Talk: Neonatology at the Carol Service

In 2015 I spoke at the Christian Medical Fellowship’s annual carol service. This is the text of my talk

Familiar carols – evocative music – nativity scenes – peace on earth – childhood memories.  It’s possible to see Christmas as a time of warm nostalgia and sentimentality.

Luke, the author of the gospel was not writing a romantic and beautiful fairy tale. He was an educated man, a physician, almost certainly a member of the Hippocratic guild, and his gospel shows a concern for historical accuracy and attention to detail. He had obtained first-hand eye-witness statements and interviews and he had woven them into an orderly account – that’s what he states at the formal introduction to the gospel. 

Interestingly Luke’s narrative of the life of Jesus doesn’t start at his birth, but some months before.  Luke records an eye witness account he mus have obtained of the meeting of the pregnant Mary and the pregnant Elizabeth. He chose to put in a homely incident of two pregnant women having a natter – not the stuff of which most heroic narratives are woven. 

Mary has just received the strange and wonderful news that she is going to have a child  called the Son of the Most High. And she runs to see her cousing Elizabeth who also happens to be pregnant with a child who will be John the Baptist. And as Mary runs into Elizabeth’s house calling her name the baby in Elizabeth womb leaps – the word is that not for an ordinary baby kick but for a great exultant leap. And John sees something remarkable. From the outside there are only 2 people in that room but actually there are 4. And the unborn John is leaping for joy at the presence of Jesus in the same way that the lame man will leap for joy as Jesus passes by later in the Gospel.

Luke then places the birth narrative in its historical context, when Quirinius was governor of Syria. He is reminding us this is not a beautiful fantasy – it’s the hard stuff of reality. Scholars have repeatedly demonstrated that Luke was surprisingly accurate and precise when incorporating historical detail into his narrative. Luke was not a sentimentalist about the human drama. In my experience not many health professionals are. It’s hard to retain sentimental illusions about humanity when you’ve experienced the A and E department on a Saturday night, the psychogeriatric ward, the failed CPR attempt and the post mortem room.

In fact the greatest danger for health professionals like me, and you, is that we become disillusioned, hardened, cynical, battered down by human pain, human tears, human weakness, and the apparent futility of the struggle against death and degeneration. I for one have some sneaking sympathy with the cynic who described life as a sexually transmitted degenerative condition with 100% mortality.

The historical account which Luke is recounting is strange, shocking and frankly weird. We are so familiar with the story of the baby in the manger that we have lost its scandal. Luke is claiming that the God who upholds the entire cosmos, the ultimate God of supreme power, intelligence and glory, that God, has actually chosen to become, to turn himself into, a pathetic, fragile, vulnerable baby. Not some kind of Christmas card fantasy cherub with rosy cheeks, beaming smile and halo, but a real baby – who cries, and sucks on a human breast and pukes and squits down his mother’s front.  Do you know the neonatologists definition of a baby?  – “a baby can be regarded as a gastrointestinal tract with no sense of responsibility at either end” – And this is the kind of baby that God became – a baby who needs to have his bottom wiped, who needs to be carefully wrapped up and swaddled to prevent hypothermia.

In the culture of the time babies were often despised and neglected.  Infanticide was common, even routine, in the Roman world, approved by many philosophers and statesmen. At almost exactly the same time as the birth of Jesus, a Roman physician is writing a textbook for midwives. It includes a chapter called “How to choose the newborn that is worth rearing”.  And it was standard clinical practice for babies who were too small or weak or malformed to be worth rearing to be exposed, strangled or drowned at birth. In Roman culture it was the so-called masculine virtues which were universally respected – strength, athleticism, military prowess, courage – of what possible significance was a puking, wailing baby, for goodness sake.

The suggestion that the God of the universe might become a baby like that was ludicrous, crude, offensive, distasteful. To the orthodox Jew, God’s glory was eternally hidden from human eyes in deepest darkness, worshipped by seraphim and cherubim. To the Platonic philosophers of the time God was mystical and immaterial – the eternal Form of The Good, far from the sordid realities of a stable.

But in the Gospel narratives God reveals himself in physical, tangible form.  And Luke revels in the paradoxes. The angels with their astonishing message unaccountably bypass the religious elite in Jerusalem and proclaim good tidings to a collection of half-wits on the hills. And the infant King is worshipped not by seraphim and cherubim but by a bunch of shepherds who may have been imbibing a little too much wine on a cold night. And if the tradition is right that Jesus was born in a stable – then I have to say it is an incredibly dodgy and dangerous place for a newborn baby. If I had been asked to give a bit of neonatal advice to the Almighty I would have advised against it.  Swaddling clothes – fine as long as they are freshly washed, sharp kitchen knife to cut the cord – good idea – but a manger in a stable – no sorry very bad idea. Just think of all those anaerobic bacteria and tetanus spores.  

Most strangely God reveals himself in weakness, fragility, dependence. The God in that manger can do absolutely nothing for himself – he is totally dependent on human hands to feed him, to clean him, to protect him. And yet the historic Christian faith claims bizarrely that at that very moment as he lying in the stable, he is upholding the universe by the Word of his power.  His divine power and status is not in any way demeaned by his vulnerability and dependence.

Two thousand years later fierce ethical debates about the value of a newborn baby’s life continue, as I know only too well. Is it really worth investing serious NHS resources to give a pathetic premature baby at the limits of viability a chance of survival? Perhaps we too should be concentrate more on identifying the newborn that is worth rearing.

And whatever happened to Luke’s strange narrative. That crude and offensive story of a pathetic, fragile God squirming in a borrowed animal’s manger was surely doomed to oblivion compared with the eternal and beautiful truths of orthodox Judaism or Platonic mysticism. That God in a stable stuff was a weird idea which was destined for the dustbin of history along with all those mystery religions of the same period. 

And yet here we are 2000 years later. Great convulsions have taken place in world history and thinking. The Roman Empire disintegrated. Islam rose and flowered. The Renaissance, The Reformation, The Enlightenment, the 20th century they have all come and gone. Science and technology have transformed our world and our understanding. The acids of secularism have destroyed comfortable religious dogmas. 

And here we are in 2015. Platonic mysticism doesn’t seem to have too many followers. Orthodox Judaism continues but only as a tiny faithful remnant.  And this month somewhere between 1 and 2 billion of the planet’s inhabitants will be celebrating the birth of that pathetic fragile baby in a stable.  Funny that…

Why was Luke above all the Gospel writers fascinated by the details of Mary’s pregnancy and the birth narratives of Jesus? Perhaps because Luke saw that if we wish to meet the God of the universe then he is not found by escaping from our humanity in mystical experiences. We don’t find God by becoming more spiritual and less human. No, God is here – with us. God has become one of us. God is found in human flesh, in the stuff which we as health workers and carers touch and treat, operate on and clean every day. In the incarnation God authenticates our humanity with all its frailty, limitation and brokenness.

In our modern secular age which once again prizes the masculine virtues, which claims that autonomy, self-determination, is the highest of all possible goods, and that dependence on others is demeaning and dehumanising – the story of Christmas has special resonance. It shows that dependence does not diminish our status and intrinsic value. In fact we all come into the world utterly and totally dependent on the love and care of others. This is part of the human narrative.  And we are called to treat other human beings with respect and gentleness because they too share in the vulnerability which Jesus shared. Because Jesus was a baby, all babies are special. 

So if you are feeling jaded and burnt-out, driven to cynicism by too much human woe, too much pain and despair, too much hypocrisy and spin, too many efficiency targets and quality indicators, may I prescribe a dose of the Christmas story. The real historical, scandalous Christmas story, not the sanitised sugary version. In fact may I prescribe a thoughtful reading of Luke’s Gospel. For Luke’s historical account of the life of Jesus doesn’t stop at Bethlehem. It carries on to Galilee and then to its climax in Jerusalem and a place called the Skull, and it ends on a road to a village called Emmaus, when Jesus again appears as an unrecognised stranger.

As I have reflected on the Christmas narrative – I’ve realised that it is reflected in a photograph of two hands.  It’s a photograph taken on the neonatal unit at UCH some years ago. In fact it’s a photo of my hand and the hand of one of the babies on the unit. Where is God in that picture?  If we think of God as the almighty creator and sustainer of the universe then his is the huge hand and ours is the tiny hand. But the Christmas story transforms our understanding of the picture. Now God chooses to make himself dependent – strangely and wonderfully he chooses to reverse the picture – he becomes a baby. And the world will never be the same again.

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