color through two eyes and coordinate it into a single detailed image. The most remarkable thing to me is the blind spot. The small section of the retina where the optic nerve and blood vessels enter the posterior aspect of the eye is devoid of rods and cones. No sensory signal is transmitted from this small area of our visual field, and yet we do not consciously notice the hole. The visual cortex somehow fills in the blank spot with color and light from the surrounding sections of the retina. The blind spot is aptly named for two reasons: it is an actual area of blindness, and, because of the filling-in phenomenon, we are blind to the fact that we’re partially blind.
I’ve come to learn that I have spiritual blind spots. These are areas of spiritual ignorance or sin that are often visible to others, but not to me. I have somehow managed to or cover up my spots so that I remain happily unaware of my blindness. It is a gracious gift from God when he reveals these spots to me. Sometimes he uses the scriptures, sometimes painful experiences, and sometimes the hard counsel of godly friends. It’s not pleasant to face the shameful reality when the blindness is revealed, but I know it’s ultimately for my good, “because the Lord disciplines those he loves, and he punishes everyone he accepts as a son” (Hebrews 12:6)
IT’s THEIR OWN FAULT
Because he is gracious, God is beginning to show me some of my blindness regarding our patients. He has shown me my previously unrecognized attitudes of superiority and even racism. I had unconsciously adopted the widely held view that the struggles of the poor are largely of their own making. After all, it’s undeniable that many of the problems in the inner city are related to unwise personal, family, and cultural choices. If the poor would just get off drugs, stop promiscuity, get married, get a job, etc., they would be able to provide for themselves and stop being a drain on the larger society. In short, if they would just be responsible and righteous like me, then things would be just fine.
RICK THE PHARISEE
The only problem with the above understanding is that it is remarkably hypocritical. I judge a mom who’s a teenage single parent, because I come from a stable two-parent family. I judge a teenager who drops out of his failing high school, but I got a good education paid for by my parents. I judge a man for wasting money on a fancy cell phone, when I have an unnecessarily large home. In my heart of hearts, I actually think that I earned or deserve the good things I have. Conversely, I unwittingly assume that the poor would have such things if they were like me. If I rightly understood the gospel, I’d know how offensive that sort of thinking is to Jesus. I am desperately needy, not just before my conversion, but now, twenty years later. Any material or spiritual blessing I’ve had (parents, wife, education, money, salvation, biblical instruction) is a GIFT from God. As the Apostle Paul says “For who makes you different from anyone else? What do you have that you did not receive? And if you did receive it, why do you boast as though you did not?” (I Corinthians 4:7).
It’s very hard, maybe impossible, to serve someone you think you are better than. Jesus did it, but I don’t think we can. My patients sensed that attitude of superiority from me, and it put a wall between us. And there are already enough walls. I’m white and most of my patients are black. I’m rich and most of my patients are poor. I’m well educated and most of my patients are students, graduates, or dropouts of our failing public schools. Race is a particularly divisive problem in Memphis, the city where Dr. Martin Luther King was assassinated.
TURN, AND GO THE OTHER WAY
When the Holy Spirit shows us our sin, we’ve got two choices. If we’re wise, we pleadingly pray for help to turn from our sin and go the other way. If we don’t, we risk a very dangerous outcome: the hardening of our hearts. As God has revealed my sins of pride and racism, I’ve prayed that he would change my wicked heart. I believe he’s answering that prayer. I’ve got a long, long way to go, but he’s moving in me and it’s making a difference in my interaction with patients. I’ve noticed that I’m able to connect in ways I’ve never been able to before. I’ve moved from just listening to caring. With their permission, I commonly pray with patients about their struggles, and I share the gospel more than ever. We’ve seen some remarkable changes in some of our patients, including recovery from crack addiction, the resolution of debilitating fearful dreams, and real progress with an eating disorder. I’ve taken a new interest in the history of racial problems in our nation; what I’ve learned has changed my mind in many ways. With more love and less judgment, I get to feel the joy of Jesus ministering through me. Now patients often thank me or send cards; a few have wanted to take my picture! With thanksgiving, I even see God working changes in the attitudes of several of our employees.
IT COULD HAPPEN To_ You
There are many Christian health care professionals actively serving the medically needy in this country. It’s been my pleasure to get to know some of them through my involvement with the Domestic Missions Commission of CMDA and through CCHF. I’m not sure, but I guess that the overall percentage of Christian doctors and dentists routinely serving the poor is quite low. I suspect many suffer from blind spots like my own.
One of my goals with the Domestic Missions Commission is to encourage a larger number of our Christian colleagues to consider ways that they can increase their own ministry to the poor. Not everyone is called to start an inner city health center (if you think you are, call me), but nearly everyone can become more involved. There are numerous avenues, including volunteering at local clinics for the needy, opening your practice to a manageable number of uninsured or poorly insured patients, or lobbying your practice or hospital to increase their services to the underserved. Is there a way that you could significantly increase your contribution?
Look for opportunities in your community. Find out the scope of the local need and learn who’s presently meeting that need. Interact with others who have an interest in serving the poor through CMDA or CCHF. Lobby local and national representatives on behalf of the poor. Contact us, and we’ll help find a way to plug you in. More than anything, pray for God to reveal your spiritual blind spots. When he does, pray for his strength to move beyond them for his glory and the benefit of our less fortunate neighbors. It’s the kind of prayer he loves to hear.
Do any of these sound familiar? Could you be missing something? Here are some common rationalizations for limiting our service to the poor.
1. “It’s the government’s job to serve the needy.” A commonly held view, and an odd one from people who generally think the government is too involved in our business. Jesus made it pretty clear. If we feed the hungry, clothe the naked, and care for the sick, we’re serving him. You remember what he said about those who didn't do those things (Matthew 25). The church has always served the poor, whether the prevailing government did or not.
2. “My first responsibility is to my family and then to my church.” True enough. But are we so intent on meeting those responsibilities that we don’t have any time or resources left for the poor? Are we providing our families with what they need, or with what they want? Could we actually be doing our families a disservice by keeping up with Dr. Jones? Even our churches can inadvertently become self-directed by using resources primarily to serve the membership (recreation programs, newer and bigger buildings), to the exclusion of the needy.
3. “If I open my practice to the poor I’ll be overwhelmed. I’ll go broke.” Things in medicine and dentistry are tougher than ever; we’re already doing more with less. This makes sense, but it’s not the logic and loaves. We give our tithes and gifts because God tells us to and because we believe that he will provide for us in a bigger way. A measured increase in our service to the needy can be undertaken without the fear of disaster.
4. “My partner/administrator/banker/hospital would never go for it.” Expect some opposition whenever you step out of your comfort zone in obedience to God. Spiritual leadership often requires stepping up and standing firm, but obedience comes with a reward. Remember what God’s angel said to Cornelius, the first Gentile convert, in Acts 10, “Your prayers and gifts to the poor have come up as a memorial offering before God." God will not lose count of our service in the name of Jesus.
Dr. Rick Donlon is a med-peds doc, and the co-founder and CEO of Christ Community Health Services in Memphis, TN. In 2011 Rick founded a residency track of the UTHSC-Saint Francis Family Medicine Residency in Memphis that focuses on underserved and international missions. Rick has dedicated himself to challenge and inspire students, residents, clinics, and residency programs to express their service to Christ by embracing sustained careers in primary care among the underserved, incarnational living among the poor and church planting