The most common reasons given for assisted suicide have to do with pain: the need to get rid of it. There are political justifications, to be sure, mostly dealing with the demands of autonomy, the right each of us should have to control our own bodies. Still, the more pressing, more passionate motive for assisted suicide is the anguished burden felt by those who have watched persons they loved suffer excruciatingly, to the point that justice and compassion both seem to demand simply that pain be ended. Destroy the pain, even if it means destroying a life.
I have never suffered the physical pain these passionate exponents of euthanasia have had to accompany. I have, however, probably suffered mental anguish — as well as watched it — of a kind that today’s laws are pressing to permit as the requisite pain that could demand a death. We have only to recall the now notorious case of “Laura,” as she was known, a 24-year old woman in Belgium whose unremitting depression was considered as legal grounds for her lethal injection. Having been granted her death wish by the required panel of three medical doctors, at the last moment she changed her mind, and a documentary set of interviews is now available online. (She still thinks that the permissive law is good: it gave her freedom to think through options.) Laura, though, was only a window onto a burgeoning scene: 56 persons were killed in the Netherlands last year based on the suffering of mental illness. I can only say, in any case, that I agree: pain can indeed feel unbearable. But we should be clear that this is what we are talking about: pain.
And here’s the funny thing: “pain” has a history. It is a history in which Christian faith has a special place, which is all I want to stress. It was only 40 years ago that the maverick anti-institutionalist priest Ivan Illich wrote his socio-philosophical tract against the health industry, Medical Nemesis: The Expropriation of Health (Pantheon/Random House, 1976). Illich had quickly become a countercultural celebrity, having taken aim at universal schooling, industrial production, and social space. Soon after his book on modern medicine, though, he was dropped by the Left, as his writings on gender and common life were recognized as having too much of a religious whiff, and his later works on medieval texts, reading, and more seemed culturally retrograde.
His book on medicine was perhaps the hinge here. Illich had much to say about the economic order of the medical establishment. But his deepest interest was in how our medical regimen has changed our cultural expectations of value. In his chapter on “the killing of pain,” Illich brilliantly, and with wide-ranging learning, exposes the obvious (if now occluded) reality that “pain” is far more than a simple physical phenomenon. Its experience is shaped by at least four “functional factors”: culture, anxiety, attention, and interpretation.
The pain “felt” by a Buddhist monk in Thailand is not the same as the pain felt by a high-school athlete in America. Even the same individual feels pain differently depending on goals and contexts (the dentist’s office vs. the battlefield). It is possible to trace these differences across cultures and histories. In doing so, we realize that the “pain” our technologically medicalized culture seeks to “treat” via quantitative diminishment and extirpation is actually a radically dehumanized experience — naked, material, without character. As such, Christian pain is not the same as medicalized pain.
Thus, Illich, not quite in passing but at least without fanfare, notes the alternatives, particularly the Christian alternatives, that found their epitome in the expansive and rich discipline of what he calls “the craft of suffering.” It is a marvelous phrase, and comes from one of the most popular of the first books printed in English at Caxton’s Press in 1491, the Art and Craft to know ye well to die, a version of the many artes moriendi or “art of dying” devotionals that had sprung up in the Middle Ages and continued well into the 19th century. Suffering, and hence dying, is a “craft,” an “art” in the sense of something we make through creative training, struggling, and formation. Within such a “craft,” pain finds a special home and meaning.
One dismissive critic said that Illich was arguing for pain as adding to the “quality of life.” He was right. Illich writes: “The well being of men and women increases with their ability to assume personal responsibility for pain, impairment, and in their attitude to death.” The flowering of such personal responsibility lies in ordering our pain, somehow, toward and on behalf of the deepest thing that grounds our being.
Illich knew what he was doing here: he was arguing for the essential place of God — God in Christ — in understanding pain’s meaning for a human life, simply because a human life is God’s altogether, as given in Christ. Hence, the need for a Christian view of what a human being is. Nothing so illustrates the anti-Christian, and ultimately atheistical character of our culture —our culture’s fundamentally blasphemous soul — than legalized euthanasia.
Pain without God is intolerable. Everything in our culture flows from this “without God”; and, in this case, pain therefore sweeps everything before itself. But with God — whom we know in Jesus Christ most fully — pain is something else, indeed, many things, but all things that ultimately find their rest in the Lord who came down from Heaven, became man, died, and rose again.
Forty years before Illich’s book, the greatest reflections on pain that I know of were written by an Irish Dominican, Vincent McNabb — surely one of the finest spiritual and theological writers of the early 20th century. McNabb’s slim volume, The Craft of Suffering, was published in 1936 from a verbatim transcript of retreat talks he had given. The book followed an earlier volume on The Craft of Prayer, and the connection between the two is close. What McNabb does — obviously quite independently of Illich’s worries, but nonetheless already attuned to cultural shifts taking place (he mentions “aeroplanes” and telephones) — is to demonstrate concretely, simply, and profoundly what it means to feel pain as a believing Christian. In a sense, he writes here a small history, the personal history, of Christian pain, laid out as a discipline of attitude, prayer, and always struggling hope, driven by and drawn to grace.
McNabb was a learned and sophisticated Thomist. But he speaks here with a disentangling directness that can somehow carry with it the deepest theological markers. The book’s contents are too varied to summarize. This is not a “theodicy” or an apologetics; it has no single argument to “explain” pain or resolve its difficulties, let alone lessen its intolerable burdens. That is the point: his reflections are not meant to be an “answer” to anything, but rather to point to a “craft” that is learned and experienced as deriving simply from the truth of the world that is God’s and the truth of God’s self. In every way, however, his book is so antithetical to anything we hear today, even (perhaps most notably!) in our churches, that to read McNabb’s book is to be shocked over and over, before finally acquiring the grammar or skills of his insight. Pain, in its truth and being most purely, is about Jesus Christ. It cannot be “done away with.”
The opening talks are difficult. McNabb initially links our pain to faith itself. Faith lives through pain; genuine faith finds itself by living through pain; faith is, one might even say, perfected in pain. Pain here is not the goal, but rather faith is. Yet unless our faith can turn to God, and rely on God, receiving God’s strength alone, then its actual reality remains only vague. It is in pain where faith is shown to be true faith. “Only under opposition,” he writes, is the true “power” of our lives “brought out.”
This is a simple “fact” of this world’s existence — neither eternal in its arrangement, nor something to be conjured: We are truer when we are tried; we go “further” when we are denied; we hear God more fully, when we are assaulted by the silencers. We discover certainty when we can finally say, in the most painful place we find ourselves, “Thy will be done.” “We should beware of trying to prepare a state where we are free from all anxieties,” for such a state would prove a spiritual stagnation of the bitterest sort. This, of course, is as much a cultural judgment as a theological one, because it is bound up to a “craft.”
This discussion on faith is only a kind of attitude-adjuster. What does it mean, more concretely, to “suffer well”? McNabb fills his talks with small vignettes — persons he has visited in the hospitals, prisoners he has ministered to, relatives who have struggled in agony, his own quiet life. He remembers as a child — this was another era — having his mother take him along to visit an old woman who had done some work for them. The woman was now dying, and his mother wanted to share some love and comfort.
I can remember, thank God, how the old dying charwoman slowly undid some wrapping and bandages and showed the mother and her little child the great yawning festering wound that cancer had made in her breast!”
It was strange gift, but a real one, because it positioned the woman’s suffering in the midst of a set of relationships of love, hope, and witness that ultimately reflect the presence of God. In this case, part of the craft of suffering is generational, familial, relational. Again, a cultural judgment, not only a theological one.
The generational life of faith draws us to one place. To “suffer well” seems, in McNabb’s vision, to be the same as coming to know Jesus himself. Jesus is not only the one who suffers, but as God he is the one who suffers and thus transfigures that which otherwise would be a deadened sterility simply awaiting its destruction. Over and over again, as he describes some illness or burden of emotional distress, McNabb shifts his view to Jesus and his life in the body of his incarnate presence.
The titles of the short talks follow, mostly, this constantly refocused vision: “God’s Attitude Toward Suffering” (that is, in God’s own engagement with it), “Tears,” “Mourning and Joy,” “The Lesson of Suffering” (here tied to Jesus “teaching” the disciples that he “must suffer”), “Suffering and Sin,” “Joy and Suffering” (there is a good deal about joy in this book, in a paradoxical way), “The Cross,” “Thanksgiving,” “Apprehension,” “Shrinking,” “Dereliction,” “Standing at the Cross,” “Pruning,” “Perfection.” This is “all Jesus,” in the end. McNabb will constantly remind his listeners that we must not desire faith, but desire God; we must not desire joy (and certainly not suffering), but desire God, and so on. But in desiring God in Christ, we are turned to the very things that touch our pain, because they are more deeply yet God’s own pain in Christ; and hence we can turn back to our own pain, having come to know Christ, as a place of divine encounter.
There is nothing sentimental in any of this. McNabb knows that everything about suffering is deadening, in itself. Hence, even in speaking about Jesus, he must assume that the Lord’s own suffering is itself a tearing down, which, in its own terms, must demand an utter rejection. Yet because such suffering is the Lord’s, taken by God out of divine love for us, just this actual pain is a bridge to God, offered in grace. He speaks to this, among many places, in a wonderful talk on “shrinking,” that is, on the agony of the Garden, where Jesus himself shrinks from death.
McNabb points out, using a Thomistic distinction between the sensitive appetite and the intellectual appetite, that Jesus’ shrinking from suffering and death was indeed his human appetite appropriately at work — “seeing” pain before him, and drawing away from it. Even the application of human reason would only increase his terror by leading him beyond his present experience to calculate more pain and hence multiply the fears, the distaste, the shrinking. Only after the senses and the intellect do their frustrated work does “faith” come, which McNabb rightly notes is actually “dark,” un-luminous, without the contours of sensitive and straightforward predictive intellectual apprehension. Such faith is “heroic,” truly, and it leads Jesus to accept the “cup” of his Father; but it is a faith nonetheless clothed in a fog almost, at least in human terms. Jesus simply presses through the agony. There is no sign that he “feels” something besides his pain.
Yet this faith triumphs. It is a strange triumph in our experience because we have been trained to see accurately its utter uselessness according to our cultural standards. It is “folly,” in the sense that it is instrumentally pointless — as is every pain we feel. Yet, until such pointless pain is reset within the Son’s own life, we shall never attain the truth.
Humanly speaking, what could His reason find to make Him accept death at the hands of those by whom He was to die? What human reason was in that? Alas! this is human folly. Rightly they blind-folded him and mocked Him as a fool. Until we can do some great thing, in the eyes of the world reputed folly, we shall never have the Wisdom of the Cross.
That “wisdom” is bound up with pain. Thus pain, of the most extended (because divinely grasped) kind, cannot be bypassed by the Christian, for the very sake of his or her own soul.
The “craft of suffering,” in McNabb’s vision, is the straightforward, steady learning to live with Jesus. Such a life will be filled with pain, for all kinds of reasons that require other forms of inquiry to parse. At root, though, living just this inevitably painful life with this Jesus is to fashion a good life, ultimately a beautiful life. Yes: a painful life lived with Jesus is indeed “beautiful”; it is, after all, God’s life. Ultimately, it is all about knowing Christ: being taken to him, living with him, learning from him, dwelling within him, and being transformed by the gift of his self. Suffering and Christ — that is entry into God.
One can see here how the Christian view of pain has little to do with the disputes of our era. It has everything to do with the truth bound up in these disputes, but unless Jesus is a part of this discussion, that truth will be fundamentally obscured. That should tell us something about our vocation in the midst of a culture that, feeling the pain everyone feels, can only seek to destroy it, even if it means destroying the life that bears it. This is an evangelistic vocation at its root, a vocation of witness in its breadth and purpose, a creative vocation, where craft and discipline of life are everything, not just head work and word work; and even more than that, it is a vocation of the deepest form of life with Christ Jesus that one might imagine. To be distracted from such a vocation is to be overwhelmed, as so many are, by the simple burden of existence.
All of us will suffer, some far more than others, but suffer we will. We need not seek it or pray for it. What we do with our suffering, as a reflection of what Christ Jesus has done with it, is all that is important. Tears of pain and tears of love are indistinguishable in themselves. The former is but matter, the latter a craft that transforms it into the image of God.
I’d only want to slightly nuance this by noting Christians have sought to mitigate suffering, especially through such things as hospitals. Rodney Stark points out that it was precisely the early Christian’s desire to alleviate suffering (caring for plague victims and taking in abandoned (girl) babies) that caught the attention of their pagan neighbors.
Even this, though, in the end, argues for the point that Christians do not avoid pain. Certainly they do not fear it.
And as is often the case, I wonder how the rest of the (non-Western) world view something like euthanasia.