Monday, September 22, 2008

“I shall not harm.” (THE PRIEST AS PHYSICIAN OF SOULS)

The Hippocratic Oath, traditionally taken by physicians, believed to have been written by Hippocrates in the 4th century B.C., and (in a modern form), is still taken by students graduating from medicine today. (The modern translation is at the end of this article.)

Ὄμνυμι Ἀπόλλωνα ἰητρὸν, καὶ Ἀσκληπιὸν, καὶ Ὑγείαν, καὶ Πανάκειαν, καὶ θεοὺς πάντας τε καὶ πάσας, ἵστορας ποιεύμενος, ἐπιτελέα ποιήσειν κατὰ δύναμιν καὶ κρίσιν ἐμὴν ὅρκον τόνδε καὶ ξυγγραφὴν τήνδε.
Ἡγήσασθαι μὲν τὸν διδάξαντά με τὴν τέχνην ταύτην ἴσα γενέτῃσιν ἐμοῖσι, καὶ βίου κοινώσασθαι, καὶ χρεῶν χρηίζοντι μετάδοσιν ποιήσασθαι, καὶ γένος τὸ ἐξ ωὐτέου ἀδελφοῖς ἴσον ἐπικρινέειν ἄῤῥεσι, καὶ διδάξειν τὴν τέχνην ταύτην, ἢν χρηίζωσι μανθάνειν, ἄνευ μισθοῦ καὶ ξυγγραφῆς, παραγγελίης τε καὶ ἀκροήσιος καὶ τῆς λοιπῆς ἁπάσης μαθήσιος μετάδοσιν ποιήσασθαι υἱοῖσί τε ἐμοῖσι, καὶ τοῖσι τοῦ ἐμὲ διδάξαντος, καὶ μαθηταῖσι συγγεγραμμένοισί τε καὶ ὡρκισμένοις νόμῳ ἰητρικῷ, ἄλλῳ δὲ οὐδενί.
Διαιτήμασί τε χρήσομαι ἐπ' ὠφελείῃ καμνόντων κατὰ δύναμιν καὶ κρίσιν ἐμὴν, ἐπὶ δηλήσει δὲ καὶ ἀδικίῃ εἴρξειν.
Οὐ δώσω δὲ οὐδὲ φάρμακον οὐδενὶ αἰτηθεὶς θανάσιμον, οὐδὲ ὑφηγήσομαι ξυμβουλίην τοιήνδε. Ὁμοίως δὲ οὐδὲ γυναικὶ πεσσὸν φθόριον δώσω. Ἁγνῶς δὲ καὶ ὁσίως διατηρήσω βίον τὸν ἐμὸν καὶ τέχνην τὴν ἐμήν.
Οὐ τεμέω δὲ οὐδὲ μὴν λιθιῶντας, ἐκχωρήσω δὲ ἐργάτῃσιν ἀνδράσι πρήξιος τῆσδε.
Ἐς οἰκίας δὲ ὁκόσας ἂν ἐσίω, ἐσελεύσομαι ἐπ' ὠφελείῃ καμνόντων, ἐκτὸς ἐὼν πάσης ἀδικίης ἑκουσίης καὶ φθορίης, τῆς τε ἄλλης καὶ ἀφροδισίων ἔργων ἐπί τε γυναικείων σωμάτων καὶ ἀνδρῴων, ἐλευθέρων τε καὶ δούλων.
Ἃ δ' ἂν ἐν θεραπείῃ ἢ ἴδω, ἢ ἀκούσω, ἢ καὶ ἄνευ θεραπηίης κατὰ βίον ἀνθρώπων, ἃ μὴ χρή ποτε ἐκλαλέεσθαι ἔξω, σιγήσομαι, ἄῤῥητα ἡγεύμενος εἶναι τὰ τοιαῦτα.
Ὅρκον μὲν οὖν μοι τόνδε ἐπιτελέα ποιέοντι, καὶ μὴ ξυγχέοντι, εἴη ἐπαύρασθαι καὶ βίου καὶ τέχνης δοξαζομένῳ παρὰ πᾶσιν ἀνθρώποις ἐς τὸν αἰεὶ χρόνον. παραβαίνοντι δὲ καὶ ἐπιορκοῦντι, τἀναντία τουτέων.

A literal translation of the oath reads:

I swear by Apollo, Asclepius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath.
To consider dear to me, as my parents, him who taught me this art; to live in common with him and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art.
I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.
To please no one will I prescribe a deadly drug nor give advice which may cause his death.
But I will preserve the purity of my life and my arts.
I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art.
In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves.
All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal.
If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot.

* * * * *

There is a very ancient image of the priest which patterns itself after the identity of Jesus as healer. Ancient Christians understood Christ’s role as “savior”—soter in Greek and salvator in Latin—in terms of carrying God’s healing and life-giving balm. Jesus is the one who brings health and wholeness to a broken and sinful world. (The English word “salve” is itself derived from salvus which means “healing”.) In line with this thinking, the priest as an alter Christus is seen as one who mends broken hearts, heals hurting souls, and applies God’s soothing balm on pained and wounded lives. He is a “doctor of souls”.

The person of Jesus is the source of healing for the Christian, and conformation to his ‘image’ by means of imitation is the key element in the process. Jesus is the ‘image’ or ‘icon’ of the Father, the highest manifestation of God’s love for our fallen and broken world and his pledge of healing for souls that bear the wounds of sinful humanity. The Incarnation is the ultimate proof of God’s healing love, the ‘door’ through which one who desires his life to be made ‘whole’ passes. A person who is conformed to Christ, the Incarnation of God, also finds his life transformed from one that is shattered and fragmented to one that has become ‘whole’ and now has room for growth and enlargement.

Just as Jesus is the ‘icon’, the revelation of the Father’s healing love, the priest likewise serves in an iconic capacity—mirroring for the people to whom he ministers, the image of Christ, in much the same way as the bronze serpent crafted by Moses in the desert healed all those who looked upon it. There’s a certain ‘representationality’, even ‘sacramentality’ that’s going on here. For the priest is precisely that—a ‘representation’, ‘image’, ‘symbol’, ‘sacrament’, and ‘reminder’ of who and what Jesus is.

A priest’s very existence is encompassed and defined by such a relationship. In this relationship we find the essence of his healing ministry; apart from it he is a hollowed-out shell, able not to heal, but to harm. For just as the serpents in the desert poisoned and killed the Israelites, and it was the power of God, not the bronze serpent that healed those who were dying, so it is the person and the power of Jesus and not the priest, that heals the sorrowing heart.

It is important that our being healers in the image of Christ begin as early as our days in seminary. It happens when we strive to mirror to one another, Christ’s unconditional love and acceptance for us. Despite the relative comfort afforded by seminary life, there is much in seminary that causes pain and difficulty. The close proximity by which we live with one another and go about our daily business of formation sometimes gets the better of us. We sometimes tend to forget that we are in formation to approximate day by day, the loving, accepting, caring, and compassionate person of Jesus Christ. Patience with one another, tolerance, understanding, charity in speech, a thoughtfulness and concern that constantly anticipates the needs of those we live with, these are only some of the means by which we can gradually grow into the healing persons that priests are called to be.

However, just as there are ways by which we can imbibe the healing character of Christ, there are also ways by which we can not only lose it, but actually act against it. “I shall do no harm”—medical doctors make this ancient oath of Hippocrates, the father of medicine, reminding them of both their responsibility to heal, but also of the possibility that they can in fact end up hurting people instead of healing them, and destroying lives instead of building them up.

The Hippocratic Oath is a recognition that even a healer can in fact cause pain if he isn’t careful. And the difference between healing and wounding is sometimes defined not accidentally, but by a conscious choice on the physician’s part. The priest’s case, as a physician of the soul, is no different. For him, what spells the difference between causing pain and bringing healing to people, is a conscious choice to live, speak, and act never in himself, but in the person of Jesus the healer. Apart from this conscious choice, a priest can cause very great harm.

In this thoughts. A priest can cause harm when he fails to remember and recognize that he is not the source of his strength but Christ, that he is not the source of healing and therefore must not claim credit for himself, but always point to Christ as the sure foundation and ultimate purpose of his ministry. Failure to do so could lead him to wound others, because while they may find a temporary solution to their pains in him, this can only go so far, and ultimately, he fails to provide them with the complete and lasting healing of their wounds which only Jesus can give.

And he also wounds himself in the process, for when his personally-made solutions no longer help those he assists, he discovers in himself a yawning abyss and he is left with the most profound sense of ultimate uselessness and despair. He comes face to face with his nothingness. If Christ’s healing balm is not applied to this self-discovery, the priest enters into the downward spiral of self-destruction, dragging along the way, the lives of others he had originally intended to help. This is a tragedy of gigantic proportions, and priests must be careful that they do not enter into this path.
Pride comes before a fall.

In his words. When a priest loses sight of the intimate connectedness of his healing-work with the ultimate font of all healing—Jesus Christ—he begins to see himself and his ministry in a grossly exaggerated way. He becomes proud, vain, even pompous. Worse, he can start seeing others in a most deprecatory light—as individuals who are utterly dependent on him, and therefore, of second-rate status to himself, who is the “star of the show”. He comes to see himself as the repository and oracle of truth and the final arbiter of what is right and good.

Instead of being a tender of God’s Word meant to console and comfort the weak and sorrowing, his words can become like sharp knives that cut through the already scarred flesh of those he now looks down upon as his inferiors. Instead of binding the wounds of those weaker than himself, he can sprinkle salt on them and heightens their agony. Instead of empowering the weak, he can make them even weaker by making them utterly dependent on him. He starts to find joy in the thought that “they can’t survive without me”. But surely they can survive without him! The world and the church have existed long before we are born, long before we were ordained, and they will continue in existence long after we are gone. Jesus saved the world two thousand years ago, the priest is not meant to duplicate this saving act.

In his actions. When a priest forgets that he is no more than an instrument, and not “the healer” himself, he loses sight of his true identity and value, and begins to build monuments to himself. The repository of his self-worth, once the deepest part of his being where he is intimate with Christ, is now found externally—in his projects, his building plans, his programs, his crusades, his ambitions, degrees, and titles. He ceases to be a “wounded healer”, but a “wounding” one, running roughshod on anyone who stands in the way of his work. His ministry and service become a show. The people he assists and serves become means to an end. And his priesthood degenerates into a hollowed-out shell, an empty temple at the altar of which is erected no longer Christ, but himself.

The Incarnation is the key to avoiding this trap and is the first step to a priest’s conformation to the image of Christ the healer. The Incarnation is at the heart of the iconic understanding of the healing work of the priest. Just as Jesus is the Incarnation of the Father’s love for a broken world, so the priest is called to be the Incarnation of this continuing love in every age. He is tasked with communicating, not his own message, but the message of love and salvation that is from Christ. But it’s a task that can only be carried out to the full if the priest has become empty in himself and full of Christ. Even for his task as doctor of souls, kenosis--the emptying of self--is for the priest, the order of the day.

This is not self-debasement, instead it is the discovery of the greatest source of self-worth there can ever be, namely, knowing that one is an instrument in the hand of the Great Physician himself. It is the confidence wrought by knowing that I belong to Christ and am an extension of his healing work begun two thousand years ago and continues to this day.

* * * * *

Modern Version of the Oath taken by Graduates of Medicine Today:

I swear to fulfill, to the best of my ability and judgment, this covenant:I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.I will prevent disease whenever I can, for prevention is preferable to cure.I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

Text of the Modern Version written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used in many medical schools today.

"The Kingdom of Heaven is a condition of the heart." (Friedrich Nietzsche)