Category: Quote

If it’s not ‘all in the mind’ quite a lot is.

Gavin Francis’ book Recovery — GP’s take on the neglected art of convalescence –:

has a brilliant example of what good, or harm, our minds can do as part of our well-being; worth quoting. Francis talks about two middle-aged men who ‘a few weeks apart both suffered a cardiac arrest and collapsed, ostensibly dead, but who were successfully resuscitated with electric shocks. Both were then fitted with portable electronic defibrillators …[that were] about the shape and size of a matchbox’. If either man collapsed again, ‘the portable defibrillator would sense the change and shock the heart back into a healthy rhythm.’

‘For one of the men, the intimate experience of the proximity of death, the fragility of life and his new reliance on the implanted defibrillator was utterly traumatic. He began to suffer panic attacks and fiddled ceaselessly with the swelling beneath his collarbone. He couldn’t find a way to stop fretting that it might fail. At the time of his cardiac arrest he had been working as an administrator but he found himself unable to go on working. He was afraid to be alone, and his nights became a torment of insomnia.

‘For the other man, the almost identical experience of collapse and then resurrection became an epiphany of gratitude. His new life was a gift, he said, for by rights he should now be dead, and all the tedious, niggling irritations that once troubled him seemed to dissolve. It was enough to be able to breathe this air, walk on this earth, see his grandchildren. He had always lived modestly, but now began to emjoy sumptuous meals, fine wine, and booked holidays to places he would never before have considered visiting.

‘He had died, but then he lived again, and that new life into which he was born seemed one of richness, tenderness and gratitude.’

The powers that be (2)

More about the teaching of Walter Wink, as mentioned last week, in his book The powers that be, which was a later summary of earlier work.

Wink teaches that every institution possesses an ‘outer, physical manifestation’ and ‘an inner spirituality, corporate culture or collective personality’ (p24) and combined they correspond to what the New Testament called ‘powers’, which were a tangible part of life back in New Testament times. Materialism has slanted our impression of them, but perhaps they have not gone away.

For our struggle is not against flesh and blood, but against the rulers, against the authorities, against the powers of this dark world and against the spiritual forces of evil in the heavenly realms (Ephesians 6:12).

For in him all things were created: things in heaven and on earth, visible and invisible, whether thrones or powers or rulers or authorities; all things have been created through him and for him (Colossians 1:12).

For I am convinced that neither death nor life, neither angels nor demons, neither the present nor the future, nor any powers … will be able to separate us from the love of God in Christ Jesus (Romans 8:38-39).

Are these ‘powers’ good or bad? It is customary in my part of the church to think of them (or at least the spiritual components) as ‘bad’, spiritual remnants perhaps of an original fall that led to the fall of some spirits into evil; the same worldview as can be found in the Bible and which John Milton used in Paradise Lost. And it is true that Jesus is never recorded as coming across an evil being that he wished to redeem. He apparently wished to expel all of them from his good creation.

In Wink’s view, however, the powers are:

  • Good
  • Fallen
  • Needing redemption.

He argues that:

These three statements must be held together, for each by itself is not only untrue but downright mischievous. We cannot affirm governments or universities or businesses as good unless we recognize at the same time that they are fallen. We cannot face their oppressiveness unless we remember that they are also a part of God’s good creation. And reflection on their creation and fall will seem to legitimate these Powers and blast any hope for change unless we assert, at the same time, that these Powers can and must be redeemed. But focus on their redemption will lead to utopian disillusionment unless we recognize that their transformation takes place within the limits of the fall.

Wink, op. cit., p 32

Whether or not the Powers can be redeemed (or merely expelled), the material, earthly institutions certainly are created, fallen, and can be redeemed. At the moment this is within the limits prescribed by our current fallen world; in the future it will be fully so, as part of New Creation.

This is eye-opening stuff:

  1. Institutions have a spiritual character as well as a material form.
  2. Institutions are good, fallen, and capable of a degree of redemption.
  3. They will be fully redeemed at the so-called eschaton, the full arrival of the New Creation.

How can the Powers be opposed? How can institutions be redeemed, or at least cleaned up a bit, capturing more of their divine vocation?

I have to skip over a large and brilliant part of his analysis here but the central understanding is that violent overthrow won’t do it. All violent overthrow does is replace one system of spirit-fueled domination with another. A revolution is rightly named: it’s just the turning of the same wheel. What do ‘work’ (and again I am oversimplifying) are the things Jesus taught so directly. Turn the other cheek. Hand over all your clothes if someone takes your cloak. Love your enemies. Do good to those who hurt you. Feed and water your enemies. You want to lead? Be a servant. You want to line up with God’s rule? Be a child. Jesus himself entered Jerusalem on a donkey, not a charger. He won the day by going to his death like a lamb to the slaughter.

The aim is not conquest, but relationship: humanizing the oppressor, so that oppressors are themselves liberated from being oppressed by their own oppressive behaviour: ‘today, salvation has come to this house.’ These same acts also restore dignity and agency to the victim.

That’s how we ‘win’. And the winning may not be seen in this life, or certainly only partly seen, but it is putting a foothold in eternity, it is filling up our storerooms in heaven, it is investing in the future.

The Powers that Be (1)

In his striking and unusual book, the late theologian Walter Wink writes this:

This book is unashamedly about things spiritual. It assumes that spiritual reality is at the heart of everything, from photons to supernovas, from a Little League baseball team to Boeing Aircraft. It sees spirit– the capacity to be aware of and responsive to God –at the core of every institution, every city, every nation, every corporation, every place of worship … [It] celebrates a divine reality that pervades every part of our existence.

Walter Wink, The powers that be, 1998, Galilee Doubleday, p 13

Wink points out that ‘Latin American liberation theology made one of the first efforts to reinterpret the “principalities and powers” — which occur naturally in New Testament writing — ‘not as disembodied spirits inhabiting the air, but as institutions, structures and systems … Powers such as a lumberyard or a city government possess an outer, physical manifestation (buildings, personnel, trucks, fax machines) and an inner spirituality, corporate culture or collective personality. The Powers are simultaneously an outer, visible structure and an innner, spiritual reality’ (p24).

This is striking and unusual stuff. As Wink goes on to point out, when it comes to ‘Powers and principalities’, ‘fundamentalists treat the Powers as actual beings in the air … and secularists deny that this spiritual dimension even exists’ (p26).

The elegance of this outlook is that it roots the New Testament worldview into everyday structures of injustice and unrighteousness (or indeed structures of justice and righteouness). So by doing battle against, say, injustice, you are actually resisting spiritual powers, for which the gospel offers weapons and tools.

For example, Ephesians 6 says:

Finally, be strong in the Lord and in his mighty power. 11 Put on the full armour of God, so that you can take your stand against the devil’s schemes. 12 For our struggle is not against flesh and blood, but against the rulers, against the authorities, against the powers of this dark world and against the spiritual forces of evil in the heavenly realms.

Ephesians 6:10-12 NIVUK

This scripture makes a lot of sense in contexts where spiritual forces are rife and obvious, where local industry manufactures charms and amulets, and where you can buy services like spells, curses, protection from the evil eye and love potions. I have worked with many missionaries who have spent time in those contexts and found New Testament-type solutions beneficial and fruitful.

It’s a lot harder though, in secular and materialist contexts, to know quite what to do with all these scriptures.

Wink offers a further insight. These powers, he claims, become fallen and demonic when they pursue ‘a vocation other than the one for which God created’ them (p29). So, calling an institution to be just and and upright and to fulfill the purpose God intends for it, is not just a matter of (for example) campaigning but is also a spiritual conflict requiring the kind of spiritual weaponry that the gospel offers. This is because the institution involved has a spiritual face as well as a material one.

This makes a lot of sense.

  • Ir explains why in the book of Revelation, letters are written to ‘the angel’ of each of the seven Asia Minor churches — not to the pastor, or the leadership team, or the congregation, but to the spiritual reality, the culture, that they together contribute to and embody.
  • It explains why in the same book, earthly realities are described withthe imaginative imagery of dragons, beasts and whores, a spiritual view of human institutions.
  • It helps make sense of the Beatitudes, which sees human attitudes and behaviours as having potency as spiritual weapons: Are you spiritually bankrupt? You’re blessed: yours is the reign of heaven (Matthew 5:3, my paraphrase).

Here’s his summary:

Evil is not just personal but structural and spiritual. It is not simply the result of human actions, but the consequences of huge systems over which no individual has full control. Only by confronting the spirituality of an institution and its physical manifestation can the total structure be transformed.

Wink, op.cit., p 31

There’s more to come.

Convalescence, the lost-ish art

Photo by Isaac Quick on Unsplash

Just finished an illuminating book called ‘Recovery’ by practicising GP Dr Gavin Francis. I am drawn back again to the idea of healing (I was in hospital when I wrote this) and really enjoyed how this book taught me things I’d previously groped towards. Some snippets:

Psycho-social

We fall ill in ways that our profoundly influenced by our past experiences and expectations, and the same can be said of our paths to recovery. (p8)

Green and growing

He talks of the difference Florence Nightingale made in the Crimea, how hospitals should have ‘the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet’. (p 13, quoting Nightingale’s own 1859 Notes on Nursing). Windows should look out something green and growing. After her arrival in 1854, the rate of soldiers dying from their wounds fell from 1 in 2 or 1 in 3, to 1 in 50

Convalescence

But in changing times and with new drugs something has been lost:

It’s not possible for me now, as a GP, to admit a frail, elderly patient somewhere for nursing care and convalescence alone – the hospital gates don’t open unless there’s a medical diagnosis, and a plan in place that prioritises getting the patient out again as soon as possible (p15).

You might not find ‘convalescence’ or ‘recovery’ as a heading in the medical textbooks but you will find ‘post-viral fatigue’… Long-term symptoms from viral infections will be different for everyone, but can include varying amounts of breathlessness, difficulty concentrating, forgetfulness, mood changes, insomnia, weight-loss, exhaustion, muscle weakness, joint stiffness and flashbacks.

All these are to be considered normal – not evidence that recovery has stalled or is going (p20) into reverse.

Pacing

He suggests ‘pacing’ as the route forward – not the boom and bust cycle of activity and exhaustion, but steady efforts, frequent rests, small meals, not doing much for an hour after a meal, getting fresh air, sitting down a lot, avoiding exerting. With boom and bust, your world narrows; with careful pacing, it slowly widens.

Work aids recovery

He talks about the world of sick-notes, and that doctors are better coaches than judges. ‘Many of the patients I sign off from the obligation to find a job could undoubtedly work in some capacity, at something, if support were available to help them do it… Work aids recovery in all sorts of ways… If I could sign my patients up to a supportive back-to-work scheme, rather than simply signing them off sick, I would‘ (p27)

A misfortune whose cost should be shared

He notes Aneurin Bevin’s championing of the idea that illness is ‘neither an indulgence for which people have to pay nor an offence for which they should be penalised but a misfortune the cost of which should be shared by the community’ (p 29. Bevan was borrowing his ideas from T H Marshall, a sociologist.)

Healing: the future of the NHS

Photo by Daniel Chicchon on Unsplash. The photo is of San Francisco; note that bridge in the background.

I read a short article by Matthew Taylor, Chief Executive of the NHS federation, in the current Wired magazine (July-August 2023). This is an unashamed abridgement of that fine article.

Taylor points out that the human species is better at developing technology than thinking through its consequences. He sees these issue for the NHS:

  1. A revolution in diagnostics. This really good thing– catching disease early– depends a lot on how willing we are continuously to monitor our health. This is not so simple. Already there are harmless incursions in my life. Under my bed is a device that downloads my pacemaker data and sends it to my hospital in London. One time when I was developing symptoms, they asked for a download, then called me in, then re-timed the pacemaker and fixed the problem: really nice. On the other hand, when I was in hospital recently, nurses were taking observations several times a day. My observations are problematic and sometimes set alarms off. At least twice they sent a more senior nurse to redo the observations as they didn’t believe what a junior nurse had recorded. These constant readings do no good whatsoever to how I feel about myself. They are stressful and discouraging. Heaven forbid that I should have a thing on my wrist that did this to me all the time.
  2. The fact that diagnostics are usually probablistic, not black-and-white. In any case, diagnostics don’t help as much you’d like. If you might develop cancer, or might not, but will develop side effects to treatment, whaddya do?
  3. Inequality. Matthew Taylor points out that technology empowers people, but usually it is only some people, and inequality increases given that other people, already disadvantaged, don’t benefit. (This actually is a slightly curious argument when things are on average getting better, but let it pass.)

Finally he talks about care. He makes some fascinating observations: ‘Medicine is technocratic and scientific; care is human and relational‘. Medical expertise is sort-of expected by us patients; care is what makes the difference to how we feel about our treatment. That is very true in my experience.

Medicine is technocratic and scientific; care is human and relational

He points out this issue is especially important in end-of-life care. End of life treatment is usually the most expensive medical phase in a person’s life, but still ‘a lot of people don’t get the end of life care they want. They might receive expensive care, when they would rather have cheaper care that’s more humane, at home, with loved ones.‘ This is fascinating. Having watched friends die both in government hospitals and in our local (charitably run) hospice, I know which of the two I would choose. Give me the lovely hospice every time.

Perhaps a contribution that people of Christian faith can offer in their last days is choosing not to have every possible intervention to keep us hanging on, but to decide our time’s up, go home, or to a hospice, to face the end of life in peace? It is oddly the opposite of euthanasia, realizing our time has come and accepting it. Interesting.

Healing and social justice

One of our local miracle drugs

I’m struck (but then I’m a slow learner; it’s obvious when you think about it) how much health and social justice are linked. For churches, it’s fascinating how important this ‘pre-healing’ ministry is. And any church interested in ‘healing’ ought to be fascinated by the possibilities of pre-healing people before they ever get sick. The good we can do! The changes we can make! Look at this from the current Wired magazine 1, which finds its way to us among articles about virtual wards, remote robotic surgery, and unlocking the NHS’ troves of digital records.

… about one in five people live in poverty in the UK. Poverty has an awful impact on physical and mental health: it is associated with higher infant mortality, lower adult life expectancy, poorer mental health, asthma, diabetes, cardiovascular disease and obesity. It has been estimated that getting your daily calories from healthy foods costs three times more compared to buying poor quality food.

Housing is another big problem. According to the Health Foundation, one in three people reports a problem with the affordability, security, or the quality of their housing. Issues such as mold and damp can lead to respiratory problems and headaches…

Green spaces are another massive issue. There’s a lot of evidence now proving that exercise is like a miracle drug. There is also plenty of evidence that if you provide more open, free, green spaces to people, you end up with higher levels of physical activity in the population, and improved mental health. In 2020, the government itself estimated that if every citizen had access to green spaces, it could save the NHS billions of pounds a year.

… We need to realize that almost all policy has an impact on population health, and think more holistically about what our health priorities are for the longer term.

The missing story that leaves us wandering in the dark

Photo by Sixteen Miles Out on Unsplash

One of Britain’s leading disaster planners recently wrote this:

In disaster planning, you usually see an event of total destruction followed by a fragile, precarious rebuild. But we haven’t got there in terms of explaining the damage done by the pandemic. We’re trying to pretend it hasn’t happened. Until we find a narrative to explore the damage wrought that is not political and not partisan, you won’t get to explore what a build-back might look like.

Lucy Easthope, Wired Magazine, July-August 2023, ‘The opportunity to change the NHS has arrived.’

Lucy Easthope is the person you want around when a disaster has happened, or better still, hasn’t yet happened. Her book When the Dust Settles is in turns moving and thought-provoking, one of my favourite reads of the year. We are collectively lucky to have her wisdom and care. When she speaks on her subject, you are inclined to listen.

Then add the sense of crisis all around us. Every government institution that opens its doors to everyone who needs it (NHS, schools, courts, prisons, social care) seems to be short-staffed, stretched, demoralized, near to being overwhelmed. Years of funding cuts have removed many of the buffers that helped people outside of school, hospital, the doctors, the prisons. Then we were wopped by the pandemic, a national heart attack.

Stories have power to motivate and mobilise whole nations. This is obvious: think not just of Churchill’s speeches in 1940, or the Ukrainian president today, but also of the populists who by saying ‘Take back control’ or ‘Make America Great Again’ put heart into many people who were otherwise disillusioned (for good or ill). I was not around for the post-war Labour government but I am struck that despite national bankruptcy, trauma and loss they dreamed up a new nation, inventing the NHS and the welfare state. For all their faults and failings, they presumably at least partially captured a recovery moment and a recovery narrative.

What would a recovery narrative look like? How about something like this?

  1. We’ve suffered a pandemic – a quarter of a million of us died before our time and the nation stumbled to an eerie halt, locked up at home. This harmed and affected all of us.
  2. We’re still convalescing, nationally and individually. We’re fragile. We need to be gentle with each other and the failings all around.
  3. This is a moment for rebuilding. We can rethink how the government spends its money, what national thriving looks like and how to achieve it; we can be patient with schoolchildren and students who have lost years from their learning; we can bear inconveniences, so long as they are the inconveniences of living on a building site. We can put things in place today, in battered today, that will bear fruit in decades to come.
  4. Today we can make choices that will make higher and wider the lives of our children and grandchildren, even if we don’t see the day ourselves. A damaged generation, we can be an optimism generation.

And this should not be

This post doesn’t need a commentary really. I have an interest in youth justice and this landed in my in-box. 1 On April 26 2023, just a few weeks ago, the Chief Inspector of Prisons wrote this about His Majesty’s Youth Offender Institution at Cookham Wood:

An inspection of a HMYOI Cookham Wood in April 2023 found that a quarter of the boys were being held in solitary confinement for extended periods, including two for more than 100 days, as a means of managing conflict between children. Records showed that it was not unusual for these boys to not come out of their cells for days on end, with no meaningful human interaction, education or other intervention. At the time of the inspection, 90% of children were subjected to ‘keep aparts’ meaning they were not allowed to mix with some of their peers, and staff were managing 583 individual conflicts in a population of 77 children.

Children told inspectors they felt unsafe, and were increasingly resorting to carrying weapons, many of which were made from metal which boys had scavenged from equipment in their cells, including kettles, in a bid to protect themselves. More than 200 weapons had been recovered in the six months preceding the inspection, despite inadequate searching procedures.

Cookham Wood was in a poor overall condition, with dirty living units and broken equipment. Prison staff were exhausted, with significant shortfalls on wings, and, while many clearly cared about the children, they felt unsupported by senior managers and had given up hope that improvement was possible. Four-hundred-and-fifty staff were employed at Cookham Wood, including 44 directly employed managers, of whom 24 were senior leaders. The fact that such rich resources were delivering this unacceptable service for just 77 children indicated that much of it was currently wasted, underused or in need of reorganisation to improve outcomes at the site.

The findings of this inspection represented the culmination of a steady decline in standards documented in inspections since 2016 that cannot be allowed to continue.

I’m glad we have a Chief Inspector of Prisons, that their work is public, that (on government directions) they require immediate action from the government, and that we ordinary people can write about this stuff without people turning up in vans accusing me of ‘insubordination’ or ‘spreading instability’ as might happen in many countries. I’m glad there are caring people at Cookham Wood and others who will campaign and fight. I’m glad we don’t incarcerate that many children (fewer than 1000 in the whole country). But the good news stops somewhere there.

The gift of curiosity

Image by Pexels from Pixabay

I have realized that I hide from people who have too much certainty.

This is largely confined to people with a Christian faith, probably because I hang around with them a lot of the time.

But I have learned to dread them. Like Russian battle tanks, they approach, waving their whatsit, ready to turn their turret on anything that departs from the Doctrines of Grace, ‘the faith once-for-all delivered to the saints’. They’re good at it too, and I feel myself shrivel as they gun for my theological loose thinking.

I think I’ve always felt this dread, so it is unlikely to be a virtue. When I was a young Christian I remember the pastor of my then-church say during a sermon, ‘I was reading C S Lewis recently and I’ve found the error in him.’ Given that their relative intellectual attainments were as different from each other as a sideboard is from a lunch-box, I did not feel this was an especially wise thing to say.

Where is the curiosity? Where is the head-in-shower joy in discovering that you are completely wrong? Where is the zest for learning, and growth, and change? Where — we might add– is the humility, the poverty of spirit? It is not that there isn’t certainty in the Christian faith — there is — it is that people can get carried away and have too much of it, in too many areas, and it isn’t pleasant to see; gracelessly and proudly defending grace.

While all the while, shafts of truth can flash from completely outside the Christian space, or from theologically-dubious people within it, and do us the world of good.

I think of Isaac Newton’s famous quote:

I do not know what I may appear to the world, but to myself I seem to have been only like a boy playing on the sea-shore, and diverting myself in now and then finding a smoother pebble or a prettier shell than ordinary, whilst the great ocean of truth lay all undiscovered before me.

That was Isaac Newton. Meanwhile Russian tanks are proving a bit vulnerable, much better parading around the place than seeing real action.

The perils of music

Especially if you’re trying to avoid invisible beings

It can bite. Photo by Raúl Cacho Oses on Unsplash

I had to write an article recently about what happens to people who leave God and God-stuff alone 1.

I wrote about my suspicion that God doesn’t leave them alone.

One culprit was music:

Perhaps this is a stretch for some of us. But theology teaches us that music is a shared feature of heaven and earth. Both realms ring with song, heaven more so than earth, and for a reason. Think of an orchestral or choral performance: unity, diversity, individual gifts, some performers with a great range and others just bashing triangles at appropriate moments, all blended into a completeness that is not static or boring, but fluid and dynamic; at its best, an ever-flowing perfection of fulfilled performers harmonizing together. Isn’t it, can’t it be, a heavy hint of what God and his people are destined finally to be? When you hear or perform music, are you distantly echoing what the divine is and does? Are your expressing a desire for something greater than what you have now? Are you reaching for transcendence? If I may say so, I think you may be. Even some of the most hard-boiled atheists I know seek transcendence in music.  

Food for thought.

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