TY - JOUR
AU - Ridenour, Autumn, Alcott
AB - Abstract Responding to Max Weber’s modern diagnosis of nature, science, and medicine as disenchanted, this article aims to reenvision nature and medicine with a sense of enchantment drawing from the Christian themes of creation, Christology, suffering, and redemption. By reenvisioning nature as enchanted with these theological themes, the vocation of medicine might be revitalized in terms of suffering presence, healing care, and works of mercy toward the neighbor in need. I. DISENCHANTMENT AND ITS DISCONTENTS Max Weber diagnoses the world as “disenchanted” in his famous essay “Science as Vocation,” describing the desacralization of nature in which no clear meaning can be derived from the inhabited world (Weber, 1946, 143). Nature lacks meaning or purpose, and thus science, including medicine, exists to relay facts about interrelated biological and physical processes, thereby clarifying knowledge that assists control over nature and human activities (Weber, 1946, 148). Weber represents a modern worldview that encloses nature from divine origins or activity and, instead, reduces nature to “facts” about interrelated processes with no ultimate meaning or value. From a modern philosophical perspective, Weber represents material reductionism in which no religious or intrinsic value might be derived from nature or the world around us. Natural science may only give us the means to “master life technically,” but it does not tell us “whether it ultimately makes sense to do so” (Weber, 1946, 144). Lacking mystery, wonder, or “enchantment,” the natural sciences and the profession of medicine exist for clarification about the material world only, its processes and interrelated facts (Weber, 1946, 152). When the physician or teacher of science offers meaning concerning normative claims regarding ethics or values that constitute a good life, the scientist steps beyond the realm of knowledge and into the role of religious “prophet” who sacrifices intellect to “academic prophecy” that potentially descends into “miserable monstrosities” (Weber, 1946, 155). While perhaps humble regarding the overreach of science, Weber’s conclusion leaves the scientist and medical practitioner with a vocation of facts alone and a discipline devoid of meaning. The natural world is rationalized in terms of “disenchantment,” and the field of medicine lacks clear goals or purposes other than the “trivial” assertion to “maintain life and diminish suffering” while giving no indication “whether life is worth living” (Weber, 1946, 155). Weber’s analysis merges well with Jeffrey Bishop’s recent critique of modern medicine as devoid of formal and final purposes or what might be described as ultimate causes in The Anticipatory Corpse (2011, 20). Likewise, Gerald McKenny’s To Relieve the Human Condition (1997, 2) critiques modern medicine as captive to the Baconian project of control in which health care and medicine function without a philosophical vision of the good life. In both criticisms, medicine lacks enchantment, also known as wonder, awe, or meaning, in that nature is regarded as a substance merely to be manipulated, devoid of ultimate purposes. Instead, Promethean autonomy seemingly becomes the primary value in this modern worldview in which nature is only assigned meaning insofar as individuals determine its value (Verhey, 2010, 26–32). In other words, there is no wisdom or purpose to be derived from nature and certainly not from a divine being who created nature. Nature, for Weber and many ascribing to the modern mind, is one of “disenchantment.” If Weber’s analysis of nature as disenchanted represents the modern mind, science, and medicine in some form, is it any wonder that bioethics and medicine feel increasingly vulnerable to human choice as the highest value that, at times, may appear contrary to the patient or society’s best interest? Jesuit scholar John Paris claims medicine now faces a new era of “autonomy gone amok” in which health care is asked to serve patient choice even when certain procedures may seem medically futile, or its opposite, eliminate the patient altogether, as seen in physician-assisted suicide (Paris, 2015). In both cases, Paris acknowledges that autonomy appears to be the primary goal at the expense of beneficence. Protestant theologian Allen Verhey identifies how the three myths of liberal society, capitalism, and the modern Baconian project converge together to form the “Dominant Social Matrix” in which modern medicine often functions (Verhey, 2010, 39). He explains how the Baconian project entails control over nature (much like Weber’s analysis), liberal society emphasizes autonomy as supreme, and capitalism reduces nature to commodification (Verhey, 2010, 39–40). Driven largely by patient choice and economic pressures, many physicians increasingly find themselves facing burnout and an eroded sense of calling within the structure of modern health care institutions (Sulmasy, 1997, 8–10). Health care entails long hours and large patient quotas that can feel simultaneously monotonous and burdensome when divorced from ultimate meaning that might ground patient care with intrinsic worth or even spiritual purposes (Sulmasy, 1997, 8). Now is there an alternative? Are there still narratives or ways of perceiving the world as “enchanted”? If so, how might such a narrative transform one’s approach to medicine and health care? While perhaps risking the role of “prophet” according to Weber’s criteria in the desire to ascribe meaning, I turn to the narrative of Christian theology that emphasizes the themes of revelatory creation, Christology, and redemption as grounding an enchanted view of nature. Second, I reenvision healing as vocation by attending to the suffering patient in the desire to restore the body to its creative and redemptive purposes. Third and finally, I offer suggestions to help revitalize the professions of medicine and health care with enchantment through suffering presence and healing care. II. REIMAGINING NATURE AS ENCHANTED THROUGH CREATION, CHRISTOLOGY, AND REDEMPTION Colloquially, the term enchantment may invoke visions of fairy tales and forests in which characters encounter creatures in nature, who help offer a new perspective on the world or contribute to transformation in some way (Grimm, 2001, x). Whether Briar Rose, Snow White, or Rumpelstiltskin, the forest and its enchantments serve as an important locus for self-reflection and transformation. Stories are evocative, often convening some meaning or moral attained through character development. As cultural folklore across the ages or bedtime readings, countless children have identified with imaginary forests full of wonder. Citing Aristotle, Allen Verhey says, “Every Ethos Implies a Mythos” (Verhey, 2010, 13). Stories convey meaning, and meaning conveys purposes that shape the way we live. Verhey continues, saying, “It is not just a point in literary theory. I take it also to be true of moral development and of moral discernment. Discernment of our human responsibilities requires a myth” (Verhey, 2010, 13). Religious traditions and ethics involve narratives for interpreting the world. Pondering the question as to whether nature might be enchanted, traditions such as Eastern Hinduism or Native American traditions affirming pantheism in which the world is alive with divine presence may initially come to mind. In these traditions, all nature is animated by spirit, whether tree, earth, sky, or water. The material world is not merely valuable, but sacred. Nature in Christianity seems to pale in comparison. However, Christian theological themes that describe creation in terms of revelation aiming for redemption might merit a reconsideration of the wisdom and beauty intrinsic to nature and its possibilities for enchantment. Nature as Revelation: Our Nature and Christ’s Natures Western Christianity may seem an odd bedfellow for the term enchantment, which sounds more like “magic,” “mystery,” or “fanciful visions,” for which Weber seemingly categorizes religion in general (1946, 139). However, if enchantment also implies “wonder,” “meaning,” and “value,” then Christian theology may offer some sense of enchantment through its awe of the created world (Weber, 1946, 142, 148). A closer look at resources within the historic Christian tradition might unearth ways that theology affirms the value of nature and the material world, given its role in revelatory purpose as the so-called “book of nature” through creation, Christology, and redemption. Recognizing the difficulty in defining a clear sense of the term “nature,” Verhey identifies at least 16 meanings for its use. Like Verhey, the mythos or story I use to describe the term nature is one set within the narrative of Christian theology in which God creates the world from nothing, assigning value to all creatures as seen through the term “good” in the first chapter of Genesis. Unlike the Gnostic Marcion who privileges the spirit over the material world, Christianity rejects a mythos that departs from the Hebrew Scriptures and its creation narrative with value for nature and the material world (Verhey, 2010, 66). By affirming the work of God in creation, the Christian story confirms the ongoing value of nature and the human body. Concerning problematic interpretations of the creation narrative, Verhey specifically responds to the critique of nature’s “disenchantment” in Christianity. He says, The creation story famously—or infamously, according to Lynn White, Jr.—“desacralized” nature, “disenchanted” it. “Disenchanted,” however, may be too strong, for neither this story nor the larger narrative renders nature simply an “it.” The creation story will not permit idolatry, but it does not empty the world of “animism”; it does not render nature a machine. It does not deny a continuing and intimate relationship between God and nature. God is continuously present to the creation, involved in its life, and the creation continuously manifests God’s power and grace. (Verhey, 2010, 70) Here, Verhey demonstrates the value, life, and ongoing sustenance afforded nature through its relation and dependence on the Creator God. Nature has meaning and value because of its source in God and ongoing presence by the Creator. The climax of God’s presence with creation culminates in the center of the Christian story where the Creator enters creation through the gift of the Incarnation (Verhey, 2010, 105). St. Athanasius’ famous On the Incarnation considers the primary reason for why God became human. In his oft-quoted description that “God became human in order that we might become God,” he sets forward the purpose for Christ’s incarnation as one aimed at union or regained presence between God and humanity (Athanasius, 2000, 29–30). The union, of course, is a reunion of a relationship once severed following the experience of sin and separation in the world. Relying on the literary mythos of Genesis, Athanasius follows the tradition’s description of an “enchanted garden” where God and humanity dwell together in close relationship. However, a serpentine figure deceives the archetypal humans into exchanging the original harmonious relationship for one of distrust and self-reliance in their desire for lesser objects, hereby introducing what Christianity calls “sin” into the state of nature (Genesis 1–3). According to Athanasius, Christ became human to restore creatures—and nature itself—from death with the hope of resurrection, an outward sign that points to an inward reality (Rom 8:22-23). The spiritual reality facing human creatures following the fall into sin involves losing a sense of purpose or meaning. Humanity’s outward physical decay becomes a sign of an inward spiritual decay in which individuals now lack a sense of ultimate understanding, meaning, purpose, and love of God (Athanasius, 2000, 29–30). Nature that was once enchanted now seems comparatively dull. Much like Athanasius, St. Augustine writes detailing the loss of unified purpose between body and soul, wisdom and knowledge, or material and spiritual aspects of the world in places such as The Trinity and The City of God (Ridenour, 2018, 107–114). Unlike the Manichaeans, Augustine found material reality to be a created good, integral to full human identity, including Christ himself who was composed of both body and soul (Williams, 2008, 180). Implicit within Manichean philosophy was the idea that spirit was good and matter was evil. Augustine, on the other hand, affirms spirit and matter as good in that God establishes both dimensions in the creation narrative. Augustine believes God created humans as “ensouled bodies” that once had access to the tree of life in the enchanted garden as a kind of ongoing sacrament for sustained life (2002, 323). Access to the tree of life entailed not only ongoing physical life, but also access to eternal wisdom in humanity’s dependence on the Creator for knowledge (Augustine, 1991, 155). Here, relying on an allegorical interpretation of the Genesis narrative, persons no longer have access to the mythological tree symbolizing eternal wisdom until a new tree of life becomes available. In Jesus Christ, a new tree of life emerges, offering not only the hope of ongoing physical life through the resurrection, but also reintegrating humanity with its source of wisdom in dependence on God. As Lewis Ayres interprets The Trinity, the divine and human natures of Christ reintegrate wisdom and knowledge, or the meaning and purpose for nature again in his person (1998, 111–139). In Christ, nature is seemingly re-enchanted with revelation. Revelatory creation that is often darkened or misunderstood by sin is best illuminated through Christ. The Christian narrative affirms the person of Christ as integral not only for redemption through reconciliation with God, but also for revelation in knowing God and creation’s meaning once more (Barth, 1960, I/1, 304–334) In The Trinity, Augustine notes that a two-fold sacramental death takes place in humanity’s sin in which the soul becomes “wisdomless” while the body becomes “lifeless” (1991, 155–157). Christ comes to offer new life for the soul and body. In turning to the person of Christ, believers gain access not only to the promised benefits of the resurrection, but also to the “mind of Christ” who offers meaning to nature once again through his own person as material body and soul (1 Cor 2:16ff). Through union with Christ in the Spirit, believers gain access to wisdom or meaning that helps interpret nature in light of his death and resurrection (Ridenour, 2018, 50–54). This kind of wisdom views nature and the world as dependent on a Creator, subsisting in God. In Divine simplicity, the Triune God creates a world of multiplicity and processes dependent on God as its origin (Williams, 1994, 17–19). Just as God’s nature is unity in divine trinity, so too is the world purposed for sacramental unity, thereby invoking a sense of enchantment in its harmonious intention and profound wonder. However, sin might be personified through disharmony when creation works against itself in conflict or the tension often encountered between body and soul. Rather than experience full harmony, much of life includes fragmentation and discord. Christ’s person came to offer our nature healing through participation in Divine wisdom or union with His person through the Spirit alongside future hope of physical resurrection to help repair our sense of fragmentation. The Hypostatic union of Christ’s two natures, human and divine, serves as the source of reintegration of spirit and matter, soul and body in his person (Ridenour, 2018, 193–195). Through union with Christ, humanity has the possibility for communing with Divine presence again and reintegrating a sense of self as body and soul intended for harmony. Reimagining nature through the lens of Christ sheds light on created nature for Christianity and its meaning. Responding to Faustus and the Manichaeans in his desire to make explicit the value of the created world, Augustine coins the phrase “The Book of Nature” as a second “literary text” or “narrative” for revealing God along with the person of Christ and the narrative of Scripture (2007, 422). Seeing “nature” or “creation” as contingent on a “Creator,” Augustine affirms the dependency and subsistence of humanity along with the world on God. Not surprisingly, perhaps, Thomas Aquinas references Augustine throughout his voluminous Summa Theologica as the “Doctor of Grace” in his reappraisal of Augustine’s sense of wisdom and knowledge alongside Aristotle’s teleology in his own “enchanted view” of nature. Offering a systematic view of nature in terms of formal, final, material, and efficient causes intended for happiness and ultimately, union with God, Aquinas’ natural-law theory is nothing short of “enchanted.” In Aquinas’ natural-law theory, life takes on goals or an implicit teleology. Laden within nature are purposes, purposes that point to making creatures the kind of species that they are (Verhey, 2010, 2). This coheres with Aristotle’s four causes composing the natural world, one in which St. Thomas Aquinas builds upon in his theology. For Aquinas, formal and final purposes inform material and efficient causes (1948, 229–232). The world is full of purpose, whether a chair, acorn, animal, or human being. While nature aims at happiness or human flourishing, grace or supernature aims specifically at happiness as union with God through Christ (Aquinas, 1948, 583–602). A surprising ally to Aquinas, perhaps, might be Reformer John Calvin. Like Aquinas, Calvin affirms “the final goal of the blessed life” as happiness or knowledge of God (1960, 51). Like Augustine, Calvin says knowledge of God is intimately tied to knowledge of ourselves in that “humanity’s very being is nothing but subsistence in the one God” (1960, 35). Humanity’s essence or being is fully dependent on God, and wisdom is contingent on knowledge of the Creator for creation’s ultimate purposes, much like Augustine. Calvin also envisions the created world as “the book of nature” in its reflection of the Creator’s character, making the invisible qualities of God’s essence manifest through God’s works (1960, 52). Building on this reasoning, Calvin esteems the structure of the human body as one of the greatest demonstrations of God’s works, describing the body in terms of “the greatest keenness in order to weigh, with [physician] Galen’s skill, its articulation, symmetry, beauty, and use . . . the human body shows itself to be a composition so ingenious that its Artificer is rightly judged a wonder-worker” (1960, 53–54). Looking directly at the body or nature itself, observers find themselves in awe, wonder, or enchantment. While self-identifying as humanist, yet sounding much like John Calvin, the late physician Sherwin Nuland describes the sacred privilege of working with the human body. The language he uses sounds much like the wisdom or beauty identified with revelation in the Christian theme of creation. He says, “For thirty-five years, my hands have been deep within the body of humanity . . . Revelation is not too grand a word for what I experienced . . . The multicolored, multitextured fabric of tangible, pulsating reality that is our innermost sanctum represents, to me, nature’s most exquisite artistry . . . I write as a physician, albeit one who is the subject of an enchantment” (Nuland, 1997, xix–xx; emphasis mine). “Enchanted,” Nuland entitles his work the Wisdom of the Body, supporting a more religious approach to nature as something revealed, rather than Weber’s account of nature as one without meaning and thus subject to the dominant social matrix of autonomy, capitalism, and technological mastery (Verhey, 2010, 39). Instead, the body itself contains a form of wisdom. For Nuland, the practice of medicine is primarily an art—not just a science—by which caregivers practice “the art of maintaining and restoring the integrity of [the body’s] diverse faculties . . . [that encompass not only] the structure of us, but also the infinite variety of processes by which we maintain that singular constancy and unity of moment-to-moment life” (1997, xx). His final decades were committed to humanizing medicine and seeking renewal for his beloved profession through writing and speaking on its purposes and ethics (Nuland, 2010). Because of Nuland’s enchanted view of nature, like the religious, he approaches his work in the practice of medicine as a privilege or sacred calling. III. REENVISIONING HEALING AS VOCATION After reimagining nature as enchanted in ways that invoke awe or revelatory purpose and meaning, I now turn to the Christian tradition’s description of vocation as it relates to the healing practice of medicine. Because nature has meaning within the Christian themes of creation, Christology, and redemption, medicine alongside other professions has a calling to participate in creative and redemptive endeavors. This approach stands in contrast to Weber, who argues that science offers information only about biological processes and facts, rather than narratives pertaining to meaning. Because of this, medicine and science have no clear vocation for Weber other than to clarify knowledge or offer the “trivial assertion to maintain life and minimize suffering” (1946, 155). In contrast, interpreters within the Christian tradition offer meaning to nature as well as the subject of vocation with implications for the practice of medicine. The term vocation or calling is most associated with the Pauline text describing believers as called into a “state”—whether married or single—deriving from 1 Corinthians 7:20 (Kolden, 1983, 386). Whereas the medieval, Catholic perspective emphasized the role of vocation as reserved for the religious life, Reformer Martin Luther democratizes vocation for professions beyond religious life, whether butcher, baker, or candlestick maker. Emphasizing the “priesthood of all believers,” Luther considers the “orders of creation” (marriage, family life, work, citizenship or government, and church) to have eternal ends personified through love of neighbor (Benne, 2016, 10). Luther’s description of vocation helps break down sacred/secular divisions in the natural world, thereby supporting the doctrine that secular life, and much of secular work, is sacred. In Luther’s Freedom of the Christian, he says, “The Christian is perfectly free lord of all, subject to none. The Christian is a perfectly dutiful servant of all, subject to all” (1962, 53). For Luther, Christians receive love from Christ and, subsequently, reflect divine love through active love of neighbor as “servant of all” (1962, 53). Vocation becomes a primary way in which individuals love the neighbor (horizontal dimension) through connection to love of God (vertical dimension). On Luther, Gustaf Wingren says, God has made all the offices. Through this work in man’s offices, God’s creative works goes forward, and that creative work is love, a profusion of good gifts. With persons as his “hands” and “coworkers,” God gives his gifts through the earthly vocations, toward man’s life on earth—food through his farmers, fisherman, and hunters; external peace through princes, judges, and orderly powers; and knowledge and education through teachers and parents. (Benne, 2016, 11). While not speaking directly to the realm of medicine, Luther considers various professions as possible vocation before God. An important theme to emphasize for vocation is his description “servant of all” through one’s active love of neighbor. In serving the other, or viewing one’s profession as service, one enacts love. Medicine is a profession intimately tied to service in its care for bodily needs affected by sickness and disease. By attending to others’ need, one encounters her calling. Humanist physician Richard Selzer also identifies the call of a physician as vocation. Much like Sherwin Nuland’s claim that the wisdom of the body is revelatory through nature, so too does Selzer acknowledge the call from the neighbor or “suffering other” akin to Christian interpretations of neighbor love. His description of calling is one that develops over time in response not only to the physical needs, but to the humanity of the patient (Selzer, 2001, 82). Selzer says, When the patient becomes the surgeon, he goes straight for the soul. I do not know when it was that I understood that it is precisely this hell in which we wage our lives that offers us the energy, the possibility, to care for each other. A surgeon does not slip from his mother’s womb with compassion smeared upon him like the drippings of his birth. It is much later that it comes. No easy shaft of grace this, but the cumulative murmuring of the numberless wounds he has dressed, the incisions he has made, all the sores and ulcers and cavities he has touched in order to heal. In the beginning, it is barely audible, a whisper, as from many mouths. Slowly it gathers, rises from the streaming flesh until, at last, it is pure calling—an exclusive sound, like the cry of certain solitary birds—telling that out of the resonance between the sick man and the one who tends him there may spring that profound courtesy that the religious call Love. (2001, 82) The suffering of the patient calls the physician (see also Bishop, 2011, 311; McCarty, 2016, 627). In responding to that call, physicians care for souls as well as bodies through love. Selzer was deeply acquainted with this call by regularly attending the suffering of his patients, whom he perceived as whole persons, both bodies and souls. While Selzer offers a humanistic account of caring for the patient as body and soul, interpretations within Christian theology are deeply familiar with suffering, given the longing for redemption, Christological focus, and its implications for imitators of Christ. Stanley Hauerwas asks what religion has to do with medicine (Hauerwas, 1986, 68). He reminds medical practitioners that central to the Christian community is a narrative of suffering that calls Christ-followers into a world of suffering with others to image Christ’s compassion. He says, For unless there is a body of people who have learned the skills of presence, the world of the ill cannot help but become a separate world both for the ill and/or those who care for them. Only a community that is pledged not to fear the stranger—and illness always makes us a stranger to ourselves and to others—can welcome the continued presence of the ill in our midst . . . the hospital is, after all, first and foremost a house of hospitality along the way of our journey with finitude . . . It is our sign that we will not abandon those who have become ill simply because they currently are suffering the sign of that finitude. (Hauerwas, 1986, 81–82) Sickness becomes a sign of finitude and loneliness in the patient’s sense of “strangeness” and alienation from the self and world. Yet, Hauerwas offers meaning to health care from the narrative of a community shaped by suffering. Looking to Christ’s broken body, nature takes on meaning in its brokenness as one informed by those central doctrines of creation, as well as by the incarnation, death, and resurrection in its hope of redemption. Looking at nature in light of Christ’s incarnation, death, and resurrection—eighteenth century American theologian Jonathan Edwards held a deeply enchanted view of the created world as one purposed for redemption. Nature is not only glorious in its created goodness, but also laden with purposes that point to redemption. The central doctrine of creation alongside Christ’s death and resurrection helps shape a believer’s view of the world as purposed for something more. In “Images and Shadows of Divine Things,” Edwards notes the bittersweet reality of creation pointing to life’s meaning. The rose entails a bittersweet mixture of briars and blossoms, revealing our created goodness and sin; the silkworm points to redemption in which Christ clothes believers in his righteousness (Edwards, 2004b, 161–162). Creation is a shadow of things to come, driven toward eschatological ends (Edwards, 2004b, 162). Beyond Aristotelian causes, the doctrines of creation, incarnation, death, and resurrection embedded in the Christian narrative accounts not only for beauty, but also for suffering in life. With this enchanted view of nature, the believer can in one moment celebrate the beauty of the “sun, moon, stars, clouds, sky, grass, trees, and water” as “God’s excellency” like Edwards (2004a, 22) and in a differing moment grieve deeply with the suffering other by affirming loss as true and genuine (Ridenour, 2018, 42–44). Here, themes within the Christian narrative depart yet again from Weber’s description of science and medicine as disenchanted in its inability to ascribe mystery, awe, or meaning to nature as well as account for genuine loss in suffering. Weber’s “trivial assertion” that medicine should “maintain life and diminish suffering,” reflects the ambiguity surrounding ultimate goals associated with medicine or the ability to determine “whether life is worth living” (Weber, 1946, 144, 155). For Weber, science and medicine are devoid of meaning. The best science can offer is clarity regarding “knowledge of interrelated facts” (1946, 152). Just as Weberian science lacks purpose and meaning for life, so too does it lack compassion and comfort in suffering. If knowledge pertains to facts only, then what value is there in life, its diminishment, suffering, or end? Who is to say how or when one should live or die—and not “master nature technically” according to individual choice? (Verhey, 2010, 39). The theme of suffering within Christianity might offer mercy by entering into the suffering of other’s chaos with realistic (as opposed to naïve) hope (Keenan, 2010, 118). Hope of resurrection does not side-step pain and suffering, but walks through these experiences as seen in a Savior who endured the cross. Brett McCarty offers a helpful corrective to Jeffrey Bishop’s totalizing diagnosis of modern medicine within The Anticipatory Corpse by offering incisive critique (as opposed to total critique) of contemporary western health care (McCarty, 2016, 625). McCarty appeals to premodern historical practices in which the roots of the relationship between medicine and religion run deep (2016, 632). In the West, the first hospitals emerged in medieval Catholic religious communities administering hospitality to the sick, poor, and dying (Keenan, 2010, 118). Practices associated with caring for the neighbor in need or attending the particularity of the neighbor through works of mercy became commonplace. Humanistic physicians such as Selzer and Nuland find proximate meaning in a strong call to respond to those who suffer. While not speaking from the locus of a specific religious tradition with ultimate ends in mind, their enchanted view of nature is informed by the call and practice of medicine in attending human bodies in need. The practice of compassion and service to the suffering other informs them of proximate values within medicine’s vocation. Here, unlike Weber’s account of disenchanted nature in its inability to articulate substantive goals for the vocation of medicine, Selzer’s and Nuland’s response to the suffering neighbor resonates in part with James Keenan’s description of compassion that enters into the suffering other’s chaos (Keenan, 2010, 118). Not unlike the general goals of Selzer and the more specific theology of Keenan, the founder of modern nursing, Florence Nightingale, admonishes young nurses on entering their career to live up to their profession as a calling (Nightingale, 2012, 248). By loving Christ in loving the patient, Nightingale describes the ways in which the nurse can live beyond the mere bustle and activity of the hospital. The way in which individuals pursue supernatural love for the patient—even when the call proves difficult—comes through communion with God or prayer. She says, “Hospital life without the depth of religion is shallow” (Nightingale, 2012, 247). In an attempt to consecrate mundane activity, Nightingale recognizes the profession of nursing and healthcare work as a high calling, one that serves both God and patient as neighbor. In this way, Nightingale aims to revitalize nursing with care for spiritual life rather than physical life only. Herein lies the practical approach for serving patients as neighbor—attending others as bodies and souls. IV. REVITALIZING MEDICINE WITH ENCHANTMENT An enchanted view of nature might incorporate at least three practical postures in caring for patients through vocation. The first is to attend to patients as gifts through reception, given those creative and redemptive purposes that offer meaning to nature and creation. To revitalize medicine with animating life, perhaps our vision should be attuned to welcoming the sick and stranger as more than those bodies, diseases, and sicknesses we might measure. As McCarty recognizes, increasing interest in patient narratives and histories has become more commonplace within bioethics and the practice of medicine (McCarty, 2016, 630). Listening to narratives beyond medical charts alone recognizes patients as subjects with full lives beyond the temporary objectification that comes with diagnosis and prognosis of sickness and disease. Whole lives and self-narratives extend well beyond acute and chronic conditions of suffering, just as nature extends well beyond what might be singularly observed under the microscope or on the operating table. In this sense, medicine is an art form (Nuland, 2010) that seemingly distends or at least momentarily slows down time and space to intimately intervene with healing care (Selzer, 1982, 49, 54). Through such care, medicine and health care point to the great physician who ultimately intervenes beyond our boundaries of time and space in his healing miracles and above our nature with physical resurrection. A second posture situated in the creative and redemptive narrative is to view the call of medicine and health care as primarily healing care and, at times, cure. Daniel Callahan specifically critiques medicine as supposedly accepting mortality as part of human nature, while ironically researching cures for every disease that ends in death (2000, 72). Interestingly, Robin Gill identifies contemporary medicine’s cure-based medicine as a relatively new phenomenon in relation to the meaning of healing. Ancient and Biblical understandings of healing, on the other hand, distinguish between healing and cure (Gill, 2006, 71). Gill asserts that modern medicine looks for cure or cause of disease under the microscope, whereas ancient medicine looked for symptoms that helped locate diagnosis in order to respond in socially meaningful ways. Relying on John Pilch, Gill says the primary healing narratives in the Gospel stories have to do with recovering value, identity, or a state of being in community. In other words, healing meant restoration to life’s meaning and purposes. Healing focuses on comforting and aiding the present condition rather than on future disease. Pilch likens this to contemporary medicine by broadening the term “care” to “healing” that, at times, involves “cure” (Gill, 2006, 73). Gill juxtaposes medicine in the modern west as focused on underlying cause, individualism, the future through cure, and control over nature. New Testament healing, on the other hand, focuses more on immediate illness and identity, communal relationships, being and becoming, the present, and recognizes human nature as beyond our control (Gill, 2006, 74). Gill uses the example of John Pilch’s wife who suffered from ovarian cancer to demonstrate his point. Although she was never officially “cured,” (which meant five years of remission, according to her physician), both she and her husband affirmed that she encountered “healing.” After experiencing three years of remission from her cancer, Pilch says, “My wife was healed even before she went into remission and continued in her healed state until she died. She and I discovered new meaning in life, meaning specific to this shared experience of battling the disease, and ultimately—in our case—recognizing that the disease had won” (Gill, 2006, 74). Here, healing offers a broader view of care beyond cure only. Healing involves restoring meaning to life in accord with nature’s creative and redemptive purposes. Gill’s analysis accords with Bishop’s description of modern medicine’s irony: life is flux while death is stasis (2011, 310). Baconian medicine and Weber’s disenchanted approach to natural science tries to control “flux” or that which is uncontrollable. Nature or life is one of perpetual motion and change. Death, on the other hand, is unchangeable. Thus, to revitalize medicine with a sense of enchantment, one needs to reenvision nature as mysterious and beyond human control even while doing our best to care for the immediate need in the present moment. Stanley Hauerwas affirms that the ultimate goal of health care is not cure, but care by being present to the other in pain (1986, 79). Still, healing might be a hopeful endeavor in that its mystery includes its power to point to the great physician beyond human control. In an interesting passage, Karl Barth acknowledges ways in which healing is a sign of the kingdom of God invoked in the here and now, while awaiting its final consummation in the future. He says, “Jesus . . . as the Representative of the positive will of God . . . first institutes, in His miracles of help, healing, exorcism and resurrection, signs of the kingdom of God, of His true kingdom on the right hand in which He himself and man on earth will be really glorified” (Barth, 1960, III/4, 367). In a sense, every healing act of care (and in some cases, cure) point to the presence of God through the incarnation, atonement, and resurrection. Healing is primarily care in our suffering and, at times, temporary cure of our immediate pain while awaiting final glorification or “cure” in the fulfillment of Christ’s kingdom for eternity. This leads to a third and final posture appropriate to an enchanted view of nature that animates the vocation of medicine with practices known as works of mercy. For centuries, Christianity, and Roman Catholicism in particular, has been concerned about caring for the neighbor’s body and soul through love and works of mercy. Drawing from the parable of the sheep and goats in Matthew 25:31–46, Jesus describes sheep who will enter the kingdom of God as those individuals who fed Jesus when hungry, gave him drink while thirsty, invited him in while a stranger, and helped him when he was sick or in prison (Matt 25:35–36). The sheep then humbly ask when they administered these actions to Christ. He replies by saying, “Truly, just as you did it to one of the least of these who are members of my family, you did it to me” (Matt 25:40 NRSV). The Roman Catholic tradition later formalizes the teachings from Matthew 25 into seven corporeal and seven spiritual works of mercy that include feeding the hungry, giving drink to the thirsty, sheltering the homeless, clothing the naked, visiting the sick, visiting the imprisoned, and burying the dead for the corporeal acts (Keenan, 2010, 118). The spiritual works of mercy, on the other hand, include giving good counsel, teaching the ignorant, admonishing sinners, consoling the afflicted, pardoning offenses/injuries, bearing offenses patiently, and praying for the living and the dead (Keenan, 2010, 118). Caring for body and soul serves as a sign of God’s care for the whole person. Interestingly, physician Daniel Sulmasy’s use of the five senses as basic both to physical and spiritual care through diagnosis and prayer emphasizes the role of touch, taste, smell, sight, and listening in the healing process, thereby offering a kind of spiritual focus in the physical care of one’s patients (1997, 71–89). Through this discipline, he seemingly inculcates themes consistent with corporeal and spiritual works of mercy as he attends patients under his care. In caring for the bodily needs of hunger, thirst, sickness, nakedness, isolation, imprisonment, or burying the dead, caregivers point to the temporal, physical world as a sign of the spiritual needs manifest in the human spirit. In doing so, the corporeal works of mercy reveal something about human nature as connected through body and soul by recognizing the sacred call to attend individuals as whole persons with past histories and future identities intended for community. To care in this way is to be subject to what Nuland describes as a kind of enchantment. For enchantment, human nature is revelatory in that nature points to something greater and beyond our control, namely to the Triune God as transcendent and unified. To reinvoke this sense of enchantment is to reinstate a sense of mystery, awe, and wonder at the human body and nature itself as something to be received rather than manipulated through choice as technological mastery (Weber, 1946, 144; Verhey, 2010, 39). Here, nature points to meaning both within and beyond itself. By approaching patients as whole persons with this kind of enchantment, perhaps medicine might reestablish its vocation as one aimed at healing care, as opposed to trivialized in its meaning according to Weber (1946, 144). By departing from Weber’s modern perspective that isolates nature from meaning or purpose, medicine might again find beauty and wisdom with an enchanted view of the body. 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TI - Re-Enchanting Nature and Medicine
JO - Christian Bioethics
DO - 10.1093/cb/cbz010
DA - 2019-11-05
UR - https://www.deepdyve.com/lp/oxford-university-press/re-enchanting-nature-and-medicine-PK2i2pJCGZ
SP - 283
VL - 25
IS - 3
DP - DeepDyve
ER -