Helen Rhee on Illness, Pain, and Health Care in Early Christianity

Helen Rhee teaches church history at Westmont College in Santa Barbara, California, and is an ordained minister of Free Methodist Church Santa Barbara. She specializes in how early Christian identity formed in the context of Greco-Roman culture. The books she’s written or edited include Loving the Poor, Saving the Rich: Wealth, Poverty, and Early Christian Formation (2012), Wealth and Poverty in Early Christianity (2017), and Illness, Pain, and Health Care in Early Christianity (2022). In this edited conversation, she explains how Christians today can practice distinctive care for those who are ill and in pain.

Why did you write this most recent book, and for whom did you write it?

Illness, Pain, and Health Care in Early Christianity completes my trilogy on distinctive theologies and practices that helped early Christians understand their identity within Greco-Roman culture. In my first book, Early Christian Literature, a monograph based on my dissertation, I looked at accounts from the first three hundred years or so of early Christianity. I learned that one way Christians defined and represented themselves during a time of pagan-Christian conflict was to care for the poor. I expanded on this in my second book, Loving the Poor, Saving the Rich. It covers early Christian writing through the first three centuries, focusing on the second- and third-century developments and culminating in the early fourth century, when Constantinople put the church in charge of caring for the poor.

I edited Wealth and Poverty in Early Christianity (2017) to introduce readers to the broad range of translated texts that reflect early Christian thoughts and practices about wealth and poverty. Many ancient sermons, letters, and writings highlighted care not just for the poor, but also the sick, including the poor sick. Illness, Pain, and Health Care in Early Christianity shows how early Christians developed a theology of illness and pain and health care. They taught that caring for the sick is another essential marker of Christian identity. My audience is scholars in early Christianity and history and students interested in how early Christianity adapted and reframed Greco-Roman culture by their engagement with Greco-Roman medicine. Other leaders are also welcome to take up the book.

Did you have a personal connection to your research?

I’ve had chronic pain from fibromyalgia and chronic fatigue for thirty-six years. I hope to someday write contemplative spiritual reflections about what it means to experience constant pain yet live as a Christian in hope. About ten years ago, I read The Illness Narratives: Suffering, Healing, and the Human Condition, by Arthur Kleinman, and thought, “He knows what I’m going through.” Kleinman’s approach is not specifically Christian, but I appreciated his model of medical anthropology and thought it would make a good lens for my book on illness and pain.

What is medical anthropology?

People sometimes think of disease, illness, and sickness as synonymous. Kleinman explains that medical anthropology considers more than a medical diagnosis. Disease is the medical diagnosis of a biophysical abnormality. Illness is how patients experience disease and try to make meaning of their illness in light of their social, cultural, spiritual, historical, and relational contexts. Kleinman says that sickness is a generic term to label events involving disease or illness, especially in relation to larger forces such as poverty or malnutrition.

Medical anthropology constructs layers of meaning in addition to biomedical diagnoses. It uses the word cure for a biomedical cure. Being healed from illness involves “rational medicine” cures but also restoring a person to the community. For example, Jesus not only stopped the woman’s constant bleeding but also called her “Daughter” and said she was no longer ceremonially unclean.

Whom did Greco-Roman culture and early Christian culture prioritize in health care?

The Romans built short-term hospitals for those considered most important to the empire’s economy—soldiers and slaves. There were no hospitals for everyday folks, no organized program for treating the sick on either a regular or emergency basis. By contrast, the third-century Apostolic Tradition, by Hippolytus of Rome, said that whether a catechumen regularly visited the sick was a measure of their readiness for baptism (20.1). Providing meals for the sick, widows, and the poor was a common duty of all the faithful. Sometimes, Christians with means paid for health care and burials for those who couldn’t afford it.

Deacons (and deaconesses, especially in the East) cared for the sick and the infirm and informed the bishops about who should be visited and prayed over. They created concentric circles of care for the sick, which prepared them to meet overwhelming pandemics. In Carthage in 252, Bishop Cyprian gathered his people from the whole city and taught them from Christ’s example and the scriptures that it was their duty to care for sick Christians and non-Christians. They cared for the plague-stricken, performed the last office for the dying, and buried them. In doing so, some Christians got infected and died. Eusebius of Caesarea recorded a similar situation of Christians’ self-sacrificial care for the sick during famine and another plague in 312. Meanwhile, during both plagues, it was reported that non-Christians abandoned even their own family members to avoid contagion.

How did Christianity’s organized medical charity continue?

Because the church so consistently cared for the poor and the sick, Constantine put it in charge of caring for the poor in the empire, including the indigent, the sick, the infirm, migrants, strangers, and lepers. In the fourth and fifth centuries, as an extension to caring for the poor and the sick, the church founded poorhouses, hostels, hospices, hospitals, and infirmaries, usually connected to monasteries or urban churches. As Ambrose wrote, “Minister to a poor person and you have served Christ.” Organized Christian health care included medical treatments, psychological and nursing care, religious instruction, and charismatic healing.

“Minister to a poor person and you have served Christ.”

What can we learn from how early Christians used or adapted Greco-Roman medical practices?

Early Christians accepted Greco-Roman ideas that disease results from an imbalance of the humors and disconnect between mind and body. They tried to remove excess humors through purgative medicines, bloodletting, or cauterization. Tertullian, Clement of Alexandria, and other church fathers saw medicine as God’s gift. We, too, can welcome modern medicine such as surgery and pharmaceuticals to affect a pathological organic state.

Today, in post-Enlightenment culture, psychiatric medicine often has no reference to spirituality. However, the Hebrew, Greco-Roman, and early Christian worlds were full of God, gods, and spiritual beings, so they were free to interpret illnesses from a much more inclusive perspective. We can build on that wisdom by broadening how we understand healing. 

How did early Christians find new ways to understand and experience suffering?

Adopting biomedical diagnoses and cures didn’t prevent early Christians from also making meaning of their suffering. Paul pleaded three times—meaning not just three prayers but the beginning, middle, and end of petitioning God—for removal of the thorn in his flesh. This unknown condition assaulted and oppressed him throughout his ministry. However, Paul concluded that God meant to use this thorn for his own good.

I’ve taken 2 Corinthians 12:9-10 as my life verse: “But he said to me, ‘My grace is sufficient for you, for my power is made perfect in weakness.’ Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me. That is why, for Christ’s sake, I delight in weaknesses, in insults, in hardships, in persecutions, in difficulties. For when I am weak, then I am strong” (NIV). I cannot make physical healing a controlling factor or condition for my relationship with God. When Nebuchadnezzar asked Daniel’s three friends whether God could protect them from the fiery furnace, they said Yes, but even if God didn’t, they still would not serve other gods or worship the golden statue Nebuchadnezzar had set up (Dan. 3:17). Our faith must allow this aspect of “even if God doesn’t, we will still worship the Lord.” 

How does God provide sufficient grace?

Early Christian bishops thought of scripture and sermons as therapy for souls, words that brought healing. Augustine described the Christian life as a convalescent life, a journey home to God in which we are gradually healed from sin, vices, and worldliness. Though we never become perfect in this life, we can experience God’s healing.

In my book’s third chapter, I explain that Paul’s metaphor of the church as one body in Christ helped early Christians see themselves as a community of pain and co-suffering in Christ. What Christ suffered for us in his incarnation, suffering, and death connects us all in Christ and with each other. I experience God’s sufficient grace through prayer and through Christians who drive me to doctor’s appointments, bring me meals, and literally take a walk with me so that I get needed movement but don’t become overexerted. 

How can churches today apply these teachings in worship?

We can emphasize God as our Creator, our Great Physician, and healer of our every ill through sermons, prayers, songs, and liturgical practices. We need to reintroduce the concept that God’s healing may come in the form of physical or mental relief but might also or instead be spiritual and emotional healing. While encouraging worshipers to go to doctors and take medications, we can ask God for healing and anoint people with oil. At the same time, physical cure is not the ultimate goal because all healing in this life is temporary.

We should also pray for God’s grace, strength, wisdom, and hope in navigating and living with pain and illness. Many Christians do not experience biomedical cure and get discouraged, as if deliverance from pain and illness is the only way God cares for them. In addition, today we can give more space for worship leaders and worshipers to be open about mental health issues so they’re not stigmatized.

Do you have any cautions for preachers, worship planners, and pastoral caregivers?

Depending on the Christian context you’re in, some churches are hesitant to talk about healing in any way other than medical explanations. Other churches are quicker to recognize that illness can rise from physical or spiritual problems. But it’s important not to overspiritualize illness either. Don’t assume that if someone has cancer, then it must be because of a secret sin. Don’t say that everything happens for a reason. When Jesus healed a man born blind (John 9:1-7) and when Lazarus became ill and died (John 11), he did not attribute disability, illness, or death to God’s retribution for sins.

When giving pastoral care or talking with a friend with a health challenge, remember that we can ask God for healing but not force God to heal. When friends or family are going through challenging times, simply listen. It’s not helpful to ask whether they have enough faith to be healed or to say that they are ill “because God knows you are strong enough.”