Of Wound Healing, Scar Tissue, and Humility

My students just finished a unit on perioperative nursing – the nursing responsibilities and interventions associated with caring for surgical patients. One of the most important of these is monitoring surgical incisions for signs of infection and other problems.

By definition, surgery is invasive. It requires getting past the superficial layers of our skin in order to manipulate, remove, and/or introduce structures underneath, and so surgery generally involves some kind of incision, some kind of wound.

So, part of our classroom time was spent talking about the wound healing process – from inflammatory response and new tissue proliferation to maturation, remodeling, and restoration of function. It’s the same process, more or less, for all kinds of tissue disruption beyond the most superficial ones, although the results vary widely depending on a variety of factors.

Chief among these, perhaps, is how clean the original wound was and how closely its edges can be brought together in order to facilitate the repair. Some wounds are clean and even – like the incisions that surgeons make – and so they heal by what clinicians call first intention. The cut is bound together by sutures or the like, and so there’s direct communication between the separated sides as the tissue re-building commences. Healing by first intention is usually relatively rapid and thorough, with minimal scarring and limited loss of tissue integrity.

Other wounds, however, are not so tidy – like extensive traumatic injuries and bad bedsores. The edges can be jagged and hard to bring together, and they may be left open to allow nature to take its course – which is healing by second intention. Since the gap is so large, there’s no mechanism for healthy tissue to fill the void, so the body substitutes scar tissue instead. It takes longer, it’s unsightly, and it results in an area considerably weaker compared to the surrounding skin. Plus, they don’t seem to ever go away.

It was today’s Mass readings that got me thinking about incisions, wounds, and lingering scars. The first reading had Isaiah cowering before the majesty and glory of the Lord, and overawed by the angelic beings proclaiming their praise. In contrast, Isaiah was plagued by his inadequacy. He was “a man of unclean lips, living among a people of unclean lips.” Seriously scarred, in other words. Yet God (through his angel) intervenes, the imperfections are addressed, and the prophet steps up to his heavenly commission. “Here I am,” he tells the Lord, “send me!”

Then, in the Gospel, we see a crew of fishermen marveling at a miraculous catch of fish orchestrated by Jesus. It’s an epiphany moment, an encounter with incarnated divinity, and it causes Simon Peter to collapse and confess his own unworthiness, his own deep scars – going so far as to direct the God-man to scram: “Depart from me, Lord,” Peter pleads, “for I am a sinful man.” But Jesus calls him anyway, without even an Isaiah-like healing, and Peter, like James and John, drops everything to follow him.

There is no healing by first intention in the spiritual life. That would mean that God himself creates our wounds: precise, orderly, divine incisions in our souls that are meant to bring about miraculous healing while we passively sit back and await the outcome.

No such luck.

Aren’t we responsible for our own wounds? Some of them are downright self-inflicted, serious, and messy, but more often they’re simply collateral damage that we suffer as a result of our dumb choices and selfish behavior. God can always heal us, but the cavernous holes in our spirits, our psyches, our emotions and equilibrium, will not cover over easily. It’ll be a second intention kind of healing, taking much time, leaving weakness in its wake, and almost always leaving nasty scars.

But gaping lesions have to be filled up with something, and scar tissue is better than nothing. Besides, they’re good reminders to avoid what led to the original injuries in the first place, and they’ll make us sympathetic toward those with scars and injuries of their own, make us more generous toward them, more kind.

Even so, like Isaiah and Peter, we’re still terribly embarrassed by our sinful scars, and so we tend to draw back from the One who seeks to heal us and deputize us. “Be content that you are not yet a saint,” Thomas Merton prescribes. “Then you will be satisfied to let God lead you to sanctity by paths that you cannot understand.”

Our interior scars might be weakened parts of our selves that declare our damaged histories, but they also demonstrate that we haven’t given up trying – that is, if we haven’t given up trying. And not giving up trying is at the heart of wholeness and holiness. Don’t give up.
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  1. Of Wound Healing, Scar Tissue, and Humility | God-Haunted Lunatic

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