Jean-Claude Larchet, you are one of the first to have developed a theological reflection on disease, suffering, medicine. Your book “The Theology of Illness” published in 1991 has been translated into many languages, and in connection with the COVID-19 epidemic, it will soon be published in Japanese translation. You have also published a reflection on suffering: “God does not want human suffering,” which has also appeared in various translations.
First of all, what is your general opinion on the epidemic we are currently experiencing?
I am not surprised: for millennia there have been about two major epidemics per century, and several other smaller epidemics. Their frequency is, however, increasing, and the population concentration in our urban civilization, the traffic favored by globalization, and the multiplicity and speed of modern means of transport easily turn them into pandemics. The present epidemic was therefore predictable, and was predicted by many epidemiologists who had no doubt that it would come; the only thing they did not know was the precise moment when it would occur and the form it would take. What is surprising, though, is the lack of preparedness of some states, which, instead of providing the medical staff with the hospital structures and equipment needed to deal with the scourge, have allowed hospitals to deteriorate and the production of medicines, masks, and respirators, which are now sorely lacking, to be outsourced (to China, like everything else).
Diseases are omnipresent in the history of mankind, and nobody lives a life completely unscathed by them. Epidemics are simply diseases that are particularly contagious and spread rapidly until they reach a large part of the population. The characteristic of the COVID-19 virus is that it seriously affects the respiratory system of the elderly or people weakened by other pathologies, and has a high degree of contagiousness that rapidly saturates intensive care systems with the large number of people affected simultaneously in a short period of time.
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The fact that it has become impossible to receive communion for some time poses a serious problem for some of the faithful. Here again, some extremists see the successful effect of an anti-Christian conspiracy…
I do not share these conspiracy theories, insofar as they involve people or organizations, and especially since, as I have said, epidemics are recurrent and cyclical in the history of humanity; nevertheless, I believe that in this epidemic and its consequences, the devil is at work; I will tell you why in the rest of our interview.
With regard to the deprivation of communion, several things can be said. Those who are accustomed to weekly (or more frequent) communion and draw from communion great strength for their lives are suffering a lot in this situation and we understand them. As a consolation, we can recall that the Life
of St. Mary of Egypt, whom we solemnly commemorate on the fifth Sunday of Great Lent, recounts that she received communion only twice in her life: immediately before embarking on her life of ascesis, and just before her death; and that in her time (as is recalled in her Life
which we read in church on the occasion of this commemoration), the custom was that monks living in community withdrew individually into the desert at the beginning of Great Lent, and returned to the monastery only on Holy Thursday to receive communion. It may also be recalled that many Fathers who withdrew to the desert only communed at most once a year. We are by necessity subject to the same distance from communion during this Great Lent, and thanks also to the confinement in our apartments and homes (which for many, in our world of incessant movement and outside occupations, have become as austere as any desert), we can share a little of their experience. We can benefit from this. First of all, today—especially in the Diaspora—communion has become frequent (whereas a few decades ago, in Orthodox countries, it was rare), to the point that there is a risk of it becoming commonplace. A few years ago, I spoke about this with Bishop Athanasius Jevtić, who told me that it is useful to fast periodically from communion in order to regain a sense of its seriousness and to approach it with a genuine desire and need. Second, we can recall that the effects of communion do not dissipate after receiving it. Its effects are proportional to the quality of our receptivity, and this receptivity concerns not only our state of readiness for communion, but our state towards it after receiving it. To help us, the Church provides us with a series of prayers before communion and after communion. I know of several spiritual fathers who encourage their spiritual children to read the prayers after communion each day until the next communion, so that they may remain aware of “the precious gifts that have been received” and continue to actualize the grace they have brought to us.
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How do you live with containment? This apparently poses problems for our contemporaries…
We are fortunate that the state-imposed quarantine coincides in part with the “holy quarantine” of Great Lent. It is the tradition for us Orthodox during this period to limit our outings, leisure activities, and consumption; it is also the tradition to take advantage of this period of calm and greater solitude, to return to ourselves, increase our spiritual readings, and pray more. For all this, we have the experience of the past years; it will only be necessary to prolong the effort by a few weeks.
Overall, the confinement is a good opportunity to experience the hesychia
dear to Orthodox spirituality, a state of solitude and especially of exterior and interior calm; to rest from the incessant movement, noise, and stress linked to our usual living conditions; and to re-inhabit our interior dwelling—what the Hesychastic Fathers call “the place of the heart.”
Confinement also allows couples and children to be together more often than usual, and this is beneficial for everyone. Of course, this is not always self-evident, since some are not used to living together for a long time, but it can be an opportunity to strengthen relational bonds positively.
This return to oneself and to married and family life should not be a forgetting of others, however. Almsgiving, which is part of the usual practice of Lent, can take the form of a more sustained and regular assistance to people we know who suffer from illness, loneliness, or excessive worry. For this activity, modern means of communication are good…
I note that many of our fellow citizens have had to come up with sports activities in their homes and apartments. During Lent, we are used to making great prostrations. We can multiply them (the monks have a rule of doing at least 300 a day, some of them do up to 3000!). Patriarch Paul of Serbia, who did them every day until he was 91 years old (only a knee injury could stop him!), said, with the strength of his medical studies and his good health, that they were the best gymnastics people can do to stay in shape…
Let’s turn now, if you don’t mind, to some more theological questions. First of all, to whom or to what can we attribute the current epidemic and diseases in general?
An epidemic is a contagious disease that spreads. All that can be said about disease can be said about it as well, except that its massive character that is imposed on a region, a country, or the whole world (as is the case at present), raises additional questions. It is not surprising, in religious discourse, to see the theme of Revelation, the end of the world, or the idea of divine punishment for the sins of men, with allusions to the flood (Gen 6–7), the fate of Sodom and Gomorrah (Gen 19), the plague that decimated the camp of David after the census (2 Sam 24:15) or the seven plagues of Egypt (Ex 7–11). Some clarifications are therefore necessary.
According to the Orthodox conception developed by the Fathers from the Bible, ancestral sin (which in the Western tradition is called original sin) had, on the physical level, three effects: passibility (of which suffering is a major form), corruption (of which sickness is the main form), and death, which results from the latter. The sin of Adam and Eve consisted in separating from God, which resulted in the loss of the grace that assured them of impassivity, incorruptibility, and immortality. Adam and Eve, being the prototypes of mankind, consequently transmitted to their descendants their human nature that had been altered by the deleterious effects of their sin. The disorder which affected human nature also affected the whole of nature, for man, separated from God, lost his status as king of creation, and deprived the other creatures of the grace he transmitted to them as mediator. Whereas creation was originally entirely good, as God had created it (as we are told in Genesis chapter 1), evil has entered into it as it did into man: an evil that is not only moral but also physical, and which results in the disorder that affects the original order of creation as well as the processes that destroy what God has established. God’s Providence, as Vladimir Lossky notes, has prevented creation from being completely destroyed, but nature has become a battlefield in which good and evil constantly clash. Living organisms are constantly fighting to eliminate microbes, bacteria, viruses, or genetic alterations (due to aging or environmental factors) that seek to destroy them, until, weakened by old age (which diminishes their immune defenses), they are finally defeated and die. For millennia, bacteria or viruses can affect only animal species, or be hosted by them without affecting them, and then suddenly be transmitted to humans. This is what has happened to the different species of viruses that have caused epidemics in recent decades.
You’re pointing out the guilt of the first parents in this process. Do the sins of their descendants, our own sins, play a role in this process? The prayers found in the Great Euchologion (the official prayer book of the Church) for times of epidemic, but also the speeches of some bishops, priests, or monks, blame here the sins of all, seeing in what is happening a kind of punishment on their account, and call for repentance.
According to the Orthodox conception (which differs on this point from the Catholic conception of original sin), the fault of Adam and Eve themselves is personal and is not transmitted to their descendants; only its effects are transmitted. However, their descendants, from the beginning to the present day, have, as St. Paul says in chapter 5 of the Epistle to the Romans, sinned in a manner similar to that of Adam; they have imitated him and have confirmed his sin and its effects by their own sins. There is, therefore, a collective responsibility for the evils that affect the fallen world, which justifies that one can blame sin and call for repentance. However, this applies on a general level so as to explain the origin and sustenance of sickness and other evils, and not on a personal level to explain whether it happens to a particular person or group of people. While some illnesses can be traced to personal faults or passions (e.g., illnesses related to excessive eating or drinking, or sexually transmitted diseases), others occur regardless of the spiritual quality of the people they affect. Sick children are not guilty of any fault; saints do not escape illness and often have more illnesses than others who are morally disordered. Epidemics sometimes strike down entire monasteries; for example, an epidemic of plague struck the monasteries of the Thebaid after Pascha in 346, killing a third of the Desert Fathers who lived there, including St. Pachomios, the father of cenobitic monasticism; the successor he had appointed; and nearly a hundred monks in each of the great monasteries of the region. During the great plague epidemics of the past, Christian observers were forced to observe that the disease struck people randomly in terms of their moral or spiritual quality. The question of the relationship of disease to a person’s sin or the sin of his parents was put to Christ, who replied to his disciples about the man born blind: “Neither he nor his parents have sinned.” The illness therefore has an original, principal, and collective relationship to sin, but only in a minority of cases does it have a present and personal relationship. I think, therefore, that the question of sin and repentance in prayers or sermons can be addressed but must be addressed in a discreet manner. People who suffer from illness do not need accusations of guilt added to their suffering, but need support, consolation, compassionate care, and also help to take spiritual responsibility for their illness and suffering so that they can spiritually turn it to their advantage. If repentance has a meaning, it is as a turning point, a change of state of mind (which is the meaning of the Greek word metanoia). Illness gives rise to a series of questions that no one can escape: why? Why me? Why now? For how long? What am I going to become? Every illness constitutes a questioning that is all the more lively and profound because it is not abstract or gratuitous, but rather part of an ontological experience. This questioning is very often a kind of crucifixion. For sickness always calls into question more or less the foundations, framework, and forms of our existence, the acquired equilibrium, the free disposition of our physical and mental faults, our reference values, our relationships with others, and our very life, because death always appears more clearly than usual (this is the case in particular for this epidemic, which has unpredictably and rapidly felled people, especially the elderly, but also younger people without there being serious underlying pathologies in every case). Illness is an opportunity for each person to experience his ontological fragility, his dependence, and to turn to God as the one who can help overcome it: if not physically (for there do occur, in response to prayer, miraculous healings), then at least spiritually, and give it a meaning by which one builds oneself up, and without which one only allows oneself to be destroyed.
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Your earlier remarks raise another question: why does God, if he is good and all-powerful, not abolish sickness and suffering in this world, and why do they persist when Christ has overcome them for all humanity, which he has assumed in his person?
This is a strong objection among atheists, and often raises doubts among believers.
The answer of the Fathers is that God created man free, and respects man’s free will even in its consequences. Because sin is perpetuated in the world, its consequences continue to affect human nature and the entire cosmos.
Christ removed the necessity of sin, put an end to the tyranny of the devil, and made death harmless, but he did not remove sin, the action of demons, physical death, or the consequences of sin in general, so as not to force and deny the free will that caused it. On the physical level, the fallen world remains subject to its own logic. For this reason, too, illness affects each person differently, and this is particularly striking in the case of an epidemic: according to individual physical constitutions, it affects some and spares others; it affects some slightly and affects others severely; it causes some to die and leaves others alive; it kills teenagers and spares great old men.
Only at the end of time will the restoration of all things take place and there will appear “a new heaven and a new earth,” where the order and harmony of nature destroyed by sin will be restored in a nature raised to a higher mode of existence, where the goods acquired by Christ in his redemptive and deifying work of our nature will be fully communicated to all who have united themselves with him.
The man who lives in Christ in the Church, where the fullness of grace is found, receives the “pledge of the Spirit,” knows spiritually the first fruits of the goods to come. On this spiritual plane, sin, the devil, death and corruption no longer have power over him, cannot affect him; he is spiritually free from them. But incorruptibility and immortality, if thus assured to him, will become real for his body only after the Resurrection and the Judgment, just as the deification of his whole being will find its complete fulfillment only at this ultimate moment (cf. 1 Cor. 15:28).
With this expectation, Christianity is concerned with alleviating human suffering and healing diseases, and it has always encouraged the means used to do so…
Love of neighbor is, together with love of God, the main virtue advocated by Christianity. Love of neighbor implies compassion, a willingness to help him in everything, to console him, to support him, to relieve him of his suffering, to cure his illnesses, to keep him healthy. The miracles performed by Christ and the Apostles set an example. This is why Christianity, from the very beginning, has recognized the merits of medicine, has not hesitated to integrate the “profane” medicine practiced in the society where it was born and developed, and has even been one of the founding figures in the creation of hospitals. For centuries, in both East and West, and until relatively recently, nurses were nuns (in Germany, nurses are still called Krankenschwestern, “sisters of the sick”!). In the current epidemic, all researchers, doctors, nurses, ambulance drivers, but also all technical and maintenance staff, have shown a dedication and spirit of sacrifice, even to the point of endangering their own health and lives, which is in every way in keeping with Christian values. All the churches bless them, and we must strongly support them with our prayers.
Since you have said that somehow fallen nature follows its own logic, can our prayers have an effect on this epidemic, to slow it down or stop it?
Our duty is to pray to God to stop this epidemic. But for this to happen, everyone would have to turn to him and ask him for it. Otherwise, out of respect for their free choice, he will not impose his omnipotence on those who do not want to acknowledge him and ask for his help. This is the reason why divine action has not manifested itself to stop the great epidemics of the past. God, on the other hand, has responded to the request of small united groups and has miraculously stopped localized epidemics. In the same way, breaches in the logic of the fallen world have always been made in favor of particular persons through the intervention of God, the Mother of God, or the saints. But by definition, miracles are exceptions to the common and usual order. Christ himself did not perform collective healings, but always individual healings, and always, it must be emphasized, in connection with a spiritual goal and concomitant spiritual action (the forgiveness of sins) related to a person’s life and destiny. This gives me the opportunity to recall that just as sickness can be spiritually turned to our advantage, the health preserved or regained is useless if we do not make good spiritual use of it. Likewise, one of the questions posed to us by the current epidemic is: what have we done so far with our health, and what will we do with it if we survive?
With regard to the miraculous healings accomplished by Christ, we see that they were granted sometimes at the request of the people he healed, sometimes at the request of their relatives. This reminds us that it is important to pray for ourselves, in order to obtain protection and healing, but also for our loved ones, and more broadly for all people, as do all the saints who pray for the whole world, because in their own person, they feel solidarity with all.
Prayers of all kinds have flourished on Orthodox websites in recent weeks. Which prayer(s) do you particularly recommend?
Every prayer is good, because it brings us closer to God and to our neighbour. One can address Christ, the Mother of God, and all the saints, because, as St. Paisios the Athonite told me during one of my meetings with him, every saint can cure all illnesses and the saints are not jealous of each other.
Nevertheless, I remain somewhat skeptical about certain forms of piety which border on superstition, but which are inevitable in such circumstances: for example, a Saint Corona has recently been brought out of oblivion; she will no doubt soon be joined by Saint Virus (the bishop of Vienna in the fourth century).
For my part, I like very much and use several times a day the prayer composed by Patriarch Daniel of Romania, which is short, simple, and complete at the same time. I have modified the text very slightly:
“O Lord our God, who are rich in mercy and who with diligent wisdom guide our lives, hear our prayer, receive our repentance for our sins, put an end to this epidemic.
You who are the physician of our souls and bodies, grant health to those who are afflicted by sickness, making them rise promptly from their bed of sorrow, so that they may glorify You, the merciful Savior.
Preserve those who are healthy from all sickness.
Preserve us, Your unworthy servants, and our parents and relatives.
Bless, strengthen, and guard, O Lord, by Your grace, all those who, with love for humankind and a spirit of sacrifice, care for the sick in their homes or in hospitals.
Remove all sickness and suffering from Your people, and teach us to appreciate life and health as gifts that come from You.
Grant us, O Lord, Your peace and fill our hearts with an unshakeable faith in Your protection, hope in Your help, and love for You and for our neighbor.
For it is Yours, O our God, to have mercy on us and to save us, and we glorify You: Father, Son, and Holy Spirit, now and ever and unto the ages of ages. Amen.”