In verses ten through twelve of Isaiah chapter 58, the Lord speaks through the prophet:

And if thou draw out thy soul to the hungry, and satisfy the afflicted soul; then shall thy light rise in obscurity, and thy darkness be as the noon day: and the Lord shall guide thee continually, and satisfy thy soul in drought, and make fat thy bones: and thou shalt be like a watered garden, and like a spring of water, whose waters fail not. And they that shall be of thee shall build the old waste places: thou shalt raise up the foundations of many generations; and thou shalt be called, The repairer of the breach, The restorer of paths to dwell in.

In the early 1980s a missionary family from the United States moved from their mission field in Mexico to San Blas, a neighborhood outside of Madrid, the capital of Spain. There, the family, headed by Elliott Tepper, found more breaches in need of repairing than anyone who had never visited San Blas could have imagined. Yonkis, the Spanish version of “junkies,” huddled in wastelands shooting up. Petty crime, and often violent crime, funded much of the addiction. Despair fed on despair, drawing more and more men and women down into perdition. Elliott Tepper, his wife Mary, and their four young boys, David, Jonathan, Peter, and Timothy, lived, by choice, in the middle of a place that seemingly everyone but the addicts — and many of them, too, especially they — wanted to escape.

Day by day the Teppers went into the breaches, repairing them. They handed out leaflets to yonkis. They welcomed homeless felons into their tiny apartment. They built a church, Betel (“Bethel” in Spanish), and satellited it with workshops and garages and farms where those fighting to be free of the living death of drug addiction worked on building up lives worthy of human dignity. Many formerly destitute addicts joined the church and helped build it bigger. More and more lost souls came in. The original symbol of Betel was a dove over a broken needle, indicating that the spirit of truth and love is stronger than the death we sometimes choose instead. Dead men walking became living men preaching the word of the living God.

In this world grew the four Tepper boys, learning to love the fallen. Or perhaps it is closer to the truth to say that the Tepper boys lived in two worlds, the rough-edged streets of San Blas and the borderless realm of education and the arts. Elliott Tepper, a Harvard alumnus whose calling took him out of Cambridge’s comforts and into the hard life of a missionary, and Mary, as much a bibliophile as her husband, imparted to their children awareness of a horizon probably unimaginable to most of the people they worked with. The men and women fought to stay sober and employed day by day. The Teppers, who lived and worked among them, read CS Lewis and TS Eliot to one another around the dinner table, knew fine art and good music, and had, in general, a global grasp of the social problems that far too many San Blas residents knew only as intensely personal suffering.

In Shooting Up, one of the Tepper boys, Jonathan, writes powerfully of both worlds, that of books and that of recovering heroin addicts. Jonathan Tepper went on to be a Rhodes Scholar and successful businessman, clearly gifted with the intellectual light that shone at his parents’ feet in their walk with Jesus. And like his parents, Jonathan, a missionary, was the mission field of the mission. The suffering he saw transformed him. The great books of a half-dozen languages have been Jonathan’s companions, but no human wisdom has been able to lay to rest the unease that comes from knowing, intimately, that death comes for us all, and that God will have his souls back whether we like it or not.

Books have been Jonathan Tepper’s companion, then, but so has pain. The faith he grew up in blinked in the face of grief. To the terrors of addiction was added, in time, a strange new virus, later understood to be HIV, which ended up taking from the Teppers so many of those whom God’s love, working through human hearts and hands, had saved from wretchedness and the needle. What kind of a God countenances so much pain, Tepper wonders again and again in Shooting Up. The addicts who have found their calling in Betel are without self-pity, wanting only to serve. But for those who accompany the sufferer, doubts creep in. Death takes friend after friend, family member after family member. Tepper is left to wonder what the meaning of it could possibly be. In the middle of the book, disaster blindsides the Tepper family. The book closes with another sharp and personal grief. There are no pat answers in Shooting Up. One must simply do as Christ did and as Elliott and Mary Tepper tried to imitate: overcome pain with love, walk with the heartbroken, repair the breaches as best one can.

Jonathan Tepper quotes from Isaiah 58 in Shooting Up, the above passage about repairing the breaches. As I kept reading Tepper’s memoir, I could not decide if the breaches inside of him were ever repaired, or ever could be. The Tepper mission succeeded almost miraculously, one might say. More than a hundred thousand people have been saved from the streets, and the Betel organization has expanded into so many places besides San Blas: Australia, Mongolia, Brazil, Germany, Russia, and more. Elliott and Mary Tepper’s faith has been repaid again and again, one renewed life at a time. What it cost them and their children, though, is incalculable. Every time the Teppers visited Ramón y Cajal Hospital to watch as another friend slipped away from HIV-related complications, it felt to me as if a new breach had formed in their hearts. The dying were serene, eyes fixed on Heaven. Jonathan wants to believe as they do, but breaches accumulate. When Raúl, one of the brightest Betel lights, a former addict who became a preacher and a leader of men, dies in the hospital with the Betel family around him, Jonathan is thrown down hard in the heart. “Who could fill Raúl’s place?” Tepper writes. “Who could stand in the breach as he did?”

Life is short and loving has a cost, Tepper concludes. He knows more than most what that cost is. Following a wrenching loss as a teenager he had “tried to live for two,” he tells us, “but had only lived half a life.” He gave up on a dream of being a jazzman when death took the Charlie “Bird” Parker to his Dizzy Gillespie. “Even if I could have been Dizzy,” Tepper says, “I am not sure it would have been worth it without Bird, the other half of my heartbeat.” When Bird dies, Dizzy never gets him back. Nobody ever takes the place of the dead. San Blas loses Betel battalions to HIV, and those left behind, including the Teppers, must find some way to move on, resisting the temptation to harden their hearts.

Shooting Up is a vivid portrait of a Madrid neighborhood and a foreign mission, but it is also set partially against an American backdrop that anyone from the States who grew up in Jonathan Tepper’s generation will recognize. There are mentions of Reagan and of the trade imbalance with Japan. Tom Cruise gets a nod. So do the Berlin Wall and Bill Clinton. But for all that, those who read Shooting Up will want to follow up with some books of Spanish history to figure out how society broke apart so badly as to let the heroin scourge in. The Gypsies who appear in Shooting Up are only the middlemen. A once proudly Catholic country, Spain found itself in need of Protestant missionaries to pick up the pieces. When Mother Teresa was in India, some Americans were in Spain, doing much the same work as she. Franco and the Spanish Civil War appear in flashes, as names only, but there is much more to fill in.

American readers may also shift uncomfortably, as I did, wondering if Philadelphia will ever be won back as San Blas was. Tepper tells us that Thomas L. Webber’s Flying Over 96th Street: Memoir of an East Harlem White Boy (here) was an inspiration for Shooting Up.

There are so many breaches to repair. There are so few doing the repairing.