Over the past week, the world has turned its full attention to the protein-thorned crown of COVID-19. It is rare to experience such a widespread global unease, in which we all find ourselves dwelling on the very same thing. In a way, the noise of modern life has been ousted by what C. S. Lewis called “God’s megaphone”: pain.
Patients are dying. People are scared. And we find ourselves stuck between the flippantly arrogant (“The coronavirus is just another flu”) and the fearfully paranoid (“We are on the brink of financial collapse”). Following Saturday’s episode of the “Italian COVID19 Experience” podcast, in which American and Australian pediatric intensivists spoke candidly with intensive care specialists in the ICUs of Italy, each of our institutions are preparing us for the next few weeks with a seriousness that is unique—even for those of us in medicine familiar with suffering, triage, and uncertainty.
It’s okay to be fearful—we are too. However, as Christians working inside and outside the health care space, this is a moment where our response might distinguish us as a people who practice what was once called by early pagans “a religion for the sick.”
To that end, we want to share some of our experiences of the COVID-19 pandemic as resident physicians and trainees—and as fellows of the Theology, Medicine, and Culture Fellowship at Duke Divinity School, which brings together medical trainees, theologians, and pastors to think theologically at the frontlines of health care—in order to highlight the unique Christian contributions of repentance, hospitality, and lament to our preparations for the new coronavirus.
Repentance Among Idolatry of Health
Health is a good in our society, and for good reason. The prophet Jeremiah spoke of God’s promise to bring health and heal wounds. In Ecclesiastes we are told to delight in the health of our youth. The apostle John prayed for the health of his readers.
While health is a good to be pursued and maintained, we sense we’ve turned a “good” into a “god.” Indeed, while the coronavirus is novel, it does not represent a new fear. It merely reveals a quiet, well-nourished idolatry toward the health of our bodies and our trust in the ability of our medical institutions to save us. The West is feeling one of its greatest idols shiver.
Orthodox theologian Jean-Claude Larchet goes so far as to argue that clinicians constitute a “new priestly class” of this idol, in which doctors and other health care workers minister a new “salvation of health” to devoted worshipers. In A Theology of Illness, he writes that modern medicine “encourages patients to consider that both their state and their fate lie entirely in the hands of the physician … and that the only way they can endure their suffering is to look passively to medicine for any hope of relief or healing.”
The hysteria surrounding the new coronavirus and our obsession with “flattening the curve” unmasks a deeply held belief that for any of us to die would prove both an extraordinary occasion and a failure of our society’s efforts to protect us. It should be little surprise then that in an effort to counter our anxiety, we employ the language of medical control: “the morbidity and mortality for the relatively young and healthy is low.”
And yet, it is precisely the opposite population—the relatively elderly and unwell—to whom Christians are called to pay closest attention. Psalm 82 and Romans 15 make it clear that worshiping our own well-being neglects our call to the weak—those whom Christ repeatedly identifies with throughout the New Testament. It is medical hubris that tells us that 99 percent of our population will likely survive the coronavirus. But it is the love of the shepherd that asks, unashamedly, “What about the 1 percent?”
Health is a good thing, but it is not an ultimate thing. It is not something that we can master through biohacking or guarantee through new vaccines—even as it is a gift and a duty to seek such medicine. Our comfort ought not lie in the fact that we are protected under the banner of epidemiological peace. Our comfort lies in the fact that even if we are stricken with the coronavirus and die, our lives are known and sealed in Christ.
Hospitality Among Social Distancing
Historian Gary Ferngren points out in Medicine and Health Care in Early Christianity that the only care for the sick during a smallpox-like epidemic in 312 AD was provided by Christians. The church even hired grave diggers to bury those who died in the streets.
Something we have quickly forgotten, in the age of antivirals and personal protective gear, is the sheer fear that the possibility of sickness like this would instill in others. If you interacted with someone with plague in 1350, or with Spanish flu in 1918, there was a real possibility you would get it and die. The prayer “and if I die before I wake, I beg the Lord my soul to take” was a real plea, not a nighttime trope.
The new coronavirus has brought a bit of that fear back into our daily lives. It is a fear that manifests in shelves swept clean of masks and cleaning supplies in department stores and hospitals and even xenophobia and hate crimes against individuals for their perceived ethnicity relative to COVID-19’s origin in China. It is evident in our inboxes filling with cancellations and ever-updating protocols.
But Christians are a people for whom hospitality toward the minority and the potentially infected is a central virtue—one that undergirds Christian tradition and the practice of modern medicine, whether we know it or not. We forget there was a time in which people did not unconditionally take care of the sick simply because they were sick. Indeed, the word hospitality (from which we get hospital), comes from the Latin hospes meaning “host” or “guest.” The first prototype of the hospital arose from medieval monasteries in which Catholic nuns or monks housed strangers in need of lodging and nourishment. These medieval institutions were centered around the conviction that to serve the suffering stranger was to serve Christ himself. That cliché metaphor for the church—“a hospital for sinners”—enjoyed a new depth.
It for this reason that the now household term “social distancing”—the conscious effort to reduce interpersonal contact in order to prevent viral transmission—has Christians wondering what to do. Amid Christianity’s longstanding tradition of communion and attention to the outcast, we should expect discomfort with the idea of intentionally avoiding those in need.
And while the talk of quarantine is certainly unsettling, we might remember that it has been commonplace for some time to sequester the ill. Indeed, we already isolate the dying in hospitals and often permanently displace them in nursing homes. We live in the midst of an epidemic of loneliness that already leads to adverse health outcomes. When real life-threatening illnesses arise, we shouldn’t be surprised that we have no idea what to do. We haven’t practiced for it. We haven’t raised our children around it. Ours is a culture that treats death and physical suffering as an exception to ignore rather than an eventuality to prepare for. Ethicist and theologian Stanley Hauerwas puts it this way:
The hospital is, after all, first and foremost a house of hospitality along the way of our journey with finitude. It is our sign that we will not abandon those who have become ill. … If the hospital, as too often is the case today, becomes but a means of isolating the ill from the rest of us, then we have betrayed its central purpose and distorted our community and ourselves.
The metaphysical poet John Donne wrote, “As sickness is the greatest misery, so the greatest misery of sickness is solitude.” Whatever practices of social quarantine we undertake, we would do well to remember that our era of isolation will remain once this practice of “social distancing” fades. Perhaps this pandemic is a chance to wake us up to the reality that we have been surrounded by the isolated ill long before the new coronavirus found us staying at home.
At the same time, social distancing is something the church gets to perform charitably and courageously. It is a literally corpor-ate (“bodily”) duty that we have the opportunity to enact out of love to protect the vulnerable among us—in which we partner infectious disease science with practical wisdom and humility.
We get to be creative in how we reach out and practice “social accompaniment” to those who are already prone to social isolation: the elderly, infirm, and disabled. We might bring the Eucharist to the sick in protective garb, make calls to those in nursing homes (who will become increasingly isolated as visits are limited to those communities), and write letters of prayer. One of our own pastors hopes to arrange congregants at a distance while continuing to practice the sterility that priests are already well familiar with as they handle weekly Communion.
When we put Christian imagination to work, we discover practices like that of a medical student who participated in the Physician’s Vocation Program, created by John Hardt at Loyola University Chicago. As Christian ethicists Brett McCarty and Warren Kinghorn describe the student: “Instead of mindlessly applying the hand sanitizer, he instead pictured his Catholic priests washing their hands in preparation for handling the Eucharist. … Through this theological vision, he prepared to meet Christ in the body of a sick patient.”
Lament Among Anxiety
While the world laments the cancellation of sporting events or the halting of the economy (all appropriate things to be dispirited about), Christianity recognizes that both the new coronavirus and our response to it through social distancing makes the church something less than its full self. If social distancing is something we must do, we shouldn’t do it without psalms of lament.
And lament will become increasingly important in the coming weeks. Medical workers in Italy (perhaps North America’s closest comparable health care system) have greatly limited family interactions with the sick in the ICU. Most families cannot view the bodies of their loved ones after death. As we’re learning from our Italian intensivist colleagues, we may find ourselves unable to do what is best for each patient, and instead must balance what is best for the entire community—something that greatly troubles those of us in medicine used to being able to do all that is possible. All of this has the potential to lead to great grief and exhaustion.
It is uncanny that we are in the season of Lent. Perhaps we should look to Easter Sunday with newfound hope, not only of open tombs but of reopened cathedrals. Holy Week in the time of COVID-19—in which we remember the suffering of the King on his way to Golgotha—will surely take on new meaning.
Indeed, it is interesting that the coronavirus gets its name from a spiked ring of proteins on its surface that resembles a crown, hence the title of “corona.” In many ways, the coronavirus is revealing the crowned heads we already worship—health, self-protection, medicine. Our global, sustained attention to COVID-19 demonstrates that which we look to out of anxiety, control, and fear.
Of course, we know that Jesus wore a different crown—one that calls us to worship not out of anxiety or control but out of a love that drives out all fear. That crown doesn’t make this coronavirus moment any less serious; however, it does tell us where to cast our anxieties, who to comfort, and which thorned crown to remember.
Brewer Eberly is a first-year family medicine resident physician at AnMed Health Medical Center, a community hospital system in Anderson, South Carolina.
Ben Frush is a second-year internal medicine and pediatrics resident physician at Vanderbilt University Medical Center and Monroe Carrell Jr. Children’s Hospital at Vanderbilt, a high-volume university hospital system in Nashville.
Emmy Yang is a fourth-year medical student at the Icahn School of Medicine at Mount Sinai.
Each is a fellow of the Theology, Medicine, and Culture Fellowship at Duke Divinity School. The views expressed are those of the authors and do not necessarily represent the opinions or policies of the institutions they represent.