DEVOTIONAL
About Hernias and
the Holy Spirit
 
What I learned about salvation as a surgeon
 
 
As a surgeon, my mission is to repair broken people.
 
Yet even after pouring the majority of my life into the pressure cooker of academia and the indentured servitude of surgical residency, these purportedly talented hands can actually do but little to that end. I cannot heal the spirit. I cannot heal the soul. In fact, I am incapable of healing the body.
 
Granted, I can skillfully cut and sew. Yet full healing depends on the body itself joining together, incorporating the prosthetic material, or raising an immune response after the gangrenous appendix, bloated gallbladder, or cancerous mass has been extirpated. All these require the action of what I would call biologic grace, the body’s amazing, God-given ability to regenerate and overcome. 
 
None Righteous, No Not One 
The quip “physician, heal thyself” (see Luke 4:23) exposes a fundamental fault apparent to all introspective physicians. We work for the healing of others while we ourselves are broken. That brokenness may be in our own bodies, as we are notoriously poor stewards of our own body temples and have a life expectancy that is shorter than that of the average patient. This inner brokenness may be revealed in an unhappy spirit, ungoverned emotions, and deep relationship failures. Most certainly this applies to the soul and our relationship with God. We need a Healer, and the farther we wander the more broken we become.
 
In an effort to regain that lost distance, to rediscover and experience anew the reality and blessing of our hope of salvation in Jesus Christ, I have turned again to the treasure of His Word and the light given to Adventists as a people. In this search I have been struck by the surgical nature of the Holy Spirit’s work. “The sanctification of the soul by the operation of the Holy Spirit is the implanting of Christ’s nature in humanity.”1
 
These are surgical terms used here by Ellen White. Contrary to popular usage, surgeons do not perform surgeries; they perform operations.2
 
Foreign material incorporated into the body is an implant—be that in the form of prosthetic mesh, alloys, donated tissues, etc. This quote is reminiscent of the many hernias that I treat in my practice, and leads me to compare herniorrhaphy (hernia repair) with salvation.
 
Hernias, like sin, are common to humanity and found in all ages, genders, locales, and peoples of the world. There are myriad subtypes of hernias, yet most occur in rather customary sites—in areas of congenital or acquired weakness, such as the groin, the navel, and surgical scars. Despite their differences, all hernias carry the same potentially fatal risk of incarceration and subsequent strangulation, the involved organ becoming trapped in the hernia and then having 
its blood supply compromised, respectively.
 
Being Justified Freely by 
His Grace … 
For patients presented with this life-threatening condition, treatment involves two separate and critical components: reduction and repair, comparable to salvation’s components of justification and sanctification. Survival of the herniated organ depends upon its urgent reduction by pressing it back into its proper anatomic residence.
 
Hernia reduction is an art, something learned through years of study and practice. Often I am called to the emergency department to evaluate patients with supposedly incarcerated hernias, which have resisted the most determined attempts of the emergency personnel.
 
Why do they call me? I am paged because my hands are more skilled in this regard. They have been through the fires of surgical residency; they have conquered a legion of hernias, reducing them and performing their definitive repair. In like manner we are all dying spiritually and eternally, unless we are touched by a pair of qualified hands. Not mine, but Jewish hands bearing scars from previous impalement. He can succor. He can save. He alone can justify the soul. 
 
And This Is the Will of God, Even Your Sanctification … 
Though reduction of the hernia resolves the immediately life-threatening concern by restoring correct anatomic arrangement and blood flow, it does nothing to address the underlying problem—the physical defect that caused the apparent affliction. Were the hernia only reduced, it would again protrude and risk strangulation. So the underlying condition must be treated.
 
Herniorrhaphy today typically involves an implant of mesh—a woven, porous sheet of polypropylene, polyester, collagen, or other material. This mesh is sutured in place, yet the true strength of the repair is achieved over the ensuing weeks as the body incorporates itself into the interstices of the mesh. Similarly, the work of the Holy Spirit is to operate, implanting not mesh but the nature of Christ. This is no inanimate prosthetic; it is in reality a living graft. Like scion on the stock. “Abide in Me, and I in you,” Jesus said (John 15:4). When Jesus’ nature is implanted into me, when through the daily (and, at times, painful) process I grow into Him and He grows into me, then I am part of Him and He of me. 
 
Not by Works, Lest Any Man Should Boast … 
Periodically, a patient will ask me what exercises they can perform to fix their hernia. They believe that the problem is a muscle weakness that they can remedy by strength training. In fact, the deficiency is not in the muscle itself, but in the sheetlike connective tissue, termed fascia, which gives the abdominal wall its actual strength. Sadly, once this is torn or incised the body is generally unable to repair itself without the intervention of a surgeon, for whom “a chance to cut is a chance to cure.”
 
 I cannot heal myself, no matter what exercises or maneuvers I perform. My greatest efforts are at best but a hernia truss, a mechanical brace that merely presses on the hernia site to minimize discomfort and make the bulge less noticeable. I need the Great Surgeon, who alone can heal me. 
 
There, but for the Grace of Christ, Go I 
While all analogies fail eventually, let us in closing extend this one step further, looking beyond our own navels to consider God’s lost children. Rather than sitting in judgment and condemnation as the supposedly righteous are prone, let us approach sinners as we would our loved ones with hernias. “We must set ourselves against sin, as we do against sickness and diseases, by showing ourselves tender and compassionate to the sick and diseased.”3 Then we can be emissaries of grace to the fallen, not driving them away, but drawing them toward the Great Surgeon. 
 
1 Ellen G. White, Selected Messages, vol. 3, p. 198, cf. The Advent Review and Sabbath Herald, Dec. 4, 1894, and The Advent Review and Sabbath Herald, Apr. 9, 1895. 
2 Surgery is what a surgeon practices. An operation is what a surgeon performs. In this context, there is no such word as surgeries. In Great Britain, surgeries are treatment rooms. Neither an operation nor a patient is a case, but that’s another commentary.”—C. J. Allen, Archives of Surgery 131 (1996): 128. 
3 William Law in “A Serious Call to a Devout and Holy Life” (London: Printed for WILLIAM INNYS, at the West End of St. Paul’s, 1729) chapter XX (see www.anglicanlibrary.org/law/serious/).