Understand what we thirst for

Whether for water or meaning, it’s a primal force.

Helen Cowan

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A child wearing a wool hat holds a glass and drink water from it.

Johnny McClung on Unsplash

Quenching thirst is a global problem. It can also be profoundly personal, impaired by illness. For nurses, it can be ethically and emotionally difficult, when treating dying patients. But is there ultimate relief?

Thirst is the subjective sensation of a desire to drink something that cannot be ignored. The world is thirsty; globally, 703 million people lack access to clean water. That’s 1 in 10 people on the planet.

Thirst is a life-saving warning system that tells your body to seek satisfaction through swallowing fluid. It works in partnership with other body processes - such as changes in blood pressure, heart rate and kidney function - to restore fluid, and salt, levels back to where they belong. Failure of any part of this beautifully balanced system leads to dehydration (or water intoxication), and perhaps to seizures, swelling of the brain, kidney failure, shock, coma and even death.

Sometimes it’s difficult to quench thirst, because of problems with supply. According to the World Health Organization, at least 1.7 billion people used a drinking water source contaminated with faeces in 2022. Sometimes in war, water is weaponised, with systematic destruction of water sources and pipes. Water laced with rat fur, arsenic and copper has meanwhile been reported in prisons across the USA.

At other times, there may be “water everywhere, but not a drop to drink” because of individual problems with swallowing. As a nurse, some of my most heartbreaking moments have been when I have been unable to fulfil a need as basic as a patient’s thirst; when even thickened fluids have led to intense coughing and distress, and a realisation that I can only moisten mouths and give so-called “taste for pleasure”: very small amounts of a favourite liquid or taste using a soft toothbrush, or a circular brush gently sweeping around the mouth and lips to release some of the liquid - even, and especially, at the end of life when the patient is unconscious.

Difficulties in drinking are common in dementia when fluid can seem foreign and swallowing a surprise to the system. It’s thought that over 50 per cent of people in care homes have an impaired ability to eat or drink safely; 30 to 60 per cent of people who have had a stroke and 50 per cent of those living with Parkinson’s may struggle to swallow.

Other conditions that may affect swallowing include multiple sclerosis, cerebral palsy, and head and neck cancers. Diabetes is characterised by a raging thirst owing to problems with insulin (diabetes mellitus) or an imbalance in antidiuretic hormone levels (diabetes insipidus). In intensive care, patients are predisposed to thirst through mechanical ventilation, receiving nothing by mouth, and as a side effect of some medications. But thirst is a “neglected area” in healthcare, writes palliative care researcher Dr Maria Friedrichsen.

“Knowledge of thirst and thirst relief are not expressed, seldom discussed, there are no policy documents nor is thirst documented in the patient’s record. There is a need for nurses to take the lead in changing nursing practice regarding thirst.”

Is there another thirst that is also being missed in nursing, and in life in general – a spiritual thirst, beyond the physical desire to drink? In his book, Living in Wonder, writer Rod Dreher argues that humans are made to be spiritual, and that a critical sixth sense has been lost in a “society so hooked on science and reason”. We humans crave love in our deepest selves; we have an insatiable thirst for everything which lies within – and beyond – ourselves. Auschwitz survivor Viktor Frankl, who was later appointed professor of psychiatry at the University of Vienna, became convinced that human beings have a basic “will for meaning.” “The striving to find a meaning in one’s life,” he wrote, “is the primary motivational force in man.”

In the harsh sun of a Middle East day, an ancient story of a man and a woman encountering each other at a water well illustrates this dual thirst for water and meaning. The man, Jesus, thankful for a drink of water given to him at the well by an outcast Samaritan woman, said that “Everyone who drinks this water will be thirsty again, but whoever drinks the water I give them will never thirst. Indeed, the water I give them will become in them a spring of water welling up to eternal life.” In that midday sun, such imagery made a powerful statement.

Being mindful of spiritual thirst when drinking water is something also captured in a Ghanaian proverb and pictured perfectly in the many birds that drink by gravity, so tipping their heads back when they swallow.

“Even the chicken, when it drinks,

Lifts its head to heaven to thank God for the water”.

Unsatisfied thirst is part of the human condition, we long for something more; it’s living proof of our immortality, says French poet Charles Baudelaire. Despite his Olympic success, athlete Adam Peaty said that society didn’t have the answers he was seeking, and that a gold medal was the coldest thing to wear. He “discovered something that was missing” when attending church for the first time, and now has a cross with the words “Into the Light” tattooed across his abdomen, symbolizing his spiritual awakening. We are more than mechanical machines with physical needs. We are rather gardens to tend in a dry and thirsty land, with souls in need of intensive care.

Review

Belief

Culture

Film & TV

20 September 2024

4 min read

Kate Winslett delivers the performance of her life, in a film that doesn’t look away

The true quality of witness shines in Lee Miller’s biopic.

George Pitcher

George is a visiting fellow at the London School of Economics and an Anglican priest.

Two war photographers creep along a shadowy corridor.

Kate Winslett and Andy Samberg in Lee.

Sky Cinema.

If we might indulge an absurd anachronism, I wonder what the American photojournalist Lee Miller would have done, had she been one of the women at the foot of the cross. To my mind, she would have held her nerve to record – on her German-made Rolleiflex camera held at her abdomen – not only the horror of the crucifixion of Jesus of Nazareth and the criminals beside him, but also the suffering of his mother and the other women who looked on.

I’ve had these ruminations since I watched Miller’s biopic, Lee, on its UK premiere. In passing, I should record that Kate Winslet delivers the performance of her life in the title role, because it’s in the quality of her interpretation that I’m led to consider the nature of what it means to witness, which is an act at the heart of humanity as well as central to the Christian faith.

Witnessing is what reporters, at their best, do if they are to honour their vocation. Especially war reporters. But the act of witnessing isn’t confined to journalists. The case for professional witness can be made for other jobs – police officers, aid workers, medics, lawyers all come to mind.

It’s just that this movie shows witness at its sharpest end. “Even when I wanted to look away, I knew I couldn’t,” says Lee Miller. That imperative, not to look away, is central to our human story and I would argue that this is because it’s central to my faith, which has at its centre a God who doesn’t look away.

That’s why Lee Miller made me think of the historical event of the crucifixion. The Church down the ages has been inclined to turn the cross into the Christ’s great victory – rather as reportage of the Second World War has concentrated on its conclusive victory rather than the horrors that Miller recorded.

Her magazine employer, Vogue, at first declined to publish her photos of the liberation of concentration camps Dachau and Buchenwald, in part because it detracted from the joy of that victory (though they were subsequently published in the US). If you will, Vogue looked away.

I’ve found that to go down this path with Miller, accompanied by faith, a kind of terrible road to Emmaus, delivers some unexpected reactions.

We’re called to refuse to look away from the grotesque horrors of the cross, to resist it becoming simply a jewellery symbol on a pendant, to acknowledge its centrality in man’s inhumanity to man and, ultimately, our God’s choice to share that experience. “Jesus Christ,” mutters Miller at the door of a room, possibly a gas chamber, stacked with skeletal corpses, before entering to take her photographs. Jesus Christ, indeed.

This is not to make a claim for Miller as a figure of faith. It is rather to make the claim that those of us of faith should be highly alert to where we might find the witness to it. Over the past week, I have to say I’ve found it in the work of Miller, not only in the hell of the camps, but in the shaven heads of collaborator women, the frightened children and even in that bath in Hitler’s Munich apartment.

In the last of those, there she is, naked, washing herself clean from the dirt of Dachau, which stains the bathmat from her boots in the foreground. Here is a witness to a spiritual defiance, the portrait of Hitler propped on the bath edge as she is cleansed. It’s not just that he hasn’t won, it’s that death itself hasn’t won.

I’ve found that to go down this path with Miller, accompanied by faith, a kind of terrible road to Emmaus, delivers some unexpected reactions. And they’re not the kind of reactions normally associated with faith.

The first is anger. It clearly accompanied Miller throughout her work: Anger at military discrimination against her womanhood; rage that Vogue censored her work. We could all do with being more angry at injustice, especially those of us of religious faith. Note that when American Vogue published her photos, they headlined them “Believe It!” True belief, arguably, is angry.

My second takeaway is the danger of real witness. Miller described her work as "a matter of getting out on a damn limb and sawing it off behind you". Discipleship can, maybe should, be like that.

The third is the cost of witness. Miller’s war left her with depression and what today would be called PTSD. Not looking away has its price. The cost of witness to disciples may not be as extreme as it was in the first century of its practice, but we should also be aware that it’s not a cosy lifestyle choice either.

For Miller, part of the price of her witness was alienation from her son, Antony. In the movie, though (spoiler alert), he discovers after her death how devoted to him she was. At a stretch I would say he was a son in whom she was well pleased.

That’s not to imbue her with something messianic. It is perhaps to say, with the poet Philip Larkin, that what will survive of us, especially those who have witnessed the worst of humanity and come through, is love.