Culture, Essays

Healing and Culture

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He approached the victim, poured oil and wine over his wounds and bandaged them. Then he lifted him up on his own animal, took him to an inn and cared for him. The next day he took out two silver coins and gave them to the innkeeper with the instruction, “Take care of him. If you spend more than what I have given you, I shall repay you on my way back.” Which of these, in your opinion, was neighbor to the robbers’ victim?” He answered, “The one who treated him with misericordia.”
Jesus said to him, “Go and do likewise.” (Lk 10: 34–37)

I’m not exactly sure why I’ve been invited to address you. I’m not a theologian. Now in the mouths of some that claim might appear to be just bragging. But in my case it is a true confession of ignorance. By and large the theology I know has been by assimilation rather than study. Nor am I a liturgist. Again, by saying that I am no liturgist I’m not trying to assure you that you have no reason to fear me. You all probably know many more jokes about the tyranny of liturgists than I do, so I won’t repeat any here. My experience of liturgy is firmly in the camp of those who participate in the pews, and occasionally read from the ambo. Other than being familiar with some of the dogmatic statements about the nature of the Mass, and occasionally trying to say the Liturgy of the Hours with my wife, but mostly failing, I haven’t given much thought to liturgy. I go to Confession. I received the Anointing of the Sick once twenty-five years ago. I attend Mass weekly, but also weakly. Mostly I’m probably like a lot of people in the pews—sometimes attentive, sometimes not, sometimes looking at what others are doing, sometimes not, sometimes judging others, sometimes not, sometimes repenting, sometimes not, sometimes thankful, sometimes not, sometimes worshipping, sometimes not, sometimes singing, many times not—in short, a whole of lot of sometimes this or that or what-have-you and sometimes not. I am a sinner, which is why it is always good for me to be in Mass in any condition. Still, I fear I won’t be able to say much of interest to you that all of you don’t already know about liturgy.

Things don’t get much better when we turn our attention to Healing and Culture, the topic about which I was asked to speak. I have mostly healed from things that have ailed me so far, but as time goes by, I find myself failing more and more at that as well. And my experience of medicine is as a consumer, like most people in our culture, looking for a product the medical industrial complex promises to sell me for a price. I am overly fond of cigars. I grill my red meat over noxious carcinogen producing charcoal. I’m part of the bourbon craze. In ages past you would have looked upon my fine profile and judged me to be a prosperous man. But not one of you looking at me now in this day and age would dare to judge me a good authority on health or healing.

As for culture, it is a cliché among faculty who leave Notre Dame to explain in practically weepy emails that they are leaving because of the desire for greater culture than one can find in South Bend. I once had a colleague leave for the University of Las Vegas reporting his desire for greater culture. I felt like responding as Thomas More does to Richard Rich in A Man For All Seasons: “But for Las Vegas?” Still, if these colleagues are right, and given the fact that I love Notre Dame so unabashedly, I’m probably not the most cultured of persons. So really, I’m also probably not the best person to speak to you on the central topic of your conference, and now is the time for any of you to leave if you came expecting serious theological reflection upon liturgy by a cultured and healthy speaker.

If you want to stay, however, and listen to a mere lover of wisdom like me, I think Tim O’Malley asked me to address you because of something I said in a talk last year about the field of bioethics and prenatal testing for disabilities. After fairly extensive reading in the field for the purpose of my presentation, I said that bioethics struck me as by and large a moral wasteland, possessing little serious moral reflection upon the goods of a medical care that seeks to help those who suffer some illness or disability when possible and to extend comfort to them in all cases. I was struck by a sense in the context of prenatal diagnosis that the field by and large isn’t about healing. It’s about killing. As a field it seems to be designed to manage the killing in a rational and autonomous way. It’s pretty well taken for granted that if a child is diagnosed within the womb with a serious illness or disability, of course the child will be killed. If you think I’m being hyperbolic, consider the recent debate in England within the medical and legislative communities about whether a diagnosis of cleft palate was a serious enough condition for the machinery of death to turn on and public financing in the National Health Service to pay for it.

The key pursuit of bioethical reflection is that the killing take place as a result of the informed consent of rational, free, and autonomous agents. Much of the theorizing is about what sorts of social and medical conditions undermine the rational and free choices of the agents involved. How can procedures be put in place to guarantee autonomy in the choice to let die or kill. And so on.

Many different reasons will be given for the killing that bioethics seeks to manage. Sometimes the reason will be the need to prevent the future suffering of the child herself or himself that may result from the condition identified. Sometimes the reason will be the need to provide the parents with the opportunity to try again and produce the healthy baby they want. In the more abstract forms of this logic, you will see arguments on behalf of the non-existent but possible future babies that the parents might be able to produce with the assistance of the doctor. The thought in such arguments is that the life of this existing child with a disability is a harm committed against the future not-yet-conceived children the parents might have, either by preventing the birth of the non-existent but possible children, or by making their possible lives more difficult if they should happen to be born, as family resources will be consumed in taking care of the disabled child, resources that would otherwise go to the un-conceived but presumably healthy future kids.

“In the beginning was the Word” (Jn 1:1), and here are some exemplary words of a contemporary bioethicist that are characteristic of the field:

To have a child with Down syndrome is to have a very different experience from having a normal child. It can still be a warm and loving experience, but we must have lowered expectations of our child’s abilities. We cannot expect a child with Down syndrome to play the guitar, to develop an appreciation of science fiction, to learn a foreign language, to chat with us about the latest Woody Allen movie, or to be a respectable athlete, basketballer or tennis player.[1]

At first you might think from the pastoral tone of this passage that it comes from a work on how to help people with Down syndrome and their families cope with the medical and social difficulties that often accompany the syndrome. The child is suffering a disability or illness. She needs our care. Parents are the primary caregivers of their children, and the medical profession devotes itself to assisting them in that care, aiming at healing when possible, but always at ameliorating the suffering the child may experience out of a loving concern for her. So, you might think such care would be a compassionate expression of the moral character of the practice of medicine devoted to healing in our culture.

But you would be wrong. The passage cited above is taken from Princeton philosopher Peter Singer’s famous book Rethinking Life and Death. And that book isn’t so much about figuring out how to help human beings cope with suffering from the medical difficulties and illnesses that often accompany conditions like Down syndrome, that is, how to expand the scope of our compassionate medical care for those who suffer. On the contrary, it is an extended meditation devoted to exploring and expanding a rather different scope, the scope of those human beings whom “we” may legitimately kill. To make that case it focuses upon what it takes to be obvious manifestly diminished abilities in certain paradigmatic instances of human activity. The emphasis is upon what it is thought a child with Down syndrome won’t be able to achieve. And yet it forms a crucial moment in Singer’s narrative account of why parents of children with Down syndrome—and several other conditions besides—ought to be allowed to let them die after birth, indeed that it ought to be acceptable for such parents even to actively kill such children with the assistance of the medical profession to make sure the killing is done well, that is, to practice infanticide.

Now, don’t be misled—there is a kind of compassion expressed in Singer’s extended discussion, but it is not a compassion that is directed at the child with Down syndrome. On the contrary, it is directed towards the parents. Singer goes on in his discussion to emphasize the importance of the disappointment of the parents, disappointment brought on by their dashed expectations. They expect to produce and have the medical community help them produce a healthy baby, where health is measured by potential for future achievements. What parent wouldn’t want a kind of chess-playing-Woody-Allen-movie-going-guitar-strumming-Lebron-James? The money spent caring for this child with a disability could be better spent on basketball camp for a new, better, more promising child.

A 16th-century painting depicts what art historians Andrew Levitas and Cheryl Reid believe is an angel with Down syndrome. By: Follower of Jan Joest of Kalkar, "The Adoration of the Christ Child" (c.1515); The Metropolitan Museum of Art, The Jack and Belle Linsky Collection, 1982, www.metmuseum.org

A 16th-century painting depicts what art historians Andrew Levitas and Cheryl Reid believe is an angel with Down syndrome. By: Follower of Jan Joest of Kalkar, “The Adoration of the Christ Child” (c.1515); The Metropolitan Museum of Art, The Jack and Belle Linsky Collection, 1982, www.metmuseum.org

No doubt the reflection begins with a description of what people with Down syndrome supposedly will never do. If the child with Down syndrome were conceived of as part of “our” community, these difficulties mentioned might be the beginning of a reflection upon how we might with the assistance of the medical community aim at healing those conditions that can be healed and assisting to minimize the struggle brought on by those that can’t be healed. However, in this discussion, the child is not considered part of the community; she is not a patient. In fact, she is an illness, a pathology. The parents are the patients. But it’s not even the mother’s pregnancy that is the focus of the diagnosis and healing the bioethicist is arguing for. The illness that is being diagnosed is failed expectations for future greatness; again, the parents’ health is being judged by a standard of achievement—their ability to produce a certain sort of high achieving child. The suffering is sorrow at one’s inability to have achieved what one wanted, and what society wants from them. So notice: it’s not even really about what the child with Down syndrome may never achieve. At its heart, it’s about what the parents have already failed to achieve—a chess-playing-Woody-Allen-movie-going-guitar-strumming-Lebron-James. The standard of health is achievement, and the medical profession should be devoted to healing our failure to “be all we can be.” By killing the pathology, the medical profession can alleviate the illness that is the failure on its part and on the part of the parents to be high achievers.

Although occasioned by the phenomenon of children with Down syndrome, this famous passage captures very well the sentiment that animates much of the contemporary bioethical discussion of illness generally. Many philosophers have noted that most of the arguments employed in bioethics to manage the killing of prenatally diagnosed children are only arbitrarily directed to life in the womb before birth, and actually extend to the lives of children even up to two years after birth. There is a kind of cultural squeamishness that is acknowledged about killing a human being to whom we may have grown attached and allowed into our moral community of concern. So many will suggest that it would be best to do the killing before six months or so, if one wants to avoid this squeamishness. But that addresses a cultural fact, and is not a philosophical argument.

The illness that is being diagnosed is failed expectations for future greatness.

Formally speaking, the arguments extend beyond two years and throughout the life of the person with the illness or disability. Consider the argument about future harm done to possible but actually un-conceived children. If anything, that particular argument has more force after birth than before. The consumption of resources devoted to caring for the child with a disability or illness is real after birth and throughout life, not simply imaginatively projected before birth; if the parents conceive another child, the continued existence of the child with the illness or disability long after his or her birth is an ever-present harm to the new presumably healthy child because the child with a disability is depriving the other child of resources that could help him or her achieve his or her greatness. What I’ve said so far has focused upon the beginning of life, but the attitudes expressed within this contemporary discussion can also be seen in questions about the end of life as well.

Several years ago an article appearing in a bioethics journal drew an extraordinary amount of attention beyond the typical audience of bioethicists and medical professionals by arguing for what the authors called the importance of “After Birth Abortion.” What was interesting about this article was that it did not actually break any new ground in the philosophical arguments for killing in abortion, infanticide, or euthanasia. It took the moral legitimacy of these medical acts as firmly established within the community of bioethical scholarship. What it argued for was a change in linguistic practice. The authors argued that we need to stop using words such as ‘infanticide’ and ‘euthanasia’ when talking about killing disabled children because of the stigma suffered by the parents and medical professionals who do the killing. You see, those words have an unfortunate cultural relevance in the twenty-first century because of the historical accident of World War II and the association with the eugenicist programs of National Socialism with its judgments about life not worthy of life, eugenicist programs that started here in the United States.

Parents and medical professionals suffer from the stigma of the words; so again, we can alleviate suffering by a shift of language to use a term that nowadays does not have those negative associations, namely, ‘abortion.’ In the view of the authors, because no one suffers a stigma for having or performing an abortion any longer, and because there is no morally significant difference between abortion, infanticide, and euthanasia (all being morally legitimate acts designed to alleviate suffering in the best healing traditions of the medical profession), infanticide and euthanasia ought to be given the honorific title of abortion, but “after birth abortion.” This, of course, is a cultural argument.

If you think I’m being overly dramatic by emphasizing this culture of healing advocated by the community of bioethicists, consider the government of Denmark announcing a couple of years ago that by the year 2050 it expects through pre-natal diagnosis and abortion to have healed Down syndrome. What does that mean? Healed Down syndrome? It can’t mean that it will have found a way of preventing the genetic mutation that leads to the extra chromosome. As my wife points out, this healing will only last until another child with Down syndrome is conceived. Then it will have to be healed again. And again. And again. And again.

But what exactly is being healed here? The culture. The existence of people with Down syndrome is taken to be a pathology in the culture. Danish culture will be healed of Down syndrome because if they are successful, there will be no men, women, or children with Down syndrome living within the community, much the way that polio has been healed in most parts of the world, with only a few people left who have the scars of it. Of course, polio wasn’t healed by killing human beings who suffered from it, but by a vaccine. But in the instance of ‘healing’ Down syndrome, healing and culture go hand in hand by killing. The culture is a culture of achievement in which human beings are judged to be worthy members of the community and subject to our healing concern insofar as they are capable of moderate to great achievements, and judged to be unworthy members—indeed pathological members—insofar as they fall short of this standard of achievement; these unworthy human beings are pathologies from which the culture suffers and of which it must be healed.

Strictly speaking, I wasn’t asked to speak to you about the killing of children before or after birth or the killing of the elderly. My having done so previously occasioned this invitation, and I’ve done so here because I think it poses a clear way into thinking about healing and culture in two strikingly different ways. We’ve already seen one way: a culture that measures the worth or dignity of human beings by their potential for achievement; underachieving human beings are an illness within a culture, an illness it is the task of medicine to heal. When we look around at our broad Western culture, do we have any real doubt that it is obsessed with achievement and success, and that such obsession permeates almost every element of culture from parenting, to sports, to education, to medicine? I can certainly confess my own faults in this regard when I think of the way I have at times pushed my children in their upbringing, and when college application time comes around—watch out. So every J’accuse is equally a mea culpa.

Now, I am unapologetically pro-life in the ordinary sense of the term. From womb to tomb. One unfortunate side effect of our cultural politics is that Christians who are pro-life in the ordinary sense of the term are often accused of not caring for anything other than the baby in the womb—not for the woman who is pregnant, her husband, or family, and not for the child after it is born. This accusation may be true of this or that individual. However, given the extraordinary extent of social services provided by the Christian community that is the Church—its hospitals, schools, adoption agencies, soup kitchens, financial assistance programs, women’s care centers, charitable clothing and household goods services, and so on, this accusation cannot be truthfully laid at the door of the Church and the culture it nourishes. By and large it’s just a false charge. But it’s false in an interesting way that draws attention to what I think is another way entirely of thinking of healing and culture that is inseparable from the topic of liturgy.

The Church thinks of a culture of healing in ways quite different from the way our broader culture increasingly tends to think of it. The bioethical issues I just rehearsed raise these differences in particularly striking ways, but I think the difference permeates medicine in our culture. We live in an individualist culture that increasingly commodifies everything and everyone. Everything becomes a product in a market of buying and selling, and this includes medicine. The only thing we can agree on is the price we are willing to pay for objects, although in the case of health care we know there is a good deal of disagreement about that price.

I won’t bore you with a long story taken from the history of modern philosophy as to how we have gotten where we are in our commodified materialist and individualist culture. But there are some salient markers to be mentioned. First, there is the goal of producing autonomous rational agents capable of making free choices independently of limiting conditions of any sort. Stated abstractly, this is a good thing to a certain extent. However, it may also disfigure our lives together because of the attitude it inculcates about our dependence upon one another. If we are going to be such agents, we need to be free of the conditions that surround us, that limit our capacity to act rationally and autonomously. Among those conditions are social structures that impose certain conceptions of human goodness and happiness upon us from our earliest days of life. So the motto of modern enlightened culture is to dare to think for yourself apart from all influence of authoritarian teaching; but any teaching of its very nature must be conceived of as authoritarian, since it relies upon the authority of another to communicate some truth or other to us. The two greatest philosophers of the modern age, Descartes and Kant, both suggest in their own ways that we can only be rational and autonomous agents when we throw off what Kant calls “the yoke of tutelage.”

Other conditions that limit our autonomy have to do with the embodied character of our existence. Free and responsible agency is about rationality and the autonomy of the will. And yet, quite often, the condition of our bodies, either because of some disability or some episodic illness, makes it impossible for us to pursue unconditioned rationality and autonomy of the will. But it’s not just illness and disability that condition our autonomous agency—it’s the very character of embodiment itself. As bodily human beings, we are by nature weak, dependent members of an animal species who have to rely upon one another if we are going to survive, much less flourish. Even if we suffer no illness, because of our bodily existence, it is next to impossible to achieve independence of others in pursuit of our autonomous freedom. And yet technology can help. As we have increasingly mastered the world of nature around us by technological means, so too we have increasingly turned that technological mastery upon our own bodies, and medicine has increasingly become concerned not simply with healing pathologies with which we suffer, but with producing better and better bodies as we would have them. Not the bodies we are born with, but the bodies we can create. We might say that our embodiment itself has come to be seen as a kind of pathology for our life of rationality and mastery of the will as human agents, a pathology from which technological medicine can heal us. Doctors are the engineers we hire to implement the blueprints of our existence as we have designed them.

It’s not just illness and disability that condition our autonomous agency—it’s the very character of embodiment itself.

Finally, because of the emphasis upon freeing ourselves of the conditions that limit us—conditions into which we are born without the exercise of reason or the consent of our wills—you can see how a model of human achievement as the measure of human dignity and worth naturally arises. You show your worth, your dignity, by your capacity to overcome by reason and will what would otherwise limit you. That requires healthy capacity for achievement. It’s not just that you are tall and strong, it’s that you are LeBron James, an extraordinarily intelligent and skilled basketball player making all the right choices at all the right times, provided your leg doesn’t cramp up on you. You show your worth, your dignity, by what you are capable of achieving in overcoming the limits of embodied creaturely existence. And so the measure of human dignity becomes the exercise of reason and will. But human dignity for us is simply a way of talking about those whom we choose to include within the moral community of concern as worthy of having their lives protected and promoted. Thus, those who suffer from cognitive disabilities that limit their exercise of reason are particularly susceptible to being excluded from the moral community.

This is an extraordinarily oversimplified painting I have drawn of our modern culture, particularly our modern Western culture. But just stop for a moment and consider just how Western and bourgeois Peter Singer’s judgment was of what children with Down syndrome won’t be able to do, and how that Western and bourgeois portrait of the lives of others expresses a culture that would heal by killing those who through some disability or illness have no chance of overcoming the conditions into which they are born before they can reason and without their consent.

From its beginnings, the Church has approached human dignity, moral concern, and healing in a way quite different from the way the broader culture we live within now does. Fundamentally, the Church approaches healing sacramentally and liturgically.

If you check your Oxford English Dictionary you’ll see that in ancient Greece “liturgy” meant: “at Athens, a public office or duty which the richer citizens discharged at their own expense.” And as you know, the early history of the Church involved taking care of those who suffered, the poor, the sick, the hungry. The absurdity of the claim that being pro-life means only caring about the child in the womb and no one else is made manifest by reading the history of the Christian Church. The service of healing was by and large not a public office of the state, which quite often did little along these lines. It was a public office of the Church discharged at its own expense. So at least in that sense of the term from the Oxford English Dictionary, it was liturgical.

But in saying that the Church thinks of healing in the context of medicine liturgically, I don’t mean simply to make a play on words, as if it is an accidental coincidence that we refer to the sacraments as liturgical and that medical healing is a public service that has always been a part of the life of the Church. I do actually intend to suggest that the Church’s public liturgical service of healing body and soul in hospitals, schools, soup kitchens, charitable organizations, and so on, is directly related to, indeed flows out of Christ’s liturgical act of healing made present to us in the sacraments. Christ heals within us the image of God which was damaged by sin but never completely lost, and in his image we turn to the world to offer it what healing we can because we see the image of God in those who suffer. These offerings are called the Works of Mercy, or better, the Opera Misericordiae.

So I want to turn now to misericordia whom we are taught is a person by that wonderful hymn:

Salve, Regina, mater misericordiae: Vita, dulcedo, et spes nostra, salve. Ad te clamamus, exsules, filii Hevae. Ad te suspiramus, gementes et flentes In hac lacrimarum valle. Eia ergo, Advocata nostra, Illos tuos misericordes oculos Ad nos converte. Et Jesum, benedictum fructum ventris tui, nobis, post hoc exsilium ostende. O clemens! O pia! O dulcis Virgo Maria.

This hymn tells us that Mary is the Mother of misericordia. She mothers misericordia to us when she offers us her Son. Misericordia is a Person.

Our Lady of Mercy, Geddes Hall Chapel; courtesy of the Institute for Church Life.

Our Lady of Mercy, Geddes Hall Chapel; courtesy of the Institute for Church Life.

I said I didn’t want to bore you with a philosophical history of our modern predicament. Now I fear I am going to bore you with St. Thomas Aquinas on the virtue of misericordia and what might appear to be an arcane medieval theological question. The question was “Cur Deus Homo?” Why did God become a human being? Many medieval theologians held that even if there had been no fall of Adam and Eve, God would still have become incarnate in Christ Jesus because, in a way, God entering into his creation would fulfill and complete it. St. Thomas Aquinas disagreed. In the first place, he didn’t like the suggestion of imposing a necessity upon God, which it would seem he would be under if the Incarnation was necessary to complete creation. In the second place, he opposed it mostly for biblical reasons. Citing the Easter liturgy, “O felix culpa,” Aquinas argued that the entire weight of biblical evidence stands in favor of the Incarnation being a response to the Fall, not a completion of creation. To be sure, he thought God could have become incarnate without the Fall. But in fact, he became incarnate because of the Fall. But that response then raises another question. If the Incarnation is God’s response to the Fall, did God have to become incarnate to respond to the Fall? Couldn’t he have responded to the Fall in some other way? In effect, this becomes a question as to whether we could have been forgiven and satisfaction been made for our injustice without God becoming a human being in Jesus Christ.

Again, Aquinas tells us that there is no necessity to the Incarnation. To say that Christ had to become incarnate to respond to our sin looks like the imposition of another sort of necessity upon God. On the contrary, God could have forgiven us our transgression and satisfaction been made for us without Christ’s Incarnation, Death, and Resurrection.

But that just brings us back to our original arcane medieval theological question: “Cur Deus homo?” Why did God become a human being, if it was not necessary to complete creation and it was not necessary for our salvation? It is in fact how we are saved, but it was not necessary that we be saved in that way. The answer is misericordia. Unfortunately, the English term ‘mercy’ doesn’t really translate the Latin ‘misericordia’ very well. Mercy as we use it is often associated with the activity of a judge, who acts mercifully when he or she forgives some aspect of punishment that has been justly imposed upon a wrongdoer. Recall Portia in Shakespeare’s The Merchant of Venice when she says, “The quality of mercy is not strained; / It droppeth as the gentle rain from heaven / Upon the place beneath” (4.1.173–75). She is pleading that the Duke forgive the pound of flesh that Antonio owes to Shylock. But the Duke cannot forgive it because Shylock does not forgive it. Shylock will have his bond.

This sense of mercy is bound to and exists within the confines of justice. Aquinas calls this judicial mercy clementia or clemency. But to see what misericordia is, and why it isn’t what we mean by the mercy of a judge, we have to understand how misericordia goes beyond justice without violating it.

God forgives us of the justly imposed punishment we are due for our transgressions, so he does extend to us clemency or mercy in the sense of a judge. But we’ve already seen that Aquinas thinks that mercy in the sense of judicial forgiveness—clemency—could have been extended to us without the Incarnation. God certainly forgives us in the Incarnation, Death, and Resurrection of Jesus. But we do not call Mary the mother of forgiveness. We call her “Mater Misericordiae.” Misericordia goes beyond justice and forgiveness because it extends healing. Forgiveness when we have been wronged by others may be a first step toward healing. Forgiveness when we ourselves have wronged others may be a first step toward healing. But forgiveness itself is not healing, as we see in the case of a just judge who may forgive a punishment but in his forgiveness does not heal the one who has been forgiven. The healing that is the fruit of misericordia springs from companionship or friendship.

If you will allow me, God’s liturgical act, his public service springing from his wealth, goes beyond his forgiveness. It heals. What his liturgical act heals is our friendship with God as creatures made in God’s image and destined for what Aquinas calls our companionship in beatitude with God.

When St. Thomas talks about misericordia as a virtue, he inherits a discussion from the Greek philosophers. Their discussion involved the Greek term eleos, the term that shows up in Luke’s Gospel when Christ asks the scholar of the law who had acted as neighbor to the man who had been set upon by thieves. The scholar of the law says “the man of eleos.” Notice in this moment that the scholar of the law can be seen to represent the order of justice. But he acknowledges something more and beyond justice or the law when he acknowledges eleos, which is translated in the Vulgate as “the man of misericordia.” Christ commands him, the man of the law, to do other and more than justice; he commands him to live misericordia.

Etymologically, misericordia means ‘a suffering heart.’ The Greeks recognized that we are often pained when we see others suffering, believing that this occurred because we see the others as like ourselves, and we fear that a similar suffering may befall us. But this Greek notion grounded in fear for oneself doesn’t capture the Gospel sense of eleos that we see in the parable of the Good Samaritan. The Samaritan does not fear for himself. On the contrary, he is pained by the suffering of the man on the road. Nothing suggests he feels fear. On the contrary, he experiences compassion. Etymologically, compassion means “suffering with.” So the Samaritan suffers with the man on the road, and then he acts to alleviate the man’s suffering. He acts to heal him. The Greek notion of eleos did not involve suffering with others. It involved suffering out of fear for oneself upon the occasion of others suffering. Most importantly, it did not involve a virtue by which one would act to alleviate suffering prompted by compassion.

Now, when Aquinas talks about misericordia, which is the Latin translation for eleos, he acknowledges this Greek sense of fear for oneself among the philosophers. And he even suggests that one will often act to help others prompted by this fear for oneself: do unto others as you would have them do unto you. You, too, might someday suffer in this way, and you would want aid in your suffering. But Aquinas then goes beyond this kind of aid motivated by fear for oneself when he introduces the notion of friendship into the discussion of misericordia. Compassion need not be motivated by fear. It is often motivated by friendship. We grieve when we see our friends suffering, whether or not we fear for ourselves. We “rejoice with those who rejoice, and we weep with those that weep” (Rom 12:15). Out of that friendship, we act to help our friends. To assist them. To heal them. But who is my friend? Who is my neighbor? The Good Samaritan acts because he sees the man on the road as his friend. We know this because he does not simply help the man, and then move on. He tells the innkeeper that on his return voyage he will stop by and check in on the man to see how he is doing, and will continue to assist him. Misericordia is ongoing and does not end, because it springs not from fear for oneself, but from friendship with those who suffer. And the man on the road is every man who suffers.

What then of the Incarnation? Recently Pope Francis has drawn our attention to misericordia by choosing it for the motto of his pontificate. He even quotes St. Thomas in his encyclical Evangelii Gaudium as saying that misericordia is the greatest of all virtues, considered in itself greater even than caritas, because it is the most godlike of virtues. When we manifest misericordia in our lives, we manifest the image of God within us.

The Rossano Gospels (Folio 7v), in which Christ is shown as the Good Samaritan; courtesy of Wikimedia Commons

The Rossano Gospels (Folio 7v), in which Christ is shown as the Good Samaritan; courtesy of Wikimedia Commons

Had God merely forgiven us like a just judge, he would not have entered into the human condition in order to suffer with us. Judges do not and should not weep for the condemned when they forgive them. Had God merely forgiven us like a just judge, He would not have wept. And yet we know that Jesus wept. Once over Jerusalem (cf. Lk 19:41–44), the other time before he healed Lazarus by raising him from the dead (cf. Jn 11:35). God in Jesus Christ weeps because he suffers with us. And it is important that he suffers in his humanity, not his divinity. Divine suffering would not be compassion, suffering with us. To suffer with us, God must become human—must become incarnate. And in Christ’s suffering, genuinely human suffering becomes the vehicle of divine love in his liturgical act. It is not prompted by a divine fear, whatever that might be. It is prompted by divine friendship.

God’s friendship for us answers the arcane medieval theological question “Cur Deus homo?” Why did God become a human being? Because he first loved us (cf. 1 Jn 4:19). In that friendship he chooses to suffer with us. Suffering with us, he acts to heal our suffering. The Incarnation transcends mercy of a judge forgiving our transgressions. The Incarnation is the healing act of a friend. And because Christ’s compassion—his suffering with us—is truly human, human compassion itself becomes the vehicle of divine love, which means that, having been united to Christ in Baptism, our compassion, our misericordia, can also be the vehicle of divine love. As we know, Catholics and their Opera Misericordiae are at times accused of thinking that they can buy their salvation through good works. However, seen through the eyes of Misericordia Incarnate, it becomes clear that the Opera Misericordiae are simply the overflowing extension of Christ’s ongoing liturgical act of healing in the world brought about by those who live and move and have their being in the friendship of Christ.

Friendship has no price. It cannot be bought. It cannot be sold. It can only be offered.

We should not seek out suffering. That would be masochistic. But we should seek out those who suffer and befriend them. When we do that and act to help those who suffer, we truly manifest the image of God within us, and our acts become the vehicle of divine love like Christ’s before us. We love because He first loved us.

Turn your attention back for a moment to that other culture of healing that looks to manufacture outstanding exemplars of human achievement, and sees those who suffer disability and illness as pathologies within the culture needing to be cured through killing. Do we see friendship there? Certainly not friendship for those who are suffering disability or illness, for how does friendship kill if it first adopts the suffering of the friend as one’s own? Is friendship that tells a mother or a father to kill their child or their parent an adoption of their suffering as one’s own? Do we suffer with them as friends when we judge them to have failed in producing a good basketball player and advise them to kill the living reminder of their failure?

Doesn’t friendship instead require that we live with them, adopting their troubles as our own, helping them to live and love the lives that have been given to them? There are very good reasons why medical professionals have to retain a certain psychological distance from those whom they assist. And yet. The alternative cannot be a culture in which the care they extend to those who suffer is just one more commodity in the market of commodities to be bought and sold, iMacs, iPads, iPods, iPhones, and iDoctors. What we must do is assist their service to life by embedding what they do within a culture of life which is nothing other than a culture of friendship in beatitude made present by Christ’s liturgical act of healing. And that culture of life begins when we ourselves participate in Christ’s liturgical act of healing made present to us in the sacraments. In the end, it is Christ’s liturgical act of healing that shows us the way to heal the suffering world around us. Friendship has no price. It cannot be bought. It cannot be sold. It can only be offered. There is no better way for us to understand that fact than to look upon the face of divine friendship, the Misericordia Incarnate that Mary mothers to us.

Editorial Note: This essay was originally delivered on June 16, 2014 as a keynote address during the Notre Dame Center for Liturgy Symposium, Liturgy and Healing.

Featured Image: Vincent Van Gogh, The Good Samaritan detail; courtesy of Wikimedia Commons 

[1] Peter Singer, Rethinking Life and Death: The Collapse of Our Traditional Ethics (New York: St. Martin’s Griffen, 1996), 213.

John O'Callaghan

John O'Callaghan is an associate professor of philosophy at the University of Notre Dame and a permanent member of the Pontifical Academy of St. Thomas Aquinas.