case histories

The following sayings illustrate the negative mindset of cynics on campus and to patients on ward rounds:

• 'God's only excuse is that he doesn't exist' (1)
• 'He's a born-again Christian. The trouble is, he suffered brain damage during rebirth.'
• 'Life is a sexually transmitted disease and the mortality rate is one hundred percent.' (2)
• 'To turf. Verb: To find any excuse to refer a patient to a different department or team.'

But medical students are far less cynical than doctors. They are often admired for their breezy optimism and activism. Only one thing can account for the slide from optimism to world-weary and suspicious cynicism: experience.

For instance, I recently investigated an outbreak of vomiting, causing dozens of staff to take sick leave, whilst I struggled on an understaffed unit. But the path reports showed that it wasn't the expected Norwalk or Rotavirus, it was Salmonella from the patients' canteen egg rolls. So either staff had faked a sickie, or they had been eating patients' food. Which was more likely, I wondered? Cynicism is all about the breakdown in trust. We see it when colleagues routinely Datix their colleagues in retaliation, sometimes pre-emptively(!), when a quiet word would be more constructive.

Patients record consultations on their phones 'just in case anything goes wrong', and the only thing rising faster than patient litigation is your medical defence subscription.

Perhaps our leaders in the NHS are more noble. A few years ago, a health minister resigned without scandal, apparently to spend more time with his family. That's laudable. But a sharp-eyed CMF member (now working in the student department) discovered him a year later on the board of a company manufacturing MRI scanners for the NHS. (3) The same minister who lobbied in government to give the contract to this company. The same minister who had campaigned to prevent doctors from working in the private sector. Self-interest! Double standards! These are the things that make doctors cynical.

anatomy: definition and historical roots

What exactly is cynicism? It is the distrust of others and assuming they have false motives. Its not the same as skepticism, doubting truth. Cynicism doubts people. To the cynic, he dare not trust, because there is nothing but selfinterest in the world. This mistrust can be applied to several areas of life. For doctors it may be compassion fatigue that leads to cynical characters in dark medical dramas like MASH, House of God, Cardiac Arrest and House. Disappointment in romantic relationships can leave us wary and cautious. And few people today instinctively trust institutions such as government, the police or even church.

However, cynicism was not invented by Dr Cox. (4) A century ago the modern 'masters of suspicion', Marx and Freud gave cynicism intellectual respectability, particularly as an assault on faith. They weren't questioning the factual basis of religion, but going behind them to the motivation for holding beliefs. Marx encouraged the suspicion that religion (Christianity in particular) was attractive to believers because of its economic and social incentives, as it legitimised the status quo with 'The rich man in his castle, the poor man at his gate'. (5) The poor are taught to accept their station, sedated by the 'opiate of the masses', awaiting compensation in the afterlife for their sacrifices. Meanwhile the rich can use religion as a smokescreen to justify selfishness, as they thank providence for their dominance. Like Nietzsche, Marx portrayed Christian morality as deeply suspect.

Freud also claimed to see through faith claims, but saw psychological rather than economic pay-offs. Drawing on Feuerbach, he saw God as a crutch for our fears and inadequacies. We are weak and corrupt, creatures helpless before the blind forces of nature. As our childhood feelings of helplessness are eased by the belief in our parents competence, so deep down our belief in God is wish fulfilment, particularly in the face of death. A father in heaven is an infantile projection that offers consolation and a crutch in time of need. Christian teaching was rooted in psychological needs, not divine reality. Freud found that he was most persuasive in theological debate not when tackling the issues themselves, but by making his adversary feel embarrassed by their motivations for belief. It's curious that the father of therapy pioneered shame as an academic weapon. It was a cynical move, playing the man and not the ball.

But cynicism is older still. The word cynic is often ascribed to Diogenes (412–323 BC), a Greek philosopher, because of his canine lifestyle (the words have the same root in Greek). He lived in a barrel, on the street like a dog, as if to say 'you and me baby ain't nothing but mammals'. (6) In his time, Diogenes acted out his suspicion that human integrity does not exist in a humorous way. He took a lamp in broad daylight through the streets pretending to look in vain for an honest man! Perhaps you've heard similar messages in lectures. Evolutionary psychology reduces all human behaviour ultimately to self-interest, or the selfish genes that have shaped us. It's a dog-eat-dog world; altruism, love and God are all delusions.

embryology: emotional and spiritual roots

But cynicism is older than Diogenes. Perhaps the biblical term for a cynic is the mocker or scoffer, (7) who avoid seriousness or earnestness at all costs. We all know people like that. Perhaps it is particularly unfashionable to hold truth commitments in our postmodern age. Cynicism offers a defense against potential scorn.

The author Douglas Coupland observes:
• Knee-jerk irony: The tendency to make flippant ironic comments as a reflexive matter of course in everyday conversation
• Derision pre-emption: A life-style tactic; the refusal to go out on any sort of emotional limb so as to avoid mockery form peers. Derision pre-emption is the main goal of knee-jerk irony (8)

So behind the flippancy and mocking, cynicism may be a form of self-protection to prevent disappointment. If you trust no-one, no-one can let you down. Even the hardnosed philosopher Nietzsche wrote 'when trodden on a worm will curl up. That is prudent. It thereby reduces the chance of being trodden on again. It is the language of survival.' (9) When we are burned by past experiences, it's tempting to curl away from the muddy boots of the world.

But the king of cynics appears in the book of Job. Like the philosophers of suspicion, he claimed that there is nothing but self-interest in the world. Apparent goodness and faith is always instrumental, just a means to an end. His very name means the accuser. His name is Satan, and his slogan is 'TRUST NO-ONE' especially God. Right back in Genesis, God had trusted Adam with Eden, and Satan's message had been 'God doesn't trust you! He knows that if you eat the fruit you will become like him! Don't trust him!' Later, Satan tells God that he can't trust Job, because his faith is only skin deep, he's only in it for what he can take from his heavenly sugar daddy. But God challenges him to consider his servant, whom he trusts will be vindicated. We will return to him later.

physiology: what's right with cynicism?

sham virtue has always offended God.

Firstly, the Bible encourages us to be suspicious of just the kind of fake virtue and deception that cynics are so wary of. The Bible has plenty of biting satire, irony and even sarcasm to make this point. (10) The prophets and Jesus both warn us 'watch out', (11) 'let no-one deceive you', (12) 'be on your guard', (13) 'beware of' self-serving rhetoric. (14) Cynics are right to expose it.

naivety is not a biblical virtue

Jesus was no fool. He knew the hearts of men, (15) and warned: 'I am sending you out like sheep among wolves. Therefore be as shrewd as snakes and as innocent as doves.' (Matthew 10:16)

My GP trainer was also shrewd. She once saw a driver knock off a wing mirror on a parked car. The driver got out and he wrote a note on the windscreen. She thought that was unusual so she went and checked. It said 'everyone thinks I am leaving my number but sorry love, this is London!' She amended the note 'I am also a Londoner, and witnessed a driving offence by the car with this number plate…' Busted! We need to be shrewd because the world is full of wolves.

pathology: what's wrong with cynicism?

physicians heal yourselves!
Question our own hearts first.

However before we get too self-righteous, Jesus tells us to target our suspicions. Guess where? Remember Jesus' saying about the blind ophthalmologist? 'How can you say to your brother, "Let me take the speck out of your eye," when all the time there is a plank in your own eye?' (Matthew 7:4)

We need to be suspicious of our own hearts first! We can barely fathom our own hearts, let alone someone else's: 'The heart is deceitful above all things and beyond cure. Who can understand it?' (Jeremiah 17:9)

When I was at university, I was a lazy student. In the summer term I sidled up to the more studious female students who had taken copious notes and asked pleadingly if I could borrow their revision notes. I remembered being unusually friendly, taking particular interest in their hobbies, and was delighted when their notes got me better results in the exams than any of them. But I knew I had used them. It was cynical. Self-justification is the default mode of the human heart, and we should be quick to judge ourselves before others.

But, the cynics claim goes much further: they say that there is absolutely nothing else but self-interest in the world. It's a totalising or universal claim. For instance, it's one thing to notice that a politician once tried to claim a duck house on expenses. (16) It's another thing to say all politicians at all times in all places care only for themselves. That they 'are all the same'! How would anyone know that? We would have to read the inner workings of the heart of all people at all times in all places wouldn't we? It's a tremendously arrogant claim, and we are somewhat under qualified to make it.

was Jesus cynical?

However, it is the Bible's claim that one man has had that 'God's-eye view', Jesus Christ. He knew men's hearts better than they knew themselves. If anyone in all of history had a right to cynicism, it was Jesus. What was his verdict? Was Jesus a cynic, even at the end of his life, after all he had seen?

Let's look at one passage, Mark 14:1-11. It's a scene of high drama right before Jesus' death. In just eleven verses we have a murder pact, an unholy alliance, a riot threat, a secret defection, blood money. Seething powerplays.

But in the central more intimate scene, there is a cocktail party, a gate crasher, who scandalizes the onlookers by throwing around top of the range perfume. Was it attention seeking? Perhaps a sexual motive? In the other gospel accounts the disciples rebuke her especially Judas. John remarks that Judas 'did not say this because he cared about the poor but because he was a thief; as keeper of the money bag, he used to help himself to what was put into it'. (17) Ah, the money motive! Presumably his end of year accounts finally caught up with him after his death, another fake unmasked. It's an ugly scene of accusation and counter accusation. From man's perspective we have the dirt on every single character in this scene: priests, teachers, gate crasher, guests, disciples, Judas. He said she said he said she said… money, sex power. It explains everything. The cynics are right, and it stinks.

special investigations: the God's-eye view

But here's the surprise. What does God see? He sees beauty. He smells fragrance. He says this woman will be remembered worldwide, in fact we're doing just that 2000 years later, remembering genuine goodness, verified sealed and stamped by God himself. To the cynics, she was invisible, they had explained her away, reduced her to her track record. Their deconstruction of her motives is just wrong: 'leave her alone, why are you bothering her...she has done a beautiful thing to me'. (18) He doesn't see through her. Do you ever imagine that God basically views you as a sum of your failures? He doesn't see through us. We're not ghosts. CS Lewis wrote this:

'You cannot go on "seeing through" things for ever. The whole point of seeing through something is to see something through it. It is good that the window should be transparent, because the street or garden beyond it is opaque. How if you saw through the garden too? A wholly transparent world is an invisible world. To "see through" all things is the same as not to see' (19)

Here's a message you don't hear often: God believes in man! He trusted Job and his trust was vindicated. It's as if He says of Job proudly 'That's my boy! Real faith exists!' Marx and Freud listen up. Elsewhere, Jesus said of Nathaniel 'Here truly is an Israelite in whom there is no deceit'. (20) Diogenes, look again! An honest man does exist!

So is God blind then? Clearly there is plenty of nastiness all around him. It's remarkable that just a few hours before his death, Jesus is not despairing at the very real wickedness around him, even though he is the only one with the right to. Instead he pauses with a woman written off by her peers (and the disciples) and celebrates a moment of genuine love. That's the generosity of God. He sees that his creation is not beyond redemption. It's like he's saying, 'I can work with this!' Even on the cross, a thief asks for his help. The cynic says 'Really? A death bed conversion? That's just desperation!' But no, Jesus welcomes without cynicism to the very end. Why is that?

I recently read of the businessman Martin Lang who bought a Marc Chagall painting for £100,000 and took it to the BBC Fake or Fortune programme. They sent it to the Chagall Committee in Paris who deemed it a fake, and under French law declared it should be confiscated and scrapped! Oh the heartache! Whereas for a genuine masterpiece the owner would do everything in his power to restore it. The gospel declares that each one of us is the genuine article, not a fake. But we are flawed masterpieces, made in the image of God but fallen: glorious ruins, battered, marred, crumbling, but not beyond repair. Jesus hasn't scrapped us. Whereas cynicism gives us no hope and humanism gives us false hope, (it's too naive!) only Christianity is real about both the glory and the ruin. Only the gospel give us humility to face the shame, and hope for future glory in Christ.

treatment: is there an alternative to cynicism?

'And now these three remain: faith, hope and love. But the greatest of these is love.' (1 Corinthians 13:13)

Cynics tell you that time is on their side: you will eventually lose all trust (just a secular word for faith). 'If you're not a socialist in your 20s you haven't got a heart. If you're not a capitalist in your 30s you've got no brain.' But the slide into despair is not inevitable. Cynics are not tired of life as they claim, but understandably tired of the deadening effect of mistrust and suspicion. And thankfully, whatever the headlines say, theirs is a passing world order. Jesus' kingdom is the future, it has come to stay, and it is life enhancing.

Have you ever seen the Youtube clip Top 5 proposals gone wrong? (21) It features a guy at a basketball match who, having spent thousands of dollars on a ring, proposes with millions watching on live TV. But he totally misjudged his beloved's response: she runs off blushing. It is the most painful public rejection to witness. But one question you have to ask is 'did this guy not know his partner?' In contrast, how did the woman in the gospel have the confidence to interrupt Jesus in public, smother him in perfume, risking scandal and humiliation from a judgmental crowd?! After all, she was probably carrying a reputation. (22) It could have gone so very wrong! Didn't she expect to get burned and turned away, remembered forever for all the wrong reasons? She must have known Jesus very well and that he would never turn her away. She was captivated by him and that's why she spent a year's wages on him. She knew that she was worth more than that to him, perhaps her weight in gold?

In fact in just a few hours he'd prove that she was worth her weight in blood to him, perhaps with her perfume still fragrant to him on the cross. That's why Jesus makes that strange statement in Mark 14:8: 'She poured perfume on my body beforehand to prepare for my burial.' The perfume anticipated Jesus' burial, whether she knew it or not. His death would show his love most definitively: generous, confident and open-hearted. We have even more reason than this woman to trust Jesus. But even she had utter assurance of Jesus' love, and it transformed her. Luke tells us that she loved much because she was forgiven much. The cynics were wrong. Her motive was pure thankfulness, no scheming to manipulate his affections, she was already confident of them. And as a result she could face scorn, misunderstanding, rebuke, all without fear, without really worrying what anyone thought. She had already uncurled and dared to love like Jesus: generous, confident and open-hearted. Isn't that a more desireable way to live?

So Christians resist cynicism not because we are naive optimists. Far from it, we are frank about our dark sides. Instead, our hope is anchored in the purposes and character of God who loves extravagantly and can be trusted. The more we become like him, the more we will be generous towards others and they will want to trust us and him. When we are tempted to be cynical, let's remember we can't read others' hearts any more than they can read ours. There will be surprises on judgment day!

'It is the Lord who judges me. Therefore judge nothing before the appointed time; wait until the Lord comes. He will bring to light what is hidden in darkness and will expose the motives of the heart. At that time each will receive their praise from God.' (1 Corinthians 4:4-5)

summary

Cynicism is not new. It is as old as Satan, the accuser, who desires to undermine all faith, trust and love. It has been reasserted by Marxists, Freudians and evolutionary psychologists, who have tried to shame people of faith by questioning their motivations. But cynicism is understandable as a defence when we are let down and hurt by self-serving people, much like ourselves! But Jesus challenged the cynics' assessment that humanity was beyond redemption. Whilst we wait for his kingdom of faith (trust in action) to be finally established, we need the humility to recognise our part in the brokenness of the world. We live hopefully in the light of future promise not past hurts. We seek to be softened by his love that we might trust him and be generous to others. His light has overcome the darkness, (23) and the future is bright. We can trust him!