March 26, 2025

The Limits of Medical Diagnosis

From time to time, I’m reminded of a fascinating article I once read in The Free Press about a subculture whose members call themselves “spoonies.” By and large, self-proclaimed spoonies are teen girls or younger women afflicted with a chronic illness that doctors can’t quite figure out, often because it defies easy classification as something purely physical or something that bleeds over into the realms of psychology and mental health.

The spoonies—their name comes from a sympathetic blogger who pictured chronic illness as having fewer “spoons” for scooping up the energy needed to navigate daily life—want to get well. Why else would they continually seek out new specialists, new opinions, new forms of treatment? But some seem to wrap their identities around persistent sickness, often to an unsettling degree. Without chronicling their symptoms or relating tales of medical-establishment indifference on social media, some might suffer an acute crisis of meaning.

I thought of the spoonies’ dilemma while reading Bonnie Kristian’s CT review of The Age of Diagnosis: How Our Obsession with Medical Labels Is Making Us Sicker. The author, Irish neurologist Suzanne O’Sullivan, addresses readers who fit a similar profile. Their suffering is real, albeit mysterious. But they might be ill served—and tempted toward an unhealthy fatalism—by a habit of boxing that suffering into an exclusively medical paradigm.

Kristian closes her review by connecting O’Sullivan’s insights to the work of pastors, who confront plenty of suffering—physical and otherwise—in their midst.

“Again and again in the patient stories she shares, O’Sullivan raises the matter of how to care for people as they experience the ordinary hardships of human life,” she writes. “Overmedicalization has expanded disease definitions, she argues, ‘so that over time, people who would once have been considered healthy are drawn into the disease group.’

“That may seem well outside the pastor’s purview, and no doubt it is where some diseases are concerned. Seminary doesn’t give you any special expertise in discerning signs of cancer or determining what blood sugar levels qualify as prediabetic.

“But with other conditions, particularly those affecting behavior and mental state, O’Sullivan’s insights hold vast relevance to pastoral ministry and the larger work of the church. In fact, I would recommend this book to any pastor in the United States, and particularly pastors of churches with large populations of children and young adults. The Age of Diagnosis can equip pastors for tasks of both exhortation and encouragement.

“Pastors are not doctors, of course, and they should have all due humility about physical and mental health care. But they should hesitate to bench themselves when they encounter physical, mental, and emotional distress. In some cases, what’s intended as deference to medical expertise may actually be abdication of pastoral responsibility toward suffering with some spiritual component.”

Alexei Navalny’s Faith-Fueled Courage

Late last year, a posthumous memoir from Alexei Navalny appeared in print, only eight months after the determined opponent of Vladimir Putin had succumbed to reported malnutrition and mistreatment in a Siberian prison. Published, to great fanfare, under the title Patriot, the book has inspired many reviewers to hail Navalny’s courage in the face of political persecution.

Yet as CT news editor Daniel Silliman observes in his own review, that courage can’t be entirely decoupled from the Christian faith that the activist embraced toward the end of his life. Having tasted the hope of resurrection, Navalny no longer worried about getting on the wrong side of authorities who wouldn’t shrink from putting him to death.

The “final part of Patriot,” writes Silliman, “is Navalny’s prison diary, an account of the minutia of incarceration that feels like an update to the Soviet-dissident classic One Day in the Life of Ivan Denisovich. Navalny describes the maddening bureaucracy of prison, the endless transportation between different cells, the sense of passing time, the sense of losing time, emerging friendships with fellow inmates, and the constant companion of hunger.

“In the process, he discovers his faith. The political activist writes about faith not in terms of arguments but more as, to borrow a description from one of Augustine’s sermons, ‘a great jar in which you can receive a great gift.’

“Navalny learned prayers as a child, spending summers with his Ukrainian grandmother, who also had him secretly baptized. When he had a daughter of his own, he realized he wasn’t an atheist. At some point he started to cross himself whenever he passed a church, a practice his friends and fellow activists regarded as wildly old-fashioned, superstitious, and gauche.

“He didn’t disagree. In fact, he saw something about the gaucheness of religion—the uncoolness of Christian life—that attested to its truth.

“In one scene in the memoir, Navalny recalls how an older prisoner who never really spoke to him gave him a prayer card with an angel on it. This was not a beautiful icon but kitsch. The prayer was written in a pseudo-Slavonic script, and Navalny jokes that ‘there seems to be a consensus that angels and archangels alight more readily’ when there’s an old-timey font.

“He received the card, however, as a sign. There was something about the incongruity, the aesthetic poverty, the complete uselessness of this item that in fact made it powerful. Navalny, by faith, rejected the valuation of authoritarianism.”

Matt Reynolds

Senior Editor, Books

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Even amid scandals, cultural shifts, and declining institutional trust, we at Christianity Today recognize the beauty of Christ’s church. In this issue, you’ll read of the various biblical metaphors for the church, and of the faithfulness of Japanese pastors. You’ll hear how one British podcaster is rethinking apologetics, and Collin Hansen’s hope for evangelical institutions two years after Tim Keller’s death. You’ll be reminded of the power of the Resurrection, and how the church is both more fragile and much stronger than we think from editor in chief Russell Moore. This Lent and Easter season, may you take great courage in Jesus’ words in Matthew 16:18—“I will build my church, and the gates of Hades will not overcome it.”

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