Wednesday Bible study: metaphoritis

John 15 begins with a bizarrely extended metaphor about fruits and vines, which apparently is supposed to mean something. Well, one meaning is clear: people who don't worship Jesus will be burned alive. (v. 6) The stuff about loving each other sounds great, but unfortunately many Christians take it to mean that they should love only other Christians, and even more specifically Christians who adhere to the same interpretations of the Bible. 

Once again, keep in mind, this appears only in John. The other Gospel writers apparently weren't in on this particular speech. 

 

15 “I am the true vine, and my Father is the gardener. ² He cuts off every branch in me that bears no fruit, while every branch that does bear fruit he prunes^[a] so that it will be even more fruitful. ³ You are already clean because of the word I have spoken to you. ⁴ Remain in me, as I also remain in you. No branch can bear fruit by itself; it must remain in the vine. Neither can you bear fruit unless you remain in me.

⁵ “I am the vine; you are the branches. If you remain in me and I in you, you will bear much fruit; apart from me you can do nothing. ⁶ If you do not remain in me, you are like a branch that is thrown away and withers; such branches are picked up, thrown into the fire and burned. ⁷ If you remain in me and my words remain in you, ask whatever you wish, and it will be done for you. ⁸ This is to my Father’s glory, that you bear much fruit, showing yourselves to be my disciples.

⁹ “As the Father has loved me, so have I loved you. Now remain in my love. ¹⁰ If you keep my commands, you will remain in my love, just as I have kept my Father’s commands and remain in his love. ¹¹ I have told you this so that my joy may be in you and that your joy may be complete. ¹² My command is this: Love each other as I have loved you. ¹³ Greater love has no one than this: to lay down one’s life for one’s friends. ¹⁴ You are my friends if you do what I command. ¹⁵ I no longer call you servants, because a servant does not know his master’s business. Instead, I have called you friends, for everything that I learned from my Father I have made known to you. ¹⁶ You did not choose me, but I chose you and appointed you so that you might go and bear fruit—fruit that will last—and so that whatever you ask in my name the Father will give you. ¹⁷ This is my command: Love each other.

The World Hates the Disciples

¹⁸ “If the world hates you, keep in mind that it hated me first. ¹⁹ If you belonged to the world, it would love you as its own. As it is, you do not belong to the world, but I have chosen you out of the world. That is why the world hates you. ²⁰ Remember what I told you: ‘A servant is not greater than his master.’^[b] If they persecuted me, they will persecute you also. If they obeyed my teaching, they will obey yours also. ²¹ They will treat you this way because of my name, for they do not know the one who sent me. ²² If I had not come and spoken to them, they would not be guilty of sin; but now they have no excuse for their sin. ²³ Whoever hates me hates my Father as well. ²⁴ If I had not done among them the works no one else did, they would not be guilty of sin. As it is, they have seen, and yet they have hated both me and my Father. ²⁵ But this is to fulfill what is written in their Law: ‘They hated me without reason.’^[c]

The Work of the Holy Spirit

²⁶ “When the Advocate comes, whom I will send to you from the Father—the Spirit of truth who goes out from the Father—he will testify about me. ²⁷ And you also must testify, for you have been with me from the beginning.

Footnotes

1. John 15:2 The Greek for he prunes also means he cleans.
2. John 15:20 John 13:16
3. John 15:25 Psalms 35:19; 69:4

 

TV Review -- cont.

Of course, The Pitt is unrealistic in the ways TV shows generally have to be. The recurrent characters, unless there's a good reason for them not to be, are generally quite physically attractive. That's obviously a quality that helps actors get parts -- for some of them it's about the only one that matters. And their characters are interesting and charismatic, which is not necessarily true of doctors and nurses. I mean, that's okay, they want people to watch.

 

None of the cases that come into The Pitt are routine and boring. Mostly what happens in EDs is standard stuff -- broken bones, lacerations needing stitches, acute appendicitis, heart attacks (oops, I meant acute myocardial infarctions), chest pains that might be AMIs but aren't after all, and all kinds of other stuff that doesn't produce a lot of drama. The people with the broken fifth metatarsal or inflamed appendix might well have interesting lives or qualities, but the ER staff don't know that, or much of anything about them at all. The writers have to resort to a lot of contrivance to pull interesting stories from the outside world into their universe. That includes a lot of highly unlikely coincidental connections between the staff and the patients, but obviously implausible coincidences are fairly ubiquitous in fictional plots and we just accept it.

One thing I should have mentioned when I talked about physicians treating people like shit is that the doctors and nurses in The Pitt are entirely free of any sort of prejudice. It doesn't matter if you're gay, or Black, or don't speak a word of English, or you're overdosing on opioids or drowning in ethanol, you get total acceptance and respect. I can assure you, there is plenty of evidence that all of those characteristics can result in unequal treatment. (Actually, Unequal Treatment is the title of a well-known book length study by the Institute of Medicine.) A few years back, the editor of the Journal of the American Medical Association got fired for publishing an editorial in which the authors denied this. As I say, the writers want to present an idealized world and they want their heroes to be heroic. I understand that, but don't believe it's real.

Finally, I'll close with the finale. Season one ends with a mass shooting at a music festival, obviously modeled on the horrific incident in Las Vegas in 2017. Level One trauma centers most certainly do drill for mass casualty events and yes, they do happen. And this one definitely did create an opportunity for the writers' heroes to be heroic, as indeed ED staff generally will be when such a thing happens. But such a thing, while very noteworthy and highly memorable, is actually quite rare. 

 

We call it a mass shooting when four people get shot, and certainly there have been incidents since 2017 with bigger numbers than four, but in fact five or six people showing up in the ED with gunshot wounds is a lot, and in this episode The Pitt got dozens, nearly all of them very serious and life threatening. That may be realistic in the sense that if it were to happen, it would look a lot like what the show presented. But unless you live in Orlando, Boston (marathon bombing, not a shooting) or Las Vegas, it hasn't happened in your city. For example, the worst mass shooting in Sacramento history resulted in four people being taken to the nearby Level One trauma center. (Believe it or not, there were very few serious injuries from the 9/11 attack in Manhattan because either the people got out, or they ended up under the rubble. The EDs braced for mass casualties that never came.)

So, in short, it's a TV show. I will say that what it depicts about the pernicious influence of financial pressures in medicine is salutary, but it probably doesn't go far enough. The long hours and dedication, and the emotional burdens that go with medical training and the practice of emergency medicine are rightly respected and we should all be appreciative. But realistic is a relative term. 

 

 

TV review

A streaming service I subscribe to offered the first season of The Pitt, so of course given my profession I had to watch it. I must admit that wasn't hard because it was pretty engrossing. But I'm not here to do drama criticism, I'm a medical and public health sociologist, so that's the take you're gonna get.

 

In case you are just awaking from a 40 year slumber, the series is set in the emergency department of a fictitious Pittsburgh hospital. Each episode constitutes one hour in a 12 hour shift, though the last hour runs overtime. If there's a lead character it's senior attending physician Michael Robinavitch, known as Dr. Robby (Noah Wyle, who's already been an emergency doctor for many seasons of ER so I guess that gave him a head start). However, it's really a deep ensemble cast and there are ongoing plot lines and vignette stories featuring residents, medical students, nurses, a couple of other attending physicians, and of course patients. The writing is intricate and there's a lot to keep track of. 

 

The series has been widely praised as highly realistic, and that's what I want to focus on. I'm not a real doctor, I'm a doctor of philosophy, so I'll take other people's word for it that the medical processes are legit: how the patients present, how the physicians respond to that and go about making diagnoses and choosing a course of action, all technically sound. The special effects are extraordinary. The actual procedures that happen in the ER, which involve a lot of cutting of flesh and inserting into orifices, are convincingly gory. There's a birth scene and the only way they could have done it, as far as I can tell, is to film an actual childbirth and intercut it with the acted scene.

 

But that's not so important. The status relationships and behavioral norms among the various castes -- attending, senior resident, resident, intern, medical student, head nurse and nurses in general, also a social worker -- are generally as I understand them to be in reality. The way the clinicians interact with patients, however, is somewhat idealized. I'm a member of the Academy of Communication in Healthcare, and we have a pretty good consensus about how physicians should interact with patients, and the doctors in the Pitt have evidently all read our books. They are even seen to instruct the medical students and interns just how I would want them to. However, if there's one thing we healthcare communicationists know for sure it's that most doctors don't really do all that good stuff all of the time, or even most of the time.

 

However, I'm pretty sure the writers know that, and their purpose isn't to make us believe that this is actually really real, but to give lessons about what ought to be. Robby and the senior resident get opportunities to give little speeches about what's wrong with the world and how to do things right. More broadly, the series is unrealistic because it has to be more interesting than reality, and it has to pack a lot more meaning into an hour than you could normally get from sitting and watching reality unfold for that long, even in a busy ED. All of the cases present either an unusual and complicated medical problem, an intense human drama, or plenty of both. 

 

Oh, and by the way, the doctors and nurses view everybody with respect, positive regard, and compassion, without respect to gender, age, race ethnicity, personal comportment or behavior. As a personal note, I have written more than a couple of papers about how doctors treat people like shit because they have substance use disorder, don't take their pills the way they're supposed to, or otherwise annoy the Gods. So again, that isn't realistic, but it's didactic. The writers are trying to show us how things ought to be. 

 

This is a long enough blog post for now, I'll finish up next time. 

Sunday Sermonette: The most important dispute in all of history

Well, maybe not quite, but arguably. John 14 might be the most historically important chapter in the Gospels because in centuries hence, dispute over the proper interpretation of this gibberish caused turmoil throughout Christian Europe. It  sparked wars, fractured institutions, motivated torture and murder, tore apart empires. . . .

 

The whole thing is so ridiculous that if you don't already know about it you probably won't believe me. The position that the Catholic church arrived at after a couple of centuries is called trinitarianism, which holds that God the Father, God the Son (i.e. Jesus) and the Holy Spirit are three distinct persons sharing one essence, co-existent and co-eternal. (If you're wondering what the fuck that means, don't bother.) The so-called Arian heresy holds that the son (Jesus) is distinct from the father, that he was born of the father and therefore did not exist before he was begotten. There are variations on these themes. If you really want to know more about it, here's the Wikipedia article on Arianism, and the one on Trinitarianism, but you can take my word for it, it's 100% meaningless bullshit.

 

14 “Do not let your hearts be troubled. You believe in God^[a]; believe also in me. ² My Father’s house has many rooms; if that were not so, would I have told you that I am going there to prepare a place for you? ³ And if I go and prepare a place for you, I will come back and take you to be with me that you also may be where I am. ⁴ You know the way to the place where I am going.”

Jesus the Way to the Father

⁵ Thomas said to him, “Lord, we don’t know where you are going, so how can we know the way?”

⁶ Jesus answered, “I am the way and the truth and the life. No one comes to the Father except through me. ⁷ If you really know me, you will know^[b] my Father as well. From now on, you do know him and have seen him.”

⁸ Philip said, “Lord, show us the Father and that will be enough for us.”

⁹ Jesus answered: “Don’t you know me, Philip, even after I have been among you such a long time? Anyone who has seen me has seen the Father. How can you say, ‘Show us the Father’? ¹⁰ Don’t you believe that I am in the Father, and that the Father is in me? The words I say to you I do not speak on my own authority. Rather, it is the Father, living in me, who is doing his work. ¹¹ Believe me when I say that I am in the Father and the Father is in me; or at least believe on the evidence of the works themselves. ¹² Very truly I tell you, whoever believes in me will do the works I have been doing, and they will do even greater things than these, because I am going to the Father. ¹³ And I will do whatever you ask in my name, so that the Father may be glorified in the Son. ¹⁴ You may ask me for anything in my name, and I will do it.

Jesus Promises the Holy Spirit

¹⁵ “If you love me, keep my commands. ¹⁶ And I will ask the Father, and he will give you another advocate to help you and be with you forever— ¹⁷ the Spirit of truth. The world cannot accept him, because it neither sees him nor knows him. But you know him, for he lives with you and will be^[c] in you. ¹⁸ I will not leave you as orphans; I will come to you. ¹⁹ Before long, the world will not see me anymore, but you will see me. Because I live, you also will live. ²⁰ On that day you will realize that I am in my Father, and you are in me, and I am in you. ²¹ Whoever has my commands and keeps them is the one who loves me. The one who loves me will be loved by my Father, and I too will love them and show myself to them.”

²² Then Judas (not Judas Iscariot) said, “But, Lord, why do you intend to show yourself to us and not to the world?”

²³ Jesus replied, “Anyone who loves me will obey my teaching. My Father will love them, and we will come to them and make our home with them. ²⁴ Anyone who does not love me will not obey my teaching. These words you hear are not my own; they belong to the Father who sent me.

²⁵ “All this I have spoken while still with you. ²⁶ But the Advocate, the Holy Spirit, whom the Father will send in my name, will teach you all things and will remind you of everything I have said to you. ²⁷ Peace I leave with you; my peace I give you. I do not give to you as the world gives. Do not let your hearts be troubled and do not be afraid.

²⁸ “You heard me say, ‘I am going away and I am coming back to you.’ If you loved me, you would be glad that I am going to the Father, for the Father is greater than I. ²⁹ I have told you now before it happens, so that when it does happen you will believe. ³⁰ I will not say much more to you, for the prince of this world is coming. He has no hold over me, ³¹ but he comes so that the world may learn that I love the Father and do exactly what my Father has commanded me.

“Come now; let us leave.

Footnotes

1. John 14:1 Or Believe in God
2. John 14:7 Some manuscripts If you really knew me, you would know
3. John 14:17 Some early manuscripts and is

 

Stochasticism

As you are no doubt aware, unless you have recently emerged from a coma, the UCONN men's basketball team beat Duke in their quarterfinal game on an intercontinental ballistic buzzer beater following a miraculous steal, giving UCONN a one point victory after they had trailed the entire game. So okay, it's a win, and UCONN gets to go on to the semifinal and maybe win the whole enchilada while the Duke players are crying themselves to sleep.

 

But does either team deserve their fate? The shot could as easily have rimmed out, the stolen pass could have been two inches higher, with one less missed free throw it wouldn't even have mattered. What people seldom realize that the same principle is true for historical events of vastly greater import than a basketball game. We are built to look for patterns and meaning and causes everywhere, but sometimes stupid shit just happens. For example, if the very aptly named Anthony Wiener hadn't texted a 15 year old girl, Ronald Dump never would have become president. Now watch out -- that doesn't mean that was the single cause! It wouldn't have mattered if the corporate media hadn't been bizarrely obsessed with Hillary Clinton's information security practices, or if not for the unreality show The Apprentice, or a million other contingencies that had to happen for the Wiener dick pic to matter. 

 

For want of a nail, a shoe was lost . . .  

Wednesday Bible Study: The Love that Dare Not Speak Its Name

John 13 is interesting for a few reasons. One is that it makes it pretty clear that Judas is not betraying Jesus, but rather carrying out the orders Jesus has given him. "So what you are about to do, do it quickly." That's the only way the whole thing makes any sense in the first place, because Jesus repeatedly says that getting crucified is the plan. 

Then there's the whole footwashing business, which seems fairly kinky. Interwoven with all this is the unnamed disciple "who Jesus loved," (verse 23) who is physically intimate with Jesus. This "disciple who Jesus loved" comes up a few times in John, he is never named, and well, not that there's anything wrong with that. . . . 

 

13 It was just before the Passover Festival. Jesus knew that the hour had come for him to leave this world and go to the Father. Having loved his own who were in the world, he loved them to the end.

² The evening meal was in progress, and the devil had already prompted Judas, the son of Simon Iscariot, to betray Jesus. ³ Jesus knew that the Father had put all things under his power, and that he had come from God and was returning to God; ⁴ so he got up from the meal, took off his outer clothing, and wrapped a towel around his waist. ⁵ After that, he poured water into a basin and began to wash his disciples’ feet, drying them with the towel that was wrapped around him.

⁶ He came to Simon Peter, who said to him, “Lord, are you going to wash my feet?”

⁷ Jesus replied, “You do not realize now what I am doing, but later you will understand.”

⁸ “No,” said Peter, “you shall never wash my feet.”

Jesus answered, “Unless I wash you, you have no part with me.”

⁹ “Then, Lord,” Simon Peter replied, “not just my feet but my hands and my head as well!”

¹⁰ Jesus answered, “Those who have had a bath need only to wash their feet; their whole body is clean. And you are clean, though not every one of you.” ¹¹ For he knew who was going to betray him, and that was why he said not every one was clean.

¹² When he had finished washing their feet, he put on his clothes and returned to his place. “Do you understand what I have done for you?” he asked them. ¹³ “You call me ‘Teacher’ and ‘Lord,’ and rightly so, for that is what I am. ¹⁴ Now that I, your Lord and Teacher, have washed your feet, you also should wash one another’s feet. ¹⁵ I have set you an example that you should do as I have done for you. ¹⁶ Very truly I tell you, no servant is greater than his master, nor is a messenger greater than the one who sent him. ¹⁷ Now that you know these things, you will be blessed if you do them.

Jesus Predicts His Betrayal

¹⁸ “I am not referring to all of you; I know those I have chosen. But this is to fulfill this passage of Scripture: ‘He who shared my bread has turned^[a] against me.’^[b]

¹⁹ “I am telling you now before it happens, so that when it does happen you will believe that I am who I am. ²⁰ Very truly I tell you, whoever accepts anyone I send accepts me; and whoever accepts me accepts the one who sent me.”

²¹ After he had said this, Jesus was troubled in spirit and testified, “Very truly I tell you, one of you is going to betray me.”

²² His disciples stared at one another, at a loss to know which of them he meant. ²³ One of them, the disciple whom Jesus loved, was reclining next to him. ²⁴ Simon Peter motioned to this disciple and said, “Ask him which one he means.”

²⁵ Leaning back against Jesus, he asked him, “Lord, who is it?”

²⁶ Jesus answered, “It is the one to whom I will give this piece of bread when I have dipped it in the dish.” Then, dipping the piece of bread, he gave it to Judas, the son of Simon Iscariot. ²⁷ As soon as Judas took the bread, Satan entered into him.

So Jesus told him, “What you are about to do, do quickly.” ²⁸ But no one at the meal understood why Jesus said this to him. ²⁹ Since Judas had charge of the money, some thought Jesus was telling him to buy what was needed for the festival, or to give something to the poor. ³⁰ As soon as Judas had taken the bread, he went out. And it was night.

Jesus Predicts Peter’s Denial

³¹ When he was gone, Jesus said, “Now the Son of Man is glorified and God is glorified in him. ³² If God is glorified in him,^[c] God will glorify the Son in himself, and will glorify him at once.

³³ “My children, I will be with you only a little longer. You will look for me, and just as I told the Jews, so I tell you now: Where I am going, you cannot come.

³⁴ “A new command I give you: Love one another. As I have loved you, so you must love one another. ³⁵ By this everyone will know that you are my disciples, if you love one another.”

³⁶ Simon Peter asked him, “Lord, where are you going?”

Jesus replied, “Where I am going, you cannot follow now, but you will follow later.”

³⁷ Peter asked, “Lord, why can’t I follow you now? I will lay down my life for you.”

³⁸ Then Jesus answered, “Will you really lay down your life for me? Very truly I tell you, before the rooster crows, you will disown me three times!

Footnotes

1. John 13:18 Greek has lifted up his heel
2. John 13:18 Psalm 41:9
3. John 13:32 Many early manuscripts do not have If God is glorified in him.