The Theology of BYU Med

Sometime in the next few years, BYU will open a medical school. This is likely the only time this will ever happen within the confines of The Church of Jesus Christ of Latter-day saints. As a proud graduate of BYU and a doctor myself, I have spent a great deal of time thinking about what the opening of the BYU Medical School means and what such a school might contribute to the wider medical discourse.  

To outline the importance and potential of restored Christian theology in contributing to that discourse in the twenty-first century, let’s consider the problem that I believe a BYU medical school could help to solve as it pertains to medicine and the medical workforce. Then we’ll look at ways those same problems are reflected more broadly in society.

Over the last thirty years, the landscape of medical care in the United States has been transformed almost unrecognizably, proceeding along three important fronts. First, medical care has become corporatized in a way that is historically unprecedented and that was largely unanticipated. When I graduated from medical school some fifteen years ago, many recent graduates would go on to careers as solo practitioners or as members of very small groups. The last few decades, however, have seen the remarkable growth of health care corporations that increasingly buy up the solo practices of various doctors, transforming them from a kind of entrepreneur into employees. While this corporatization of medicine undoubtedly has some benefits—for example, many doctors now spend less time on the business side of medicine—it has left many medical providers feeling isolated, disempowered, stranded, and underused.

Second, medicine has undergone a technological revolution. Previously, doctors spent most of their time directly interacting with the people who are their patients. After all, what else would a doctor do? Increasingly, however, doctors spend significantly less time interacting with people and much more time interacting with computers and other screens. Indeed, in multiple studies, GPS tracking has demonstrated that in many cases, doctors now spend more hours tending to computers than to people. While no one would argue for returning to the days when medical records were kept in endless rows of three ring binders, the process of technological innovation has also undoubtedly left many doctors feeling bizarrely cut off from the very people they are meant to serve.

Finally, over the past few decades, medicine has also undergone a philosophical transformation. Multiple forces, including those listed above, and likely a shift in the cultural zeitgeist have left doctors increasingly feeling like machinists for very complex robots. It is as if, instead of caring for other people, doctors find their work so fragmented and their approach so technocratic that it often feels as though their job has been emptied of its spiritual or existential essence. This shift is more difficult to prove but no less potent for its subtlety. It is a change that haunts the current landscape of medicine.

In my view, these changes have not limited themselves to the practice of medicine. It seems that each of these changes has parallels in wider society. Increasingly, people in many walks of life feel that unjust capital accumulation has left too many of us at the mercy of too few. This process of corporatization and centralization of resources strikes me as one of the most haunting problems of the twenty-first century. By the same token, overly swift technological changes have left many of us feeling as though we are adrift in an unfamiliar sea, on the cusp of being overtaken by generative artificial intelligence, the Internet, smartphones, Google, social media, and all the rest. And, again, in part for all these reasons, it often seems that an existential malaise has settled over large portions of the populace. It is not for nothing that the leading cause of death in many demographic subsets has come to be called “deaths of despair.”

It is in this fraught atmosphere that I believe the theology of a BYU medical school could find profound resonance. I recognize, as a doctor at an entirely secular university, that this idea seems uncomfortable, even contradictory. What possible impact could the theology of a brand new, probably small, untested, unproven, and heretofore entirely unknown medical school tucked in the valleys of the intermountain west possibly have on the larger practice of medicine? Still, we should begin by recognizing that this is not an entirely novel idea. For example, Loma Linda University Medical School in California already pursues a very similar mission. Loma Linda’s stated mission beautifully reflects the values we might imagine for BYU Med:

Affirming the Christian view of wholeness—which recognizes that the needs of patients go beyond the healing of the body, and that the development of students involves more than the training of the mind; promoting physical, intellectual, social, and spiritual growth in our faculty and our students; and transforming our daily activities into personal ministries. "To Make Man Whole."

All of this is to say: BYU will not be the first to enter the fray here. Rather, we will enter a medical educational arena where we will already have allies in fusing the theological, the physiological, and the pharmacological. My hope is that we will embrace this allyship with gladness and enthusiasm.

At the same time, it remains true that we are a distinct branch of Christianity. There are specific and distinctive theological insights we will bring to the realm of medical education that I hope will help to strengthen our potential as healers. I see four fundamental tenets of our theology that I believe position us to bring a unique beauty to the way in which we seek to alleviate suffering.

First, as members of The Church of Jesus Christ of Latter-day Saints, we have a deep and thorough belief in the beauty and holiness of embodied mortality. We do not see this mortal coil as a burden to be shuffled off when we finish our time on the human stage. Furthermore, we do not believe that our noble spirits are at war with our fallen bodies or that our earthly desires were forged in sin and are meant to be purged. We believe, instead, in bodies that are meant to be embraced and celebrated—in human organisms constructed of the same stuff as the very stars and of souls that will outlive those same heavenly bodies. Furthermore, believing literally in a bodily resurrection, we also embrace the notion that something about embodiment is eternally important. Therefore, in our theology, the taste of a summer blackberry on the tongue, or the ability of the human form to climb a mountain, or the bringing together of two beings in a lovers’ embrace, or the sensation of smelling a favorite aroma, are not just interesting phenomena or passing mortal fancies but, instead, part of the very fabric that makes up eternity.

Given this, the practice of medicine takes on a sacred valence. Perhaps, in this vein, it is not for nothing that I must imagine that ours is the only worldwide church in history to be led by a heart surgeon. There is something both fundamentally prosaic and yet strikingly sacred about a prophet who for many years earned his keep by replacing or repairing heart arteries and heart valves. Within our theology, fixing the mortal body is not only a way to extend our time on a passing earth but also carries echoes of whatever fundamental change will eventually come to make our bodies perfect and eternally whole. In this regard, my deep hope is that our theology can help to address the call of Abraham Verghese, perhaps the preeminent physician-author of our generation, who wrote in 2008: “For the clinician, the bedside is hallowed ground, the place where fellow human beings allow us the privilege of looking at, touching, and listening to their bodies. Our skills and discernment must be worthy of their trust.”

Second, just as we as church members embrace the divinity of embodiment and see our bodies as being made of the same eternal substance as our souls, we likewise also accept the eternal nature of opposition. It may seem strange for me to cite this as one of the theological offerings we have to present to the world, but I believe the case for this is inescapably strong. A crimson thread that winds its way through our theology is that the universe is constitutionally oppositional. After all, Lehi teaches his abused son Jacob that there is “an opposition in all things.” I cite this belief as being possibly transformational in the following sense: If we believe that the suffering manifest all around us in this world is merely a temporal state of affairs, meant to be endured for a short season so that it can be left behind in the eternities once this fallen world has passed away, we might be left to feel that the most important thing would be, precisely, to move beyond fraught temporal concerns and to focus our thinking, instead, on heavenly things. In our theology, however, we learn that the universe will never stop being oppositional. And, because this is the case, we come to understand that the world is a wound that is meant to be healed but, paradoxically, that healing can never be complete. In other words, our theology suggests that suffering will always be the natural state of sentient beings who exist in an oppositional universe and, therefore, our theology suggests that there will always be the wounded who need ministration. In his conversation with us on our podcast, The Doctor’s Art, Dr. Elisha Waldman described working with suffering children as a pediatric palliative care doctor: 

I don’t know the answer when you get to that molten core of suffering, when you sit with a patient who’s just ‘in the fire’ and you don’t know what to do. I am not sure, beyond presence. Human presence. There is an ineffable mystery that is great as well as terrible sitting at the center of all of this. And, you know, it’s an honor and a challenge and beautiful and awful to be a part of it—all rolled up into one. 

And that brings us to the third and perhaps most substantive contribution that Latter-day Saint theology can make to this wounded world. One of the aspects about our religion that most insistently strikes me is this: Ours is not an abstract or theoretical faith. I cannot be an engaged member of The Church of Jesus Christ of Latter-day Saints by shutting myself up in my office and reading, or praying, or writing, or doing any other individual exercise. I am not in any way questioning the need for and value of personal devotion. To the contrary, personal devotion constitutes an unmistakably important aspect of my spiritual life. But given our belief in a foundationally oppositional universe, with the result that we will always be surrounded by those who suffer, I believe the central ethic of a Latter-day Saint life is, precisely, to seek to heal the wounded, to lift the poor, to assuage grief, and to minister to the suffering in every guise. We know this is true because we see it reflected in the language describing the life of Latter-day Saints who are bound by ordinances and covenants to try to emulate Jesus.

After all, the foundational covenant by which we enter into the Latter-day Saint faith is baptism, and Alma reminds the people at the waters of Mormon that the fruits of this covenant include an instinct to mourn with those who mourn and comfort those who stand in need of comfort. Similarly, when the Lord articulates the way in which we will know that priesthood power is being righteously exercised, he focuses squarely on the way the powerful use their power to help the powerless. In other words, the central ethical imperative of all priesthood authority is to walk justly and love mercy and to let that impulse be our ethical north star. Finally, it is striking that in the temple we are invited to bind ourselves by covenant, precisely, to sacrifice on behalf of those who are in need. To live the self-sacrificial law outlined in Jesus’s Sermon on the Mount. And, finally, to consecrate all that we have and are, in effect, to healing the wounds of those around us and to making the world a better place.

I believe that these principles offer a substantive moral scaffolding that, if embraced carefully, can equip us to bring something beautiful and unique to the world of medical education. But even in this recognition there lurks a challenge that has often hindered our cultural ability to fully embrace the light and beauty of the restored Gospel of Jesus Christ. If we are not careful, our conceptions of our own theological distinctiveness can poison the very humility needed to fully embrace the beauty of that theology. If we do not take care, we can end up like the Zoramites from the Book of Mormon, who ascended their Rameumptom precisely so they could crow about their distinctive spiritual specialness.

Thus, even as we recognize the beautiful truths that can allow our branch of Christianity to contribute meaningfully to the healer’s art, perhaps the greatest truth we must concurrently recognize is this: we are, all of us, broken. Indeed, we are all sick and in need of healing. The world cannot be divided into healers and sufferers—into those who are whole and those who are sick—every one of us is in desperate need of grace. There is not a single person among all the sojourners in this world who is not, as King Benjamin reminds us, a beggar. 

I believe the opening of the BYU medical school has the chance to help us collectively embrace a truth that has often proven elusive to our body of saints. Historically, we have often inclined, for example, toward lionization of our leaders. Similarly, we have sometimes strayed into imagining pioneer ancestors who crossed the plains as virtually without flaws. Even now, we tend to regard our current leaders as Mary Poppins prophets—practically perfect in every way.

But the advent of the internet and a decade of widespread historical reassessment have rendered these hagiographic impulses untenable. Increasingly, when we pretend that we as church members have it all figured out, or that we alone possess the truth, or that we are meant to be saviors for a weary world, we crash up against craggy shoals, recognizing that sometimes we don’t have much figured out, sometimes we are prone to falsehoods, and sometimes we are the sufferers who find ourselves in need of saving. This theological insight may initially strike us as uncomfortable—but a school meant to teach the practice of medicine can remind us that this reality is woven thickly into the fabric of being human. After all, any experienced doctor will tell you that experience soon disabuses her (or him) of the notion that he is a whole being out to save the broken. In medicine, we have only messy humans, riddled themselves with imperfection and disease, out doing their best to care for other humans who bear similar burdens. We are, all of us, traveling unidirectionally toward an inevitable grave with all the mystery and suffering such a mortal ending portends.

In all of this, we can remember that the most important goal of this new medical school must be to center its healing mission in the Savior, Jesus Christ. We recall that Jesus willingly descended below all things. It is a bracing fact to know that the savior of the universe was born into mortality, squeezed through a birth canal, and covered in amniotic fluid—just like every other mortal who ever came here. Undoubtedly, he stubbed his toes and jammed his fingers and became ill with disease long before being whipped mercilessly and then having those same hands and feet nailed to a cross. It is a thing of deep theological substance and visceral physical resonance that multiple Book of Mormon prophets, among them Nephi, Benjamin, and Alma, remind us that Jesus did not suffer abstractly or only in theory. He did not simply sit in a celestial classroom and take courses on what it might be like to be a human and to suffer. Instead, in that memorable Book of Mormon phrase, he actually came to Earth and suffered “according to the manner of the flesh.” 

And he did all of this precisely because he loves us.

Perhaps we can finish by quoting a man who, while not a doctor, reflects in his lifelong work a physician's very best impulses. Toward the end of his magisterial book, Just Mercy, Brian Stevenson outlines a case where he had fought for leniency for a client who was sitting on death row, only to learn his appeals for mercy had been denied. After the prisoner is executed, Mr. Stevenson finds himself weeping, reflecting on his inability to help this particular friend. Of that epiphany, Mr Stevenson writes:

We are all broken by something. We have all hurt someone and have been hurt. We all share the condition of brokenness even if our brokenness is not equivalent.  We all have our reasons. Sometimes, we're fractured by the choices we make, sometimes we're shattered by things we would never have chosen. But our brokenness is also the source of our common humanity, the basis for our shared search for comfort, meaning, and healing. Our shared vulnerability and imperfection nurtures and sustains our capacity for compassion.

This stands as one of the most morally insightful and ethically resonant passages I’ve read. I am confident that Brian Stevenson is cut from the same cloth as King Benjamin precisely because this quote seems composed of the same substance as King Benjamin's reminder that we are all, in the final account, beggars in need of the grace of Jesus. Thus, BYU Med’s most compelling purpose may not be to bring a certain set of truths to the world—as important and beautiful as those truths may be—but, rather, to remind all of us, especially those of us who are members of The Church of Jesus Christ of Latter-day Saints, that we are very much broken together, that we are all in need of healing, and that the physician-in-chief is not a dean, or a surgeon, or an internist, but Jesus Christ, the Savior of the world. It will forever stand as a stunning theological fact that the one who came with healing in his wings needed to achieve that healing ability precisely by being broken. It is my hope that this stunning paradox will underlie all that happens at our new medical school. 

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Art by Carol Bloch.