I recently wrote in support of the recent Cincinnati city counsel resolution regarding mask wearing indoors in public spaces. My hope would be that people would be masking already to protect those around them, but given the seriousness of the situation for our community, I feel it is wise to have a more concrete resolution during the current pandemic.

This resolution would in no way harm the economy or businesses, as other regulations regarding coronavirus might. Specifically, its goal is to allow businesses to remain open safely, and decrease transmission of the virus in hopes of preventing economic hardship. As I considered whether this resolution would infringe on my freedoms, I realized that it may be likened to regulations requiring people to wear shoes in public spaces, or wearing appropriate clothing. These regulations, while they propose an action that may be uncomfortable, pose no threat to the wearer and serve to protect the safety of others.

Additionally it is important to remember that every right comes with a corresponding responsibility. In this case, the right to convene in public places necessitates the responsibility to wear a face covering in public to protect others.

As Catholic physicians, we can look to our Faith’s social teachings for additional guidance. The principal of the Common Good teaches us the importance of participating in actions that promote good of ALL, as long as we are ensuring the dignity of each individual human person. Mask wearing promotes the good of all, and does not offend my human dignity. Furthermore, Solidarity means recognizing the responsibility we have for each other and taking an active role to help others achieve their full potential. Evangelium Vitae says, “Yes, every man is his ‘brother’s keeper,’ because God entrusts us to one another,.. This is a great gift of the Creator, placed as it is at the service of the person and of his fulfillment through the gift of self and openness to others…(#19)” Whether or not mask wearing is beneficial to the wearer herself, I would say that I certainly have a responsibility to help others stay healthy and safe. My prayer is that mask wearing becomes not an awkward or ostracizing action, but a way of smiling at another and saying, “I care about you!” ((especially when I am wearing the beautiful and classy Sacred Heart and Immaculate Heart mask that my mom just made for our family!)

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COVID-19 is not the first plague Christians have grappled with.  Of course, we think of the Black Death – and Monty Python’s depiction of it – but perhaps reason away any contemporary relation to the middle ages, void, as it was, largely of modern understandings of microbiology and public health policies.  Yet we should not be too hasty so as to divorce any opportunity of learning from Christians of yesteryear; it was those middle age Christians who developed the ars moriendi literature, after all, helping all learn ‘the art of dying’ in the 14^th century.

With people dying by the millions from a contagion merciless against the poor, rich, lay, and clergy alike, a pastoral challenge presented itself.  How are so few priests to visit the many sick and dying people, especially when they meet their demise so quickly?  Focused much upon the art of living – striving for virtue, engaging ascetic practices, participating in the Church’s sacramental economy – how may Christian lay people and clergy alike grow into the full stature of Christ, as Paul says, amidst such dark days filled with suffering and death?  Enter the ars moriendi, spiritual handbooks for helping suffering souls prepare for their death by resisting the common temptations of the dying and calling upon the Lord – the victor over sin, death, and plagues – to carry them safely to their eternal home (see this also).  Those Christians truly took Matthew 25 to heart in the midst of trying times: “Whatsoever you do to the least of these, you did it to me.”  They did all they could to bring the saving grace of the Lord Jesus to the sick and dying.  We ought to learn from it today, and work to help people die well in the best ways we know how in each of our own contemporary clinical contexts.  Medicine ought to be about more than perpetually beating back death individually and collectively; clinical and policy work ought to be integrated within our Christian vision.

Perhaps more inspiring than the Bubonic Plague, however, was the Christian response to the ancient Plague of Cyprian, named after the detailed account left in St. Cyprian of Carthage’s writings (~200-258AD).  Historian Gary Ferngren provides a gripping narrative.  Christianity during the 3^rd century, prior to Constantine’s edict of Milan, was officially an illegal sect undergoing intermittent persecutions from both local Roman authorities with bones to pick against bishops and the occasional vicious emperor wishing all subjects to burn incense to him as a god.  Obviously these were not easy times for the young Church, and innumerable martyrs come from these early days.

Yet heroes arose when the plague struck around 250AD.  Christians from across the spectrum of formal medical training were ready for a profound ministry, while their pagan co-citizens – including the Greek-style physicians – largely fled the city.  Contagion swept across the empire, provoking as much fear and despair as suffering and death.  Up to 5000 people a day died in Rome alone – including two emperors –after bouts of diarrhea, vomiting, fever, deafness, blindness, paralysis, swollen throats, and bloody eyes (medical historians wonder if the culprit was a hemorrhagic fever virus, like Ebola).  Pagans thus blamed the gods for this pestilence of such horror and magnitude.

According to a certain Pontius:

All were shuddering, fleeing, shunning the contagion, impiously exposing their own friends, as if with the exclusion of the person who was sure to die of the plague, one could exclude death itself also. There lay about the meanwhile, over the whole city, no longer bodies, but the carcasses of many, and, by the contemplation of a lot which in their turn would be theirs, demanded the pity of the passers-by for themselves. No one regarded anything besides his cruel gains. No one trembled at the remembrance of a similar event. No one did to another what he himself wished to experience.  

Cyprian concluded, It appeared as if the world was at its end.

The Christians were ready to respond, however, and not out of confidence in their scientific prowess or anxiety over the end of the world.  Theirs was true love.  Despite their small numbers and intermittent persecutions, they had built up an impressive network of charity and financial resources to care for widows, orphans, and the sick – pagan and Christian alike.  You might imagine Christian physicians, deacons, subdeacons, and more rushing into the heart of their respective cities, and passing their pagan neighbors heading the opposite direction for the hills, abandoning sick friends and family in the process.  Recalling the great commission, those devoted Christians heard their Master continually say, “I was sick and you cared for me.”  Many, of course, lost their own lives to the virus, though as martyrs, in a sense; they were certainly witnesses to the unstoppable divine power directing their sect.  What sort of group could be so audacious as to run to the middle of a plague?  Narratives from secular historians cannot deny the bold Christian charity during the plague of Cyprian.  It was out of this world.

Understandably, many of the sick and dying were incredibly moved at the compassion shown them by these Christians they had never met, but the impact proved even bigger.  Many converted to the faith, and played a major role in the empire becoming Christian as a whole.  The culture critically began to shift from an oppressive empire valuing the healthy and wealthy noblemen to a Christian society acknowledging the Image of God in each person.  The poor and sick – who one ancient saint called the “Church’s riches” – began to be more than throwaways.  The change was far from overnight and took an emperor of good will to legalize Christianity and make it the official state religion, but it was irreversible.

We are not left with a litany of stars from either the Bubonic plague nor the plague of Cyprian, but we are left with a testimony and an example to emulate in healthcare – at all times, but especially during this current pandemic.  Christians in healthcare are able not only to survive a plague.  They can turn it around for the glory of God.

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BY NOLAN JOHNSON, ED Physician Assistant

“I think I have it…”. The statement arising from my young patient hovered in the air before me. The “it”
in question is, of course, COVID19. In this first week of government mandated stay-at-home orders, I
have cared for many similar patients expressing a similar fear. As I consider her question, I become
faintly aware of the bustle of chaotic activity behind me in the Emergency Room. Her fear is
understandable, and the eerie atmosphere in the ER reflects the fear of our population. Outdoor
isolation tents have sprung from the ground awaiting an influx of the coughing, feverish, and hypoxic.
Boxes upon boxes of plastic gowns, yellow surgical masks, large face shields, and a plethora of hand
sanitizer are stacked in corners, on desks, in carts. Without nametags or a brief glance at an uncovered
face, healthcare providers share the same amorphous, unidentifiable, scrub-blue shape of the full
ensemble that is personal protective equipment. Our healthcare team is united with our patients in a
tamed anxiety as we await the unknown.

I am reminded of the apostles facing a similar anxiety after the death of our Lord on Good Friday. Jesus
had revealed Himself as the Messiah, the Anointed One, the righteous King of Israel that had been long
awaited; yet, quite suddenly, He was gone, dying on a cross in apparent shame. Scripture tells us, “For
they did not yet understand the scripture that he had to rise from the dead” (John 20:9). Imagine the
apostles’ pain, hopelessness, and depression as they faced the unknown: a suffering they did not yet
understand.

In our current time, we, as Catholic healthcare providers, face a similar dilemma. How do we respond to
the vast suffering placed before us? Indeed, the idea of redemptive suffering is unique to the Catholic
faith. We are, after all, called to share in the suffering of humanity as the body of Christ. But in a modern
pandemic? This is uncharted territory.

St. John Paul II, in Gaudium et spes, provides guidance. “The Law of the Gift” outlined by the newly
minted saint states, “man cannot fully find himself except through a sincere gift of himself”. He goes on:
“We are at our best, we are most fully alive and human, when we give away freely and sacrificially our
very selves in love for another.” During this Lent and Easter season, what better example of this
sacrificial love exists outside of Christ, the Divine Physician, on the Cross? What better time than Lent,
Easter, and the COVID19 pandemic to express this love through medical practice?

As Catholic providers, we are all called to “give away freely and sacrificially our very selves” for our
patients. Some of us will be required to perform great deeds: a timely intubation, advanced ventilator
strategies, and compassionate palliative care come to mind. These are laudable feats; yet, most of the ill
will need simple acts of love: an encouraging word, an extra five minutes explaining test results, an extra
cup of juice or snack from the food pantry, a silent prayer, empathy for a heroin addict, a reassuring
telemedicine call, endless patience. As St. Mother Teresa observed, “Not all of us can do great things,
but we can do small things with great love.”

“Am I going to die?” asked the young woman in front of me. I glance again at her reassuring vitals and
easy breathing. A hand on her shoulder (in PPE) and some reassuring words cause her tears to fade
away. Did she require great acts of medical knowledge? A rapid, life-saving intubation? No, just a small
act that reflects our Savior’s infinite love.

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