Theology and Relationships

Theology and relationships

I am not sure what exactly the focus of the big meeting planned for February 2019 at the Vatican will be, but I hope that there is actually a forum and quorum for the issues of relationships as evolving and dynamic, and not static.   We need to have language which articulates respect for each person, and that people are never to be treated as an object. 

Most of the theology of sex and sin when we were young centered on single acts, not on relationships.  For more than 40 years, we have had theologians who are Teilhardians in the assessment of progress of human culture and well-being.  We have been able to discuss the theology of marriage, and of good theology in general, as a deepening conscious integration of the love of God, and the knowledge that goes with that love of God.  Thus, the issues of honesty, vulnerability, respect, compassion, tenderness, humor, caring, generous listening, accountability, forgiveness, boundaries, self-esteem, etc, which were never covered in discussions about moral theology in the past, are now at the forefront of  how we should be able to form good healthy relationships in safety with other people— not just sexual intimacy but emotionally satisfying friendships, spousal relationships which mature over time, parent-child relationships which also mature over time,  and other kinds of interactions which may contain emotional, spiritual and physical components of intimacy. 

I think it is a good time for us as a church to retire the wrong thinking which got embodied in the encyclical “Humanae Vitae” as a proscription against birth control.  Sensible family planning decisions need to be left to the conscience of the couple, as they plan their lives and take on the burdens of parenthood.  I think we need to address how to include gay people in a respectful way, which recognizes that sex is part of intimacy and love relationships of many kinds.  We need to have informed theology which leans on modern psychology and the best spiritual guidance about being a healthy human being.  We need to aim at protecting people from STDs and traumatic side-effects of having a sexual event which is disrespectful and not loving, such as incest, rape, abuse of a minor, sexual assault, etc.  We need strong proscriptions against sex trafficking, and concerted efforts all over the world to provide shelter for people who are at risk for this modern slavery.  I believe this is actually something our Church should be doing. 

  

I certainly hope that international agreement will happen in making sure there are always 2 adults when children are present, to lessen the risk of a child being injured or taken advantage of in any way.  We need to have strict protocols in place, to protect children from sexual predators.  We also need to do ongoing surveillance and rigorous assessment to keep pedophiles from having access to children;  and to protecting our schools and parishes, with reasonable oversight of committees which include laypeople and parents.  Since sexual assault is a crime, we also need to be sure that predators go to jail, and are not promoted or hidden within the church. We need to have  full cooperation with the law and the police. 

We also need to have  credible pastors, who are attempting to live their own vows in a healthy and humble way.  For this reason, I am even more hopeful that we will now move to have the clergy have the option of marriage, and also that women will be given a wider role in pastoral care.  

Maybe this time, in which my friend Tim’s daughter Katie has embarked on the vocation of becoming a Poor Clare, can be a time of great growth in the Church, equivalent to when Galileo said that the movement in the heavens is such  that the earth rotates around the sun.  

Anna Karenina

Every 10 years or so, I re-read my favorite book, by Tolstoy.  It was written in 1877, and that is an amazing thing; that it was around the time of our Civil War, and the advent of expansion of railroads across the continent, and also mirrored the expansion of railroads across Russia.  Tolstoy's amazing skill at writing this book remains, in my estimation, without parallel. 
In my 20s, I loved the book, envied and admired Kitty, and wanted to find a spouse like Lewin.  In my 30s, I was absorbed with the worries about the scope of women's lives, and especially about women like Dolly, with several children and a husband who was both a spendthrift and chronically unfaithful.  In my 40s, I loved the passion in the love affair between Anna and Vronsky, but also I began to consider the change in the relationship to the land and the way the peasants were affected with the advent of railroads, and the thought that the book preceded the Russian revolution by at least 30 years, while they grappled with how to become a more effective government.  I had sympathy for Alexis Karenin.
In my 50's I could really feel like I understood all the characters, and what affected me most was the death of Lewin's brother Nicholas, of Tuberculosis, also called Consumption.  Almost no Americans have ever seen anyone dying of TB, but I have.  Because of my time in the Peace Corps, and travels, I deeply identified with Kitty trying to help this bitter dying brother of her husband's.  I admired Varenka, who is a prototype for women in medicine who are skilled and practical, and self-effacing, and very good at helping solve problems for patients. 
Now I am in my 60's, and my dislike of Vronsky has washed away, and I pity him, and admire that he built a modern hospital in his district, and tried to become an effective member of the political arm of the landlords, as he was also trying to become a good steward in managing his estate.  And I come to the book now with so much more admiration for the mind of Tolstoy, who could describe Anna's thoughts so clearly, as she descends into the hell of her self-obsessed, isolated, emotionally feverish attempt to hold Vronsky with her attachment, without any social ballast.   I admire his ability to describe the mind of a morphine addict.  I admire his ability to show the enormous 2-faced social miasma around Anna, and how it contributed to her suicide. 
There are many things in the book which bring big questions for reflection-- about how to educate people, what to do about governmental systems so that they are effective instead of burdensome tangles, the differences in the classes which Tolstoy presents so clearly, and we have not eliminated, although it is hard to speak truly about what we DO have, and the economic burdens of consolidated power and money in a shrinking upper class.  And there is Lewin's joy in working in the fields with his scythe, just for physical joy; and his hunting, and his attempt to be a better steward and make worthwhile improvements in the farming of his estate.  I LOVE this book.  If you haven't read it, I really recommend it, and I also love the audiobook format.  My eyes get tired now, and listening to it also is a pleasure. 

Angels in America: reflections

Gratitude!
I trained in obstetrics and gynecology in Brooklyn NY.  I began my residency in 1983 and finished in 1987.  I was in Brooklyn when young men who were previously in the peak of health began dying of a mysterious disease which attacked their immune systems, produced Kaposi's Sarcomas on their skin, gave them terrible oral candidiasis, chronic diarrhea, ulcerated mucosal membranes, herpes blisters, genital warts, and Pneumocystis Carinii pneumonia.  Then there were atypical viral meningitis cases.  There were also some women coming down with these symptoms.  Immunodeficiency.  AIDS.  HIV.  People would hear the answer to their blood tests, and some would commit suicide.  Some went home to die.  No one was certain what else could be done to mitigate this plague.
When I was in internship and residency, it was required that we put an i.v. into every woman in labor, before the baby came, to be able to treat quickly any postpartum hemorrhage or other crisis.  We had a little machine in Labor and Delivery to be able to spin a hematocrit, to know if the patient was already anemic before delivery, to be prepared even better for meeting the crisis that might kill her.  Some of the women in my neighborhood, especially Orthodox Jewish women, were having a dozen children, having been instilled with the hope that they could help replace children for so many relatives lost in the Holocaust.  These women were very anemic and often exhausted, and at great risk of hemorrhage after delivery, as the uterus may not close down well when it is tired.  Some of the women in my area were from one of the many sub-cultures in Brooklyn, and some were drug addicts.  Putting an iv into the arm of a pregnant woman who is writhing and wiggling with the pain of labor is not always an easy task.  The risk of non-cooperation or panic is inadvertent fingerstick contamination of the person starting the iv.  All during my career, there were advances being made to make this less risky, but in the beginning, we all were moving very fast, and often didn't put gloves on, to get the iv going, as delivery was imminent, and we needed to get the patient ready, and the hematocrit had to be on the chart. 
And so, gratitude:  because when I got to California, my HIV test was negative.  Otherwise I couldn't have even gotten a job in my field, or had my career at all. 
     I have been watching the movie "Angels in America".  I guess it came out in 2003, but I was working, and never saw it.  I wanted to see it, and I read the reviews, but until today, I had not gotten to see either the play or the movie.  I am riveted, deeply riven, by what I remember from my time in Brooklyn, from the death of young and beautiful men, from the bewilderment of mothers like Mrs. Pitts, and from the kind of guy Roy Cohn was.  It is an amazing thing to me that Tony Kushner wrote that play, and centered it in 1986.  It is an amazing thing about faith, about how we consider time, and what we think about all the shadowy things in complex places like New York.  About 2 years ago I read the book by Abraham Verghese, "My Own Country".  He was an Infectious Disease specialist, trained in NY at the same time, and went to Tennessee.  His book is about the beautiful young men who went home to die, in Appalachia.  Yes, there were some medications, like AZT, which helped keep some of the young men alive, and helped raise their T cell counts enough to keep them from contracting every damned infection we could name, as well as several new ones.  Every day and every week there were funerals, and people were talking about miracle cures, and what adjunctive supplements might help your immune system to stay strong. 
     One of my best friends in college and afterwards was gay.  He was very fluent in German, and was in Heidelberg during the beginning of the AIDS epidemic, and by the time he came back to the US, there was more information, more prudence, more ways to help.  But still, he watched and help many friends die, and one of our mutual friends went blind before he died, a terrible thing for a librarian who loved beautiful books. 
     There is so much I did not understand about the whole epidemic, even as a doctor.  And it was quintessentially male, in some ways;  the attention to it, the men who rose to the challenge in medicine to try to stop the wild fire it was;  the complexity of the immune system.  One of my women friends was a lab tech at UCSF, and she was one of the first who saw the cells in the lab, the blood work, the problem;  working with hematologists at the vanguard of the medical front to treat, to deal with, to attempt to find a vaccine.  Luckily, she also did not get stuck, she is alive, like me. 
     Watching the movie was amazing, and there is that weird and wonderful coincidence of Joe's being a Mormon, and the kookiness of the angel appearing even to his mom.   There is the self-defeating oddity of Joe's wife, very much like most women who find out they are married to a gay man, and can't get past the excoriating feeling that somehow it was all their fault, and the basic terrible unhappiness and sadness, tension, anxiety, despair.  I was glad she got out.
     And there is Roy Cohn, the epitome of cynicism and mean and nasty use of power.  What a tour de force by Al Pacino.  Wow, that is acting!   And also Meryl Streep.  I loved her playing Ethel Rosenberg, and I really loved her helping Lou remember the words for the Shema.  But my favorite character was Belize;  such a complex character, and with great sweetness and compassion, even as he is hemmed-in by cynicism and very difficult realities. 
All in all, a fabulous movie, and deserving the accolades it got. 
A powerful story, with powerful characters, and of course, since I like angels, it was interesting to see the struggle with the angel, and the whole dilemma of prophecy, the uncertainty about what it means.  I love those big wings, and the hallucinatory experience of the heavenly committee. 

Heuristic structures in knowledge

My friend Thomas Ball, the filmmaker, has posted another fabulous reflection on his blog, at Telos productions;  which was previously called "The diary of a filmmaker".   I have loved his essays over the years, on art;  and what art means for us.  This month's reflection is about the Venice Biennale, and the show on the time between the world wars, as fascism intensified, and what that futuristic cultural context was, both in history and art, and how they interacted. 
One of the things Tom quoted was a discussion of the meaning of heuristics.  When I was in college, I majored in philosophy.  My metaphysics professor had us learn from the book "Insight" by Bernard Lonergan, SJ.  Lonergan was interested in the way we know, in the structure of knowledge and shared thinking in scientific endeavors.  He wrote a LOT about heuristic structures of knowing.  SO here is my posting to Tom's blog on this issue:
"I also have to say something about the word “Heuristic”. It warms the cockles of my heart, as it is a very important word in philosophy. You probably remember that I majored in philosophy! I was taught in metaphysics, that the stuff of knowledge fits into heuristic structures of thought, much as we fit things into boxes for mailing, or for packaging something. A heuristic structure in philosophy is something like a steel girder skeleton of a skyscraper– you are going to fill it with the rest of the building, with the details and the actual stuff, but you need this scaffold to begin with. The scaffold in thinking is the outline or the container of such information, and how it fits together with other information. For example, we could say that knowledge is sort of like a castle, with lots of turrets and rooms, and occasionally a whole wing gets redone, when it seems it is too narrow or too dark, or a whole new idea comes about. (for example, when physics was grappling with what Einstein said, which shifted us away from Newtonian physics. We acknowledge that we started with Newtonian physics, but we have this second or third floor, where a more sophisticated model exists, and where finer tuning for what is real can be done by scientists working at the edges of knowledge in this field. We have to use the materials we know, and we have to build on what has come before. Kant worked to try to explain categories of thought such as gravity, weight, space and time, sequence, coherence; ways we can describe scientific processes so that something can be checked for accuracy, or taught to someone else. How can we agree on what the scaffolding IS, for thinking and for exploring new theories or new data, finding new answers to our endless questions and with our ever-present curiosity? This is the issue of heuristics. Lonergan said that we are constantly expanding knowledge at the border of the known, with heuristic structures which are needing to be filled in. This also has to do with process, with evolution, with finding the boundaries of the known and then exploring something experimental beyond that. Thanks for sharing that word, which has so much philosophical nuance attached to it!"

Patience, way and pace, rhythm; Singing the Psalms

The Benedictine monks in the Monastery on Big Sur have been teaching me something about pace: peace, pax, pace.  Singing with them, trying to follow the plainsong melody and rhythm, singing psalms which are maybe 3-4,000 years old, singing in the rhythm of the peaceful and prayerful day.  Vigils at 5:15, Lauds at 7 am, Mass at midday,  and vespers in the evening, provide a structure of a day which mirrors the seasons, allows work and rest, contemplation and action.  At night, the stars encrust the heavens, and they are there in the daytime too, but the sunshine hides them.  The ocean with the whales moving north, the whitecaps on the windy afternoon, is also a lullabye.  They are teaching me the time-honored patience in the rhythm of a peaceful day.  My impatience is carefully folded into the singing, into trying to stay in tune and in the pace of the verses.

Perhaps some would rather hurry, go faster, be like the hare in the fable of Aesop, the hare that runs, then dawdles, not plodding along steadily like the tortoise.  In the music there are whole notes, half-notes, quarter notes and eighth notes, up and down the scales.  i get it now that these singing lessons are an invitation to stability and sustainability, gently pulling us along by melody and rhythm, and praise and thanksgiving, until we are capable of tilling our own fields and living our own days in a reasonable pattern.  

I have been reading the AA big book through this weekend, and understanding more about the drowning, the fear of suicide, the desperation to quit when one cannot quit drinking.  Last weekend I went to the NAMI-California meeting, to discuss and go deeper in understanding the problems of the mentally ill.  Failure, loss, violence, madness, inability to trust in the Lord’s goodness, generations of cruelty, neglect and a belief in a violent God.  How do we come to see and fill the gaping holes in consciousness from bad parenting, bad training?  How can we begin to heal these deep, deep wounds?  

I   think of the plagues in Europe, the death of almost everyone, starting over again, and reinventing civilization.  I think of Julian, the anchoress saying “All shall be well” from her tiny cell cemented to the wall of the abbey in Norwich, while the plague decimated the town around her.  

Today’s was my favorite reading from the Gospel of John, the empty tomb—- Magdalene sees, and calls Peter and John to come.  The clear particular details, the binding cloth for his head folded and left on a bench nearby, not with the rest of the burial cloths.  (We will not worship a pile of stones;  the monument is empty— He is risen!)

(I want a painting of Mary Magdalene’s face, looking at the risen Lord.)

The only way the pace makes sense is that the cosmos is held in a loving embrace of God, that we are moving toward the Eschaton as Teilhard de Chardin said, not in the way of a football goal post, but with the imprint of the goal in our DNA, in our souls.  As we grow in all of evolution, as human evolution takes hold, we move toward the goal expressing itself within us as our deepest yearning.  

There is a way and pace which leads to life more abundantly;  succeeding in blooming, not burnt out or failed to bring forth fruit.  This rhythm must be in community, not in private.  This singing, this plainsong, teaches the lessons of community effort.  I try to stay in the rhythm, and on the right page, and in the right key, my voice rising and falling with those who know better and are more skilled at this melody.  My voice is channelled between their voices, and we are harmonic in our praise.   This is my lesson in patience, matching breath and tone and words to the psalms, to the melodies, to the holidays, the solemnities and the stories from the communion of saints.  Love, respect, generous listening, communion!  And in our end is our beginning.  

Patience is one of the fruits of the Spirit, but also there are the others: peace, kindness, goodness, faithfulness, gentleness, self-control, love and joy.  We must seek to understand and also to forgive, to tolerate the flaws in each other, to look more to our own, trying to sing “in key” and to encourage each other to sing with more joy and less self-consciousness, so that all things work together for good. 

Viktor Frankl said “All the freedom in the world lies between stimulus and response”.  We are free to be silent, and we are free to sing.  In singing, we grow to be a choir together! 

This cruciform pattern of life, of seasons, of the resurrection; new life, the whales heading north playing in the bay, the baby birds learning to sing and to fly, the wildflowers blooming in the cliffs, all creation in labor to bring forth new life!  Alleluia! 

Malpractice lawsuits

I believe one of the most damaging things about these lawsuits,  is that they use our finely tuned consciences and our self-doubt against us. We need to be resilient, but not hardened. We need to CARE about our patients, not become hardened and suspicious and angered by their needs. We need to take risks to be able to solve their healthcare needs, sometimes we are uncertain, which is the actual real part of practicing medicine which doesn't exist in the coding system. Gauging uncertainty and probability are the art of differential diagnosis. Patients respond differently to treatments. We need to keep having that tensile strength, and trust in our instincts and our medical acumen. Get help with counseling, to trust yourself and believe in yourself. We cannot control the outcome, we can only do our best to offer good care.

Nonviolence

We need to recognize that the word "nonviolence" was only invented in the 60s. It followed on Ghandi and Martin Luther King's work, when they began to link all kinds of oppression to bullying and violence. Considering history, we have made a lot of progress, in recognizing that we do not have to behave this way, that we can learn to use tools of nonviolent conflict resolution. But we HAVE to use them, and we have a whole world to protect. We need DIPLOMACY NOW. We need real and muscled effort in the State department. We need to actually get people to see that we MUST start to dismantle nuclear weapons, as Daniel Ellsberg is now saying in his new book. Nuclear winter is the outcome of any nuclear war. The planet will not be able to produce food, and people will starve to death. MOST of the people on the planet. We have to try to prevent that.