To the Bone

Sidney Callahan begins her fifth book with these celebrated lines from William Blake’s “Auguries of Innocence”:

Man was made for Joy and Woe;
And when this we rightly know
Thro’ the world we safely go.

The purpose of woe—or suffering, to use a more modern word—has never been an idle question. It touches us personally; it has occupied philosophers throughout history. New York Times online columnist Stanley Fish contends it is “the central problem of theodicy—the existence of suffering and evil in a world presided over by an all powerful and benevolent God.” Tell us, we demand: Is the Higher Power a practical joker, sadist, absentee father, or helpless bystander?

In Created for Joy, longtime Commonweal contributor Sidney Callahan views this question through the eyes of a devout Catholic psychologist. Callahan rejects the notion that suffering has intrinsic value. Pain, grief, hunger, depression, and loneliness, she asserts, are not sent by God to test our faith or punish us, to grab our attention or to perfect us. Nor should we—on the secular side—buy the self-help agenda that assigns blame for illness to toxic anger, irresponsible diet, or neglect of our third chakra. The gist of Callahan’s argument is a theological one, and follows the thinking of Karl Rahner. Suffering does not arise from God, but from what is “not God.” It stems from the malicious use of free choice, or from accidents that occur in a natural world still evolving toward perfection. It cannot, of itself, either calibrate our self-worth or make us better people.

I have been a family physician for more than two decades, spending most of my workdays on the pragmatic (and billable) task of treating disease. Occasionally I am present when patients manage to transcend their deep distress. We know that suffering can ease when a patient accepts its necessity. But healing requires something more. The physician Eric Cassell, who has written extensively on caring for the terminally ill, once observed that “to be whole as a person is to be whole amongst others.” When illness shatters our sense of wholeness, that wholeness can be repaired only inside human relationship. Callahan quotes the writer Eva Hoffman, a daughter of Holocaust survivors, who said, “It may be that suffering shared, suffering respected is suffering endurable.”

As a family physician, I have often marveled at how one alcoholic can give up the bottle while another spirals out of control, or at how normal, unheroic people manage to cope with a diagnosis of cancer or the loss of a spouse, a job, or the ability to live independently. In my work with addicts, I have come to value the concepts of Motivational Interviewing, a therapeutic approach pioneered by the psychologists William Miller and Stephen Rollnick. Here, the therapist understands “change” as something that occurs naturally. It cannot be hurried or manipulated, but happens at a pace dependent on the patient’s ability to resolve his ambivalence between two or more competing desires. A positive outcome depends on the patient’s and the therapist’s shared belief that they will succeed together.

The longer I participate in the process of recovery, the more I believe that relationships matter. And the most effective therapeutic relationships resemble real relationships, those that follow an organic timetable and rely on mutual understanding, vulnerability, and love. In this way therapy mimics life itself. When I was thirteen years old, my father died. My mother was just forty-six; and despite her insistence that “faith pulled me through,” in the day-to-day reality of our loss, it was the faith community that attended to our needs. We were supported by the church ladies who fed us for two weeks, by Mass intentions, and the widows who became a staple in our new social life. It is through the love of Christ’s disciples, and through our absolute commitment to love, that we come to know God’s love.

Callahan understands this to the bone. Her book begins with the story of her infant son’s death on her birthday—March 6, 1961. Exactly thirty-five years later, her daughter-in-law suffered a postpartum embolus and died the following day. Here the realities of birth and death, intense joy and inexorable grief, are no less intertwined than in Blake’s poem. And Callahan has composed—through her life and in her writing—a vigorous defense of God in language true to her feminine and therapeutic sensibilities. She relies on the mystic Julian of Norwich to flesh out the feminine attributes of God, the one who “gives birth to us through his passion and nourishes us with the Eucharist.” It is God the Mother who reads our hearts, feels empathy with our ills, and loves us with the tenderness and intimacy of those who suckled us.

Created for Joy should be read with a companion piece on suffering that Callahan wrote for the November 17, 2006, issue of Commonweal. In “My Mother’s Keeper: Life in the Alzheimer’s Ward,” she described her difficult decision to place her stepmother, Virginia, in a nursing home. There, Callahan came to admire the young, immigrant and minority women who cared for her stepmother, and their success in keeping “everyone as socially engaged as possible so that they do not slump down into withdrawn stupor or constant sleep.” Communal activities included television, sing-along, Bingo, the batting of giant balloons, and, of course, meals (which Callahan’s stepmother particularly enjoyed). Throughout it all, the aides ministered to the residents with gentle voice, fresh smiles, tender hands, attentive eyes—in a word, with love.

Callahan is at her best when she offers a post–Vatican II emphasis on the incarnate and risen Christ over the broken body of Jesus on the Cross. “We are saved by God’s Spirit and love,” she assures us, “not by the satisfaction of debt through blood vengeance.” Readers of faith cannot come away from Created for Joy with indifference to human suffering. Nor with any doubt that its relief requires love of a very personal nature, in gratitude for the love we have received. We are biologically wired for pain and pleasure, but these sensations exceed mere biology. Our social nature seeks to interpret and share our pain and pleasure in the context of human relationships. That these relationships are always with us, even when God remains veiled, is perhaps the greatest mystery of all.

Published in the 2008-02-29 issue: 
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David Loxterkamp is a family physician who practices in Belfast, Maine. He is the author of A Measure of My Days: The Journal of a Country Doctor (University Press of New England).

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