Spirituality, Religious Wisdom, and the Care of the Patient

The Role of Love in the Treatment of the Patient: A Protestant Perspective

Harvey Cox

Harvey Cox is the Victor S. Thomas Professor of Divinity at Harvard Divinity School and one of the world's leading theologians. His 1965 study, The Secular City, remains a classic. Nearly a million copies have been sold and it has been translated into 11 languages. While ordained as a Baptist minister, Professor Cox has throughout his career shown an uncommon degree of interest in and respect for differing traditions. He has served as a consultant to the Roman Catholic Bishop of Latin America and his recent works include Many Mansions: A Christian's Encounter With Other Faiths and most recently Common Prayers: Faith, Family, and a Christian's Journey Through the Jewish New Year.

I will divide my remarks into five brief sections: 

  1. Love in the Teachings of Jesus and Its Relationship to the Jewish Tradition

  2. Love in the Early Christian Tradition:  St. John and St. Paul

  3. The application of the Law of Love

  4. The Relationship Between the Christian Concept of Love and Asian Religious Traditions

  5. The Relationship Between Knowledge (Expertise) and Love in the Care of Patients

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1. Love in the Teachings of Jesus and Its Relationship to the Jewish Tradition

As a rabbi and a teacher of Torah, Jesus was often asked - as rabbis often are - some perplexing questions.  One of the best known of these was the query put to him by a man who wanted his view on what is the "first commandment"?  What is the greatest, the "top priority" principle of the Law?  It is an understandable question.  We all wonder at times how to reconcile the often contradictory and conflicting demands of duty, responsibility, indeed of love.

The answer the Rabbi from Nazareth is now so familiar it has become almost commonplace.  "You shall love the Lord your God with all your heart and mind and soul; and your neighbor as yourself."  Commonplace, yes.  But notice two things.  First, the questioner already knew the Law itself.  His question was about priorities within the Law.  Second, in his answer Jesus builds on the fusion of love and justice, but then takes another step.  He makes this fusion pivotal.  His real twist is NOT that love supercedes Law, but that Jesus pushes what for him was the core of the Law to its ultimate point.  As he puts it in another context:  "Love your enemies."

Clearly, for Jesus, the source and model of love is God.  As human beings, we are called upon to imitate, as far as possible, the kind of love with which God loves us.  What does it mean to say that God is source and model of love?  It means that kind of love is:

1.  Indiscriminate, extending to all creatures.
2.  Freely forgiving, as much as "seventy times seventy".
3.  Reaching out, not waiting for person in need to come to us. (therefore, Jesus tells stories about searching for one lost sheep, the lost coin, etc.)
4.  Love is not a sentiment but a free action.

In the Greek New Testament, the word used for love is agape, which translates an Aramaic word (the language Jesus spoke) based on the Hebrew word 'ahebh'.  This Hebrew term refers to the kind of love by which God loves his covenant people, and the kind of love that is expected between a husband and a wife, i.e. "covenant love."  This is important to bear in mind and we will return to it later.  It is not based on feeling, but requires fidelity-in-a-committed-relationship.

Still, we have questions.  Different relationships (husband/wife, parent/child, health care provider/patient, colleague to colleague) require different kinds of fidelity, and conflicts inevitably arise.  Our question, then, is rarely a general one.  It is what is the appropriate role of love in the context of this particular relationship?  It is fair to say that Jesus offered responses to specific situations, but was reluctant (as most rabbis still are) to lay down general rules that are expected to apply in all situations.  The earliest Christian thinkers had to deal with more particular cases.  We turn now to them. 

2.  Love in the Early Christian Tradition:  St. John and St. Paul

I want to turn first to St. John and draw your attention to the First Epistle of John - this is in the fourth chapter, a very central passage about love in the New Testament.  John takes love and applies it a little bit more than Jesus himself applied it in the passage from Matthew that I previously quoted.  "Beloved, let us love one another for love is of God, and he who loves is born of God and knows God.  He who does not love, does not know God for God is love.  In this the love of God is made manifest among us as God - sent his only son into the world so that we might live through him.  And this is love not that we loved God, but that he loved us and sent his son to be the expiation of our sins.  Beloved, if God so loved us, we also ought to love one another."

John goes on to say that no man has seen God, but if we love one another, God abides in us and God's love is perfected.  His love is perfected in us - a very interesting idea that the love of God is not quite perfect yet, and is "perfected" in expressions of love toward our neighbors.  That's not quite the "supreme being" of classical deism.  Rather this is a God whose love needs to be improved on or perfected.

Now there's an interesting question that's raised in that phrase "Beloved if God so loved us, we also ought to love".  It is the ought.  This has always raised an interesting question.  How does the word "ought" get into the same sentence with love?  Can love be an obligation?  Mustn't all love be a free expression, and not an obligation?  To answer that question, we have to go back to this concept of love that Jesus and John are talking about.   It's not simply a feeling; it's not a sentiment.  Because you can't be obliged to have a sentiment.  We all know that.  Feelings are feelings.  But if love is something we can learn, we can will, we can try to do, we can enact, if it's a kind of love that Jesus, within the Jewish tradition, was talking about albeit, focusing it and pushing it a step further, then it makes sense.  It makes sense as a kind of obligation.

Now I want to go on to St. Paul as you know has sometimes gotten a negative review and there are many things for which he merited that negative review.  However, I think he has been wrongly interpreted as having distorted the teachings and example and meaning of Jesus.  I don't accept that theory of Paul I think what he's doing is innovative interpretation, in particular in complex and difficult circumstances - something the rabbis were used to doing.  Paul didn't claim to be a rabbi; although he was trained in that tradition, still the law of love has he learned it from Jesus.

3.  The application of the Law of Love

But what Paul is doing is a very difficult job.  He says, "Yes, love is of God.  Love your neighbor, but what does it mean in terms of real human behavior?  How is it applied in terms of the care of patients, for example?  In order to make little clearer what Paul is getting at, let's examine the most famous passage he ever wrote, which is his famous Hymn of Love, taken from the thirteenth chapter of his letter to the Corinthians.  Although I'm not sure it's appropriate, it's appropriate; it's read all the time at weddings.  It's a polemical-poem!  This is great poetry, but this is an attack poem in which he is really going after some of the religious practice of his day in a very negative way, albeit clothed in a kind of poetical rhetoric.

He is attacking some of the religious practices that were appearing in the movement, which would later be called Christianity; in Paul's time, it wasn't yet called Christianity.  "If I speak in the tongues of men and angels, but have not love I am a noisy gong or a clanging cymbal.  If I have a prophetic power and understand all mysteries and all knowledge and have all faith to remove mountains, but have not love, I am nothing.  If I give away all I have, if I deliver my body to be burned, but not have love, I gain nothing.  Love is patient and kind; love is not jealous or boastful.  It is not arrogant or rude; it does not insist on its own way; it is not irritable or resentful.  But it simply does not rejoice in wrong" and he goes on in that vein.

Now what is he doing here?  He is rhetorically attacking some current spiritual practice.  This is quite relevant because many of these we can find in the religious movements of our own day including my own tradition, such as the search for ecstasy, peak experiences, personal spiritual titillation.  To some people this is the essence of religion.  Paul says, "You can have that if you want, but without love, it's rubbish, nonsense."  Prophecy-that means eloquence-persuasive power, wisdom, expertise, technology, know-how, even faith that can move mountains or faith that can result in your healing.  One of the things that I think we might talk about today is the television evangelists that say that if you have enough faith you can be healed, and if you haven't gotten healed, then you obviously haven't had enough faith.  I don't think St. Paul would have agreed with that.  If you have enough to move mountains, that's a lot of faith, but if you don't have love, nonsense, empty, zilch.  What about extreme asceticism or even extreme philanthropy - also doesn't work unless love is there.  Love is very, very central.  It's not departing from the central message of Jesus at all.  If anything it's emphasizing it, and playing it off against some of the other tendencies that were appearing in Paul's own movement.

Now, summing up so far before I take this next step, for Jesus himself and for St. John and Paul; God is the source of love and also the model.  Love as God loved us.  Both the source and the model.  What does that mean?  Four things.  First love is indiscriminate, showered on all creatures.  It does not discriminate.  Two, it is free.  Number three, it is proactive.  That means reaching out, not waiting to be asked.  It moves out.  And fourth, it is not a sentiment, but a free act in what has to be called a covenant relationship.  This is so often forgotten in Christian discussions of love.  We're talking about the love which is not based on a feeling, but which requires fidelity in a committed relationship of one kind or another - what the Jewish scripture calls a "covenant."  In our own time, we live in a number of different covenants:  the covenant of marriage, the covenant with our families, the covenants we have with others in our profession - whatever that profession may be - covenant with our nation, with our religious tradition, with our patients.  And very often the issues come up of what we call a conflict of covenants.  Here I am stuck with a certain kind of loyalty to this covenant but the other covenant is calling me this way.  We all live with that.  This is why I'm a little more sympathetic with this lawyer, who came to Jesus and said, "What's the first commandment?  What's the most important commandment?"  Facing all these conflicting and often times contradictory commandments.

The figure that comes into Christian thought about love very early is the sun - the SUN.  That is the sun sheds its light without losing any light.  It sheds light on everything:  the good, the bad, the old, the new.  It sheds its light, and it still has enough light.  We may not like that, however.  We only have a certain amount of light to go around.  The sun doesn't burn out - at least they thought it wouldn't burn out - I'm told now that if we're around 6 billions years from now it will burn out.  I think Woody Allen in one of his movies told his parents that he didn't bother to do his homework because the sun is going to burn out in six million years.  It undercut his motivation.

4. The Relationship Between the Christian Concept of Love and Asian Religious Traditions

Now, I want to move to what I have learned from my exposure to non-Western traditions about love and caring.  The old, old question, at least in Christian theology:  Does God need our love?  There are different answers.  Some say, "Well, God doesn't need anything; God is perfect, "even though we've just heard from St. John that in man God's love is perfected.  We are the recipients of God's love.  God doesn't need our love; he needs our gratitude, which is expressed toward fellow human beings and not toward God.  God doesn't need it.

However, there's another perspective within the Christian tradition, and I was reminded while I was living briefly in a Vaishnauite temple while in India.  And I used to get up at 5:30 in the morning to go with the priests into the temple while they woke up and fed the deities.  The deities were there in the temple, and they were covered with their little cloths.

The priests would burn some incense, wake up the deities and leave some milk for them.  I have to say the first couple of times, I was dumbfounded, astonished and a little put off.  Here you have a nice Protestant kid going in to wake up the deities and even give them their breakfast!  What is going on here?  Very different concept of God.  Very different from what I grew up with.  After a few days or a couple of weeks there, I began to see that there's something to this.  What's being nurtured here is an attitude toward the world, toward being as such.  We are caretakers, if you will, of the whole universe and the universe is represented in these deities.  And when I was still pondering this I did a special study of depictions of Jesus, where Jesus himself - who we take to be the manifestation of God - is in need of our attention, of our care:  a baby who needs his diapers changed, who needs to be suckled, who needs to be taken care of.  And then thirsty, he needs something to drink, asks a woman at a well to give him something to drink.  Incident after incident seems to demonstrate that insofar as God was in our midst in the figure of Jesus - he continues to be in our midst, I believe - God has some need of us.  At the very end of his life, there's this wonderful scene in Spanish art called the Descendamiento, when the crucified figure of Jesus is tenderly taken down from the cross and wrapped and taken for burial.

There's a message here: that there is a kind of reciprocal relationship between human beings and God.  It's not just a one-way relationship.  We need God, but God also needs us.

5. The Relationship Between Knowledge (Expertise) and Love in the Care of Patients

Finally I want to say something about love and expertise.  I picked a rather strange passage to do this.  That's another letter that Paul is sending in which Paul is asked by the Corinthian Christians a very typical rabbinical question:  What do we do when we go to a friend's house for dinner and we are served meat to eat which has been offered to idols?  How do we maintain our devotion to the law and avoid idolatry.  This may sound picky to us -or to me - but nonetheless, they ask.  Here is what he says when he writes to these people.  Look, you know and I know that these are not the real gods.  Even the Greeks know these are not the real gods.  {They had the philosophical tradition by that time.  They weren't believing in Greek mythology.}  The Jews who were living there in the diaspora, knew these idols; namely that there was nothing to them.  So, why not?  Just go ahead and eat the meat.  But he said, now you know this, but there are some people who don't.  There are some people who don't have that level of expertise or knowledge, and you have to be careful not to act always just on your expertise.  You should qualify your expertise with love for what he calls the "weak brother" or the "weak sister" who might be misled by what you do.  You're perfectly free to do it, but that's not the question, Paul often answers questions that way.

If you look in Corinthians "Knowledge puffs up, but love builds up . In preparing for this talk I looked up this word "puffs up" and it's a perfect word to use for this occasion, because it's a medical term Phusioi means abscess or tumor or boil - something that fills up with pus.  So Paul borrowed the term:  If you don't watch he says knowledge can be like an abscess or a boil.  It's a fairly negative characterization, I would say.  And so you shouldn't always be acting only on your knowledge.  That is knowledge has to be balanced with love - and not just balanced, but directed by love.  At the bottom of the next paragraph you'll see he says, "And so by your knowledge this weak man is destroyed, the brother for whom Christ died.  Thus in sinning against your brethren and wounding their conscience when it is weak, you sin against Christ."  This is really astonishing.

We often think of ourselves imitating God by helping the patient, serving the patient.  Here he reverses the image.  It is actually God, or in this case Christ, who is present in the patient.  In the one we're helping, not the other way around.  And Jesus, of course, has said this before in the final chapter of the Gospel of Matthew when he's talking about the final judgment and he says that I was in prison and you didn't come to me, I was sick and you didn't visit me . in as much as you didn't do it to one of the least of these, you didn't do it for me.  And he does it in reverse, too, in as much as you did it for the least of these, you did it for me.  He puts the presence of God as revealed in Christ in the hungry, the lost, the weak, the imprisoned - that's where we meet him.  It is not as though we're always the bearers of God's love and God's care to weak, sick people; but that we also somehow meet it coming the other way.  I think this is a very important message.

Let's go back to the thirteenth chapter where Paul says, "love never ends, prophecy will pass away, tongues will cease, knowledge will pass away, for our knowledge is imperfect and our prophecy is imperfect, but when the perfect comes, the imperfect will pass away.  When I was child, I thought like a child, I reasoned like a child, but when I became a man, I put away childish things.  And now we see through a glass darkly, but then face to face.  Now I know in part, but then I shall understand fully, even as I have been fully understood."

Paul says that ultimately, I will understand as I have been understood.  This is a change from knowledge of the thing to knowledge of the person.  I will understand as I am understood.  That's personal knowledge, what Martin Buber called an I - Thou kind of knowledge and not just an I - it kind of relationship.  Maybe what we're hoping for is to combine what Buber called the I - it relationship - the expert who knows what to do with something that has to be like a thing that you're measuring, watching, analyzing - but also remembering that there is also a Thou in whom God is indeed present.

So Paul ends up with this most famous of all phrases:  "So now abideth faith, hope and love, these three, but the greatest of these - the greatest of these - is love."  What I tried to do in rapid sequence here is talk about love in the teaching and example of Jesus himself, love in some of the earliest interpreters, the application of love in certain situations.  What I hope we have learned here is that the relationship between love and expertise is very important and is also a delicate and tricky business.

Rabbi J. Rolando Matalon, "Love and the Care of the Patient"
Love: Introduction
Table of Contents  

Published: April 2, 2003