Hale and Hearty - Health and Beauty in the Human Person, Part 2

Does it help a doctor to treat the patient if he appreciates the beauty of the person and relates to him as a Christian? I think so.

In this article, I argue that the best doctors will be aware of what human health is to be able to treat them. Furthermore, to know what health is requires them to understand what a human person is, which means the study and acceptance of Christian anthropology. I argue that the very best doctor - or health practitioner of any description - will do more than grasp this intellectually, but will relate to the patient as a human person. To relate with a patient fully involves more than simply the adoption of Christian morality. It is a Christian formation, with the liturgy and mystagogical catechesis at its heart that will most powerfully form a good doctor.

In the first part of this article, I tried to establish a good working definition of health. In this part, I discuss why the best doctor, one who can help a patient to achieve this ideal, will be one who relates to others as a Christian. I explain why, in my view, such a doctor will be one who deeply appreciates also the beauty of the human person and is formed supernaturally as a Christian through a mystagogical catechesis with the worship of God at its heart. I begin from the definition of health that established at the end of part one.

Plastic surgery is the response of the modern medical profession to the question of human beauty. The best doctors, I suggest, appreciate the beauty of the human person in a way that is not limited to physical attractiveness.

A proposed definition of health
Reflecting on all of this so far, here is a proposed definition of health: health is the harmony of all aspects of the human person - body, soul, and spirit - in accordance with our freedom to choose happiness both now and in eternity. Healthcare, regardless of what particular aspect of the human person it is focussed on is always concerned, therefore, with the treatment of the whole person and the optimization of that freedom to choose happiness.

Happiness. What is it and how do we get it?
What we all seek is happiness, and as Aristotle points out, every choice we make is done with a view to increasing our happiness. The doctor cannot prescribe happiness, but he can contribute to the freedom of the person to choose it if he knows what happiness is and what is necessary to obtain it. The source of the difficulty in defining precisely well-being and health relate with all its ramifications, I suggest, is at root a reluctance to acknowledge a fundamental truth, that happiness is what we seek in this life and the next, and that God made us that way so that we might seek Him.

Happiness is one of those words that is almost impossible to define without descending into circular definitions of the sort that we have already encountered. An inability to define the word doesn’t mean that we don’t know what it is, however. Most people who could not define it would nevertheless say that we know it when we get it, and we know when we don’t have it. Also, most people can naturally distinguish between various degrees of superficial or temporary happiness. All forms of happiness are desirable and good, but not all fulfill the desire for a deep and permanent happiness that is in our hearts.

I would make the case that happiness is in fact, indefinable - ineffable - that is, beyond words. This is a mystery that need not worry us however, for what we desire is available to all of us. I quote here from the Orthodox theologian Alexander Schmemann (d.1983):

‘The ultimate mystery of the Church consists in knowing the Holy Spirit, in receiving Him, in being in Communion with Him. It is He (and not ‘grace’) that we invoke in prayer and acquire through spiritual effort..‘For in the words of St Seraphim [of Sarov] “when the Spirit of God descends upon man and overshadows him with the fullness of His outpouring, then the human soul overflows with unspeakable joy because the Spirit of God turns to joy all that he may touch.”

‘All this means that we know the Holy Spirit only by His presence in us, the presence manifested above all in ineffable joy, peace, and fullness. Even in ordinary human language these words - joy, peace, fullness - refer to something which is precisely ineffable, which by its very nature is beyond words, definitions, and descriptions. They refer to those moments in life when life is full of life when there is no lack of and therefore no desire for anything, and this no anxiety, no fear, no frustration. Man always speaks of happiness, and indeed life is a pursuit of happiness a longing of life’s self-fulfillment. Thus one can say that the presence of the Holy Spirit in us is the fulfillment of true happiness. And since this happiness does not come from an identifiable and external cause as does our poor and worldly happiness, which disappears with the disappearance of the cause that produced it, and since it does not come from anything in this world, yet results in a joy about everything, that happiness must be the fruit in us of the coming, the presence, the abiding of someone who Himself is Life, Joy, Peace, Beauty, Fullness, Bliss. This Someone is the Holy Spirit.’

The miraculous event at Pentecost is a sign of what is available to us as Christians. The gift of divine wisdom, a gift of the Holy Spirit, is the end of all Christian education, and so ought to be incorporated into the formation of health workers too!

Treating the whole person
Given the profound unity of the human person, a single entity that is body, soul, and spirit and in which each aspect bound up with the other. There is no treating part of the person without treating the whole person, and a doctor’s treatment of the person is incomplete if it is not in accord with our desire for God.

This is about more than medical ethics. It is governed by the first assumptions of what the person is. A doctor may know all the practices of medicine, but he cannot know how to apply them properly if he doesn’t understand what makes a person free to choose happiness.

Getting the heart of the matter: the human heart used to be organ that symbolized the place where we are, as a person, the vector sum of all our thoughts, feelings and actions. Modern medicine treats it as a machine and represents it mathematically as a series of functions. This approach is good for treating heart disease, but it could be better if all this data was understood in relation to the well-being of the whole person. 

The ancient Greeks, it appears, had a greater grasp of this idea of the need for the harmony of the parts than the specialists of modern secular medicine. Their general mathematical theory of harmony and proportion began with the consideration of the beauty of things, and the realization that when we recognize that the relationship of the parts to each other is ordered to the whole and to its purpose we see it as both beautiful and good. So the consideration of what things are begins with the recognition of their beauty as a sign of their goodness. This applies to both mankind and creation. Greek medicine considered health to be the balance of the parts and ill-health, it was assumed, could be linked to an imbalance. An example would be their approach to the four ‘humors’ - yellow bile, black bile, phlegm, blood. They understood also the profound unity of the physical and spiritual, so they tried to consider how an imbalance of these humors might lead to an emotional imbalance. It is from this that we still have words in the English language related to mood or character such as bilious, phlegmatic, or sanguine (the last from “sanguis”, the Latin word for blood).

In regard to the moral life, Aristotle in his Nicomachean Ethics (a book still studied in Catholic liberal arts colleges today), directly links virtuous behavior to a proportional relationship between extremes, citing arithmetic and geometric proportions. Many people read this and think that he is speaking loosely or figuratively, but he uses these terms with precise meanings in mind. (If you want to understand how, you can read of the mathematics of proportion and harmony in Boethius’s De Institione Arithemetica and De Institutione Musica, or my summarization of those principles in The Way of Beauty. These are also taught in my class offered by Pontifex University, called The Mathematics of Beauty.)

In considering the value of what the ancients did in the field of medicine, I am not suggesting that we adopt their scientific understanding of the human person which was inferior to that of the present day. Rather we should think about how this holistic approach to medicine can restore the humane to healthcare. Nor is this an argument for abandoning specialization in medicine. It does seem appropriate for a physician to primarily consider bodily health, but at the same, it seems reasonable to say that he cannot be a good physician without some awareness, at least, of how his specialization relates to the whole.

The modern doctor, for example, very often considers a chemical imbalance and its connection to unhappiness, and prescribes antidepressants. To do this without considering the possibility that a chemical imbalance might be the result of spiritual ills (which is different even from considering it to be a mental problem) could lead to a wrong diagnosis and treatment. Unhappiness, like physical pain, reveals a difficulty and on these occasions treating it with antidepressants might be akin to treating a broken bone with painkillers.

The Sacred Heart, by David Clayton, 20th century. Devotion to the Sacred Heart gives us an appreciation for Christ's humanity. Perhaps also, ironically, by meditation upon the symbol of the heart as the seat of the whole person, it can give us (including those of us who are in the medical professions) an appreciation for the spiritual aspects of man also.

Beauty and Health
Defining health in this way creates a direct connection to our perception of the beauty of the human person. In the traditional Western approach, beauty is the proper ordering of the parts of something in relation to each other, so that the whole is ordered to its purpose. We apprehend that beauty we are discerning this right pattern of the parts to each other and of the whole to its purpose.

Human beauty, therefore, could be defined as the radiance of health.

This definition speaks a deeper recognition of the human person than the superficial recognition of sexual attractiveness, which is a true but incomplete assessment of human beauty. To recognize a person as beautiful in this way - radiantly healthy - is to do more even than to grasp vital information about his health. It must be apprehended by one who appreciates that he is in relation to the person regarded, and is sympathy what those goals are. This is one who loves and who takes delight in the freedom of the other.

There is real value in doctors being formed to see us in this way. For all the blood-pressure readings or vital signs, it is their judgment, formed by experience will tell them in combination with this, just by looking, how healthy a person is. Such a doctor will not only have a heightened sense of when something is wrong, he will naturally look for the restoration of balance and have a sense of how to put the parts together again, so to speak. This requires each doctor and nurse to be, as well as practitioners of medical science, to be mystics and lovers who take an interest in, and ideally even know well the patient as a person.

An education that incorporates a formation in faith and a formation in the apprehension of beauty will increase the chances of the doctor being that person. The best health practitioners will be men and women who strive to be partakers of the divine nature and who can see with the eyes of purity, and so they are kings, priests, and prophets living the life of the Spirit (in common with all Christians). This is why medical training ought not to be separated from a spiritual formation in the Christian life. The good doctor will be a man of love attuned to the beauty of the human person in the way that a mother sees the beauty of her newborn baby.

The Lucca Madonna by Jan Van Eyck, Flemish, 15th century. It is the love of a parent for the child that allows her to see the beauty of a baby in a way that others don't. All people, by virtue of our humanity, are as beautiful as a baby, and it is our lack of love for others that restricts our ability to see it. Nevertheless, the recognition of the beauty of the whole person is an ideal that we can strive for, difficult though it is to achieve.

Clearly, this is asking a lot of our doctors and nurses and something that no training can ever guarantee for them. Medical exams can test knowledge of the information that might aid such a transformation, but they can’t measure the transformation itself. Nevertheless making medical students aware of the principles outlined, and offering them mystagogical catechesis and spiritual guidance directed to these ends should be a matter of policy and I would make it a priority over any other general education, even the traditional Great Books and Liberal Arts programs that American Catholic colleges and universities offer. This is, I suggest, the authentic role of our Newman centers on the university campuses and it is not beyond any of them. I believe that if they were offering this, the uptake would be from a pool far wider than simply medical students!

But let all those that seek thee be joyful and glad in thee, and let all such as delight in thee say always The Lord be praised. (Psalm 70 (69), 4)

Hippocrates (460-370 BC)

Hale and Hearty - Health and Beauty in the Human Person, Part 1

What is health? What does it mean to be healthy? We use the word all the time, but could you define it? And does it even matter?

In this article, I argue that the best doctors will be aware of what human health is to be able to treat them. Furthermore, to know what health is requires them to understand what a human person is, which means the study and acceptance of Christian anthropology. I argue that the very best doctor - or health practitioner of any description - will do more than grasp this intellectually but will relate to the patient as a human person. To relate with a patient fully involves more than simply the adoption of Christian morality. It is a Christian formation, with the liturgy and mystagogical catechesis at its heart that will most powerfully form a good doctor. The article will be presented in two parts. In today's I try to establish a good working definition of health and why it is important to do so. In part two, which will be posted on Thursday, I discuss why the best doctor, one who can help a patient to achieve this ideal, will be one who relates to others as a Christian. I explain why, in my view, such a doctor will be one who deeply appreciates also the beauty of the human person and is formed supernaturally as a Christian through a mystagogical catechesis with the worship of God at its heart.

A Visit to the Quack, by Hogarth, English 18th century. We can expect better today as the treatment of bodily ailments has improved dramatically, but to what end?

Given that health is something we all desire, one would imagine we could say what it is, but in fact and perhaps surprisingly, it’s not that easy. When I looked up the word in an online dictionary it defined it as a negative: a state of being free from illness or injury. This, surely, is inadequate? For while it tells us what we don’t want - illness and injury - it doesn’t define the good that we do want, health.

Philosophically, it seems to be an inversion: the usual approach is to define the good as an entity and consider evil to be a distortion that restricts or reduces what is good. So by this approach, illness, and injury, as human evils, would be defined as privations of health. But if we cannot say what health is, we cannot say what a privation of health is, and accordingly, we can’t say what illness is either. So a definition of health-based upon an absence of something argument is a circular definition, effectively health is the absence of ill-health!

The right wing of Rogier van der Weiden’s Altarpiece of the Seven Sacraments, ca. 1445-50, depicting Holy Orders, Matrimony, and the Anointing of the Sick. (Public domain image from Wikimedia Commons, cropped.)

Perhaps we might suggest that health is an attribute of the human person that can be equated to a wholeness of being? This seems to be better, but still, it doesn’t quite fit. We can imagine a situation where we have an amputee or a blind man, for example, who would not be considered a whole person, could nevertheless be considered healthy.

Looking further, the World Health Organization - which, given their name, you would think ought to know - defines health as follows: Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity. Similarly, Medical News Today, in an article aptly entitled, What is Good Health?, defined health as a state of complete emotional and physical well-being. Healthcare exists to help people maintain this optimal state of health.

The Barber Surgeon by Adriaen Brouwer, Flemish, 17th century. If we view limit our idea of the human person to body-as-machine, then aren't our modern doctors just glorified and highly-trained barbers? I would argue so, except that at least the barber is usually sufficiently interested you as a person to ask you where you're going for your holidays. No doctor has ever asked me that! 

These seem to be getting closer, but in order to understand what these definitions really mean, we need to have a clear understanding of what we mean by physical, mental, social or emotional well-being and unless we can do that, we are still stuck. Well-being is described in the dictionary as a state of health, happiness, and prosperity. This still leaves us floundering somewhat with another circular definition: health is well-being and well-being is health.

Well-being as a state of happiness, the second part of the definition above, does seem to be a better starting point; however. I think we can disregard serious consideration of prosperity - success in material terms - which is only important to the degree that it contributes to happiness, as it seems reasonable to assume that the happy person possesses all the prosperity they need.

So while happiness is not the same thing as health, there is a strong connection, and this will be our starting point in the consideration of what health is. In order to establish what that connection is, we need to consider first why it is important to know what health is.

Why worry about the definition of health?
This matters. Unless our healthcare providers have a clear answer as to what health is, precisely, then every time we go to the doctor’s surgery or the hospital we cannot be sure that he really is trying to make us healthy! Try asking your doctor what he thinks health is and you may be disturbed to find out that he doesn’t really know.

I first learned about this anomaly through my own GP, who told me that throughout his medical training he was never formally taught exactly what health is, and that after many years of practicing, it had dawned on him how detrimental this was to healthcare provision in the country.

Most commonly the goal of a doctor’s treatment today is about relief from illness. So the doctor does not assist the patient in his search for the Good, but rather aids his escape from something bad without really concerning himself with where he is going. This is better than nothing, but it does lead to problems. At best each doctor decides for himself what health is, perhaps in consultation with the patient. We cannot establish what the Good is for a human being without consideration of him as a person, body, soul, and spirit. A physician who is trained to treat the body as a mechanical device to be repaired and often it will not occur to him to consider how it relates to the whole person, especially the spiritual aspect.

Blood-letting in the 14th century. Medical science has undoubtedly improved since then, but has the medical profession lost a sense of how to treat the whole person in the process?

As Christians know, the human person is a profound unity of body, soul, and spirit. Modern medical training studiously avoids taking any position on the spiritual well being of the person, and this has profound consequences because there can be no neutrality in this. As in all things, either we are for God, or we are against Him. A philosophy of medical treatment that takes a position of spiritual ‘neutrality’ as one of its foundational premises will inevitably be anti-spiritual, and will undermine the spiritual health of man, leading us to misery.

Doctors today, it seems to me, are trained experts who treat best the particular slice of human nature they are trained to examine, but they do not have sufficient knowledge of how that slice relates to the whole. To be able to make this connection most likely requires a study of Christian anthropology and the integration of this study with their medical training.

A way of summarizing the situation is that modern doctors are able to analyze well but are less able to synthesize. They can treat the parts in isolation, but they are less competent when putting all those parts together.

To illustrate how this can have an impact on physical health alone (without any thought for the spiritual needs of the person at this point), here are two examples. First, in the appendix of my book The Way of Beauty, entitled Liturgy and Intuition, I describe how on a number of occasions nurses in intensive care wards predicted that a patient was going to have a heart attack. The specialist cardiologist would come in to check the readings of all the vital signs, and say, on the contrary to what the nurse was saying, that there was no risk, because all readings were within the defined limits of healthy function. When asked to explain why they were worried for the patient, the nurse couldn’t say, it was simply a conviction that came from intuition. So typically, the doctor ignored the warning; then, as often as not, the patient had a heart attack. Later, it was discovered that while individual readings of heart function were within the limits of safety, there were certain combinations of such readings that were dangerous. The nurses were picking up intuitively the pattern of readings an unhealthy heart, because of their great experience of being with patients. Their experience and intuition were overriding the knowledge given to them in their training.

Here is another example, given to me by a practicing cardiologist. There are four atria in the heart and sometimes a diseased heart can reveal enlarged or diminished atria. In their training, the doctors are taught the ‘healthy’ range of sizes of each individual heart atria. However, he told me, very often there will be situations where one or more of the atria are outside the range of health, but an experienced cardiologist will ignore the reading if they judge, in light of their experience, the pattern of the relationships between one atrium and the three others to be healthy.

So just as all the parts of the heart ought to be in right relation to the others, the heart should be in right relation to the body as a whole, and the body, therefore, should be in right relation to the soul and the spirit. Then each part is in right relation with the whole.

Hugh Laurie in House. The idea of the doctor who is brilliant at what he does but seems to despise his patients and colleagues makes for great drama. But in truth, could such a doctor be even better if he was joyous and Christian? I believe so.

A proposed definition of health
Reflecting on all of this so far, here is a proposed definition of health: health is the harmony of all aspects of the human person - body, soul, and spirit - in accordance with our freedom to choose happiness both now and in eternity. Healthcare, regardless of what particular aspect of the human person it is focussed on is always concerned, therefore, with the treatment of the whole person and the optimization of that freedom to choose happiness.

Part two of this article will be posted on Thursday. ...