19 August 2010

On the Pathological Reliance on Medicine

I witnessed a convergence of ideas the other day when reading Rob Moll’s The Art of Dying: Living Fully in to the Life to Come. (A book, incidentally, that I think ought to be read, along with Elisabeth K├╝bler-Ross' classic On Death and Dying.)

A few months ago I came across (again) Gilbert Meilaender's brief article
"I Want to Burden My Loved Ones" (first published in 1991 in First Things—back when it was less of a rag). Moll then brought it up in The Art of Dying and unpacks it a bit: 

"Meilander gently argues against the application of living wills or advance directives as the modern fix-all to the tendency of doctors to rely too heavily on medicine. We say we don't want to burden our families with making difficult choices when we cannot make medical decisions on our own, so we turn to legal documents that outline what we would and would not want should we ever be unable to tell a doctor ourselves. . . .
[But] this appeal to a piece of paper overturns what families are supposed to do—carry each other's burdens. When we allow someone else to care for us, make decisions for us, Meilander says, we most often discover that they are willing and eager to pick up our burdens." (p. 90)
Advance directives are, of course, not inherently wrong, but "it is best when a range of people . . . are part of the conversation about what medical care a patient desires." The main benefit of advance directives is getting the conversation started.

Moll also writes early on in the book about what he alludes to in the above quote—relying too heavily on modern medicine. "Our hope in medicine can lead to an unrealistic expection that medicine can cure whatever disease we or our loved ones might have. Such expectations tempt us to believe we need not contemplate and prepare for our death or that of our family members." He goes on: "Aggressive medical care may always be our first option, but by pursuing powerful medicine until there is 'nothing left to do' we likely forgo time with loved ones, final pursuits or perhaps a spiritual deepening in anticipation of life with God" (p. 35). Such is the irony of certain Christians' proclivities toward being "so pro-life [that] we're anti-death" (in the words of one Christian gerontologist, p. 33).

Then along came Hauerwas. In
"America's God Is Dying," he writes (among other things that are actually the piece's focus):

"The fear of death is necessary to insure a level of cooperation between people who otherwise share nothing in common. In other words, they share nothing in common other than the presumption that death is to be avoided at all costs.
That is why in America hospitals have become our cathedrals and physicians are our priests. I'd even argue that America's almost pathological reliance on medicine is but a domestic manifestation of its foreign policy. America is a culture of death because Americans cannot conceive of how life is possible in the face of death. And thus 'freedom' comes to stand for the attempt to live as though we will not die."
The point about foreign policy aside, think how this same culture (of triumphalism and glory) has gripped the American church—the very place where the cross ought to be rooted. Christians here cannot conceive of how life is possible in the face of death. And so American Christians, just as much if not more than non-Christians, die poorly, precisely because they have forgotten how to die well, which means they've forgotten how to live. 

11 comments:

Chris E W Green said...

Chris,

You're so right about this. As I watch my parents and grandparents grow older and weaker, I realize more and more how unChristian -- and so, unrealistic -- we all are in our thinking (and feeling) about death and dying. We hide behind cliches. Thank you for broaching this topic, and for the link to the article.

Chris Donato said...

Hi, Chris. Thanks for the encouragement.

This is kind of like self-therapy for me, truth be told. It's at those precise moments when my thoughts about death and dying lack resurrection-infused hope that my world begins turning very dark. I find myself groping for the light and, Ironically, often the only thing I'm able to latch onto in these moments are deeper, more critical contemplations of what it means to die in this world, such as it is now.

I understand that freedom is truly found in letting go of the comfortable life. One of those things, no doubt, that's easier said than done.

steve said...

Chris, provocative post, though I’m not altogether convinced that living wills are as much a culprit as is the rather unchecked pro-lifery that abounds. One wonders what the unchecked piety does with biblical suggestions that we are to hate our very lives if we want to live.

Chris Donato said...

Thanks for shootin' straight, Zrim. I agree. Living wills are probably just another symptom of "pro-lifery."

Z Mom said...

"Have you ever seen someone wail without actually being able to articulate a cry, his heaving chest and terrified visage giving the secret away? Larger than life since my childhood, this great man was now a helpless as an infant and more pitiful than any life I had ever known, his buant flesh wasting and yellowing with every passing week."

Micheal Horton's Book "Too Good To Be True.", page 11.

This was Mikes' experience with his dying father....This was EXACTLY my experience with my dying father who died on April 1st of this year after two months of agonizing pain and suffering.

I was blessed that someone gave me Mikes' book to read when I didn't have a clue how very much I was going to have my theology tested.

"Where all of this leads is to a conviction that learning theology is very difficult to do in the trial itself. It is not a good time for being taught. The wounds are too open to the elements. This doesn't mean it coannot be done, but it is more difficult, at least for many." pg. 18

"Theology is the most serious of business." Pg 18.

Because I've been there, am reformed and have experienced a front row seat to death and hits horrors I will say that this is the single best book that I have ever read that gets to the heart of the matter of death, suffering and it's cure.

This book is for everyone, and I mean everyone.

Chris Donato said...

Thanks for the recommendation, Z Mom. And thanks for taking the time to respond.

Many of us, by this time in our lives, have had at least one experience like the one you describe above. For me it happened in childhood (and a few times thereafter), and I think I've been slowly (very slowly) recovering ever since.

Bobby Grow said...

Chris,

This is an interesting post. Every time I went in for treatment they asked me if I had an advanced directive (at first I didn't even know what that was); and I would say, "No, and I don't want either" . . . I wasn't planning on dying :-).

The thing is when faced with death like that you quickly realize what a "gift" this life is. We weren't created to die --- indeed, die to ourselves (yes) --- but not die "physically". We were created for life in Christ; isn't this the telos of Creation? That's why death is such a deplorable thing; "the last enemy", as it were. I hate death, I hate the thought of death. I think we as Christians, of anyone, should exude life --- eternal life that is!

Jesus was afraid to die; He didn't want to go through it, yet He did. Something greater or someOne greater compelled Him to submit for us! I don't think there is anything "noble" or beautiful about dying; it is a grotesque, violent, and ugly thing --- I really want nothing to do with it!

Dying to ourselves is another thing; I don't see it the same way as I do facing physical death. Dying to ourselves, in fact, brings life; in one sense dying physically for the Christian brings the realization of beatific vision and eternal life. Nevertheless, I don't believe in the notion of "dying well!"

As far as medicine. There are better ways to deal with ailments than "traditional medicine." Certainly the Lord used trad medicine in my situation, but I believe He is also using alternative treatment in my current situation (I follow an alkaline diet now).

I'm still collecting my thoughts on this season, Chris! Death is ugly!!! And cancer sucks!!!

Chris Donato said...

Bobby,

Thanks so much for weighing in on this. No doubt, Death is an intruder, a thief, an evil. Thankfully, Moll, in the book mentioned in this post, doesn't wave it away with platitudes or try to sweeten it. He's intimately familiar with death, and he aims his writing at those who are facing a terminal illness or those who are caring for those with such an illness.

Your situation is, in a certain sense, exceptional. For starters, you're young. Of course you'd throw every sort of aggressive treatment at that monster—because you could handle it. The prospect of dying just wasn't an option!

Fast forward 50–60 years, and it becomes a little trickier: maybe aggressive treatment is the first reaction, but then maybe not after a few rounds, especially if it means being robbed of potentially (and relatively) peaceful times with family, etc. For Moll, "dying well" was just a modern's meditation on the old Christian concept on "the art of dying." And he brings home one major point: we'd all do well if we were "prepared" for our deaths.

Of course, speaking of this in the abstract is a bit silly. Until we're literally facing it, how can we speak? That what makes your comments so valuable. Thanks again.

Bobby Grow said...

Chris,

I'm not sure how well I handled it. Except for the first two cycles of chemo everyone after that resulted in me either going into the hopital with neutropenia and blood transfutions (a total of 10 units) and with other complications (I still have neuropathy in my feet). Chemo is a monster, while the Lord used it, it was bad bad stuff! Indeed, dying was not what I believed was going to result throughout that whole thing; but I think only because the LORD put that confidence in my heart right from the beginning (cf. Jn. 11.4). Yet, whether old or young, at least with cancer, age really makes no difference --- although yes, the body can probably handle a lot more, in some situations.

"Aggressive" treatment of a traditional kind is not necessary. Just see Bill Henderson's book: Cancer-Free: Your Guide to Gentle, Non-toxic Healing. It's interesting people believe the "natural" way is quackery; if you look at the statistics, chemo is quackery (except for the rare few, and except for certain kinds of cancer). There are way too many stories of people, old people too (in fact my mom works with a guy whose wife was "terminal" she became alkaline, and she's with us today . . . and that story can be multiplied over and again). Certainly, when it's time, it's time; nevertheless, the "old" can come through cancer through a radical lifestyle change, just as the young can (I'm alkaline right now, and have been for the last couple of months).

There is no doubt that in some sense we should be "prepared," Chris; but in some sense this is all too noble or Western of a notion, I really don't know what to make of that. I suppose having our finances in order, and provision for loved ones left behind is prudent; but even that is an interesting notion in light of passages like Jms 4. Their's prudence and then their is the reality. My only point with dying well is made within the context of "death as an enemy" . . . there is no "dying well" in that context. There is no noble face for death. It's scary scary stuff, and that's even when we know where we're going!

I don't want to come off too brash, Chris; this is still a raw point for me.

Chris Donato said...

Don't worry about that, Bobby. I'm glad you're taking the time to respond. By the way, I totally agree with you regarding so-called alternative treatments. I've been keen on such things since college (early-mid 90s), and I am glad to hear you've gone "alkaline."

By "prepared" I only mean it in the sense that we, God willing, take advantage of whatever time we have left in the face of a terminal illness and embody Christ all the more in our relationships—not least with respect to issues revolving around reconciliation, etc. (with God and neighbor). I'm definitely not talking about maintaining a "stiff upper lip"!

Bobby Grow said...

Thanks, Chris, for clarifying on "prepared," I wasn't sure what you meant. I sat next to a "brother" in Christ at the chemo clinic once --- his whole family (wife and 3 daughters all in their 20's) was their with him. He was "terminal" and was just doing chemo to prolong his life; yet he seemed to have the attitude you speak of here in re. to being "prepared." He was an encouragement; I don't know what happened to him, his name was/is, Jay.

 
Design by Free WordPress Themes | Bloggerized by Lasantha