The Unmercenary Physicians

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Among the most comforting doctrines of our faith is the Communion of Saints, the spiritual connection that binds the faithful across space and time, on earth and in heaven.  As a Catholic physician, this spiritual tether to our forebears comes to mind every September 26th, the Feast Day of Saints Cosmas and Damian, patrons of physicians and pharmacists.

While little is known about their lives, they have been venerated widely since their martyrdom in the late third century. Twin brothers, who studied medicine in Syria, they were renowned as effective and compassionate physicians.

Animated by their Christian faith, Cosmas and Damian reflected the love of Christ as servants of the Divine Physician, as in the legend of their miraculous transplantation of a leg from a recently deceased Moor onto a cancer patient.  Cosmas and Damian gained notoriety for their refusal to accept payment for their services, earning them the title of “the moneyless ones.”  In the Eastern Church, they are honored as “unmercenary physicians.”

For their faithful witness, they were imprisoned during the great Diocletian persecution.  The various attempt to kill them – by hanging them on a cross, stoning them, burning them, and shooting them with arrows were unsuccessful.  Ultimately, they were martyred by beheading.  Veneration of Cosmas and Damian spread rapidly among the faithful; a church was constructed on their tomb site and a basilica in their honor in Constantinople.  Their feast days are still celebrated in the Eastern and Western Catholic and Orthodox churches.

My devotion to Saints Cosmas and Damian derives from their selfless practice of medicine as a form of evangelization and their fearlessness in the face of intense persecution leading to martyrdom.  The veneration leads to a chastened humility at the relative comfort I am afforded in my life and work compared with the hardships they faced.

I also stop to consider the challenges posed by present-day ideologies and persecutions in the profession of medicine.  While modern Christian physicians out of line with the current regime may not face physical beheading, consequences for dissent include loss of license and livelihood, legal intimidation, and character assassination.

In contrast to Cosmas’ and Damian’s evangelical zeal, it is commonplace for today’s medical practitioners to feel burdened by a rigid and labyrinthine bureaucracy that places the zeitgeist above the healing of the sick.  Much like the compulsory sacrificial offerings to the Roman gods during Diocletian’s times, today’s medical climate often affronts to the consciences of Christian clinicians.

Among present-day ideological challenges is the institutionalized assault on certain categories of human life. Conscience rights of healthcare professionals are targeted, most clearly in the case of the unborn, through lawsuits and codes of ethics that would strip legal protections from clinicians refusing to participate in or refer patients for abortion.


Regarding care at the end of life, states are legalizing physician-assisted suicide in increasing numbers, promoting it as an assertion of individual dignity.  The normalizing effect of such permissive attitudes and legislation leads Christian physicians in America to fear an erosion of medical ethics as has already occurred in neighboring Canada, where courts have ruled that physicians opposed to “medical assistance in dying” (MAID) must provide “effective referrals” to willing providers.

Another contentious issue threatening the integrity of Christian medical personnel is contemporary gender theory.  Nearly overnight, societal and legal opinion has cast as hateful the promotion of the once undisputed fact that the natural sexual differentiation of male and female is a biological and immutable attribute of the human person.

As state and federal governments discover an ever-expanding category of rights of those who would not recognize their natural sexuality, there is a growing political animus that seeks to subdue voices professing the truth of human sexuality.  These newfound rights have swelled so rapidly as to eclipse constitutional rights to religious freedom.

Underpinning these issues is a strain of utilitarianism distorting our societal understanding of medicine and its role in society.  Increasingly, physicians’ professional opinions have been subjugated to patients’ and employers’ preferences and appetites.

A mercantile approach to medicine, combined with an oversized government role in healthcare financing, has led to a mushrooming of medical bureaucracy and regulation.  Increasing corporate employment of physicians further hamstrings freedom of conscience by conditions of employment that often override conscience decisions.

Now with the COVID-19 pandemic’s threats to financial viability, it is not hard to see why many healthcare pundits are calling this the end times for the independent physician.

Faithful men and women have heard the anguished pronouncement of the end times in prior ages.  As I contemplate the Communion of Saints, I consider how Cosmas and Damian would carry out their ministry in our contemporary American context.  Their defense of the Gospel would surely run afoul of pronouncements from the likes of the American College of Obstetricians and Gynecologists to perform or refer patients for abortion.

I imagine they would not acquiesce in the use of gender pronouns, nor prescribe or refer self-proclaimed transsexual patients for hormonal castration or surgical mutilation disguised as therapeutic beneficence.  Rather, I suspect they would sympathize with the immense suffering being borne by these sons and daughters of God, seeing in their pain the face of Christ crucified.

And by ministering to the spiritual wounds inflicted by libertinism and self-determination, these healers would point souls to Christ by speaking Truth to worldly power as living examples of the Gospel of Life.  (And given their designations as the “unmercenary physicians,” I doubt they would accept assignment for Medicare or Medicaid.)

The lives of the saints (Church Triumphant) serve as models for the faithful on earth (Church Militant).  As we celebrate their feast today, may the intercession of Saints Cosmas and Damian give strength and hope to medical professionals striving to be the hands, heart, and mind of Christ the Physician in the midst of so much suffering, anxiety, and confusion.


*Image: A verger’s dream: Saints Cosmas and Damian performing a miraculous cure by transplantation of a leg, attributed to the Master of Los Balbases, c. 1495 [Wellcome Library, London]

Dr. James O. Breen received his doctor of medicine from Jefferson Medical College of Philadelphia and completed internship and residency in Family Medicine at Brown University. He is in clinical practice and medical education and lives with his wife and children in Fort Myers, Florida.