Primary Care Physicians (of Souls?)

So I was at the doctor's office yesterday. Not fun, but nothing tragic either; one of the occupational hazards of living with 400 disease-riddled undergraduates. But my own primary care doctor couldn't see me until Wednesday, so I went to another physician on staff.

(BTW, can't recommend Fenway Community Health in Boston enough. Everyone on staff with whom I interacted yesterday was friendly, helpful, professional, caring, etc. If you live in the Boston area, particularly if you're looking for healthcare professionals aware of the concerns of lgbt people, check it out.)

The doctor, whom I didn't know before, was pleasant, answered my questions carefully, gave me a diagnosis and sent me on my way. I wish I could say that we formed a close, personal bond, but that didn't happen. Not that that's the case with my primary care physician either; I've seen him all of two times in the past three years or so, and I probably would walk right past him on the street without recognizing him -- never mind his recognizing me. I imagine that this is similar to the doctor-patient interaction of many people in the contemporary U.S.; don't know if it's an age-thing which will change when I'm 40, or simply a cultural shift, but at least for this point in my life, the phenomenon I remember from childhood of having a single doctor who had known me over the course of a decade and a half, and who could know and understand my health within a wider context than the immediate crisis, is gone. Is this the case because I'm pretty healthy and in my 20s, or is this a function of the way a crisis-based health care system works in the U.S.? It's a question, but not the subject of this post.

The spark of insight I had yesterday, which those of us who are in "the holy biz" probably need to be reminded of over and over again, is that the majority of the members of our congregations and communities don't know the priests in our parishes as "Joe" or "Fr. John", but simply as that most impersonal of ecclesial figures, "The Priest". The Priest is who you go to in crisis, who shows up when you're in the hospital, who you talk to when you want to get married, etc. And, as in my interactions with The Doctor yesterday, they're pretty much interchangeable, since what is important is not the relationship but their professional role and presumed theological skill set. You might actually talk to The Priest (or The Minister among other Christian churches, though I suspect there are some important differences here, and so most of this is directly primarily towards R.C.'s) once every few years, in your moments of crisis, but precisely to maintain the professionalism needed in those moments, other social interaction outside of a handshake at the end of Mass is curtailed.

This is problematic, for our medical health and for our spiritual health. But I think it's particularly difficult sometimes for those of us who are somehow involved in church life, either as theologians, or, more often, as lectors, eucharistic ministers, youth ministers, or any of the dozens of other people whose time and dedication make the church actually work, to realize that the guy we know as "Bob" is, to many of our fellow laypeople, this liminal/threatening figure called "The Priest". Some of us have experienced at secondhand the effects of this distancing; when someone finds out you're a theologian or lay minister and promptly apologizes for swearing or telling an off-color joke a few minutes earlier, we get a taste of what life is like for our pastors who go through the world being encountered only as an officer -- to be held at arms length and feared (resented?) -- and never as a person. This might have been less common when most Catholics had a family member, a brother, sister, aunt, or uncle, who was a priest or a member of a religious community, but this has changed dramatically in a generation or two.

Now, I'm not saying this is someone's fault, or particularly the fault of laypersons. One can easily find, among both seasoned clergy and some of our up-and-coming seminarians and priests, lots of men who find filling the role of The Priest a lot easier and more fulfilling than interacting with their parishioners as people. There's a prestige, a mystique, and a comfort in being an ecclesiastical specialist, called in during emergencies, brought on board at certain key moments, but otherwise left alone and unbothered. While no longer the sole source of authority in his parishioners' lives, as he was when they were immigrants, The Priest is still the unquestioned expert in all things spiritual, making his life, and that of his congregants, less messy. And there are, sadly, more than a few priests who are as megalomaniacal as the most egoist neurosurgeon.

But the problem is that this isn't a Christian understanding of ministry. Christian ministers aren't only or even primarily like pagan priests who do things on behalf of people, they're leaders who are called to do things with people: overseeing their communities, leading them in prayer and service, maintaining the bonds of relationship within a parish or diocese, etc. All of this requires that they be not only The Priest, but also "Fr. John" or "Jim", a Christian among Christians who brings his training, his experience, and his prayer to the service of his community as a part of that community, as an individual with needs, strengths, and weaknesses, and not as a catch-all presbyterus ex machina known as The Priest.

And not only is this not a particularly Christian understanding of ministry, it's also not a particularly good model for promoting spiritual health. Just as crisis-management only goes so far in actually promoting physical health (hence the arguments that for poverty programs increasing free wellness funding for things like physicals, regular checkups, etc., would actually save money when compared to the expense of emergency visits when crises demand immediate action), spiritual crisis management isn't going to do too much good in the long run either. Many of our priests are under the same pressures as doctors in this country -- too many patients and not enough support in their work. But a contributing factor is still a culture, held by some priests and by many laity, in which The Priest is not someone you know, over time, in a variety of contexts, but a professional to whom you go when you're having the spiritual equivalent of a heart attack, a bout of pneumonia, or a tumor. And, as in medicine, by that point small symptoms that could have been an opportunity for conversion towards fuller life have become malignant, aggressive, spiritually deadly. If ministry is going to truly be a cura animarum, a "care of souls" in the traditional phrase, then step one might be our communities, clergy and laity included, rethinking their relationship, and particularly how to make The Priest more than an interchangable guy in a funny outfit for many of our fellow Christians.

Not that I have many good answers on how to begin doing that -- this post is more about diagnosis than treatment.

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