Sunday, 1 November 2015

Mid-life Opportunity

A sermon given at St Matthew's Church, Oxford, Sunday 1st November 2015

Readings: Matthew 6: 19-34; 
2 Corinthians 11: 21 – 30

This is the fourth in our series of sermons on ‘Growing up in Christ’.  We have been looking at birth, childhood, youth and today we come to middle-age.  In this sermon I want to talk to you about journeys and in particular the journey we are called to called to go on in the second half of life.  I’ll give you an example of such a journey from the Bible, drawn from the story of the life of Abraham.  I’ll also explain why I think this second half of life journey is different from the first half of life journey.  I hope you’ll find this sermon useful even if you don’t think you have reached the second half of life yet

At this point I’d like to try an experiment.  Please could you look at your neighbour on your right and work out for yourself what stage of life you think she or he is at.   Is she or he young, middle-aged or old?   Now I’d like those of you who think of yourselves as young to put up your hands.  Now those of you who see yourselves as middle-aged.  Now those of you who think you are old.

My prediction is that what you thought, whether your neighbour is young, middle-aged or old, doesn’t tally very well with how they view themselves.  I also thought that most of you would think of yourselves as middle-aged rather than young or old.   Was I right? 

Of course age is partly objective, partly subjective.   Clearly at aged 0 you are not old and at aged 100 you are not young.  But in between?  Some say you are as young as you feel and we might equally say that you are as old as you feel or even that you as middle-aged as you feel.

The title of this sermon is ‘Mid-life opportunity’.  This is obviously a pun on ‘Mid-life crisis’.  To claim that you are having a mid-life crisis has come to be regarded as a bit of a joke, somewhat self-indulgent, even selfish.  But the NHS Choices website gives the mid-life crisis a page and even attributes it to physiological changes that take place in middle-age.   They suggest that around 20% of people have a mid-life crisis.

But defining what a mid-life crisis is clearly tricky.  It seems to be connected with reaching a point in life – somewhere between youth and old age - where you re-evaluate your life up to that point and seek to decide what to do next.  It’s often connected both with a dissatisfaction with life as it is or as it seems to be and a growing realisation of mortality.  And perhaps this is something everyone in middle-age experiences – at least at times.

It sounds over-dramatic to call this dissatisfaction with life and realisation of mortality a crisis in most cases – and so when planning this sermon series we decided to entitle this sermon ‘Mid-life opportunity’.  I am now a bit concerned that talking about mid-life opportunity is to deny the suffering that some - perhaps many - people experience as a result of reaching the middle of their life.  And we that know that suffering isn’t necessarily bad or to be denied.   The way of the cross teaches us that.  

And obviously middle-age is generally more of a process than an acute event such as the term crisis implies.  Clearly too middle-age is not all suffering and viewing it as an opportunity is surely more of a hopeful way of looking at it.

Perhaps, rather than viewing middle-age as the occasion for a crisis, or even simply as an opportunity that you can take or leave as you choose, we should see middle-age as a journey. 

The Biblical writers constantly use the journey as a metaphor for life.  The story of the Exodus involves a journey first from their home in Canaan to Egypt, on the part of Joseph and his brothers, and then from Egypt back to Canaan by the Israelites, under the leadership of Moses.  This journey home for the Israelites has lots of formative incidents along the way: the destruction of Pharaoh and the Egyptian Army who are pursuing the Israelites, the giving of the Ten Commandments to Moses, etc.  Jesus’ parables often involve journeys.   For instance the parable of the Prodigal Son involves the younger son leaving home on a journey of adventure only to return home to a welcoming father when things get difficult.  

No doubt you can think of many other journeys in the Bible.  Many of these journeys involve a returning home.  And life itself, of course, involves a journey back to where you started if only in that, as you get older, you become more dependent on others for your very existence, just as you were when you were young.  But more importantly, as Richard Rhor, paraphrasing TS Elliott’s poem East Coker in the Four Quartets, says: ‘Somehow the end is in the beginning and the beginning points towards the end’.  This is from his book – Falling up: a spirituality for the two halves of life - from which I have drawn upon heavily when writing this sermon.

Now Biblical journey stories are often illustrative of the first half of our lives.  They are about the creation of identity.  The Israelites – after the Exodus – see their identity as a people chosen by God and rescued from the Egyptians.  They see Moses as the founder of their religion – a religion centred around the law, given to Moses on that journey.   The prodigal son, through his journey, comes to the realisation that home with his father is where he really wants to be.   In the first part of our lives our task is to find our self.  Part of that finding our self is to work out our relationship with God, to recognise and to accept his power to give our lives meaning.

A well-known first half of life journey in the Bible is the journey Abraham takes as the start of his life – or at least his story as recorded in Genesis.  You’ll remember that God tells Abraham to leave Haran - the country in which he is living at the time – for a new land which God will show him - Canaan.  God tells Abraham that this is because, ‘I will make of you a great nation and I will bless you, and make your name great, so that you will be a blessing’.  Abraham obeys God’s instructions and, with his family, including his wife Sarah and his nephew Lot, sets for Canaan.  When Abraham gets to Canaan, God says to him, ‘To your descendants I will give this land’ and Abraham and his family settle down in Canaan.  This too is story about how Abraham comes to see himself, how he finds his identity as the founder of a great nation whose home is Canaan.

Now if this were a fairy story the story would perhaps end there with: ‘And they all lived happily ever after’.   But we know that, in this respect at least, fairy stories are not true to life.  So too things don’t go smoothly for Abraham.  He ends up staying in Egypt for a while, where he runs into trouble with Pharaoh because he fails to tell him that Sarah is his wife and is forced to leave.  He falls out with his nephew Lot and then patches up the quarrel.   But also Abraham begins to question his identity when he and Sarah fail to have a son.  How can God of make of him a great nation if he has no son and heir?  But as we know God does give the couple a son – Isaac.

At this point Abraham is required by God to go on a second journey, this time to for the land of Moriah and up one of the mountains there, where he is to sacrifice his son, Isaac.  Abraham obeys God, goes up the mountain, and is just about to sacrifice his son, when God supplies him with a ram to sacrifice instead.   And Abraham returns home to Canaan.

Now this isn't a journey of identity creation.   It’s symbolic of a journey of the second half of life where the name of the game is letting go of the identity you have, often painfully, constructed in the first half of your life.  Abraham has to let go of his identity as the founder of a great nation in order, perhaps paradoxically, to get it back.   In this he has to trust God to do what seems logically impossible.   If he kills his only son how can his descendants become as numerous as the stars of heaven as God has promised him?

This is the nature of identity.  Jesus say in all four gospels as he does, here, in Matthew’s gospel:  ‘Anyone who wants to save his life, must lose it.   Anyone who loses his life will find it.’  

The purpose of the journey of the second half of life is therefore different to the journey of the first half of life.  This is to find a role, develop a career, accumulate some wealth for reasons of financial security, find some friends and a partner, have a family.  Of course not all of these things are given to all of us.  We’ll also, if so inclined, find a religion to believe in, a religious group to belong to and a place to express our religion.  We might even learn to put our trust in God and find salvation in him. 

All of these things are good: the development of a career, the finding of a source of salvation, even the accumulation of wealth – if you don’t take that too seriously – see it as your ultimate treasure.  The first half of life is unlikely to be problem free.  In fact it is highly unlikely to go as you hoped when you were young.   And on the way you are likely to encounter suffering.  Jesus says that whosoever wants to join him on the journey will need to take up his cross. 

In the second half of life things get done to us rather than us doing things.  Our career comes to an end whether you like it or not, our children leave home to create their own identities, you are progressively likely to lose your parents and friends through death.  You may start to lose your own health.  What were religious certainties may come to seem more uncertain.  

However another journey awaits you if you are willing to take it.  Not everybody goes on this journey even though aging itself is inevitable.  As Richard Rhor says, ‘The first half of life task is no more than finding the starting gate.  It is merely the warm-up act, not the full journey’.  However ‘a ‘further journey’ is a well-kept secret, for some reason’.  Many people do not even know there is one ‘and there are too few who know that it different from the journey of the first half of life.’

In fact it is incredibly easy to get stuck on the first half of life journey.  To ignore the fact that you no longer have the same role and purpose that you had.  In fact this denial may lead to the mid-life crisis of the type which leads people to try and start the journey again to seek to create another identity.  The journey in the second half of life has, or rather ought to have, a different purpose.

TS Elliott says, in his poem East Coker:  
When here and now cease to matter.
Old men ought to be explorers
Here or there does not matter
We must be still and still moving
Into another intensity
For a further union, a deeper communion
Through the dark cold and the empty desolation,
The wave cry, the wind cry, the vast waters
Of the petrel and the porpoise. In my end is my beginning.

The good news that there is a guide for this exploratory journey to a deeper communion: the Holy Spirit.   As Paul puts it in his letter to the Romans, ‘The love of God has been poured into our hearts through the Holy Spirit that has been given to us.‘  The Holy Spirit guiding on this journey from home and toward home is also described by Jesus in John’s gospel as an advocate who will teach us and remind us as if some inner part of us already knows where we are to go but still needs us a prod in the right direction.

This being done to rather than doing in the second half of life means that our task becomes to accept what is given to us.  We no longer have to strive for an identity, to prove who we are.  Life can become purely trust in God for what we need – as Jesus enjoins us to do in our Gospel reading today – saying that if we seek for his kingdom – that deeper communion that TS Elliott talks about – then everything else that we need will be given to us. 

In the second half of life there is no longer any need to protect or project one’s identity as Paul is, in effect, is saying in our Epistle reading today where he reflects back on his life and calls himself a fool.   When you are in the second half of life, finally you are who are and can be who you are without disguise or fear.  

So I hope that I have convinced you that second half of life journey can be even more exciting and in the end more worthwhile than the first.   As some of you know I have just turned 60 and one of my 60th birthday cards said, helpfully I think, 60 is the new 30 x 2.

Saturday, 23 May 2015

God, evolution, global warming and heart disease: a personal reflection on population health

An ‘inaugural’ lecture given in the Nuffield Department of Population Health at the University of Oxford, on 18th May 2015,  for my Professorship in Population Health.  For the slides see: here .

In general I think you should never apologise when giving lectures but I am going to start this lecture with three apologies.

Firstly I know that it is conventional to give lots of acknowledgements in an inaugural lecture but I only have two: firstly to the University of Oxford, and in particular Professor Rory Collins, for awarding me this professorship and secondly to the British Heart Foundation for paying my salary for the last 22 years.   There are too many other people I should thank so to avoid missing people out I will stop there.  Sorry.   I will however in the course of this lecture acknowledge some of the people who have affected my thinking about population health.

Secondly I also know that it is conventional to try to be inspirational in an inaugural lecture.   I would like to be inspirational but my trajectory from DPhil student in the Department of Zoology to Professor of Population Health has hardly been ‘conventional’ and I would not advise anyone else to follow my example.  So I am sorry if you’d come to this lecture hoping to hear some tips on how to become a Professor of Population Health.  I do however hope to inspire you to think differently about population health.

Thirdly this lecture is more valedictory than inaugural.  This seems to inevitable given that I have been working in the field of population health for about 30 years and by my reckoning I have less than ten years left.    I have fought against the consequent temptation to be self-referential and even worse self-indulgent but you’ll see that I haven’t been able to resist these temptations completely.   Sorry.

I have chosen as the title for this lecture God, evolution, global warming and heart disease, not because I am an expert on these four things but because all four topics have figured extensively in my intellectual life: much as particular songs or pieces of music provide the sound track of one’s general life.   Incidentally the actual piece of music which has done this most for me is ‘Without You’ by Nilsson.   Don’t’ worry I won’t be playing you a clip: that would just be too self-indulgent.    I guess we all have many pieces of music that provide the sound track to our lives and there are more topics I could have included in this list: foods and diets being an obvious one. 

These four topics of God, evolution, global warming and heart disease do I think have a relationship with population health and the aim of lecture is merely to persuade you that they do.  It is clearly obvious that heart disease is relevant to population health but, of course, less so when it comes to God, evolution and global warming.

[OHP] Here then are four paintings of God, evolution, global warming and heart disease.  Three of these paintings were painted by my friends for me.  Top left is a painting of Jesus’ miracle of turning water into wide at a wedding at Cana which hangs in my office.  It depicts God in the shape of an actual living person – I don’t know his name - who represents Jesus, second from the left.   God has always been an important topic in my life.  So much so that I became an Anglican priest in 2008 as many of you know.  Theologians have much to say about health.

Top right is a painting by Desmond Morris that illustrates the front cover of the first edition of a book called ‘The Selfish Gene’ by Richard Dawkins.  The Selfish Gene was published in 1976 while I was studying for a degree in Zoology here at Oxford and I had some tutorials with Richard Dawkins.  I think the book has been very important in the way we think about many things including health: perhaps even comparable in its influence to Charles Darwin’s ‘On the Origin of the Species’ published in 1860.   I do not think the influence of either book has been good.

Bottom right is a painting entitled ‘Global Warming’.  Since around the mid 1990’s - through meeting an energy scientist called Alwyn McKay who had worked with Nils Bohr in Copenhagen.  I have increasingly come to see that that global warming is a much bigger problem for the human species than anything else including heart disease.   And this has had an influence on my perspective on population health as I’ll briefly explain later

Finally the last painting, bottom left, is entitled ‘Heart Disease’   Heart disease is a topic that I have been concerned with since 1986 when I joined the staff of a non-governmental organisation called the Coronary Prevention Group.    I guess this picture’s does not make for comfortable viewing but it reminds us that heart disease isn’t in the end a comfortable subject – it affects people we know and love including some of us here.  It is an evil that many in this department of population health are seeking to eradicate or at least to ameliorate.  

This picture obviously has both theological and biological references: the three hooded figures represent – at least to my way of thinking - three of the four horsemen of the apocalypse in the book in the Bible called the Revelation to John – and the yellow gunge the cholesterol laden plaque that clogs up coronary arteries thereby causing heart disease. 

Before moving on the relationship between God, evolution, global warming and heart and population health I fell a need to provide you with a definition of population health. Here is my definition: [OHP] 'The science and art of preventing disease and promoting health through the organized efforts of society, organizations, communities, families and individuals'.

For those of you familiar with definitions of population health and what it used to be called - public health - you’ll note that this definition is basically the same as that of Charles-Edward Winslow dating back to the 1920s[i] and also that of the Faculty of Public Health – the standard setting body for specialists in population health in the United Kingdom - although with some modifications of my own.  

An important thing to note about this definition is that it regards population health as both a science and art which suggests that the arts have just as much to contribute to population health as the sciences.   By arts I do mean art, but also literature, myth and history which I’ll come on to later.  The definition also makes it clear that, when it comes to disease, population health is about prevention rather than cure.   This definition also begs the questions of what we mean by disease and health. Here the World Health Organization’s definition of health is, I think, useful. [OHP]t hat is that: ‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.’

The word to note here is social.   From this definition it follows that health is not just something individuals might aspire to but also groups or populations i.e. families, organisations – such as this department, communities and indeed societies and from this it can be argued that: [OHP] The health of a population is not just the sum of the health states of the individuals within that population.

Now I know it will sounds odd to some of you to suggest that groups rather than individuals can be healthy or unhealthy, and even odder to suggest that the health of a population is not just the sum of the states of health of the individuals of which it is composed.  But for me these ideas are at the heart – forgive the pun – of population health and distinguishes it from medicine which might be defined as the ‘science and art of treating and alleviating the disease of individuals’.  

Do we have any evidence to suggest that the health of a group is not just the sum of the health states of the individuals within that group?   Well I think we do in the work of various population health scientists and most strikingly in the analyses of Richard Wilkinson and colleagues.    To take just one example: [OHP] Here is a graph of income inequality against infant mortality in rich countries.   Each point represents a country.  The countries with the greatest income inequality such as the US are to the right.  The countries with the least income inequality such as Sweden and Japan are to the left.  It shows that there is a relationship between income inequality and infant mortality with countries having the greatest income inequality experiencing the greatest infant mortality.

Now it is important to note that the X and Y variables on this graph are not the properties of individuals but of societies.  Income inequality can only be measured when you have two people at least, in relationship with one another.   Income inequality can be experienced by an individual but only when another individual is present.   Similarly, but perhaps less obviously, the infant mortality rate of a county can only be measured when there is a group of individuals in which more than one child dies and the same may be said of any disease rate. 

I think the properties of groups and their relationship to health is an important area for future research.   Of course societies are clearly not merely defined by how unequal they are.   But this area of research has been hampered by the notion that there is no such thing as society – as articulated by Margaret Thatcher in a famous interview given to Women’s Own in 1987. [OHP]

She said in this interview: "They are casting their problems at society. And, you know, there's no such thing as society.. There are individual men and women and there are families. And no government can do anything except through people, and people must look after themselves first. It is our duty to look after ourselves and then, also, to look after our neighbours."

Of course population health does not merely aim to describe the healthiness or otherwise of individuals and populations but to do something about what is observed.   In addition it is worth emphasising [OHP] that population health aims to improve the health of groups: societies, communities, organisations, families and not just individuals.  Public health is therefore concerned with both problems and solutions.   Incidentally some of us think that population health research spends much too much time on the problems and not enough on the solutions but I do not have time to go into that issue today.

Turning again to my definition of population health.  Another important couple of words in this definition are ‘organised efforts’.   What are organised efforts?  At this point I can’t resist the temptation to show you my favourite diagramme of the complexity with which population health must deal.  [OHP]  This is a map of the causes and possible solutions of just one population health problem: obesity.  It was produced by the UK Government’s Foresight Programme for the Government Office for Science in 2007.   I say favourite but actually I think it obfuscates rather than enlightens.  To me the solution to the problem of obesity is simple as many of you will know.   My solution is to tax sugary drinks.   Although I acknowledge that this isn’t going to be the only measure necessary.

There is no mention of sugary drinks in this map let alone sugary drinks taxes.  The closest you get to that is ‘the market price of food offerings’ circled here.   Rather strangely you get a whole section of the map devoted to ‘self-esteem’ and ‘psychological ambivalence’ shown here.  There is even a box for ‘genetic and epigenetic predisposition’ shown here.   But how, I ask, does knowing that there is a genetic predisposition to obesity – which there probably is - help generate a solution?

A better way of explaining the organised efforts necessary to prevent obesity and indeed the organised efforts necessary to prevent disease and promote health as a whole is a poem called ‘The Fence or the Ambulance?’ by Joseph Malins written in 1895.  I’ll read it to you.

Twas a dangerous cliff, as they freely confessed,
Though to walk near its crest was so pleasant;
But over its terrible edge there had slipped
A duke and full many a peasant.
So the people said something would have to be done,
But their projects did not at all tally;
Some said, "Put a fence 'round the edge of the cliff,"
Some, "An ambulance down in the valley."

But the cry for the ambulance carried the day,
For it spread through the neighboring city;
A fence may be useful or not, it is true,
But each heart became full of pity
For those who slipped over the dangerous cliff;
And the dwellers in highway and alley
Gave pounds and gave pence, not to put up a fence,
But an ambulance down in the valley.

"For the cliff is all right, if you're careful," they said,
"And, if folks even slip and are dropping,
It isn't the slipping that hurts them so much
As the shock down below when they're stopping."
So day after day, as these mishaps occurred,
Quick forth would those rescuers sally
To pick up the victims who fell off the cliff,
With their ambulance down in the valley.

Then an old sage remarked: "It's a marvel to me
That people give far more attention
To repairing results than to stopping the cause,
When they'd much better aim at prevention.
Let us stop at its source all this mischief," cried he,
"Come, neighbors and friends, let us rally;
If the cliff we will fence, we might almost dispense
With the ambulance down in the valley."

"Oh he's a fanatic," the others rejoined,
"Dispense with the ambulance? Never!
He'd dispense with all charities, too, if he could;
No! No! We'll support them forever.
Aren't we picking up folks just as fast as they fall?
And shall this man dictate to us? Shall he?
Why should people of sense stop to put up a fence,
While the ambulance works in the valley?"

But the sensible few, who are practical too,
Will not bear with such nonsense much longer;
They believe that prevention is better than cure,
And their party will soon be the stronger.
Encourage them then, with your purse, voice, and pen,
And while other philanthropists dally,
They will scorn all pretense, and put up a stout fence
On the cliff that hangs over the valley.

Better guide well the young than reclaim them when old,
For the voice of true wisdom is calling.
"To rescue the fallen is good, but 'tis best
To prevent other people from falling."
Better close up the source of temptation and crime
Than deliver from dungeon or galley;
Better put a strong fence 'round the top of the cliff
Than an ambulance down in the valley.

But to return to my title: what have God, evolution, global warming and heart disease got to do with population health?  I’ll take each in turn.

The easiest of these topics to deal with is heart disease because it is self-evidently a population health problem.  And I am going to take it as read that it can be prevented by improving our diets, increasing our levels of physical activity, smoking less and reducing our consumption of alcohol.

As I said heart disease is an issue that I have been concerned with since 1986 when I joined the staff of the Coronary Prevention Group.  In that year coronary heart disease was responsible for about 180,000 deaths a year in the UK and we could confidently say that coronary heart disease was the UK’s Number 1 killer.   In 2012 coronary heart disease was responsible for 74,000 deaths and now even the British Heart Foundation concedes that cancer is the UK’s Number 1 killer with nearly 166,000 deaths a year.  

Can we explain this success story?  Here are some slides from a paper I contributed to.   It was published in the British Medical Journal in 2012 and the first author was one of my DPhil students – Kate Smolina.  The first slide [OHP] shows this decline in deaths from heart attack – the most acute form of coronary heart disease - between 1999 and 2007.  The blue line shows the decline in deaths from heart disease overall, the green line shows deaths from heart disease in hospital and the red line deaths out of hospital.  So the decline in overall deaths has had nothing to do with improving hospital care.  Your chance of dying from a heart attack if you reach hospital hardly changed over that time.

So what was happening which led to this rapid decline in people dying from heart disease out of hospital.  This slide [OHP] shows that it was two things: the number of actual heart attacks was falling – the event rate as described in this slide - and people were living longer after their heart attacks: case-fatality, as it’s called here, was improving.   So why was event rate declining and case fatality improving?   I still think this question lacks an entirely satisfactory explanation.   My friend Simon Capewell has tackled it but I don’t think he, or anyone else, as yet has given us the full answer.

What we can say is that it wasn't just down to the increasing use of statins and other drugs that reduce your risk of a heart attack.   Here is a slide I have borrowed from Richard Peto [OHP].  It shows the decline in vascular mortally as a whole: i.e. deaths from both heart attacks and strokes for the past 50 years.   And here is the date of the publication of the first major study showing the effectiveness of statins as a drug that reduces your level of blood cholesterol and thereby your risk of vascular disease [OHP].   You can see that this trial was published long after the decline in vascular mortality began.

Oh here [OHP] is the Daily Mail’s explanation of our results published in the British Medical Journal.  For once I think they got it about right but we didn’t actually say this in our paper.  Their headline was – for those who can’t read it – ‘Heart attack deaths halve in eight years due to fewer smokers, better diet and improvements to care.

We have come a long way – in past 30 years - in our understanding of the causes of and remedies for heart disease as illustrated by this bill-board advert from 1994 [OHP] – when I’d just left the Coronary Prevention Group – to start what has become the British Heart Foundation Centre for Non-Communicable Disease Prevention.   The advertising campaign used statistics from a compendium of statistics on heart disease which the Centre had produced for the BHF.  We have continued to produce such a compendium since 1993, but it is inconceivable that the BHF would use the slogan ‘Cross your heart and hope not to die’ nowadays

How we explain things brings me to the next issue in my title: God or rather theology.   But firstly I want to say something about other ologies besides theology and their contribution to population health. 

I think we often suffer from a limited understanding of what counts as an explanation.   Scientific explanations are not the only sort of explanations we need to help us live our lives. A framework for thinking about different types of explanations is provided by the philosopher Ken Wilber in his book ‘A theory of everything’ [OHP].    Wilber divides theories into four types: individual objective, group/objective, group/subjective and individual/subjective.    An easier way of understanding this classification of theories is to show how different disciplines or ‘ologies’ can be classified by this framework [OHP]. 

So physiological theories are archetypical individual/objective theories – aiming objectively to study individual bodies.  Modern day psychological theories are generally of the individual/objective type though in the past they were more subjective [OHP].   Epidemiology is the discipline that is most associated with population health.   It too seeks objectively to study individuals – in particular their health status – but as I have suggested earlier – sometimes seeks objectively to study the health of groups – and indeed in my opinion it should do more of that.   In this it touches upon group/objective theories such as those generated by sociology [OHP].  Sociology is a discipline that seeks to explain – largely objectively (at least almost everywhere except France) the characteristics of groups and in particular societies.

So In the two right hand quadrants we find disciplines that primarily rely on objective knowledge and on empirical data, preferably quantified and ideally from experiments.  In the two left hand quadrants we have disciplines that rely primarily on subjective understanding and on story rather than numbers.

Theology - top left – within which I would include atheistic theologies (if that isn’t a contradiction in terms) as well as theistic theologies – generates the archetypical individual/subjective type of theory.  But there are also theories which can be described as group/subjective theories: such as historical theories – bottom left.  Theology is generally thought of as seeking to explain the individual’s subjective experience of their place in nature, his/her relationships with others including God, etc. but it, like epidemiology should, in my view, be more concerned with the collective experience.

Of course this classification of ologies is hugely simplistic and many of you will object to where I have put your favourite disciplines.

So how does all this relate to the problem of heart disease?  Well firstly different types of theories to explain the problem, in actual fact, seek to address superficially similar but actually very different questions [OHP].  For example in relationship to heart disease, individual objective theories might address the question: Why does he/she have heart disease?  Group objective theories: Why do they (as a group) have heart disease?  Group subjective theories: Why do we (as a group) have heart disease?  And individual subjective theories: Why do I have heart disease?    

[OHP] Physiology tells us how heart disease is a result of cholesterol laden plaque building up in arteries sometimes breaking away to form a clot that blocks a coronary artery bringing oxygen to the heart.  [OHP] Epidemiology gives us some answers to the question of why heart disease is more prevalent in certain groups rather than others (incidentally these are some results – published only the other day – but similar to those I showed you earlier about income inequality and infant mortality).  OHP] History explains how we as a society – such as that of the UK - have become defined by our patterns of consumption – many of which turn out to be bad for us – for example our tendency to over consume high sugar foods, leading to overweight and obesity and in turn to heart disease.   [OHP] Theology seeks to explain why human beings suffer: suffer from diseases such as heart disease.   In Christian theology the reasons for suffering are addressed in the book of Job and in the sayings and stories of Jesus – both his parables and the narrative of his life.  

Different ologies bring different answers to the problem of heart disease but also propose different solutions.  [OHP] Physiology suggests tackling the build up of cholesterol in arterial plaque through dietary change or pharmacological treatment.  [OHP] Epidemiology suggests that policies which affect income distribution may have the additional benefit of reducing overall rates of heart disease.   This is a picture of students celebrating the fact that the University of Oxford has signed up to being a Living Wage employer.   [OHP] History suggests that we need to tackle the over-consumption of particular consumer goods such as sugary drinks through for example increasing their price.  This is a billboard urging people in Berkeley, California to vote for a sugary drinks tax there, which in fact they did.   [OHP] Theology tells us of the importance of eating together and if we do we will lead happier healthier lives (to cut a rather long story short).  

Now these ologies are complementary not competitive in both their analysis of problems and generation of solutions.  This is one reason why the Nuffield Department of Population Health, at the University of Oxford needs more than just epidemiologists, but also psychologists and sociologists (as being researchers in neighboring ologies in my conceptual framework) and dare I say it theologians.

So that was God – or at least theology – what about evolution and global warming?   I don’t have time to give them much attention but I will briefly say something about them.

Firstly evolution or rather evolutionary biology.  I mentioned earlier that particular theory of evolution that was summarised in Richard Dawkin’s book, ‘The Selfish Gene’, published in 1975.  This theory called Neo-Darwinism and its fore-runner Darwinism has, I think, had a profound effect on our thinking in all disciplines not just biology.   The influence of Darwinism on other disciplines including psychology, sociology, economics and of course theology is brilliantly laid out in this book [OHP] entitled Darwin’s Metaphor, by Robert Young, and published in 1985, from which I have taken just one quote, but I could have taken many. 

A particular effect of Neo Darwinism on our ideas, and relevant to my personal perspective on population health, is its influence upon our ideas about the nature of societies and whether they might be described as healthy, irrespective, at least to some degree, of the health of the individuals of which they are composed. 

You’ll remember that Margaret Thatcher said that: ‘There is no such thing as society’.  In, to my mind, an extraordinary interview with Eddie Mayer on Radio 4’s iPM Programme in April 2013, Ian Swingland, now Emeritus Professor in Conservation Biology at the University of Kent says: “Thatcher eschewed the idea of society because of a high table dinner at Magdalen College at Oxford [in March 1978.  [At this dinner] ‘Richard Dawkins convinced her there was no such thing as society just individual.”  Swingland himself had attended this dinner.  Here is a transcript of that interview which you can read at your leisure.  I am looking forward to the second volume of Richard Dawkin’s autobiography to see whether Dawkin’s confirms Swingland’s view.

And secondly global warming.   Now anthropogenic global warming is a problem which is similar to heart disease.   It, like heart disease, threatens our physical, mental and societal well-being.   To be concerned about human health and not about the health of the planet seems increasingly absurd, given that, if the predictions of those who are tracking climate change are correct, human health will, in the future, be profoundly affected by global warming.   

Anthropogenic global warming, like heart disease, can be explained in various ways and will require different types of solution.   But explanations for and solutions to global warming seem extraordinarily similar to those for heart disease: we would reduce our risk of heart disease and save on fossil fuels if ate more plant based foods and less meat and walked and cycled more rather than travelling by car.   Moreover, like population health problems, global warming will only be solved through the organized efforts of society, organizations, communities, families and individuals.

So finally I would like to close with some words of a hymn which I we sung in my church yesterday.   They seems peculiarly apt to what I have been saying.

Spirit of truth arise
Inspire the prophet’s voice
Expose to scorn the tyrant’s lies
And bid the poor rejoice
O Spirit, clear our sight,
All prejudice remove,
And help us to discern the right,
And covet only love.

Give us the tongues to speak
The words of love and grace
To rich and poor, to strong and weak
In every time and place
Enable us to hear
The words that others bring
Interpreting with open ear
The special song they sing

I know I said I would only give two acknowledgements in this lecture but I have a few more.  Thank you all for coming and thank you for listening.  And thank you too to Charlotte Payne for providing some sushi made with edible insects to eat as snacks after this lecture.  I’ll leave you to work out the connections between insect sushi and God, evolution, global warming, heart disease and indeed population health.

[i] Winslow, Charles-Edward Amory (Jan 9, 1920). "The Untilled Fields of Public Health". Science 51 (1306): 23–3. doi:10.1126/science.51.1306.23. PMID 17838891.

Sunday, 8 March 2015

Noah and why we should eat meat reverently

A sermon given at St Luke's Church, Oxford on 8th March 2015

Readings: Genesis 8: 20 - 9: 17 and Matthew 5: 17-20.  

I am delighted to be talking to you about Noah today.   I think the stories of Noah that we find in Genesis are much neglected.   Particularly the story of Noah’s drunkenness – which comes just after the passage we heard just now.   And the story of Noah and the Ark seems to be, these days, a story that is only deemed suitable for children.   Perhaps this is because scientists - and I consider myself a scientist – have told us repeatedly that the stories couldn't possibly have actually happened – at least in the way they are told in Genesis – and so they are at best, considered as being of minor significance, compared with other stories in the Bible, and at worst, discounted as irrelevant.

All the stories in the Genesis are there to explain why things are the way they are.   They are all creation stories if you like.  Not just the creation of the natural universe, but of things like speech and reason, agriculture, cities and nations, music, technology, law and justice, and so forth.   And the stories of Noah are no exception.   Today I am going to concentrate on the story of Noah and the Rainbow.   And this is a story about the origins of law and justice.

The meaning of the Noah stories – and the other stories in Genesis - doesn’t really depend on whether they are actually happened or not.   Although to my way of thinking, it is not implausible that there was, at some point in history, a man called Noah who built a large boat for his family and some of his animals to escape a great flood, then saw a rainbow, then got drunk in front of his kids, etc.  But I do not think that the flood covered the whole earth or that there were woolly mammoths, if not dinosaurs, on that boat as some people do.  

First, and before turning to the story of Noah and the Rainbow, a few words about the meaning of the story of Noah and the Ark because that story is the context for the story of Noah and the Rainbow.

The story of Noah and the Ark always seems a bit barbaric to me.  I have difficulties with the idea of God destroying most of humanity in an almighty cataclysm – and yet of course we know that there have – over the course of human history – been many natural disasters: earthquakes, tsunamis, plagues and epidemics and indeed floods – which have killed vast numbers of people.  The 1918 flu epidemic killed between 50 and 100 million people across the globe - more than three times as many as were killed in the First World War.

The Noah and the Ark story also seems to suggest that whether we survive such natural disasters depends upon our moral character.   In Genesis Chapter 6 verse 13 God tells Noah, ‘I am going to put an end to all people, for the earth is filled with violence because of them. I am surely going to destroy both them and the earth.’ But God also tells Noah that he and his family are to be saved because he has, ‘seen that you, Noah, are righteous before me in this generation’ (Chapter 7 verse 1).  

I find these verses disturbing and seeming to contradict the notion that you find later in the Bible – such as in the book of Job - that people suffer whether they are righteous or not – and indeed that the most righteous person – in the shape of Jesus –  ends up suffering the most.  

But Genesis is about creation and origins and surely we all appreciate that there is a basic connection between the life well lived and the benefits thereof, and conversely the relationship between man’s tendency towards violence and the evil that brings.   With Noah, God, essentially starts again.   It’s a new creation of the world.

In the first creation God – according to Genesis - started with a clean sheet, and out of nothing and made a world fit for the first humans – Adam and Eve – to live.   With Noah he starts with a pre-existing world seemingly washed clean of violence through the Flood, and with a new first human, Noah.  Adam was initially neither good nor bad, but Noah we are told was a righteous man.   And this brings us to the story of Noah and the Rainbow.

You might say it’s not much of a story, there’s not much of a plot.  I suppose that’s true but it’s an important and meaningful story nevertheless.   The Flood is over.  Noah and his family, having spent 40 days afloat, have left the Ark so what happens next?   Well, firstly Noah builds an alter and sacrifices some animals, and secondly God says some important things to Noah and his family: firstly he gives the new first humans a promise, secondly he gives them the first and probably most important set of laws we know of, and thirdly he gives them grounds for hope for the future.

So firstly that odd sacrifice that Noah makes.   Remember that the Ark was built to accommodate, not only Noah and his family, but at least a pair of every living animal.  We are told that God instructed Noah to bring enough food for them all for 40 days.   Because Noah follows God’ instructions he, his family and all the animals survive.  But no sooner than they have all left the Ark to take up their new lives we find Noah killing some of the very same animals he has just spent the last 40 days feeding and cherishing.   Why on earth did Noah do this?    The death of the animals is, I think, a reminder that violence – the violence that God wanted to wash away in the Flood - is here to stay, despite Noah being a righteous man.

Did God want this sacrifice?   I don’t think he did.   God doesn’t demand the sacrifice.   The sacrifice is Noah’s idea: presumably because he thought God would like it.  We are told that the smell of the sacrifice was pleasing but pleasing to whom? To God?  Perhaps only to Noah and his family.   Certainly not to the animals concerned.

God does not thank or praise Noah for the sacrifice of the animals.  On the contrary he almost immediately complains that ‘the imagination of man’s heart is evil from his youth’ (Chapter 8, verse 21).  But the sacrifice does prompt God to give Noah some important information and in effect, it’s at this point, that God establishes a new world order.

Firstly he gives Noah a promise.  A promise of a stable world, where never again will all living creatures be wiped out, and where seedtime and harvest, summer and winter, day and night, shall follow one another in an orderly fashion.

In the days between Adam and Noah – and despite Adam’s transgression - we saw the beginning of agriculture, the foundation of the first cities, the origins of technology and of music. Nevertheless humans' tendency to violence – beginning with the death of Abel at the hands of his brother Cain – began to get out of control, culminating in the violence that preceded the Flood.  This led to chaos and destruction.

In the new world order, after the Flood, human beings are accepted not for what they ideally might be but for what they are – including their tendency towards violence.   But God promises that never again will this violence and the resulting chaos be allowed to get out of control.   The law that God gives to Noah is to ensure this.   This law makes explicit and also regulates what is implicit in Noah’s violent sacrifice of the animals.

So next this law.   The most important part of this law is, ‘Whoever sheddeth man’s blood by man shall his blood be shed.’   In the service of both safeguarding life and securing elementary justice this law, for the first time, prohibits murder and compels its punishment.    Note here that this law demands one life for one life and no more.   It is thereby designed to prevent vicious spirals in violence.   It protects society against family feuds, for example, where one murder leads to another and then to another, and then to another.   It is designed to stop wars.   Note too that that intent or mitigating circumstances do not come into this elemental form of justice.   Indeed human bloodshed even by an animal must be avenged.  Rather strangely to modern ears God says, ‘At the hand of every beast will I require it’ i.e. their life too if they kill a human (Chapter 9 verse 5).  So strictly speaking the deed that is to be avenged is not just murder but any human death at the hands of another human being or animal whether intentional or accidental.

Of course the ‘life for a life rule’ given to Noah sounds harsh and unforgiving to our way of thinking and later Mosaic law, and Jesus’ interpretation of the law will modify it but, as the verses from St Matthew’s Gospel we heard just now suggest, the basic principle remains intact i.e. that life is sacred.  And here we learn why ‘That human beings are made in God’s image (Chapter 9 verse 7) and that the killing of another human being is to disrespect that image.

However Noah’s law – if we can call it that - was not just about containing our violence towards one another but also about our attitudes to the natural world.   This is the first time, in the Bible, where God gives express permission to human beings to eat meat.  In the Garden of Eden we were given fruit from trees.  After the expulsion from the Garden we had to till the ground and ‘by the sweat of our brow’ grow plants, such as corn, for making bread.  Only at this point, when Noah, has demonstrated his violent tendency towards animals and his desire for a celebratory roast dinner, does God, permit humans to kill and eat animals, and then only under controlled circumstances i.e. without blood, that is with respect for their life.  The respect we should show for the rest of God’s creation is thus intimately tied up with basic rules about violence towards one another.

I think that we should look to Noah’s law to tell us more about how we should treat creation.  I.e. we now know that eating excessive amounts of meat – particularly cows and sheep - is contributing significantly to global warming and that to eat less meat and more reverently is clearly going to be good for the planet.

But the law – important is this is - is not the end of this story. Noah’s law is prefaced by a promise of stability.   And after the giving of the law God reiterates and elaborates upon this promise.  This promise is not any old promise it’s a covenant or a binding promise.  The Hebrew word ‘berith’ translated covenant in Chapter 9 verse 8 and repeated six more times before the end of the chapter comes from a root meaning ‘to bind together’.  The covenant announced here corrects a dangerous cleavage in the pre-Flood world.  After the unspoken bonds which should have unified the world in that world were broken, they had to be replaced by explicit bonds.  God here explicitly binds himself never again to destroy all life and in effect to limit creation’s indifference, if not hostility towards us.   God’s promise is unilateral, one-sided, and unconditional.   It thus provides humans with the hope of a terrestrial future secure against global natural catastrophe.

Belief in the covenant is crucial to the new world order.  It is of equal importance to the law.  Just as human nature in the absence of law always threatens human life and the life of the planet through violence, so the natural world, in the absence of covenant, always threaten human life through cataclysm.  Thus the hope that we will not ultimately succumb to global warming, or whatever next turns out to be the biggest threat to human existence is absolutely indispensable for human life.   In the absence of such hope, why would humans be inclined to accept the restraints of the law?   And this is why God’s promise, though it comes after the law is pronounced, does not depend on humans following the law.  On the contrary, our following the law rests on our belief in God’s remarkable promise: no more floods: or at least a flood that we cannot recover from.

Yet Noah and his family, hearing God’s promise make no response.  They are either dumbfounded or disbelieving.   God must speak again and this time he gives them a visible sign of his promise – a rainbow.   The spoken promise of a secure future is insufficient.   Noah and his family require a sign.  

Just in the days of Noah we too require a sign of God’s promise, and in the light of that promise, the need to obey God’s laws.   Our sign is not the rainbow.  Remarkable as a rainbow is – it quite quickly fades.   It is ‘just’ a natural phenomenon brought about the refraction of light through rain drops.   Our sign is Jesus.   He is our permanent sign, the physical sign that God rescues us from the floods and other adversities of life; that he is with us, preserving us from ultimate catastrophe – just as God promised Noah that he would be.   Jesus is our new covenant.: on which more later.

With thanks to Leon Kass, The Beginning of Wisdom, 2003, Univesity of Chicago Press. 

Sunday, 8 February 2015

A sermon in response to Stephen Fry

A sermon given at St Matthew's Church, Oxford, 8th February 2015

Readings: Psalm 34,  Peter 3:13 – 4:6, 

I wonder whether you heard the interview between Stephen Fry and the veteran Irish TV presenter Gay Byrn on RTE television’s The Meaning of Life last Sunday.   It’s created one of those media storms with over 5 million hits on YouTube at last count[1]   I thought I’d play a clip this morning but I guess some people here might find it offensive so I won’t.  Here, though, is what Stephen Fry says when asked what he would say to God if he found himself standing at the gates of Heaven:  

"I think I would say, ‘Bone cancer in children? What’s that about?  How dare you.  How dare you create a world in which there is such misery that's not our fault?  It’s not right.  It's utterly, utterly evil.  Why should I respect a capricious, mean minded, stupid God who creates a world that is so full of injustice and pain?’  That’s what I’d say.”

This interview created some consternation in some Christian quarters.   Perhaps the best reaction came from Giles Fraser who said, ‘I don’t believe in the God that Stephen Fry doesn't believe in either.’

What Stephen Fry says is of course relevant to what I will be talking about in today’s sermon: the problem of suffering and the question of why our loving, just and powerful God allows suffering – and in particular allows suffering amongst his followers.   This is a question over which more ink has been probably been spilt than any other religious question and I hesitate to suggest an answer.   Peter tackles the question in his epistle and in particular in the reading we heard just now and in the reading we will be thinking about next week.   His answer is that Jesus suffered.   I am fairly sure that Stephen Fry wouldn't find that a satisfactory answer but I think it is an answer that should satisfy us and in this sermon I’ll try and explain why.

But back to Stephen Fry for a moment.   Note that, in answer to the question from Gay Byrn, Stephen Fry is able to imagine speaking to God.   It’s almost that he believes in God for a moment and speaks to him out of his desire to tell him what he thinks about the world and in particular the suffering he sees around him, particularly unjustified suffering such as bone cancer in children.   Stephen fry is angry with God for creating such a world - and anger with God - particularly about suffering - is something that authors of the Psalms – also do quite a lot.

We have, in effect, in the Book of Psalms, 156 recorded prayers.   In these prayers we can find petitions - requests for help, healing from ill-health and disease, rescue in the face of persecution from others, etc.  There is also quite a bit of thanking – thanking God for his help in healing, rescue, etc.   But often the Psalmist just tells God what he or she thinks of him.   There is a lot of praising of God for who he is - his goodness, his justice and his love -  but there is also a lot of complaining about what he is doing and in particular his allowing of suffering.

Take Psalm 44, for example.  After praising God for doing what he did to help his people in the past – reminding him that he saved them from their foes and put to confusion those who hated them - the Psalmist – let’s assume it’s a man - complains that now (verses 9 -12):
You have rejected us and abased us, have not gone out with our armies.  You have made us turn back from the foe; and our enemies have taken spoil for themselves. You have made us like sheep for slaughter, and have scattered us among the nations. You have sold your people for a trifle, demanding no high price for them.

The language may be more antiquated but the sentiment behind these verses is the same as Stephen Fry’s.  The Psalmist is angry with God.

But note also, as well as the anger, the puzzlement on the part of the author of Psalm 44 and Stephen Fry.   The Psalmist is asking God why, when he went out with our armies in the past, does he not do so now;  why when they, his people, ‘have not forgotten him’ he seems to have forgotten them.    Stephen Fry similarly wants to know from God, why he created a world with suffering in it.   People do want to know.

But our first reading today wasn't from Psalm 44 it was from Psalm 34.   The reason why I chose Psalm 34 is that a quote from it – verses 12-16 – comes just before our reading from 1 Peter.   And 1 Peter Chapter 3 verse 13 to the end of Chapter 14 can be seen as an expository sermon on Psalm 34.   Peter is, if you like, taking as his text for today, Psalm 34 and elaborating upon it, just as I am seeking to do with his text.  

So let’s take a look at Psalm 34.  This psalm, unlike Psalm 44, is a rather upbeat psalm.  Let’s assume that the psalmist is a woman this time.   She starts with the very un-angry and un-puzzled words, ‘I will bless the Lord at all times; his praise shall be in my mouth’.   This psalmist, like the author of Psalm 44, then proceeds to remind God what he has done for her in the past before moving back to the present.  Verse 4:  ‘[In the past] I sought the Lord, and he delivered me from all my fears.’  Verse 6: ‘This poor soul cried, and was heard by the Lord.’ And now to the present.  Verse 8: ‘O taste and see that the Lord is good; happy are those that take refuge in him’.   And verse 17, coming just after the verses Pete quotes : ‘When the righteous cry for help, the Lord hears, and rescues them from all their troubles.
At this point you might be tempted to say to the Psalmist as I am. " ‘When the righteous cry for help, the Lord hears, and rescues them from all their troubles.’  Oh come on?   Is this really your experience?    The Lord might listen and let’s hope he does ‘when the righteous cry for help’ but does he always rescue them from their troubles?   Surely not?" We know that the righteous suffer as much as the unrighteous, and sometimes even more. 

Actually the author of Psalm 34 is caught in a bit of a logical bind.   She acknowledges – verse 19 – that, ‘Many are the afflictions of the righteous’ in which case God clearly hasn't, at least yet, rescued them so when she says, ‘When the righteous cry for help, the Lord hears, and rescues them from all their troubles’ she must mean that Lord will, at some point in the future, rescue them.   Or at least she hopes so.  

So now to 1 Peter and Peter’s exposition of Psalm 34.  It might be a favourite psalm of his as he quotes it elsewhere in his epistle.   Now it is clear that Peter is writing to Christians who are suffering in some way – so much of it is devoted to the subject for a start.   I don’t know whether Steve covered this in his introduction to 1 Peter – a few Sundays back - but commentators think that this suffering wasn't state-sanctioned persecution of Christians such as under the Emperor Nero in AD60 – under which Peter himself died - but lower level physical and verbal abuse from hostile neighbours.   Nevertheless this was bad enough for Peter to have to write to them about it – possibly in answer to the question of why God was allowing it to happen.

Reminding them of Psalm 34 is perhaps a good way to start.  After that, and in the same vein as the Psalmist, Peter asks his readers a question: ‘Now who will harm you, if you are eager to do what is good?’   That’s Chapter 3 verse 13.  It’s a rhetorical question.  Pete’s assuming the answer 'no-one', No-one will harm you if you are eager to do what is good.   By ‘harm you’, he clearly doesn't mean physical harm – he knows that they cannot avoid physical harm.  Indeed Peter acknowledges that the recipients of his letter may well suffer physical harm in the next verse when he says, ‘But even if you do suffer for doing right, you are blessed’. 

When he asks rhetorically, ‘Now who will harm you ?‘ he must mean that they will avoid some spiritual harm – such as loss of faith in a God that will ultimately rescue them from physical harm – an amazing claim if you think about in that way.   And when he says, ‘If you do suffer, you are blessed’, he obviously doesn't mean physically blessed but rather spiritually blessed: in the way Jesus means when he says, in the Sermon on the Mount: ‘Blessed are those who are persecuted for righteousness’ sake for theirs is the kingdom of heaven’.

All this might sound over-simplistic – even just pious rhetoric  - on Peter’s part – but he goes on to urge his readers to reflect on and stick with their situation.  Verse 14: ‘Do not fear what they [your persecutors] fear and do not be intimidated’.   That is, acknowledge that your suffering at the hands of those around you is often a result of their fear of you – a needless fear – and this understanding might help you a bit to feel less intimated and bear the suffering more easily.   Fair enough.   He also gives them some further advice – here and later in the epistle - about how to cope with their suffering.
But just as you might question the apparently na├»ve optimism of Psalm 34, you might well say, as I am sure his readers also said, ‘But why do we need to suffer in the first place?’

I think we can all see what Stephen Fry is getting at when he questions why an all-powerful, creator God, who is supposed to be all loving and just, allows unjustified suffering.  Stephen Fry particularly questions the suffering of innocent children, but others such as Job - to whose suffering a whole book in the Bible has been devoted - have questioned the suffering of good people.   In the case of Job, Job himself.  

I personally think that the apparent problem with this question comes in our thinking of God as omnipotent – all powerful.   As I have said before I do not think God is omnipotent in the sense that Greek philosophers thought God was – a thinking that seems to me to have been imported into Christianity and is unnecessary.

My main reason for thinking that God is powerful but not omnipotent, in that way, is this.   Paul in his letter to the Philippians tells us that Jesus ‘emptied himself, taking the form of a slave, being born in human form.’  That is, that God, in Jesus, made himself voluntarily powerless – like a slave.  And this for me helps explain – not only God’s saving work through suffering on the cross – but also his - God’ the Father’s - creative work at the beginning of time- and remember that Jesus was there too.   Only through God making himself voluntarily less than all-powerful could creation begin to happen.   And creation, we learn from science, seems necessarily to involve physical pain and indeed physical death.

But back to suffering.  Peter supplies the reason for why his readers are suffering at verse 18 when he says, ‘You suffer for Christ also suffered’ and then goes on to explain why Jesus suffered, that is: ‘for sins once for all, the righteous for the unrighteous, in order to bring you to God’.   And this for me is the key verse in this passage from 1 Peter. 

Now I am not going to talk about how Christ’s suffering achieved what it achieved – a huge subject in itself.   The important thing I think to note, today, is the fact of Jesus’ suffering and that his suffering wasn't meaningless:  it was for something.  

One part of the amazing good news that Jesus brings is that God himself suffers.   He is not a remote and distant God who created the world with all the suffering it contains and left it at that – as Stephen Fry seems to be assuming that he – the God he doesn't believe in – does.   Our God is a God who suffers – once on the cross – and now in response to our suffering.  And through that suffering makes our suffering meaningful.  

Peter goes on to say – Chapter 4 verse 1 – ‘Since therefore Christ suffered in the flesh for us, arm yourself also with the same intention….so as to live for the rest of your earthly life no longer by human desires but by the will of God.’   So just as Christ’s suffering had a purpose, an intention, so too does our suffering and we should view it in that way.  

It is of course difficult for us to fathom the meaning of our own suffering and even harder to discern the meaning of the suffering of others.   In fact it is hazardous – and can be offensive to do so.   As I said, the Book of Job is a long exposition on the meaning of one man’s suffering and you are left at the end not really knowing what it was all for.  God’s answer to Job towards the end of the book is to reassure him that he, God, is indeed God.   ‘Where were you when I laid the foundation of the earth?’ he asks Job.   He does not explain what has happened to Job.

But nevertheless we can be assured – as Job and indeed the Psalmists could not be - because they had yet to encounter Jesus - that that our suffering isn't pointless because God has suffered for us and now suffers with us.  Suffering can only make sense, if instead of argument and reason, we gaze on the suffering of Jesus.

Saturday, 3 January 2015


The true meaning of Christmas, St Matthew’s Midnight Communion, Christmas Eve 2014

My sermon this evening is entitled the true meaning of Christmas.   I had decided on this title and this subject last Sunday because of something Steve said at the Carol Service.   I can’t quite remember what he said exactly but he said something like ‘These days people often tell us that we need to find the true meaning of Christmas but without specifying what that is’. 

And then yesterday I found that the Church of England has invited all its followers on Twitter to tweet what Christmas means to them in 140 characters using the hashtag: ‘ChristmasMeans’.   {Sorry if you don’t know what a hashtag is: you’ll have to ask a Twitter user.)

In response there have been thousands of tweets over the last few days – in particular from Bishops who tweet.   Tweets such as ‘#ChristmasMeans that in Jesus, God has given us the most precious gifts of all: forgiveness and hope’ from Justin Welby - the Archbishop of Canterbury.   And ‘#ChristmasMeans God in humility enters the heart of the world, once and for all, the eternal remedy for the deadly poison of our pride’ from Stephen Croft , the Bishop of Sheffield.

And then there are quite a few clever one such as ‘#ChristmasMeans God used means to save mean people’ or ‘#Christmasmeans the Meaning became moment, the moment became movement and the Meaning moved us’ both from Graham King, the Bishop of Sherborne.  But the best tweet with that hashtag I have found so far is: ‘ #Christmasmeans 'fun and feasting' says the Bishop for Ripon, James Bell.’   I’ll explain why I like this tweet best later.

Perhaps the attempt to summarise what Christmas means in 140 characters is a pointless, even impossible task, but clearly many Bishops and others can’t resist trying.   I am not sure sermon of about 7000 characters words (I’ve not counted) can do justice to the subject either.   And I am not going to tell you what I think what Christmas means.   I think it has multiple meanings and I think we have to work out what it means to us personally for ourselves.

Of course –I cannot resist leaving it at that.   Firstly of course I think we can assume – this being a church that – that the true meaning of Christmas has something to do with the story of the birth of Jesus – as told in two of the gospels, those by Matthew and  Luke.   And secondly that the search for the meaning is worth reflecting upon.

This search for the true meaning of Christmas seems to suggest that, somehow, we have lost something we previously had a hold on.   I wonder if that is true.  I wonder whether anyone – from Mary and Joseph onwards – and surely if anyone they would have good reason to understand the meaning of Christmas they would have - have had a good grasp on the meaning of Christmas.    

The idea that we have somehow lost hold of the true meaning of Christmas seems to go hand in hand with idea that Christmas has come to mean something other than what it should mean.   The complaint nowadays is generally that Christmas has become over-commercialised and t merely an excuse for over- indulgence – particularly of food and alcohol.   It goes without saying these things that Christmas has come to be are to be regretted and also that they are a modern phenomenon – never before experienced by previous generations.   I'm thinking that moaning that Christmas has come to mean something other than it should has been prevalent ever since Mary’s mother complained that the three wise men had spent too much money on completely inappropriate gifts for the baby Jesus. 

I begin to think that there is too much moaning about the commercialisation of and over-indulgence at Christmas: these after all are by-products of the fact that Christmas is and always has been a source of fun - in the words of the Bishop of Ripon - or more precisely a celebration to be shared in the form of hospitality and present giving.   If you are going to have fun then you need to spend money – and on more than the bare necessities.   After all a feast – again in the words of the Bishop of Ripon - is not just nourishment.  The communion we will share later is not just a meal it’s a feast.   You don’t need wine for a meal - water will do. 

I am not denying that commercial interests have attempted to hijack Christmas for their own ends nor that that have a tendency to consume more than is good for u, but the meaning of Christmas is constantly having its meaning changed by different ways of telling the Christmas story. Think here about Father Christmas.  

Is this Father Christmas anything to do with the Christmas story?   On the face of it no, because Father Christmas, Santa Klaus, St Nicholas, whatever you want to call him doesn’t figure in the story of Jesus’ birth.   On the other hand trying telling most children that Christmas has nothing to do with Father Christmas and they’d laugh and in a sense Father Christmas, Christmas trees even turkey are now part of the story which gives Christmas its meaning.  The question is whether we should resist this or go with it.  Some nativity plays apparently have Father Christmas bringing a present to the baby Jesus.  Does this really matter?  I think not.

So the meaning of Christmas comes from the story and the Church down the years – culminating in this year’s tweets – has sought to explain the meaning of the story.   The basic story - when you come to actually think about it is a bit strange - to have such apparent significance as to generate a festival that is celebrated each year in most countries of the world.

An unplanned pregnancy after a visit from an angel, a trek to a far-away town, a birth in a stable, visits to the new-born baby by complete strangers, a flight from a King who is trying to kill the baby: which of these parts of the story give it its meaning?   It’s the baby itself who figures in most of the tweets from the Bishop’s as if all the other characters in the story don’t matter in comparison and this is surely right.   After all, the baby is the main character.   

And of course the baby is no ordinary baby.   Extraordinary claims are made for this baby.   Actually rather a lot of claims – and this is where the true meaning gets complicated.   Referring to the baby, John – the writer of the fourth gospel – who tells us nothing about the circumstances of his birth, says that the baby was God ‘s word made flesh and dwelt among us.

But as Steve pointed out at the Crib service earlier today: the baby – the Word of God - says nothing in the story.   He does of course grow up to become an adult who says quite a lot.    But for the moment he is silent, even ‘no crying he makes’ if the Christmas carol is to be believed.  And there is a sense in which the meaning of Christmas cannot be put into words and perhaps we should let the baby be a baby and just celebrate his birth.   And that is why I like the Bishop of Ripon’s tweet best - #Christmasmeans fun and feasting