The Hebrew fear and resentment of systems that organize human life runs in a true line from the earliest parts of the scriptures straight through the teachings of Jesus of Nazareth. Paul is far more respectful of Roman power than Jesus ever was, but neither were exactly anarchists. In the scriptures the anxiety of authority starts with 1st Samuel, when Israel tires of being overseen by judges (an informal/formal structure of people appealed to for decisions settling disputes between people; similar, in many ways, to the roots of English common law) and wishes, like other people around it, to have a king. God, through Samuel, warns the Hebrews of wanting a king, but eventually accedes to their wishes, and raises up Saul (so much for God has Hairy Thunderer demanding only fealty and blind obedience). That there is a straight line, in the fragmented and disjointed scriptural narrative, from Saul to the Exile, is indisputable. God did warn them, after all.
The problem is a king requires a system of governance far more formal than judges mediating disputes and generally keeping everything on an even keel. Of course, a burgeoning society needs something more than a tribal ruler to maintain social order. But the problem with system is: they soon become about the system, and not about the people the system supposedly serves. The system becomes the power, and the people get shut out. Jeremiah and Isaiah and even Hosea and Amos would rebuke the kings of Israel for their heresies against God (mostly for not caring for the poor and the marginalized. God specifically doesn't care about their worship practices, but about their life practices.). But the prophets also berate the faithlessness of the people. The real sin of the Exile is letting the system become paramount, and care for the other become somebody else's, or even the system's, problem.
I saw this last night in a hospital. A hospital is now, more than ever, a complex system bent on serving itself. On the computer screen in the ER room I was in (as a visitor, not a patient), it flashed news relevant to the staff of the hospital. One was a recent award to a staff member who noticed an item placed in the wrong bin, an error that could cost the hospital money, and affect the care given to a patient. But it was mostly an award for maintaining the system of the hospital, not for extraordinary care of a patient. The message was clear: maintain the system, and the system will maintain the patient.
Except I had to tell two different ER doctors and two different ER nurses my concerns about the treatment of the patient. My concerns had to do with diet and blood tests (the patient is diabetic). They listened, responded well, seemed attentive, and went on to do what they were going to do anyway: follow the system. 2 hours after the second doctor said the patient could have water (they were waiting for test results to be sure emergency surgery wouldn't be required), no water was supplied, despite repeated requests. The system hadn't recorded the approval, and until everyone involved checked with the system, no water was available. The patient also needed a blood sugar check 4 hours into what was a 6 hour stay in ER, as well as food: none was forthcoming. 2 hours after admission to the hospital, and diagnosis, the patient was still in ER: unfed, no insulin provided, no water. The system had to be served first, not the patient. In this case, such neglect could be life-threatening; it certainly worsened the condition of the patient. But the system made no allowances for such individual peculiarities, so the patient's needs had to wait for the system to work. The patient finally got a room at 11 p.m., over five hours after admission. Whether the patient was fed, as again requested before I left, is still unknown. This is a diabetic who should not go more than 4 hours without food and insulin. Both were withheld for at least 6 hours, and probably for over 12 (as the last prior meal would have been at noon).
But the system was served well by its workers. No real failure of care occurred. In the end, all is well. The system was served first, foremost, last, and always. The outcome did not endanger the individual, so no alarms were sounded, no correction to the system, not even a minor tweak, was required. Was it the best outcome for the patient, in all the patient's particularity? No. But it was the best outcome for the system; and that's what mattered.
Which is what Samuel warned against; and the prophets railed against; and Jesus of Nazareth preached against. "Give Caesar what is Caesar's and God what is God's" is as clear and pointed a rebuke and Gov. John Bel Edwards on election night saying of President Trump, "God bless his heart." The system is not the master; the system is the servant. Except the system must become the master, because as even Reinhold Niebuhr understood, no system can survive where the first of all is last and servant of all. The system can't make that determination for the subjects protected by the system, and who are servants to it. That decision can only be made by the individual. Which raises the critical question: can the individual serve the system, and serve God?
What would happen, if the machine stopped?
Excellent post. I'm going over one of Brueggemann's sermon-lectures to post on it. This is so much in line with what he says about totalizing systems. Sometimes I wonder if hospitals aren't a reflection of doctors becoming even more about their profession than about patient care than they used to be. The insurance-hospital-industry certainly is a big part of it but I think the doctors, themselves, are, in many cases, far less motivated by the morality of care than they are supposed to be. Too much Ron and Rand Paul in too many of them.
ReplyDeleteThe system is overwhelmed. Without hospitals, many cures of modern medicine are impossible. But without the systems set up to make the hospitals run, the efficacy of the hospital also fails. But eventually the point is to maintain the system (or the state) and good patient outcomes are just further proof of the value of maintaining the system. Except for the people not served by the system but, you know, gotta break a few eggs, right?
ReplyDeleteI learned a lot of this from Brueggmann's students, and then later from him, too.