Sualeha Shekhani
Karachi, Pakistan

“If the swords of past conflicts are beaten into plowshares, and if taboos regarding the discussion of religion can be overcome, both medicine and religion can learn constructively from each other.”¹

The opposition of reason and religion has a long history. While this may be due to their unique epistemological positioning, bitterness and animosity on both sides have also been shaped by historical events. Scientists such as James B. Conant have stated it is not possible for religion and science to have a dialogue since they constitute “incompatible universes of inquiry.”²

Gabriel Garcia-Marquez captures this dichotomy in his 1994 novel Of Love and Other Demons. The novel tells the story of a twelve-year-old girl, Sierva Maria, who is bitten by a rabid dog. She does not develop rabies, but her father, Marquis de Casalduero, in utter desperation seeks the counsel of healers and physicians, who in turn worsen her condition. The ultimate recourse is to seek help from the Church, which then claims the symptoms of Sierva Maria are due to demonic possession, and that exorcism is needed to “save her soul.” Sierva Maria is confined to a cell in the Convent of Santa Clara and is tortured. She finds romantic love in a priest, Cayetano Delaura, who has been told to investigate her demonic possession. Delaura tries to convince the higher order that she is not possessed by demons, but his own guilt due to his desire for Sierva Maria and a series of unfortunate events lead to an exorcism ritual practiced by the Bishop himself.

In the eighteenth century post-colonial world where this story is set, the boundaries of medical science remain limited, and the Church still yields unquestioning authority. Even Marquis de Casaldeuro, who has long given up faith in God, starts to pray and believes it is ordained by Divine Will for his daughter to undergo exorcism. Garcia-Marquez therefore cleverly weaves into this narrative how traditional beliefs still permeate a world increasingly influenced by medical science and reason.

An interesting contrast between religion and reason is also seen in the largely differing characters of the Bishop and the Jewish physician Abrenuncio who is also summoned by Marquis to treat his daughter. Abrenuncio’s life is described as “without God.” He is regarded as heretical by the Church, and some of his antics are considered “an affront to faith.” When the Marquis puts forward medical reasoning for his daughter’s symptoms, they are disregarded by the Bishop until the desperate father has no choice but to protect his daughter from “eternal damnation.”

While one can consider the unquestioning authority of the Church as tyrannical, Sierva Maria fares no better either at the hands of physicians (apart from Abrenuncio) and healers who attempt to treat her or through the efforts of the Church to save her soul. Yet there are lessons here in how traditional beliefs about disease guide the decision-making of many patients.

More often than not, explanations for disease and illness stem from theology, such that illness represents demonic possession, a punishment from God, or a way to atone for one’s sins.

Healthcare professionals must understand that patients and their families may want to discuss this, especially during moments of consolation or despair.¹

Garcia-Marquez also shows how science and religion reject each other. Consider the conversation between the Bishop and the Viceroy. The Bishop suffers from violent coughing episodes and other symptoms of asthma. When the Viceroy offers his physicians to the Bishop, the response is “Everything that pertains to me is the hands of God,” thus ultimately rejecting the benefits of scientific advances.

For the Church to also view rabies as “one of the many snares of the enemy,” the enemy of course being Satan, is another profound symbol of how diseases are viewed through the lens of spirituality. The idea that Garcia-Marquez presents in his novel is not new. Throughout history various cultural traditions have regarded rabies as demonic possession or sorcery.³ Even Abrenuncio in the novel provides a lengthy explanation of rabies through the lens of demonic possession.

The profound and ultimate question is whether religion and science will continue to reject one another or should learn from each other in order to provide holistic care to patients?

The interaction between the Bishop and Delaura brings forward the viewpoint that reason can help to resolve matters of faith and religion. Delaura, though a devoted priest, is also interested in secular ideas and loves poetry. After spending time with Sierva Maria, he concludes that her behavior is a result of parental neglect and time spent with slaves rather than demonic possession. His “reasoning” is rejected by the Bishop, who claims “The Enemy makes better use of our intelligence than our errors.”

The Bishop represents the strict authority of faith, spirituality, and reason, but such rigidity is also not uncommon among healthcare professionals who simply cannot relate to the spiritual aspect of their patients’ lives. Garcia-Marquez also presents the limitations of reason and science in the words of Abrenuncio, “Science has not given me the means to tell you anything else.”

Traditional belief systems, some of which may be regarded as “superstitious,” will continue to play a role in healthcare in one way or another. In Pakistan, a South Asian Muslim country, the first point of contact for psychiatric illnesses are often traditional and faith healers, with the underlying cultural belief in symptoms of mental illnesses interpreted as a result of black magic, or black eye.⁴ This is true for other societies as well. In Ghana, for instance, a study found that patients and their families preferred to seek spiritual healing as the first point of contact for illness because healthcare professionals do not have enough time and patience to listen to their unique stories.⁵

In times of vulnerability, particularly when science fails to answer questions about the reasons for disease and illness, patients and families may cling to faith, as Garcia-Marquez demonstrates through the steps taken by Marquis. The schism that exists between traditional healing practices and modern biomedicine has to be reconciled and brought together in harmony. One should not dismiss the other but rather interact with one another. There is historical evidence of the two working together; for example, in Judaism some of the rabbinic sages were also people of medicine and science, including Moses Maimonides.⁶

Abrenuncio, the physician who is considered an atheist, proclaims towards the end of the novel, “Our patients entrust their bodies to us, but not their souls, and like the Devil, we try to win them from God,” emphasizing the importance of spirituality and faith in the process of healing. It also signals to physicians to not attend only to the bodies of their patients, but to also to try to understand the intricate workings of their minds and souls. While there might be difficulties in understanding how traditional medicine works, healing is promoted because patients derive some meaning from it.⁷

If physicians simply reject the spiritual aspect of illness, this will only serve to alienate the patient and create more distance between science and religion. On the other hand, cultivating this aspect within the physician-patient relationship may help to find purpose, meaning, and hope. And if all fails, as Garcia-Marquez presents in his book, it is love and happiness that can heal, as captured powerfully in Abrenuncio’s proclamation, “No medicine cures what happiness cannot.”

Note

All quotes from Of Love and Other Demons have been taken from the 2008 version published by Penguin Books.

References

1. Vanderpool, Harold Y. “Religion and medicine: A theoretical overview.” Journal of Religion and Health 19, no. 1 (1980): 7-17.
2. Roth, Nathan. “The dichotomy of man: Religion vs. science.” Journal of religion and health 15, no. 3 (1976): 151-158.
3. Mahawar, Madan Mohan, and D. P. Jaroli. “Traditional knowledge on zootherapeutic uses by the Saharia tribe of Rajasthan, India.” Journal of Ethnobiology and Ethnomedicine 3, no. 1 (2007): 25.
4. Assad, Tarek, Tarek Okasha, Hisham Ramy, Tamer Goueli, Hanan El-Shinnawy, Mohamed Nasr, Heba Fathy et al. “Role of traditional healers in the pathway to care of patients with bipolar disorder in Egypt.” International Journal of Social Psychiatry 61, no. 6 (2015): 583-590.
5. Peprah, Prince, Razak M. Gyasi Mohammed, Prince Osei-Wusu Adjei, Williams Agyemang-Duah, Emmanuel Mawuli Abalo, and Josephine Nii Amon Kotei. “Religion and Health: exploration of attitudes and health perceptions of faith healing users in urban Ghana.” BMC public health 18, no. 1 (2018): 1358
6. Levin, Jeff. “Partnerships between the faith-based and medical sectors: Implications for preventive medicine and public health.” Preventive Medicine Reports 4 (2016): 344-350.
7. de Andrade, V. ““Traditional healers and modern doctors do not understand each other because they learn different things” South African traditional health practitioners training with regards to hearing impairment.” International Journal of Health Promotion and Education 49, no. 3 (2011): 120-127.