God the physician
The face of God as physician is a profoundly biblical reality; I would like to begin with a review of the theme, investigating the degree to which it is a constant through the Bible.
In church history, the view of God as physician was an approach adhered to particularly by the Greek Fathers. The Latin Fathers, little by little, left it aside, and the result is that today it is being increasingly forgotten; instead, the image of God as judge was emphasized, at times to the point of distortion. This western tradition is so strong that today, despite its importance, we need to take great pains if we are to recover the biblical revelation of God the physician in its true proportions.
I will therefore rest my case on biblical texts, but if I also mention the Greek Fathers, it is in simple thankfulness since it is they who have helped open my eyes to this aspect of revelation.
Indebted as I am to the Greek Fathers, I am also to Jean-Claude Larchet; he became their spokesman in an enormous book which is also very present in what I will be saying; however, so as not to overburden my remarks, I will not actually be citing it. Where Larchet is almost essentially patristic in his approach, I wish to stay close to the biblical testimony which forms the basis and the support for the Fathers’ elaborations.
One of the major difficulties we will encounter stems from the fact that in the western world the discourse of psychology has prevailed over the spiritual. Words which are common to the two methodologies have come to be somewhat booby-trapped; they don’t have the same resonances, and this leads to misunderstandings. I will be using them according to their spiritual acceptation, whereas they all too easily understood according to the psychological; thus, there is ambiguity today if we speak of maladies or sicknesses of the interior life. My intention is to keep to a discussion of spiritual maladies, knowing full well that doubtless others may immediately think in terms of psychological illness; this is to be avoided. Spiritual maladies are those such as pride, avarice, or lust; not schizophrenia, neurosis or psychosis. Please be careful! There is a wide range of potential misunderstandings.
Our interior life can be understood along two separate lines, the psychological and the spiritual; complicating matters further is that God does not occupy at all a similar role in the two methodologies. In modern psychological discourse God may be taken into account, but is then generally regarded as just one of the possible factors in traumas. In the spiritual discourse, God is ever present; it is he who fills the role of therapist, and, indeed, is seen as the only therapist, encounter with whom is far from traumatizing! In short, we see that to approach God as the physician for our spiritual life goes rather against our normal mindset; we will press forward nonetheless!
May our proceedings be truly spiritual,
which is to say born of and illuminated by the Holy Spirit, without whom we cannot
but become enmeshed in misunderstandings! May he guide us now in our quest for
God the physician!
 Jean-Claude Larchet Therapeutique des maladies spirituelles, Le Cerf, Paris, 1997.
Jesus heals sins
Jesus takes account of the connection between sin and spiritual sickness, but in such a way that he corrects the way sin is regarded. Effectively, the link between sin and spiritual sickness means that Jesus looks at sin less in its penal aspect and more as something to be cured. He does not judge the sinner; on the contrary he labors to treat and heal him.
When the Evangelists cite Isaiah 6:10, it is very interesting to note that the people who are sick with sin are converted so as to be “forgiven” according to Mark 4:12, or to be “healed” according to Matthew 13:15 (see also John 12:40; Acts 28:27). Mark here keeps sin in the penal sphere whereas Matthew, Luke and John place it in the medical. This hesitation of the Evangelists about the verse from Isaiah show that sin pertains thoroughly and simultaneously to both the penal and the medical. However, all things considered, Jesus himself seems to have considered sin more from the medical angle than the juridical; it is rather as from the mouth of a healer that we should understand the statement that “I am not come to judge but to heal.”
This outlook of Jesus on sin modifies our outlook on sin. Before a judge, I hide my ills, my sin; before a physician I expose it. So, according to the way Jesus invites me to look at my sinI will either hide from God or open up to him . . . What a turning point in the spiritual life with the discovery that Jesus presents himself, above all, as a physician!
God heals sins
To think of sin in its remedial dimension is not an invention of Jesus. The Old Testament very often envisaged sin from this angle. For example, when there is a question of the infidelity of the people of Israel, in a context which threatens condemnation, God suddenly changes his tone and speaks in this way to the people, “Return and I will heal your unfaithfulness” (Jer 3:22). God does not speak of “pardoning” the unfaithfulness but of healing it. God presents himself not as a judge who is merciful, but as the physician to the people’s sins, the healer of the spiritual malady of unfaithfulness.
Earlier, before Jeremiah, God had said the same thing in the mouth of the prophet Hosea, “I will heal their apostasy” (14:4).
We said with regard to Jesus that a name reveals the identity of a person, the mystery of their being. What of Cain? It is an interesting name.
First of all, it was given Cain by his mother, who explains the choice making a play on words with the verb qânâh, which means “acquire” or “procreate.” “I have formed a man with the Lord,” as our translation says. Eve affirms here that God is a father to Cain, and indeed God behaves as a thoroughly admirable father throughout this passage. The spiritual father is certainly more of a physician to the soul than he is a judge. It is with both the love of a father and the abilities of a physician that God sits down at the bedside of his sick son.
But also, the name Cain makes a play with the verb qana, which means “to be jealous, full of zeal, ardent,”and this makes Cain the prototype of the passionate and fervent; for this reason, when the Fathers comment that anger is a sickness of the passions, it means that Cain is engaged, assailed in the depths of his being, at the core of his identity.
For the Fathers, the soul comprehends three functions: passion, desire and reason. Passion, like the other functions of the soul, is positive, created by God. Man is in the image of God and this with regard to passion as well. God himself is passionate, zealous, jealous, except that he does not become sick in his passions in the way men do.
In his passion, in his jealous zeal, God turns against everything that can assail man, his covenant partner. In the same way, man’s passion turns against everything that might assail his covenant relation with God. This passion which protects the covenant relation with God is a passion of great good, but man’s passion can easily be led astray and become sick. This is the case when it mistakes its goal and seeks to protect other bonds, other attachments. Passion falls ill when it throws away its concern for the divine connection in favor of alternatives. Anger is surely a spiritual malady since it affects relationship both with God and one’s neighbor.
Cain, passionate, full of zeal and
jealous, in the image of his spiritual father, here becomes sick in the depths
of his being.
 KJV perhaps tries to recreate this – “I have gotten a man from the Lord.” (Trans.)
Why are you angry and why is your face fallen?
In fact, God asks not just one question but two. Perhaps he even left a pause between them, expecting a reply. Cain responds to neither.
Would a judge ask such questions? Certainly not! A judge asks about actions, and Cain has done nothing. It is not even he who has intended his anger, but anger which has taken hold of him. “Why has this inflamed you so?” asks God. The truth is that Cain here is more a victim of anger than the guilty party. We know that Cain will later turn murderer, but at a present he has not raised so much as his little finger. No, a judge has no reason to step in here.
It is rather the physician who sits down at Cain’s bedside to ask his patient about the changes in his appearance: “why this reddening of the nose and why this downcast look on your face?”
God thus begins his consultation, asking questions about the symptoms he notes so as to reach a diagnosis with a view to prescribing an appropriate treatment.
When God asks questions like this, it is not that he doesn’t know the answers. God, in fact, sounds out the kidneys and the heart and so understands the symptoms in the nose or the face without having to ask questions! When he asks, the objective is more that Cain will ask too, ask himself the questions, “Why am I angry and why are my features downcast?” The spiritual father is a good teacher!
God does not ask about the strength of the anger (“Why are you very angry?”), but the reason which has given birth to the anger; “for what reason are you angry?” We see that God is guiding Cain to look within himself, to take a good look at his behavior and the hidden motivations behind his state of mind. God is helping Cain realize what has provoked his anger; he reveals to Cain that anger comes in reaction to something that provokes it. This truly is a spiritual father helping his son to discern things; the questions are positive, friendly and salutary.
All this is most just; anger is provoked by some fact, but we don’t always know what; or alternatively, we don’t want to know. Meanwhile, to discern the cause of the anger, to look it in the face, is to already be on the road to healing. God is seeking with these questions to set Cain in this direction.
What then is the fact that has provoked Cain’s anger? This is told us just previously in the passage; it is the fact that God has accepted Abel’s offering but not Cain’s.
We might think that it is Abel who has provoked Cain’s anger by making an offering at the same time. Cain had indeed taken an initiative which Abel immediately followed, but, if that were the reason for Cain’s anger, he would have become angry earlier. His anger would have been signaled immediately after the mention of Abel’s offering, even before God responds to the two offerings.
No, it is not Abel but God himself who has aroused Cain’s anger!
God knows why he accepted one offering rather than the other, but Cain knows nothing. God does not explain himself, but here he asks Cain in order to find out how he felt about and understood this choice. “Why are you angry?” also means “How has your understanding of my attitude produced such a state?”
Cain, however, has no desire to reply! This silence is embarrassing. Faced with Cain’s silence, the Fathers have sought the answer to God’s question, and we shall try as well.
I don’t believe that Cain’s anger proceeds from the fact that God prefers mutton to fruit or even shepherds to growers. Rather, I believe God chose the second offering rather than the first because it is that of the younger brother not the elder. It is Cain alone who took the initiative in making the offering, an excellent initiative which speaks of Cain’s love for God. God has not required any offering so Cain’s is freely given; it is the gesture of a freely-given love. Abel has done nothing but copy! The initiative belongs to Cain, to the elder. God should have honored this initiative, honored the right of the elder brother, honored this act of love.
Cain was attached to his initiative, to his act of love, to his rights as the elder. I would say right here that passion becomes anger when it protects something to which it is more attached than God or a neighbor. So, Cain is attached to the fact that he is the older brother and the initiative he has taken. When God doesn’t honor this, he undermines this attachment of Cain’s; he undermines Cain’s self-love. God’s choice has wounded Cain in his self-love and the anger betrays this wound. This is very common; anger bespeaks a wound to self-love.
This is something anger can signify, what it might translate into, but it doesn’t state or formulate it. Now it is Cain’s place to do just this, to find a way to put it into words before God. But he is silent!
Why should we seek to reply in Cain’s place? It’s because through this text God is searching us out too, about our anger. “Daniel, why are you angry?” Faced with a question like this, I am going to have to learn how to answer. This is why the Fathers sought to see clearly what it is that provokes anger. When a physician questions, it is good to know how to respond; it is part of the healing.
By digging into the reasons for anger, the Fathers perceived that wounding of self-love can bring to light various spiritual maladies.
Cain might have been attached to his rights as the older brother in the same way one can be attached to some item as a piece of personal property; in this case his attachment would be a form of the spiritual malady known as avarice; avaricious of his right to seniority.
Cain might have found in his seniority a reason for pride, another spiritual malady; a Cain attached to his rank would be wounded in his pride.
He might also have been frustrated not to have been honored by God as he expected. In this case he would be attached to others’ opinion of himself, which is another form of spiritual malady, vain glory.
As we see, the same anger might be the expression of pride, avarice or vain glory, as well as other latent ills, buried but revealed by the anger which is their symptom. We also note that it is easy enough to discern the anger, but that to discern the malady behind the anger is more difficult.
When we come down to it, the question posed by God is essential, welcome and even salutary; it is an invitation to discern the deep-seated ill hidden behind the anger. God asks the question precisely because there are a variety of possible answers. He is thus an excellent spiritual father, an excellent doctor to the soul — two facts joined at the hip.
It is now for Cain to say whether he finds himself to be proud, avaricious, attached to vain glory, jealous or something else . . . But his reply is awaited!
The account is wonderful, leading us to the discovery of a multitude of points noted by the Fathers. In particular this: one spiritual malady often hides another; it is its symptom, because it comes wrapped in it, as if it were its daughter. What we have noted about anger is of value when it comes to other spiritual maladies in that each can be a symptom of another. In such a case, the spiritual malady should no longer be treated as though it were the sickness itself, but as a symptom of something more profound, something it manifests and which should be the real object of treatment. Just as there are connections between spiritual maladies and physical maladies, so there are connections between different spiritual maladies.
By taking a contrary position we can see how anger could be the symptom of another, more hidden malady.
If Cain was not proprietorial, avaricious of his position as the elder, he would not have become angry, but would rather rejoice to see himself dispossessed of his asset in favor of his younger brother.
If Cain was humble, he would marvel to see God exalting the lesser.
If Cain was not attached to vain glory, he would rejoice to see the honor God has done to Abel.
All this clearly shows, it seems to me, that behind Cain’s anger another spiritual malady is hiding.
If then a malady can be symptomatic of another malady more deeply buried, the Fathers would apply themselves to the treatment of the hidden malady rather than the symptom. One can well understand that in the healing of the buried malady, the symptom will go, whereas healing of the symptom will not cause the deeper sickness to leave. In short, to heal anger, it is the hidden malady which must be treated.
Further though, since the maladies hidden behind the anger vary with each case, we understand why the Fathers propose different remedies for different cases of anger. For example, anger could be treated by fasting if the anger comes from an excessive attachment to food (“greed”). It could be treated by charitable giving if the anger proceeds from avarice, etc. All this is correct; avarice healed does not become angry when its money is touched; the healed gourmand does not become angry when wronged with regard to food. This would also suggest that it is not easy to treat oneself; there must be discernment of what lies buried within.
Without the help of a physician of the soul, who are we to discern what is hidden? In general, it is only after many fits of anger that we can work out in ourselves what the source is; it is usually for the same reason that we become angry, not for other reasons, so, when the same situation repeats itself, we do eventually learn. With the access of anger, we note the source; I leave you to examine yourself. But here, what about poor Cain?! This is his very first crisis of anger! Happily for him, it is God himself who questions him in order to help. If Cain’s responses to the physician are not clear, this itself will push him to be more precise, to the point where he can see the source of his anger.
But he doesn’t reply!
Cain’s silence is understandable; the one who is questioning him is the very cause of his anger. The physician is himself responsible for the crisis he wishes to treat. It is he who has made the patient sick! The consultation has reached an impasse.
This is what so often happens; we wish to be treated by God, but it’s God’s fault that we are sick, or so at least we think . . .
Nevertheless God draws near. God takes the first step; he could do no more. In effect, he comes to reconcile things and with his question he holds out the olive branch to Cain, for him to vent his spleen, his bile, his anger on God. God knows that Cain is angry with him, and he comes to reconcile. This is the best remedy that God can offer Cain for his healing. “Why are you angry?” God awaits an answer something like, “It’s your fault! You shouldn’t have looked down on my offering . . .”
However, Cain does not answer! The drama of anger is that it sometimes refuses reconciliation; the anger then closes over once more on the wrong done it, and becomes resentful in its silence.
God’s attitude in this process of reconciliation is very important for us. God humbly takes the first step towards us and offers us his hand. The response he awaits is prayer. Prayer is a remedy for anger. To pour out one’s anger before God is a wonderful remedy, even if it is anger directed at God. The physician is quite used to being attacked by the patient; he is used to the pus when he lances an abscess. Even if Cain feels the need to curse, God is ready to listen to the cursings of his prayer if this will be liberating for him. He doesn’t come to judge but to heal.
Prayer comes from a heart that is opening; this opening up is essential in any therapeutic process, and this is what God is awaiting, looking for, and what he wishes to provoke with his questions: the opening up our heart before him.
If it is difficult for us to discern the reason for our sicknesses, here too, in prayer, we can ask God for insight. To tell God that we lack discernment is also prayer; it is once more to open our heart to him.
When Cain begins to open his heart to God, he will have taken the first step along the road to healing. Instead, Cain obstinately refuses to go down that road.
Faced with this silence, there is no
capitulation from God. He perseveres in his approach, as do the best of
spiritual fathers, the best doctors of the soul. He doesn’t leave Cain to
enclose himself in silence.
 See Psalm 26.2. (Trans.)
Christ, the vanquisher of the passions
The Fathers noted that the three principal passions are exactly the same as those that Jesus overcame in the wilderness during the temptation. Even Jesus has therefore been exposed like us to the seductiveness of the passions, though he kept himself from them. Jesus was exposed to greed when it was suggested he turn the stones into bread (Luke 4:3–4); to avarice, when the tempter proposed the kingdoms of the world as goods to be possessed (Luke 4:5–8); and to vainglory when it was suggested he throw himself down from the Temple pinnacle, thereby bringing him glory in the eyes of the crowd (Luke 4:9–12). Jesus, however, was able to reject each suggestion, each seduction, thanks to his perfect attachment to God; he mastered the beast, and so kept himself from any malady. By overcoming the three principal passions, Jesus also vanquished each passion that derives from them. He alone is the true overcomer, the one in perfect health, and in our baptism we become beneficiaries of his triumphs. Each of our victories over the passions is none other than a participation in the victory of Christ who fights besides us, with us, in us, by his Spirit. This is what it means to be a beneficiary of Christ’s victories, and without him we are already, subtly, sick with pride. In Christ, with him in us, we can have good spiritual health.
The most important of all
As they examined the three major
passions, the Fathers concluded, in the light of the Bible, that avarice is the
most important of the three. They reached this conclusion on the basis of the
verse of Paul’s that says, “The root of
is the love of money” (1 Tim 6:10). This verse helps us understand this
saying of Jesus: “No one can serve two
masters; either he will hate one and love the other or else be attached to this
and despise that. You cannot serve God and Mammon (which is to say, money)”
(Matt 6:24). In speaking like this, Jesus presents us with the primordial
choice; to prefer God over Mammon is to resist all the maladies.
 “All evils” or “all kinds of evil,” according to the Greek.
The remedies are very various, firstly because the maladies are so numerous, but also because, for the same malady, the remedies vary as a function of how advanced it is; and again, because each malady is linked to the others in multiple combinations. The anger of a greedy person is not the anger of the avaricious or proud person . . . Each sort of anger has its own remedy, so again there is the question of discernment.
That said, there are some remedies that it is good to know as being of value for a great number of maladies. For example, all the maladies that affect the desire have temperance as a remedy; all those affecting the passion will be remediated by courage; and those which affect the reason are treated with prudence.
Among the remedies which treat a range of maladies, there are two which are valuable in all cases, and we have already mentioned these; they are love and humility. With these two remedies everything can be healed, though we must not forget that love itself can be diseased should we at any time propose to do without God. When it comes to humility, it has the peculiarity of needing an infinity of time and care if we are to know how, not to acquire, but to welcome it, since it is a gift. Humility is a little like a transplant, and not any transplant — it is a new heart! For this remedy, there is nothing you can do of yourself except put yourself entirely in the hands of him who says he is lowly of heart and who calls out to us, “Come to me, all you who are weary . . . because I am meek and lowly of heart”(Matt 11:28–29).
All the remedies are given by God, who gives to those who ask, and at times even to those who don’t, great as his love is. Ask all the same, Jesus counsels, but ask simply, without repetition, “because your Father knows what you need before ever you ask” (Matt 6:8).
God gives and also personally regulates the dosage according to each one’s needs. To take a remedy in excess is also a malady! “Your Father knows what you have need of,” also means that he knows the correct dose.
The whole of the Torah is a veritable pharmacy where an impressive array of remedies is to be found. Each article of the Law can perform the office of a cure. We said a little about that in the first chapter so we won’t go back there; instead I would like to point out the way this is present in the Sermon on the Mount. The sermon is often received as though it were a new legal code, thereby forgetting its therapeutic dimension. A few remarks on this subject . . .
The Sermon on the Mount is found in Matthew’s gospel at an extremely significant point, right at the outset of Jesus’ ministry; exactly in fact at the moment when he is about to acquire extraordinary fame as a healer. The end of chapter 4 of Matthew insists on this point (4:23–25); next, immediately after the sermon, chapter 8 describes in detail an imposing sequence of healings: that of a leper (8:1–4), the centurion’s servant (8:5–13), Peter’s mother-in-law, and then, so as not to tire the reader, Matthew gives us a sort of et cetera, saying that “he healed all the sick.” Have you ever seen a doctor who “healed all the sick”?
This is the context in which we find the Sermon on the Mount and so we are invited to understand it as issuing from the mouth of a healer. It was a physician the crowds followed up to the mountain; it is to him they entrusted their sick, and to him that they listened.
I will leave you to read over the sermon yourself; you will see that it contains a wealth of advice of a healing nature which will help both in diagnosis and as a prescription with its expert recommendations. To what is your brother’s sin compared? To a speck of dust in the eye. This is the language of the hospital not the tribunal. As for the beam, this is hyperbole to say that emergency services and intensive care are required! There is one remedy, both curative and preventative: “Don’t judge!” (Matt 7:1)
As a good healer, Jesus knows exactly what remedy suits each case. We might note the account of the rich young man. He is sick, a troubled person who knows himself to be sick, but doesn’t know what his trouble is. He had tried all the remedies of the Torah but without success, which is why he says to Jesus, “What must I do to have real life?” In reply, Jesus first of all checks that the man has been following the prescriptions of the Law, then he gives the only medication suitable for the problem he discerns. The man’s sickness is avarice; the medication is a sort of emetic; “Go, sell all that you have, give it to the poor, and then come and follow me” (Matt 19:21). If these words of Jesus were somehow a law, they would apply to everyone, but Jesus did not say this to all his disciples, only to those in whom he discerned avarice. This is a medication given with love, as Mark notes (“looking on him, he loved him” 10:21); and a medication which works with the violence of love. However, the young man was unable to discern the love; all he saw was the violence of the purgative. He went away “very sad,”Matthew concludes (19:22). Avarice went to seek its neighbor, sadness, to take up residence in the man’s home.
God also provides us
with medicine through the events of life. We spoke above of the things that can
help us discern, but we must realize too, that events can also at times work as
remedies. It’s precious to remember this when it comes to events that are
painful and full of sorrow for us. They sting like alcohol on a wound; they are
painful, but after a while, short or long, we can see the way events produced a
healing effect. For the avaricious person, every loss of money is experienced
as a catastrophe, when really there is matter in it to bring healing.
 As above, ardeur, the inner fire, the motivational force.