Nosokomia

In recent years I have had a growing burden for providing soul care to those in vocational ministry. It is often difficult in those contexts to access trained mental health services, for many reasons, and yet that might be were soul care is most important.

Any helping profession requires that those providing help be equipped to “do no harm” in the effort of doing good. For many helpers, e.g. doctors, nurses, EMTs, lawyers, etc., the Hippocratic Oath is most importantly fulfilled through competencies in knowledge and skills. The scalpel must be clean, the hand must be steady, and the mind must know where to cut. In the very personal and intimate settings of counseling, pastoring and teaching, however, the possibility of doing harm results not only from lack of competency but also from lack of character and personal growth. This is why all good counseling training programs require students to participate in their own personal counseling. If we believe what Scripture says about the infectiousness of sin (“a little leaven leavens the whole lump”, Gal. 5:9, 1 Cor. 5:6), then the person of the counselor/pastor/teacher must also be clean or otherwise risk the soul equivalent of a healthcare-associated infection.

^{Photo by Piron Guillaume on Unsplash}

In a recent podcast Curt Thompson explored the comparison of hospital acquired infections (HAI) and trauma that can occur within churches and Christian organizations. The HAI metaphor is pretty self-explanatory. He also used the medical term nosocomial infection. Nosocomial is an adjective from the Greek word “nosokomos” which means “one who takes care of the sick”, or perhaps “nosokomia”, the care given to the sick. So a nosocomial infection is an illness caused by the caretaker and the care being provided. Rather than being healed by the action of the healer, the sick person is harmed. The biblical equivalent of that is of course the metaphor of the shepherd who is really a wolf, one who, instead of feeding and protecting, actually feeds on the sheep (Ezek. 34:2-3; Matt. 7:15; Acts 20:29-30).

Brothers and sisters, I don’t want to be a wolf, but I know it can happen to counselors just like it can happen to shepherds. I don’t want there to be wolves among God’s flock, but that desire alone is not an inoculation. Jesus and his inspired apostles tell us there will be wolves, not outside the church, but “from among your own selves” (Acts 20:30). Imagine being one of the Ephesian elders listening to Paul’s farewell message: “What, wolves from among these godly men? Really Paul, one of us? Will it be me? Surely not!” We could react that way, but we would be imitating the mistaken incredulity of the 12 apostles: “Is it I, Lord?” (Matt. 26:22). I don’t know about you, but the “Is it I?” question doesn’t sound like a very receptive inquiry; more like a denial framed as a question. While only 1 of those 12 men were living in deep, soul-destroying denial, the other 11 were in enough denial to justify forsaking their Lord. If you’re anything like me, you know the appeal of that defensive denial. But denial is not an inoculation.

Rather than denial, the preventative immunization for nosocomial infections is biblical soul care: “Pay careful attention to yourselves” (Acts 20:28). In the words of Diane Langberg, we must be immunized “in our lives first.” In my life first. In your life first.

That careful attention to my life first is at the heart of my mission as a counselor, and a mission that I would like to share with fellow pastors, ministers, missionaries, and anyone tending to the souls of Christ’s sheep. In the spirit of Archibald Hay writing to the newly appointed Archbishop of St. Andrews in 1539, my desire is to be one “who have undertaken the part not of an accuser, but of one that points out the disease,” and does so first in my own life.

Quote from T.S. Eliot

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_The wounded surgeon plies the steel That questions the distempered part; Beneath the bleeding hands we feel The sharp compassion of the healer's art Resolving the enigma of the fever chart.

Our only health is the disease If we obey the dying nurse Whose constant care is not to please But to remind of our, and Adam's curse, And that, to be restored, our sickness must grow worse._

Recommended reading

In Our Lives First by Diane Langberg

Wounded Healer by Henry Nouwen

Question

I’m no Greek scholar, but I wonder if the “pay careful attention to yourselves” of Acts 20:28 might bear the sense of “pay careful attention to one another.” Soul care in the Christian tradition has never been a solitary matter. Who helps keep watch over your soul? Do you have somewhere to turn for preventative care should there be signs of possible infection?

Praying for and laboring with you,

Aaron Hann