For author Dr. W. Lee Warren, death is a constant companion: He stares it down daily, previously on the front lines as a combat surgeon during the Iraq War and currently as a neurosurgeon specializing in GBM, glioblastoma multiforme, a lethal brain tumor.
In his latest book, I’ve Seen the End of You, A Neurosurgeon’s Look at Faith, Doubt, and the Things We Think We Know, Dr. Warren grapples with questions of religious faith as a practicing Christian and medical doctor. The novel chronicles his conundrum—equal parts an existential crisis and an ethical dilemma: How can he give hope to his patients who are destined to die from GBM? How does he believe in a God, when his faith is constantly tested as he witnesses the cruel, unfair, indiscriminate and senseless way death comes for people in their prime—children, young parents, professional luminaries. The essence of the author’s crisis of faith is the question we all ask ourselves at some point: “Why do bad things happen to good people?”
Faced with so much tragedy on a regular basis, the author feels at once relieved and a bit guilty at his good fortune. He is happily married to the love of his life, Lisa. They share a blended family of five children and they work together in his private practice. She manages the office and is his emotional confidant and rock. It all seems so perfect until it isn’t.
The novel progresses as a series of patient stories that Dr. Warren shares with the reader. He examines their brain scans, performs biopsies and frequently sees the end of their lives in the form of a glioblastoma tumor. He struggles with how to give his patients hope when he isn’t convinced God is listening to all of those prayers. He begins to find praying futile; no matter how much he believes in God, no matter how much he prays, he feels powerless to stop death’s forward march on his patients.
Dr. Warren’s skill at writing with empathy, raw honesty and introspection captures the humanity, dignity and despair of each of his patients. I found myself becoming emotionally attached to each dying patient, experiencing some of the same emotions as Dr. Warren—outrage, frustration, sadness and loss. As the reader, we witness how people can go through their darkest hours and still hold on to their faith. Their deeply touching experiences remain with me even as I write this book review.
Just as Dr. Warren believes his battered and bruised faith can’t possibly stand anymore, he suffers a very personal tragedy that brings him to his knees. “I realized that I was standing on the deathbed of my shattered faith.”
As the novel progresses, Dr. Warren confides in Pastor Jon, a hospital chaplain who encourages him “not to see prayer as an act of bending God’s will but rather an act of bending us to God’s will.” This only serves to confound him more as he tries to explain to Pastor Jon: “That’s awfully convenient, isn’t it? To fall back on the ‘God has a plan’ platitude when things are hard? That’s exactly what is bothering me right now, Pastor. I see somebody who’s going to die: I know they’re dead when I look at the initial MRI. But I’m supposed to pray for them, encourage them to have faith, believe they can make it, when I already know.”
Dr. Warren’s faith has been tested before, on the battlefields of Iraq where death, war and catastrophic injuries overwhelmed his makeshift hospital. It was 2005 and Dr. Warren was working a surgeon at the Balad Air Base in Iraq, often praying that God would deliver him through yet another attack.He struggles to defend his beliefs to his atheist friend and surgeon, Aaron. Back then, he admits “Something was nagging at my soul in the darker places I didn’t let myself look into often. Did I really believe, or did I believe I was supposed to believe?” He struggles to reconcile his duality as a man of faith and a man of science.
After returning to his practice in Alabama, the answer to his struggles slowly crystalizes: “My work had to be about learning how to live—in a painful world but still somehow be able to have faith.”
Through his spiritual and emotional journey, Dr. Warren discovers a profound truth. It’s only then that he can begin to reconcile his faith with the reality of tragedy and death. “My happiness cannot depend on my life being pain-free.”
At its essence, the novel is about accepting life as both a painful and poignant journey and being at peace with what we can not know for certain but believe with conviction. Dr. Warren sums up his writing as “a book about faith, doubt, and the things we think we know.” To doubt and to question the things we think we know doesn’t make us non-believers, it makes us better humans. We will never understand why “Bad things happen to good people,” but we can be at peace with the randomness of life and learn to cherish the beautiful moments.
Dr. Warren Lee is also the author of No Place to Hide: A Brain Surgeon’s Long Journey Home from the Iraq War