Sunday
October 13
Spring Tonic
By Marsh Chapel
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Every Spring, when I was a child, right through high school, our mother would dose my brother and me with our “Spring tonic” of cod liver oil. It came in a tube, colored a sort of sickly green-blue-gray, and on the tube was a line-drawing of a fish, balanced on its tail, with a distressed look on its face – no doubt because of the spigot drawn protruding from its belly, dripping oil. The fish’s distress was nothing to ours. Our mother squeezed out two healthy dollops of oil, mixed each with water, and we drank our glasses down. The taste was vile, and it lasted a long time, even after teeth brushing. My brother and I never did know just why we were subjected to this challenge to our comfort and filial obedience – our Spring tonic was good for us, it was what we did, and that was that.
It turns out that cod liver oil is actually good for human beings, Rich in vitamins A and D, it may also help with inflammation and other health issues, and back in the day it was given all over the country to help prevent rickets, a softening and weakening of children’s bones that often led to deformity and ongoing issues. So, even though it was a challenge in the short run, my brother and I did reap benefits from our Spring tonic. And, I and my brother still did not give cod liver oil to our children.
The word that informs our preaching here at Marsh Chapel this semester is “health”. Perhaps not coincidentally, our own Dr. Sandro Galea, Dean of the Boston University School of Public Health, has recently published a book, entitled Well: What We Need To Talk About When We Talk About Health. His own experience as a physician is as one who has practiced medicine internationally and with various populations. As an epidemiologist – one who studies how diseases spread – he has researched and taught at the University of Michigan and Columbia University, before he came here to Boston University as the youngest dean of a school of public health in the country at the time of his appointment. In addition to this experience, his book is also informed by two facts. One is that the biggest concern of the American electorate in the 2020 presidential election is access to healthcare: insurance, doctors, medicine, and surgery. The other fact is that Americans spend more on healthcare than any other nation, and we experience increasingly lower outcomes in relation to costs than any other peer nation, and in some areas, than many other nations period. Galea’s book Well is a foundational text, full of interesting stories, great quotes, fascinating history, and thought-provoking science presented in layperson’s terms. In it he writes about health from a public perspective, a consideration of health as a public good in which the health of the individual is recognized as dependent on the health of the whole. Galea argues that our current cultural focus is on individual decision-making and healthcare – the doctors, medicine, and surgery that come into play when a person is already sick and that is overwhelmingly concentrated toward the end of a person’s life. He posits that we have neglected or ignored the public, community infrastructure that promotes health itself throughout human life. So we deprive ourselves and others of the increased opportunities and possibilities for a richer life for everybody that come with public health goods,
The titles of the chapters in Well provide a broad outline for the components of the infrastructure that Galea promotes for our consideration of health as a public good. I am going to read them now, all twenty of them, and invite you to note any of them for your later consideration that surprise you as being part of health, for either its support or its detriment, for both personal and communal health. The Past. Money. Power. Politics. Place. People. Love and Hate. Compassion. Knowledge. Humility. Freedom. Choice. Luck. The Many. The Few. The Public Good. Fairness and Justice. Pain and Pleasure. Death. Values.
Interestingly enough, with some allowance for differences in context, our Hebrew Bible lesson this morning illustrates some of the complexities involved when we consider some of these chapter titles as naming the elements of an infrastructure that shapes health.
Naaman is a great man, commander of the king of Aram’s army in what is present-day Syria. The king of Aram holds Naaman in high favor for his successful military victories, given to Aram over Israel by, oddly enough, the God of Israel. But in spite of his military might, Naaman suffers from leprosy. This may or may not have been Hansen’s disease, what we think of as leprosy, but could have been one of the other noxious skin conditions of the time. These may not have caused Naaman to be shunned, but they were almost certainly disfiguring and inconvenient if not painful. A young Israelite girl, taken prisoner in a raid by Aram against Israel, was made to serve Naaman’s wife. She tells her mistress about the Israelite prophet residing in Samaria, which was a region in central Israel now part of the West Bank. This prophet, she says, can cure Naaman’s leprosy. His wife tells Naaman. Naaman tells his king, and his king sends a letter to his vassal, the king of Israel, to smooth Naaman’s journey. Naaman is a very wealthy man, and expects his wealth to smooth his way and pay for his cure, and he packs accordingly. At the time, one silver talent weighed seventy-five pounds and was worth $6,000 in today’s money. Naaman takes ten of them, six thousand shekels of gold that were worth even more, and ten sets of garments worth a significant amount on their own. His entourage consists of servants, horses, and chariots, consistent with his high status. He sets out for the king of Israel. Meanwhile, as if he does not have enough trouble being a vassal to an overlord, the king of Israel takes the letter from the king of Aram as a demand for an impossibility and as a thinly-veiled attempt to renew the conflict between Aram and Israel. Elisha, the man of God, the successor to the great prophet Elijah, the prophet with the cure for leprosy, steps in. He calms the king of Israel and tells him to send Naaman to him, Elisha, not with Naaman’s cure as the first priority, but so that he, Naaman, will know that there is a prophet, Elisha, in Israel.
When Naaman finally reaches Elisha, he feels insulted, becomes enraged, and leaves. He is going back to Aram! Then his servants step in. They calm him down, and persuade him to wash in the Jordan. Naaman washes seven times in the Jordan, and is cured of his leprosy. He returns to Elisha, and in front of all his company, acknowledges the God of the prophet, the God of Israel, as the only God in all the earth.
A number of the pieces of Galea’s infrastructure are at play in this story. The past has set the stage: Naaman’s high status and wealth, his marriage and servants have already been achieved, and he has developed leprosy. The conflict between Aram and Israel has brought him the young Israelite girl as a servant. Politics certainly plays a part, in the interwoven relationships that involve and surround Naaman. Power and money are there, in Naaman’s sense of entitlement to certain treatment and in his assumption that money will secure his cure. Without the knowledge of the prophet given to Naaman by his wife’s servant girl and his wife, Naaman would have had no idea that a cure might be possible. Naaman has the freedom to make two important choices: he goes to Elisha, and he allows himself to be persuaded to wash in the Jordan. But he did not choose to have leprosy, and his cure is brought into possibility mostly by the choices of other people. Naaman does not come to his health alone. And if any of the pieces of this infrastructure had been different – if Naaman had had no knowledge, no support, no choice because of no power or wealth or freedom or the support of those around him for whatever reason – Naaman’s health would be compromised to the extent that he would still have leprosy, and his life would as well have less opportunity and possibility to that extent.
A number of the pieces of Galea’s infrastructure are at play in our Gospel account as well. By this time in history, the leprosy in this story is likely enough to be Hansen’s disease, as lepers in Jesus’ time were shunned by all, including their families, friends, and the religious community. They suffered a living social and cultural death-in-life as well as the looming death from the disease. There was also in that time a general public consensus that if one suffered the misfortune of illness or disability one must have done something wrong, and probably something sinful.
In this context, ten lepers come to Jesus and beg for his help. He tells them to go and show themselves to the priests, who are the arbiters of social and ritual cleanliness in their power. As they go, they are healed of their leprosy. And, as Jesus points out to his disciples, only one of them comes back to praise God, and that one was not just a foreigner but a Samaritan.
The past is at play in this story: the lepers are already sick, the prejudice against persons who are ill and Samaritans is well-established. Compassion also enters the picture: in Luke Jesus has already extended his healing beyond Israelites to heal the servant of a Roman centurion and a man from the country of the Gerasenes, and he extends healing to the Samaritan leper as well. While the lepers did not have the choice to become sick, had limited freedom and probably had little money or power, they choose to follow Jesus’ direction. People also are a consideration: while shunned by the rest of society, the lepers had created their own sort of community, even including a Samaritan. Knowledge plays a part as well: the lepers recognize Jesus, and know him as a person who can help them, even heal them. And again, if any of these pieces of health infrastructure had been missing – no knowledge, no support to bring the lepers to this point, no compassion from Jesus but blame for the lepers’ poor choices or morality, the lepers’ health would be compromised to the extent that they would still have leprosy, and their life would as well have less opportunity and possibility to that extent.
Fast forward to our own time and place. The elements of Galea’s health infrastructure that are present in our morning’s biblical texts are still with us. And, the knowledge we have gained about the causes of and challenges to health has exponentially increased. And now the realities and complexities of a globalized world have expanded the infrastructure elements present in the biblical stories and have brought in all the others elements as well – all twenty of them.. So now all these health infrastructure elements are at play, and their import for health for good or ill have increased the challenges to a staggering degree, not just for individuals but for the collective human race, and for the whole of the planet as well. In particular, while people in biblical times may be excused for blaming people with health issues for poor choices or moral laxity, our knowledge no longer allows us to blame or admire individuals or groups for individual poor or good health. Too many choices were already made for them in the past or in the present, sometimes without their knowledge or consent – just ask the people of Flint, Michigan. These choices include: to whom they were born, where they lived as children, the wealth or poverty of their families, the kinds and quality of foods that were available to them growing up, the level of pollution in their homes/communities/environment, the political decisions made on their behalf whether these decisions were in their best interests or not, with all of these elements of health infrastructure having irreversible effects for good or ill on their health. Likewise, in a globalized world, the health of the individual is dependent on the health of all other people and the health of the planet. Germs, viruses, plagues, and epidemics know no boundaries and are no respecter of persons. The global climate change that threatens the health of everyone’s earth, air, and water, if left unchecked, threaten public ill health, and thus individual ill health, on a scale previously unimaginable. There is still room for individual choice when it comes to personal health. And, in the present day, this is increasingly limited by the choices of others and by the collective choices we make as communities, nations, and the human race.
Here I would like to lift up in particular two of Galea’s elements of public health for further consideration. One is compassion, which Galea defines as “sympathetic consciousness of others’ distress together with a desire to alleviate it … something that links our engagement with the infrastructure that shapes our health to the values that shape our conscience.” He quotes Martin Luther King, Jr.’s statement that “Compassion is more than flinging a coin to a beggar; it comes to see that an edifice that produces beggars needs restructuring.” It is this kind of compassion to which Jesus inspires us: in his call for non-judgment, in his call to love our neighbors as we love ourselves, in his call to resist injustice and evil.
The second element for consideration is values. Galea notes that we invest our energies and resources in healthcare, and ignore improvements to the infrastructure that will promote our health throughout our lives. This means that we have not embraced health as a value worth pursuit and protection, nor do we address the forces that actually produce health. He raises the question, what does it mean to value health, not just as an individual issue, but as a collective, public value. Because if the public debate continues to focus solely on healthcare, on individual choice, doctors, medicine, and surgery, our health as a public and as individuals will continue to worsen, and we will continue the pattern that has made our health worse than that of all our peer countries. To embrace health as a collective value in fact means that we embrace compassion, compassion that reveals how the suffering of individuals connects with the infrastructure that produces or denies health.
I would like also to include an infrastructure element that Galea does not include, because he was not writing this sermon. That element is faith – faith in opportunity, faith in possibility, faith in human courage and compassion, faith in God. The challenges to our personal and collective health can seem daunting, not least because in this our time and place our responses to meet these challenges, especially as Christians, look to be counter-cultural and against great odds. But, we do not respond alone. In the Lowell Lecture given by Gary Dorrien that Dr. Jessica Chicka mentioned last week, he also said that he was glad to be living in a time of mass movements and demonstrations once again, where hundreds of thousands of people are beginning to organize, plan, protest, and advocate once again, not just for themselves as individuals, but for the public good, even to a global scale. So we will have plenty of company against the odds. We may even create a new culture of health for all people and for the planet..
To do this, as our biblical stories this morning remind us, we can consult with the prophet and be told what to do. We can ask Jesus for mercy, and he will tell us what to do. And, both of them will tell us the same thing as to what to do first. They will tell us, “Go”. And we will find, as did Naaman and the Samaritan leper, that our faith is in our going, and, it is when we go that we are healed. AMEN.
–The Rev. Dr. Victoria Hart Gaskell, Minister for Visitation
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