It wasn’t until medical residency that I began to fast during Lent. While foregoing food from dawn to dusk one day a week for those forty days might have been a creative re-casting of a practice often undertaken unintentionally due to the rigors of training, something about the act of volitionally surrendering a good I might otherwise presume upon felt meaningful.
The power of this practice was amplified, I think, by my observation of the interplay among power, food, and desire around me on a daily basis in the hospital. While contemporary society may be (in some ways, justifiably) apt to divest physicians of the power they have historically wielded over patients, one way this power still remains manifest is in the fact that, as a physician, I can literally forbid another person from eating.
NPO—nil per os—is an order that physicians can place, instructing nurses and those in proximity to the bedside that patients are not allowed to take anything by mouth. Sometimes this is done because patients are deemed too high a risk for aspiration during meals due to global weakness or de-conditioning. At other times, it is in anticipation of a surgery or endoscopic procedure which might require sedation which is safest done on an empty GI tract.
It is a curious thing to prevent another human from eating. It feels patronizing, calloused, sometimes crass. Yet amidst the busyness and stress of residency, it is frustrating to encounter resistance to one’s orders. I can recall multiple perfunctory conversations with patients, insisting that they were “starving,” having “waited all day” for their procedure, even “dying of hunger,” begging for a sip of water. It is remarkable to me in retrospect how easy it was then, and sometimes remains today, to ignore the stark yearning of these patients by way of retreat to an instrumental pragmatism—that such visceral discomfort would be viewed as merely incidental to the biomedical task at hand.
I remember one gentleman in his sixties, body wracked by metastatic cancer, set to undergo a high-risk surgery I personally viewed as futile, telling me that if he were to die on the table, it would be best to do so on a full stomach—arguing that to prohibit him from eating was “an inhumane power play.” My response was one characteristic of a stolid resident, offering some vague acknowledgement of the difficulty of hunger, while also noting this was standard practice with his health and safety in mind.
*
Witnessing famished patients in the hospital and ensuring their ongoing hunger coercively is, if we have eyes to see, sometimes a tragic part of the job, but one most all in medicine have made peace with. Nevertheless, the work of forbidding an otherwise capacitated person from engaging in one of the constitutive acts of their being—eating—highlights all the more powerfully the beauty of Christ’s temptation in the wilderness, the Scriptural passage often used to inaugurate the Lent season.
Unlike the patients who are unilaterally prevented from eating through my orders, Christ undertakes his fast volitionally—foregoing the very embodied good of sustenance he would later extol in his ministry, when he fashioned new wine, multiplied fish and loaves, and broke bread in Emmaus. Contra a Gnostic or Stoic stance which would denigrate bread as, at best, a necessary and instrumental evil, Christ’s fasting retains power to the extent that it represents a forsaking of something intrinsically good, and conducive to flourishing. This power lies in his subordination of bread to the greater good of reliance upon God and every word that comes from His mouth.
And while I remain today impressed with the courage and resolve of those patients whom I, with the stroke of a finger, render “NPO,” the true goodness of Christ’s fasting is bound up with his freedom to do otherwise. The prospect of hunger, of yearning, of exhaustion, is not foisted upon Christ peremptorily. Rather, Christ recognizes that as one whose life cannot be taken from him, yet he “lays it down of my own accord,” he actively chooses to subordinate the good of eating to the task of obedience. He neglects the comfort, strength, and security of bread for the vicissitudes and vulnerability of hunger—rendered so weak at the end of passage that he requires angels to attend to him.
It is the contrast between the volitional forsaking of bread that Christ undertakes and the coercive, external imposition of an “NPO” order that invites those who would follow Christ, particularly in Lent, to consider both how they may be bound up in systems that reinforce injustice upon others, but also how they may be called themselves to surrender agency and thwart desire in pursuit of a higher good.
*
Yet this is not all. Jesus does not leave us in the Wilderness, pondering the necessity of fasting as an essential ascetic practice to follow him well. Recognizing our proclivity to view such practices instrumentally, it is a second encounter, which bookends the final day of Lent, that invites us to remember that Christ’s message is not one primarily of forsaking food, but of obedience in the face of desire which might urge otherwise.
In the same way that the quotidian work of medicine lays bare the visceral desire of patients who yearn to eat but are not allowed to, it also displays how powerful the opposite desire can be. That is to say, there is perhaps no more challenging (and tragic) task than trying to force food upon those who lack hunger.
This is true for patients beset by deep and torpid depression, for whom eating feels pointless, burdensome, and banal. It is true for those wracked by anxiety, in a constant state of hypervigilance, adrenaline coursing and inducing an unremitting nausea and pseudo-satiety. It is especially true for the dying, whose natural metabolic capacities slowly diminish as family members often frenetically attempt to feed them in spite of their terminal repugnance to such efforts. Despite remarkable pharmaceutical developments in modern medicine, medications to stimulate hunger to help patients restore their desire to eat and gain weight remain notoriously ineffective.
If choosing to forego food in a state of hunger is heroic, attempting to eat in a state of repugnance to food seems impossible, requiring a form of resolve that is rarely witnessed. Yet in Christ, for whom the primary call is not merely to fast, but to obey, we see such fortitude embodied.
In the Upper Room on the eve of his betrayal, Christ gathers his disciples. Knowing what lay ahead, one can scarcely imagine the impending sense of doom which beset his every word and action that night. As one who bore our infirmities, Jesus knew those visceral sensations in the gut which defy articulation but are universally felt—anxiety at the prospect of an imminent violent death; anger at a friend who would betray him; deep sadness at the systemic brokenness that has led to this moment.
If ever there were a person whose hunger would be suppressed, who would sense both the dread and seeming futility of sharing a meal at this hour, it was Jesus. Indeed, it is telling that Christ’s plea to his father later that night would be that the cup might pass—that he might not be forced to drink to the dregs that which revulsed him.
And yet, hands trembling, he breaks bread. Voice shaking, he gives thanks, and he shares what cannot yet be understood. And against every deep-seated signal urging otherwise, he eats and he drinks and in so doing submits his will and desire to that of his Father. In the same way that he resists the temptation to eat in the wilderness, rendering him vulnerable and dependent upon a community of angels, he resists the temptation to abstain and merely serve this meal to his disciples, instead partaking—joining and knowing them in the breaking of the bread, revulsion be damned.
*
Lent holds the power to discipline our desires, to subordinate our yearnings to the will of God. Yet to fully grasp what this means, and what obedience to the Father looks like, we must remember both the lonely wilderness and the crowded Upper Room, and learn to discern when we are called to fast and when we are called to feast, even when our yearnings signal otherwise. And praise God for a Savior who meets us in both our hunger and our revulsion, ever present and sanctifying our pangs.
