What I Would Keep

Words to Know

Hospice — care for people who are dying, focused on comfort instead of a cure.

Monastery — a community where people devoted to religious life live together, follow a shared rule, and often serve the area around them.

Name one good thing first.

Somewhere in your congregation, right now, someone is doing something nobody is thanking them for. A meal driven to a house where somebody is dying. A ride to chemotherapy, every week, from a person who is not being paid for the gas. A relapse met without a lecture. A grief that gets a casserole and a phone call for months after everyone else has stopped calling.

That is not decoration on my movement. That is my movement, running exactly the way I described it (Matthew 25:35–36).

I did not invent hospitals. But my followers built the first ones, and I can give you the names.

The word your language uses for a place that cares for the sick, hospital, comes from the same Latin root as the word for a guest. That same root sits behind hospice and hospitality. ¹

Here are the starting points, with dates, the way we have done everything else.

Around the year 370 a bishop named Basil of Caesarea, in what is now Turkey, built a settlement outside his city for the sick, for travelers and for people with leprosy, with attendants and physicians in it. Historians of medicine usually call it the first hospital. About twenty years later, in Rome, a wealthy widow named Fabiola sold her property and opened a house where she gathered sick people off the streets and nursed them herself. In Paris, the hospital called the Hôtel-Dieu — God’s guest-house — stood beside the cathedral, was run by the church for roughly a thousand years, and is still there. ²

Then the monasteries, and this is where it gets long.

Around the year 530 a man named Benedict wrote a rule for monks. It is called the Rule of St. Benedict, it is still in use, and it is short enough to read in an evening. Chapter 36 opens with this line: “Before all things and above all things, care must be taken of the sick.” ³

That one chapter is why a thousand years of European monasteries had a sick-house in them.

Honestly: the infirmary was mostly for the monks. But the same houses kept a guest-house and an alms-gate where travelers, pilgrims and the poor were fed and nursed, and for centuries in Latin Christian Europe that was the closest thing the continent had to a hospital system. ⁴

Now follow the chain, because it does not run straight from a monastery to the building where you get chemotherapy.

First it moved out of the monasteries. From the twelfth century, bishops, towns and trade brotherhoods began founding hospitals in the streets instead of behind walls. Two in London still carry the names they were given then: St Bartholomew’s, founded in 1123, and St Thomas’s, from about the same time.

Then it broke. In England the king dissolved the monasteries between 1536 and 1541 and took their property. The hospitals inside them went too, and in much of the country care for the sick poor simply stopped. Londoners had to petition the crown to get two of their hospitals back, and the city ran them afterwards.

Then it was rebuilt by subscription. From 1719, groups of private subscribers in Britain — people who paid an annual sum and elected the governors — founded hospitals in cities that had none: Westminster in 1719, Guy’s in London out of a bookseller’s fortune, and dozens of provincial infirmaries after them. Many were started by clergy and promoted from pulpits.

And nursing was rebuilt by religious orders. Vincent de Paul and Louise de Marillac founded the Daughters of Charity in 1633 to nurse the sick poor in their own homes. In 1836 a German pastor named Theodor Fliedner opened a training school for deaconess nurses at Kaiserswerth, and in 1851 a young Englishwoman named Florence Nightingale went there to learn the work.

Then cities and denominations built the rest. Look at the name on the hospital in your town. In a great many American towns it still says Saint somebody, or Methodist, or Presbyterian, or Baptist, or Lutheran, or Mercy. That is not decoration. That is the last link of the chain, still bolted to the wall. ⁵

The hospice movement has a name, a date and a delivery route.

The modern hospice movement is the idea that a dying person deserves pain control and company instead of abandonment. A British doctor named Cicely Saunders built it. She opened St Christopher’s Hospice in south London in 1967, and she said plainly, more than once, that her Christian faith was the reason she did it. ⁶

Two of her changes did the work.

First, she gave painkillers on a clock instead of on request — regular doses given before the pain came back, rather than when a patient had suffered enough to ask for relief. That one change is most of what hospice is.

Second, she taught that the pain is not only in the body. She called it total pain: the ache, plus the fear, plus the money, plus the family, plus the question of what any of it meant. So she built the place with a chaplain and a social worker in it, not only a pharmacy.

Then it travelled, and not by inspiration. An American nurse, Florence Wald, dean of the Yale nursing school, heard Saunders speak, went to work at St Christopher’s, came home, and opened the first hospice in the United States at Branford, Connecticut, in 1974. Then the law moved: in 1982 Congress created a hospice benefit under Medicare, so that this kind of care was paid for. That is the actual reason there is a hospice in your county and a nurse who comes to the house. ⁷

A bishop’s charity, a monk’s rule, a doctor’s clock, an act of Congress. That is how care travels.

I did not invent recovery, either. But look at where it actually started.

If you have ever sat in a church basement at a support-group meeting, you were sitting in a room with a longer memory than you knew.

In 1935, in Akron, Ohio, a New York stockbroker named Bill Wilson met a local surgeon named Dr. Bob Smith. Both were drunks. Both had been trying to get sober inside a Christian fellowship movement called the Oxford Group, which asked its members to surrender to God, take an honest inventory of their own wrongs, confess them out loud to another person, make restitution to the people they had harmed, and ask God each morning what to do. Wilson had got sober through it. Smith had not, yet. They began working on each other, and that is the beginning of Alcoholics Anonymous. ⁸

Now watch what Wilson did with the borrowed material, because this is the interesting part.

He kept the practices and changed the words. Surrender, inventory, confession, restitution, guidance — all five are the Oxford Group’s, and all five are still there in the Twelve Steps he wrote down in 1938. But the New York alcoholics broke with the Group around 1937, and when Wilson printed the steps the Christian vocabulary was gone. God had become “a Power greater than ourselves” and “God as we understood Him.” ⁹

That is why the meeting in your church basement sounds the way it does: a Christian practice with the doctrine deliberately unscrewed, so that anybody at all could walk in.

None of this excuses what I am about to show you in the rest of this unit, and none of what is coming cancels this out either.

Both things are true at once. The same building that inherited four centuries of putting conditions on the poor is, this week, probably also the only place in your town that will feed someone without asking why they need it. I am not going to let you use the good in this room to wave away what is wrong with it. I am also not going to let what is wrong with it erase the good. Tell them apart. That is the whole method of this book, one more time, pointed at the room you are actually sitting in, instead of at history.

Check It Yourself

Look up: Matthew 25:35–36

You will find: the six things I actually asked for — food, water, welcome, clothing, care for the sick, a visit in prison. No belief statement anywhere in the list.

The Short Version

• Whatever else is wrong with it, real, unpaid, unglamorous care happens inside churches every week, and that part is not fake.
• Hospitals began as Christian charity: Basil’s house at Caesarea about 370, then a thousand years of monastic infirmaries under Benedict’s rule (c. 530, chapter 36), then town hospitals, then the subscription hospitals of the 1700s.
• The modern hospice was built by Cicely Saunders in London in 1967. It reached America through Florence Wald in 1974 and the Medicare hospice benefit of 1982.
• Alcoholics Anonymous began in 1935 with two drunks out of a Christian movement called the Oxford Group. Bill Wilson kept its practices and took the Christian words out.

Think About It

1. Name one person in your congregation who does something like this without being thanked for it publicly.
2. Would it still happen if the building disappeared tomorrow — or does it need the room to exist?