[ JBEM Index / Volume 4 / Number 4 ]

In the Valley of the Shadow of Death

The twenty-third Psalm, probably the best-known and best-loved of all the psalms, voices this confidence, “Yea, though I walk through the valley of the shadow of death, I will fear no evil: for thou art with me” (verse 4).

Despite the immense progress made by medical science, more and more people seem to be spending more and more time down in that mournful valley. Although medicine has scored great victories in dealing with diseases which used to be medically intractable and uniformly fatal, we seem constantly to be encountering new medical problems which confront the patient, his family, and his physicians with the prospect of a long stay in the valley of the shadow of death, afflicted by increasingly intractable suffering and often with an irreversible loss of mental powers. Alzheimer’s disease is one such phenomenon, and even more attention has been attracted by the uniformly fatal, degenerative immunodeficiency syndrome known as AIDS.

Alzheimer’s disease patients require complete nursing home care and after a certain point are totally out of touch with reality. They themselves do not suffer, but the prospect of watching them irreversibly deteriorate usually causes great anguish to those who love them. However, Alzheimer’s disease is not contagious and thus represents no danger to health care personnel or family members. In addition, there is no “moral component:” Alzheimer’s patients have done nothing to make themselves sick.

AIDS is contagious, but not highly so as long as one avoids high-risk behavior. However, unlike Alzheimer’s, it can be caught by health care personnel, and when contracted it is 100 per cent fatal. Anyone who has been to the dentist in the last two years has probably been confronted with the unaccustomed sight of a masked, gloved, and goggled practitioner looking like Darth Vader in white. AIDS, as we have said, is not very contagious, but if caught, is incurable and uniformly fatal, and this explains the apprehension, sometimes even terror, with which many health care personnel view dealing with AIDS patients.

This past Wednesday morning the Scripture Union passage assigned for the day was the entire chapter 28 of Deuteronomy. There are several verses, warnings of what the LORD God will do to those who neglect to keep his covenant, which seem to pertain to our “public health” situation today, with especial reference to AIDS. (The former surgeon general, our friend Dr. C. Everett Koop, would probably apply them to cigarette smoking, but I think that no one where will deny the close parallel to AIDS). Verse 22 states: “The Lord shall smite thee with a consumption, and with a fever, and with an inflammation, and with an extreme burning, and with the sword, and with blasting, and with mildew, and they shall pursue thee until thou perish.” Verse 27: “The Lord will smite thee with the botch of Egypt, and with the scab, and with the itch, whereof thou canst not be healed.” Verse 35: “The Lord shall smite thee in the knees, and in the legs, with a sore botch that cannot be healed, from the sole of they foot to the top of thy head.”

[ JBEM Index / Volume 4 / Number 4 ]