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.

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21 June 2024

4 min read

It's our mistakes that make us human

What we learn distinguishes us from tech.

Silvianne Aspray

Silvianne Aspray is a theologian and postdoctoral fellow at the University of Cambridge.

A man staring at a laptop grimmaces and holds his hands to his head.

Francisco De Legarreta C. on Unsplash.

The distinction between technology and human beings has become blurry: AI seems to be able to listen, answer our questions, even respond to our feelings. It becomes increasingly easy to confuse machines with humans. In this situation, it is increasingly important to ask: What makes us human, in distinction from machines? There are many answers to this question, but for now I would like to focus on just one aspect of what I think is distinctively human: As human beings, we live and learn in time.

To be human means to be intrinsically temporal. We live in time and are oriented towards a future good. We are learning animals, and our learning is bound up with the taking of time. When we learn to know or to do something, we necessarily make mistakes, and we take practice. But keeping in view something we desire – a future good – we keep going.

Let’s take the example of language. We acquire language in community over time. Toddlers make all sorts of hilarious mistakes when they first try to talk, and it takes them a long time even to get single words right, let alone to try and form sentences. But they keep trying, and they eventually learn. The same goes with love: Knowing how to love our family or our neighbours near and far is not something we are good at instantly. It is not the sort of learning where you absorb a piece of information and then you ‘get’ it. No, we learn it over time, we imitate others, we practice and even when we have learned, in the abstract, what it is to be loving, we keep getting it wrong.

This, too, is part of what it means to be human: to make mistakes. Not the sort of mistakes machines make, when they classify some information wrongly, for instance, but the very human mistake of falling short of your own ideal. Of striving towards something you desire – happiness, in the broadest of terms – and yet falling short, in your actions, of that very goal. But there’s another very human thing right here: Human beings can also change. They – we – can have a change of heart, be transformed, and at some point in time, actually start to do the right thing – even against all the odds. Statistics of past behaviours, do not always correctly predict future outcomes. Part of being human means that we can be transformed.

Transformation sometimes comes suddenly, when an overwhelming, awe-inspiring experience changes somebody’s life as by a bolt of lightning. Much more commonly, though, such transformation takes time. Through taking up small practices, we can form new habits, gradually acquire virtue, and do the right thing more often than not. This is so human: We are anything but perfect. As Christians would say: We have a tendency to entangle ourselves in the mess of sin and guilt. But we also bear the image of the Holy One who made us, and by the grace and favour of that One, we are not forever stuck in the mess. We are redeemed: are given the strength to keep trying, despite the mistakes we make, and given the grace to acquire virtue and become better people over time. All of this to say that being human means to live in time, and to learn in time.

So, this is a real difference between human beings and machines: Human beings can, and do strive toward a future good.

Now compare this to the most complex of machines. We say that AI is able to “learn”. But what does it mean to learn, for AI? Machine learning is usually categorized into supervised learning, unsupervised and self-supervised learning. Supervised learning means that a model is trained for a specific task based on correctly labelled data. For instance, if a model is to predict whether a mammogram image contains a cancerous tumour, it is given many example images which are correctly classed as ‘contains cancer’ or ‘does not contain cancer’. That way, it is “taught” to recognise cancer in unlabelled mammograms. Unsupervised learning is different. Here, the system looks for patterns in the dataset it is given. It clusters and groups data without relying on predefined labels. Self-supervised learning uses both methods: Here, the system uses parts of the data itself as a kind of label – such as, for instance, predicting the upper half of an image from its lower half, or the next word in a given text. This is the predominant paradigm for how contemporary large-scale AI models “learn”.

In each case, AI’s learning is necessarily based on data sets. Learning happens with reference to pre-given data, and in that sense with reference to the past. It may look like such models can consider the future, and have future goals, but only insofar as they have picked up patterns in past data, which they use to predict future patterns – as if the future was nothing but a repetition of the past.

So this is a real difference between human beings and machines: Human beings can, and do strive toward a future good. Machines, by contrast, are always oriented towards the past of the data that was fed to them. Human beings are intrinsically temporal beings, whereas machines are defined by temporality only in a very limited sense: it takes time to upload data, and for the data to be processed, for instance. Time, for machines, is nothing but an extension of the past, whereas for human beings, it is an invitation to and the possibility for being transformed for the sake of a future good. We, human beings, are intrinsically temporal, living in time towards a future good – which machines do not.

In the face of new technologies we need a sharpened sense for the strange and awe-inspiring species that is the human race, and cultivate a new sense of wonder about humanity itself.