We see the patient differently—as a creature in community and in some mysterious way—as Christ Himself.
All medical trainees are formed to see the human body in a particular way. This “clinical gaze” is established early—through gross anatomy, clinical clerkships, and the simple social assumption of patients as individuals in private communication with their doctors. Good physicians do need to learn to see well—to know “the nature of things,” which is what the word physician means.
But within an education and training system prone to objectification and reductionism, one quickly learns to view sick patients as an amalgam of their various pathologies. Patients become problems to solve or “manage”—bundles of functions rather than creatures with purposes. More insidiously, doctors learn to view their patients as machines to be fixed. In many ways, the dualism which presents patients as machines is self-protective for both clinicians and patients; to consider the soul of those we care for (and to have one’s soul touched by a patient), might prove disruptive—too difficult to bear.
But Christians claim a view of the body grounded in the incarnation and resurrection of Jesus Christ, which holds that we are ensouled creatures, created out of the dust, destined to return to the dust, and promised new life in Christ in the resurrection. Adherence to this Christological view means that the clinician views the body as deeply good, even and perhaps especially in its states of brokenness and illness—worthy of care, attention, and healing. The goodness of the body, and its inseparability from the soul, means we cannot reduce patients to “the liver in room 18,” over spiritualize the patient at the expense of their bodily health, or constrict our focus to physical ailments to the exclusion of existential longing.
This vision also tempers the temptation to view the body as the greatest good to preserve at all costs. The body (and life) are great goods, but not the greatest good. Such a recognition can begin to release physicians and patients from the fear and hubris of believing that death and disease can be warded off by sheer force of will. Moreover, woundedness itself can become a sight of wonder and meaning in the Christian life—rather than merely something to be eradicated or escaped. The wounds of Christ, which remain in his resurrected body, call us to consider wounds through what the theologian Karl Barth called, “The will to be healthy.” We are invited to see the health present even within the sick.
This Christological view of the body is not abstract or theoretical. We are reminded that when we witness to, lay hands on, and care for the sick, we are meeting Christ himself. For us, this is not mere metaphor. Like a priest who washes his hands before touching the bread and wine to serve communion, the physicians who scrub before surgery or wash their hands before examining a patient are preparing to touch, in some sacred and mysterious way, the presence of Christ. This reality recognizes what we are taught by Christ himself in Matthew 25: “I was sick and you looked after me.” If true, this is the most radical and metaphysically disruptive claim in the history of medicine—what palliative physician Kimbell Kornu calls “iconic perception.” This way of seeing the patient changes everything.
We have eyes to see “the least of these”—perhaps in unexpected patients.
As we have slowly learned to see Christ in each of our patients, our vision continues to expand as Jesus changes more and more in the lives of those we serve. We have observed that many Christians enter medicine with a desire to care for the sick, the poor, and the marginalized. This is a great thing. Despite immense structural, financial, and bureaucratic obstacles to this work, we have found that most clinicians still adhere to this call, and will go out of their way for those who need help, perhaps especially those who are acutely ill or impoverished. The way of Christ in medicine certainly calls for what some have called “a preferential option for the poor.” Christians in medicine prioritize the least of these. As the late physician and anthropologist Paul Farmer wrote, illness itself has a preferential option for the poor. And as Jesus suggests, it is the sick, not the healthy, that are in need of a physician (Luke 5:31). Practicing medicine in the way of Christ may well mean, as our mutual friend and fellow physician Farr Curlin puts it, “Just medicine, for those who need it.”
But there is more to say here. Christ has also moved us to see how “the least of these” might take on a deeper, more subversive meaning. Just like the young lawyer who asked, “Who is my neighbor?” (Luke 10:29) we have been surprised by the answers Christ offers. We have learned that Christ does not call those of us in medicine to merely care for the suffering, but also the “insufferable.” It is not enough that we treat the kind patient with a new cancer diagnosis with patience and compassion (although this is of course good and right). We are called to extend the same level of care to those notoriously “difficult” patients that many in medicine write off—patients with substance use struggles, personality disorders, those who are entitled and manipulative and ungrateful—patients who allegedly “have brought it upon themselves.” This is where following Christ manifests most starkly, where we do not extend grace and love to those who have earned it, but precisely to those who have not. This is practicing medicine through the vision of the parable of the debtors, forgiving as we have been forgiven (Matthew 7; Matthew 18).
Besides these “difficult” patients, Christ calls us to re-imagine whom the vulnerable might be in our places of work. These include students and trainees entrenched in places of relative disempowerment in the medical hierarchy. These include nursing assistants, aides, and janitorial staff who are often treated as anonymous in these spaces, and yet are often those who are practically and faithfully present to suffering patients in unique and tangible ways beyond what we know and do as physicians. We have learned to see and learn from the “keepers of the house.”
We are called to heal and relieve suffering when we are able to, but not to abandon patients when our ability to heal fails.
Jesus has also changed how we see suffering. The default (and sometimes only) response many medical practitioners have to suffering is to attempt to eliminate it, or at the very least control it. Yet shortly after one begins the work of medicine, it becomes apparent that, despite our best efforts, there is much we cannot fix. Patients and families often place great hope in the techniques and therapies of modern medicine, but those of us who practice quickly realize the limits of our powers.
Yet we are trained in a medical system that emphasizes effective and efficient control at every turn, so that when we are faced with suffering that resists our interventions, our only recourse is to double down on these very interventions. Because medicine does not necessarily equip its practitioners with the virtues required to care well for those we cannot cure, we either delude ourselves into believing that more technique will solve this problem, or we are tempted to abandon patients we cannot fix.
The Way of Christ resists responses to suffering that urge either control or abandonment. Rather, as those who follow Christ, we recognize that we are invited to enter into suffering with others, to join in lament and to offer steadfast presence and accompaniment for those we cannot heal. As the theologian Allen Verhey wrote, “Jesus did not teach his disciples how to avoid suffering, but how to share it.”
Christ the Great Physician
We have written as mere Christians who practice across the domains of primary care, hospital medicine, and palliative care. There are burdens and beauties that touch the worlds of surgery, psychiatry, occupational therapy, nutrition, public health, and other domains of health care practice that we have not addressed, and that deserve their own testimony. Our comments are but an introduction to one of the richest (and most difficult) areas of practical theology alive today, to which we hope readers will engage in new ways, especially when they find themselves in conversation with friends and loved ones who are ill, or as they become patients themselves. Indeed, it is the witness of patients who have often revealed to us the way of Christ in medicine.
This “Way” in our professional lives is made most clear and known not only in patient care, but in our rest and participation in the life of the local church; this is important amidst a clinical culture of busyness, prestige, power, influence, and affluence. The physician turned preacher D. Martin Lloyd-Jones, when giving a lecture to a group of medical students, quipped, “I have met many a man whose tombstone might well bear the grim epitaph, ‘Born a man, died a doctor.’” It is a special temptation of those who study medicine to become lost in the profession and to elevate the practice beyond its proper place. Knowing the title of “Christ the Great Physician” risks much hubris on the part of those who become physicians and aspire to greatness.
The final word we want to offer on the way of Christ in medicine is how we come to the foot of the cross not as doctors but as fellow men and women. We come to the Lord’s Table not as healers with powers but as fellow patients with nothing to offer but our need—our own wounds aching for the one who truly heals—the one who changes everything.
Ben Frush is a hospitalist at Duke University in Durham, North Carolina, and a McDonald Agape Fellow in Bioethics in the Kennedy Institute of Ethics at Georgetown University.
Brewer Eberly is a third-generation family physician at Fischer Clinic in Raleigh, North Carolina, and a McDonald Agape Fellow serving the Theology, Medicine, and Culture Initiative at Duke Divinity School.
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