When I started reading Amy Julia Becker’s new book To Be Made Well and Liuan Huska’s Hurting Yet Whole, I was gripped instantly by the opening anecdotes. I had something of a reputation during my Family Medicine residency for attracting patients whose illnesses were difficult to treat due to their maladies’ psychosomatic origin or the social situations that complicated these patients’ quest for healing. Becker and Huska’s own stories instantly brought me back to those days that I spent trying to convince my patients that there was no pill (especially not one called oxycodone) to fix what years of trauma had wrought or that they had more power over their illnesses than they might have thought previously.
Becker, whose op-ed earlier this year in the New York Times brought a full-throated defense of human dignity against modern obstetrics’ ghoulish prenatal testing regime, was a teenager when she developed chronic nausea and vomiting. Clinicians told that her stomach was emptying with the efficiency and speed of a 95-year-old. Huska was a busy young graduate living in Chicago when she found herself beset with joint pains that made it nearly impossible to walk at times and kept her “trapped in the cage of my own body.” When I read these narratives of illness, I couldn’t help but think of my own patients and their illnesses that felt (and sometimes even now feel) impossible to diagnose or treat properly.
“We have lost the ability to suffer well,” writes Huska in a sentence that sets up the problem she wants to address in Hurting Yet Whole. This loss takes many forms: name-it-and-claim-it theologies that take more inspiration from Job’s friends than from Christ, medical technology that encourages us to treat doctors like priests and MRI scanners like oracles, or simply treating our churches and workplaces as if the only people in them are able-bodied and independent. While she doesn’t take a turn through the Enlightenment’s emphasis on autonomy and independence that many other recent books feel obligated to include, she very well could have as she explains how a “cult of normalcy” fears suffering, dependence, and disability.
For Huska, living well with pain means embracing our dependence on others and letting our vulnerability be an invitation to relationship rather than an opportunity for shame and withdrawal. Including those who are disabled or suffering with chronic pain requires certain accommodations and embracing weakness means that we will likely sacrifice some efficiency and cost-effectiveness as we reject the cult of normalcy. Yet examples like the Bruderhof demonstrate that the value of inclusion is something that can’t be measured against time or money saved.
Suffering is inescapable in our lives, and, as both Huska and Becker point out, we are surrounded by it. Yet whenever suffering cannot be quickly ameliorated by medical science, our first instinct is to hide it—often by hiding the sufferer. Stanley Hauerwas points out in Suffering Presence that this extends quickly to killing the sufferer in utero before their suffering can weigh the rest of us down. Becker notes in her NYT article that only 37% of medical providers who deliver a prenatal diagnosis of Down Syndrome suggest that delivering a baby with an extra chromosome could be an option.
Hurting Yet Whole is focused on how and why to suffer well, while To Be Made Whole takes up how holistic healing can take place through a variety of extra-medical means—and might not be exclusive of enduring pain. Becker traces the ways in which Jesus’ healing of the woman who bled for 12 years is paradigmatic for our healing—His work alleviates physical symptoms, restores the suffering to community, and makes us right with God. While never making any promises about how healing will or will not happen, Becker emphasizes that there is a great deal of physical healing to be had when we seek peace in our soul by turning to God, resting in His salvation, and attending to our needs to be connected with others.
This isn’t a simplistic mind-over-matter equation, and part of the genius of To Be Made Whole is how Becker carefully unpacks holistic healing and wholeness in a comprehensive manner. Most of us have probably heard paeans to holism from health authorities, theologians, or our bosses, but most of these wind up being little more than air escaping from our GI tract. Becker traces out the individual and communal practices that our bodies need to be truly healthy, especially those that will include the less able-bodied.
Medical science has long recognized the role that stress, relationships, and spirituality play in our physical health, although it profoundly underemphasizes them because hospitals, clinics, and the people who staff either can do very little about them. Until the recent trend of conspicuous consumption as “self-care” came about, there was very little money to be made off of anything resembling holistic care. Indeed, when considering how effective conspicuous consumption as self-care seems to be, the things that give us the most health and joy are going to be perennially unprofitable.
Further complicating the questions addressed here is the fact that clinicians (especially doctors) are not fond of admitting their powerlessness, so when they can’t figure out what’s wrong or can’t fix it, they tell a patient “it’s all in your head” and move on. Writing off a patient’s symptoms as “psychosomatic” is an easy way to avoid the otherwise painful tension that exists where medicine can’t fix things. (Huska dedicates an entire chapter to women and their unique vulnerabilities, and I would also recommend this essay on the subject.) Becker doesn’t explicitly address the challenge of illnesses that we know are linked explicitly to stress and trauma (like fibromyalgia) or that medical science does not have a good explanation for (like chronic Lyme Disease), but I think her words can be helpful for any illness, but especially for those whose suffering doesn’t have a simple diagnosis and cure.
Becker also describes in detail the barriers to our healing. Distraction, anxiety, shame, and status are all powerful hindrances, some profitable and others simply part of our individual and corporate fallenness. Jesus took on each one in his care for Jairus’ daughter and the woman who touched his robe, in Becker’s reading, overcoming them in order to bring healing and salvation.
However, there’s more that could have been said here. Becker frequently references her intermittent struggles with alcohol overuse (and, less frequently, her struggle to use screens in a similarly unhealthy self-medicating manner). However, these references usually just add a bit of narrative tension before she describes a way of thinking or acting that is more meaningful and holistic. There’s a good chapter about how distraction (which is mostly screens in our day and age) get in the way of health, but a more detailed discussion of either alcohol or other addictions is a missed opportunity in To Be Made Well considering the prevalence of addictive behaviors and the unique place addiction sits at the crossroads of illness, health, and salvation.
After all, it is generally acknowledged that addiction is an illness—“just like diabetes,” some might say. I have discussed my complaints with comparing addiction with other illnesses previously, but in an age where pop psychology is trying to make us look at everything through a therapeutic lens, addiction is one of the few places where someone must say “I am sick, therefore, I must change my behavior.” Most 12-Step programs start with the idea of surrendering, casting one’s healing from addiction as a matter of being saved. Contemporary addiction treatment simultaneously emphasizes that one’s destructive choices are often rooted in trauma or what has been done to the sufferer, and also that one is now fully responsible for future choices regardless of what has happened in the past.
In this, I think the language of addiction provides a way for people to understand how the feelings they experience in their minds and bodies are self-medicated in unhealthy and sinful ways. Whether it’s more ubiquitous addictions to social media and pornography that afflict wide swaths of the Church or the deadlier problem of alcohol misuse and drug overdoses (both of which rose during the COVID-19 pandemic), there’s a desperate need to apply what Becker is saying to these behaviors which kill body and soul. My only regret is that she did not specifically draw out this theme, and I hope she will return to it in the future.
Similarly, Huska’s book also doesn’t discuss addiction. When it comes to chronic pain, I think this is a huge oversight because our opioid epidemic was preceded by a chronic pain epidemic. In the first decade of the 21st century, pharmaceutical companies conspired to promote opioid painkillers (e.g. OxyContin, Dilaudid, morphine, oxycodone, and Percocet) as safe and effective treatments for chronic pain. In truth, they are often dangerous and rarely effective. Clinicians prescribed these medications in vast quantities, acting out of compassion, ignorance, recklessness, or exasperation, and this corporate greed has caused incredible suffering and loss through addiction and overdose deaths.
However, the problem of chronic pain hasn’t gone away. When a patient has experienced some kind of relief from their chronic pain by taking an opioid, it feels cruel for a clinician to pull out charts showing that most people who take opioid medications chronically end up rating their pain at the same intensity over a long period of time. The use of opioid medications for certain chronic pain syndromes is extremely controversial among clinicians, patients, and advocacy groups. Huska describes how frustrating a clinic visit can be for someone with chronic pain; the frustration increases exponentially for both doctors and patients when opioids are involved. I would have appreciated Huska’s sensitive and careful analysis applied to this vexing problem.
The two books overlap and converge in several places, but as I read them side-by-side I never felt like they were repeating each other. Each provides different emphases within the same framework of embracing our vulnerability as embodied creatures in order to find true healing where medicine and technology falter. If you’ve ever read Alisdair Macintyre’s elegant little volume Dependent Rational Animals, both Huska and Becker are spelling out in much greater detail how to live as Macintyre recommends.
If I had my own practice in the US, I’d put copies of Hurting Yet Whole and To Be Made Whole right next to each other on the bookshelf in my waiting room. I’d give Hurting Yet Whole to a patient who feels overwhelmed with the burden of chronic pain or illness or someone who knows that there’s no going back to the way their body used to be. I’d give To Be Made Whole to a patient who feels powerless and trapped in their illness—or to a friend or family member of someone who doesn’t believe that there’s any healing for them. I’d give either—or both!—to a pastor or ministry leader who is struggling with how to best minister those who are suffering from chronic illness or disability. Holistic healing is a lot easier to talk about than it is to live out, but Becker and Huska have given us two very helpful guides for doing the difficult but necessary work to help ourselves and others be whole.
- Huska’s book is not new, but it had the unfortunate coincidence of releasing on January 6, 2021. ↑
- Both Becker and Huska both use the word “doctor” more often than “clinician” or “health care provider,” but I prefer the term “clinician” because it is more inclusive of nurse practitioners, physician assistants, clinical officers, and other health care professionals who diagnose and treat illnesses. Nurses, physical and occupational therapists, respiratory therapists, counselors, psychologists, medical social workers, and other allied health care professionals are also invaluable in caring for people in health care settings, but they can be just as guilty as doctors of reinforcing the negative experiences patients have with allopathic medicine. ↑
- The two that come to mind that I’ve read in the past year are Freddie deBoer’s The Cult of Smart and Matthew Crawford’s The World Beyond Your Head, which are not otherwise similar except for the fact that they each spend a full chapter discussing Enlightenment liberalism and autonomy as major sociocultural forces in our time. ↑