This review was first published at "A Book Pastor Recommends" on May 9th, 2011. It is a powerful reflection on God, medicine and the problem of suffering.
TITLE: NAMING THE SILENCES - God, Medicine, and the Problem of Suffering
AUTHOR Stanley Hauerwas
PUBLISHER: Grand Rapids, MI: William B. Eerdmans, 1990, (154 pages).
According to Hauerwas, while he recognizes that there is a legitimate need for sufferers, and people in pain to find an explanation for life's pressing questions, he is more interested to tackle the 'question' behind the question, made famous by Harold Kushner.
What the Book is About
The book while it talks about pain and suffering, it does not try to explain things away. First, Hauerwas ponders on the premise behind Kushner's way of reasoning. In doing so, the author:
"By exploring this question I hope to help some people by enabling them to name the powers that possess us. No powers determine our lives more completely than those we think we have under our control. I believe that the most decisive challenge which the experience of childhood illness presents is our inability to name the silences such illness creates. Modern medicine can and too often has become a noisy way to hide those silences. I will try to show how the God whom Christians worship can give a voice to that pain in a manner that at least gives us a way to go on." (xi)Secondly, Hauerwas chooses to deal with the issue of children who suffers. He speaks out against theologizing about pain and suffering. Children has no such ability to speak out. He uses stories as his megaphone.
"The kinds of suffering that drives us mad are those that we say have no point. But it isn't always clear what we mean when we talk about pointless suffering." (2)
He distinguishes suffering from happiness by saying that suffering is always unique.
"No two sufferings are the same: my suffering, for example, occurs in the context of my personal history and thus is peculiarly mine." (3)
Third, most significantly is Hauerwas's insistence that there is no 'point' in suffering, not even the thought of 'learning from it.' In other words, he attacks the notion of a theodicy that seeks to explain suffering.
"There is no hope for us if our only hope in the face of suffering is that 'we can learn from it,' or that we can use what we learn from the treatment of that suffering to overcome eventually what has caused it or that we can use suffering to organize our energies to mount effective protests against oppression. Rather, our only hope lies in whether we can place alongside the story of the pointless suffering of a child like Carol a story of suffering that helps us know we are not thereby abandoned." (34)
Why The Problem is NOT Theodicy?
The second part of the book tries to explain why people often miss the point when they try to find some sense of meaning behind suffering. In other words, theodicy is in itself its own problem, not the suffering per se. In other words, one cannot see suffering as a 'problem,' like how theodicy wants to see it. This is because when one tries to 'solve' the problem of suffering, one is unwittingly trying to divorce the existence of God from the character of God (42). Hauerwas insists that suffering is part and parcel of life.
"For Christians, suffering - even the suffering of a child - cannot be separated from their calling to be a new people made holy by conversion." (52)
The author makes an interesting philosophical observation regarding the role of medicine. In fact, medicine plays a kind of theodicy role in trying to eradicate suffering and pain, because it sees suffering and pain as 'problems' in the first place. It is because of such a philosophy that leads to a less humane society in which:
"We do not need a community capable of caring for the ill; all we need is an instrumental rationality made powerful by technological sophistication." (62)
Illness is pointless, and so medicine tries to erase illness. Being sick is 'wrong' and doctors try then to right things back. The author's main point is that suffering should not 'challenge' the existence of God in the first place, because suffering is not a 'problem' to be solved. He tries to turn the age old problem of suffering on its own head. In other words, it is not the suffering, but the philosophy behind the question of suffering that is the problem.
Drawing on the psalms, which are largely learning to 'name' the suffering as they are, Hauerwas writes:
"The psalms of lament do not simply reflect our experience; they are meant to form our experience of despair. They are meant to name the silences that our suffering has created. They bring us into communion with God and one another, communion that makes it possible to acknowledge our pain and suffering, to rage that we see no point to it, and yet our very acknowledgement of that fact makes us a people capable of living life faithfully." (82)In Part Three, Hauerwas attacks the premise of Medicine, especially when it tries to silence the pain or mute the suffering. Here, the author asks the question about how a person wants to die. Typically, people will want a painless death, or a death that incurs minimal burden on their loved ones. The way medicine is practiced in our culture reflects the way of life we are living. Mankind in its pursuit of 'living well' has lost a sense of what it means to 'die well.' He quotes from Michael Ignatieff's brilliant work, The Needs of Strangers,
"We no longer share a vision of the good death. Most other cultures, including many primitive ones whom we have subjugated to our reason and our technology, enfold their members in an art of dying as in an art of living. But we have left these awesome tasks of culture to private choice. Some of us face our deaths with a rosary, some with a curse, some in company, some alone. Some die bravely, to give courage to the living, while others die with no other audience than their lonely selves." (99)The limits of medicine can only be overcome by the stories of both life and death. While medicine focuses on 'cure,' it ignores the place of 'care.' Medicine tries to keep one 'alive' at all costs, despite the fact that one is 'dying' whatever the costs. Hauerwas tackles the question of how to rationalize limited resources to sustain an aging population. He argues for a change of perspective, to be more critical of the 'sustain at all costs' model. The way ahead is something like Callahan's prescription to "live out a full and natural life span, not simply more life without discernible end." (107)
'Construe life as a narrative,' to give the natural way a bigger say in health care. In other words, see 'illness and death' in much the same way as 'health and life.' Don't accept merely the latter and deny the former. In other words, when the practice of medicine leads one toward the loss of one's narrative, medicine has overstepped its limits. Returning to dying children, Hauerwas tells the compelling story of kids suffering from leukaemia and the confusion played out through 'mutual pretense' and their unwitting discontinuation of the children's narratives.
This book is an important voice to speak into the vacuum of pain and suffering. While it is critical to speak and name the silences, it is also important to let silence remain silent. Grief needs to be given the fullest repertoire in the music of mourning. Like key notes and melodies, it is the pauses both short and long, that makes music meaningful and beautiful.
I am particularly touched by the narrative of the leukaemia patients that are unfortunately and rudely interrupted because of adults and the medical circle's inability to deal with their own narratives. Using Bluebond-Langner's 5 stages of relating with the sick child, the author laments how messed up our medical world and adult treatment of sick children has become.
The Acquisition of Information about the sick child;
- Stage One: illness is serious; [kids suddenly get a flood of gifts and nice treatment]
- Stage Two: Drugs and side effects revealed; [kids being made to believe they will get better]
- Stage Three: Purposes of treatments and procedures; [kids start noticing adults hush-hush about their illnesses, leading them to suspect information is getting scarce and contains half-truths]
- Stage Four: Diseases, relapses, and remissions; [kids feel pain more and more, and they play less and less]
- Stage Five: Leading to death. [kids play in the sombre spectre of death and dying]
Hauerwas hits home with the story of Charlotte's Web, of friendship and loyalty. I like Hauerwas's emphasis on the narrative part of life that embraces pain and suffering as a part of life. I learn about the need to retain the humaneness of being present with the sick. A caring disposition is more important than curing formula. We all share a common story of living and dying. Hauerwas ends with a brilliant piece by Wolterstorff great book, Lament for a Son.
"Suffering is down at the center of things, deep down where the meaning is. Suffering is the meaning of the world. For Love is the meaning. And Love suffers. The tears of God are the meaning of history. But mystery remains. Why isn't Love-without-suffering the meaning of things? Why is suffering-Love the meaning? Why does God endure his suffering? Why does he not at once relieve his agony by relieving ours?" (150)
Some questions are meant to be asked, but also meant not to be answered. Like Hauerwas, I agree that some parts of suffering and pain are not problems to be solved, but part of life to be lived with.