Fearfully and Wonderfully

by Dr. Paul Brand

  An Act of Oneness

  Human society approaches such unity only rarely. Families achieve it sometimes, as in the powerful tug of loyalty that binds me to my children scattered around the world. During a crisis, such as an earthquake or a forest fire, a town or even an entire nation may join together in common cause.

  Jesus prayed for an even richer experience of unity in his Body. He asked “that all of them may be one, Father, just as you are in me and I am in you. May they also be in us so that the world may believe that you have sent me” (John 17:21). Do we in the church catch the vision of that unity—a unity based not on social class or interest group or kinship or race, but on common belonging in Jesus Christ?

  Sadly, we see many examples of disunity in the church. I have, though, seen what can happen when the Body truly welcomes a new member. Those scenes give me a lasting vision of God at work in the world. I will mention only one example.

  John Karmegan came to me in Vellore, India, as a leprosy patient in an advanced state of the disease. We could do little for him surgically since his feet and hands had already been damaged irreparably. We could, however, offer him a job and a place to stay.

  Because of one-sided facial paralysis, John could not smile normally. When he tried, the uneven distortion of his features would draw attention to his paralysis. People often responded with a gasp or a gesture of fear, and so he learned not to smile. Margaret, my wife, stitched his eyelids partly closed to protect his sight. Though grateful for her efforts, John grew more and more paranoid about what others thought of him.

  Perhaps in reaction to his marred appearance, John acted out the part of a troublemaker. I remember many tense scenes in which we had to confront him with some evidence of stealing or dishonesty. He treated fellow patients cruelly and resisted authority, sometimes organizing hunger strikes against the leprosy hospital. By almost anyone’s reckoning, he was beyond rehabilitation.

  Perhaps John’s very irredeemableness attracted my aging mother to him, for she often latched onto the least attractive specimens of humanity. She spent time with John and eventually led him into the Christian faith. He was baptized in a cement tank on the grounds of the leprosarium.

  Conversion, however, did not temper John’s high dudgeon against the world. He gained some friends among fellow patients, but a lifetime of rejection and mistreatment had permanently embittered him against all nonpatients. One day, almost defiantly, he asked me what would happen if he visited the local Tamil-speaking church in Vellore.

  I went to the leaders of the church, described John, and assured them that despite obvious deformities, he had entered a safe phase of the arrested disease and would not endanger the congregation. They agreed he could visit. “Can he take Communion?” I asked, knowing that the church used a common cup. They looked at each other, thought for a moment, and agreed he could also take Communion.

  Shortly thereafter I took John to the church, which met in a plain, whitewashed brick building with a corrugated iron roof. I could hardly imagine the trauma and paranoia inside a leprosy patient who attempts for the first time to enter that kind of setting. As I stood with him at the back of the church, his paralyzed face showed no reaction, but his body’s slight trembling betrayed his inner turmoil. I prayed silently that no church member would show the slightest hint of rejection.

  As we entered during the singing of the first hymn, an Indian man toward the back of the church turned and saw us. We must have made an odd couple: a white person standing next to a leprosy patient with patches of his skin in garish disarray. I held my breath.

  And then it happened. The man put down his hymnal, smiled broadly, and patted the chair next to him, inviting John to join him. John could not have been more startled. Haltingly, he made shuffling half-steps to the row and took his seat. I breathed a prayer of thanks.

  That one incident proved to be the turning point of John’s life. Years later I visited Vellore and made a side trip to a factory that had been set up to employ disabled people. The manager wanted to show me a machine that produced tiny screws for typewriter parts. As we walked through the noisy plant, he shouted at me that he would introduce me to his prize employee, a man who had just won the parent corporation’s all-India prize for the highest quality work with fewest rejects. As we arrived at his work station, the employee turned to greet us, and I saw the unmistakable crooked face of John Karmegan. He wiped the grease off his stumpy hand and grinned with the ugliest, loveliest, and most radiant smile I have ever seen. He held out for my inspection a palmful of the small precision screws that had won him the prize.

  A simple gesture of acceptance may not seem like much, but for John Karmegan it proved decisive. After a lifetime of being judged on his damaged appearance, he had finally been welcomed on a different basis. God’s Spirit had prompted the Body on earth to adopt a new member, and at last John knew he belonged.

  Chapter Six

  THE ECSTASY OF COMMUNITY

  I AM SITTING IN MY CLUTTERED OFFICE on a lazy summer day, leaning back in my chair. In the spirit of mindfulness, I decide to concentrate on reports from my sense organs, starting with my eyes.

  Around me, stacks of journals, notes for books in process, and unanswered correspondence collect in ragged, top-heavy piles. They oppress me, so I pad over to a window. I glance at my vegetable garden, and a pang of guilt reminds me I have not watered and fertilized it recently. Just to the right, however, the plant that gives me greatest delight, the fig tree, is bearing fruit in full glory.

  Pendulous figs in velvety shades ranging from green to purple dangle so thickly off every branch that the entire tree bows. Each year when the figs ripen, a population of admiring butterflies suddenly appears, and thousands of them now encircle my fig tree in a shifting corona of color. I can actually hear the papery sound of their beating wings. I watch as the butterflies test each tempting fruit with a “tongue” smaller in diameter than a thread. They light on the unripe figs momentarily, linger a few seconds at those just turning red, and settle in to gorge themselves on the figs two days past perfect ripeness. I have learned a foolproof method of selecting perfect figs: pick the ones that butterflies loiter on but do not pierce.

  Sounds reach my ears: my mongrel dog snuffling around in a corner, the deep throb of a barge on the Mississippi River, the distant chatter of a lawnmower, piano music wafting in from my daughter’s practice room. The lawnmower gives rise to the pungent aroma of cut grass. If I tilt my head a bit and sniff, I can also smell the sweet fermentation of figs on the ground. Both these scents are partly spoiled by a more pervasive, sulfurous odor from the petrochemical factory down the river.

  On one level, nothing much is happening today. By attending to my environment, however, I realize very much is happening. My nose, eyes, and ears had been recording all those sensations even before I consciously tuned in to them. So important in forming my view of the world, these senses merit closer scrutiny.

  Hearing

  “God gave man two ears,” remarked Epictetus the Stoic, “but only one mouth, that he might hear twice as much as he speaks.” Compared to those of an elephant or a rabbit, human ears seem puny and underdeveloped. They capture far less sound than a dog’s or horse’s ears, and cannot compete for ear expressiveness—we wiggle ours only as a party trick. Even so, the organs of hearing serve us well. The pliable eardrum can register sounds as soft as the drop of a straight pin and as noisy as a New York subway, one hundred trillion times louder.

  High school biology students learn what happens after the eardrum vibrates: three miniature bones, informally known as the hammer, anvil, and stirrup, transfer that vibration into the middle ear. As an orthopedist, I have worked with most of the bones in the human body, and none impress me more than this trio, the body’s smallest. Unlike every other bone, these do not grow with age; a one-day-old infant has a fully developed set. They are in perpetual motion since every perceptible sound causes these tiny bones to swing into action.

  How do
I distinguish two different sounds, such as the buzz of a fly droning about in my room and the rumble of the lawnmower a block away? Every distinct sound has a signature of vibrations per second. If your ears detect a wave of molecules oscillating 256 times per second, for example, you are hearing the musical middle C. A tuning fork demonstrates the process, for its tines visibly move back and forth when struck.

  Inside an inch-long chamber known as the organ of Corti, twenty-five thousand sound-receptor cells line up to receive these vibrations, like strings of a piano waiting to be struck. A few of these cells will fire off signals to the brain when a 256-cycle vibration reaches them, and I thus recognize a middle C. The others await their own programmed frequency. Imagine the bedlam of cellular activity when I sit before a full orchestra and hear twelve notes at once, as well as the variety of musical textures from many different instruments.

  Except in the case of extremely loud sounds, the vibration itself never reaches the brain. Instead, the transmission process resembles the digital coding on a compact disc or MP3 player. The brain receives messages from sound receptors in a series of on-or-off blips, sorts them out, and pieces together the meaningful result.

  Of course, the brain makes its own contributions. I experienced this in a most poignant way when my wife and I celebrated our fortieth wedding anniversary. The phone rang, and Margaret and I picked up extensions simultaneously. “Hello, Mom. Hello, Dad. Congratulations!” we heard, recognizing the voice of our son, Christopher, in Singapore. Then, to our surprise, we heard the same words again, this time from our daughter Jean in England. And then again from Mary in Minnesota, Estelle in Hawaii, Patricia in Seattle, and Pauline in London. Our six children had conspired to place a globe-girdling conference call.

  Those sounds transported me back to scenes around the family dinner table when we laughed and teased together. The voices of my six children instantly brought tears to my eyes and filled me with joy. All the warmth of my love for them and the history of our shared lives surged up at once. The sounds, which began as mechanical forces from thousands of miles away, touched the person inside the computer brain, the “ghost in the machine” in Gilbert Ryle’s term.

  The brain even has the ability to simulate sound when there is none. If I let my mind drift even now, I can hear the four crashing chords of Beethoven’s Fifth Symphony, the melodious voice of my daughter Pauline, the piercing tones of a London air raid siren. Apart from any vibration of molecules and firing of receptor cells, somehow my brain resurrects the sounds from stored memory.

  Smell and Taste

  I write of hearing with a sense of wonder but of smell with near incredulity. Certain phrases recur in textbooks describing smell: “difficult to explain,” “not yet determined,” “it is still not understood precisely how.”

  A male moth comes across a single molecule of a pheromone emitted by a female three miles away. He will not eat or rest until he finds the one who tantalizes him, and one molecule per mile will suffice to track her down. Or consider a salmon that leaves a river in Oregon as a mere fingerling and voyages far into the ocean, thousands of miles from home. Without a map or visual signposts, with no clues other than its sense of smell, the adult salmon will find its way back to the stream of its birth.

  Smell compels action. A pig will excavate earth like a bulldozer in pursuit of a truffle; a bear will rip down a tree branch and brave a hundred stings for a slurp of honey. A male boll weevil will passionately attempt to mate bolls of soft cotton all day long when the fields are sprayed with a female’s scent.

  What humans lack in smell intensity, we make up for in variety. We have between six and ten million neurons devoted to smell, each one relying on olfactory receptors devoted to specific types of chemicals. The signals from overlapping receptors allow us to distinguish an enormous spectrum of smells.

  Taste deserves mention, of course, as one of the five major senses. “Gastronomy rules all life,” wrote the nineteenth-century, French epicure Jean Anthelme Brillat-Savarin. “The newborn baby’s tears demand the nurse’s breast, and the dying man receives, with some pleasure, the last cooling drink.”

  The experience of taste stimulates gastric juices in the same way the smell of sizzling steak or frying bacon can awaken in us a sudden, unexpected hunger. If a hospital patient “primes” food by tasting it first, before having the food administered through a feeding tube or intravenously, the body will absorb more nourishment. Taste also serves as a barrier to keep us from putting poisons and toxic substances into our mouths, many of which we instinctively reject as bitter.

  Even so, it takes far more of a substance to stimulate a stubby taste bud than it does to register on a smell receptor. Taste, in fact, relies mostly on smell, as any gourmand with a stopped-up nose can confirm. The two senses together played a leading role in human history. Absent the craving for spices that led to expeditions, the Americas might have lain “undiscovered” by Europeans for another century.

  The amount of substance needed to trigger smell defies belief. No laboratory can perform an analysis with a hundredth the speed and accuracy of a bloodhound’s nose. A detective holds a sock before a baleful dog, who has forty times more olfactory cells than any human. The bloodhound sniffs deeply a few times, sorting out stale cigarette smoke, the artificial odor of Dr. Scholl’s footpads, the complex history of a piece of leather, traces of bacterial action, and a few bits of the criminal himself. Then the dog meanders through the woods, snorting and evaluating. Suddenly a yelp. The pine needles, the dust, the people around him, the thousand smells of the forest floor—none of these interfere with his singular determination to follow the one faint odor imprinted on his brain. He will track that spoor wherever it leads—through creeks and swamps, across logs, down city sidewalks, up apartment stairs—one day, two days, even a week after the criminal has left the telltale bits.

  The nose is also an organ of nostalgia. The smell of coffee, a whiff of briny seashore, the faintest trace of a certain perfume, or perhaps the etheric odor of a hospital room can stop you like a bullet. In a flash you relive a former moment, yanked backward in time by the fragrance stored inside your brain. I experience déjà vu whenever I visit India, a country that appreciates the sense of smell. In 1946, as a young doctor I sailed into the Bombay (now Mumbai) harbor after a twenty-three-year absence. An upsurge of distant childhood memories swept over me as the fantastic scents of that country drifted across the sea: steam-powered trains, bazaars, spicy food, sandalwood, Hindu incense, all airborne to my nose.

  Nevertheless, a few days later these overpowering sensations faded into the background. The brain squelches odors after the initial excitement—“nasal ennui,” Richard Selzer calls the phenomenon. Smell is primarily a sentinel warning and, once warned, why should the brain be troubled with redundancy? Fish merchants, tanners, garbage collectors, and sewage workers gratefully accept this mercy of habituation. “You get used to it,” they say with total accuracy.

  Origins of Pleasure

  Rods and cones, sound receptors, taste buds, olfactory cells—by serving the body as a whole, individual cells contribute to what I call the ecstasy of community. No scientist can yet measure how the sensation of pleasure materializes, but individual cells certainly play a role. Hormones and enzymes bathe the body’s cells, bringing on the emotions’ response of quickened breathing, a tremor of muscles, a flapping in the stomach.

  If you search for a pleasure nerve in the human body, you will come away disappointed, for none exist. We have nerves to detect pain and cold and heat and touch, but no nerve dedicated to pleasure. Rather, the sensation emerges as a byproduct of cooperation by many cells.

  I enjoy listening to a symphony orchestra. When I do, the chief source of what I interpret as pleasure centers in my ear, which picks up sound frequencies that flutter my eardrums as faintly as one billionth of a centimeter. My brain combines these impulses with other factors—how well I like classical music, my familiarity with the piece being played,
the state of my digestion, the friends sitting beside me—and renders the result in a form I perceive as pleasure.

  What about sexual pleasure? Even that is not as localized as we may think. Erogenous zones have no specialized pleasure nerves; the cells concentrated there also sense touch and pain. The saying “The sexiest organ resides between your ears” turns out to be true. Good sex draws on such things as romantic desire, a bank of intimate memories, visual delight, and perhaps the setting and background music. At a deeper, cellular level lies the urge to propagate life and ensure genetic survival. All these factors work together to produce the ecstasy of community.

  Specialized cells have their origin in the fertilization of a single egg. In The Medusa and the Snail, author and physician Lewis Thomas muses about why people made such a fuss over the first “test-tube baby” in England. The true miracle, he says, is the union of a sperm and egg that results in another human being. “The mere existence of that cell,” he writes,

  should be one of the greatest astonishments of the earth. People ought to be walking around all day, all through their waking hours, calling to each other in endless wonderment, talking of nothing except that cell. . . . If anyone does succeed in explaining it, within my lifetime, I will charter a skywriting airplane, maybe a whole fleet of them, and send them aloft to write one great exclamation point after another, around the whole sky, until all my money runs out.

  From the basic protein of collagen, the maturing fetus fashions cells that divide up functions in exquisite ways: hair, skin, nails, bones, tendon, gut, cartilage, blood vessels. Billions of blood cells appear, millions of rods and cones—eventually some forty trillion cells emerge from a single fertilized ovum.