Sunday, October 18, 1981
PREVENTION AND CURE
John 21:15-17; Jude 1:24-25
Life is filled with mystery; filled with unanswered ques-tions. Here are some of mine. Why in the game of golf is the sand trap easier to hit than the green even though the sand trap is smaller? Why is crab grass not subject to disease and drought as is blue grass? Why did God make mosquitos? In a grocery store, or when standing in any line, why does the other line always move faster? Why is the coat that really fits never on sale? Why is it that, when the plane you’re on is late, the plane you want to transfer to is on time? Why does jelly bread always fall jelly-side down? Why does the wind die down the minute you try to launch a kite, and then start up when you drop a $20 bill?
An even more serious question is — why is the prevention of something never as impressive as the cure? We’ve all heard the old saying, “an ounce of prevention is worth a pound of cure, but it’s difficult to put into practice.”
The church custodian who removes some oily rags from a closet receives no accolades, not even from the fire department, whereas the firefighter who rescues the minister from his study in the church tower may receive headlines and praise from all except a few disgruntled members. Yet the custodian may have prevented a devasta-ting fire, thus making heroism unnecessary.
Prevention is never very dramatic. Hundreds of concerned citizens will spend days searching for a lost or hurt child but will do little to prevent children from getting lost or being abused in the first place.
Even the New Testament in the Bible seems to give more space to cure rather than prevention. There are stories of rather dramatic conversions; stories of sinners who were lost and then were rescued. We think immediately of Mary Magdalene the prostitute, or Zaccheaus the tax-collector; of Matthew and of course Saul who became Paul in a conversion experience on the road to Damascus.
In our own time we read and hear of similar experiences. Someone who has been lost is found. An individual who led a life of crime is completely changed and dedicates his or her life to serving humanity. A person has a heart attack and emergency surgery saves his or her life. A drug addict reforms. When we hear of such cures, it is dramatic and something to cheer about.
But there is another side to life. A side that is not dramatic but is equally or more important for all of us, a side that we do not hear too much about. I’m talking about prevention. Few people take much note concerning the processes by which fires are prevented. They seem commonplace and even kind of dull and drab. But a fire engine with its siren screaming and then some brave person risks his or her life in a thrilling rescue, that is dramatic, and the papers are full of it.
Or we like to hear or read about how some famous trial lawyer in a spectacular courtroom scene saves a person or settles a raging dispute. But what about those millions of people who live quiet, peaceful, faithful lives and who are never taken to court? Or we hear about a brilliant marriage counselor who saves a marriage through her counseling. But what about those millions of faithful marriage partners who live quiet and joyful lives and never need their marriage saved because of their commit-ment and faithfulness — because they practice prevention.
It is dramatic if a divided church congregation that has been split for years rallies around new leadership, but it is better, far better, if a church stays together because church leaders and members know how to prevent crippling strife and division.
Prevention — that’s the side of life we need to honor, celebrate, and reward in more creative ways.
I think of parents, teachers, social workers. Boy Scout leaders, Girl Scout leaders, Campfire leaders, little league coaches in many sports, church schoolteachers, and all kinds of other volunteer leaders who day after day faithfully and persistently work with children and young people, love them, teach them, care for them and in so doing pre-vent many youngsters and others from ever becoming delin-quents, but such undramatic work seldom makes the headlines.
Our physical and mental health is another example. Preven-tion has done more for the overall health of individuals and society than any curative measures. That’s because the overall health of human beings is determined by our behavior, our food, and the nature of our environment. It is not primarily determined by how many doctors or hos-pitals we have or the sophistication of our technology.
More than half the reduction in mortality rates over the past three centuries occurred before 1900 and was due in nearly equal measure to improved nutrition and reduced- exposure to ax and water-borne infection. The provision of safe water and milk supplies, the improvement in both personal and food hygiene and the efficient and safe dis-posal of sewage, all helped to reduce the incidence of infectious disease.
Vaccination further reduced mortality rates from smallpox in the 19th century and from diphtheria, pertussis, tetanus, poliomyelitis, measles, and tuberculosis in the 20th cen-tury; although the contribution of vaccinations to the overall reduction in mortality rates over the past 100 years is small, perhaps as small as 10%, as contrasted with that due to improved nutrition and reduction in the transmission of infectious disease. An even smaller contribution has been made by the introduction of medical and surgical therapy, namely antibiotics and the excision of tumors in the 20th century.
These facts are not often enough celebrated. Unfortunately, with the discovery of new kinds of drugs and with new technologies and surgical techniques, there has been a tendency in recent times to emphasize cure more than prevention. Some people, therefore, don’t work much at prevention because they believe that disease can be conquered through scientific and technological advance.
Yet on the other hand it has been estimated by researchers that 75% to 85% of all cancer could be prevented. In a recent book entitled, “THE GREATEST BATTLE,” Dr. Ronald J. Glasser shows that the majority of all malignancies are caused not by viruses but by environment factors such as smoking, and that it is we who are killing ourselves and our own children.
All of this is not to say that we should give up on finding effective treatments and cures for those who have cancer. Chemotherapy, radiology, surgery, and other methods of treatment need to be expanded, but at the same time even more attention needs to be given toward prevention.
There is an old and suggestive test for determining whether or not an individual is an imbecile. Turn on the faucet, let the water run into the basin and then tell somebody to empty the basin by dipping. If he or she starts dipping out the water from the basin without turning off the faucet, that person is probably an imbecile. If he or she knows enough to turn off the faucet and then dip out the basin, the chances are that the individual is normal.
Most heart disease could be prevented before surgery or medication is required. Meanwhile too many people have been led to believe that national health insurance, more doctors and greater use of high-cost, hospital-based technologies will improve health. Unfortunately, none of these things will. They will only help us cure or treat many of the diseases which could’ve been prevented in the first place.
As I mentioned earlier, the marked increase in life expec-tancy at birth has been due to control and eradication of infectious disease, directly through improved nutrition and personal hygiene and environmental changes, namely the provision of safe water and milk supplies and safe sewage disposal.
Today the major health problems in this country are the chronic diseases of middle and later age, mainly heart disease, cancer, and strokes. Death and disability in middle age is premature and potentially preventable. For those under 44 years of age, the leading causes of death are accidents, heart disease, cancer, homicide, and suicide.
There is now fortunately a trend toward more emphasis on prevention. In the health field it is called. the “wellness” movement. Adherents of wellness insist that the pleasures of robust health are addictive, and scores of corporations, insurance companies, and hospitals are hoping that wellness is also contagious.
The fundamental elements of a wellness program are simple, familiar and beyond controversy — exercise, sound diet, adequate rest, no smoking, moderate weight, no alcohol or only in moderation, and control of stress. In undertaking a wellness regimen, the individual assumes responsibility for his or her health. Prevention, not pathology, is the keystone. Wellness advocates remind us that up to 90% of disease, disability and premature death involve lifestyle choices. Doctors can only influence about 10%.
A similar trend in prevention is coming to the forefront in the reduction of crime. Here in Lincoln, for example, the police are advocating such preventative measures as the neighborhood watch program.
In religion too, we need to remember that prevention is as important as cure. That’s what Jesus was talking about when he told the Apostle Peter to “feed my sheep, tend my sheep.” Certainly, we need to also go after the lost sheep. But better to prevent them from getting lost in the first place. Jesus was talking about Christian nurture, the kind of religion and Christian faith that prevents us from fal-ling.
A man once went to Dwight L. Moody, it is said, with a tale of moral disaster and after having narrated the harrowing facts said, “Now Mr. Moody, what would you do if you had gotten into such a situation?” To which Mr. Moody replied, “Man, I never would get into it.” True religion is not simply an ambulance at the foot of a cliff to pick up those who have fallen over; it is also a fence at the top to prevent their falling in the first place. As the fine familiar benediction at the end of the Epistle of Jude puts it, “Now unto him who is able to keep you from falling.”
Nothing thrills me more than to feel that I have been a part of some sensational change within a person’s life. But what is more difficult is the sometimes slow, pain-staking, persistent work that must go on and is helpful in preventing people from getting into situations that call for dramatic rescue.
Think for a moment of those millions of Christians who have been sustained year after year by an integrating and sustaining faith in God and thus have had no spectacular rescue. They are dragged out of no moral hells because they got into none. And there are many forgotten persons — and unknown persons who were their helpers in their Chris-tian living; those who helped to prevent them from falling. These are the very people we seldom hear about and yet are those who form the backbone of our society.
Surely there must’ve been hundreds and hundreds of people who followed Jesus but who were not dramatically converted; yet people who became his devoted followers and who because of this contact and the Christian community of which they became a part were kept from falling. The most important work Christ is doing on earth today through the church and in other ways is not rescuing the fallen but producing a quality and strength of character that keeps us from falling.
Why then is prevention never as dramatic or sensational as cure? First of all, because prevention is difficult to measure. How do we know how many people this congregation has kept from falling? There’s no way to measure it. Perhaps that’s why it’s much easier to get money and support for the ambulance in the valley rather than for the fence at the top of the cliff. At the end of the month or the year one can say — “we have picked up and saved 250 people who fell off the cliff.” But we’ll never know how many the fence prevented from falling. That’s what makes the work of the church so difficult to measure at times — it’s what makes any prevention seem so dull. We like to know about our successes, and we like to point with pride to our accomplishments.
2. Secondly, prevention and the faithfulness and commit-ment that go with it is seldom news. It doesn’t attract -attention. Can you imagine a news story with the headline — “50 million husbands did not abuse their wives today.” or “50 MILLION YOUNG PEOPLE did not get into trouble today.” The exception is news.
But no matter — as Christians it’s not publicity we seek in the final analysis — nor do we always need to seek proof of our success or faithfulness by quoting statistics. As Christians we are in the prevention business as well as in the curative business. Both are needed, but in the world at large and in our individual lives the old proverb is true, “An ounce of wholesome, healthy-minded religious prevention is worth a pound of religious cure,” and this is true in the fields of law-enforcement, medicine, fire- fighting, and every other aspect of life. Today, let’s celebrate those who have led us in prevention — the fence builders in society. “Now unto Him who is able to keep us from falling.”