The Alchemy of Illness. – book reviews

Arthur W. Frank

LIKE MANY sick people,” Kat Duff writes, “I had begun to realize that my illness was not so much a state of being as a process of transformation.” Duff, a counselor who lives in New Mexico, still suffers from chronic fatigue syndrome, or myalgic encephalomyelitis, as people in the Commonwealth call it–what the media cruelly call “yuppie flu.” She does not spend much time on the controversies over what kind of disease it is. Her symptoms were debilitating to the point of being life-threatening, but also intermittent. Her book was written over several years.

Ever since John Donne wrote Devotions, which Duff quotes frequently, illness narratives and spiritual autobiography have merged. Their common question, tacit in most illness narratives but explicit in Duff’s, is how the illness has changed the patient. “Inevitably, at some point in the course of a lengthy illness–for me it happened when in front of the refrigerator one day–the startling question arises: Who am I?” Duff’s grace is to know her illness as a call to answer this question on terms not entirely her own; or rather, on terms she must learn to accept as her own. Illness takes away the capacity to act on what have been our own terms, and out of that loss the ill person can begin “some kind of reformulation.”

Part of the interest of a narrative about chronic fatigue syndrome is that physicians can prescribe little more than rest. For better or worse, sufferers are left to their own devices. Some are devastated by the absence of the legitimacy that a disease label brings; Duff finds possibilities for initiation and regeneration. Modern medicine, she argues, can “keep us from the promise of wisdom” that suffering brings “by intercepting the disease process, which is also, in alchemical terms, the process of enlightenment.” Duff finds the same insight expressed by Donne, who wrote, “a sickness must ripen of itself, [we] cannot hasten it.”

Alchemical terms become Duff’s metaphors for evoking the process of illness as well as her route to Jung. For those who appreciate Jungian dream analysis, she provides a virtual casebook. For skeptics, among whom I would have included myself, Duff opens some windows.

As dreams of illness meld into illness as a waking vision, the spirituality Duff finds is Donne’s famous “no man is an island” reflection. She takes this insight through many permutations of personal and family history, issues of environmental damage, and world mythology. She portrays illness as a dense conjunction of forces that she has not caused but can affect. Illness for her is a product of karma, but not necessarily her own karma. “Many Buddhist scholars insist that it is incorrect to speak of ‘my’ karma or ‘your’ karma, since notions of mine and yours belong to the illusory sense of individual self we call ego,” she writes. Illness strips away ego–or in the alchemical sense it “cooks” ego–and what remains is, for Duff, well worth the suffering.

Ultimately Duff finds who she is by learning to pray, or by learning to be as prayer. “Most religious traditions actually prescribe the disciplines that illnesses impose–abstinence, isolation, and stillness–creating artificial walled spaces for the purposes of spiritual development.” Like all good spiritual autobiography, The Alchemy of Illness creates by itself such a space for spiritual development. Duff concludes by hoping that someday when he might reconsider the significance of the warnings his bishops issued in Economic Justice for All:

Catholic social teaching does not maintain that a flat arithmetical equality of income and wealth is a demand of justice, but it does challenge economic arrangements that leave large numbers of people impoverished. Further, it sees extreme inequality as a threat to the solidarity of the human community, for great disparities lead to deep social divisions and conflict.

If anything, the signs of these divisions are more evident today than they were when the pastoral letter was written.

NEUHAUS’S muddle over economic inequality is particularly troubling given his apparent acceptance of the perspective on social “marginalization” made familiar in the same pastoral letter. His chapter on “The Potential of the Poor” clearly shares the view that marginalization can be overcome by securing access to markets for all persons. But instead of advocating antipoverty programs, both public and private, that will empower the poor for effective participation in the marketplace, Neuhaus tries to finesse the church’s “preferential option for the poor” by identifying it with the ethical and cultural diagnosis offered by Charles Murray in Losing Ground (1984). Readers will be distressed to find Murray’s views more or less equated with those of William Julius Wilson, even though Wilson’s The Truly Disadvantaged (1987) rejects Murray’s faith in market forces and advocates government intervention to promote full employment. Neuhaus recognizes their differences in a footnote, but even there he suggests–very implausibly–that Murray’s views are closer than Wilson’s to the teachings of Centesimus annus.

A similarly muddled account of the role of government is given in Neuhaus’s chapter on “Society and State.” Catholic social teaching’s traditional “principle of subsidiarity” is justly celebrated, as it is in papal encyclicals and in the bishops’ pastoral letter, as a bulwark against statism. Government intervention in either the economy or other primary social institutions such as the church or the family must meet a certain moral burden of proof. But Neuhaus suggests that the principle of subsidiarity “sounds very much like what political scientists call the ‘night watchman’ state or ‘umpire’ state,” and he uses it to reject policies that identify government as “the employer of last resort.” This inference is made despite the fact that both the bishops’ pastoral letter and Centesimus itself hold to a more positive view of government, even with respect to the goal of full employment. Neuhaus avoids reconciling these perspectives by emphasizing the social significance of what he and Peter Berger have termed “mediating structures” or private voluntary associations. Neuhaus is she is well, she will not forget what she has learned. Her book can remind anyone how much we are constantly forgetting.

COPYRIGHT 1993 The Christian Century Foundation

COPYRIGHT 2004 Gale Group

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