Last Sunday, hundreds of American churches closed their doors to congregants, many of whom watched via livestream. It may be like this for weeks. That same day, the Centers for Disease Control and Prevention urged Americans not to congregate in groups larger than 50.
These types of restrictions will have significant repercussions for many churches, where groups of 50 or larger gather on a weekly basis, especially with Easter just weeks away. As church leaders and pastors wrestle with these restrictions as well as navigating weddings and funerals, there’s a larger question we wanted to explore: What type of opportunity does a pandemic like this allow Christians to be remembered for?
A strong empathy for the suffering of other people characterized much of the church’s response to sickness during the Roman Empire, says Gary Ferngren, a history professor at Oregon State University who studies the social history of ancient medicine, religion, and ancient medicine.
“The compassionate model in health care is, I think, the very distinctive contribution that Christians have made,” said Ferngren.
Ferngren joined digital media producer Morgan Lee and president and CEO Tim Dalrymple to discuss the state of health care in the Roman era, why the Christian response to the plague of Cyprian stood out, and how Christians came together to open hospitals.
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The transcript is edited by Bunmi Ishola
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Highlights from Quick to Listen: Episode #204
We're going to be talking about the third-century plague, but let’s start with the first century and what we see in the Book of Acts or any of the other apostles’ writing. To what extent do we get a sense of the Church engaging in a countercultural approach to the way the sick people are usually treated?
Gary Ferngren: The countercultural approach comes over time, and you find it in the beginning in the gospels and a bit in the Book of Acts, but more so as it's developed in the epistles in the New Testament, which were intended by Paul and John and James and other writers to provide the normative teaching to the church—that is how the church ought to act in a variety of circumstances.
Acts as a historical book, it describes the period of what we would call the post-apostolic age, which comes after Christ’s resurrection and ascension. You don't find a lot of reference to healing in the Book of Acts. You find that in that post-apostolic period, there was both miraculous healing and sometimes no healing at all. There's no single pattern in the New Testament for how a Christian should expect to face illness, other than the fact that they should act as servants of Jesus Christ, that they should love and show spiritual and even
We see within the gospels stories of Jesus addressing physical ailments of different kinds. To what extent were those counter-cultural?
Gary Ferngren: Jesus was always moved by human sympathy, and we see that on a number of cases when he even heals somewhat reluctantly. You see cases such as the parable of the Good Samaritan, where the religious leaders of the Jewish community did not act with sympathy.
I think that's the number one point, and one that we could take away from Jesus’ healing ministry. Everywhere he went, he was asked to heal, and he often did so—by very long days and into the night—healing large crowds. But it was sympathy with him and always pointing to their father and always indicating that suffering was a means by which God could often act to teach them things.
Could you give us a sense of what the Roman approach to healthcare was, starting in the first century and up to the third-century plague?
Gary Ferngren: There was a multi-layered approach. There were doctors, and they were relatively common trained in what we would call Greek theoretical medicine. And there were not just doctors who healed, but there were a whole variety of other healers. There were people who healed through magic, through exorcism, so one can't say there was a single pattern of healing.
The person you went to often depended on the kind of community in which you lived, depended on your financial resources. Those who could afford it often went to doctors. Those who couldn't, looked for local healers. Sometimes if you went to one healer and he or she couldn't heal you, you went to someone else.
But then that's always been the resort of healing. One approach doesn't help you go to another. Take a woman, for example, whom Jesus healed, who touched his garment. She had been to many doctors and was unhealed, and that must've been a common practice because medicine was much less able to heal in the ancient world than it is today.
When the early church began to grow, where they adopting some of the Jewish norms around cleanliness and treating the sick, or were they keeping the Roman norms that had been around, or were they inventing new ones?
Gary Ferngren: That's a hard question to answer because it had different solutions in different places, but I think you could say that the early Christians did not operate with a Jewish context.
The earliest Christians were Jews, but once the gospel was preached outside Jerusalem, there were a number of Gentiles. And I would say within a generation, as the apostle Paul, Peter, and others traveled throughout the Roman Empire, the number of Gentiles overwhelmed the number of Jews in the Church. And the result is they usually depended on whatever healing they were used to, and throughout the Roman empire that was healing by physicians.
So, for example, we can't say definitely that Luke, who accompanied the apostle Paul, was a conventional healer, but my guessing was that he was. He had probably done the apprenticeship in what we would call Greek healing, but we don't know. The Roman style of healing through physicians, who were trained by apprenticeship and who had a theoretical basis for medicine, was probably the most conventional means of healing.
So then I'm guessing that especially by the end of the first century, most Christians, who looked to a doctor and who could afford to, went to a physician trained in Greek medicine.
We hear stories of how in Roman times children and the elderly who had major birth defects or health issues were often abandoned and left to die, but that Christians often took a different approach and would care for them. Is that accurate? And are there other examples like that, where we see Christians showing the sympathy that's demonstrated by Jesus in the gospel stories?
Gary Ferngren: I've argued in some of the things that I've written that compassion is the distinctive Christian contribution to health care.
It's true that in the ancient world, there was no idea that anyone who was born into the world had the right to live. In fact in Greece, and we know that it was the case in Roman culture as well, unwanted children were often sent out to die. The exposure of children was the normal means to exercise population control. Birth control was known, but it was pretty iffy. Since it wasn't guaranteed that you could prevent unwanted children from being born, children were often exposed.
The idea of a right to life, the idea that children had an inherent quality of life or quality of sacredness that allowed them to live, simply did not exist in the ancient world until the Christians introduced it. I think it made a difference over time as Christian values penetrated the culture of the Roman empire.
What was going on in the Roman empire around the time that the plague breaks out?
Gary Ferngren: The plague broke out in the middle of the third century. We call it the Plague of Cyprian because Cyprian was the Bishop of Carthage.
The large cities in the Roman empire attracted as bishops educated Romans, often wealthy men who had received the best kind of education in rhetoric or philosophy or whatever, and you can tell that by the way they write, they were educated people. Cyprian was in Carthage, and we know that about the middle of the third century, a plague broke out.
There were several plagues in the Roman empire. The two greatest were the one of the second century, brought back by soldiers who had been fighting in the east, and the second one broke out and spread to the large cities in the third century.
They carried away a large portion of the citizens of the Roman empire, especially in the cities. We're told by [historical records] that 5,000 people died a day in Rome because of the plague. There were similar figures for Carthage and for Alexandria, the biggest cities in the Roman empire.
And in each of those cities, it was the Christian church that undertook to do what they could because the Romans have no pattern of treating a mass disease. They didn't seem to know what to do and therefore they did nothing except plead with the gods to remove what was considered to be a punishment on the Roman society. The Romans had no organized response. It was the Christians who really introduced that concept.
How and also why?
Gary Ferngren: Well, why is easy—the idea of “Imago Dei,” the image of God. That all human beings, Christian, non-Christian, pagan, whatever, are bearers of God's image. And that is something that has a spiritual component and also one that naturally draws our compassion to others. That was the foundation for it. There was nothing like that in Roman cultural or moral values.
How did they do it? They offered burial to those who were exposed on the streets in times of epidemic plagues. Conventional morality, respect for even members of your own family, was abandoned because people didn't know what to do. They were overwhelmed by the sheer suffering. People would often throw bodies out into the streets and they lay on buried. So Christians who had been offering a burial service to their own members began to bury pagans.
They began to take care of those who were sick, first in their own family and then in their own church and finally outside because they had already in the Book of Acts established deacons who supplemented the elders in providing acts of mercy. Deacons very quickly took on the ministry of mercy in the early Christian Church, and that became one of the best-known ways in which Christians were recognized.
Early Christian literature and even early Greek and Roman literature focus on how the Christians acted during plagues. You find that the pattern of public behavior was more or less the same. There was no constraint on it. What you should do to protect others. There was no compassionate response to suffering. You find writers appalled by the way in which the sick and the suffering, even including one's own family were treated. They were ignored because people were taking care of themselves and their families, and they didn't know what to do. As far as we know, the Christians were the first people who began an active campaign to take care of sufferers or to bury the dead or to help. We find that as an underlying theme of late Roman Imperial history.
Do we have any evidence that there was division in the Church as these Christian leaders decide to take the initiative and take care of the sick in these situations?
Gary Ferngren: I don't know of any. I don't know of any cases where some Christians said, we ought not to be doing this. I think the compassionate ideal was there and it was there from the early New Testament. It was there from the teaching of Christ. That if you see suffering, it's an obligation for Christians to do what they can because Christ has placed them in the world to help others. And that became a pattern of the early Christian community.
There are several passages. I'll just mention one, and that's the treatise short work by Cyprian. Cyprian is calling on Christians at the risk of their own health and lives to take care of others. He says Christ didn't place you in the world to enjoy a life of comfort. When you see suffering around you, your neighbors, your friends, even those who have been persecuting you, you should help them. That was as fine a statement as I know of the Christian obligation to care for others.
The role Christians played in the midst of affliction is arguably what played a critical role in the expansion of Christianity. However, with the lack of knowledge of germ theory of disease, they also could have served as agents of the spread of those diseases. What are your thoughts on this?
Gary Ferngren: I think they would have thought it a poor excuse, and it's probably a poor excuse today. The compassionate model in health care is, I think, the very distinctive contribution that Christians have made. And this has been pointed out by a number of people.
People are suffering. Do you take that as a reason not to help because you know you might afflict or be afflicted yourself? And I think that is not the approach that Jesus would have us take. The number of hospitals in the Western world—and hospitals are a contribution of Christians since the fourth century—that's a direct outgrowth of Jesus' call to help those who are in need.
And I'll just add one more to this. I think the greatest growth of Christianity was following the third century when so many cases were given throughout the Roman empire of Christians coming in to take care of the sick when no one else would do it. And I think that was noticed and very much appreciated by those who benefited from it.
Let’s talk about the formation of hospitals and the role that Christian have played in that.
Gary Ferngren: There's been a real interest in the history of hospitals in the last generation. The evidence is overwhelming that the hospital was a specifically Christian institution, lacking in any other culture.
There was one precursor used by the Romans for two special classes of people—for slaves on the largest estates and for soldiers in the Roman army. But those were meant only specific groups of people and they weren't founded charitable reasons.
It was the Christians who in the fourth century believed that there ought to be some way of caring for those who were sick. The person who really gets the reputation as the founder of the hospital movement was Basil, who lived in the fourth century. During the widespread epidemic of leprosy, he founded the first hospital. He founded it probably initially for lepers, but he added several different groups for the sick and for children, because foundlings were still widely placed in open places around the forum or sometimes in churches, sometimes in the porches of temples.
Within a hundred years, it had reproduced itself in a sense that Basil's hospital in Turkey was extended to places all over the Eastern empire. And a generation or two later, it spread to the Western empire. And actually a woman named Fabiola founded the first hospital in Rome at the end of the fourth century.
I should mention, however, that it was mostly for the poor. For centuries, hospitals were meant for those who had no place else to go—no place else to go for treatment or even to die. That was the case up until probably the 19th century.
The connection of Christianity with the foundation of hospitals, from Basil's hospital onto the present time, is a good argument against the view—which has been held by a surprising number of people—that Christianity was opposed to ordinary medicine.
Did the scientific revolution and some of the medical discoveries that were made in the aftermath of that have any effect on the relationship between Christianity and medicine?
Gary Ferngren: That's a much more complex issue than the early church.
Both Calvin and Luther were strong upholders of ordinary medicine and believed that it was God's gift that should be used by everyone. Actually, Luther wrote quite a lot about that particular issue.
There was a change at the time of the reformation in which hospitals, which had ordinarily been maintained by monastic movements, were secularized and they were controlled under the administration of the cities. And there were gains and losses in that.
Medicine was taken out of the hands of monastic orders and given to more secular people, and I would say that wasn't a gain. On the other hand, hospitals were spread. They were given good leadership, good support and the like.
Martin Luther wrote surprisingly a lot about medicine and God's blessing of medicine to help other people. The Protestant Reformation did introduce perhaps one element that was of value, and that was the idea that a vocation (which under the Catholic church had been a call to a divine ministry as a priest, nun, or monk) was made as God's calling to any particular trade—from motherhood to a doctor.
Many of the Protestant doctors from the 16th, 17th, 18th, even into the 19th century, took medicine as their calling from God.
Timothy Dalrymple: I can't think of areas in which during the scientific revolution or immediately thereafter where there were significant tensions between the church and the emerging scientific consensus.
I know there were concerns about the dissection of cadavers and that form of studying and learning medical facts. But I don't think you had quite the same tensions that you did in places like astronomy or in geology.
Gary Ferngren: Medicine just wasn't a matter of dispute. I would say, so strong was the compassionate ideal of the Christian faith that no one ever doubted that Christians had a strong calling from Christ to take care of the suffering. I hope that remains with us today.
It should always be the calling of every Christian, not necessarily to go into a medical field but to know that we're supposed to be ministers to those in suffering—those who are sick, those who are ill, those who are dying. And in every one of those cases, there’s been a very, very strong, compassionate opinion on the part of Christians.
Timothy Dalrymple: You mentioned Luther, and it's worth noting that we published a piece not too long ago on what Luther had to say about the plague. Calvin was involved in Geneva in the midst of numerous plagues as well. And so going forward from there, of course, you could talk about people like Florence Nightingale and all the way up into the 20th century with people like <other Teresa.
Gary Ferngren: Most people don't realize that Cicely Saunders, the founder of hospice was an evangelical Christian who believed that to found hospices as places to go to die was something that God had placed on her heart. That's not as widely known as it should be.
So this idea of compassionate medicine as an outgrowth of Christianity has continued right down to the 20th and 21st centuries.
What does it look like for Christians to practice self-sacrificial love and compassion today in the midst of coronavirus? Are there lessons that you think that we can learn from history that will provide some guidance for us today as we struggle with coronavirus?
Gary Ferngren: Well, the first lesson probably is that we're living in normal times. We read about the black death, about the plague of Cyprian, about even the SARS virus or cholera in the 19th century.
I think the tendency of most of us is to want to cut ourselves off and isolation so that we and our family won't suffer. And I think the people who have made a difference in relieving the suffering of others, they're not taking that attitude. Where they saw suffering, they went into the midst and in some cases, they gave their lives for that. That's a very famous pattern. It's been widely used to help others.
What should we do? Should we isolate ourselves? Should we look after our own interests? I don't think that's compatible with the gospel.
Timothy Dalrymple: Yeah, and I think that's very much a live discussion right now. What does that mean for us today? On the one hand, I'm a big believer in subjecting ourselves to risk and being self-sacrificial. But I'll tell you very honestly, I also don't want to be a part of spreading it even more in such a way that introduces the disease to even more people and leads to an overwhelmed hospital.
And so I'm very keen on figuring out can I provide childcare for a parent who needs to work, but their child now no longer has the schooling option? Can I help with food? Are there deliveries that I can make to people who are in quarantine? What are some organizations that I might be able to give financially?
I think there's this conversation going on across the American church and even the broader global church about how what are some creative ways in which we can show love in this particular moment, in this particular set of circumstances.
Morgan Lee: And also giving people a sense of camaraderie and community too. At the same time, given that people are so separated and they're not at work where they may normally be, they are stuck at home, some people live alone and so they're really not seeing people. And so thinking about creative ways to get people a sense of what it would be like to have presence.
Gary Ferngren: I'm not an expert in that field, but it does seem to me that we have plenty of models in the Gospels, that we have plenty of models in the early church.
First of all, in our community, the church was known as a group of people who loved one another. That was a characteristic feature. And in any church that we're belonging to, it seems to me that we find people who need our care. And that to me would be the first place we would look.
The second would be in our neighbors, or people that we know, or our particular need that we read about in the newspaper. I think there's plenty of need and I don't think we have to spend very long looking for it.
I realized that different personalities have different callings and that some people aren't able to do that, but it does seem to me that wherever there's human need, we can find a place to work.
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