The Doctors of Hubei and the Grace of the Caregiver in Crisis

Li Wenliang, Liu Zhiming, Xu Depu, Peng Yinhua, Xia Sisi: these are the names of some of the doctors that have died while treating COVID-19 patients in Hubei Province in China, according to media reports. As of late February, 3,387 health workers in China have reportedly been infected; at least 18 of these have died. Some of the earliest cases of community transmission of the disease in the United States, the United Kingdom, and Australia have likewise afflicted frontline health workers.

Images circulating in the news media and online of the Hubei doctors show them staring into the camera, masked and inscrutable. How, one wonders, did they think about the actions that they had just taken—actions that resulted in their deaths? How might we understand those actions? If these people, in their last few chaotic months, present an example of life well lived, then exactly what kind of living in the face of crisis did they enact?

At least two possible answers readily surface, traceable to distinct political traditions. Let me sketch these briefly, before setting them aside. In democracies founded in part on liberal individualist traditions, it is tempting to cast the Hubei doctors as tragic, romantic heroes, lighting sparks of freedom within an oppressive system. The story of Wuhan Central Hospital medic Dr. Li posting a chat room warning of a new virus and weathering official rebuke from the Chinese Public Security Bureau—this story aligns well with narratives championed by many U.S.-based digital platforms. It is at once a story of the speech-enabling wonders of online media and the deadly dangers of state censorship or “over-regulation.” In this account, what the Hubei doctors’ actions suggest is the irrepressibility of individual agency. They suggest, too, the ability of a resilient, purposeful mind to surmount the frailties and fears of the body, and to surpass the strictures of the social order, at least for a time.

In a second account—some version of which the Chinese authorities appear to favor—the Hubei doctors are emblematic of more or less an opposite kind of a political virtue. Their living well consisted precisely in their abnegation of individualism. The story of Dr. Peng’s willingness to delay his wedding to continue treating patients in Wuhan is the kind of story around which this account pivots. The Hubei doctors lived well by dedicating themselves to their work and the wellbeing of the community at large—not so much rocking the boat as bailing it, and pulling flailing people into it, until their last breath. Even when afforded official designation as “martyrs,” their martyrdom was cast by Chinese authorities as that of the unusually committed minor player. Accordingly, the Wuhan Municipal Health Commission lauded Dr. Liu for having made “important contributions to the city’s epidemic prevention and control.”

There seems something caricatured and inadequate about both of these versions of the Hubei doctors’ (and so many others’) quotidian commitment to care at imminent risk of death. There is certainly something awe-inspiring about what they and other health workers have done so far, and continue to do, in addressing COVID-19 and in tackling many other frightening diseases before this. And yet there is something banal about it too. Those living in extreme poverty routinely make decisions at their own expense about intra-household distribution of food and healthcare. When resources are scant, those responsible for food preparation—typically women—often eat “last and least” to ensure the wellbeing of others in their household.

Another way of understanding the actions of the Hubei doctors—and those of other frontline caregivers (professionals, volunteers and daily dispensers of meagre household resources) working at their own peril—is by recourse to the ambivalent notion of grace. Talk of grace might call to mind theology, or the Charites or Graces of Greek and Roman mythology. I am not the person to elaborate on such traditions. Of theology, suffice to say that, in broad terms, grace connotes an unmerited gift of divine favor whereby humans are enabled to live in faith without deserving that capacity. In a number of religious traditions, the giving of grace affords a theological justification for humanity and a justification for all creatures to which it is said to have been given. Grace is, however, also a sphere of power or jurisdiction—and a possible basis for exclusion—in the sense that Christians are described in the letters of Paul as living “under grace.” Drawing on Paul’s letters, in the Christian tradition, grace is often distinguished from law. Attention to the commands of law alone affords a justification for sin so will not suffice to overcome evil; grace supplements or redeems the practice of adhering to law. So, Augustine writes, in On Grace and Free Will, “lust is increased and strengthened by the prohibition of the Law, unless the spirit of grace helps us.” Here, instead of exploring any of these traditions, I want to evoke an idea of grace conveyed by a novelist whose writing both wove through and warped such teachings—James Joyce. I am thinking specifically of his short story, “Grace,” written in late 1905 and published in The Dubliners in 1914.

This is the story of Tom Kernan whom we first encounter lying unconscious on the floor of a pub— “smeared with…filth and ooze”—after having fallen drunkenly down the stairs on his way to the lavatory. A “commercial traveller of the old school which believed in the dignity of its calling,” Kernan is on the downward side of an “arc of…decline” thanks to “his frequent intemperance.” Aided initially by an unknown young man in a cycling-suit who washes his injured mouth and administers brandy, Kernan is eventually helped home by his friend, Mr. Power, to the house that he shares with his wife. Power is an employee of an armed British police unit and a some-time provider of “small, but opportune loans” to the Kernan household. The remainder of the story involves three of Kernan’s friends—later joined by a fourth—trying to persuade Kernan to join them in a religious retreat to “confess [their] sins” and “renew [their] baptismal vows”. Each of these friends is either the holder of some minor local office or engaged in modest business dealings of one sort or another. The story concludes with the five men attending the so-called retreat, where they listen to the teachings of one Father Purdon, a Jesuit priest named after a street in Dublin’s red-light district. Purdon presents his religious teachings as guidance for “business men and professional men,” inviting them to imagine Jesus Christ as “their spiritual accountant” before whom they should “open [their] books, the books of [their] spiritual life, and see if they tallied accurately with conscience” and, where they found wrong, to say “with God’s grace, I will rectify this…I will set right my accounts.”

Here, then, one encounters a number of different renderings of grace inextricably bound together. There is the petty, slightly tragic “grace” of Kernan’s vanity. Kernan, a professional tea-taster, is “never…seen without a silk hat of some decency and a pair of gaiters” and “by grace of these two articles of clothing,” Kernan maintains, “a man could always pass muster.” Grace is also one possible dimension of the beleaguered Mrs. Kernan’s care. She accepts her husband’s addiction “as part of the climate” and “heal[s] him dutifully” despite finding “a wife’s life irksome,” acting in the scant safety afforded by the fact that “he had never been violent since [their sons] had grown up.” Being financially indebted to Power and presumably others, Kernan is also the recipient of “grace” in the sense of a period within which to repay his dues. Indeed, he and his four friends appear to be connected by “a web of mutual indebtedness.” It is this “web” which seems to underpin the misinformed theological discussion in which the five men engage—a tussle for authority punctuated by “word[s] of belief and submission” culminating in the “deep raucous voice” of Martin Cunningham, one who works for Dublin Castle (that is, the British) albeit only “during office hours.” “We’ll all renounce the devil…together,” Cunningham insists, “out-generall[ing]” the others, and prompting the group’s segue into the near-parodic version of spiritual accounting pedaled by Father Purdon in his retelling of the parable of the unjust steward—the final rendering of grace in the story. The stewardship of the church, in this depiction, is no more just or inspired than that of the small-time business-people, imperial officials and family members to whom Kernan and his like find themselves perpetually beholden. Appealing for “God’s grace” in the context of a balancing of the books, Purdon’s teachings make of grace some divine commendation for the conduct of sound business practice.

Yet, here, among this assembly of Dublin clerks and lenders and their spurious spiritual guides, one also encounters a grace not so readily framed, as one does perhaps in stories of frontline care work from Hubei and elsewhere. The transitory figure in the cycling-suit who “cleared his way through the ring of bystanders” to “[kneel] down beside the injured man and [call] for water” is difficult for the other characters to recall, place or describe; he only warrants, it seems, the most fleeting and vague of mentions. “That was a decent young chap, that medical fellow,” Kernan says. “Yes, yes…” Kernan continues, “trying to remember”; “Decent young fellow, he seemed. How did it happen at all?” Kernan quickly becomes distracted by other things. And there’s no further mention of the “young man in the cycling suit” from that point on.

The cyclist is patently worldly, not divine. He is even faintly clownish in his get-up, as health workers in hazmat suits are too. Yet his is not the “manner of worldlings” to which Father Purdon later alludes. Here amid the “filth and ooze” of the commonplace and the ridiculous, the characters are so distracted by their concern for higher grace, public approval and sanctimony that they all but miss the human gift of unmerited aid extended to them, without apparent recourse to any structured human relation or “conscious[ness] of citizenship.” The cyclist’s intervention is passing and unexplained in Joyce’s story. The figure he cuts is a little absurd. Precisely as such, his actions cannot stand reliably either for individual heroism or systemic imperative.

Misidentified, perhaps, as a “medical fellow,” the cyclist seems not to be performing any official role, nor pursuant to law or policy (unlike the “constable” who, first “ready to indite,” is only moved to aid Kernan after the cyclist intervenes). There is nothing expert about his administering of water and brandy. Nor are his actions referable to a clearly definable interest or moral position. His personage is shrouded—hard to identify and unlikely to be remembered. Kernan has difficulty remembering the “decent young chap” who helped him, before that “young chap” simply passes, unremarked, from the scene.

Perhaps Joyce inscribes here the strange propensity of people to act in ways not fully explicable by consciousness of citizenship, virtue, duty, expertise, system, merit, interest, authority, law, policy, or office. And perhaps this is a capacity to be cherished. Grace—administered human to human or human to non-human, without warrant, bond, or desert—might be a singular if unpredictable feature of a wide range of political systems and social formations, more ubiquitous than often appreciated. For all the apparent comprehensiveness of interlocking national and international regimes, both public and private, there still abides a sense of people fitting awkwardly and uneasily among them. Their unity seems ever contested; this is often seen as a problem to be overcome. Yet might it be this ill-fitting or incomplete quality of prevailing regimes that equips people to act beyond the range of conventional routes of interest or connection?

Then again, I could have it all wrong. Perhaps the secular grace that I would have you hear among the stories of frontline health workers grappling with the spread of COVID-19 is just another version of the “magic-lantern business” that Tom Kernan resists in Joyce’s story. Perhaps the cyclist in Joyce’s story is a would-be actor seeking fame, a trained medic acting out of professional duty, or a parishioner called to action by his faith. Or maybe I am simply trying to extract too much out of Joyce’s short story, even as it disavows, as Father Purdon does, any “extravagant purpose.”

Yet for all these alternative explanations, and the ever-present possibility of having misread, when one meets the masked gaze of the Hubei doctors, there seems to linger in their faces a question that remains for Tom Kernan in Joyce’s “Grace”: “How did it all happen?” Or, as Mr. Power puts it to Kernan, “How could they be anything else…?” However base, destructive and compromised, humans can, it seems, perform quite extraordinary acts of grace in the direst of conditions. Those extraordinary acts may sometimes entail stepping forward from the crowd, and sometimes continuing to do a job that one has been trained, formally or informally, to do. And people do such acts with great frequency all the time without anyone really being able to explain fully how they come to pass, or understand how to engineer their recurrence. This is a kind of grace not readily entered into the “books of [a] spiritual life,” or accounted for in one or other political or policy design. That may be, indeed, wherein lies its effect as grace.

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