2nd Mar, 2003

The Sunday Next Before Lent

Preached by the Rev. Ian Elliott Davies

In 1969 a talented young medical doctor took up a position as a neurologist in Mount Carmel Hospital on the outskirts of New York City. It was, in those days, a hospital for the chronically ill. There was a particular ward in the hospital that was home for a group of so called “human wrecks”, survivors of the sleeping sickness encephalitis lethargica, which swept America in the 1920’s. For thirty or forty years these people had been stuck in various states of physical and mental immobility, immured in bodies that would no longer work as mediums of life in any normal sense. “Extinct volcanoes” one writer called them.

The young neurologist Oliver Sacks tells the story of his twenty-year relationship with these people. He is especially concerned with the revealing moment when the administration of a new drug, L-dopa, precipitated a rehabilitation, a re-awakening of life for the patients. The tragedy of the story is that the re-awakening was not sustained and eventually the sufferers fell back into their former state of tribulation and frozen frenzy. I will not tell the story as Sacks does, you can read the book or see the film entitled Awakenings for that. But what I am going to tell you about is his attitude to the people he was treating.

From the very beginning Sacks had been discouraged from committing himself professionally to these patients. Current medical opinion as well as his own experience had always stressed the hopelessness of the situation. “Chronic hospitals- you’ll never see anything interesting in those places” he was told by his superiors. But it turned out to be a question of a point of view and perspective. Meaning was not there for those who looked only at the surface: the apparent stillness, darkness, and emptiness of arrested and frozen lives. People of the abyss. Perhaps not real people at all. In time Sacks found another dimension, completely at odds with the reports given by his medical superiors. In terrible abnormality he found how often it, that is the “normal”, appears as a shrunken caricature of itself. To observe, to care, to attend in this strange place was, he found, to be forced to scale the heights and depths of what being human means. It was to see people, we would want to say as Christians, men and women made and being re-made in God’s image, not as patients, nor statistics, but as people struggling to survive.

Sacks contrasts this call to care with much that characterizes medical action and, indeed, human relationships in general, in our technological civilization. The determination to see disease as mechanical, chemical and physical malfunction of the machine-like body or computer-like mind dominates our twenty-first century perspective and world-view. Quantities, locations, durations, classes, functions are all clear-cut and finite. They allow precise definition, measurement and estimation. But they cannot see the self, much less God. And I’m not saying that this way of precision in looking is wrong. It has brought immense gains to healing and to our dealings with this world and to exploration of our universe. It is just that we seem to have made it the only or the primary way of attending. It is a way of looking and reading the world (and there’s the danger of this even in religion as well) it is a way of looking that demands detachment from the observer and objectification of the observed. That is its strength- and its weakness.

Sacks writes:

“Folly enters when we try to “reduce” metaphysical terms and matters to mechanical ones: worlds to systems, particulars to categories, impressions to analyses, and realities to abstractions. This is the madness of the last three centuries, the madness which so many of us- as individuals- go through, and by which all of us are tempted. It is the Newtonian-Lockean-Cartesian view- variously paraphrased in medicine, biology, politics, industry etc. – which reduces men to machines, automata, puppets, dolls, blank tablets, formulae, ciphers, systems and reflexes. It is this, in particular, which has rendered so much of our recent and current medical literature unfruitful, unreadable, inhuman, and unreal.

Stance is crucial if we want to be fruitful, readable, human and real. The stance that sees, or has the chance of seeing, is the stance that respects the human being as one, whole, unified and living. Health is ours. Disease is ours. Reactions are ours. They cannot be understood in themselves, but only in reference to us

Thus an adequate view of the human canvas would, ideally, embrace all that happens to a person, all that affects or is affected by that person. In the end, therefore, a human self is only held in its completeness in the eye of God. On earth biography, a detailed history of the person in concrete immediacy, is the place from which personal truth may be glimpsed. It is an effort to see in part as God sees whole. And so the very heart of Sacks’ book is a series of superb and moving case histories of people in their struggle with disease

The desire to see clearly must be on guard against what Sacks calls reductionism, which is the temptation too see the whole in terms of a part. We try to reduce “metaphysics” the big, the vast view of the complete, to mechanics he says. The questions “how are you?” or “how are things? or to Elijah “what are you doing here?” are the most basic medical questions. Clinical data is needed to answer them. But before that they are human questions, questions that are addressed to human beings and they have to do with the human condition as a whole. The terrors of suffering, of sickness, depressions, death, of losing our powers and with that losing our world, are among the most intense and elemental feelings we know. So too are our longings for recovery, rebirth, transfiguration, the hope of being restored to that sense of what essentially we were meant to be

Remember that Sacks is writing about the people in Mount Carmel Hospital, but he might have been writing about…well I leave it to you to make a connection..

“For all of us have a basic, intuitive feeling that once we were whole and well; at ease, at peace, at home in the world; totally united with the grounds of our being; and then we lost this primal, happy, innocent state, and fell into our present sickness and suffering. We had something of infinite beauty and preciousness- and we lost it; we spend our lives searching for what we have lost; and one day, perhaps, we will suddenly find it. And this will be the miracle, the millennium!”

Clearly this is not medicine in the everyday sense. It is another kind. “Something deeper, older, extraordinary, almost sacred”- the search for well being, perhaps a medical metaphysics. It may not be Christian theology in its usual sense. But it is an exploration of themes that are very important to our religious understanding. It takes little imagination to see that Sacks is talking about matters that parallel what classic theology has called creation and goodness, the fall and its corruption, reconciliation and its renewal in people’s lives, the renewing of the image of God in us, transfiguration, in short, the quest for grace. It is when these questions are warped or fixated on the purely technological or on the part, it is then that the person becomes warped, disfigured and damaged.

I went to see Matt Damon, Gwyneth Paltrow and Jude Law in the “The Talented Mr Ripley” sometime ago. What is so terrifying and disturbing about that story is that an individual is so fixated on mimicking another, trying to be anyone other than himself that he warps and perverts not only himself but all those around him, even the people that tell him they love him and care for him. Mr Ripley prefers to be a fake somebody, anybody, rather than a real nobody.

For me the most brutal of all the scenes is when perhaps, just perhaps, Mr Ripley has found someone that loves him and Peter Smith-Kingsley is in the very act of trying to bring healing and telling him he loves him, and as Smith-Kingsley recites his litany, a long list of what is positive, attractive and perhaps even graceful (in the best sense of that word) it’s as if Tom Ripley cannot bear too much reality, his own reality; and he would rather be someone else, anyone else, so long as it does not confront him, and so he strangles, murders Smith-Kingsley.

For the Christian the human is not fully human unless it reaches beyond the human in becoming human. Most of our readings of each other and ourselves are too pallid, skimming on the skin of being, too narrow. But to see what Sacks calls the “forces below the surface of consciousness, forces below the surface of the world, powers beyond powers, depths beneath depths” then we might begin to see that we are grasped and held by God’s grace, not only in ourselves, but in others as well, perhaps that is what the Transfiguration is all about… being able to see the beyond, the deeper, the divine in the here and now, in you and me.


“only if we experience those who cannot yet or can no longer do anything for their existence as a blessing, only if we respect their dignity instead of asking about their- fluctuating- value, will our worship radiate the gospel into the everyday world in such a way that our achievement-oriented society may deserve to be called humane.” [Eberhard Jungel, Theological Essays II, p.258]

Then came the still small voice, and in that still small voice, onward came the Lord.

From the Second Epistle of St Peter:
You will do well to be attentive to this as to a lamp shining in a dark place, until the day dawns and the morning star arises in your hearts.


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