How can Christian healthcare workers be salt, light and yeast within a system that seems close to being broken? In this brief theological reflection I want explore three critical questions:
- What has gone wrong with the healthcare system?
- What is health and what is it for?
- What difference can Christian healthcare workers make?
In his book Sabbath as resistance: Saying no to the culture of now, (1) Walter Brueggemann reflects on the Exodus story and the slavery of the people of Israel. Brueggemann astutely observes that Pharaoh was driven by profound anxiety. He demanded that the people of Israel work without reward in the toughest of conditions in order that he could overcome his anxiety that there may be another famine and his grain vaults would be empty.
Pharaoh turned people into commodities in order to ensure that he would be successful in meeting his goals and targets, maximising the limited resources that were available. There was no rest for the slaves. As Pharaoh became more anxious, so the slave's conditions became worse and worse.
God's response was profound and surprising. Rather than engaging in the political or military process in an attempt to bring down Pharaoh, God issues a command: 'Remember the Sabbath.' He ordered the people of Israel to respond to their oppression by taking time out to rest with God and for God. Such a response must have looked ridiculous in the face of Pharaoh's violence and anxiety-driven oppression. And yet this small gesture revolutionised the situation, subverting the anxious power of Pharaoh and putting Yahweh in his proper place.
Brueggemann draws a comparison between Pharaoh's anxious presence and contemporary speed-driven work cultures. He points out the ways in which we are all driven by time pressures, league tables, quotas and a desire to succeed at all costs. My point is not that healthcare workers are treated like slaves. There is, however, a tendency to commodify healthcare and those who deliver and receive such care. It is easy to forget that the healthcare system, like the Sabbath, was created for the benefit of human beings; human beings were not created for the benefit of the healthcare system. (2)
Into our current NHS system, God speaks these simple words: 'Remember the Sabbath day by keeping it holy.' (3) Such remembering does not simply mean that we rest for a single day, without looking at our emails. It means learning to rest in Jesus at all times 4 and finding ways to create Sabbath moments within our daily healing encounters; moments wherein God can be given God's place. Perhaps the most radical and transformative thing that Christians can do is to create non-anxious Sabbath spaces within our daily work lives where we can slow down and find God in the apparently relentless flow of anxiety and activity that surrounds us. Where are the Sabbath moments in our working lives? If there are none, then we probably haven't heard God's command.
What is health for?
One of the problems for healthcare systems in the West is that it is not clear exactly what health is actually for. In an arguably post-Christian society wherein the only story that matters is the story that we can tell about ourselves in-the-now, the question of what health is for seems obvious. Health is for my personal happiness. If there is nothing after this life then health is the only way in which I can find salvation now, in the present. The commodification of health is just another example of secularisation. Health perceived as a commodity is a personal thing: 'it belongs to me because my body belongs to me!' The task of the Health Service is to make me better. The target for the Health Service is to get as many people 'well' and out into the community (no longer relying on the professional services) in the cheapest and most effective ways possible. If we can't meet our targets or we can't achieve perfect health, we become anxious; we feel the need to blame someone, whether that's the doctor, the system, the government or the healthcare workers.
Within the Bible, health is not perceived as the absence of something - illness, distress, suffering. Rather it has to do with the presence of someone: God. The Hebrew term Salôm (shalom), which occurs 250 times in the Old Testament, represents something of how the Bible understands health. The basic meaning of the word shalom is 'peace'. But such peace is much more than the absence of disease or conflict. The root meaning of the word shalom is wholeness, completeness and well-being. (5) Shalom has several secondary meanings, encompassing health, security, friendship, prosperity, justice, righteousness and salvation, all of which are necessary if wholeness, completeness and well-being are to come about. (6)
To be healthy is primarily to be in right relationship with God. It's not what we have or how we feel that makes us healthy; it's whose we are. It is therefore possible to be dying, psychotic, deeply depressed or in pain in the midst of illness and to be healthy. Health is membership of the people of God and the recognition of one's membership of the whole of God's creation. Healing understood in this way has to do with reconnection rather than curing.
Understanding health as shalom makes all the difference. Health is not a commodity; it is a relationship. Faithful medical practice is not aimed primarily at enhancing personal happiness, or even at curing complex diseases (important as both of these things may be). Faithful medical practice finds its primary focus in ensuring that people are given the opportunity to connect and remain connected with the Divine even in the midst of the most difficult storms. This means moving beyond the commodification of health, towards the sanctification of medical practice. Put slightly differently, it means taking day to day practices and imbuing them with new theological and spiritual meaning.
Take for example the act of giving pain medication. At one level pain medication seems quite straightforwardly technical and pharmacological. However, when viewed as an agent of God's shalom, its function shifts from the technical to the spiritual. Pain is the enemy of shalom; it is an agent of Pharaoh. Pain separates us from God and from one another. Perceived in this way, offering pain medication is a deep form of spiritual healing, not simply because it takes away the unpleasantness of pain, but because it creates a context for healing reconnection with God.
What difference can Christian healthcare workers make?
The difference that Christian healthcare workers are supposed to make is completely up to God. Christians working within the NHS are called to bear witness to the truth that has been given to them. The thing to notice about the previous reflections is that the things that have been highlighted as Christian callings are not big things. Taking a rest, encouraging others to rest, re-thinking the nature of health and healing and acting accordingly, looking at one's practices in a different light, are not overtly radical. They are however deeply subversive. The task of the Christian healthcare worker is not to try single-handedly to transform the world or the healthcare system (these things are God's job). Rather, the task is to signal the kingdom through small, faithful gestures. Such small things can seem, well, foolish. But, small gestures have great power. Jesus tells us that: 'He who is faithful in a very little thing is faithful also in much'. (7) Jesus is often found in the small things. The NHS needs Christians because the world needs Jesus.
John Swinton holds a Chair in Divinity and Religious Studies, University of Aberdeen.