I will never forget the first patient I failed.
The fear swimming in his eyes still haunts me. The lightest pressure of my fingers on his abdomen elicited a guttural groan, a wordless plea wrenched from the depths of delirium. Then his glazed eyes locked with mine, and language resurfaced. “Stop!” he growled.
I backpedaled and felt my cheeks flush. As a medical student, I was eager to help, but naïve, and terrified of overstepping my boundaries. I mumbled an apology and slipped from the room. At the end of my shift in the emergency department, I stammered an incoherent narrative to my supervising physician, and with my face still ruddy, skulked out of the hospital.
A few months later, I remembered this poor gentleman, and the memory stopped me cold. Equipped with more experience, I realized that I had missed peritonitis, a harbinger of catastrophe that shocks the abdominal muscles into a rigid wall. I hadn’t recognized the ominous meaning behind his groans. I failed to diagnose the disease festering within his belly, the infection that leached more bacteria into his bloodstream by the second. I had endangered someone entrusted to my care.
The gravity of my error crushed me. Never again, I vowed. For years afterward, the sickening weight of remorse infused every moment with anxiety and compelled me to check serially on my patients to the point of absurdity. Desperate not to harm someone with another mistake, I obsessed over every data point, and awoke in the middle of the night to scour medical records from home.
My compulsiveness helped future patients, but it could never reverse the errors I had already committed. No matter how many people I returned home to their families, I was never able to sponge away the stain of my failures: my suture lines that did not hold, the bleeding I could not stop, the infections that swept over wounds I had dressed. The gentleman whose eyes pleaded for help at the touch of his belly. Diligence could not expunge the guilt that loomed like a gray specter over my heart.
The American Gospel of Try Harder
The American dream purports that our justification hinges upon working hard enough. In the land of opportunity, it asserts, effort and success are bound in a one-to-one correspondence. Work hard enough, and you can forge your own destiny. Perform enough good deeds, and you can repair a broken past. In this fallen world, however, such assertions are deceptive.
The truth is that no matter how dutifully we strive to do good, crookedness still lurks within our hearts and works its terrible poison. “God looks down from heaven on the children of man to see if there are any who understand, who seek after God,” the psalmist writes. “They have all fallen away; together they have become corrupt; there is none who does good, not even one” (Psalm 53:2–3). Sin afflicts even those most faithful to God, “For I do not do the good I want, but the evil I do not want is what I keep on doing,” writes Paul (Romans 7:19). David, a man after God’s own heart, similarly laments, “I know my transgressions, and my sin is ever before me” (Psalm 51:3).
Guilt debilitates us because while we strive to make amends, inwardly we know that we transgress against God, and that before him we cannot redeem ourselves. “Against you, you only, have I sinned,” David confesses to the Lord, after plotting Uriah’s murder for his own lascivious desires, “so that you may be justified in your words and blameless in your judgment” (Psalm 51:4). The Bible teaches that justification does not follow a system of checks and balances. Contrary to the assertions of some Eastern religions, we cannot tip the scales in our favor, accruing deposits of karma to overshadow the evils we have committed. We serve a God who is holy (Psalm 22:3).
Even when we labor toward righteousness, sin muddies our hands, blackens our hearts, and condemns us before the author of all goodness (Romans 3:23; Isaiah 64:6). We know that however frantically we strive, when we present our deeds before the Lord, we will crumble beneath the weight of our wrongdoing. “If you, O Lord, should mark iniquities, O Lord, who could stand?” (Psalm 130:3). And so guilt bears down upon us daily, twisting us from within. No deed, no fruit of human will can unyoke us from its sinister burden. We deserve death. We cannot atone for our sins against our great, holy God.
So God redeems us instead. This is the magnificence of the gospel, the breathtaking good news to which we cling. We sin; Christ saves. We are guilty; God gives us grace.
God’s Gospel of Grace
When the heavy burden of remorse presses down, we can neither ignore our wretchedness, nor correct it with desperate strivings. Yet the churning pangs of guilt that torment us direct us to the cross. Beneath its imposing shadow, we encounter the stunning breadth and depth of God’s grace. We deserve no pardon. Our hearts are corrupted. And yet, God sacrificed his own, blameless Son to cleanse away our sins, “For our sake he made him to be sin who knew no sin, so that in him we might become the righteousness of God” (2 Corinthians 5:21).
Where we have only defilement, and sin, and guilt, Christ renews us, such that we become the righteousness of God. He washes our stained hands in righteousness. He molds our contorted hearts with righteousness. He wipes away our jealousy, greed, deceit, and pride, and scatters our filthy rags like waves breaking from behind a ship, leaving only righteousness shimmering in their wake. And not righteousness of the world, but of God! Holy, unblemished. Made new.
Guilt steeps us in misery, but the cross washes us in living hope (1 Peter 1:3). When we repent and place our faith in Jesus, we embrace the magnificence, benevolence, and exquisite vastness of God’s love for us (John 3:16). Jesus laid down his life for us out of love (John 15:13). That love has the power to redeem us, to mend our fractured souls, to undo all the evils our feeble hands cannot repair.