Tag Archives: healthcare

On how, and why, whole sectors of modern work were birthed from the heart and mind of the Christian church


Been very busy over the past few years, and a bad blogger – not posting much at all.

Among other pieces I’ve posted elsewhere but forgotten to link here at the Grateful To the Dead blog is this one, featured at The Public Discourse blog – run by the Witherspoon Institute at Princeton. The piece is a fairly brief meditation on what the Incarnation has meant in Western culture. It contains some ideas that I first published in the Medieval Wisdom book, and that I’m looking forward to extending in my next book. That book will most likely explore how entire sectors of human work that foster and support the material and social dimensions of human flourishing emerged ex corde ecclesia – from the heart of the church (and informed by the mind of the church!):

Christianity is so much more solid, and real, and human, than the “spiritual, but not religious” imitations of today. Christian faith touches every aspect of our lives—material, social, cultural. It does so because our God was born as a human baby in a stable and nurtured by a teenaged girl named Mary.

. . .

Out of a desire to imitate Christ’s compassion for those suffering from bodily illness, they poured the work of their hearts into a new institution called the hospital, succored (especially) the poor sick, and so birthed not only modern medicine but also our whole non-profit sector.

Out of fidelity to Christ’s command to “love God with their minds,” they poured the work of their minds into a new institution called the university, and so laid the foundation for the scientific revolution.

And out of aching devotion to the beauty of God’s holiness, imaged forth in Christ, they poured their imaginations and craft and labor into the glorious, soaring beauty of the Gothic cathedrals, and so nurtured and fostered artists in all media from then to now.

Healthcare. Education. Culture. To us, who labor in every kind and corner of modern human work, medieval incarnational faith speaks a “word in season.” It tells us:

Our bodies matter.

Our minds matter.

Our relationships matter.

Our work matters.

C S Lewis’s quasi-medieval ministry of mercy – part II


C.s.lewis3 (1)Here is the rest of the conclusion of the “compassionate ministry” chapter draft from Getting Medieval with C S Lewis (the first part is here). Here we see more of how Lewis applied the classic medieval virtue of mercy in his own life, as well as how he accused modern materialists of forgetting that we cannot solve all of our problems by application of better and better techniques.

More concretely, Lewis was also lavish in his almsgiving. He said this on giving: “Giving to the poor is an essential part of Christian morality. I do not believe one can settle how much we ought to give. I’m afraid the only safe rule is to give more than we can spare. In other words, if our expenditure on comforts, luxuries, and amusement, is up to the standard common of those with the same income as our own, we are probably giving away too little. . . . For many of us the great obstacle to charity lies not in our luxurious living or desire for more money, but in our fear – fear of insecurity. This must often be recognized as a temptation.”[1]

Barfield, who was Lewis’s trustee as well as his friend, observed how Lewis followed this principle in his own life. “He gave two-thirds of his income away altogether and would have bound himself to give the whole of it away if I had let him. . . . There were substantial donations to charitable institutions, but what he really liked was to find someone through a personal connection or hearsay whose wants might be alleviated. He was always grateful to me for suggesting any lame dog whom my profession [as a lawyer] had brought to my notice.” (14) Nor did he worry about wasting his money on undeserving types. Instead, he reflected, “It will not bother me in the hour of death to reflect that I have been “had for a sucker” by any number of impostors; but it would be a torment to know that one had refused even one person in need.” Continue reading

C S Lewis’s quasi-medieval ministry of mercy – part I


Kindly Lewis photoHere is the first bit of the conclusion of the “compassionate ministry” chapter draft from Getting Medieval with C S Lewis (the second part is here). Here Lewis helps us see the breadth and spiritual dimension of the classical medieval virtue of mercy:

How can we benefit today from this consistent though evolving medieval witness to compassionate charity through healthcare? For one thing, I believe we can see in that witness a clear reminder of the supreme role of mercy in living out the gospel. Lewis, who knew the tradition well, insisted that “if one virtue must be cultivated at the expense of all the rest, none has a higher claim than mercy.”[1] He understood, of course, the teaching of the scholastics that mercy both is and is not Christianity’s highest virtue. It is not the highest virtue, as Aquinas taught, because the theological virtue of caritas, love for God, must be counted greater, since its object (God) is greater than that of mercy (humans). But as far as “external works” are concerned, we know that “the sum total of the Christian religion consists in mercy.”[2]

This puts individual acts of mercy in the right context: they are agape, caritas, made concrete through action. “Agape in action,” as Lewis put it in a letter to a Mrs. Ashton, who has taken in a poor illegitimate child to her household. “Charity,” he wrote to her, “means love. It is called Agape in the New Testament,” which is the kind of love that “God has for us,” which is “all giving, not getting.”  As the word was used by the medievals: not just throwing a few dollars at a problem—though giving money can be one kind of charity—but actualizing one’s love, which is why “to give time and toil is far better and (for most of us) harder.”

The unfortunate history of the word “charity” actually illustrates the breaking of this holism between acts of mercy (social ethics) and Christian love (personal ethics, character). Continue reading

Medieval lay ministry to the sick – joining in their sufferings to meet Christ


medieval-doctorsAnd here is a bit more from Getting Medieval with C S Lewis on the “charitable revolution” in late medieval Europe, with its outpouring of personal care to the sick – founding of hospitals, waiting upon the sick hand and foot, entering into their sufferings with compassion, and finding in all of that the personal presence of Jesus Christ, just as Matthew 25 promised.

A paragon of the new model of lay involvement in healthcare was Elizabeth of Hungary. A wealthy laywoman on the model of the ancient Roman Christian hero Fabiola, the 13th-century lay saint Elizabeth began, after her husband’s death, to feed, wash the feet of, sew clothes for, and bury the sick poor. No arms-length philanthropist, she delighted in the unpleasant, humiliating labor of personally attending – after the manner of a modern nursing assistant – to the basest and messiest physical needs of her charges.

One might interpret such devotion to healing tasks as self-interested, since the theology of the day at times seemed to virtually assure salvation to those so engaged. No doubt this was a motivator, but theologians also stressed the attitude of the heart in ministering to others. Because Matthew 25 clearly showed that charitable acts to the needy were, in fact, done to Christ himself, physical charity wove itself into the fabric of one’s heart relationship with God (see “affective devotion” chapter).

In fact, Elizabeth’s actions represented (and promoted) a new, strongly affective theology of healthcare: in com-passion, the empathetic experiencing of others’ pain and suffering, she—and increasingly the Western church at large—found redemptive value because it brought them closer to Christ. By helping the sick and poor, they were not only imitating the example of Christ, but at the same time pouring out their love to him “in the most intimate and sacrificial way.”[1] Continue reading

The medieval charitable revolution: Healing as “the Jesus thing to do”


Works of Mercy

Works of Mercy (Photo credit: jimforest)

More from the “hospitals chapter” of my Getting Medieval with C S Lewis:

During this time, a new theology of sickness sprang up: “like monks, martyrs, saints, and finally apostles, the sick could function as mediators between God and His people. Their intercessional prayers on behalf of patrons and caregivers were believed to be valuable.”[1] This was an important development, and in the 12th century, in a more urban and more economically stable and flourishing Europe, it would contribute to a massive uptick in the foundation of hospitals by wealthy lay donors.

And that was a good thing – the “charitable revolution” of the 12th century – because by the 11th, monasteries were nearing the end of their hospitalling. The culprit? Economic change: Continue reading

Monks, illness, demons, and sin


Monastic hospitalFitting right into the modern Monty Python stereotype of medieval people as backward, ignorant, and superstitious is the assumption that especially the monks of the Middle Ages sought only supernatural explanations for things. Understanding that up to the 12th century, healthcare took place almost exclusively in the monasteries, we jump to the logical conclusion: such care couldn’t possibly have attended to the physical causes of illness. Didn’t those monks just believe that illness was caused either by demons or by the sins of the sick person? There’s a germ of truth here (pun intended), but the reality was quite different. That’s the subject of the next section of the hospitals chapter in my Getting Medieval with C S Lewis.

Monastic phase

The distinctly monastic flavor of healthcare during the Middle Ages – even when it was provided by lay orders like the Hospitallers – deserves a bit more probing. From the beginning, monasteries in the West took Benedict’s cue and made caring not only for ill monks but also for needy travelers one of their primary tasks. The “stranger” was always an object of monastic charity. This “rather broad category,” says medical historian Gunter Risse, included “jobless wanderers or drifters as well as errant knights, devout pilgrims, traveling scholars, and merchants. . . .”[1] Monastic care for the stranger and the ill was formalized in the 800s during Charlemagne’s reforms, as assemblies of abbots (leaders of monasteries) gathered to reform and standardize that aspect of monastic life. At that time many of the scattered church-sponsored hostels (xenodocheia) across the Holy Roman Empire were given “regula”—quasi-monastic rules, and “monasteries . . . assumed the greater role in dispensing welfare.”

Organized, ubiquitous, stable, pious: the monasteries of the West became sites of care and of medical learning. “Benedict’s original rule ordered that ‘for these sick brethren let there be assigned a special room and an attendant who is God-fearing, diligent, and solicitous.’ This monk or nun attending the sick—the infirmarius was usually selected because of personality and practical healing skills. The latter were acquired informally through experience, as well as through consultation of texts, medical manuscripts, and herbals available in the monastery’s library or elsewhere. . . . The infirmarius usually talked with patients and asked questions, checked on the food, compounded medicinal herbs, and comforted those in need. . . .”[2]

“A rudimentary practice of surgery (‘touching and cutting’) at the monastic infirmary was usually linked to the management of trauma, including lacerations, dislocations, and fractures. Although these were daily occurrences, the infirmarius may not have always been comfortable practicing surgery on his brothers, for it was always a source of considerable pain, bleeding, and infection. Complicated wounds or injuries may have forced some monks to request the services of more experienced local bonesetters or even barber surgeons. . . .”[3] Risse notes other popular healing practices of the Middle Ages that were integrated into the monastic medical routine, including herbology, bathing (not otherwise common!), preventive bloodletting, and diagnostic examination of pulse, urine, stool, and blood.

The mention of some of these “backward” medieval medical practices may raise another stereotype many have in their heads about the Middle Ages. Just as some still believe the fabrication that medieval people believed in a flat earth, some assume that medievals did not know, and were not interested in, the physical causes of illness. Instead, the story goes, they assumed all illness came from devilish or demonic sources, or, a variant, from some hidden sin in the sick person. Continue reading

From poorhouse to hospital – a medieval development


Basil

Basil (Photo credit: el_finco) Not actually Basil the Great, but the herb, which has been used since ancient times as an anti-inflammatory.

Here’s the next bit of the “hospitals chapter” in Getting Medieval with C S Lewis. It follows from this bit on Lewis, this introductory bit, and this description of the very first proto-hospitals in the earliest Christian church

Basil’s House of Healing

The hospital itself, it is generally agreed, begins to emerge in the fourth century from the compassion of a well-known monk—Basil, now called “the Great.” In setting the scene for this story, historian Timothy S. Miller reminds us that Lewis’s “two-edged” description of the faith (body affirming + spirit affirming) characterized monks as well as laypeople – in a way many moderns find surprising. Mentioning some of the monks’ more severe ascetic practices (for example, the unforgettable Simeon Stylites’ long stretches sitting atop a pole in the desert), Miller admits, “Their lifestyles of severe self-denial may seem to pull against the truth that God made us human beings and called us ‘very good’—bodies and all.”

“But,” continues, Miller, “if monastics really thought of the body as evil, then how is it that some of the greatest strides in the history of healthcare arose within monasticism? Monks cared for the ill in Benedictine monasteries, Franciscan leprosaria, the institutions of the monastic ‘hospitallers,’ the many hospitals of the Augustinians, and so on throughout the history of monasticism.” Basil started it all, and his story “decisively dispels” our “myths of body-hating monks.”[1] Continue reading