Suffering Presence: Theological Reflections on Medicine, the Mentally Handicapped, and the Church
(University of Notre Dame Press, 1986).
Our culture has no memory, and indeed at times it seems to actively prevent one from forming in its people. By memory, I do not mean here each individual’s remembrance of past events, which may coincide with others’. Rather, I mean something along the lines of a deep intuition of where we as a culture have come from, what we as a society value, and who we as a people are. The Canadian philosopher George Grant has written at length about this in his essay, “In Defense of North America.” We North Americans, Grant observes, have a difficult time saying who we are because our cultural memory is lacking. We know not what the humanum is, as this knowledge has not been passed down through our generations.
We might ask what this has to do with the mentally handicapped, or society’s treatment of those who are mentally handicapped. Enter Stanley Hauerwas’s Suffering Presence: Theological Reflections on Medicine, the Mentally Handicapped, and the Church. Published originally in 1986, some of what it takes up seems rather naïve, given the bioethical issues we now face as a culture (the chapters on brain death, physician-assisted suicide and IVF, for example, all treat these issues as if they are remote possibilities), but the underlying point of all these essays remains clear: when what it means to be human is premised upon only what we as autonomous individuals can do or produce, rather than upon a much broader and deeper understanding of the humanum that takes into account our communal nature and even our natural neediness, the most vulnerable in our society will at best be pushed off to one side and neglected, and at worst be persecuted for their very vulnerability.
The book is a collection of reprinted essays, originally published from the years 1975‒1981. The topics range from medicine and medical ethics in general, to caring for the mentally handicapped in particular. Though Hauerwas never uses the term memory thematically, I think it a good way to tie together the at times disparate points of these essays—no matter to which deficiency Hauerwas alerts us, all have this deep cultural memory problem (or amnesia, as it were) in common.
...to be and to do the good is never a quest for a single individual’s superiority or freedom, but rather a community’s memory of itself and what it exists to do.
The first part of the book addresses medicine broadly, and here Hauerwas returns us to the memory of our own body, that is, the intuitive knowledge we have of both the natural powers and the natural constraints of our body. The body, then, is a natural sign of what is true about the whole of the human condition—we are limited and vulnerable, and we rely on each other all the time. The practice of medicine is a particular way in which we address this natural vulnerability (though not the only one). Medicine, Hauerwas reminds us, is not—or at least was not, for a long time—an all-out technological pursuit of life, but rather an art that is always dealing with and working within the constraints of nature. Patients and doctors alike remind each other of the memory of the body—for this is what doctors deal with, a body that lives and breathes and thinks in a necessarily limited way, and whose bounds cannot always be overcome—even with the most sophisticated technological innovation.
We come up hard against these limits when we encounter suffering, either our own or others’. This is the point at which our body—which is normally so enabling or active—becomes a burden and we know not how to face it. Hauerwas suggests that this is why we so often turn to technology in these moments; “too often we seek to do something, rather than simply learn to be with” (175), he writes. The memory of our body—what it is, its beauty, its significance—also necessarily entails the acknowledgment of our dependence, especially during these times of suffering, when we are at a loss.
It is this memory of our dependence that leads us to reject those that are mentally handicapped, Hauerwas avers. The great strength of these essays is that Hauerwas realizes, and helps his reader to realize, that the situation of those people who are mentally handicapped is not alien to our own. They, too, are human; therefore, we all have more in common than not. But this last part is no longer a given, and that has a lot to do with how we understand ourselves and what it is to be human in this culture.
Our dependency, our insufficiency, is not an evil. Nor is it an annoyance to be taken care of in some way or another. It is, rather, in some sense our very form, that out of which we grow and learn what it is to be human. Think of an infant in all its helplessness. But it is this substantial part of our nature with which we, Hauerwas points out, are entirely uncomfortable as a culture. We do not like to be reminded of it in any way, and therefore people who are mentally handicapped, who are dependent in perhaps more outward ways, are ostracized in a society like ours.
This does not mean that those who are mentally handicapped are reducible to their dependency, devoid of any agency of their own. “Are handicapped people not born like the rest of us with limits and possibilities?” (182) asks Hauerwas. This is the point: that we are always dealing with the humanum in all its dependency, though that dependency shows forth in every body in different ways all the time. But our society is based on an ethos of pure freedom, says Hauerwas—to be able to do what we want, when we want is, it seems, the ultimate good.
Nor can one individual or many individuals together simply overcome this ethos if they accept its given premise about what it means to be human. Hauerwas spends some time on the concept of rights and how we can see through the experience of the mentally handicapped and those around them that fighting for rights over against society is not a solution to the poor treatment or ostracization of those with mental handicaps. Rights come precisely out of an ethos of pure freedom, and thus “fighting for them” will never be an answer to changing our society as a whole. Hauerwas emphasizes again and again throughout these essays that to be and to do the good is never a quest for a single individual’s superiority or freedom, but rather a community’s memory of itself and what it exists to do. Thus, the “issue is not whether retarded children can serve a human good, but whether we should be the kind of people, the kind of parents and community, that can receive, even welcome, them into our midst in a manner that allows them to flourish” (167).
Too often the question about the mentally handicapped revolves around doing something about—trying to fix—the handicap or the person with the handicap. Hauerwas turns the question on its head, asking us instead to remember first of all what it means to be human, and whether, in this remembering, we might finally recognize the handicaps in our broader cultural understanding.
 This essay can be found in Communio: International Catholic Review Volume 38.2 (Summer 2011).
 This is obviously a culturally loaded term, but Hauerwas does give a reason for using it despite its grossly negative connotation. He thinks "mentally handicapped" ambiguous: "Many suppose that 'mentally handicapped' suggests mental illness. Of course someone mentally retarded could also be mentally ill, but it would be a terrible mistake to underwrite the idea that mental retardation and mental illness are necessarily related" (16). Hauerwas’s broader underlying point, however, seems the strongest reason to keep the word as it appears in his texts: that the stigmatization of the word “retarded” relies already on a society formed by an ethos of pure freedom, and he would rather not play into that ethos.