Wendell Berry, Health,
In a lecture entitled “Health is Membership” delivered at a conference on “Spirituality and Healing” held in Louisville, Kentucky, on October 17, 1994, Wendell Berry unpacks the notion of health as wholeness, particularly with respect to a person’s community and physical or geographical place.[i] After rehearsing the etymology of health in terms of “heal,” “whole,” and “holy,” Berry claims, “wholeness is not just the sense of completeness in ourselves but also is the sense of belonging to others and to our place” and concludes his claim with “health is not divided.”[ii] In other words, it is not limited to a single body part or even to a single body but it is the product of a collection of bodies organically related to one another and physically located in a particular geographic place. Health then is not just personal but also public and even planetary, and such health has important implications for the current coronavirus disease 2019 (COVID-19) pandemic.
Berry develops his notion of health based on several personal beliefs. One belief is that wholeness is rooted in love and that this love is what sustains the wholeness not only of the induvial but also of the individual’s community and place. Another belief is that wholeness is equivalent to health, and in defense of this belief he quotes the botanist Albert Howard, “the whole problem of health in soil, plant, animal, and man [is] one great subject.”[iii] In other words, for Berry health is ecological at its very foundation. If the soil, plants, and animals are healthful, then so is humanity. Thus, “a place and all its creatures,” according to Berry, “is the smallest unit of health and that to speak of the health of an isolated individual is a contradiction in terms.”[iv] One final belief is in the materiality of the body and place as it relates to health. For Berry, “to respect the body fully [in terms of its health] is to honor fully its materiality.”[v] And he goes on to reject the divide between the physical and the spiritual as relevant to a person’s heath, which brings us to two major assumptions that he critiques.
According to Berry, modern industrialized medicine assumes both dualism and reductionism to frame its approach to health. And he acknowledges that he “would like to purge my own mind and language of such terms as ‘spiritual’ [and] ‘physical.’”[vi] What he argues is that a person is composed of “one continuous fabric” embedded within its place. For Berry, nothing is really gained by dividing the person into a false dualism of body and spirit. Rather, it leads to loss of personhood through the second assumption—reductionism. Modern medicine, he argues, analogizes the body to a machine and then reduces it to parts that can be separated from the body as a whole and treated individually. The impact on medicine is over specialization such that a gastroenterologist “will pay attention only to your stomach” but not to your “home, community, and family.”[vii] The Harvard physician Francis Peabody made a similar observation almost a century ago when he encouraged clinicians to paint an “impressionistic painting of the patient surrounded by his home, his work, his relations, his friends, his joys, sorrows, hopes, and fears.”[viii] Finally, Berry critiques this analogy of the body with a machine in that a machine lacking fuel is simply idle while a body lacking food, water, etc., is a “cadaver.”
Berry continues critiquing reductionism by confronting the notion that the mind is comparable to a computer. For him, just as the body is not a machine so the mind is not a computer. To support his position, Berry distinguishes between knowledge and information. Knowledge pertains to “the ability to do or say the right thing at the right time.”[ix] In other words, knowledge is a type of wisdom that allows a person to act appropriately. Information, on the other hand, is simply “data.” “Whereas knowledge moves and forms acts,” Berry insists, “information is inert.”[x] Only minds can produce knowledge not computers and to compare minds to computers is to lose knowledge in a morass of information or data. Berry’s distinction between knowledge and information is reminiscent of T.S. Eliot’s chorus from The Rock: “Where is the knowledge we have lost in information.”[xi] For Berry then, health, particularly mental health, is not simply the smooth running of a computer that analyzes data qua information but rather it is the wise analysis of such information qua knowledge that allows a person to behave healthfully towards not only oneself and others but also the environment.
Midway through the lecture, Berry queries whether modern industrialized medicine can “produce an adequate definition of health.”[xii] In an interesting move, he claims that a definition of health is not complete unless it includes death, not just in the abstract but also in the concrete. For him, death—in contrast to modern medicine’s belief—is not a “curable disease” but a constraint on human existence and one not necessarily to be lamented but celebrated. In other words, for a life lived well death is a fitting closure and must be afforded dignity. This is an important observation. Modern industrial medicine marshals all of its power and resources to save lives or to prolong life, and when a life is lost medicine considers itself a failure. But death, Berry argues, is part of the cycle of life. He returns to Howard for support and claims that Howard “saw accurately that the issue of human health is inseparable from the health of the soil, and he saw too that we humans must responsibly occupy our place in the cycle of birth, growth, maturity, death, and decay, which is the health of the world.”[xiii] In other words, for the soil to be healthful its health must be returned by those living beings that borrowed it for their health. Finally, for Berry, the dead no longer occupy the place of life but the place of death—cemeteries separated from the living. Historically, the dead were buried on the land in which they lived, and their graves served as reminders for their offspring of their lives.
As noted above, Berry’s notion of health in terms of membership in a community located in a particular place has important implications for the current COVID-19 pandemic. One notable implication is that the pandemic is the outcome of wounding the earth’s ecology. That wounding provides opportunities for pathogens, like severe acute respiratory syndrome coronavirus-2 (SARS CoV-2), to cross over into the human population with dire consequences, especially since COVID-19 is a zoonotic disease. The pandemic is a clarion call that we must utilize our ecology in a wise and sustainable manner and protect our planet’s health, otherwise it might become inhospitable or unhealthful for us. Another implication of Berry’s notion of health in terms of the pandemic is just how much our personal health is tethered to our community’s health. If a community is healthful in the use of its environment, then the chances of its members being infected with the SARS-CoV-2 are diminished. But if the community is unhealthful, then the chances are augmented. A good example is our industrialized food system, especially animal husbandry. Workers in slaughterhouses have been particularly susceptible to coronavirus infection.[xiv] As Gracy Olmstead sums up the relevance of Berry’s wisdom for the COVID-19 pandemic times, “we are indeed part of a membership, and that our health is therefore predicated on more than our own physical resilience. To be healthy, we must acknowledge—and love—the entire web of life we are part of.”[xv]
In conclusion, Berry’s notion of health as communal membership is still salient today as it was when he first delivered the lecture almost three decades ago—particularly with respect to the COVID-19 pandemic. First, health is more than simply a personal attribute that is severed from the public arena. Rather, it is embedded or associated physically with the public and planet, both in terms of others and place. And this has implications for political health as well. As Philip Ball writes, “We cannot expect good public health to be valued and nurtured if political health is poor.”[xvi] We need healthful politics to ensure resilient public health. Moreover, health flourishes when we are compassionate with one another and our ecology rather than exploitive. Finally, Berry’s lecture is also a clarion call for inculcating humanistic values into medicine. Medicine must treat the patient as a whole person in terms of the patient’s biological, psychological, social, and ecological dimensions. Not to do so is to provide medical care that is fragmented and ineffectual, and in the end such care is injurious to the health not only of the individual but also of the community and its place.
©2023 James Marcum
All rights reserved
…is a philosopher of medicine at Baylor University and has published extensively in the area, including an introductory text to the subject (Springer 2008). He is also a philosopher of science, who studied under Thomas Kuhn at MIT, and has written a book on Kuhn (Bloomsbury 2015) and an article in The Times Literary Supplement (17 January 2018).
[i]. Wendell Berry, “Health is Membership,” in Another Turn of the Crank: Essays (Berkeley: Counterpoint, 1995), 86-109.
[ii]. Ibid, 87.
[iii]. Ibid, 90.
[vii]. Ibid, 88.
[viii]. Francis Peabody, “The Care of the Patient,” Journal of the American Medical Association 88, no. 12 (1927): 877-882, 878.
[ix]. Berry, “Health is Membership,” 95.
[x]. Ibid, 96.
[xi]. T.S. Eliot, The Rock (New York: Harcourt, Brace and Company, 1934), 7.
[xii]. Berry, “Health is Membership,” 99.
[xiii]. Ibid, 97.
[xiv]. Leah Garces, “COVID-19 Exposes Animal Agriculture’s Vulnerability,” Agriculture and Human Values 37 (2020): 621-622. https://doi.org/10.1007/s10460-020-10099-5.
[xv]. Gracy Olmstead, “Wendell Berry’s Wisdom in a Time of Pandemic,” Breaking Ground (4 June 2020). breakingground.us/coronavirus-health-is-membership/.
[xvi]. Philip Ball, “What the COVID-19 Pandemic Reveals About Science, Policy, and Society,” Interface Focus 11, no. 6 (2021): 20210022, 9. https://doi.org/10.1098/rsfs.2021.0022.