The patient, an elderly woman visiting her family for an extended stay from another country, had been experiencing pain in her leg for several months. One night the pain was unbearable, so her family took her to the emergency room. The physician, wanting to investigate if compression of a nerve in her back was causing the pain in her leg, ordered a CAT scan. The powerful images that looked inside her body revealed nothing unusual in her back but saw something in a completely different place. Though the findings, called “incidentalomas,” were small and nonspecific, the word abnormal appeared on the report. In these situations, the fear of something bad may be generated by the doctor, the patient, or both. In this case, the medical system reacted with fear, which ultimately led to three additional studies and a painful biopsy before all were assured this was nothing bad.

Besides the thousands of dollars spent to confirm “normal,” one other casualty of “too much” in this case was the patient’s actual concerns. In the pursuit of a normal test, the patient’s ongoing pain was completely neglected. Her final reaction to high-tech medical care revealed her frustration: “I’m going back to my own country, where at least the doctors listen to the patient instead of looking at tests.”

We can only be grateful for the powerful technology we have. Yet because the United States has more of it than any other country, we who have access to it are challenged to restrain our tendency to use it. But it’ll always be difficult to use wisely as long as the world is as bad as we fear.

If only we could depend on something more than the power of our thinking and the tools we possess to stand between us and disaster.

Embracing Contingency

We’re outside the garden now; we’ve eaten of the tree, and there’s no going back. We know too much to return to its innocence and safety. Our world is scary and seemingly random, but the more we attempt to control the chaos, the more we fear what remains outside our control. Unfortunately, at one level the world of Genesis beyond chapter 3 confirms our fears.

The last third of Genesis is occupied with the story of Joseph, whose envious older brothers sell him into slavery in Egypt. After selling Joseph they assume they’ve solved their problem, but their view that having Joseph around was bad, and selling him as a slave good, created the problem of their father’s grief, which was exceedingly bad. Though all his sons and daughters came to comfort him, “he refused to be comforted. ‘No,’ he said, ‘I will continue to mourn until I join my son in the grave.’ So his father wept for him” (Gen. 37:35). Jacob’s sadness was slowly sapping the life from him.

Amid unanticipated outcomes, failed attempts to make things better by our weak understanding of good and bad, and the ongoing presence of sickness and sadness, no matter what we do we realize that despite our best efforts we don’t know how it’s going to be. It’s hard to admit, but we’re actors in a play who know only a small piece of the script, and we long for a director who knows what’s next. As C. S. Lewis writes in “The World’s Last Night”:

We do not know the play. We do not even know whether we are in Act I or Act V. We do not know who are the major and who are the minor characters. The Author knows. . . . That it has a meaning we may be sure, but we cannot see it. When it is over, we may be told. We are led to expect that the Author will have something to say to each of us on the part that each of us has played. The playing it well is what matters infinitely.

And “playing it well” we would gladly do, if only we knew we were a part of a story where contingent events don’t bother the director, uncertainty and unpredictability don’t disturb the plot, and surprise is even embraced as essential to the story.

Good News

After the garden, one might suppose God would leave us to our own devices; after all, if this is what humanity wanted, we got precisely what we reached for. But God doesn’t stop caring, as the stories of the imperfect people of Genesis show over and over. And the book of Genesis doesn’t end with Joseph’s slavery or a father’s grief.

The brothers have come to Egypt, where Joseph has risen to second in power under Pharaoh. And the father, reunited with his son, has died in peace. Now those who sold him into slavery stand before their powerful brother, afraid of the “bad” he’ll do in revenge for what they did to him.

But Joseph has a different worldview. He believes the universe isn’t random. He sees that personal knowledge of good and bad isn’t as reliable as we think. And he knows the play has a director who isn’t disturbed by contingency, completely controls the script, and even absorbs and makes use of the mistakes of the actors. As the book of Genesis closes, Joseph’s words to his brothers give us good news for an anxious age:

Don’t be afraid. Am I in in the place of God? You intended to harm me, but God intended it for good to accomplish what is now being done, the saving of many lives. So then, don’t be afraid. (Gen. 50:19–21)

That God remains an active agent in the world and is able to incorporate even the things we assume bad into a greater plan that can be good has the possibility to drastically change the way we pursue health and face sickness. Every time our health is in danger or we become ill, naturally and appropriately we’ll pursue the good of keeping or regaining our health. But are there times and places when other goods are possible?

The idea that God is good, that he seeks communion with us, and that he has power and intention to work out good no matter the bad leaves us open to a much wider range of hopes and expectations than the singular one of health at all costs and with any technique.


Editors’ note: This is an adapted excerpt from Bob Cutillo’s book, Pursuing Health in an Anxious Age (Crossway, 2016).