The Beatitudes: The promise and the praxis of hope

Re-reading the Beatitudes

Last week I read again the Beatitudes – Jesus’ famous pronouncements of blessings in his Sermon on the Mount. I’m not sure why I had failed to see it before, but this time it was staring me in the face: The Beatitudes fall into two very disparate groups.

When Jesus saw the crowds, he went up the mountain; and after he sat down, his disciples came to him. Then he began to speak, and taught them, saying:

‘Blessed are the poor in spirit, for theirs is the kingdom of heaven.

‘Blessed are those who mourn, for they will be comforted.

‘Blessed are the meek, for they will inherit the earth.

‘Blessed are those who hunger and thirst for righteousness, for they will be filled.

‘Blessed are the merciful, for they will receive mercy.

‘Blessed are the pure in heart, for they will see God.

‘Blessed are the peacemakers, for they will be called children of God.

‘Blessed are those who are persecuted for righteousness’ sake, for theirs is the kingdom of heaven.

(Matthew 5: 1-10)

The smaller group (Beatitudes 1, 2 and 8) offers a promise of hope to those who are victims – of suffering, violence and greed. The other five present, instead, a challenge to all of us to take on attitudes that counter our dominant cultures of violence and greed and to become part of the solution rather than the problem.

Seeing the Beatitudes in this light seems to me to address one of the fundamental problems thrown up by these sayings – that they just don’t seem to be true. The reality is that those who are poor in spirit, those who mourn, and those who are persecuted just aren’t blessed in any of the usual senses of the word. And even those who are meek, merciful, pure in heart, those who hunger and thirst for righteousness (justice), and the peacemakers far too often seem to be trampled on or taken advantage of rather than blessed.

But if we see the Beatitudes as holding out a very real promise of hope for victims, and a very pragmatic challenge for the rest of us, they start to carry a very different meaning.

The promise of hope

In speaking to those who are poor in spirit, those who mourn, and those who are persecuted, Jesus seems to be speaking directly to those who are the victims of suffering, violence and greed:

Blessed are the poor in spirit: those who are broken, crushed, weighed down; the victims of abuse, those who have had their spirits trampled on, who have been fed the lie that they are worthless, unloved and unlovable; those suffering with mental illness, depression or fatigue; those who are lonely, hurt by broken relationships; the disabled, the homeless, those with addictions; those rejected by society as somehow unworthy.
Blessed are those who mourn: the grieving, those who have lost loved ones; those who mourn the loss of their own innocence; those suffering from physical illness; those who have lost their homes or possessions; those made redundant or who have lost a sense of their own purpose or significance in life.
Blessed are those who are persecuted for righteousness (justice) sake: the innocent victims of violence and war; the displaced, refugees; those who are unjustly exploited or oppressed; the victims of racism or other prejudices.

And, in Luke’s version of the Beatitudes, Jesus seems to go even more directly to the point, pronouncing blessings on those who are the victims of inequity, exploitation and injustice:

Blessed are you who are poor
Blessed are you who are hungry now
Blessed are you who weep now (Luke 6: 20.21)

And to all of these, Jesus seems to proclaim the promise of a future hope: that their present lot is not the last word: for theirs is the kingdom of heaven; they will be comforted; they will be filled; they will laugh. Jesus offers the hope of something far better to come – of a time when there truly will be ‘no more death or mourning or crying or pain, for the old order of things has passed away.’ (Revelation 21: 4)

The Praxis of hope

Which brings us then to the second group of blessings – those which challenge us to a new way of living, the praxis of hope – in which we adopt attitudes of non-violence, sacrifice and humility, attitudes which counter the suffering, violence and greed of our world.

And so Jesus challenges us to be meek – to stand up, non-violently for truth; to hunger and thirst for justice and righteousness, to speak out on behalf of the oppressed, to challenge the injustices of our society; to be merciful not judgemental; to be pure in heart, not hypocritical or duplicitous; and to be peacemakers.

By creating and maintaining our cultures of individualism, consumerism, fear and blame, we all (me included) carry responsibility for those who are harmed by or cannot cope with the inequalities and pressures they create.

None of that is easy – I know that I am so bound up in our culture that I too contribute to the ongoing injustices of our world and exploitation of the earth’s resources, that I enjoy the blessings and privileges of education, wealth and power, while others go hungry, are displaced and exploited. But the alternatives seem to be either that I continue to buy in to our individualistic, consumerist mentality, and remain a part of the problem, or I strive, continually to live Jesus’ way of non-violence (Satyagraha) and become a blessing to others – part of the solution, the praxis of hope.

It may be a hard path to take, but it is the only way that we can see the kingdom of heaven, that we can be filled, to see God in other people and in our world, to receive mercy and for all of us to become children of God.

December 12, 2015

Presenteeism and the culture of indispensability

After stepping down from my clinical work in November, I received a lovely card from one of my patients thanking me for being his doctor and expressing his hope that ‘my new doctor will be as nice as you’. Six weeks on, and we are no closer to finding a replacement, nice or otherwise! So, while I don’t regret cutting back on my work and dropping my clinics, I do feel both saddened and frustrated: my decision is leaving my patients unsupported, my colleagues stretched, and my secretary struggling to troubleshoot and keep things ticking over. I knew this was a possible, perhaps even likely scenario, but inevitably I feel some responsibility for that.

And yet, I am not indispensable.

Why doctors don’t take sick leave

A leader in this week’s BMJ highlighted how doctors tend to have much lower sickness absence rates than other healthcare workers (typically 1-1.5% compared to 4-5% for all healthcare staff). There are many reasons why this might be so, but one of the most significant ones is a culture in which doctors avoid taking time off sick so as not to let others down – whether their patients or their colleagues. This is admirable to a degree, and yet it betrays a deeper, potentially destructive culture of indispensability. We have a tendency to believe that the service won’t function without us. That, in turn, feeds a driven-ness that leads to long hours, apparent busyness and a kind of bizarre pride in always being overstretched.

This isn’t limited to doctors but seems to be a culture that pervades all professions.

It seems to me that this is an inherently dangerous and damaging culture. Clare Gerada, medical director of the Practitioner Health Programme, commented that

“a common personal impact on doctors who are ill is that what goes isn’t their competence, it’s their compassion for patients”

Being overstretched

I suspect the same is true, not just for doctors who are ill, but for all of us when we are overstretched. We can carry on performing our roles, but find it hard to offer that human touch: something that has perhaps been reflected in some of the scandals in care homes for the elderly and vulnerable adults in recent years.

I suspect that another element that goes by the board when we are overstretched is humility. When we are constantly struggling to get things done it becomes increasingly difficult to acknowledge our own limitations, to take time to reflect, to learn and improve, to accept our need of others. And ultimately, to recognise and value the very real contributions that we, uniquely, bring.

Ultimately what goes is also competence, though typically this comes some way down the line. The reality though is that a driven culture of indispensability threatens effective working and patient safety. I still remember the feeling, half way through a 104 hour shift as a junior doctor, sitting at a nursing station to calculate a drug dose, and realising that I couldn’t even think straight enough to carry out a simple 2-digit addition without the aid of a calculator, and recognising just how easily I could make a potentially fatal mistake.

That is why I am supportive of my junior doctor colleagues in their dispute with the government over a new contract. The proposed industrial action is not just about pay – I would find it difficult to defend if it were – but about patient safety, and about challenging this pervasive culture with all its inherent dangers.

Challenging the culture

And I, too, will continue to challenge it, in my small way, by attempting to live and work in a way that isn’t indispensable. I know I will continue to feel some responsibility for the gaps created by my cutting down my hours. But I know, too, that since doing so I have felt more motivated and inspired, and been able to give myself more fully to those aspects of my work which are continuing. I hope, ultimately, that will be of far greater benefit to my colleagues and to the children and families I am seeking to serve.

March 15, 2015March 1, 2015

Go simply with your culture

Tomorrow is the start of the fifth week of Lent.

Our prayer this week is that we may hear our heart’s truth.

Can we live within our culture yet challenge it?

Can we learn from Nicodemus, the Pharisee, who came to Jesus in the dead of night?

Click here to go to this week’s meditations