Whenever I hear the word spiritual, I reach for my revolver. Well, not really. But I’ve learned the hard way that on hearing spiritual, it’s good practice to reach for the question, “What precisely do you mean by that?” Philosopher/author Ophelia Benson offered a definition of spiritual as perceptive as any I’ve read: “a way of palliating non-theism (you know, as in the common ‘I’m not religious but I am spiritual’); . . . a way of disavowing atheism, reason, science . . . or at least of disavowing ‘excessive’ commitment to them. In short it often boils down to saying ‘I’m as woolly-minded as the next person, I promise.’”
Here’s a fresh example of the mischief that spirit talk can create, one that might have unfortunate implications for nonreligious hospital patients. I occasionally participate in interfaith events in the Buffalo area, representing the secular humanist viewpoint as I share the stage or rostrum with (honest!) a priest, a minister, a rabbi, and an imam. Recently, the interfaith group that organizes these events presented a continuing-education seminar for nurse managers, sharing information about the medical and pastoral-care preferences of patients from various religious perspectives. I gave a presentation on attitudes toward health care among the nonreligious. I described unbelievers as a diverse group, ranging from the merely unchurched and the, sigh, “spiritual but not religious” to folks who are resolutely both nonreligious and nonspiritual (ah, home at last).
During the question period, one of my copresenters, a hospital chaplain, shared a story about a strict atheist patient who refused pastoral visits of any sort. One of the attendees, a senior nurse manager, then asked a question about patients who were nonspiritual. More attendees weighed in, sparking a conversation about patients real or hypothetical who refuse any spiritual interaction, just want to be left alone, and demand not to be touched in any way. At first I thought they were talking about patients who ordered chaplains to leave their rooms and never touch them again. Eventually, it clicked: these seasoned nurse managers were talking about patients whom the nurses believed they must not touch, comfort, or support in any human way—out of respect for the worldviews of patients who disdain ordinary human contact because they’re not spiritual.
Allow me to unpack the nested ironies here. First, nurses generally take justifiable pride in offering patients the warmth, support, and human comfort that physicians’ commitment to scientific medicine arguably precludes. Quite a few nurses describe their work as a spiritual undertaking; several at this seminar said so in no uncertain terms. Taking my own advice, I asked, “What precisely do you mean by ‘spiritual’ in this context?” The nurse managers told me that they considered having a quiet conversation with a patient, holding a patient’s hand, evaluating a patient or family member’s emotional state, even giving a comforting alcohol rub, as providing spiritual care. “But couldn’t we more accurately characterize that as emotional care?” I asked. “Holding the hand, the alcohol rub, don’t those bridge the emotional and the somatic?”
No, came the reply: anything pertaining to the nontechnological side of nursing, anything having to do with warmth and support and comfort, even favoring a patient with caring language, was in their usage inherently spiritual. “It’s very important to express my spirituality in every aspect of my nursing practice,” one participant said, and it was the human side of nursing that she meant.
Now for the next irony. Today’s health-care professionals are trained to be deeply respectful of diverse religious and life-stance perspectives. Most take great care to avoid violating these preferences, so long as they have enough accurate information about the patient’s particular tradition to do so.
Finally, the ultimate irony: since for them “spirituality” encompasses the entire “human” side of their practice, when these nurses learn that a patient is not spiritual they seem to assume they’re dealing with some hyper-rational “emotional basket case” who spurns anything having to do with affective resonance or human warmth . . . and likes it that way.
As someone who is proudly nonspiritual, I was taken aback. Let me take my own advice and ask myself precisely what I mean by spiritual. I understand spiritual in what I think is that word’s ordinary sense: having to do with spirits. I don’t believe in ghosts or angels or souls or, more generally, in immaterial substances or causes. I’m a philosophical naturalist, a small-m materialist if you will; I think spiritual refers to a class of entities that are wholly imaginary. An enthusiasm for sunsets, the ecstasy of music, the consoling warmth of holding a sick person’s hand: they’re all beautiful aspects of life, but on my view they’re not spiritual: the genuine emotions they evoke are (let’s admit it) ultimately rooted in brain or endocrine function and hence in this material world. If there’s nothing immaterial about them, they’re not spiritual.
While recognizing the social currency of fuzzier meanings of spiritual, I suspect most nonreligious, self-describedly nonspiritual people understand spiritual more like I do than in the way it was meant by many of the nurses at that seminar. Of course, when those naturalists are in the hospital and too sick to speak for themselves, it’s the nurses and their view of what nonspiritual means that will rule.
“Yeah right, we’re people who don’t care about sunsets or music or touch or affection—in fact we’re not human and we’re not even mammals; we’re some kind of mutant fleshy robot,” offered Ophelia Benson, commenting as before on my reportage of this incident on my Center for Inquiry blog (www.centerforinquiry.net/blog/a_spirited_misunderstanding).
With the gift of hindsight, I see the question I wish I’d asked at the seminar. When those nurses spoke about nonspiritual patients from whom they withheld human contact out of respect for what they honestly believed to be the patients’ convictions, was that a hypothetical discussion? Or are there really humanist and atheist patients who’ve suffered alone in hospital beds, denied anything beyond efficient mechanical nursing by caregivers who genuinely think their patient is some sort of shriveled grinch who prefers things that way?
Next time I take part in one of these seminars, I’ll make sure to raise the question whether this sort of attitude toward nonspiritual people actually guides the care patients receive. Who knows, I may have discovered a brand-new form of wholly inadvertent discrimination against the nonreligious . . . rooted in our old friend, the endlessly pliable meaning of the word spiritual.