Before I officiate at a wedding, I normally have several talks with the couple. The issues of money, sex and power always generate the most discussion and the most emotion. With one couple, sex and power immediately catapulted to the top of the list. They were conflicted about whether or not to have children. He didn’t want children; she absolutely did. Their love for each other was obvious, which made the discussion about having children so important.

To her relief, the man finally agreed to having children. But after their wedding, he changed his mind. His wife had a significant job that required years of education and additional training. A few months after I performed their wedding ceremony, she called, wanting to talk with me as soon as possible. Tears rolled down her face as she told me she longed to have children. He had given her his promise but then changed his mind. In a moment of utter frustration, she said, “Anybody could do my job. I want to be a mom.”

You need to know a crucial element in this story. Turns out, the man had a close relative who had lost a young son to an incurable disease. When the little boy died, it broke this man’s heart, knowing the suffering the boy had endured, he decided right then and there he would never bring a child into the world. Discussion over.

A physician and writer from Louisville, Ky., writes about the tension between fear and control. Cardiologist John Mandrola believes medical decision-making is terribly ill. “The cause is in large part an excess of fear and a false sense of control,” Mandrola says.

“Fear shreds the ability to make rational harm/benefit trade-offs, because it engages our fast-thinking reptilian brain. The vast majority of medical decisions benefit from slow thinking. In fact, one of the main ways a heart-rhythm doctor helps people is the removal of fear.”

Mandrola says the more education he gives his patients, the less fear they have. What would help, then, a person who fears having children come to better understand less fear about the risk? Well, education.

Throughout time, humans have taken the risk of bringing children into this beautiful yet broken world, saying that in spite of the risks, the joys almost always outweigh the sorrows.

But, and you knew this was coming, who of us doesn’t know someone — maybe ourselves — who has made poor medical decisions because of a false sense of control. This became clear to me when I was talking with another physician, a gastroenterologist, about screening patients for colon cancer, especially encouraging older adults to have colonoscopies, even those without a family history or predisposing risk.

“After people had several colonoscopies that were normal, should they keep having them?” I asked.

With no hesitation, he said, “Of course.”

And yet, this extremely lucrative procedure — garnering a hardworking gastroenterologist up to a million dollars a year — with a small but finite chance of severe complications likely results in a small reduction in the chance from dying of colon cancer.

Dying from colon cancer is just one of a gazillion ways of dying. I always am curious to know why people think that a tiny reduction in the odds of dying from one disease changes your overall survival rate.

Mandrola the cardiologist loves his work but says the key to his job is helping people with his words of comfort and encouragement as much as with catheters and scans.

“Medical decisions would be far better if there was less fear and less overconfidence in how much each decision controls outcomes.”

So, is it worth the risk to bring children into the world? For the vast majority of people, undeniably yes. Even the book of Proverbs says, “Train children in the way they should go; when they are old, they will not depart from it.” Indeed, that is a great principle, but it is not a promise.

May the one who holds each of us in the palm of his hand help us both live with joy as we embrace the tension of hearing the angel Gabriel say to Mary, “Fear not,” and accept the poignant words from the book of James: “Today or tomorrow we will go to this or that city, spend a year there, carry on business and make money. Why, you do not even know what will happen tomorrow.”

Don Follis counsels pastors and consults with a wide array of churches. He blogs at donfollis.com, where you can subscribe to his posts. He can be reached at donscolumn@gmail.com.

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