Engaging the ‘Signs of the Time’: Catholic Health Ministry as a Wisdom Community

Thomas Esselman, C.M.

Introduction

On December 26, 2004, a devastating tsunami hit the Indian Ocean region, killing over 2200,000 people and leaving unbelievable death and destruction. In the weeks that followed, technology helped the world community respond to the crisis. Relief agencies like the Red Cross, accompanied by television crews, struggled to reach and assist victims in Banda Aceh, Indonesia and other isolated and hard-hit areas. The televised reporting of the devastation caused by the tsunami helped forge a global sense of solidarity with its victims. Throughout the world, in churches, synagogues, workplaces, schools, and countless other places, people rallied to help, grappling, at the same time, with the magnitude and cause of such a terrible natural disaster.

In April 2005, a very different kind of event captured the attention of people around the world. Pope John Paul II died on April 2 after a long illness. What resulted was an enormous outpouring of sadness and gratitude for the life of the pope. Again, technology played a key role in communicating events and in helping to create a sense of community. The televised scenes of the pope’s wake and funeral—particularly, the images of the thousands who flocked to St. Peter’s Square and the willingness of so many to stand in vigil for long hours to pay last respects—left a lasting impression on many people throughout the world. It was as though for a brief while people paused to reflect on deeper matters: on the meaning of life and death and suffering and mortality. The endless analysis on cable television could not distract from the fact that, at this moment and in this person, questions about the deeper purpose of human life emerged. What does it mean to live a good life? How do we see beyond the differences that separate us to the deeper, God-given humanity that unites us? In a way that could never have been scripted or “made for television,” the death of the pope offered an opportunity for human beings everywhere to reflect on the deeper meaning of what it means to be human.

I thought of these two events when reflecting on Aquinas Institute’s new virtual community for health care, Salus & Sofia, and its online journal, Radical Imaging. Catholic health care ministers face the mysteries of suffering and death everyday, in ordinary and extraordinary ways. In various professional roles they quietly work behind the scenes, struggling to heal as Jesus did. While they may never have experienced the horror of a tsunami or the somber dignity of a papal funeral, health care ministers have been there countless time in the face of the mystery of suffering and death. As I watched on television the thousands of people quietly walking toward the bier of Pope John Paul, I was aware of health care ministers who each day stand with the sick and suffering, waiting and watching in faith, in hospitals and clinics throughout the world.

An increasing number of Catholic health care specialists see themselves not only as professionals but also as ministers of the Gospel.

But there is something new happening in Catholic health care circles today. An increasing number of Catholic health care specialists see themselves not only as professionals but also as ministers of the Gospel. Their commitment to health care flows not only out of a desire to better society but, more importantly, out of deep sense of vocation. These women and men understand health care as an expression of the Church and its mission to the world. Increasingly they realize that the long-term viability of health care as a ministry depends not only on addressing the medical and scientific complexities of healing but also on understanding the theological and spiritual foundations which ground the Church’s commitment to this work. Today, many leaders in the health care ministry are eager to discover communities of theological reflection and spiritual formation where they can nourish their ministerial identity and deepen their prayer lives. Often, it is technology that is being used to help form these communities of theological reflection and spiritual formation.

This article describes how participants in the Master of Arts in Health Care Mission (MAHCM) degree at Aquinas Institute of Theology collaborate as a “wisdom community” of theological reflection and spiritual formation on behalf of the Church’s health care ministry. The MAHCM degree was initiated during the 1999-2000 academic year in response to the growing need for theologically educated leaders in Catholic health care. While religious orders have been largely responsible for the founding and development of the Catholic health care system in the United States, their membership has significantly declined in recent decades. There is a growing consciousness, moreover, that the responsibility for the ministry of health care belongs to the whole Church. The MAHCM degree was designed to educate a new generation of ministry leaders dedicated to promoting the ecclesial sponsorship of Catholic health care into the future.

The MAHCM degree is designed for ministry leaders working in a variety of roles in contemporary Catholic health care. The degree includes courses in biblical studies, systematic theology, ethics, worship, canon law, and an ongoing seminar in formative spirituality. (For a detailed description of the program see: www.ai.edu).
The participants work together in face-to-face sessions and online. During a typical course, students from around the country meet for a four-day intensive session with members of the faculty of Aquinas Institute. When the MAHCM cohort is not “in session,” the learning process continues through the use of Web-based instruction; participants communicate online, using a Web site to access course documents and engage in small group reflections using threaded discussion boards.

The most distinctive feature of the MAHCM degree process, however, is the collaboration of the participants as a wisdom community. A wisdom community is a collaborative experience of teaching and learning. The wisdom community ideal draws on the theological belief that all the gifts of the Spirit are needed, that effective teaching and learning takes place in community, that critical conceptual reflection should lead to ongoing conversion, and that all the participants have something important to offer. In the context of Catholic health care, the wisdom community offers a context where the complex challenges of the healing ministry can engage the wider tradition of ecclesial life and theological scholarship. In the experience of students and instructors at Aquinas, the wisdom community reality is the single most important ingredient in the overall process of ministerial formation.

Theological and Pedagogical Characteristics of Wisdom Community Learning

It may seem pretentious to describe one’s teaching and learning in the language of wisdom or wisdom community. Americans are pragmatic people who think of “real” knowledge as that which is attained through empirical thinking and verification. Yet the symbol wisdom (sophia), deeply rooted in the Hebrew and Christian traditions, offers essential insight into the dynamic nature of God and what it means to mature in the ways of God. To appropriate the symbol of wisdom for theological education is not pretentiousness but rather an attempt to understand learning as truly theological. In recent years theologians interested in adult pedagogy have explored the significance of wisdom to explain the nature of theological formation. As a prelude to describing how health care ministers in one cohort collaborate as a wisdom community, I want to examine certain aspects of wisdom and the wisdom community ideal.

...the symbol wisdom (sophia), deeply rooted in the Hebrew and Christian traditions, offers essential insight into the dynamic nature of God and what it means to mature in the ways of God.

Theologically, wisdom finds rich and variable expression in both the Hebrew and the Christian scriptures as a symbol of divine life and activity. In Proverbs, Sirach, and the book of Wisdom, for example, wisdom is depicted as a female character who enjoys a significant relationship to God. She is, variously, one who offers wise and life-saving counsel (Prov. 3:13-35) and a cherished friend and host for the just one (Prov. 9:1-6). She is also a prophet, one who speaks her mind about the things of God and has intimate knowledge of God’s will and ways (Proverbs 8:1-16). Proverbs 8:22-31 speaks of Wisdom as having been with God from the beginning of creation and as one who mediates between God and the world.

In the Christian scriptures, Jesus himself is wisdom incarnate. He is God’s prophet of the Reign of God, possessing a wisdom greater than that of Solomon (Matt.12: 42). Two events in particular evoke the identity of Jesus as wisdom-incarnate: his table fellowship and the cross. In the gospel of John, Jesus’ discourse at the Last Supper points to a new community where God’s wisdom will prevail, a communion based on friendship, on bearing witness to the truth, and on the willingness to lay down one’s life as a witness to love (John 14-17). In the letters of Saint Paul this wisdom is neither human philosophy nor eloquence but the knowledge of Christ crucified (1 Cor.2:1-2). For Paul, it is the crucified Christ who is “our wisdom and also our justice, our sanctification and our redemption” (1 Cor. 1:30). Paul understands wisdom as a willingness to live for others and to take up the cross, thus building up the Body of Christ in the world. Combining his interest in this Christian wisdom tradition with that of adult learning theory, Peter Hodgson explains: “Christian theology of education takes its orientation on the paradigmatic figure of Jesus of Nazareth, who incarnates God’s Wisdom in his teaching and practice, his way of living and dying. The central image of his teaching was that of a new and radically open community of freedom in which God’s Wisdom prevails as opposed to the foolishness and weakness of human wisdom.” Jesus taught, Hodgson writes, not according to law or proposition, but by appealing to human freedom. Absorbed in the mystery of Abba, Jesus calls his followers into a unique relationship of conversion through conversation.

Pedagogically, Mary Margaret Pazdan, O.P., has written of the significance of the wisdom community for adult learning. Drawing on her exegesis of the Johannine and Pauline texts, she describes a model of collaborative and transformative learning which can be found in any number of settings in the life of the Church. Wisdom communities, she writes, “exist whenever and wherever persons gather intentionally to share life and commitment to Christian values in the presence of the Spirit.” For theological education, the wisdom community serves as an ideal or model for understanding the nature of teaching and learning. To speak of the wisdom community is to understand a process of critical reflection aimed at integral conversion where teaching and learning take place through the contributions of all, instructors and students alike. Pazdan writes:

The heart of theological education … is adult formation for ministry that includes rigorous intellectual efforts as well as deepening and expanding the faith of individuals who will be entrusted with the mission of the Church. Wisdom learning requires mutual attention to the tradition and formation of all who participate in collaborative, mutual learning. My experience of teaching biblical studies … for many years convinces me that the presence and nurturing of wisdom communities are essential for ecclesial growth and integrity.

Pazdan defines three stages or horizons that describe the wisdom community at work. On a first level of activity, learners are asked to articulate the particular experiences, issues, and questions which frame their initial understanding of a topic. Personal experience is the first horizon for interpretation out of which the wisdom community works. On a second level, learners are challenged to engage the ecclesial and theological tradition through a critical reading of texts using the appropriate hermeneutical methods. Important here is the realization that critical analysis is not confined to the author’s original intent but to that “surplus of meaning” that arises in interpretation. A critical engagement of the tradition is the second horizon for interpretation. On a third level, the wisdom community moves toward a reappropriation of the tradition for praxis in ministry. The questions and issues brought into play through the inventory of personal experience are placed into dialogue with the tradition and its critical interpretation, a move that can be liberating or disturbing. The reappropriation of original meaning through critical interpretation of the tradition leads to a second naiveté and implications for new praxis. This critical reappropriation, leading to new insight and action, is the third horizon of activity.

The wisdom community, then, draws on the experiences and questions of all its members, students as well as instructors. It relies on careful, disciplined forms of textual criticism. Ultimately, it challenges learners to understand and embrace new implications for the practice of ministry and the development of one’s spiritual life. The dynamics of wisdom community learning noted here release that “pedagogy of Wisdom” that Hodgson says includes the elements of critical thinking, heightened imagination, and liberating practice.

It is this theological and pedagogical ideal of wisdom and the wisdom community that describes the dynamics of teaching and learning in the MAHCM cohort. The next section will illustrate this by describing one wisdom community at work doing critical theological reflection on the ministry of health care.

A Wisdom Community of Health Care Ministry Leaders

As a systematic theologian I have little direct understanding of the complex world of health care. I frequently feel lost when listening to my students discuss the everyday medical, scientific, and ethical challenges they face in their ministries. For their part, students in the MAHCM feel equally challenged; the study of theology can seem, especially at the start, a bit like learning a foreign language. The pedagogical task of bringing these two “languages”—health care and theology—into a theological conversation demands the kind of cooperative teaching and learning characteristic of the wisdom community. It is out of this invitation to conversation among professionals that the wisdom community is initially formed.

In the ensuing conversation between health care ministers and theologians, I have seen the dynamics of wisdom community learning unfold quite impressively in the MAHCM degree process. Here I want to illustrate this by reflecting on one aspect of the design of a typical MAHCM course. In the Introduction to Theology course, for example, I design the learning process to engage the three levels of interpretation described by Pazdan. Rather than offer the students a pre-packaged set of lecture notes, I focus on helping them enter into critical conversation on course topics and readings as they work in small groups. For example, during an online assignment focusing on the theological meaning of faith, I might pose the following set of questions to guide their reading and discussion:

Recall an incident or case in your personal life or ministry that moved you to reflect on the meaning of faith.

a) What questions or insights did they raise in you?

b) How do theologians define faith? Compare how faith is understood in the conciliar teachings of Vatican I (Dei filius) and Vatican II (Dei verbum). How do some theologians distinguish between “faith” and “beliefs”? What are the implications of such a distinction?

c) What implications does a theological understanding of faith and belief have for your ministry in Catholic health care today?

The point of the exercise is to engage the students from within the context of their personal and health care experience, inviting them to stake out an initial set of questions and understandings. From that I invite the members of the wisdom community to enter into a critical reading of the assigned texts. Here I help them understand how theological and magisterial texts are written and the specific hermeneutical approaches needed to make sense of them today. This step requires a developing mastery of various hermeneutical approaches needed to read and interpret classic texts. From a critical reading of the tradition, I invite the wisdom community to return to the current challenges of their health care ministries. Here, I encourage them to name the implications of their theological understanding for the way they and others minister in health care.

A wisdom community identity emerges as colleagues discover each other as teachers as well as learners.

Invariably, I find the reflections of the groups rich and challenging. Certainly, students do far more than simply digest new information. They write and speak to each other with insight and imagination and a shared commitment to the ministry of health care. They take responsibility for the content and the direction of the course conversation: as an instructor I can “step aside” (especially in the online format) and let the groups direct the discussion. The questions and issues raised are impressive in the ways they explore the implications of theological study for the ministry of health care. As the group continues to work together over time, their trust in each other grows and their commitment to personal conversion becomes more evident. A wisdom community identity emerges as colleagues discover each other as teachers as well as learners. It is as a wisdom community that students come to appreciate the theological tradition as a resource for the ministry of healing. Likewise, while collaborating with their wisdom community colleagues, they challenge their instructors, other theologians and spiritual guides, and the Church to understand the complex issues facing the ministries of healing and reconciliation in society today. Perhaps the best testimony to the vitality of the wisdom community model described here is that it continues on after students have completed the MAHCM degree. What might the existence of wisdom communities of health care ministers working in Catholic health care mean for the Church at large in the future?

What’s New for the Church? The Gift of Wisdom Communities of Catholic Health Care Leaders

In these early days of the his pontificate, many people are wondering how and where Pope Benedict XVI will lead the Church in the years to come. It is, of course, impossible to know. Certainly, the election of Benedict XVI has focused a great deal of attention on the role of the papacy and its power to influence and lead the various ministries of the Church, including Catholic health care.

If would be unfortunate, however, if such speculation caused us to forget that each member of the Church has a unique and valuable role to play in the fulfillment of its mission. Most of the important renewal movements in the history of the Church have been initiated by small groups of Christians who desired to live the gospel in a more radical way. The life of the Church consists of more than its major institutional structures, as important as these are. The sources that makes up the life of the Church include a complex array of rituals, symbols, doctrines, forms of governance, spiritualities, and innumerable other elements by which the ecclesial community takes shape in history. According to Roger Haight, included among the sources that make up the study of the Church is contemporary human experience and its impact on consciousness and faith.

In this regard, the work of ministry leaders in Catholic health care today deserves attention and appreciation for its ecclesial character. In developing new mission programs for health care the Church is attempting to respond to the “signs of the times” (GS 4), actualizing its healing ministry to meet new circumstances and conditions. Wisdom communities of health care leaders proclaim the good news that healing and reconciliation are integral to the daily mission of the Church, no matter what the cost. Those who have matriculated through the MAHCM degree program, those currently in the process, and the many professionals who will read this journal are a distinct resource to the Church and its emerging ecclesial identity. It is worth reflecting on how this is so.

As a manifestation of the Church as communion.

From the very beginning, the Church identified itself as a communion of life, a koinonia. The “apostolic summaries” of the Acts of the Apostles (2:42-47, 4:32-37) and Paul’s reminder that “to each person the manifestation of the Spirit is given for the common good” (1 Cor.12: 7) drive home the essential insight that to “be Church” is to be in communion, to participate, to share in the good things of God. The communion of the Church is, ultimately, a participation in Trinitarian life, sacramentally expressed in baptism and eucharist, marking the whole of ecclesial life including the demand to share with others the basic necessities of human existence. Vatican II in its teaching on the Church makes this point: the People of God share in the mystery of the triune life of God (LG 1)v and in the ministry of Christ as priest, prophet, and king (LG 9-13). Institutional manifestations of Church as communion include the family as the domestic Church (LG 11), the local or particular Church of the diocese (LG 23, 26), and the worldwide Church, which is a communion of particular Churches. Some among the baptized are called to share in the charism of particular religious orders dedicated to the ministry of healing; as vowed or lay members, they participate in a unique form of ecclesial communion, which has particular relevance for Catholic health care.

Wisdom communities of health care leaders are authentic expressions of the Church’s nature as communion, as well. The wisdom community represents something more than a pedagogical stategy; it is for health care ministers an intentional community of sharing in the theological, liturgical, and spiritual practice of the tradition. As communion, the wisdom community invites health care colleagues into a process of deeper participation in the ecclesial vocation of healing through theological reflection and spiritual formation. The wisdom community experience is analogous to the base Christian community experience popular in Latin America and elsewhere.

Thus, wisdom communities offer an important resource to the life of the wider Church. Unfortunately, many Catholics fail to experience on the level of their local parish community a lively sense of Church as communion. The structure of parish existence as well as the pace of family and work life can lead to the kinds of individualism and isolation in one’s relationship to the Church so characteristic of American society at large. For the health care minister, the absence of communion is aggravated by the fact that, too often, there is little connection between the structures of the diocesan Church and those of the modern Catholic health care system. Wisdom community learning represents an experience of ecclesial sharing that has the potential to enrich not only the health care minister’s engagement in the healing apostolate but also his or her participation in the life of the larger Church as well.

As a model of collaboration in the mission of the Church.

The communion of the Church exists for mission. The anointing at baptism ordains the newly-baptized to a share in the mission of the Church according to his or her unique gifts.vii Vatican II addressed the issues of collegiality and collaboration as essential to the work of the mission of the Church (LG 22-23, 37). The foundation of such collegiality and collaboration is grounded in the common baptismal priesthood that all share (LG 10).

The model of wisdom community learning in the MAHCM is an example of this collaboration on behalf of the ecclesial ministry of healing. To be a member of a wisdom community is to commit to a common process of critical reflection, faithful listening, and integral conversion. Experience has shown that each learner brings valuable insights and expertise to the work of the group. The collaboration characteristic of the wisdom community model honors the gifts of all irrespective of their particular roles in the health care system. The dynamism of learning in the wisdom community challenges each participant to be both learner and teacher and to collaborate in a more theologically informed understanding and commitment to the ministry of health care today.

As an instance of the “sense of the faith” (sensus fidei) alive in the Church.

In 1848, John Henry Newman published his very influential work, On Consulting the Faithful in Matters of Doctrine. Newman’s thesis was that the faithful are to be consulted in matters of doctrine “because the body of the faithful is one of the witnesses to the fact of the tradition of revealed doctrine, and because their consensus through Christendom is the voice of the infallible Church.” The faith of believers and the careful judgment of the magisterium on matters of faith should function as a kind of conspiratio (“an accord” or a “breathing together”) in the life of the Church.ix Newman’s treatment of the role of the sensus fidelium in the developing tradition of the Church was to have an extraordinary impact on the thinking of the Second Vatican Council.

According to the Council, all the baptized, exercising the prophetic office of Christ himself, share in the mission of discerning the truth of the gospel. As LG 12 explains:

The body of the faithful as a whole, anointed as they are by the Holy One, cannot err in matters of belief. Thanks to a supernatural sense of the faith which characterizes the People as a whole, it manifests this unerring quality when, “from the bishops down to the last member of the laity,” it shows universal agreement in matters of faith and morals. For, by this sense of faith which is aroused and sustained by the Spirit of truth, God’s People accepts not the word of men but the very Word of God. It clings without fail to the faith once delivered to the saints, penetrates it more deeply by accurate insights, and applies it more thoroughly to life. All of this it does under the lead of a sacred teaching authority to which it loyally defers.

It would be hard to overestimate the significance of this conciliar text for the larger work of teaching and learning within the whole Church today. The “sense of the faith” identifies the Holy Spirit at work empowering the baptized to share in the daily task of discerning the meaning of the gospel. It is the sensus fidei that has mobilized a growing number of baptized Christians to new ministries in the Church, including that of health care. It is the sensus fidei which daily inspires ministry leaders as they respond to complex ethical issues of life and death, as they work to form their colleagues in an understanding of the work of health care as an ecclesial ministry, and as they participate in corporate decision-making about the public role of Catholic health care in the wider society. Wisdom communities of health care ministers discover in their collaborative work this grace of the sensus fidei; a grace that helps them better understand the meaning of tradition, the role of the baptized in the reception of the faith, and the need to develop the habit of “faith seeking understanding” as a lifelong discipline. The Roman Catholic Church still struggles with perception of itself as divided between the “teaching Church” (the pope and the bishops) and the “learning Church” (everyone else). But it is clear that, on a practical level, the teaching Church extends well beyond the ordained to include women and men exercising leadership in ministries such as health care. Wisdom community experiences such as that of the MAHCM degree take this fact seriously. They model and encourage the baptismal call to be a prophetic voice in the ministries of the Church.

Conclusion

In his address to the Catholic Heath Association in Phoenix, Arizona on September 14, 1987, Pope John Paul II said:

The structural changes that have been taking place within Catholic health care in recent years have increased the challenge of preserving and even strengthening the Catholic identity of the institutions and the spiritual quality of the services given. The presence of dedicated women and men religious in hospitals and nursing homes has ensured in the past, and continues to ensure in the present, that spiritual dimension so characteristic of Catholic health care centers. The reduced number of religious and new forms of ownership and management should not lead to a loss of a spiritual atmosphere, or to a loss of a sense of vocation in caring for the sick. This is an area in which the Catholic laity, at all levels of health care, have an opportunity to manifest the depth of their faith and to play their own specific part in the Church's mission of evangelization and service.

The pope’s invitation to laity to join religious in the sponsorship of Catholic health care underscores that this ministry belongs to the entire People of God. Living in a time of accelerated change in medical technology and in scientific discovery, baptized Christians are called to engage in a process of ongoing formation so that the theological and spiritual foundations of healing as a ministry may energize a new generation of health care ministers. Wisdom community teaching and learning is one ingredient in this process of forming ministry leaders in health care. Hopefully, those who participate in this Web site and journal will discover here a vitual wisdom community, an opportunity for extended conversation and friendship, and a place to both teach and learn what it means “to heal as Jesus did.”

About the Author

Thomas Esselman, C.M., was formerly an Associate Professor of Systematic Theology at Aquinas Institute. In Fall of 2007, he will begin work at the Congregation of the Mission's Seminary in Nairobi.