Rash Words And Healing Words

“There is one whose rash words are like sword thrusts, but the tongue of the wise brings healing.” – Proverbs 12:18

Atul Gawande shares a story he heard from a fellow surgeon about a young guy who came into the emergency room with a stab wound after getting into an altercation at a Halloween party. He was stable, breathing normally, not in pain. After cutting off his clothes and looking him all over, the only thing they could find was a small, pouting two-inch red slit in his belly. A thin strip of omental fat protruded out of it: they’d need to take him to the operating room to make sure his bowel wasn’t injured and sew up the gap. No big deal. They left him on a stretcher while getting things ready. Then a nurse noticed he’d stopped talking. His heart rate had skyrocketed, his eyes were rolling back in his head, he stopped responding when she shook him. The trauma team rushed back to find his blood pressure barely detectable. They intubated his airway, poured fluid into his veins, and still couldn’t get his pressure up. They raced him to the operating room. The surgeon sliced down into the abdominal cavity and an ocean of blood burst out of the patient. The knife had gone more than a foot through the man’s skin, through fat and muscle, past the intestine, and right into the aorta. Apparently the guy he got in a fight with was dressed as a soldier, with a bayonet, a detail in the history no one had managed to obtain.

In fencing, a thrust is defined as a quick attack wherein the sword moves parallel to its length and lands with the point touching the opponent. Medically-speaking, these are worst kinds of knife wounds, worse than larger lacerations because the extent of internal injury can be much greater than it appears. The Hebrew word for “rash” here is an onomatopoeia: bata. Bata bata bata—it almost sounds like the sword thrust it is being compared to. It means “to babble, to talk idly, to speak rashly or inconsiderately.”

Bata is only used three times in the Old Testament: here, in Psalm 106:33 when describing the words Moses spoke at the waters of Meribah after which he could not enter the promised land, and in Leviticus 5:4 when describing rash oaths leading to unintentional sin for which specific sacrifices should be made. In both these instances, words were spoken unintentionally, without premeditation. In both cases, they resulted in serious consequences.

I think of this verse as many of us spend time with family this holiday season, because somehow rash words happen most easily with those closest to us. We may be the ones deeply hurt by careless words spoken by parents or relatives. We may be tempted to gossip with words that wound reputations, or to speak rashly in frustration ourselves. Contrast this with the wise tongue that brings healing: these aren’t just nice words. This isn’t placation or flattery. This is to speak in a way that recognizes there is a wound, or a culture or habit of unhealthiness, and seeks to heal it. Sometimes healing comes through observation and time, and this may mean speaking less and listening more than you naturally would. Sometimes healing means supportive treatment for symptoms, and this may mean words that comfort, encourage or build up. Sometimes healing involves pain, like the draining of an abscess or suturing of a wound, and your words may be ones to rebuke or set boundaries. Regardless, there is forethought and intention, with the purpose of restoring health and life. May our words be wise words, wherever we go and whomever we see.

Life In The Loops

“A slack hand causes poverty, but the hand of the diligent makes rich.” – Proverbs 10:4

“People underestimate the importance of diligence as a virtue. No doubt this has something to do with how supremely mundane it seems. It is defined as ‘the constant and earnest effort to accomplish what is undertaken.’” – Atul Gawande, Better

I have no qualms about staying at home more than being a physician, but it is strange to have trained for over twelve years for an entirely different thing than what I do now most of the time. I found during training that in the world of medicine at least, I am at heart a surgeon: I thrive best employing mind and fingers, knowledge and artistry, to achieve visible results and progress. At home, if there’s action that needs to be taken in a crisis, I’m great: figure out if a cut from a fall needs stitches or just steri-strips; get four kids, four backpacks, one cello loaded into the van in minutes.

But that’s not most of life at home. Most of life is a litany of unremarkable, mindlessly Sisyphean tasks. Packing lunchboxes only to have to clean them out and pack them again. Dropping off kids only to pick them up only to drop them off again. Cleaning things only to have them get dirty again—counters, towels, sheets, dishes, children, clothes, floors. Teeth. I actually had this moment where I realized that having four children meant keeping 128 teeth clean (and straight) over the course of 23 years. 

Medicine does not exactly train you for this. At my previous job in private practice, the mantra was, “physicians should only do what only physicians can do.” I had two scribes with me in clinic, two assistants in the operating room; I didn’t have to touch paperwork, drape the patient, do anything except call out orders or hold out my hand for instruments or lenses. This wasn’t to be nice to us, but to work us harder, through a higher volume of patients and cases, and the pace was anything but mundane.

But at home, mundane is the language of love. Repetition speaks. My vocation is found in doing again what I did before, choosing again what I chose before. A word for this perhaps is diligence. The Hebrew word charuwts has an interesting double-meaning: literally, it means “to dig” (as in a ditch—which makes me think of Brooks’ phrase, “digging the damn ditch”) or “to sharpen” (as in, a threshing-sledge, for agricultural work). Labor-intensive, repetitive, mundane work. But charuwts can also be translated “gold,” as indeed it is in four of the nine times it occurs in the book of Proverbs. No one is sure why—because gold is dug out? Because gold has a sharp or bright color? It certainly adds a bit of poetic redundancy to this verse.

Diligence is not necessarily a vaunted virtue. It is often not seen, or credited. But it is of great value, and it leads to what is valuable. And this proverb praises not “diligence,” but “the hand of the diligent.” Diligence in action is how we live out faithfulness, how we demonstrate love, how we steward well what we’ve been entrusted with. There are days when I feel like all I do is wash dishes: which I mean less as complaint than a statement of fact. Six people eating three meals and, some of them, three snacks a day go through a lot of dishes. But at least right now, this is where I sense God wants me to be: washing the dishes, with the hand of the diligent. Living life in the loops, and believing in the value of it.