IT IS perhaps unfair to single out one point in Daniel Ménager’s fascinating Convalescences: La littérature au repos for a quibble, but, when he remarks that neither God nor the medical profession concerns itself with convalescence, he makes a surprising mistake.
As a professor of Renaissance literature, he might read the Bible’s accounts of miraculous healing with an eye to the type of literature that it is — and whatever it is, it is not a medical textbook.
When miraculous physiological events occur, the biblical writers are concerned to show God’s power and grace rather than give medical tips. Any tips offered will be concerned with receptivity to God’s life, and perhaps the writers are, in any case, only writing about miraculous spiritual events that a change of heart, or newly opened eyes, symbolise. Eternal life, after all, has never been attained by recovery from disease.
On the other hand, Ménager is surely right to point out the almost complete lack of interest in convalescence in medicine. Just as the scriptural writers rarely dwell on convalescence because it has no contribution to the messages about power and grace, medics, similarly, ignore it, for the most part, because it is not something over which they have power.
They have done all they can with drugs, or surgery, or advice. From now on, it is up to the patient, supported, educated, and encouraged by physiotherapists, nurses, social-care teams, chaplains, and/or their own families and friends.
And, as most novelists find, it is inherently boring. It is about swaths of time when nothing dramatic happens, though internal processes of mind and body are gathering forces silently, as unseen as sap rising in late winter.
Convalescence, then, is traditionally where the nursing profession (and, increasingly, physiotherapy) comes into its own, providing all the very best conditions, as a nursery does for new plants, for nurturing this new life, welling up from within the patient when whatever prevented its flow has been removed.
Florence Nightingale, that great analyst and organiser and educator of the nursing profession, had a poor view of doctors, but a high view of nursing. I learned from Mark Bostridge’s recent biography that she believed the “Cause of death” section on each death certificate should contain only the word “Doctor”. I learn from Christian Scientist friends that, while they have no doctors, they do have hospitals where Christian Science-trained nurses provide all that they believe necessary for people to learn to get well.
HOW do we get well again in these nurseries of care? Ménager speaks of the privileges and obligations of convalescence. To be cared for is a huge privilege: to escape the obligations of work, be sheltered from the wind and weather, have time to read, be brought grapes and flowers and little trays — in some respects to return to a happy childhood.
But the concomitant obligations and obediences are what account for its tedium. In a Christian Science hospital, you are also given daily scripture readings and encouragement to meditate on them, while other amusements are severely restricted.
AlamyThe Convalescent by Francis Tattegrain, 1884
In any other setting, it is certainly about strict attention to balancing exercise and rest, taking medicine punctiliously, enduring injections possibly, fasting and optimal nutrition — and sleep, exercising when it hurts, resting when one is impatient to get on with things, everything in dull moderation. We have to bring the discipline and devotion of a dancer or an athlete to the minutiae of daily life, often tiresomely, and that can make us thoroughly tiresome not only to ourselves but others as well.
Convalescence, then, is spiritual experience, just as much as receiving a miraculous stay of execution, or the restoration of powers perhaps once taken for granted, sometimes recklessly. It demands patience, perseverance, faith, self-control, faithful effort, gentleness, peace . . . you can see where I’m going here. It is a “wilderness” experience of maturing that produces fruit of the Spirit. That resulting change of life, for someone like me, would be just as much of a miracle of grace and power.
The depth of such change takes time for most of us, and even physical convalescence is an uneven race. A colleague of mine in cardiac care once commented on how the heart can be rescued by surgery pretty instantaneously, but it takes a long time for the soul to recover from the assault it has received. I became aware myself of how long some people took to recover from anaesthesia, or the disorientation they experienced in ITU, even though they were growing sound in wind and limb again.
Healing, however miraculous, is often a very long process of mind and body after an illness or injury, and the time it takes is significant. The famous convalescents who spring to mind are Francis and Ignatius, two impetuous young men who rose from their beds to change the world.
WHAT about love, then, and joy? Well, love is the basis for all healing. Doctors are beginning to re-evaluate what was once called “a good bedside manner”, and a few are even teaching love (in scientifically acceptable, “evidence-based” terms, of course) through techniques such as neuro-linguistic programming (NLP), or mindfulness.
Although Nightingale was, by all accounts, not particularly given to affectionate gestures herself, she was a Christian theologian as well as a pioneer in statistical analysis. She made sacrificial devotion on the part of her nurses the basis for all their work. Patients’ needs were her nurses’ obligations. Praying together at the start of each day was deemed essential for nurses.
AlamyAdvertisement for a convalescent home for children, in Broadstairs, 1895
It is not for nothing that there is a strong literary trope of male invalids falling in love with their nurses, because devotion readily attracts devotion, even if this was not the devotion Nightingale intended to foster.
As the NHS has lost so much ability to provide this time and depth of nursing care, convalescent homes are like hen’s teeth, and most people suffer severe financial loss in illness. (There is often a grim subtext to cheery “Get well soon” cards from colleagues and employers.) The important thing that we have discovered — at great cost to the NHS and taxpayers — is to get well surely, and not bounce back into hospital because of an “unsafe discharge” or lack of adequate nursing care at home.
Those of us who are lucky enough to have families and friends who are able to love us and care for us, as they sacrificially nurse us back to health — as well as the education and finances for a slow but sure recovery — are very privileged. We learn to love ourselves more carefully, and to love them all the more.
Faith and hope can be translated as the determined exercise of whatever agency we have in our convalescence to make ourselves better: choosing this regime or that, being disciplined about rest and exercise when we’d really rather not. Our agency may well be limited, but, after the total loss of it in an acute phase of illness, or in surgery, like a timid bird it returns again.
Then the joy of recovery: it is inexpressible. That, too, is a physical, mental, and spiritual event. The awe and wonder of those first tottering steps into the garden, to see creation again with Adam and Eve’s eyes – nothing can beat that, unless it’s the quieter joy of realising, suddenly, that life is normal again: one has slipped into the old daily routines that surround one, just as cosily as the worn-out dressing-gown and slippers did. It’s good to remember that sensation again, because it’s so quickly forgotten. It’s just as important to remember, as an encouragement to keep up the learned and practised habits that led to recovery.
Convalescence is a very privileged space and time before that joy comes. It is a plunge into eternity with life-changing potential. (It certainly feels like an eternity when you are staring at the ceiling in the school sanatorium, with no amusements, too weak even to pick up a book, and too weak even to care.)
MÉNAGER is also surely right to prick the illusion that convalescence gets us up and about again, just as before. Everything we experience changes us physiologically and spiritually, mentally and in our relationships to others.
Julian of Norwich and, more recently, the stigmatic Dorothy Kerin are women whose experience of healing at the hands of God also led them, like St Francis and St Ignatius, to devote their lives entirely to the service of others. Kerin is a notable example of someone whose miraculous physical healing was partial and intermittent — like St Paul? Or St Hildegard, or St Teresa of Ávila? You will know others.
God’s power is very evident in their lives, but the “miracle”, that which makes us wonder, is not that they were cured of their illnesses at a word or a touch, but that, after illness — or through chronic illness, even — they became human beings translucent with God’s light and life.
Laurie Vere is a veteran convalescent, and experienced also in chronic illness.
Convalescences: La littérature au repos by Daniel Ménager is published by Les Belles Lettres (2019). Florence Nightingale: The woman and her legend by Mark Bostridge is published by Penguin (2008).