We worship medicine. We put doctors on billboards, make statues of them, and name buildings and parks after them. We make hit TV shows about doctors, like The Pitt. We want physicians to be, if not our angels, then our heroes.
The idea that I would like to suggest in this blog is that this impulse to sacralize doctors is an expression of secularization. While secularization has different meanings, it is most commonly understood as the decline of religion. Often cited motivating factors for secularization include scientific progress, industrialization, urbanization, globalization, pluralism, and education. In contemporary secularization theory, it is acknowledged that there is no single, unifying narrative about secularization. Instead, secularization unfolds differently across historical and social contexts; it is not linear, universal, or inevitable—nor is it assumed to be good.
It is striking to me that, as some have observed, the displacement of religion as the central organizing force in social life is reflected in city planning. In old Europe, the church steeple was the highest point in the city, but today church steeples no longer dominate our skyline. Indeed, when I moved to Houston, Texas, for graduate school over twenty years ago, I found myself looking at the skyline of the Texas Medical Center—the largest medical complex on the planet— while walking the campus of Rice University. It occurred to me then that our steeples today are no longer concerned with saving our souls but rather with saving our bodies. It is as though oncologists, cardiologists, and neurosurgeons are the high priests of our day, for we look to them for salvation.
Looking at the skyline of the Texas Medical Center gave me the idea for The Secularization of Medicine, where I explore aspects of medicine that appear religious but are not recognized as such. For example, clergy wear black robes, while doctors wear white coats. Priests give the sacraments, while physicians write prescriptions. And people make long pilgrimages to medical centers—places like the Mayo Clinic—in search of salvation. There is a lot about medicine that is subtly religious.
Of course, I am not the first person to notice these connections. An important article in this area is Roy Branson’s “The Secularization of American Medicine,” as it summarizes a significant portion of relevant sociological literature. Also, instead of thinking about religion in terms of decline, a key idea for me is Larry Shiner’s concept of transposition. For Shiner, a transposition occurs when religious material migrates to a non-religious sphere or a secular space, where what was once religious is absorbed by the surrounding culture. A classic example is Max Weber’s thesis that the Protestant Work Ethic became transposed in Western capitalism. A contemporary example of a transposition is when a college with a religious affiliation ceases to be affiliated with a specific religious tradition but nevertheless continues to carry out the mission of education.
Following this line of thinking, it strikes me that the advances in medicine over the last century have been so profound that our hopes about what we want medicine to be for us have grown in idolatrous proportions. Or, to put it another way, the worship of medicine can be understood as a transposition of idolatry, in which common religious impulses of sanctification have migrated into the medical sphere and have been expressed in a variety of ways, including secular pilgrimages, veneration, and memorialization. For me, it is not hard to see that modern medicine is our great Golden Calf (Exodus 32).
The problem with worshiping medicine is that, when we expect so much from medicine, we don’t know how to live with each other in our suffering when medicine fails to improve our quality of life. This was underscored for me last summer by Elaina Plott Calabro in her viral article, “Canada is Killing Itself,” in which she writes about the rapid expansion of medical-aid-in-dying within Canadian healthcare, where 1 out of every 20 deaths (5%) is by medical-aid-in-dying. She rightly raises concerns about whether Canada has moved faster to expand access than to secure social supports (such as palliative care, disability services, and mental health resources), thoughtfully exploring how Canadians are reconsidering what autonomy, dignity, and the role of medicine should mean at the end of life.
Religion, of course, plays an overt role (in terms of beliefs and doctrines) in debates about medical-aid-in-dying, but I think the transposition of religious material likely plays a covert role (in terms of feelings and desires) too, which may be unrecognized. Perhaps a pastoral implication of these dynamics is that chaplains—of all faith backgrounds—would do well to help patients and families abandon the idols they didn’t know they built. My own fear is that patients and families sacrifice too much at the altars of “fighting,” “not giving up,” and “cure.” To live without idols is to let go of our desire for “more” (often expressed in terms of seeking stability and time) and instead hold onto each other.
Nathan Carlin, PhD, is Director of the McGovern Center for Humanities and Ethics at McGovern Medical School in Houston, Texas.