As part of a new occasional book review series here on the blog, we recently published a review of Dr. Bob Cutillo's book, Pursuing Health in an Anxious Age. Dr. Cutillo was kind enough to speak with us about how his experiences as a Christian and a medical provider led him to write this book. Below are excerpts of our conversation:
Is there a specific event, experience, conversation, or observation that led you to write Pursuing Health in an Anxious Age?
About 10 years ago, I was part of a Bible study that included seminary professors and other academics. Over the course of about a year, two families in our group experienced the threat of illness (abnormal test results, etc.). Despite the fact that they knew the Bible quite well and had an understanding of scripture, where it came to applying their faith to the medical experience, they didn't know how to do it. They lacked a basic awareness of how to critique their interactions and weigh whether the treatments offered to them were valid.
This prompted me to consider that maybe this is a problem for other Christians too. It turns out many believers who may be mature in other ways leave their faith at the door, genuflecting before medical technology rather than the Lord. They worry if they don't follow exactly what they are told, they are putting their health in jeopardy. I started thinking that maybe I could investigate this further and help other Christians think about this in a broader way.
What are the hurdles American Christians face in bringing a Christian worldview to bear on their interactions with the healthcare system?
I call it the technological mystique. We live in a context in which it seems like none of us can avoid the influence of technology telling us that if there's a problem, it can be fixed. We look at life as a series of problems to be solved rather than mysteries to be understood in a spiritually discerning way. There's also the technological imperative, which says if we have a technology, it must be used. It's as though it has its own power. As Christians, we have to develop discernment, keeping technology in its proper place rather than allowing it to rule us.
When we're patients, we don't really have the ability to make objective decisions. Traditionally, we enter the system from a position of vulnerability in which we are less able to objectively assess whether what is being offered is a wise choice. Through many conversations, I have realized that people don't know they can question their medical providers. It's empowering when you realize it's possible and right to dialogue with them.We should never forget that medicine is still, at its heart, human-centric. Doctors and patients have autonomy that must be honored even while we as Christians recognize that our lives are not our own.
One of the key questions I attempt to answer in Pursuing Health in an Anxious Age is this: Is health a possession or a gift? We should never forget that all we have has been given to us by a good God. We are not leading the charge. We should always ask ourselves, "How do I fit into the story God is telling? How can healthcare become an asset and a resource to help me as I live out the life God has given me?" We have come from God and we're returning to Him. In the intervening time, we are here to serve and consider how He is transforming us into the likeness of His Son. That's the purpose of our lives.
Many Christians fail to live as though Jesus has delivered them from the fear of death. We tend to feel equally as vulnerable as everyone else and act in the same way when illness or death approach. That reveals a lack of application of our faith to the situation. One of the key places we can hone our faith through struggles is within our Christian community. It's there that we can access wise counsel as we make decisions about how to proceed with our healthcare.
How can Christians share a biblical understanding of health with others? Do you think a proper understanding of health creates an opportunity for sharing your faith with others?
Here's an example from my own life: When I was in medical school in New York City, I was part of a small church of about 100 people. There was a woman in our congregation named Grace, which was a very apt name for her. She was blind and in her 80s. She got sick and it turned out to be a terminal illness. She had no one but our church family, and the congregation decided to keep watch over her during the remaining days of her life. We took shifts, so someone was always at her bedside during her last hours.
As a young Christian, I got to watch the church at work, caring for their member as a uniquely loved individual. Even the medical staff was tickled by the fact that we would care for this woman who no one else cared about. It affected them as we drove away loneliness and cared for her. We weren't afraid of her death. We just didn't want her to be alone. When Christians live in a way that meets that darkness, we can share our example by deed and by word.
We can also look to the early church as an example of this. It was said of them, "See how they love one another. See how they die." God's promises change our lives and everything we look forward to. We don't die like those who have no hope. When I decided to write this book, it was because I saw that Christians facing disease and death didn't look any different from those who don't know God. In a culture that is obsessed with control, we must remember to trust God more than we do the technologies offered to us.
You mention Gnosticism as having invaded many Christians' worldviews. How has that affected our vision of disease, death, and health?
Since the days of the early church, Christians have done battle with this worldview. In ancient Gnosticism, the body was thought of as evil and of no use, except as a temporary carrier of our lives. In the church, that yielded either the denial of self through asceticism or, at the other end of the spectrum, moral libertinism since some interpreted it to mean the body doesn't have any bearing on the soul.
Today we don't use the term Gnosticism, but the idea that the body is separate from ourselves and can be perfected is a representation of dualism. Now the body is viewed as mechanically imperfect and we seek ways to perfect it. This minimizes what Jesus did by taking on our fragile flesh. We lose a sense of wonder over how important that is as we consider our own bodies.
Our bodies play an integral part in what it means to be faithful Christians. Much of evangelical Christianity is in danger of dividing body from the soul. We get saved and then just wait for the rapture or to die when we actually ought to discover our destiny through our bodies. Said another way, we should be "incarnational" Christians, living in light of Jesus' taking on human flesh. In this way, we can fight the division of dualism.
Our bodies are given to us on purpose. While writing Pursuing Health in an Anxious Age,I remember asking myself, "Do I really believe this? If so, I have to live it." So if it's true,then what are the implications? I'm like anyone else, I run from pain. I want to get better. I'm grateful our healthcare system can help me do that. But what is my understanding of pain and disease? I can't just look at it as a problem to be solved. I should always ask, "What is God doing? How is God working for good in my life?" Then I experience the practical outcome of living in light of the story He is writing.
The topic of healthcare in the United States has become a decidedly political one. It seems every response is divided down party lines but neither reflects a Biblical worldview. Do you think it is possible to reclaim this subject from politics? How?
That's a task that will take time. Many people are dissatisfied with our current healthcare system. Some reasons they give are that they feel overwhelmed by it, or they don't feel they can trust it. All this dissatisfaction is rooted in something deeper; in human nature and a God-given desire for relationship, community, and other goods. Our current system is based on an understanding of health as a right and a possession, which has led to the healthcare crisis we're experiencing.
I like to believe and hope that in our postmodern world, more and more people are realizing that something is missing and that it won't be found in through progress and technology. It's an opportunity for the church to speak the truth of the gospel.
If nothing changes, people will continue to look at healthcare from a perspective of "How can I get the most out of this system?" It will still be just one party or agenda fighting against another. Healthcare has become such a market-based industry that every time there is an attempt at an overhaul, no one is without a conflict of interest. There is hope only if we start asking different questions and reach different answers.
I do believe there are pockets of hope, such as healthcare sharing ministries, where we say, "We're in this together and we're not expecting healthcare to solve all our woes." We can do this as community and demonstrate that to others. As a Christian community, we must keep on caring for the least of these. Not only does this signify a healthy church, but it is how we function as salt and light in this world. The more the world is aware of the things that aren't working, the more obvious that becomes.
One of the primary themes in a Biblical worldview is that God sides with the poor, the needy, and the outcasts - this isn't just for their good, but for ours also. We are blessed because we see God more clearly when we are obedient in that way. It's amazing how good it is for us when we serve others. Our health is strongly linked to our obedience to the gospel.
Finally, the ability to critique prophetically is so important. The Christian community can get involved in politics if they wish to, but that can be counter-productive if we are only seeking to get our way. We should inform the process and show an example, but if we get involved, we may end up not being able to pursue a truly Biblical vision. I don't think we can give up until the Lord comes back. We must keep speaking to the world with justice and grace.
Part of the socio-political discussion about healthcare centers on whether you believe healthcare is a right or a privilege. You ask readers to consider whether healthcare is a possession or a gift. What's the difference and how do you think this shift can change our approach to health for the better?
You have to be very careful with language. I've heard people say, "Health is a right." The issue is, you can't have a right unless someone can guarantee the protection of it. You can make healthcare a right if you define what you mean by outlining a thoughtful approach to healthcare as a whole. There is no benefit to leaving people out, but if we are going to call healthcare a right, it has to be a basic package, an affordable approach. If it's not doable, it can't be a right.
As Christians, it's not biblical to fight for our rights unless we're fighting for the rights of others. However, I do think we have a responsibility to care for our neighbors. Because my health is a gift and I've accepted it and nurtured it as such, I ought to have a sense of indebtedness. This should lead me to consider how I can care for my neighbor's health because of the gift I've been given. I don't use "rights" language in the book because it's so powerful. I'd much rather talk about creating a healthcare system that is just and equitable by using reasonable and healthy language.
You mention the risk of disembodiment in the way doctors view their patients. Are there specific choices patients can make that will change this dynamic?
What most people really want, although they may say it in different ways, is someone they can trust when they are sick and vulnerable. You want to have a relationship with someone you can trust. You can start by getting advice from others who have good doctors.
If you or a loved one ends up ill and in the hospital, you want to make sure the medical staff treats you not as a diseased organ but as a sick person. One way to ensure this is to make sure someone who can tell the professionals who you are functions as a healthcare advocate, i.e., "This is Joan, she is a teacher, and she's taught for this long." Most providers want to know Joan. They just don't get a chance to. They'd rather be in relationship than just do a procedure. Think of Grace from my earlier answer - everyone in that hospital knew her as Grace because of what the church did. You can help the staff so they know you and your loved ones.
What is your impression of healthcare sharing? How do you recommend members of these ministries make a difference while accessing healthcare?
Honestly, I haven't spent much time thinking about this. My wife and I have been members of a healthcare sharing ministry for many years and haven't had to submit bills for sharing, for which we are grateful.
I see pockets of hope in trying to reform this massive system, such as when people use healthcare with discernment, considering costs and value in the context of their own lives as opposed to on the basis of statistics. When patients don't demand every possible test and treatment, it allows for providers to give contextual care.
Please understand, I'm not advocating that patients question everything and rebel against their providers. In recent years, the pendulum has swung from patients accepting everything their doctor says to telling the doctor what to do. We all want a personal approach to medicine that is based in relationship. When patients prioritize relationship, it helps their physicians to see them as individuals made in the image of God. It's something that deep down, my fellow medical professionals and I want to do - to walk with patients through things. We truly want to engage with people and be with them, saying, "I'll walk with you through this, and I promise not to abandon you."
We're grateful to Dr. Cutillo for taking the time to answer our questions and help us learn more about the experiences that informed his book. If you haven't already, make sure to read our review of Pursuing Health in an Anxious Age.
*the opinions expressed by Dr. Cutillo here do not necessarily represent those of Liberty HealthShare.
Bob Cutillo, M.D. is a physician for the Colorado Coalition for the Homeless, an associate faculty member at Denver Seminary, and an assistant clinical professor at the University of Colorado School of Medicine. He has also served as a missionary to the Democratic Republic of Congo. Bob currently lives in Denver, Colorado, with his wife, Heather, and they have two married children.