Sickness vs Illness in Mark
Another (very) draft extract from my book on Mark...
Mark 1:21-28
21They go1 to Capernaum; and when the sabbath came, he entered the synagogue and was teaching.2 22They were astounded (ἐξεπλήσσοντο) at his teaching, for he taught them as one having authority (ὡς ἐξουσίαν ἔχων), and not as the scribes. 23Right there, in their synagogue, was a man in an unclean spirit, 24and he cried out, 'What have you to do with us, you Nazarene!' Have you come to destroy us? I know who you are, the Holy One of God.' 25But Jesus rebuked him, saying, 'Be silent, and come out of him!' 26And the unclean spirit, throwing him into convulsions and crying with a loud voice, came out of him. 27They were all amazed (ἐθαμβήθησαν), and they kept on asking one another, 'What is this? A new teaching—with authority! He commands even the unclean spirits, and they obey him.' 28At once his fame began to spread throughout the surrounding region of Galilee.
What is healing?
Our western society has a vastly different understanding of sickness and health to the society of Jesus and Mark. If we neglect this, the significance of much of what Jesus says and does will escape us. In exploring this difference, I will make a distinction between healing vs curing, and illness vs sickness.3 This analysis also has implications for our understanding of the nature of power.
Despite much effort to work with the whole person, we have a fundamentally biomedical view of health which defines healthiness according to whether our physical organs are working properly; our unprecedented technical expertise constantly lures us in this direction. Many working within western medicine are aware of the limitations of this view, but it still underpins the system. Doctors and patients alike see sickness as basically a case of the body not working. Drugs and surgery are the default solutions we offer the sick. In this view, healing is about being cured; that is, it is about making individual bodies work properly. All this is independent of any cultural definitions of health. Therefore, a doctor in Australia can treat the same sickness in Sudan. We see the limitations of this worldview when people whose organ systems are working properly can still be profoundly ill due to social trauma, for example.
An ethnomedical4 view of health understands health and illness being intimately linked to social systems. This enables it to see ill-health having causes and healings that are wider than simple biological symptoms and biomedical interventions. Here, an illness is not bounded by the body of an individual. Illness cannot be healed without attention to the effects of the social system within which it occurs. Ultimately, it may require changes to the social system.
NRSV constantly footnotes the word leper with the footnote: "The terms leper and leprosy can refer to several diseases." It demonstrates the difference between the two medical sytems. Pilch says,
The "sickness" described in the Old Testament as leprosy is simply not leprosy [Hansen's Disease] at all from a biomedical perspective. But from the sociocultural perspective—which is what the Bible always reports—this condition called leprosy threatens communal integrity and holiness and must be removed from the community.5
In Jesus social context, seborrhoea, from the point of view of illness, could be as devastating as Hansen's Disease. In a biomedical context it is mostly inconsequential compared to Hansen's Disease. In Jesus' world, both are leprosy.
Myers says that due to the effect of economic and social upheavals occurring before CE70, and made worse by the destruction of the Temple and the city, many people were dispossessed and forced into day labouring. For day labourers, illness meant unemployment and instant impoverishment.6 Indeed, sickness and illness not only exacerbate poverty but are often caused by poverty, which is a consequence of the social system in which it occurs.
In highlighting the differences between biomedical and ethnomedical understandings I risk caricaturing them. It is true that in our society we have an increasing understanding of illness as I have described it. We can appreciate the words of Tony Hillerman's book, Listening Woman, where a Navajo woman, Mrs. Cigaret, said
I told him he ought to get someone to take him to Gallup and get his chest x-rayed because maybe he had one of those sicknesses that white people cure.
Yet our deeper self defaults to the notion of biomedical cures, as anyone with an illness that defies categorisation begins to realise when doctors (and others) discount their symptoms.
Our biomedical view of health is steeped in an understanding of power which is basically about the ability to manipulate and, in this context, correct nature. It is impositional power. Our deeper self loves this sort of power because it allows us to deny death; we can, for a time, defeat death. And this simple understanding of health asks nothing of us, no self-critique of our society.
But impositional power is also the underpinning of empire. Therefore, as one would expect, ethnomedicine which also always occurs in the context of empire, has many rituals and practices which seek to impose power. The key difference I am seeking to point out is the wider horizon of ethnomedical practice, in which the body is not merely a machine independent of the society around it.
Jesus' healings need to be read as ethnomedical healings. Indeed, Pilch7 claims
Jesus and all healers of that period could only perceive illnesses and not diseases... Notice in each healing instance the almost total disregard of symptoms (something very essential to disease). Instead there is constant concern for meaning... Jesus' activity is best described etically [that is, from our perspective as outsiders to his culture8 ] as healing, not as curing. He provides social meaning for the life problems resulting from the sickness.
Biomedical power, asking no social reflection or repentance, can easily reinforce a literal reading of scripture. If we are trapped by such a reading, my reference to Pilch's analysis will often be read as a denial of Jesus' power to heal. But Mark is neither biography nor scientific text. It is a symbolic text. Its power is symbolic power. Although we often think of symbolism as wishy-washy, and lacking in power, nations are called to war, and nations place people on the moon, through the power of symbolism. All people live within a symbolic order.
By "symbolic action" I do not mean action that was merely metaphorical, devoid of concrete, historical character. Quite the contrary: I mean action whose fundamental significance, indeed power, lies relative to the symbolic order in which they occurred.
Elaborating on this, Myers continues:
In sum, Jesus' symbolic acts were powerful not because they challenged the laws of nature, but because they challenged the very structures of social existence … his healing and exorcism functioned to "elaborate" the dominant symbolic order, unmasking the way in which it functioned to legitimate concrete social relationships. Insofar as this order dehumanized life, Jesus challenged it and defied its strictures: that is why his "miracles" were not universally embraced. Depending upon one's status in the dominant order, one either perceived them as socially deviant (worse, heretical) or liberative.9
A healing in the synagogue
Jesus first act of healing is the driving out of an unclean spirit. This central act of the pericope is bracketed by the amazement of the onlookers in vv22 and 27-28. Mark uses their response to Jesus' teaching to bluntly critique the scribes lack of authority; that is, their lack of power. This is a critique of the synagogue itself, for the scribes were recognised as being among a synagogue's leaders. In drawing this stark difference between "charisma and custodianship"10 Mark prepares us for the constant hostility and opposition which will come from the religious authorities which already results in a death plot by the beginning of Chapter 3.
At the beginning of his public ministry, in this first healing act, Jesus also makes clear what the centrality of his ministry is: "Clearing the earth of demons."11
The whole mission of the Markan Jesus is encapsulated in the implicit affirmative response to the demon's question, "Have you come to destroy us?" [And] later in the Gospel the unpardonable sin will be identified as misinterpretation of Jesus' exorcisms. (3:28-30)12
An unclean (akathartos) spirit is a Jewish idiom for a demon. By contrast, holy is roughly synonymous with clean. (katharos) At base, holiness means to be separated from the realm of the profane.13 To be clean is not about hygiene in our modern sense, but more about purity. To be unclean meant to be separated from God. In driving the demon out of the man, Jesus makes him clean, and therefore restores him from being outcast. This description of ancient events may come alive for us if we consider folk in one of my congregations who had suffered some of the worst violence our society imposes. It seemed to me that their consequent sickness remained substantially the same in my time in that congregation, and was often challenging to us. But they were loved and embraced—not merely tolerated, and not patronised—so that they were healed. They flourished. They were valued. They were a blessing to us.
How do we understand Jesus at this point? Again, we meet a major difference between our society and his. Our society is largely divided between ignoring the demonic as a superstitious hangover from the past, or naively and dangerously embracing the reality of the demonic in 'ministries' of exorcism, which periodically result in the death of children, or the abusiveness of "praying the gay away, "etc.
The first approach may suggest that the understanding of demons in Mark is now superseded by the greater wisdom of psychiatry, but this still risks reducing the demonic into a biomedical sickness, rather than seeing it as a symptom and cause of illness; remember the distinction made above between sickness and illness.
Often presenting itself as "more Christian," the second approach is often curiously invaded by biomedicalesque notions that it will cure a person of possession, even though it may use the language of casting out. It risks being seduced by the power of empire because it sees exorcism as an exercise of impositional power.
Whilst there is no doubt Jesus' actions are impositional, they are performed, as the demons themselves say, by The Holy One of God. If Mark shows us anything about ourselves as disciples, it is our tendency to failure. We repeatedly betray our calling to holiness, such that our only wise exercise of power is invitational, for anything we seek to impose will always be corrupted by the values of empire. Indeed, as I seek to imagine the nature of God which transcends anything we can comprehend, I find that in relation to people, the only consistent imagining of a loving God is entirely invitational.14
Mrs Cigaret's reference to "one of those diseases white people can heal," seems to me far closer to a "Jesus infused" worldview than much we have said in church. Whilst the treatment of illness and sickness may overlap, and while each may contribute to the other—the social illness of poverty undoubtedly contributes to much sickness—illness and sickness are two distinct areas which we need to keep separate if we are to understand the healing Jesus offers us, not to mention its power. My insistence upon this is reinforced by my own personal experience. I take a daily tablet , and have done for 30 years. If I stop taking these tablets, I get sick. But while taking the tablets, I can, and do, become ill. The symptoms often look similar, but the causes are different. Jesus offers a way to be well; that is, to be healed, independent of the sicknesses "white people" can cure. Black is correct to say Mark's Gospel,
offers the reader an alternative mythic structure: this world is an arena of cosmic contest, in which powers clean and unclean wage war,
but it is not an alternative we can safely ignore.15 The perception of the demonic remains a key understanding for human healing, and discarding it, or claiming we have advanced beyond it, leads to serious blind spots in our discipleship.
Returning to the story, using the people's amazement both before and after the healing, Mark carefully places the man with the unclean spirit in the centre of the story, and in the centre of the gathering16 of God's people. This deliberate placement says that the gathered community is ill, for it has illness at its centre. More than this, Jesus heals the man on the Sabbath.17 The timing of this healing introduces a key subtlety in Mark which we must understand. Sabbath healing is not in itself a problem. This is made clear by the question Jesus asks in Chapter 3: "Is it lawful to do good or to do harm on the Sabbath, to save life or to kill?" Some conservative authorities (See Luke 13:10-17)) might argue that the man could have been healed on the next day, but the silence of everyone present at the Mark 3 healing makes it clear that Jesus' question had only one legitimate answer. In Mark, what constitutes correct Sabbath keeping is an identity marker and rallying point for the conservative custodians of the day, whose power/authority was deeply challenged by Jesus' highly visible authority. As in so many of today's social battles over gender, sexuality, abortion, and race, the point of argument is usually tangential to the real issue, which is who controls society.
Sabbath keeping has solidified as an identity and loyalty marker by Mark 3:2, where everyone (they) is watching to see if Jesus will do it again for a third time. In response, the Pharisees go out to plot his death but here in Chapter 1, already, his teaching has provoked the demonic outburst. The demon recognises the danger Jesus poses to the social system before the human authorities, who must now find an excuse to say the good healing is actually bad.
When the demon comes out of him, the man is convulsed (sparaxan). The word sparaxan implies a tearing apart and is especially used of dogs tearing meat apart.18 The thing tears at him as it is driven out. Added to this, although NRSV translates ἄνθρωπος ἐν πνεύματι ἀκαθάρτῳ as a man with an unclean spirit, ἐν is first of all in.19 This thing has swallowed him, enveloped him. We sometimes say a person is "in a state," although that phrase does little justice to the terrors which can tear at us.
We should be clear that Jesus' teaching here, is NOT a preaching against Judaism, but a teaching within Judaism. It is Jewish self-critique. My distinction here is not some sort of "political correctness." Like any sort of racism, antisemitic theology is a scapegoating, a casting out of others to create a cheap self-manufactured grace, so that we do not have to face our own demons. In not facing our own demons, we step further in the thrall of empire. The correct way to read any critique Jesus makes of his own religious tradition is to ask, with rigour, how the criticism applies to our tradition, and to us.
In Mark, there are only three times (outside of Jesus and his followers, and Herod and Pilate) where those who meet Jesus are named. If a someone is named, then their name says something symbolically important to the content of the gospel. The three occasions are: Jairus, Bartimaeus, and … Legion (Mark 5:21, Mark 10:46, Mark 5:9.) By the name Legion, that demon, which makes the man at the beginning of Chapter 5 so terrifyingly ill, is specifically identified with Rome, Mark's key symbol of empire. Empire, which has enabled us to survive after a fashion—to survive our first violence, as it were, makes us and keeps us ill. Demons are a sign of its infiltration into our lives.
In the synagogue, the unclean spirit instantly recognises who Jesus is. The nature of this recognition is made clear by the Greek words ti hēmin kai soi. This is an Old Testament idiom which usually means either "what enmity is there between us and you," and "what do we have in common." Marcus says both apply here.20 It is as though the demon instantly recognises the enmity between them, and that they have nothing in common with Jesus. In the context of the time, the biblical sounding language, the use of Jesus' name, and the statement that "I know who you are, the Holy One of God," would be seen as the demon trying to gain the upper hand. It tries to cast out Jesus! The fact that hēmin (to us) is plural suggests it sees that Jesus is hostile to more than just itself, and we see throughout Mark, that the demons know who Jesus is but the disciples and the people, on the same evidence, can't see who he is. Empire, which is what the impure spirits represent, immediately knows who Jesus is, which is why the dictators and politicians persecute the church whenever it tells truth; they see the danger. So, as Archbishop Hélder Câmara said, "When I give food to the poor, they call me a saint. When I ask why the poor have no food, they call me a communist." Is our refusal to trust/believe Jesus a sign that we don't understand, or a sign that we would rather keep the benefits empire offers us richer people? Or do we instinctively recognise the tearing of ourselves that will occur if we allow ourselves to be cleansed?
(Andrea Prior Nov 2024)
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1. Historical present. Cf Black, section The Healing of a Man with an Unclean Spirit (1:21-28)
2. Ἐδίδασκεν is imperfect and active
2. Following Myers, Chapter 4, part B.
4. I take the terms ethnomedical and biomedical from Pilch, quoted in Myers, Chapter 4, part B. ("Healing in Mark: A Social Science Analysis." Biblical Theology Bulletin, 1985 15:4, pp. 142ff. )
5. Quoted in Myers, Chapter 4, part B.
6. Myers, Chapter 4, part B.
7. Pilch, quoted in Myers, Chapter 4, part B. ("Healing in Mark: A Social Science Analysis." Biblical Theology Bulletin, 1985 15:4,
8. I have inserted the text in square brackets.
9. Myers, Chapter 4, part B, iii
10. Black, Section 1:21-28
11. Marcus, pp190, quoting Käsemann.
12. Marcus, pp190
13. Loosely quoting Marcus, pp186-7. Remember the distinction I have made between the holy, which of God, and the sacred, which is our human construction. See: The sacred
14. God's attitudes to our social systems may be rather less gentle, but even there, disappointment and grief ring more true than imagery of violent retribution and judgement.
15. Black, The Healing of a Man with an Unclean Spirit (1:21-28) Note that I am not suggesting that Black says it can be ignored.
16. The word synagogue is derived from the Greek work synagein, to gather together.
17. See Verse 21.
18. Marcus, pp189 quoting Liddell, σπᾰράσσω
19. Cf Marcus, pp187
20. Marcus, pp187
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