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July/August 2001

Margaret Bernhart, M.A., LMHC
Executive Director

Early Church Medical Care for the 21^st Century

The call came at 10 o'clock at night. "A heart has been found for your brother, Cliff, and the surgeon is flying to North Carolina, to harvest the organ from a young man who has died in a car wreck," anxiously relayed my mom. "Your brother is being prepped for surgery at the University of Alabama Kirkland Clinic as we speak." Death was imminent for my brother, Cliff, unless a new organ could be found to replace his enlarged, failing heart, severely damaged by a massive heart attack at age 31. Significant heart muscle loss resulted with an electrical impulse irregularity that left him with a life threatening condition called arrhythmia. Doctors were amazed that he had survived to age 51 with his weakened heart and sustained level of congestive heart failure.

As it turns out, the transplant was successful and the days that followed have been difficult as anti-rejection drugs have disabled his immune system, leaving him susceptible to viruses and bacterial infection. Sometimes he has to self-administer intravenous antibiotics to fight off a donor virus that lays dormant in his body and occasionally rears its ugly head. He takes massive amounts of pills to regulate his body and other medications to offset the effects of those same drugs. He has missed months from his job waiting for a new heart and countless days after the heart transplant. His wife Linda is there to assist with daily regimens and offer encouragement.

Transplant recipients have to be literate to read medication directions, follow doctors orders, and to articulate problems in their bodily functions. A support person has to be available at all times and the recipient has to have enough financial assets to sustain them during the first year. What I never realized is that the poor and illiterate are at very low odds for getting transplant organs. A pastor that was very influential in my life as a teenager, died waiting for a heart transplant. Without health insurance, the medical expenses are in the hundreds of thousand of dollars.

With the skyrocketing costs of healthcare in our country, a lack of health benefits may restrict preventative care and increase the likelihood of life threatening medical conditions, necessitating more expensive and invasive treatments. Last winter, while I was in the emergency room of Tallahassee Memorial Hospital waiting for a Doppler study on the blood clots in my leg, an older woman lay near by waiting for medical treatment. The doctor assessing her medical condition said, "What you have is a sinus infection and I will write you a prescription for some antibiotics." As I heard the diagnosis, I almost fell off the gurney.. I had waited four hours for treatment with a pass designating me as having a life threatening condition. Her wait, more than likely, was much longer than what I endured. I asked the attending nurse if this was common for people to use the emergency rooms as a primary care physician. She shared with me that the emergency room is filled with people who don't have health insurance and the hospital writes off millions of dollars each year in medical bills.

Those of us who have health insurance, and pay a $7.00 co-pay to see a physician, often are removed from the needs and dilemmas of the disenfranchised. This is why RMI is initiating a program called parish nursing. This concept is not new, as it has its roots in the early church. Over the last one hundred and fifty years it has been utilized by the Catholic and Lutheran denominations and is expanding rapidly into the mainline denominations around the world.

The Purpose of Parish Nursing

Parish nursing is emerging as one of the rapidly growing specialty fields in today's health systems. Current changes in healthcare has brought the need for parish nurses to the forefront as in earlier times. "Its unique, specialized practice of professional nursing that focuses on the promotion of health within the context of the values, beliefs, and practices of a faith community to enhance well-being and wholeness in body, mind and spirit." (Scope & Standards of Parish Nursing Practice: ANA & HMA Aug. 1998)

The role of the parish nurse encompasses many areas--health counseling, education, advocacy, liaison, and training.

As health counselors, parish nurses discuss individual health needs regarding illness, medication, prevention and wellness. As educators, they promote the relationship between faith, health, attitudes and lifestyle choices through educational programs.

A parish nurse, as an advocate, identifies the medically underinsured, indigent or abandoned members of the faith communities who need support for decision making about healthcare issues. In a liaison function, the nurse connects congregational members to each other in response to needs as well as to appropriate services within the community and government services. And

in a training role, the parish nurse recruits and supervises volunteers in health and pastoral ministries and provides formation/education to assist them in their role.

RMI wants to make available to the Tallahassee community training certification to have parish nursing available in local congregations. We are currently working with the medical community for their assistance in training and administering this program. The ministry of parish nursing is available to any interested registered nurse, young or old, holding a valid license to practice. We will update you as to when this ministry will be available in the Tallahassee area.

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Christian Education

The Early Church's Health Plan

A little known fact is that Christians in the ancient world had longer life expectancies than did their pagan neighbors. in fact, many pagans were attracted to the Christian faith because the church produced tangible (not only "spiritual") blessings for its adherents. These benefits included:

Social services. In a world entirely lacking in social services, Christians were their brothers' keepers. At the end of the second century, Tertullian wrote that while pagan temples spent their donations "on feasts and drinking bouts," Christians spent theirs "to support and bury poor people, to supply the wants of boys and girls destitute of means and parents, and of old persons confined to the house."

Similarly, in a letter to the bishop of Antioch in 251, the bishop of Rome mentioned that "more than 1,500 widows and distressed persons" were in the care of his congregation. This charity was confirmed by pagan observers, too. "The impious Galileans support not only their poor," noted the emperor Julian, "but ours as well."

Health services. When two great plagues swept the empire in 165 and 251, mortality rates climbed higher than 30 percent. Pagans tried to avoid all contact with the afflicted, often casting the still living into the gutters. Christians nursed the sick, even though some believers died doing so. We now know that elementary nursing--simply giving victims food and water without any drugs-- reduces mortality in epidemics by as much as two-thirds. Consequently, Christians were more likely than pagans to recover.

Women's rights. Women greatly outnumbered men among early converts. However, in the empire men vastly outnumbered women because of female infanticide. If you are delivered of a child," wrote a man named Hilarion to his pregnant wife, "if it is a boy, keep it, if it is a girl, discard it." Frequent abortions "entailing great risk" (in the words of Celsus) killed many women and left even more barren. Christians, however, practiced neither abortion nor infanticide and thus attracted women.

Women also enjoyed higher status and security, than they did among their pagan neighbors. Pagan women typically were married at a young age (often before puberty) to much older men. But Christian women were older when they married and had more choice in whom, and even if, they would marry. In addition, Christian men could not easily divorce their wives, and both genders were subject to strongly enforced rules against extramarital sex. The apostle Paul indicates that women held positions of leadership within the church, as was confirmed by Pliny the Younger, who reported to Emperor Trajan that he had tortured two young Christian women "who were called deaconesses."

Urban sanctuary. Greco-Roman cities were terribly overpopulated. Antioch in Syria, for example, had a population density of about 117 inhabitants per acre–more than three times that of New York City today. Tenement cubicles were smoky, dark, often damp, and always dirty. On the street, mud, open sewers, and manure lay everywhere. Newcomers and strangers, divided into many ethnic groups, harbored antagonism that often erupted into riots. For these ills Christianity offered a unifying subculture, bridging divisions and providing a strong sense of common identity. To cities filled with the homeless and impoverished, Christianity offered charity and hope. To cities filled with newcomers and strangers, Christianity offered immediate fellowship. To cities filled with orphans and widows, Christianity provided a new and expanded sense of family.

Close-knit community. Because the church asked much of its members, it followed that it gave much. Because Christians were expected to aid the less fortunate, they could expect to receive such aid, and all could feel greater security against bad times. Because they were asked to nurse the sick and dying, they too would receive such nursing. Because they were asked to love others, they in turn would be loved.

In similar fashion, Christianity mitigated relations among social classes, and at the very time when the gap between rich and poor was growing. It did not preach that everyone could or should be socially or politically equal, but that all were equal in the eyes of God, and that the more fortunate had a responsibility to help those in need.

Behind tangible motives Christians believe the Holy Spirit prodded and persuaded pagans to believe. Christian conversion, after all, is ultimately a spiritual affair. But it is not too much to think that God uses the tangible to influence the spiritual.

Used by permission Christianity Today 1998 (excerpt from Rise of Christianity: A Sociologist Reconsiders History by Rodney Stark)