The eighteenth century cardiovascular surgeon John Hunter once exclaimed, "My life is in the hands of any rascal who chooses to put me in passion." A short time later he proved those words prophetic when he died from a violent coronary artery spasm during a heated exchange at a faculty meeting at the Royal College of Physicians in Glasgow, Scotland.

Heartfelt Peril

Modern medicine recognizes angina pectoris to be the final result of years of slow deposition of cholesterol-laden atherosclerotic plaques within the inner lining of the coronary arteries. These plaques impede blood flow and hence oxygen delivery to cardiac muscle. Such factors as high blood pressure, high levels of cholesterol or triglycerides, diabetes, tobacco smoking, obesity or certain genes passed down from a family prone to heart disease can accelerate the process of atherosclerosis. Added to this, stress, platelet aggregation and vasospasm, and the acute choking of life-sustaining blood flow to part of the heart can cause a heart attack. Atherosclerosis in vessels supplying the brain leads to stroke.

By modifying correctable risk factors, one can reduce the likelihood that heart attack or stroke will cut one’s life short. The growing popular interest in curtailing dietary fats and cholesterol is a sound response to decades of research that proves that a diet high in animal fat is particularly hazardous to health. Thousands of years before the research was done, the Lord instructed the Israelites in this same dietary principle (Leviticus 3 :16-17).

Coronary Behavior

But lest we become excessively concerned with diet, Jesus exhorts us to a deeper level of Torah in Mark 7:14-23. "Nothing outside a man can make him ‘unclean’ by going into him. Rather, it is what comes out of a man that makes him ‘unclean.’. . . For from within, out of men’s hearts, come evil thoughts. . ." If the fat of animals was unhealthy to eat, how much more could one’s thoughts, attitudes and behavior influence health? Is it not likely that in this passage Jesus was interested in health, since he had just come from healing "all who touched him" in Gennesaret in the previous chapter? Can the health of the heart be judged in part by its fruit?

The type A is the short-fused person who, when waiting for a paused elevator, will immediately begin thinking that someone is purposely delaying the elevator. While standing in the express checkout line, the type A person will count the items in the basket of the person ahead and cast hostile glances if the number exceeds the limit. Caught in a traffic jam, the type A person will shove aside any safety rules to cut ahead by one car. One hopes the other driver is not also a type A.

As in Adam All Die

The general type A concept endures as an archetype of what many consider to be illness-prone behavior. More recent research has examined more specific psychological traits. Despite unresolved questions, numerous studies support the emerging conclusion that cynical distrust, hostility and, in particular, expression of anger, as opposed to experience of anger, represent the toxic core of a destructive behavioral pattern that invites coronary heart disease. This temptation to impatience, distrust and anger affects every one of us to some degree.

How does negative emotion translate to biochemical stress? It should come as no surprise that anger, hostility, time-pressuredness, suspicion, cynical distrust, and aggression arouse the sympathetic nervous system–that part of the nervous system responsible for the "fight or flight" response of brute survival. Sympathetic arousal produces elevated blood pressure, increased heart rate, a surge of adrenaline, as well as muscle tension and widespread changes in various hormone levels and intracellular metabolism. If extreme, as in rage, or habitual, as in bitterness, these changes can be potentially damaging within.

The Wrath of Anger Is Poison

The Fool Hath Said in His Heart. . .

Missing Prescription for a Poisoned Spirit

Anger management is not part of the current standard of medical care for coronary heart disease because no causal link has been rigorously proven. While many physicians would agree that extreme anger contributes to acute heart attack in scarce instances, medical science has not yet reached a verdict in the case against chronic habitual anger and its insidious consequences.

It is instructive to examine this skepticism in light of the constraints of science.

Exact Science Has Exact Limits

Medicine, as a child of exact science, focuses on tangible detail. Medical knowledge inches forward by classifying, testing and measuring, dividing and further subdividing the human body into parts of conquerable size. Inquiry by reduction penetrates into the smallest details of biochemical vitality and reveals the glory of the Creator. The final analysis always leads to the discovery that the analysis is far from final. Investigation of disease usually finds something awry at multiple levels. Multifaceted expressions of disease can sometimes be traced to a single defect, as in a miscoded gene, but the identical twin of the ill person may escape the disease or exhibit a milder form. Most diseases are multifactorial, such as coronary heart disease, which is more likely to affect persons with the risk factors previously listed. Interestingly, risk factors overlap. Some studies have linked hostility, for example, to elevations in blood pressure, smoking and poor diet. Since, for a given person, disease cannot be predicted with accuracy, there must exist other risk factors and other variables, whether undiscovered, unmeasured or unmeasurable.

Medical science deals with the hard facts of physical disease. Scientific method rests on the assumption that spiritual matters are incidental, since their relevance, by purely physical criteria, is unproven. Therefore science is forever mute even on basic questions of value and purpose, recognizing biological defects as nothing more than cold statistical variations. The life-threatening atherosclerotic plaque appears to the mathematical eye as an anomaly defined by so many degrees of lumen diameter reduction. Such observations evoke curiosity, but not necessarily concern. Mere science cannot determine whether a heart attack, for example, is good or bad. Moreover, science cannot exclude the impact of the spiritual upon the physical, but by its very incompleteness hints, at least to human beings, that reality must entail also something else.

Biblical Holism

The Bible presents a holistic perspective of body and spirit which the recent evidence linking anger with heart disease barely glimpses. The Hebraic concept of the wondrous unity of body and spirit comes into view in Genesis 2:7: "The Lord God formed the man from the dust of the ground and breathed into his nostrils the breath of life, and the man became a living being." Human beings and all that God had made were "very good" (Genesis 1 :31).

The recurrent Biblical pattern of physical and spiritual unity surpasses poetical comparison and points to their common origin and a concordant purpose. The Hebraic framework simply does not permit the separation of physical from spiritual reality. It also lends legitimacy to regarding physical disease as intimately interrelated not only with emotional, but also with spiritual health.

A Broken Holism

Through Adam’s disobedience sin entered into the world. The consequences of sin were at once physical and spiritual (Genesis 3:16-19, 22). So pervasive was the resulting cascade of evil that even the ground was "cursed" (Genesis 3 :17) and "the whole creation" still groans in "its bondage to decay" (Romans 8:21-22). The writers of the Bible did not find it useful to distinguish between physical and spiritual evil because sin encompasses all aspects of human existence.

The Hebraic concept of body and spirit is one of continual interdependence and exchange. To touch one aspect is to touch the other. Change in either aspect affects the whole. For example, the Psalms express physical accompaniments of guilt, as in Psalm 22: "My bones wasted away through my groaning . . . then I acknowledged my sin to you." In I Chronicles 8:1-4, Lord sent plague in response to David’s sin.

And while, as in Job, the connection between sin and disease often is not one of simple cause and effect, the relationship remains intimate, since the test of Job’s faith focused on his spiritual response to physical ruin (Job 1:11, 20-22; 2:34, 10). Most illness is not the direct consequence of individual sin. Many peace-loving and morally upright people suffer heart attacks

From Medication to Messiah

Medicine sometimes triumphs and always hopes. Its triumphs are possible only through the grace of God, who imparts knowledge to physicians and allows them to be servants of his healing. The physician can diagnose and prescribe a pill to lower blood pressure or another pill to lower cholesterol. God has designed the body so that the pills can be beneficial. The surgeon can graft a vessel to redirect blood flow to a diseased heart. God permits that vessel to establish connections to heart tissue and allows the incision to heal without infection.

The physician often glimpses the devastating effects of anger, hostility and bitterness on the body in ways that are very real to patients yet elusive to formal scientific investigation (tests may be negative). Kindled internal stress may, for example, erupt as chronic pain syndromes or decreased resistance to physical diseases. One’s spiritual response to inner unrest matters desperately. Only God can forgive our sins of unbridled emotions and release our hearts from the snares of bitterness and hostility.

Inasmuch as all physical and spiritual evil had a common origin, so the Bible declares it has a common cure. This cure is not a temporary or combination treatment, but the final answer once and for all. This answer is the Messiah, God with us.

A New Heart and a New Spirit

John the Baptist sent word asking Jesus, "Are you the one who was to come?" (Matthew 11:3-5 in reference to Isaiah 35:4). Isaiah 35:4-10 says, ". . .your God will come, . . . he will come to save you. Then will the eyes of the blind be opened and the ears of the deaf unstopped. Then will the lame leap like a deer, and the mute tongue shout for joy . . . Gladness and joy will overtake them, and sorrow and sighing will flee away."

Jesus’ ministry of healing in the Gospels fulfilled Messianic prophesy and was a foretaste of the healing to be experienced completely in the glorious resurrection to come. His miracles signaled no less than the return of God’s face to shine upon our lives and the beginning of the end of all of evil’s harm. When the Lord of Life walked among us, one touch fully renewed the body and refreshed the soul (e.g. Matthew 9:5-7).

Yet this Jesus who spoke with all authority, who healed the sick and rebuked the storm, humbled himself even to death on the cross. Our Lord Jesus "took up our infirmities and carried our sorrows . . . he was pierced for our transgressions, he was crushed for our iniquities; . . . and by his wounds we are healed" (Isaiah 53:4-5). The perfect sacrifice of the Lamb of God atoned for all the sins of those who believe in him and reconciled us to God our Father (Isaiah 53:7, John 1:29, Hebrews 10:14). And now although for a little while we "suffer grief in all kinds of trials" ( I Peter 1:6 95), ". . . God, who is rich in mercy, made us alive with Christ even when we were dead in transgressions . . ." (Ephesians 2:4-5; Romans 6:11).