The defining events in life ask us not simply "What are we going to do about them?", but the deeper question "How does one behave toward them?" How does one become and remain whole in the midst of them?
This deeper question goes to the issue of one's core identity — both for the person suffering through such an event and those who help that person heal. Such events do not yield altogether to our problem-solving maneuvers. No specific policy, strategy, contract, or behavior can dissolve them. As Simone Weil put it, "What could be more stupid than to tighten our muscles and set our jaws about the solution" of such problems? They must be faced rather than solved. They resemble a mystery more than a puzzle; they demand responses that resemble a ritual repeated more than a technique, as we learn how to rise to the occasion.
Such events are tinged with the sacred. Sacred occasions or holy days are set apart from other days. On such days, the ordinary canons of mastery and control do not work. "Take off your shoes: you are on holy ground." You are on turf where you are not in charge. Karl Barth once distinguished workdays from holidays by observing that on workdays we make things happen, whereas on holidays we let things happen. The letting-things-happen of the holiday is not a state of mere passivity, however. By "taking in" the sacred occasion — the puberty rite, the marriage, the public gathering, the day of atonement, the Good Friday service — we let the occasion, in a sense, do the work, as it defines us.
Serious illness and death (and other defining events in life) often resemble the holiday: They call for decorous response rather than control. And that response in turn calls for an important set of virtues, the first of which is patience.
The dying patient needs patience, but this virtue differs from the buffeted passivity of being a patient — triply passive to the ravages of the disease, the ministrations of the experts, and the regimen of the treatment. Patience calls for a purposeful willing and waiting in the course of letting be and letting go. As such, the virtue contrasts not only with the obvious passivity of the patient but also with the frantic busyness and the driven agendas of those who hover about the patients projecting the illusion of activity and control.
Such patience resembles the virtue of courage with its more active mode of attack. Active courage takes on evils and confounds them. We look for that kind of courage in the soldier, in the physician, and in ourselves when dealing with problems that can be solved. But before the insoluble, we need the more "passive" variety of courage that Thomas Aquinas identified as endurance or perseverance. Such perseverance does not mean that the person will outlast the trouble. Sooner or later, she must die. But, armed with courage, she can die without being thrown into panic and scattered by her trouble. She can endure. That is courage, not on the battlefield, but in bed.
Dr. May is the Cary M. Maguire professor of ethics at Southern Methodist University in Dallas. This article is excerpted with permission from Testing the Medical Covenant: Active Euthanasia and Health Care Reform (Wm. B Eerdmans Publishing Co.).
