CHAPTER 3
Will Hospital Replace the Church? *1
The subject on which I have been asked to speak raises a
matter of the greatest importance. It confronts not only the members of the
medical profession and hospital administrators. It concerns everyone. It will be
my duty to substantiate such an unqualified statement. In so far as one’s own
professional experience is relevant, I am in a position to speak with some
confidence. The immediate aspect of the subject before us is that there is today
a subtle move to do away with the Church. If it succeeds, will it be for
humanity’s good?
THE FUTURE OF THE HOSPITAL
That the question should need to be seriously discussed today
in medical circles arises from the fact that it has increasingly become a matter
for comment in meetings of doctors and hospital administrators. During
May of last year (1968) at a conference of the official representatives of the
associations which arc concerned with the hospital services, it was said that –
"The hospital model is now the model to which sociologists
are gradually turning their attention.... As religious causes have waned
and society has been secularised, it is the hospital which has succeeded and
taken the place of the Church.... The hospital has had a precarious and clouded
history, which is still to be properly written. But, in spite of that
history it is now emerging, not as the last refuge for humanity, but as the most
important institution of our time."
Speaking some months later at a clinical meeting of the
British Medical Association in Cheltenham, Lord Todd commented – ‘with the
general decline in religious observance the doctor has in some measure taken on
the role of confidant formerly exercised by the priest. . . .’2 The
hospital has already taken over some of the work of the Church. Is it destined
to do so more and more? The accepted notion seems to be that it will do so. My
function, therefore, is to ask whether this is desirable or true?
HISTORICAL PERSPECTIVE
The best way to approach the subject will be to look at it
historically. But it is just here that the relevant facts are so often
forgotten. It is characteristic of the age in which we live. People make false
claims because they either overlook or ignore the facts concerning the past.
The fact is that, in Western Europe at least, it was the
Church which founded the hospital. It was Christian people, who out of
compassion for the sick and the suffering, felt that something ought to be done.
It is very important that we should keep this point before us. It is true that
not merely did the Church initiate care for the sick, and in one sense by so
doing introduced Medicine, but she performed exactly the same service in the
case of both ‘Poor Law relief’ and education. Let us not forget this. Scientific
humanism, which has opposed itself to Christianity, has little that is
comparable, and it is important that the humanist should also be reminded of his
history. This concern about people – physically, mentally and spiritually – has
over the centuries shown itself chiefly amongst Christians and in the organized
Church. A number of other groups may, and do, talk a lot about doing good. They
generally, however, stop at talking!
It is similarly possible to illustrate this characteristic
feature in Christian activity from modern history. In the early days of the
developing countries, the building of the hospitals (as, for example in Africa
and parts of Asia), the building of schools, the providing of rules of public
health and much else has originally occurred as the result of the concern and
the activity of the Christian Church. Hence, what was true in more remote
history has been repeated, especially in the 19th century, in the
Church’s great missionary enterprise.
That is how it began. However, as time passed a certain
change took place, and these philanthropic functions became separated
from their parent. They were, to use the term in the first quotation above,
‘increasingly secularized’. As time passed the practice of medicine, for
instance in Europe, was undertaken by individuals who were no longer ordained
officers of the Church and who sometimes did not even belong to her. They
gradually began to take over the care of the sick, or voluntary bodies began to
do so, and, as we know, eventually medical care passed into the hands of the
state in a national service.
But, at the present time, we are clearly
confronted by a new situation. The Church’s power is waning. The question,
therefore that arises is: Can the hospital now take over all the functions of
the Church? It has already taken over the medical functions Cannot now the
hospital take over all the rest so that the Church may finally complete her
atrophy and disappear? My object is to prove that this outcome is one that
cannot, and should not, happen.
THE NEED FOR THE CHURCH
How can I demonstrate this negative? Well, in the first
instance, I want to show that this idea, that the hospital could take over the
remaining functions, rests on a totally false view of the Church. Let me hasten
to add, however, that the Church herself is in a large measure responsible for
this misconception.
What is this false view? It takes many forms. There are some people to whom
the Church is nothing but a part of our national tradition. Church attendance is
a part of ‘the thing to do’, and it is still of some social value in these
respects. The usual formalities would not be complete without going to a Morning
Service, hoping, of course, it will be suitably brief so that one can adjourn to
the sherry party as soon as possible. It is all a part of the social round.
Then a somewhat higher view is that the Church is the servant
of the state. Her main function is to perform certain things for us. She is
useful for a christening, or a marriage or a funeral. The other agencies cannot
do that kind of thing quite as well. A Register Office may be all right for
legal purposes, but there is something about a Church service which, after all,
adds dignity to the occasion. So the Church remains very useful at such times as
a marriage, a christening, and, of course, at death. Further, if there happens
to be a war and things are not going very well for the nation, then, of course,
the Church can organize a national day of prayer.
To move to a higher level, there are a number who believe in
the Church because, they say, she exercises a good and general moral influence
through her teaching. You need discipline in society they argue, and she really
can do very good work in this respect. But, then, some would go even higher
still. For, they concede, the Church does after all bring in some kind of vague
notion of God and a Supreme Being. It is good, they think, that people should
have that!
Passing from such general considerations to the more
personal, there are many who would suggest that the main function of the Church
is to provide some kind of therapy. They observe that entering a church has a
tranquillizing effect and believe that it has a distinct therapeutic value. From
the excitement and distractions of the world you are able to go into a building
with ‘dim religious light’ and feel a little bit quieter in spirit. Your nerves
become more settled and you have a more comfortable feeling. Then there are the
various services, well-ordered, well-arranged, and with beautiful singing. All
that is good for us. It is a pleasant form of escapism. In addition you will
probably hear something about love, kindness, good deeds, and affection. In this
turbulent world all these things are therapeutic and promote mental health.
This, we are told, is what the Church exists for, and she has done it all very
well so far.
To look at the matter still more personally, it has been
noted that the Christian ministry has a useful place in the common life. The
vicar has certainly had great value in the past, because it has been possible
for people to rely upon him for sympathy. He is a man who, because he is thought
to have not very much to do, will always be ready to listen to you. Most people
like to have somebody who is prepared to listen. Those in trouble are greatly
helped by just being allowed to talk, and the vicar or Free Church minister is
generally prepared to listen. More than that, he may be able to give some advice
or what is now called ‘counselling’. A Roman Catholic can confess his sins to
his priest and ‘confession is good for the soul’. The underlying idea is that
all this has had a therapeutic value. It has certainly helped people to meet
life and its problems.
THE HOSPITAL AS SUBSTITUTE
However, we are now confronted by the new position that
people are ceasing to go to church. The question therefore must be put: Can the
hospital take over all these functions so that the Church will no longer be
necessary? Again, my answer is that such a view can only be based upon a wrong
view of the basic functions of the Church. It can only be as a result of an
illusion that the hospital can now give these further services – ‘without the
"mumbo jumbo", the ceremonial and all the theological dogma’. Why do I so firmly
reject the suggestion that the hospital can be a substitute? I have sought to
classify the answers.
(i) Confidences
I would first query the suggestion of the omnicompetence of
the hospital even from the standpoint of fact. This notion is doing a
considerable injustice to the doctor of the past, and especially to the general
practitioner. It is also granting too much to the Christian minister. Surely,
the position has long been that the general practitioner has continually carried
out most of the functions that I have been mentioning – apart, of course, from
the actual services in a church – more than the minister.
My own personal experience might be brought in at this point.
I suppose that the remark which has been made to me more frequently than any
other since I have been a minister of religion has been as follows: someone, who
has come to consult me, will suddenly add: ‘Of course, I can tell you this
because you are a doctor.’ The point I am making is that if I had not been a
doctor, it seems, they would not have dared to tell me. This supports my
contention that the general practitioner in the past had achieved a kind of
father figure. He was the adviser of the family – their guide, philosopher and
friend. Most of us can remember this type of general practitioner.
(ii) Impersonalism
Then, in the second place, I come to a point at which I shall
have in a measure to express some criticism of ‘the hospital’ and the medical
workers who function in it. This aspect of the subject has its elements of irony
in relation to the question we are considering, because I have to spend a good
deal of my time, and increasingly so I am sorry to say, in listening to people
who complain that the doctors are becoming more and more impersonal and
mechanical in their treatment of their patients. I am not manufacturing such
evidence; it is something which the lay-public is asserting with greater
frankness. They have been given the feeling that they are but guinea-pigs.
Things are being done to them by their medical advisers but they themselves have
been forgotten as persons.
(a) Poor Communication Another complaint that one
often hears and any minister would confirm this very readily – is that the
patient ‘cannot get anything out of the doctor’. If they put questions, or ask
for explanations, he becomes impatient. He always seems to be too busy; and the
patient and the relatives complain that they cannot get any information out of
him. Yet, let me remind you, the proposal is that this same doctor should
take over the functions of the clergyman and minister, because someone is needed
who is ready to listen and to be very sympathetic! It seems to me that the very
crisis through which the medical profession itself is passing today answers the
suggestion that the hospital should take over the functions of the Church.
(b) Overbusyness The common impression is that the
doctor of today is far too busy. This is particularly true, I am told, of
the hospital doctor. Indeed, I hear the same thing about the nurses – that
nurses nowadays are not nurses in the old sense. They seem now to be
semidoctors, very scientific, very learned, very good at giving injections, good
at working out doses and much else, but they seem to have lost that ‘motherly’
quality which used to characterize a nurse. The nursing is deficient, whereas
the scientific knowledge seems to be increasing. One recognizes that this
difficulty must arise as medical and surgical treatment becomes more and
more scientific and, also, as the staffing problem becomes increasingly acute.
My point is that since the hospital is becoming more impersonal it therefore, of
necessity, cannot take over the functions of the Church.
(c) General Practice But someone may say: ‘What about
the general practitioner?’ Well, here again, alas, the position would seem to be
very much the same. The development of ‘group practices’ means that the patient
finds now that he cannot always have the same doctor. This is particularly true
at the weekends. His own doctor is only on duty, perhaps, one in every five or
six weekends. If some medical emergency were to occur at that time another
doctor will often come in, who probably has not seen the patient before and who
does not know anything about the case. Here, the personal relationship between
doctor and patient is disappearing. In any case the practice of medicine has
changed tremendously. In the old days the doctor could and would come in, sit
down and have a talk. Nowadays it is a question of form filling, pills,
injections, or operations; and it is all done so quickly that the patient is out
almost before he is in!
If all this is true, then what I am saying is this – that it
seems quite clear that, owing to the present state of medical practice, speaking
generally, the hospital is in no position to take over even those functions of
the Church to which I have already referred. Moreover, as general practitioners
develop the ‘clinic’ idea more and more – and they are doing so – and are less
and less disposed to pay what in the United States are called ‘house visits’,
then the relationship between doctor and patient is going to become still more
impersonal. I argue, therefore, that it will become increasingly impossible for
the hospital to take over the functions of the Church.
(iii) The Psychiatrists and Psychotherapy
But I come now to something much more basic. The radical, the
third, objection which I have to the proposal is what we already know from the
work of the psychiatrist Jung. Even he found that it was almost impossible to
help patients, especially over the age of 35, who did not possess some kind of
religious background. Psychotherapy alone, he found, could not do what was
required. There is certainly a school of thought, which is becoming increasingly
prominent in the U.S.A., and also more evident in this country, which claims
that psychoanalysis has proved to be more or less useless. It is being asserted
more and more that the concept of ‘guilt’ must be restored, if the patient is to
be helped. Workers such as O. H. Mowrer increasingly find that from time to time
they must call in the Christian minister to help them even in the practice of
psychotherapy.
This surely is serious, because the psychiatrists were
the medical specialists who earlier claimed that they could particularly help
in a personal way, in a way that neither the Church nor anybody else could do.
Even they themselves are now found admitting that in a number of cases their
therapy cannot do it. Further, there are others who are entirely opposed to the
whole notion of what is called ‘Freudianism’. More of the various types of
psychiatric condition are being routinely treated by drugs and mechanical
procedures. Even in the sphere of psychiatry the doctor-patient relationship is
said to be becoming less evident. We hear less about free-association,
deep-analysis, and the long interview
But quite apart from recent trends, that branch of treatment
was really concerned with one type of patient. It was confined to those
who were mentally ill in certain defined ways. In other words, it was only
concerned about certain aspects of man’s life and not with the man himself and
his basic problem.
THE FUNCTION OF THE CHURCH
Here I come to a fourth argument, which, to me, is the really
vital one. What, in fact, is the true function of the Christian Church? It must
be considered from two points of view –the primary, essential function of the
Church on the one hand, and what may be called the subsidiary ‘by-products’ or
‘incidental functions’ on the other. It is an essential distinction if we wish
to keep this subject in due perspective.
Those who are familiar with the New Testament will know that
this distinction is something which was very evident in the ministry of the Lord
Jesus Christ himself. There were two aspects of his ministry: he came in order
primarily ‘to seek and to save that which was lost’. Then there was also his
healing ministry and his helping people in other ways.
Christ’s primary purpose and function was neither to heal the
sick nor to bring relief in other ways. He certainly did all that, but it was
not what he had primarily come to do. The Gospel of John emphasizes this very
clearly by referring to his miracles always as ‘signs’. He did these other
things because he had a heart of love and of compassion; but he had not come
into the world for this purpose. Also, the miracles or ‘signs’ were meant to
confirm the fact that he was who he claimed to be. The healing part of his
ministry was something that was almost incidental. His primary object was to
accomplish something for all mankind, which he alone could do. This is crucial.
What, I say, was true of him in his ministry is equally true
of the Christian Church. The authentic task of the Church is not primarily to
make people happy; it is not to make people healthy; and it is not even to make
people good. The Church, of course, is concerned about making people good, and
that they should be happy; yes, but that is not her primary function. This fact
is perfectly plain, not only in the Bible itself, but in the great periods of
the Christian Church when she really has been functioning fully as the church.
Her essential task is to restore men to the right relationship with God.
Hence the real business of the Church is not something which
is man-centred. It is God-centred. This is a vital distinction. The hospital and
the state can take over many, if not most, of the indirect activities of the
Church. But they cannot, and never will, take over the primary function. It is
because people have fallen into the habit of substituting the ‘secondary
functions’ for the main function of the Church that we have come into all the
confusion. There are even many who claim triumphantly that the political parties
have also taken over the functions of the Church. It has particularly been so in
Wales. During the last century the Welsh Chapels were the centre of the people’s
life in almost every respect – cultural, as well as every other. Then a great
change took place. The politicians took over, especially the socialists, and
they drew away the people from the chapels. This was to a great extent due to
the fact that so many of the preachers had become politicians rather than
preachers. If you think of the Christian Church – and as a result of the
impressions received from the television and radio no doubt many do – as
primarily an organization to preach pacifism and socialism, to protest against
war and apartheid and other such things, then you are perfectly entitled to say
that all this can be done without the Church, and without all that is
associated with its life.
THE REAL ISSUE
The basic element in my case is that the Church’s primary
function is to restore men to a right relationship with God, and this is
something I assert, which only it can ever perform. In the true teaching of the
Church, it is man himself who is the central problem. The moment a person
realizes this, he also realizes at once that this is something which is
true of each individual. I would therefore confront the physician, the surgeon,
the psychiatrist, the administrator, or whoever he may be, who proposes that he
can take over the Church’s function, with some such reminder as the following.
‘You cannot do so, because you yourself need what the Church alone can supply.
You yourself are as much in need as those whom you think you can help.
Everybody is in need at this point – it is universal.’
Let me put it in another way. Man’s real problem is not
simply that he is sick, but that he is a rebel. Now here again is a crucial
distinction The current notion is that humanity is sick. And of course it is
sick, very sick indeed. The real question, however, is Why is it sick? The basic
answer of the Bible and the Church, when she is really preaching the Bible, is
that man’s ultimate problem is not the sickness. That is only a symptom, or a
complex of symptoms. It is a manifestation of something much deeper and
more serious.
THE CONSEQUENCES
The central message of the Church is that man is a rebel
against God. All our troubles result from that fact – all of them, without any
distinction. It is especially true of those symptoms which are most obvious in
the life of the world today. Man has made himself autonomous. He does not
recognize anything above and beyond himself. He regards himself as the greatest
factor in the universe. You must have read recently of the claim that man is now
in a position even to be a ‘creator’. Because man has become autonomous he has
inevitably become selfcentred, and selfcentredness always leads to certain
consequences. If I am a ‘god’, nobody must be allowed to reduce my status. But
the other man also regards himself as a ‘god’, so that we are both very
sensitive about our ‘powers’ and hence we are constantly over-protecting
ourselves. This paves the way for jealousy and envy. It also leads to
aggressiveness and aggression. All this in turn, of course, leads to overwork. A
man aims at a position, then when he has achieved it, he is afraid of losing it,
for ‘uneasy lies the head that wears a crown’. And so we overwork, and we become
overtired. We become deeply involved in what is known as ‘the rat race’. We
begin to feel the strain and here is the central problem of modern society.
In addition to all that, and on another level, there is the
undercurrent of lust, desire and passion. It does not matter how scientific a
man may be in his work, he is still a man. He has certain primitive instincts
within him which are much more powerful than his mind and his will. The fact
that anyone is intellectually an able man does not mean that he can control
himself and his own passions. All this leads in the long run to over-tiredness,
restlessness, a sense of guilt, remorse, and finally a sense of failure. Hence
there is the resort to ‘pep pills’, tranquillizers, hypnotics, or an excess of
alcohol. It does not matter which of them it is; experience emphasizes that so
often it all ends up in a sense of futility, and the despairing question, ‘Is it
worth it all?’
PALLIATION OR TREATMENT?
This is the position, and surely Medicine can do nothing
about all this except to palliate the symptoms. I am not, of course, suggesting
that this is a bad thing to do in itself. It is quite right to do what we can to
palliate symptoms, yet with this qualification – that a true diagnosis has
already been made. Sometimes it is a very dangerous act to palliate symptoms. If
you are confronted by a man in acute pain, say abdominal pain, and you give him
a pain-relieving injection without first doing all that is possible to discover
the cause, then I suggest that it is bad medicine! Every well-trained medical
student and qualified doctor should be in no doubt about it. But, I suggest,
that in moral and spiritual matters we are continuing to do just that and on a
national scale!
All the palliatives, and all that the hospital can do, and
all the medical profession at its best can do in these matters of which we are
speaking, is really only to deal with symptoms. They are not able to
face up to the real issue. Centuries ago the central diagnosis
was surely put, once and for all, by St. Augustine. Having tried many
palliatives, he at last came to this crucial conclusion before God: ‘Thou has
made us for Thyself, and our hearts are restless until they find their rest in
Thee.’ That is the need, surely, of modern man and his society today. The
primary function of the Church is radically to deal with that. It is the Church
alone which can do so.
THE NATURE OF MAN
We must continue to ask – what basically is Man? It is the
teaching of the Bible alone that goes straight to the basic issue. Is he only an
animal? Well, if so, what right have you to complain that he is behaving
like an animal. He is clearly demonstrating this for you. You should not be
surprised, and there is nothing for you to do about it.
But surely, he is not merely an animal.
Here we must emphasize the prevailing fallacy. It is
overlooked that, in fact, he is a creature who has been made in the ‘image and
likeness of God’. There is something about him which transcends everything else
in the universe. He is God’s representative in the world. He is what the Bible
terms ‘a living soul’. He has within him a longing for ‘an ampler ether, a
diviner air’. He has a sense of incompleteness. He has a sense of something
bigger and greater than himself. He cannot define it. But deep within him there
it is! The Church alone can enlighten him about its nature. It is God! He was
made for God and appointed ‘lord of creation’. He does not, however, find his
companionship and communion in nature. No, because he is too big for that, and
the world at its best cannot satisfy him. It can give him much, but still there
remains the void about which we have earlier spoken.
It is the Church alone, I say, that can give the real answer.
And the answer is that mankind needs God. Men in general do not recognize this.
It is the business of the Church to tell them. A given individual may feel
perfectly happy. He may be born with an equable nature – some people are. Just
as you can have nice dogs or cats so you can have nice men and women! But there
they are, happy up to a point. But the evil day will come. They need to realize
the truth about themselves as men, they need to know God. They need something
altogether beyond themselves. God has put certain laws into man’s nature, and
all his unhappiness finally results from his resisting the law of his nature,
that is, from fighting God. We stubbornly object to the claims of the Highest
and set ourselves up as petty authorities.
THE GOLDEN RULE
The first part of God’s law for men is: ‘Thou shalt love the
Lord thy God with all thy heart, and all thy soul, and all thy mind, and all thy
strength.’ The second part is ‘Thou shalt love thy neighbour as thyself (Matt.
22: 37-39). There are many who object today, ‘Surely I can love my neighbour as
myself without loving God?’ But this is where they go wrong, they cannot. In
stating these two aspects of God’s commands, Christ put them in that order
because logically it is the inevitable order. To be able to ‘love thy neighbour
as thyself’ implies that you have first to achieve a right view of yourself. If
you have not that, then love of your neighbour – and experience bears this out –
will, of necessity be a very poor thing. Left to ourselves we cannot love in
this way. And the natural reaction of most men is – ‘Why should I do it?’ No,
the only hope for the community, as well as for the individual, is that we all
equally submit ourselves to God, and come to the realization that we are meant
to function under him.
The moment a man realizes that he is only a pilgrim in this
world, that finally he has to die and to face God, and that there is all
eternity before him, his whole outlook on life changes. Immediately the Church
is able to tell him that, although for so long he has been so wrong, he can be
forgiven. The Church’s central message is the doctrine of forgiveness, based
upon the fact that ‘God so loved the world, that he gave his one and only Son,
that whoever believes in him shall not perish, but have everlasting life’ (John
3:16). It is the crucial message of the fact of the Son of God’s coming into the
world in order to bear our sins and their punishment, to reconcile us to God,
and to give us a new birth, a new life and a new outlook. This is not mere
theory. The long history of the Church is filled with proofs of it. We can thank
God that some of us know something about it in practice. To say that, to teach
that, and to bring people to a realization of it – that is the primary function
of the Christian Church. She alone can undertake it.
CONCLUSION
So to sum up, the hospital, quite rightly in my opinion, has
taken over the healing of the sick, the healing of the body, and, in a measure,
the healing of the mind. The state has also taken over the administration of
social relief, education and much else. There is no objection to all this, so
long as it is well done. But the moment that hospital or state say that they can
take over everything, including the spiritual, and that the Church has become
unnecessary, they reveal evidence of their ignorance on the grand scale. They
not only fail to discern the true nature of the Church, but reveal a disastrous
gap in their understanding of the nature of man himself – themselves included.
They fatally neglect the only power that can enable man to function truly, that
is, ‘the Gospel of Jesus Christ, because it is the power of God for the
salvation of everyone who believes’ (Rom. 1:14-17).
*1 Part of an address given to the Christian
Medical Fellowship at the Royal Commonwealth Society’s Hall on Wednesday,
March 19th, 1969.
References
1 Report of a Conference arranged by Associations
concerned with The Hospital Service in Great Britain and Northern Ireland, May
14th-15th, 1968 in the Isle of Man. (Private circulation.)
2 Lord Todd: Address to the B.M.A., Clinical Meeting, Cheltenham,
October 24th, 1968.
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