I’ve been speaking to various groups about my recently released book with Dr. Paul Brand, Fearfully and Wonderfully: The Marvel of Bearing God’s Image. An orthopedic surgeon by training, Dr. Brand served as a medical missionary in India, where he became a specialist in the disease leprosy.  Wherever I go, I find that people have a natural curiosity about that ancient and dreaded disease.

Myths and misconceptions abound. I often hear a comment like “I had no idea leprosy was still around!” In fact, some 200,000 new cases get reported each year, mainly in India, Brazil, Indonesia, and parts of Africa. Even so, leprosy ranks as one of the least contagious of diseases, for 95 percent of people have a natural immunity and wouldn’t contract the disease even if injected with leprosy bacteria.

Once diagnosed, the disease can be treated with a multi-drug therapy provided free by the World Health Organization. Within a year, active bacteria die off and the patient is pronounced “cured”; sixteen million people in the world have achieved that state. Many of them, however, learn that their problems are just beginning.

Dr. Brand and his team in India made the revolutionary discovery that leprosy does its damage by destroying pain cells. As a result, even “cured” patients, who lack the protective sensation of pain, must spend their lives vigilant against danger. They may twist an ankle and, feeling no pain, keep walking, doing permanent damage to muscles and tendons. Many go blind, lacking the gentle pain signals that prompt the lubricating blink reflex 28,000 times per day.

On a book tour in England I met an engineer from South Africa who showed me his scars. “See this?” he said, pulling up his trouser leg to reveal a prosthetic foot. “I poured hot water in a basin to wash my feet.  I couldn’t judge the temperature because of my insensitivity, and the water was far too hot.  I literally boiled my feet.”

Next, he rolled up his shirt sleeve to show me a large scar near his elbow. “And I got this one when a rat came in the night and gnawed on my arm.  I didn’t feel anything, so I didn’t wake up.”

Most of the major advances in the understanding and treatment of leprosy have come from medical missionaries.  They were the only ones willing to risk exposure at a time when leprosy victims were made to live outside the village and wear a bell to announce their presence.

“Leprosy is a devastatingly lonely disease,” Dr. Brand told me.  “In many countries its victims are kicked out of their homes, rejected by the community, and sometimes forced to live outdoors, by a pile of rocks or in a cave.  They lose contact with other humans.”

He told me of one memorable encounter.  “I was examining the hands of a bright young man, trying to explain to him in my broken Tamil that we could halt the progress of the disease, and perhaps restore some movement to his hand.  I expected him to smile in response, but instead he began to shake with muffled sobs.

“‘Have I said something wrong?’ I asked my assistant in English.  ‘Did he misunderstand me?’  She quizzed him in a spurt of Tamil and replied, ‘No, doctor.  He says he is crying because you put your hand around his shoulder.  Until he came here no one had touched him for many years.’”

Medieval leper bell. Photo taken by Cnyborg at the museum Ribes Vikinger, Ribe, Denmark, May 2005

Christian history includes episodes that rightly cause shame and embarrassment, but the response to leprosy victims makes a welcome balancing chapter.  The tradition of compassion traces all the way back to Jesus, who ignored societal rules against touching those believed to have leprosy.  Following his example, centuries later St. Francis of Assisi famously embraced a beggar with leprosy.

In the Middle Ages, as leprosy ravaged Europe, a strange rumor spread that Jesus himself must have suffered from the disease.  In the Servant Song of Isaiah (chapters 52-53), the prophet had described a man “disfigured beyond that of any human being…Like one from whom people hide their faces.”  In his Latin translation of the Bible, Saint Jerome had used the adjective leprosum to emphasize the disfigurement, and twelfth-century scholars took the word literally, as a prophecy of Jesus’ affliction.

Improbably, leprosy gained a reputation as the Holy Disease, and Christians in Europe sought out sufferers as representatives of Jesus, who had promised that, “whatever you did for one of the least of these brothers and sisters of mine, you did for me” (Matthew 25).  Defying cultural stigma as well as their own fears, devout Christians looked past the unsightly symptoms of leprosy and began treating its victims as they would treat Jesus.

Orders of nuns devoted to Lazarus (the beggar in Jesus’ parable of Luke 16, who became the patron saint of leprosy) established homes for patients—300 such homes in England and 2,000 in France.  These nuns could do little but bind wounds and change dressings, but the homes themselves, called lazarettos, helped break the hold of the disease in Europe, by limiting transmission and improving living conditions.  The disease virtually disappeared from the continent.

In the nineteenth and twentieth centuries, Christian missionaries spread across the globe to establish hospitals and clinics for leprosy patients.  Dr. Brand was supported by The Leprosy Mission, one of a network of Christian missions devoted to the disease.  “I’ve sometimes wondered why leprosy merits its own task force,” he told me.  “I know of no Malaria Mission or Cholera Mission.  Perhaps the reason traces back to the leprosy patients’ starvation for human contact.  Theirs is a unique and terrible privation, and Christian love and sensitivity meet it best.”

Whenever a social problem gets my attention today, I think back to the response of the church in the Middle Ages to the disease leprosy.  What would happen if the church treated every person with AIDS as they would treat Jesus?  Or every homeless person?  Or every immigrant?  We moderns have something to learn from a period of time often called “The Dark Ages.”  In at least one respect, they weren’t so dark after all.





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22 responses to “The Holy Disease”

  1. Anne Harmon Brett says:

    My parents, Johnny and Anne Harmon were patients at Carville. Dr. Paul Brand was my mother’s doctor and Dr. Margaret Brand was my father’s eye doctor. My father said that Dr. Brand was closest thing to Jesus Christ that he ever met. My copy of “Fearfully and Wonderfully Made” is autographed by Dr. Paul Brand. If there were a fire in my house, it would be one of the first things I would grab.

    “The Gift Nobody Wants” is another favorite. I especially liked the section about Dr. Brand visiting Stanley Stein in the later years of his life. I also have an audio tape of Dr. Brand’s speech to a medical school. He explains how he was experimenting with making shoes for mice. I remember my Mom wearing special shoes that Dr. Brand had the cobblers at Carville make for her.

    It may sound silly but I have a scrap of wood taken off a tree at Carville. A local physician gave it to me. He said that Dr. Brand was lecturing at the hospital when a huge thunderstorm erupted and lightning struck a tree. After the storm subsided, all the doctors went out and inspected the damage. Dr. Brand picked up the scrap of wood and handed it to the doctor. My doctor friend thought I should have it. It sits on my desk next to the photo of my Dad. The hands of one of the most incredible doctors that ever lived touched that scrap of wood.

    My father wrote his memoirs about Carville which I have made into a book. I dedicate the book to Drs. Paul and Margaret Brand. Although it is a simple little book, I would like to send you a copy. It may bring back some great memories.

  2. Anonymous says:

    Christians are so incredibly irrational.

  3. Willem Theuvenet says:

    Had the privilege of being trained by Dr Paul Brand and he has been my role model ever since. You mention that: “Dr. Brand and his team in India made the revolutionary discovery that leprosy does its damage by destroying pain cells”. Equally important he considered the consequences of muscle function loss as a major contributing factor to deformity, and Dr Brand developed many new surgical techniques to “re-balance” and restore the muscle function in the hand, feet and face! When we are capable of restoring this balance, even in the presence of loss of sensation, we may often be able to keep away our leprosy patients from advancing deformity and exclusion! But above all, he was a great human being and a true Ambassador of God” !!

  4. miran says:

    This is one of a kind because a prayer of a righteous man, avails much, since it is had without faith to please God, therefore, let us pray that God will increase our faith to overcome HIV and diabetes that is claiming most people in our generation yet with all all the healing scriptures with us.

  5. Larry Mais says:

    I should know by now to not read any of your posts unless a box of Kleenex is close by…

  6. Ann O'Malley says:

    And what would happen if we treated every person struggling with mental illness or addiction as if they were created in the image of God?

    There are more Christians serving these populations than most of us realize, though. Remember the movie “A Day Without a Mexican,” from 2004? I’d like to see someone make “A Day Without a Christian.” How many services to the suffering would shut down for that day? How many eyes would be opened to the humble sacrifices being made without any recognition? The popular media tend to show the ugliest side of every group, including Christians, while neglecting the good that they do.

    But I agree that we could and should do so much more. I pray for our eyes to be opened to ways to love society’s outcasts with God’s love, and for the revival that could bring to our country.

  7. Tim Ritchey Martin says:

    Church of the Brethren mission work in the 30’s 40’s and 50’s focused in Nigeria. There the Brethren established mission points and then Churches, schools and hospitals. In Garkita a leprosarium was established serving many in Northeast Nigeria for many years. In the 60’s all of this effort was turned over to Nigerians to continue the work as the EYN Church was established. Thank you for this blog and the wonderful work you and Dr. Brand did collaboratively. And thank you for the re-release of Fearfully and Wonderfully Made!

  8. Suleman John says:

    Beautiful writing as always Mr. Yancey. I want to add that in our country, the German nun Ruth Pfau did the primary work in treating leprosy patients, for which she was also awarded civil awards and was given a state funeral :3

  9. Chan H Bayne says:

    Thanks once again Mr. Yancey. Your first bookw/ Dr. Brand was just amazing. I am always inspired by your books. It is apparent that you don’t just “know about” Jesus and the gospel, but are intimately acquainted with both. God has blessed your writing. Thanks, Chan Bayne

  10. Lorry Lutz says:

    Thanks for continuing to stretch our minds deeper into Jesus’ teaching — teaching many of us should have found for ourselves. It often takes a special God-given intuition to realize the broader truths He taught. You have been gifted — and are courageous to continue to use that gift.

  11. Michèle Gyselinck says:

    Another group of diseases that are still heavily stigmatized, especially in evangelical churches, is mental illnesses. Some preachers even tell mentally ill people not to take their medications, and that they either lack faith or have unconfessed sin that causes their illnesses. They again, they also say that to people who have cancer or other illnesses. Maybe you could post a blog about “the Health and Wealth Gospel”?

  12. Jan Simmons says:

    I also read the novel Molokai about the leper colony in Hawaii. There is a sequel called Daughter of Molokai. Both paint sad and vivid pictures. Thank you for this column.

  13. Gladys Weaver says:

    My introduction to Philip Yancey’s writing, and the work of Dr. Paul Brand, was reading Fearfully and Wonderfully Made years ago. That book taught me so much, and I have recommended it to many people. It also caused me to seek out other books by Yancey and read them. What information and insights they have given me. Thank you, Mr. Yancey. Please keep writing.

  14. Brenda Vera says:

    Thank you for this article on Leprosy and the application for us as Jesus followers! I recently read a book called Molokai’ about the Leprosy colony in Hawaii around the time frame of WW2. Their isolation on the tiny island became consecrated ground because the love of Christ was evident in the priests and nuns who gave their lives to care for the orphans there. I have been encouraged to “go and do likewise”! Thank you Philip!

  15. Andrew Parris says:

    Thank you Philip for this insightful post. Yes, the church shines brightly (and brings praise to God) when she cares for the poor and needy. Many nonprofits and NGOs such as World Vision (which I used to work for) and Medair (which I now work for) continue this good tradition of the church of caring for the most vulnerable by helping them in their time of need and helping them to be better able to handle future challenges. But this is something that each of us can also do in our communities.

  16. Pamela Wood says:

    Thank you! I knew some of what you provided but, certainly, not all. May we be as willing to pour ourselves out for those who are hurting and needy as our CHRISTian forebearers.

  17. margaret kuhl says:

    Dear Philip,
    I have read ” The Gift of Pain…” countless times. Each time thankful for the pain signals that I have that tell me what to do and what not to do.
    Thank you for walking along side Paul Brandt and telling his story.

  18. Don Kidd says:

    A few years back I had the unexpected privilege of visiting a community in Bihar, India where lepers lived and were treated. I could not take pictures, not because of disfigurements, but because I felt that somehow I was on holy ground. One woman who was greatly disfigured wanted to sing a song for us. It was quite lengthy. When she was done our interpreter explained that she had just sung about Jesus’ life, from birth to cross to resurrection. So humbled. So challenged.

  19. John Isaak says:

    Thanks for ALL your very inspirational writing.
    I’ve read every single document with your name on it that has crossed my path.
    I’m absolutely convinced that you are divinely inspired.
    Thank again.

  20. Margaret Stromberg says:

    The novel Molekai helped me recognize the cost to patients…

  21. Sharon Peck says:

    I’ve always liked reading Yancey’s writings. My first e-book is his recent one-Fearfully and Wonderfully. Thank you for sharing your communication gift so beautifully. Grace and peace to you.

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