Pastoral Care as Triage: Pope Francis and the church as field hospital

As many of you now know, Pope Francis has given a long interview to an Italian Jesuit magazine that has been subsequently translated and then published all over the world, including in America Magazine.  This interview is significant for many reasons (including the fact that a long interview was given which indicates transparency as the tone of Francis’ papacy).  Pope Francis made many points on a whole host of fronts.  Some of these points are more fleshed out versions of the answers he gave to reporters on the plane home from World Youth Day.  Some things are relatively new, though consistent with his other statements.  Though there is a great deal to comment on I am going to focus on a particular image that he presented in the interview; the image of the church as a field hospital.

In this statement Pope Francis has added more substance to the glimpses of his ecclesiology present in other statements and actions.  One of the first glimpses Pope Francis gave of his ecclesiology was when he stood on the balcony at St. Peter’s to be introduced to the world and referred to himself as the Bishop of Rome.  His actions after his election indicate that he believes the Pope should be close to the people, the bishops should be close to the people and the pastors should be close to the people and that every person in this structure should walk together as one.  We must do away with this “us and them” mentality…the laity or the hierarchy.  In fact we are one, the baptized faithful and this should be at the forefront of all of our actions.

To flesh out this relationship Pope Francis says the following: “I see clearly that the church needs most today is the ability to heal wounds and to warm the hearts of the faithful; it needs nearness, proximity.  I see the church as a field hospital after battle,” (America Magazine 9/19/13).  The Pope is using the image of the church as the field hospital to indicate at least two things.  First he is calling for a church of intimacy in the foxhole.  This is the intimacy of friendship that survives a war of which I am sure that there is no stronger friendship.  I recently rewatched the second season of Downton Abbey…the season which takes place during WWI.   One of the many things that this season of this show explores is the breakdown of class structure in the battlefield.  For example, Matthew (the heir apparent to Downton and the fortune needed to care for it) and Thomas (the socially ambitious, gay footman) share a drink in a foxhole not long before both are wounded.  In this foxhole they comment on the unusual nature of the two of them sharing a drink given their respective social status.  Pope Francis avers a similar vision; the church should be like the intimacy that is forged when the really important things in life (like survival) are distilled out of the less important things (like social hierarchy).  The social hierarchy should still exist but it should exist like the relationship between the heir and the servant sharing a drink in a foxhole…it should be a relationship devoid of pretense and deep in intimacy.

Secondly (related to the first point) Pope Francis is calling for an image of the church in which class structure and hierarchy is more practically understood after the foxhole.  Continuing with my season 2 of Downton Abbey theme, one of the most striking features of this show is the idea that WWI and the breakdown of the class structure that took place in the field lead to a radically new understanding of the meaning of class structure in England once the soldiers returned from the battle.  To be sure, it did not do away with a class structure.  Lord Grantham was still the Lord of the manor; Daisy was still fixing fires and working in the kitchen, King George the V was still king.  But the distance between upstairs and downstairs shifted in a radical way.  I wonder if in an inexact way Pope Francis is calling us to reimagine the relationship between the Pope and the laity in a similar way.  He is not saying that we should do away with the hierarchical structure, rather he is saying that we should recognize the point of the structure is to walk together as one and for the mission of the church (which he identifies as healing the wounds of the broken) to direct the course of the hierarchy.  He indicates that the church needs to always be close to the ground and that the hierarchy is an intrinsic part of this.

Most importantly Francis invokes this image of church as field hospital to indicate that the focus of the church needs to be on the most proximate issues.  He says “It is useless to ask a seriously injured person if he has high cholesterol and about the level of his blood sugars!  You have to heal his wounds.  Then we can talk about everything else.  Heal the wounds, heal the wounds…and you have to start from the ground up,” (America Magazine 9/19/13).  A seriously wounded person needs to be triaged for the most life threatening issues and treated for those first.  A person in pain or deep in sin or addiction or loneliness needs to be given pastoral care that first addresses this pain.  Then after this pain is addressed and has been given time to heal then other priorities can be examined.  But the first role in a pastoral situation if to deal with the proximate issue presented.

I’ll be curious to see the other reflections and analyses on this interview in the days to come.  No doubt there are more “hot button” issues to be addressed.  The secular media it seems to me is already missing the point by saying that Francis is blasting the church.  But I think at least one very significant part of this interview is that Francis is beginning to intellectually articulate his ecclesiology that represents what his actions as pope have already shown.