Thursday 20 November 2008

Humility Medicine


A good decade ago or so the Templeton Foundation was promoting 'progress in humility theology.' I never found out what happened to that effort (perhaps those who got the awards were so humble that they were not spotted? - cheap shot that...).

HIV/AIDS has certainly forced a much needed dose of humility on medicine. After years of technology driven medicine - here was a challenge that seemed to defy all the norms of how to deal with disease - that brought about a fear and loathing that the standard bio-medical model just could not deal with.

Not that it stopped bio-medical researchers from doing their stuff. The field of AIDS research blossomed and shows no sign of stopping. The International AIDS Conferences now host a virtual city of researchers in all areas of dealing with AIDS - drawing thousands of delegates to another global city every 2 years.

There are a bunch of Nobel prizes in medicine in store for whichever team gets around the challenge of developing a robust short course therapy that can rid the body of HIV and not require a lifetime of medications (i.e. the 'AIDS cure' that has eluded us so far).

And despite most people still saying 'there is no cure for AIDS' - the progress that has been made is nothing short of breath-taking. I remember the excitement of being in a seminar room at Yale Public Health in 1995. We were listening to a researcher telling us that a large scale trial comparing the new 'triple therapy' (which was coined Highly Active Anti-retroviral Therapy - or HAART) with the then standard mono-therapy (mainly using Zidovudine) was stopped. Why? Because even early in the trial it was clear that the benefits of the triple therapy were far superior to the mono-therapy - and it would be un-ethical and cruel to continue to subject those with HIV to a clearly inferior therapy.

Today triple therapy is the back-bone of our anti-retroviral therapy. The excitement in that room was palpable. We were hearing something totally new for the first time. Those gains have been operationalised today - and we are reaping the benefits in our work here in Thane with people with HIV.

Every week the news flashes another set of messages about some progress or other. Today's was a recent study that suggests that children diagnosed with HIV should be started on HAART immediately instead of waiting for their CD4 levels to drop (i.e. that blood tests show deterioration of the immune function) since these may be delayed thus deny a significant number of children a chance to benefit from the anti-HIV medicine at the right time.

We still need humility medicine though. With all the advances - we are still dealing with the basic challenges of living each day with hope. Of seeing so many different issues crop up. Of working through drastic changes in our bodies and how they function. Of living a medicated life. Of working through the dark nights of the heart and spirit. We still need so much honesty to clearly state what we cannot do and do not know. And its a lot. Still.

Our Lord knew what it was like to have AIDS. He knows even now. He took pains to have the woman who suffered from 12 years of haemorraging come back and tell him everything she had experienced. Jesus knew her poverty, her loneliness, her alienation from God. He understood her physical weakness, her shame and rejection by others, her desperation for some kind of cure. "Daughter" he then told her after he had called her back and listened to her "your faith has healed you, go in peace" (Luke 8.48). Jesus included her in his family. He blessed her desperate faith. He sent her on her way rejoicing.

Through all the marvels of technology, through all the wonders of pharmacology, we need a human touch. We need a divine touch too. Keep praying with us as we work through what it means to live with this disease. AIDS is not going away anytime soon by the look of things now. May our hearts be tender - and our hands keep to the plough.

Keep praying for the hoped for 'miracle cure'. That minds would use knowledge to arrive at key breakthroughs in stopping the viral replication and ridding the body of reservoirs where HIV continues to linger. And keep praying for miracles of love, healing, confession, forgiveness, acceptance, hope, solidarity, perseverance, gentleness, service - the list goes on and builds a pretty good picture of the character of our loving Lord.

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