What is Needed, Right Now, for the Journey?

Walking together in illness and health

by Warren Kinghorn

“What if the meds stop working? What if the depression comes back? I can’t go back there.”

John’s voice trembled. An educated professional, he had just begun to emerge from a black hole of major depression. Hospitalized twice in recent months, he felt that several years of his life—precious years that involved parenting small children—had been irretrievably lost. Electroconvulsive therapy (ECT), talk therapy, and several psychiatric medications seemed to be helping. But his anxiety was palpable.

I felt his anxiety settling onto me and tried not to refuse it. “I can’t promise that you won’t ever be depressed again, or that we won’t need to alter your current treatment,” I told him. “But I can promise that no matter what, I’ll walk with you.” And with that, we agreed to take one week and month at a time.

Walking together is the guiding metaphor for my work as a psychiatrist, and it is also central to my life as a Christian. Images of journey and pilgrimage permeate Scripture, from the psalmist’s assurance that “blessed are those … whose hearts are set on pilgrimage” (Psalm 84:5 niv) to Paul’s encouragement to the Philippians that “I press on toward the goal to win the prize for which God has called me heavenward in Christ Jesus” (Philippians 3:14 niv). In later Christian theology, St. Thomas Aquinas (1225–1274) frequently describes humans as viatores, wayfarers journeying from the God who created us toward the same God who is the goal of our lives and the fulfillment of our longings. All of us—patients, clinicians, clergy, and everyone else—are wayfarers.

“What is needed, right now, for the journey?” It is good for us to ask when we are struggling and wondering how to invite health care professionals to walk with us.

If we are wayfarers who walk together, then when health challenges in ourselves or in others arise, the right question to ask is always, “What is needed, right now, for the journey?” Sometimes what we need is a standard medical treatment, like medication or surgery. But not always. Maybe what we need is a job, or a meal, or a stable place to live. Maybe what we need is safety from an abusive partner or spouse. Maybe what we need is prayer. Maybe what we need is a community of accountability and belonging. Maybe, as with John, it is some combination of these. But the goal of any of these interventions is not to generate clinical revenue, nor to satisfy consumer preference, nor to adhere to practice guidelines, nor to indefinitely postpone death, nor even to reduce symptoms. The goal is to attend to the needs of wayfarers as we travel together from God to God.

The question, “What is needed, right now, for the journey?” is good for clinicians, pastors, and others to ask when we seek to help someone who is struggling. But it is also good for us to ask when we are struggling and wondering how to invite health care professionals to walk with us. When we understand ourselves as wayfarers on a journey from God to God, we are reminded to prioritize three things.

First, we must keep the goal and meaning of our lives in view. The urgency of illness, particularly serious or life-threatening illness, often leads us to develop constricted and short-term vision. As we are swept into the machinery of modern health care systems, we are encouraged to focus on this test, which generates this additional referral to a specialist, leading to this treatment decision, and on and on. Before long, we can become so focused on immediate problems that we lose sight of the broader and larger truths that we are claimed by God in covenant and called to follow Jesus as his disciples. When faced with any medical question, we might ask, “How will this affect my ability to be a disciple of Jesus?”

Second, we must remember that we are wayfarers, not broken machines. In a technological age, we sometimes think of our bodies as machines that need fixing or repairing, and of health as something that is produced or “provided.” But machines cannot be wayfarers or disciples. They cannot love. They cannot even “heal.” We must always remember that we are not machines but embodied souls on our way to God. We need to be nurtured and cultivated and sometimes disciplined, but not to be fixed.

Third, we must not walk alone. In 1 Corinthians 12, Paul chastises the early believers for presuming that they could get by without one another. “Just as the body is one and has many members,” he said, “so it is with Christ … If one member suffers, all suffer together with it; if one member is honored, all rejoice together with it” (1 Corinthians 12:12, 26). This life is too hard, and the way too steep and dangerous, for any of us to walk alone. We need fellow travelers for the journey.

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