The Mockingbird | Sickness & Health Preview

T H E S I C K N E S S & H E A LT H I S S U E

No. 22

MIRACULOUS HEALING | THE FALSE GOSPEL OF WELLNESS | REDEFINING DISABILITY LOVE IN THE TIME OF AUTOIMMUNE DISORDERS | THE CURE OF SOULS 1 THE MOCKINGBIRD

“Prayers requested.

I am sick of being sick.”

— Flannery O’Connor

THE S I C K N E S S & H E A LT H ISSUE

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THE MOCKINGBIRD

Holly Andres, The Magic Elixir, 2008.

Chromogenic dye coupler print. 40 x 50 in.

Spring 2023

E D I TO R

B OA R D O F D I R E C TO R S

CJ Green

B OA R D P R E S I D E N T

M A N AG I N G E D I TO R

Jonathan Adams

Meaghan Ritchey

E X E C U T I VE D I R E C TO R

PUBLISHER

David Zahl

David Zahl

TRE ASURER

Willis Logan

A S S I S TA N T E D I TO R S

Cali Yee Ben Self

S E C R ETA RY

Emily Large

C O P Y E D I TO R

Ken Wilson

Ginger Mayfield Michael Sansbury Scott Johnson James Munroe

P O ET RY E D I TO R

Andy Eaton A RT D I R E C TO R

Tom Martin A D M I N I S T R AT I VE D I R E C TO R

OFFICE

Deanna Roche

100 West Jefferson Street Charlottesville, VA 22902

E D I TO R E M E R I T U S

Ethan Richardson

434.293.2347 x 103 434.977.1227 E M A I L : magazine@mbird.com PHONE: FAX :

The Mockingbird is a nonprofit magazine that seeks to connect the message of God’s grace with the concerns of everyday life. Our staff believes that grace, by its nature, is dynamic, unmerited, and expansive; we hope the range of voices in this issue reflects that nature. In surprising and downto-earth ways, we aim to demonstrate how the Christian understanding of reality—what people are like, what God is like, and how the two intersect— is borne out all around us. For more, visit our website, www.mbird.com.

A four-issue subscription is $60. To subscribe to The Mockingbird, sign up at www.mbird.com/shop or by sending a check to our address. Monthly supporters of Mockingbird receive a complimentary subscription.

Cover: Holly Andres, The Trail of Sparrow Lane, 2008.

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Contents

Interviews

Essays 11

In the Elector’s School BILL GARDNER

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In Sickness and In Health A N N L OW R E Y F O R S T E R

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Freedom

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RINA RAPHAEL

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R O S S D O U T H AT

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DA N I E L H A R R I S

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CALEB MASKELL

JANE ANDERSON GRIZZLE

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Healthy While Sick D O R C A S C H E N G -TOZ U N

Poetry

The Cure of Souls

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N AT H A N I E L P E R RY

SIMEON ZAHL

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Pathos & Pathology

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The Womb and the Tomb

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More Than a Metaphor The In-Between LIZ TICHENOR

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Charmed Are Your Unformed Wishes J E N N Y B R OW N E

S A R A H G AT E S

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Refleshment J O E L KU R Z

D E R R I L L H AG O O D M C DAV I D

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Bethesda DA N L E AC H

LY D I A D U G DA L E

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March

Lists & Columns

Hoping for the Best, Planning for the Worst

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SARAH CONDON

L AU R E N G N AGY

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From the Soapbox

Dear Gracie…

Famous Couples Parted Only By Death M E AG H A N R I TC H E Y

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Under Assualt DAV I D Z A H L

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On Our Bookshelf

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The Confessional

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Twelve Steps for Everyday Sinners Like Me and You CONNOR G.

Sung Kook-Kim, Considerate Signal, 2016. Oil on canvas 76 x 51 in.

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Editor's Note

Beneath the Skin

“I

felt as if I failed myself and society,” one San Francisco resident told their local news station after finally contracting COVID this past year. To the same reporter, a physician confessed that getting “coronated” “felt like a moral failing on some level”; meanwhile even those testing negative expressed embarrassment and anxiety related to the sniffles. All this checks out with a study from 2022 which reported that around 30% of participants felt guilt or shame about contracting the virus, as it indicated they had neglected to take the right preventative measures.

This isn’t a rona-specific quandary. Catching the seasonal flu, RSV, or any number of “things going around” could mean you didn’t wear your mask properly, or you went to a party with the wrong kind of people, or you 8

didn’t drink enough elderberry syrup to safeguard your immune system. You made some miscalculation worthy of your punishment.

Even cancer is, for some, attended by stigma. In her book No Cure for Being Human, church historian Kate Bowler tells story after story about the bizarre advice and off-thewall home remedies she received following her stage-IV diagnosis. Strangers—WebMD experts that they were—believed she was to blame for the tumors in her colon, and that if only she “fought harder,” she would be cured.

As for wellness, the same basic theory prevails. You can be healthy, it is thought, as long as you imbibe the right elixirs and cultivate proper lifestyle practices. Though the specifics of this observation are modern, its general shape is timeless—what theologians call “the law,” wherein literal cleanliness equates to holiness and transgression invites disease. Of course, this isn’t the whole story;

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Physician Lydia Dugdale explains how art can influence the way we live and die, and theologian Simeon Zahl lays out how the Church might offer ordinary people a cure for soul-sickness—and why it often fails to.

The gospels are clear that while Jesus miraculously healed peoples’ bodies beyond their expectations and in spite of their deserving, his foremost concern was their inner maladies, in particular the forgiveness of their sins. In arranging this magazine, we prioritized a similar concern. We reckoned directly with the limitations of the body, while paying close attention to the things submerged beneath what the eye can see.

Under the skin of this issue there pulses a steady understanding that, whether in sickness or in health, our most abiding needs require abiding tonics: unconditional love, mercy, and grace.

—The Editors

even those of us on our best behavior wind up at death’s door eventually.

In this issue of The Mockingbird, our contributors balk at feeling shame for their sickness by writing boldly of their own. Our magazine has often leaned toward the personal essay form, but never more so than with Sickness and Health, a topic that cuts so close to the bone it could never not be, well, personal.

From doctors and patients alike, we’ve collected essays on late-stage cancer, intergenerational illness, vexing autoimmune disorders, miscarriage—and faith that endures it all. In interviews, Ross Douthat recounts his experience of chronic Lyme disease, while Daniel Harris challenges popular notions about disability. We consult journalist Rina Raphael about the multibillion-dollar wellness industry and where its marketing claims lead desperate American consumers astray.

Spot illustrations by Lucy Haslam

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By Bill Gardner

Testimony

In the Elector’s School

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here is nothing remarkable about being a cancer patient: more North Americans get this diagnosis than a college education. I’m sixty-nine-years old and have lost many friends and acquaintances to cancer; I had a day recently when I learned of two such deaths.

…and following came Such a long train of spirits, I should never Have thought, that death had undone so many.

(Dante, Inferno, Canto 3) The City of Cancer is the liminal space between the Republic of the Healthy and the Kingdom of Death. It has a gate on which it is carved, “Through me, you pass into the city of woe” (Canto 3, line 1). That gate is the diagnosis.

On July 2nd, 2020, I started coughing blood. I’d been having throat pain and difficulty swallowing for months. I am a psychologist and a medical school professor in Ottawa, Ontario; my wife is a psychiatrist and professor. We knew what these symptoms could mean. But I could not get a diagnostic assessment because the pandemic blocked face-to-face medical appointments. I called my family physician and described the blood when I coughed. He sent me to the Emergency Department.

I arrived at 3:00 PM, and it was standing room only. At 8:00 PM, I was examined by a young doctor in training to become an emergency physician. He looked in my throat, said medical words that translated to “Uh oh,” and ordered a CT scan. I was scanned a few hours later and sat in the waiting room until 3:00 AM on July 3. I was called to an exam room, and a senior doctor came in. She said directly but quietly, gently, and gracefully, “I have serious news.” I was coughing blood because a tumor had broken through the tissue lining the inside of my throat.

S. Billie Mandle, Untitled No 1 Stellar Skytron Surgical Light. © S. Billie Mandle.

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Getting the diagnosis was the beginning of a difficult journey. In the Journal of the American Medical Association, Samuel Auger wrote: The emotional and physical stress on patients with head and neck cancer through diagnosis, treatment, and surveillance can be immense, and greater than that experienced by other cancer survivors. Rates of suicidality are twice that of other patients with cancer, triple that of the general US population, and increasing.

I am a Christian, but I have always been reluctant to pray for myself, believing that I have received more than I needed or deserved. When I got the serious news, praying did not occur to me.

Modern medicine, when done well, engages patients in making decisions about their care. Meeting with several cancer specialists, my wife and I threw ourselves at the question of what should be done. My tumor was far back in my throat, at the base of my tongue. That location meant surgery was not the first treatment option because it could kill my tongue. Instead, the standard treatment is to burn the tumor with focused radiation and poison it with one or more potent but highly toxic chemotherapeutic drugs. This combination has an 80% 5-year survival rate for cancer like mine. Let’s be clear, though: chemotherapy works by killing cancer cells faster than it kills you. Among the many side effects, there’s a risk of “chemo brain”—significant and persistent cognitive impairment. I agreed to the radiation but declined chemotherapy, which dropped my survival chances to 75%. My decision surprised my doctors.

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Why accept an additional 1 in 20 chances

of dying?

My wife describes me as “relentlessly mission-driven.” That mission is to improve child and adolescent mental health and, to that end, to understand why the healthcare system so often fails to help kids in trouble. I wasn’t always this way. I graduated from college in 1976, blinded by depression and writer’s block. The university gave us our degrees and opened the gate to the world, and I tumbled out face-first. I didn’t just lack direction; I lacked the sense that life had directions.

There wasn’t a moment when that blind young man found direction; there were many.

I took a minimum-wage job as a childcare worker for institutionalized mentally ill children. I woke from a nap in my girlfriend’s apartment and found John’s Gospel on her bookshelf. I read the first chapter and the light did not dawn, but the horizon warmed just a bit. After several years of rank-and-file mental health work, I saw that the Freudian doctors at the hospital were guided by theories, not evidence, and that the kids weren’t getting better. I left therapeutic childcare and went to graduate school to find methods for caring for sick children that worked.

Fast forward to the mid-90s, when I was a professor. It was 2:00 AM in my office in a vast American hospital. There was a blizzard. I was writing a research proposal due the next day to the National Institute of Mental Health, and I set out to look for coffee.

I crossed an aerial bridge connecting two buildings, three stories above the street, a quiet glass tunnel of warmth and light. Ahead of me, orderlies pushed a gurney, transporting an apparently comatose girl to some urgent procedure. Her parents trailed them, en-

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during what looked like the worst night of their lives. I had young children, and the scene terrified me. However, the parents’ grief also testified to how much children’s healthcare can matter. Why, in 2020, did I decline chemo? One reason was that I feared I might be cured but lose the mental acuity to do scientific work in the cause of children’s health.

That’s the flattering way to frame my decision. Calvin said that “man’s nature … is a perpetual factory of idols” (Institutes 1.11.8).

Scientific careers offer many false gods, starting with the worship of (what you imagine to be) your own ability. Tenacity in the pursuit of excellence is likewise a false god. This is true even if you pursue excellence to win your own approval rather than for the acclaim of a crowd. The point is to seek the truth. A career of climbing steep learning curves fired me in a kiln, transforming me from a depressed adolescent into a focused adult. But struggling with difficulty became an addiction. Marriage and children tempered this; love partially displaced struggle at the molten core of life. Nevertheless, I declined chemo to safeguard my abilities, so I could continue the struggle. Getting better at hard things was my only way to live.

Radiation was a hard path. Five days a week, for seven weeks, I lay with my head inside a large machine that targeted high-energy radiation at my tumor. My head was held still by a rigid mask covering my head, neck, and face. I had to master the fear this induced. My head needed to be still so that high-energy

beams could be precisely aimed to intersect at the tumor and burn it out. Unfortunately, these beams must pass through my neck to reach the tumor, damaging the surrounding flesh. The radiation killed most of my saliva glands and taste buds. I couldn’t taste anything, but that didn’t matter because my throat was blistered, and I couldn’t swallow anything. A tube was inserted through my nose and down my throat past the tumor site, and I learned to feed myself by dangling bags of liquid nutrition from an IV pole. Between cancer and the treatment, I lost 40 pounds.

Then it was over, and in a few months my ability to eat and taste mostly returned. The initial scans suggested that we might have killed the tumor.

Until they didn’t. The throat pain came back.

Worrisome CT scans were confirmed by a dire result from a biopsy. Resilient and militant, my tumor was on the march, and we needed a new treatment option. The cancer center scheduled a meeting with the surgeon who had confirmed my initial diagnosis.

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Interview 

Ross Douthat

Stranger Than Otherwise

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ockingbird readers will no doubt recognize Ross Douthat from his byline at the New York Times, where he has served as a regular columnist since 2009. While Douthat was brought on to inject the paper’s editorial page with a dose of thoughtful conservatism, his point of view resists easy categorization, as do his interests.

One week he’s writing about contentious midterm elections, the next, about the concept of spiritual decadence.

A devout Roman Catholic, Douthat often brings his faith to bear in his columns, exemplifying an all-too-rare combination of rigor and gentleness when it comes to religious matters. In fact, listening to him (co-)host the now sadly inactive Times podcast, “The Argument,” constituted a masterclass in how to converse constructively with those who do not share your metaphysics. I consider him to be a model of compelling Christian witness in the public square: generous yet erudite, kindness working in concert with conviction.

Douthat has written several well-regarded books that explore our nation’s socio-political landscape, chief among them Bad Religion: How We Became a Nation of Heretics. Highly recommended, especially for fans of Seculosity. So it came as a surprise when, in 2021, he published The Deep Places: A Memoir of Illness and Discovery. The book details Douthat’s long battle with the enigmatic and controversial illness known as chronic Lyme disease. It’s a harrowing (yet never self-indulgent) account of personal suffering, abounding in faith and tempered by fascinating forays into the fringes of the medical community. I was so grateful for the opportunity to speak with him about what he’s learned from dwelling in the “country of illness.”

— David Zahl, interviewer

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attitude do you need to have? What are reasonable expectations for how it’s going to go?

That said, had I read this book at the outset of my illness—with its stories of spending years and years and years trying to get better—it also would have been terrifying and depressing. So that cuts both ways. I hope the advice is helpful, the map of the territory is helpful, but the reality is that a lot of people can spend a very long time trying different things to get better before they figure out what, if anything, works.

And that’s not what anyone at the outset of an illness necessarily wants to hear. It certainly isn’t what I wanted to hear.

Writing a book like this is an act of bravery, even if it was not intended as such. I imagine you received not only a lot of unsolicited suggestions and diagnoses but also sympathy—maybe touching, maybe oppressive.

What has it been like to write a memoir for the first time?

Ross Douthat The book is a little more ambiguous than I intended it to be, about just how much better I have gotten. And I’ve continued to get somewhat better since completing it. But after its release, I did get a wave of advice. I had readers who said, “Oh, you know, if you’re still completely in the woods, you should try this obscure shaman living in a cabin sixty miles northwest of Buffalo.” I’m exaggerating for effect, but there was some of that.

Mostly the reaction you get to a book like this is people asking for help, and that was a novelty for me, as a newspaper columnist.

Unless you’re a foreign affairs columnist like Nick Kristof, my colleague who parachutes into dire war-torn areas, newspaper columnists are very bad at giving advice. Generally, we give advice to politicians, and it always goes terribly. So you must be in truly dire shape to ask someone like me for advice!

When I set out to write the book, among other things, I was aspiring to write the kind of book that I wish I could have read myself at the outset, something that was not just a personal story but a guide to the territory— to tell you not just where this disease came from, and why it’s controversial, but also to show the range of things that people try in order to get better. And what fundamental

M One of the metaphors that you explore in the book is this idea of the human body as a machine—of persons as technology—which, from a Christian point of view, is troublesome.

But then you shift to saying you think of it as a landscape—that you’re providing a map of the territory, of both the experience and the body.

Can you talk about those different images and the language we use for the body?

RD In some ways, bodies are machines, right?

They have mechanistic features: the heart pumps blood, the stomach digests food. But for the organisms that live inside your body, it is a landscape—a terrain in which they can find places to live happily and healthily.

Illness is organisms trying to find a nice place to reproduce themselves within the landscape of your body. Their homes need to be safe from your immune system, sort of hidden away. Your immune system can be disarmed or turned off or just defeated by them.

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And so, as that last line suggests, there’s a connection between the idea of the body as terrain and territory, and the other metaphor I play with, which is treatment as a kind of military campaign. As I say in the book, I’m sort of playing off Susan Sontag’s famous Illness as Metaphor, which was written as a critique of the war metaphor in disease treatment. She was writing during the Vietnam era when it was very common to hear the idea of “you must destroy the village in order to save it,” and you have to carpet bomb and defoliate the trees in order to defeat the Viet Cong. It was very easy to see how all those things could, when applied to medicine, lead people astray. When the only thing that matters is killing disease, it doesn’t matter how much damage you do to your body along the way.

At the same time, I do think that metaphor has its uses, and is in some way inescapable when you’re trying to treat an illness. You can’t really escape the idea that your body is a territory being held by forces—blind, unthinking forces but forces all the same— and that you need to find a way to liberate yourself through drugs, through changes to your immune system, through whatever means. But that means, it is a kind of campaign against the invader.

M I appreciated the way you talked about illness as sort of like demon possession. What are the ways in which it is like possession and the ways it is not? When you’re in Mass, how do you hear the demonology of the New Testament? Do you hear it differently now?

RD A little. I’m hesitant to go too far into this, because I don’t really dabble in demonology, 74

but I’m somewhat familiar with the literature of possession. The experience of chronic illness is not the experience of a malevolent, intelligent, demon setting up shop inside your body or your consciousness. But it can feel like the disease has some kind of intelligence, right?

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So in some ways, it could seem analogous to accounts of supernatural possession.

While also, most of the time, remaining I think quite distinct. But certainly, there is this sense that something is inside you that is not supposed to be there. From the beTabitha Soren, The Road to Calvary from the series Relief, 2020. Archival pigment print with acrylic, 21 x

ginning that’s one of the dominant feelings I always had: that something that was inside my flesh was not naturally at home there.

I was fortunate in that in my illness I didn’t have strong psychiatric manifestations, as some people do. I felt depressed at times, 75

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THE MERCY ISSUE