We had a shortage of surgeons in our medical college, and senior medical students like me had to do duty as surgical assistants. The real surgeons treated the big injuries, while we juniors spent many nights in the operating rooms, patiently picking fragments of glass out of the people who happened to have been standing near a window when the bombs fell.

I remember the janitor of a church, who was near a stained glass window when a bomb fell in the street. He received a full blast of colored glass fragments in his face and chest and abdomen. We joked that we could figure out the picture in that window by the pattern of colors of the glass that we removed from under his skin.

I saw that patient several times afterwards because little lumps kept appearing under his skin, and under each lump was a tiny sliver of glass that we had missed when we first operated. We cut out the new pieces, and sewed up the cuts. He would come back every few weeks, when there were enough little lumps to make a visit worthwhile, until he finally realized that he no longer needed to come back to the surgeons, because the glass would come out anyhow, or he could help it out with a clean needle when it was almost through. I gained a real respect for the millions of little cells that worked like surgeons to get rid of every last fragment of harmful material from his body. They worked more efficiently than we had, because they found the bits we had missed. They made a pathway and pushed them out and healed the little wound they had left behind. That was when I really began to realize what has amazed me more and more for fifty years. The wisdom of the body.

I have been through medical school, and was trained in surgery. I learned about anatomy and physiology and pathology. I studied germs and cancer. I know what to do when people are injured. Yet, I have come to realize that every patient of mine, every new-born baby, in every cell of its body, has a basic knowledge about how to survive and how to heal, that exceeds anything that I shall ever know. That knowledge is the gift of God, who has made our bodies more perfectly than we could ever have devised.

I suppose that I have performed tens of thousands of operations in my life time. Surely by now I should be tired of surgery, and perhaps a bit bored with it too. But now when I operate, I feel more than ever that I am entering a universe of science and of life. My knife is crude compared to the delicate vessels and tiny cells that it has to cut through. I am more careful than I used to be; I use finer instruments and work through smaller incisions and I think about the work I am leaving behind for the healing cells. My eyes still take note of the big, strong structures that I need to mend, but my mind is aware of the sub-microscopic armies of well-drilled specialists that are gearing up to repair the mess I am making, and tidy up after I've finished.

The scientists who work to uncover the wonder of all this precision in the body deserve to be appreciated. We sometimes attach their names to the wonderful systems they discover. But they did not invent them. The operating microscope and the electron microscope are revealing more wonders of the body than we ever dreamed about when I was a student. Fifty years ago we knew that the body had ways to defend itself against germs, but we had no idea that there was a highly organized immune system consisting of whole ranks of cells, each type specialized in its own unique skill, being produced in the bone marrow and in the thymus gland.

But how did all this beauty and coordination come to be? I must confess that my mind boggles. But it's good to realize how little we know. Let your mind boggle! In a world of germs, the human race could not have survived without this sort of system. Yet this sort of system could not survive without a body to feed and support it. All the major systems of the body depend on each other, and must have started with a plan. We now know that the plan of the body is written in the code of DNA, which had to exist before the body could develop. But who wrote that code?

When I was a student, the theory of Evolution was at the height of its acceptance and we were taught that the thymus gland was just a throwback, a vestige of an earlier stage of development. Today we can see from the victims of AIDS, that people cannot survive without those immune cells from the thymus and bone marrow. A lot of biologists still cling to the idea of evolution by chance, and now it is scientists from mathematics, information theory and computers that are forcing us to recognize that chance alone cannot possibly account for the code of DNA and the wonders of life. All of science points toward a creator.

I used to think of the body and the soul as being two separate entities that just shared the same accommodation. The pastor takes care of the soul at church, and I take care of the body in the hospital. But, no! I know now that the mind and the spirit and the body are all one. I know that bodily sickness profoundly affects the mind and spirit. I know that soul sickness hinders healing of the body. Perfect health cannot exist where there is fear or hatred or bitterness in the mind.

There is a wonderful word in the Hebrew tongue that is used as a synonym for peace and also for health and well being. It is SHALOM. It is used as a greeting and expresses a hope that all is well. It means wholeness, or peace within the body. In medicine we use the word HOMEOSTASIS, and it means much the same thing. It means that all the cells of the body are in harmony and following a single rule of health.

I sometimes look at a hand that has come to me for reconstructive surgery, and I feel it. It looks a little swollen and it feels warm or hot to the touch. I turn to the hand therapist and suggest that it needs more time to settle down. The heat suggests that there has been infection or trauma, and many defensive cells have rushed to the area, looking for trouble, with finger on the trigger. With a little rest, the temperature will come down, the swelling will be reduced, the inflammatory cells will disperse to their barracks. When the hand is at peace, I will operate with confidence that healing will be smooth, and the hand will work well afterwards.

But there is more to Shalom than physical rest for an inflamed part. Peace has its source in the mind and spirit. I have studied pain and suffering for many years and I know that pain which seems to be due to an obvious physical problem can be profoundly affected by what goes on in the mind. I have known it in myself. Some time ago I had a pain which I was sure was due to a cancer. It really hurt. Then I had it checked out, and it turned out to be a simple thing that needed to be removed, but was not malignant. The pain became much better, even before the operation. FEAR had gone. I can often take away a patient's pain just by spending time to talk things over, and get rid of false fears about their condition. As the years have passed, I find myself spending more time with the patient, before surgery and after the operation is over.

ANGER is another emotion that destroys SHALOM, and hinders healing. Often people get angry with God for allowing them to be hurt, or to suffer some terrible terminal disease. This may be because preachers sometimes give the impression that God makes life easy for those who are faithful to Him. So, if I am true to my faith, I should not become sick. Therefore when I AM sick and in pain it must mean that God has turned against me. The Apostle Paul talks about his own sickness and imprisonment in graphic terms, and goes on to say that "In all these things he is more than conqueror through the love of Christ, who helps him through." Notice that he says that God helps us IN and THROUGH our trouble, not that He takes them away.

We have to learn to experience the presence of God even in the midst of sickness, and even as death approaches. I have had a rich experience of being with Godly people at the end of their lives, and it has strengthened my faith. I pray that when my time comes I may not grumble that my body has worn out too soon, but hold on to gratitude that I have been so long at the helm of the most wonderful creation the world has ever known, and look forward to meeting the designer face to face.

David Hardin: You mentioned how fear, anger and loneliness can affect the course of a disease, what some people call the mind-body or the mind-soul-body connection. Is it a real thing in medicine? How do you feel about that?

Paul Brand: I think there is no doubt. The only question is how much and under what circumstances. There is no doubt at all that people can die of fear. This is why I believe good doctors are coming back to the thing that used to be fundamental to medicine and that is talking with the patient, giving time to find out what people are thinking and how it is affecting their life, their family. I love to do this. One of the greatest privileges that a physician has is to deal with these things.

Hardin: I remember Norman Cousins' books have much to do with this. He said he believed the siren in the ambulance sometimes produced more dangerous heart conditions than would have happened if the patients were treated more gently. The fear of a heart attack is serious to us.

Brand: It is indeed.

Hardin: Do you think that sometimes people can choose to get well or choose not to get well?

Brand: They can certainly choose not to get well. They can choose to get well in the sense that they can choose to put themselves into the frame of mind in which they can get well. I think it can make the difference between life and death and certainly between health and invalidism.

People talk about fighting handicaps. That is a very true thing. However, I think there is a great sense also of commitment, that you are not fighting alone. It is a wonderful thing to have the support of a community, a church and to feel that the Lord is on your side. God is the God of health. "I am the God that healeth thee."

Hardin: There are many places like the Anderson Clinic and books that talk about the value of meditation and imaging. That is kind of a form of prayer. I think it is what God would like. How do you feel about that?

Brand: In a sense, Christianity invented meditation. I think that today there is a lot of meditation going on in which one tries to make one's mind a total blank, which I think has a danger to it. Anything can come into a blank mind.

More people tend to focus on a mantram. This has been associated with many eastern religions. I think people have forgotten that meditation can help them focus on some of the realities that are real to a Christian. The use of the word Jesus, or just God, puts you into a frame of orientation in which you are receptive to good things.

Hardin: One final thing. There is a lot of talk today about letting people go when they are in serious shape and there is no hope for them. Things like Living Wills are beginning to receive a lot of attention. What do you feel about the choices we have in timing?

Brand: It is one of those things that is difficult to define but very important. I have written a Living Will myself. I have a little note in my wallet saying that if I have a terminal illness where I can't expect meaningful life afterwards, I don't want any prolongation of my life at all. That is different from what is sometimes called euthanasia. I think that there is a real danger in confusing the two. We don't want to kill people. On the other hand, science has so many methods of prolonging a meaningless life and I don't want any of them.