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.

Article

Creed

Mental Health

19 February 2024

5 min read

It’s OK to be angry about this, right?

Anger's real gift is the desire for action.

Anthony Baker

Anthony is a theology professor at Seminary of the Southwest in Austin, Texas.

In a darkened room, a man's angry face is lit as he rests on arms folded tightly around it.

Abhigyan on Unsplash.

When is anger appropriate? When we hear of hideous acts of war in civilian villages, shouldn't we be angry? When I read about a shell exploding in a Gaza hospital, I get angry. I do also when something unjust happens to me, or to someone close to me. Some moments seem to call for anger as the right, and perhaps righteous, response.

But I often don't feel very "right" when I'm angry. In fact, I feel a bit out of control, like some other force or energy has taken over my body and my will. This is especially true when my anger leads me to say or do something that is hurtful to someone else.

Is there such a thing as Christian anger? If so, what does it look like? How can anger be the sort of emotive response that deepens, rather than erodes, my connection to God, myself, and others?

It is the act, and especially the amalgamation of acts into habits, that leads to virtue or to vice.

Anger is a passion

The ambiguity of anger stems from its grouping within what Thomas Aquinas, here as usual following Aristotle, calls "the passions." A passion is a creature's reaction to either the loss of something or to a gaining of something. We are passive, or receptive, to this giving or taking. Sickness is a loss of health; sorrow is a lack of happiness. When on the other hand a friend sees me sick or sad and brings me a bowl of soup, I am receptive not only of the soup but of a passion, or a feeling—a receiving rather than a losing in this case— of pleasure.

The passions are morally neutral: we cannot really be praised or blamed for being sad or pleased any more than for being sick. They often do, though, lead to actions, and this is where virtue and vice come into play.

Love, for instance, is a passion: it identifies a desire within me, received through contact with something or someone beyond me. The act that this gives birth to might be virtuous: kindness or affection toward that something or someone. In these cases, the passion becomes the catalyst to the greatest of the theological virtues, caritas, or charity, translating the Greek word "agape", used by St Paul. It may also, however, be vicious, as when my desire leads to me to attack someone whom I perceive to be standing in its way (think “crimes of passion” here). It is the act, and especially the amalgamation of acts into habits, that leads to virtue or to vice.

Anger originates in such a taking or giving. Something or someone is taken from us, and we get angry: something that I perceive—rightly or wrongly—as belonging to or with me. Or perhaps something inappropriate (which literally means "not my property") is given to me which is not mine to have: a false accusation, say, or a punch to the jaw.

When anger leads me to hurt someone as a result of that loss or addition, I commit sin. But sometimes it also leads to virtue. How does this happen?

But this next act, as any parent or teacher knows, is likely not to be the right one. That's because I will be tempted to simply to act, rather than to seek counsel to ensure that I act prudently.

Prudence is the virtue anger needs

The key to understanding how anger about such losses or gains could lead to a virtuous, or let's say a righteous act, is in another virtue - the one Thomas calls prudence. Prudence is the form wisdom takes on within human practices. Its goal is wise action shaped by the particular context in which it is needed. The prudent person knows how to calibrate the next thing she does so that it leads will to the specific end she is pursuing.

This "know how" in turn comes through counsel. I know the next practical step not because I have memorized formulas in right action, but because I can learn from others, past or present, in ways that will instruct me in the art of finding the next right thing.

Prudence is the key to understanding righteous anger because anger is supremely a passion that demands activity. Anger wants action, as the therapists teach us. It pumps blood through my body, it makes my muscles flex and my jaw clench, and so prepares me for some bold and likely aggressive act.

But this next act, as any parent or teacher knows, is likely not to be the right one. That's because I will be tempted to simply act, rather than to seek counsel to ensure that I act prudently. Most likely I will act out of a desire for revenge: to cause equal or greater harm. What I need in that moment is the outside input that can help me shape my act in accordance with reason. This is how, Thomas says, the neutral passion becomes meritorious passion: anger becomes righteous.

Righteous anger has a gift to give

Anger's desire for action is in the end its real gift. Notice how anger and sorrow are different sorts of passions. In sorrow, what is taken from me is joy. I long for the lost joy and am tempted to become even more passive. Depression takes me to the zenith of inactivity. Even getting out of bed or calling a friend feels like too much action.

Anger though is all about action. Yes, to act too brashly, too quickly, to seek revenge on the one whom I perceive to have harmed me. Or even to harm the nearest one to me regardless of their involvement (the sin of kicking a dog or abusing a child). Still: anger calls me to act, and for all its risky unhinged-ness, this is potentially a good thing.

Disordered, which is to say un-counseled by practical wisdom, anger can lead to harm. In these cases we make matters worse by calling our anger righteous: that self-justifying claim may in fact be blinding us to the real price of our next act.

But well-ordered, anger can draw us into deeper community with God, ourselves, and others. First comes the passion itself: I am angry and primed for action. Then comes the seeking of counsel, so that my desire for action can shift from the immediate to the prudently discerned. Finally comes the act itself, which anger was calling for in the beginning, now tempered by practical counsel. In such moments I am enacting a right and righteous anger.

And on those days when a loss or an unwanted gain is enough to make me wish to withdraw from the world of human activity, anger may be just the gift I need.