Death is modern medicine’s epistemology, metaphysic, and ethic.[i] I first came across Jeffrey Bishop’s provocative argument as a medical student. Now, as a resident physician, I’m wrestling with Kimbell Kornu’s rich extension of Bishop in his Theopolis Conversation Starter: that because death is modern medicine’s stillpoint, modern medicine is also nihilistic.
I want to note upfront that I’m largely convinced by the work of Bishop and Kornu. These are thinkers I respect, and I’ve found their arguments incisive, powerful, and correct.
However, as I’ve tried to share Bishop’s work (and now Kornu’s) with fellow residents, medical students, and even pastors, I’ve noticed a disconnect. As Leithart gestures, there is a practical culture of healthcare far afield from the language of Foucault and Heidegger, in which talk of a nihilistic medicine comes across as exaggerated and fatalistic. Medicine does not feel death-centered among most patients, most of the time.
It seems to me that the task before us is therefore one of imagination and evangelism. As such, I will shift the conversation already underway between Kornu, Brian Brock, and Peter Leithart to the world of primary care and medical education. As I’ve experimented with communicating with distracted medical students, overwhelmed residents, overlooked chaplains, and local clergy, I’ve found surprising sources of connection: Harry Potter, the mere care of the sick, and beauty are accessible and ordinary launchpads for both introducing the nihilism of modern medicine and, more importantly, imagining a faithful response.
Master of Death
Modern medicine is nihilistic. As man is rendered a mere resource under an eschatology of the Nothing, medicine turns to technology to master death. What practical examples can we give?
Bishop and Kornu point to the ICU and organ transplantation—the body-turned-machine moving ever closer to “parts replacement.” Brock shows how prenatal testing “presses toward the elimination of human lives that it is assumed cannot be made useful.” Leithart echoes with attention to physician-assisted suicide, in which medicine—as Stanley Hauerwas memorably put it—increasingly seeks to eliminate suffering by eliminating the sufferer.[ii]
I think of an (admittedly odd) allusion to J. K. Rowling’s Harry Potter and the Deathly Hallows, in which the titular “deathly hallows” are imagined as three distinctly powerful magical objects: “the elder wand” (the most powerful wand in existence), the “cloak of invisibility” (cut from the shroud of Death itself), and “the resurrection stone” (a gem which can briefly recall loved ones from the dead). Once collected, they make one “master of Death.”[iii]
Modern medicine attempts to master death with its own deathly hallows: the elder wand of the biopsychosociospiritual model (presumably capable of handling the most powerful “spells”), the invisibility cloak of palliative care (from the Latin pallium, literally meaning “cloak” and imagined as that which should render death invisible), and the resurrection stone of grief counseling (in which loved ones are briefly “recalled” among mental health and the social sciences).[iv] Taken and employed together, they subtly suggest that medicine can master death—controlling it through exhaustive diagnostic schema, cloaking it through palliation, and even reaching past the grave to deaden death itself through psychiatry and bereavement care.[v]
Importantly, Harry Potter does not reject these hallows. He is aware of their power, eventually using all three. Harry’s use of the hallows is juxtaposed against their use by the villain, Voldemort (a name that, interestingly, probably means something like “master of death”). As the story goes, it is Voldemort’s obsession with controlling death that ultimately leads to his own, whereas it is Harry’s submission to death that leads him through a sort of resurrection.
It does not take long for Harry Potter to realize that the deathly hallows will not make him master of death. Nor does it take long for a new resident to realize that the biopsychosocialspiritual model of medicine—broad and helpful as it is—cannot and does not solve the problem of death. It merely gives us categories to organize our efforts in a long defeat. In order to perceive and respond to death wisely, we need an alternative metaphysic that turns death on its head. Kornu rightly points to the life, death, and resurrection of Jesus Christ. “Theology can indeed save medicine.”
And yet, as Kornu asks, “How do we approach this?” It seems to me this is the question du jour for Christians in medicine. I confess I’m weary of salvific language in which theology “saves” medicine, not because I doubt theology’s power, but because I fear medicine’s ontotheological powers and instrumentalizing forces.[vi] In so far as Christianity is held up as a way to fix or “save” a nihilistic medicine, we risk merely handing over yet another tool which medicine might immediately strip of pesky metaphysical particularities and assimilate into its deathly hallows as yet another aspect of the biopsychosocialspiritual schema.[vii] As palliative physician Farr Curlin puts it, “physicians would only make Christian faith a weak instrument in service to a strong idol.”[viii]
Broadening the Differential
William Osler (known as “the father of modern medicine”) wrote in 1921 that the new, Greek spirit of medicine “arose from the dead with the New Testament in one hand and Aristotle in the other.”[ix] A century later and it would seem the spirit of medicine has turned back to the grave with empty hands. Medicine has become what Nietzsche called a “stupid” science because it has forgone questions of meaning—formal and final purposes—in favor of material and efficient causes.[x] In medicine as in modernity, the language of purpose is undermined by the language of function.[xi]
Thus, those of us in medicine find ourselves in a peculiar tension. We lament the materialism of a medicine dismissive of metaphysics but sense that something deeply metaphysical happens nonetheless when we deliver babies and comfort the dying. Patients rightly resist being treated as machines but often demand medication refills and quick fixes as if they were just machines.[xii] The tension confirms what Curlin calls the “Kierkegaardian Irony” of modern medicine, that even if (and especially when) modern medicine is operating at its most life-affirming and meaningful, we still sense we have missed the mark, manifest in the bewilderment, bureaucracy, and much-bemoaned “burnout” which marks today’s clinicians.[xiii]
And yet, the suggestion that medicine is “stupid” (let alone undergirded by death) is likely to strike most physicians as a philosopher’s hyperbole—distant from the practical world of healthcare and dangerous to a profession already thirsty for hope. Like a patient in denial over a new and devastating diagnosis, doctors are likely to resist any diagnosis that finds their work both necrocentric and nihilistic.
As Bishop puts it, “diagnosis is easy; therapy is difficult.”[xiv] But as any new resident knows, diagnosis can actually be quite difficult. When we encounter patients and pathology, many diagnostic schema interrelate and compete at once. Sometimes it is the therapy that is easy and the underlying diagnosis that is elusive. Indeed, it is easy to “anchor” on one diagnosis.
In the same way, the nihilism of modern medicine—as accurate as it is—is only one diagnostic schema, one that risks anchoring toward fatalism and overlooking the faithful counterforces to nihilism already at work within today’s spaces of healthcare. As ethicist Brett McCarty puts it:
“…medicine still contains within it practices and goods that were present long before the rise of modern practices and discourses … Even if those goods are often unnamed and marginalized, their presence means that modern medicine contains health within it to assist in its own revitalization.”[xv]
For example, there remains a curiously deep moral imperative—universally (if subconsciously) accepted by the majority of medical workers—that the sick are to be cared for simply because they are sick. Modern medicine may find much of its ethic in the anatomized corpse of the autopsy table, but the roots of another ethic—the unconditional commitment to care for the sick—go back at least to the housing of medicine within religious contexts of care where function and purpose were not so easily divorced. The earliest hospitals were places of literal hospital-ity toward the poor and the suffering, in whom Christ claimed a particular kinship: “I was sick and you took care of me.”[xvi]
Indeed, theological approaches to revitalizing modern medicine are already underway.[xvii] The Theology, Medicine, and Culture Fellowship at Duke Divinity School and the Physician’s Vocation Program at Loyola University are just two examples of communities who seek to bind Christian tradition, anthropology, and imagination to medical practice.[xviii] No doubt many local variations exist. They are the grassroots of the very “ontological revolution” which Leithart hopes for, founded on theologies of practical wisdom, worship, and wonder.
Approaching the Beautiful
I am one of the physicians whom Leithart names as longing to practice medicine like his grandfather. My grandfather was also a family physician, one of the first when the profession was created—those John McPhee called “heirs of general practice.” While I’m following that legacy, I grew up training as an artist, and therefore the world of beauty is where I want to turn in conclusion, picking up on the telos of the Beautiful first mentioned by Kornu.[xix]
Of course, perhaps nowhere is ugliness—rather than beauty—more evident than in medicine. The miasma of a hidden abscess, the trauma of an abused child, the stark and violent aesthetic of an intubated ICU patient. Medicine can be very, very ugly.
And yet, even amidst palpable ugliness, beauty has a remarkable tendency to reveal itself. The deeply human moments of prayer at the ICU bed. The wordless recapitulation of the medical staff to surround and comfort the abused. Even the kitsch plastic icons keeping watch over the lonely in nursing homes are examples of the beautiful breaking in precisely in those places of disorder we are habituated to ignore.
Beauty not only breaks in to disorder but reorders disorder. When a laceration is brought into apposition through the careful suturing of an emergency room doc, we get a small hint at the renewal of all things. Moreover, the beauty of Christ’s redemptive work is beautiful not only in restoring right relationships among created things like skin but by restoring right relationships between created things and their Creator.[xx] The language of “informed consent” so familiar to modern medicine (in which moral strangers can do no better than join in sterile contracts with one another as legal automatons) is re-imagined as what Jonathan Edwards called the “infinite consent” of the “primary beauty of God,” in which we partner and participate with one another as fellow creatures and moral friends.[xxi]
There is more we can say. Beauty directs our actions. I am convinced by Bishop Robert Barron’s reading of Hans Urs von Balthasar that the Kantian hierarchy of the Transcendentals has “reversed.”[xxii] Put simply, our culture’s starting point for determining reality no longer begins with Truth or a search for “pure reason” (in which Goodness and Beauty follow only after sufficient exercises in logic and metaphysics). Today, it is wonder, desire, and beauty that make known what we find good.
As I’ve written elsewhere, our aesthetics foreshadow our ethics.[xxiii] Beauty heightens awareness of what-is-not-you, sharpening perception while reshaping affection. We find ourselves in moments of passing radiance in which we say, “Yes, that’s the way things should be,” simultaneously sensitized to the way things should not be—whether ugliness, injustice, or death.
Much of the aesthetics at work within the modern medical humanities is aimed at lifting the clinician out of ugliness. But a Christological account of the Beautiful simply does not allow for this kind of aesthetic escapism.[xxiv] The Beauty of Christ is one that “descended into death.” If beauty is a starting place for sparking an ontological revolution, it will be this Beauty. Like the bush that burns but is not consumed, the Beauty of Christ disrupts the reductive vision of practicing medicine in a dead, materialist world.[xxv] It demands that we remove our sandals and recognize the hallowed ground on which we walk and the deathly hallows with which we contend.
Brewer Eberly is a first-year family medicine resident at AnMed Health in Anderson, South Carolina, a past fellow of the Theology, Medicine, and Culture Fellowship at Duke Divinity School, and a current Paul Ramsey Fellow with the Center for Bioethics and Culture. He would like to thank his friends—and especially Luke Olsen—for their early critiques of this response. The views expressed are those of the author and do not necessarily represent the opinions or policies of the institutions he represents.
[i] Jeffrey Bishop, The Anticipatory Corpse: Medicine, Power, and the Care of the Dying (Notre Dame, IN: University of Notre Dame Press, 2011), 279, 21.
[ii] Stanley Hauerwas, Suffering Presence: Theological Reflections on Medicine, the Mentally Handicapped, and the Church (Notre Dame, IN: University of Notre Dame Press, 1986).
[iii] J. K. Rowling, Harry Potter and the Deathly Hallows (New York: Arthur A. Levine Books, 2007), 410.
[iv] Bishop, Anticipatory, 26, 257.
[v] Ibid., 246–55. American medicine urges the sufferer to “cope and move on” rather than mourn. cf. Allan Noble, Disruptive Witness: Speaking Truth in a Distracted Age (Downers Grove, IL: InterVarsity Press, 2019), 168.
[vi] This is, in part, Jeffrey Bishop’s response to the critique that his analysis overlooks the counterforces working against the metaphysics of death. He worries we will not take the powers and principalities of modern medicine seriously enough. See Jeffrey Bishop, “From Anticipatory Corpse to Posthuman God,” Journal of Medicine and Philosophy 41, no. 6 (2016): 679–95.
[vii] Joel Shuman and Brian Volck, Reclaiming the Body: Christians and the Faithful Use of Modern Medicine (Grand Rapids, MI: Brazos Press, 2006). See also Joel Shuman and Keith Meador, Heal Thyself: Spirituality, Medicine, and the Distortion of Christianity (New York: Oxford University Press, 2002).
[viii] Farr Curlin, “What Does Any of This Have to Do With Being a Physician? Kierkegaardian Irony and the Practice of Medicine,” Christian Bioethics 22, no. 1 (2016): 62–79, 73.
[ix] William Osler, Evolution of Modern Medicine (New Haven: Yale University Press, 1996 [1921]), 127.
[x] Friedrich Nietzsche, The Gay Science with a Prelude in Rhymes and Appendix of Songs, Walter Kaufmann, trans. (New York: Vintage, 1974), 334–6.
[xi] Though, as Leithart also notes, the language of biological “purpose” is making a welcome comeback. See Mark Bauerlein and Ruport Shortt, “Debating Richard Dawkins,” First Things, May 4, 2020.
[xii] See Neal Postman: “…everyone who has a headache wants and expects a CAT scan. … What this means is that even restrained and selective technological medicine becomes very difficult to do, economically undesirable, and possibly professionally catastrophic. The culture itself—its courts, its bureaucracies, its insurance system, the training of doctors, patients’ expectation—is organized to support technological treatments. There are no longer methods of treating illness; there is only one method — the technological one. Medical competence is now defined by the quantity and variety of machinery brought to bear on disease.” Neal Postman, “The Ideology of Machine: Medical Technology” in Technopoly: The Surrender of Culture to Technology (New York: Vintage, 1993), 93–106.
[xiii] Curlin, “What Does Any of This…”
[xiv] Bishop, Anticipatory, 285. See also Brett McCarty, “Diagnosis and Therapy in The Anticipatory Corpse: A Second Opinion,” Journal of Medicine and Philosophy 41 (2016): 621–41, 621.
[xv] McCarty, “Diagnosis and Therapy,” 627.
[xvi] Brett McCarty and Warren Kinghorn, “Medicine, Religion, and Spirituality in Theological Context” in Spirituality and Religion Within the Culture of Medicine: From Evidence to Practice (Oxford: Oxford University Press, 2017), 341–54.
[xvii] As McCarty points out, in so far as these movements act merely as “interpretative overlays” for the body reduced to material and efficient causes, they simply reinforce the human being as an anticipatory corpse in need of ever more efficient and effective forms of diagnostic interrogation and control. Rather than white-washing meaning onto a still dead machine, Bishop wants an undergirding metaphysic and medical imagination that doesn’t need to contrive meaning because it approaches the body knowing it was already meaningful to begin with. See McCarty, “Diagnosis and Therapy,” 623. See also Bishop, Anticipatory, 297–8.
[xviii] Brett McCarty and Warren Kinghorn, “Therapy for Healthcare: Christian Ethics and the Formation of Medical Practitioners,” Society for the Study of Christian Ethics Annual Meeting, London School of Theology, September 6, 2019. Publication forthcoming. See also McCarty, “Diagnosis and Therapy,” 636–7.
[xix] I recognize that offering a definition of beauty—and especially a Christian theological aesthetic—is nuanced and variegated and well beyond the scope of this essay. In my own work, I’ve explored beauty as “that which moves us toward the way things should be.” Brewer Eberly, “Beauty and the Re-enchantment of Medicine,” 2017 Conference on Medicine & Religion. cf. Jeremy Begbie, “Created Beauty” in Resonant Witness: Conversations Between Music and Theology (Grand Rapids, MI: Wm B Eerdmans, 2011), 83–108, 85; Makoto Fujimura, Culture Care: Reconnecting with Beauty for our Common Life, 2nd ed. (New York: Fujimura Institute and International Arts Movement; 2015); Elaine Scarry, On Beauty and Being Just (Princeton University Press, 2001).
[xx] Kimbell Kornu, “The Beauty of Healing: Covenant, Eschatology, and Jonathan Edwards’ Theological Aesthetics toward a Theology of Medicine,” Christian Bioethics 20, no. 1 (2014): 43–58.
[xxi] As Kornu writes, modernity knows man through mathesis (mathematical representation). In an immanent world reduced to complete metabolic panels, lab values, and numeric vital signs, only something like technology can control and mediate that reality for us (what Brock memorably names in his response as the “cyborg experience”). But if man is known through methexis (eternal participation and improvisation), then something like participating in transcendence is how we understand reality. Under mathesis, being is represented in its objectivity. Under methexis, “being is represented in its participation.” Mathesis ends in immanence; methexis begins in transcendence. The nihilism of modern medicine is in part nourished by the language of “consent” which arises from mathetic representation. See Farr A. Curlin and Daniel E. Hall, “Strangers or Friends? A Proposal for a New Spirituality-in-Medicine Ethic,” in On Moral Medicine: Theological Perspectives in Medical Ethics, edited by M. Therese Lysaught, Joseph J. Kotva, Jr., Stephen E. Lammers, and Allen Verhey, 3rd ed. (Grand Rapids, MI: Wm B. Eerdmans, 2012), 286–90. See also Begbie, “Created Beauty,” 91, for potential problems with the use of methexis and the participation metaphor.
[xxii] Robert Barron, “Evangelizing the Nones,” First Things, January 2018. See also Bishop Robert Barron, “Evangelizing Through Beauty,” February 9, 2013.
[xxiii] Brewer Eberly, “The Good, the True, and the Beautiful and the Oscars,” Mere Orthodoxy, March 15, 2018. See also Scarry, On Beauty and Being Just.
[xxiv] Jimmy Myers, “Is It True That ‘the World Will Be Saved By Beauty?’” First Things, July 25, 2015.
[xxv] Noble, Disruptive Witness, 100, 152.
Death is modern medicine’s epistemology, metaphysic, and ethic.[i] I first came across Jeffrey Bishop’s provocative argument as a medical student. Now, as a resident physician, I’m wrestling with Kimbell Kornu’s rich extension of Bishop in his Theopolis Conversation Starter: that because death is modern medicine’s stillpoint, modern medicine is also nihilistic.
I want to note upfront that I’m largely convinced by the work of Bishop and Kornu. These are thinkers I respect, and I’ve found their arguments incisive, powerful, and correct.
However, as I’ve tried to share Bishop’s work (and now Kornu’s) with fellow residents, medical students, and even pastors, I’ve noticed a disconnect. As Leithart gestures, there is a practical culture of healthcare far afield from the language of Foucault and Heidegger, in which talk of a nihilistic medicine comes across as exaggerated and fatalistic. Medicine does not feel death-centered among most patients, most of the time.
It seems to me that the task before us is therefore one of imagination and evangelism. As such, I will shift the conversation already underway between Kornu, Brian Brock, and Peter Leithart to the world of primary care and medical education. As I’ve experimented with communicating with distracted medical students, overwhelmed residents, overlooked chaplains, and local clergy, I’ve found surprising sources of connection: Harry Potter, the mere care of the sick, and beauty are accessible and ordinary launchpads for both introducing the nihilism of modern medicine and, more importantly, imagining a faithful response.
Master of Death
Modern medicine is nihilistic. As man is rendered a mere resource under an eschatology of the Nothing, medicine turns to technology to master death. What practical examples can we give?
Bishop and Kornu point to the ICU and organ transplantation—the body-turned-machine moving ever closer to “parts replacement.” Brock shows how prenatal testing “presses toward the elimination of human lives that it is assumed cannot be made useful.” Leithart echoes with attention to physician-assisted suicide, in which medicine—as Stanley Hauerwas memorably put it—increasingly seeks to eliminate suffering by eliminating the sufferer.[ii]
I think of an (admittedly odd) allusion to J. K. Rowling’s Harry Potter and the Deathly Hallows, in which the titular “deathly hallows” are imagined as three distinctly powerful magical objects: “the elder wand” (the most powerful wand in existence), the “cloak of invisibility” (cut from the shroud of Death itself), and “the resurrection stone” (a gem which can briefly recall loved ones from the dead). Once collected, they make one “master of Death.”[iii]
Modern medicine attempts to master death with its own deathly hallows: the elder wand of the biopsychosociospiritual model (presumably capable of handling the most powerful “spells”), the invisibility cloak of palliative care (from the Latin pallium, literally meaning “cloak” and imagined as that which should render death invisible), and the resurrection stone of grief counseling (in which loved ones are briefly “recalled” among mental health and the social sciences).[iv] Taken and employed together, they subtly suggest that medicine can master death—controlling it through exhaustive diagnostic schema, cloaking it through palliation, and even reaching past the grave to deaden death itself through psychiatry and bereavement care.[v]
Importantly, Harry Potter does not reject these hallows. He is aware of their power, eventually using all three. Harry’s use of the hallows is juxtaposed against their use by the villain, Voldemort (a name that, interestingly, probably means something like “master of death”). As the story goes, it is Voldemort’s obsession with controlling death that ultimately leads to his own, whereas it is Harry’s submission to death that leads him through a sort of resurrection.
It does not take long for Harry Potter to realize that the deathly hallows will not make him master of death. Nor does it take long for a new resident to realize that the biopsychosocialspiritual model of medicine—broad and helpful as it is—cannot and does not solve the problem of death. It merely gives us categories to organize our efforts in a long defeat. In order to perceive and respond to death wisely, we need an alternative metaphysic that turns death on its head. Kornu rightly points to the life, death, and resurrection of Jesus Christ. “Theology can indeed save medicine.”
And yet, as Kornu asks, “How do we approach this?” It seems to me this is the question du jour for Christians in medicine. I confess I’m weary of salvific language in which theology “saves” medicine, not because I doubt theology’s power, but because I fear medicine’s ontotheological powers and instrumentalizing forces.[vi] In so far as Christianity is held up as a way to fix or “save” a nihilistic medicine, we risk merely handing over yet another tool which medicine might immediately strip of pesky metaphysical particularities and assimilate into its deathly hallows as yet another aspect of the biopsychosocialspiritual schema.[vii] As palliative physician Farr Curlin puts it, “physicians would only make Christian faith a weak instrument in service to a strong idol.”[viii]
Broadening the Differential
William Osler (known as “the father of modern medicine”) wrote in 1921 that the new, Greek spirit of medicine “arose from the dead with the New Testament in one hand and Aristotle in the other.”[ix] A century later and it would seem the spirit of medicine has turned back to the grave with empty hands. Medicine has become what Nietzsche called a “stupid” science because it has forgone questions of meaning—formal and final purposes—in favor of material and efficient causes.[x] In medicine as in modernity, the language of purpose is undermined by the language of function.[xi]
Thus, those of us in medicine find ourselves in a peculiar tension. We lament the materialism of a medicine dismissive of metaphysics but sense that something deeply metaphysical happens nonetheless when we deliver babies and comfort the dying. Patients rightly resist being treated as machines but often demand medication refills and quick fixes as if they were just machines.[xii] The tension confirms what Curlin calls the “Kierkegaardian Irony” of modern medicine, that even if (and especially when) modern medicine is operating at its most life-affirming and meaningful, we still sense we have missed the mark, manifest in the bewilderment, bureaucracy, and much-bemoaned “burnout” which marks today’s clinicians.[xiii]
And yet, the suggestion that medicine is “stupid” (let alone undergirded by death) is likely to strike most physicians as a philosopher’s hyperbole—distant from the practical world of healthcare and dangerous to a profession already thirsty for hope. Like a patient in denial over a new and devastating diagnosis, doctors are likely to resist any diagnosis that finds their work both necrocentric and nihilistic.
As Bishop puts it, “diagnosis is easy; therapy is difficult.”[xiv] But as any new resident knows, diagnosis can actually be quite difficult. When we encounter patients and pathology, many diagnostic schema interrelate and compete at once. Sometimes it is the therapy that is easy and the underlying diagnosis that is elusive. Indeed, it is easy to “anchor” on one diagnosis.
In the same way, the nihilism of modern medicine—as accurate as it is—is only one diagnostic schema, one that risks anchoring toward fatalism and overlooking the faithful counterforces to nihilism already at work within today’s spaces of healthcare. As ethicist Brett McCarty puts it:
“…medicine still contains within it practices and goods that were present long before the rise of modern practices and discourses … Even if those goods are often unnamed and marginalized, their presence means that modern medicine contains health within it to assist in its own revitalization.”[xv]
For example, there remains a curiously deep moral imperative—universally (if subconsciously) accepted by the majority of medical workers—that the sick are to be cared for simply because they are sick. Modern medicine may find much of its ethic in the anatomized corpse of the autopsy table, but the roots of another ethic—the unconditional commitment to care for the sick—go back at least to the housing of medicine within religious contexts of care where function and purpose were not so easily divorced. The earliest hospitals were places of literal hospital-ity toward the poor and the suffering, in whom Christ claimed a particular kinship: “I was sick and you took care of me.”[xvi]
Indeed, theological approaches to revitalizing modern medicine are already underway.[xvii] The Theology, Medicine, and Culture Fellowship at Duke Divinity School and the Physician’s Vocation Program at Loyola University are just two examples of communities who seek to bind Christian tradition, anthropology, and imagination to medical practice.[xviii] No doubt many local variations exist. They are the grassroots of the very “ontological revolution” which Leithart hopes for, founded on theologies of practical wisdom, worship, and wonder.
Approaching the Beautiful
I am one of the physicians whom Leithart names as longing to practice medicine like his grandfather. My grandfather was also a family physician, one of the first when the profession was created—those John McPhee called “heirs of general practice.” While I’m following that legacy, I grew up training as an artist, and therefore the world of beauty is where I want to turn in conclusion, picking up on the telos of the Beautiful first mentioned by Kornu.[xix]
Of course, perhaps nowhere is ugliness—rather than beauty—more evident than in medicine. The miasma of a hidden abscess, the trauma of an abused child, the stark and violent aesthetic of an intubated ICU patient. Medicine can be very, very ugly.
And yet, even amidst palpable ugliness, beauty has a remarkable tendency to reveal itself. The deeply human moments of prayer at the ICU bed. The wordless recapitulation of the medical staff to surround and comfort the abused. Even the kitsch plastic icons keeping watch over the lonely in nursing homes are examples of the beautiful breaking in precisely in those places of disorder we are habituated to ignore.
Beauty not only breaks in to disorder but reorders disorder. When a laceration is brought into apposition through the careful suturing of an emergency room doc, we get a small hint at the renewal of all things. Moreover, the beauty of Christ’s redemptive work is beautiful not only in restoring right relationships among created things like skin but by restoring right relationships between created things and their Creator.[xx] The language of “informed consent” so familiar to modern medicine (in which moral strangers can do no better than join in sterile contracts with one another as legal automatons) is re-imagined as what Jonathan Edwards called the “infinite consent” of the “primary beauty of God,” in which we partner and participate with one another as fellow creatures and moral friends.[xxi]
There is more we can say. Beauty directs our actions. I am convinced by Bishop Robert Barron’s reading of Hans Urs von Balthasar that the Kantian hierarchy of the Transcendentals has “reversed.”[xxii] Put simply, our culture’s starting point for determining reality no longer begins with Truth or a search for “pure reason” (in which Goodness and Beauty follow only after sufficient exercises in logic and metaphysics). Today, it is wonder, desire, and beauty that make known what we find good.
As I’ve written elsewhere, our aesthetics foreshadow our ethics.[xxiii] Beauty heightens awareness of what-is-not-you, sharpening perception while reshaping affection. We find ourselves in moments of passing radiance in which we say, “Yes, that’s the way things should be,” simultaneously sensitized to the way things should not be—whether ugliness, injustice, or death.
Much of the aesthetics at work within the modern medical humanities is aimed at lifting the clinician out of ugliness. But a Christological account of the Beautiful simply does not allow for this kind of aesthetic escapism.[xxiv] The Beauty of Christ is one that “descended into death.” If beauty is a starting place for sparking an ontological revolution, it will be this Beauty. Like the bush that burns but is not consumed, the Beauty of Christ disrupts the reductive vision of practicing medicine in a dead, materialist world.[xxv] It demands that we remove our sandals and recognize the hallowed ground on which we walk and the deathly hallows with which we contend.
Brewer Eberly is a first-year family medicine resident at AnMed Health in Anderson, South Carolina, a past fellow of the Theology, Medicine, and Culture Fellowship at Duke Divinity School, and a current Paul Ramsey Fellow with the Center for Bioethics and Culture. He would like to thank his friends—and especially Luke Olsen—for their early critiques of this response. The views expressed are those of the author and do not necessarily represent the opinions or policies of the institutions he represents.
[i] Jeffrey Bishop, The Anticipatory Corpse: Medicine, Power, and the Care of the Dying (Notre Dame, IN: University of Notre Dame Press, 2011), 279, 21.
[ii] Stanley Hauerwas, Suffering Presence: Theological Reflections on Medicine, the Mentally Handicapped, and the Church (Notre Dame, IN: University of Notre Dame Press, 1986).
[iii] J. K. Rowling, Harry Potter and the Deathly Hallows (New York: Arthur A. Levine Books, 2007), 410.
[iv] Bishop, Anticipatory, 26, 257.
[v] Ibid., 246–55. American medicine urges the sufferer to “cope and move on” rather than mourn. cf. Allan Noble, Disruptive Witness: Speaking Truth in a Distracted Age (Downers Grove, IL: InterVarsity Press, 2019), 168.
[vi] This is, in part, Jeffrey Bishop’s response to the critique that his analysis overlooks the counterforces working against the metaphysics of death. He worries we will not take the powers and principalities of modern medicine seriously enough. See Jeffrey Bishop, “From Anticipatory Corpse to Posthuman God,” Journal of Medicine and Philosophy 41, no. 6 (2016): 679–95.
[vii] Joel Shuman and Brian Volck, Reclaiming the Body: Christians and the Faithful Use of Modern Medicine (Grand Rapids, MI: Brazos Press, 2006). See also Joel Shuman and Keith Meador, Heal Thyself: Spirituality, Medicine, and the Distortion of Christianity (New York: Oxford University Press, 2002).
[viii] Farr Curlin, “What Does Any of This Have to Do With Being a Physician? Kierkegaardian Irony and the Practice of Medicine,” Christian Bioethics 22, no. 1 (2016): 62–79, 73.
[ix] William Osler, Evolution of Modern Medicine (New Haven: Yale University Press, 1996 [1921]), 127.
[x] Friedrich Nietzsche, The Gay Science with a Prelude in Rhymes and Appendix of Songs, Walter Kaufmann, trans. (New York: Vintage, 1974), 334–6.
[xi] Though, as Leithart also notes, the language of biological “purpose” is making a welcome comeback. See Mark Bauerlein and Ruport Shortt, “Debating Richard Dawkins,” First Things, May 4, 2020.
[xii] See Neal Postman: “…everyone who has a headache wants and expects a CAT scan. … What this means is that even restrained and selective technological medicine becomes very difficult to do, economically undesirable, and possibly professionally catastrophic. The culture itself—its courts, its bureaucracies, its insurance system, the training of doctors, patients’ expectation—is organized to support technological treatments. There are no longer methods of treating illness; there is only one method — the technological one. Medical competence is now defined by the quantity and variety of machinery brought to bear on disease.” Neal Postman, “The Ideology of Machine: Medical Technology” in Technopoly: The Surrender of Culture to Technology (New York: Vintage, 1993), 93–106.
[xiii] Curlin, “What Does Any of This…”
[xiv] Bishop, Anticipatory, 285. See also Brett McCarty, “Diagnosis and Therapy in The Anticipatory Corpse: A Second Opinion,” Journal of Medicine and Philosophy 41 (2016): 621–41, 621.
[xv] McCarty, “Diagnosis and Therapy,” 627.
[xvi] Brett McCarty and Warren Kinghorn, “Medicine, Religion, and Spirituality in Theological Context” in Spirituality and Religion Within the Culture of Medicine: From Evidence to Practice (Oxford: Oxford University Press, 2017), 341–54.
[xvii] As McCarty points out, in so far as these movements act merely as “interpretative overlays” for the body reduced to material and efficient causes, they simply reinforce the human being as an anticipatory corpse in need of ever more efficient and effective forms of diagnostic interrogation and control. Rather than white-washing meaning onto a still dead machine, Bishop wants an undergirding metaphysic and medical imagination that doesn’t need to contrive meaning because it approaches the body knowing it was already meaningful to begin with. See McCarty, “Diagnosis and Therapy,” 623. See also Bishop, Anticipatory, 297–8.
[xviii] Brett McCarty and Warren Kinghorn, “Therapy for Healthcare: Christian Ethics and the Formation of Medical Practitioners,” Society for the Study of Christian Ethics Annual Meeting, London School of Theology, September 6, 2019. Publication forthcoming. See also McCarty, “Diagnosis and Therapy,” 636–7.
[xix] I recognize that offering a definition of beauty—and especially a Christian theological aesthetic—is nuanced and variegated and well beyond the scope of this essay. In my own work, I’ve explored beauty as “that which moves us toward the way things should be.” Brewer Eberly, “Beauty and the Re-enchantment of Medicine,” 2017 Conference on Medicine & Religion. cf. Jeremy Begbie, “Created Beauty” in Resonant Witness: Conversations Between Music and Theology (Grand Rapids, MI: Wm B Eerdmans, 2011), 83–108, 85; Makoto Fujimura, Culture Care: Reconnecting with Beauty for our Common Life, 2nd ed. (New York: Fujimura Institute and International Arts Movement; 2015); Elaine Scarry, On Beauty and Being Just (Princeton University Press, 2001).
[xx] Kimbell Kornu, “The Beauty of Healing: Covenant, Eschatology, and Jonathan Edwards’ Theological Aesthetics toward a Theology of Medicine,” Christian Bioethics 20, no. 1 (2014): 43–58.
[xxi] As Kornu writes, modernity knows man through mathesis (mathematical representation). In an immanent world reduced to complete metabolic panels, lab values, and numeric vital signs, only something like technology can control and mediate that reality for us (what Brock memorably names in his response as the “cyborg experience”). But if man is known through methexis (eternal participation and improvisation), then something like participating in transcendence is how we understand reality. Under mathesis, being is represented in its objectivity. Under methexis, “being is represented in its participation.” Mathesis ends in immanence; methexis begins in transcendence. The nihilism of modern medicine is in part nourished by the language of “consent” which arises from mathetic representation. See Farr A. Curlin and Daniel E. Hall, “Strangers or Friends? A Proposal for a New Spirituality-in-Medicine Ethic,” in On Moral Medicine: Theological Perspectives in Medical Ethics, edited by M. Therese Lysaught, Joseph J. Kotva, Jr., Stephen E. Lammers, and Allen Verhey, 3rd ed. (Grand Rapids, MI: Wm B. Eerdmans, 2012), 286–90. See also Begbie, “Created Beauty,” 91, for potential problems with the use of methexis and the participation metaphor.
[xxii] Robert Barron, “Evangelizing the Nones,” First Things, January 2018. See also Bishop Robert Barron, “Evangelizing Through Beauty,” February 9, 2013.
[xxiii] Brewer Eberly, “The Good, the True, and the Beautiful and the Oscars,” Mere Orthodoxy, March 15, 2018. See also Scarry, On Beauty and Being Just.
[xxiv] Jimmy Myers, “Is It True That ‘the World Will Be Saved By Beauty?’” First Things, July 25, 2015.
[xxv] Noble, Disruptive Witness, 100, 152.
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