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

Redemption

16 January 2024

4 min read

Discover the kindness of a Blue Monday snowfall

Waking to a new world, Henna Cundill considers the transformation of more than just the view.

Henna Cundill

Henna is a researcher with the Centre for Autism and Theology at the University of Aberdeen.

Two small chidlren push a curtain aside to stare out the window at snow.

“Blue Monday” in Aberdeenshire (the third Monday in January) turned out to be a “white Monday” in the end. The snow began on Sunday evening, and it continued on and off throughout the night. It was accompanied by an atmospheric howling wind, which woke me up from time to time. At each waking I peeped through the window to see the world gradually disappear under a thick white blanket.

Monday morning was a liminal place – all of us dressed for work and school but drifting about the house as if it were still the weekend. We live next to a busy road, but there were few cars and what traffic noise there was had become strangely muted. None of us could settle to anything, we simply alternated peering out of the windows with checking online for news about school. Then came the announcement that school would open at 10am (there’s little that really stops for snow in Aberdeenshire) so on went the wellies and the woollies and off we went down the front path, both excited and a little awed to sully the unbroken blanket of white with those first few footprints.

Snow suspends the rule that we have to be standoffish and dour, even in Scotland.

But as we walked, we noticed that our footprints weren’t at all the first. Tiny scratch marks testified that the sparrows, the robin, and the blackbirds had long been out and about, busy with their day’s travail. A slinky line of pawprints revealed the neighbour’s cat had paid us a visit too. All around our house, countless tiny stories of industry and encounter had already been told – (some sliding pawmarks and a few stray feathers suggested a gripping plot twist.) Later that morning, it began to snow again, and all these stories gradually disappeared. By the time my boys came tramping home from school, they were once more tasked with picking out a brand-new path across a fresh unbroken expanse of white.

After dinner I went for my own habitual walk. We’d had yet more flurries, so I had to make new footsteps all over again. By then the wind had dropped, the sky was crystal clear, and the snow had gone from powdery to satisfyingly crunchy underfoot. It felt like an awe-filled privilege to leave my trail of footprints. I walked one of my usual routes, but the white covering had softened both the landscape and the soundscape, making everything seem new and unfamiliar. As I trailed back through the housing estate, I noticed snowmen that had popped up in some front gardens, and neighbours who were chatting as they helped each other to shovel driveways and grit paths. Snow suspends the rule that we have to be standoffish and dour, even in Scotland.

What if I could always watch yesterday’s path being gently erased, and always have another chance to make new?

All in all, it was difficult to feel blue on a white Monday. The snow made it feel as if nothing was permanent, let alone usual. There was no drudgery, no same-old, same-old. I wondered if I could become like one of those tiny birds, skipping lightly through each day’s work? Even whilst canny to the fact that a certain sneaky cat was prowling about. By the time I got home, there were new prints from him also.

In the Bible, snow appears as a metaphor for forgiveness, for making a fresh start. We read in the book of Isaiah: “Though your sins are like scarlet, they shall be as white as snow.” There is much in this idea that runs counter to how our modern society responds to misdeeds – especially in this age of instant messaging and social media, when photographic evidence of our blunders can travel the world instantly and be preserved for posterity. There is also much that runs counter to how I respond to myself when I mess things up. It is not usually the howling wind that keeps me up with ‘the dreads’ on a Sunday night, but my mind’s hobby of regurgitating memories of the previous week’s mistakes, misspeaks, and misunderstandings. In the pre-dawn hours of a Monday morning, I am usually awake and well occupied with the prospect that, in the week to come, I will almost certainly make many of those same mistakes again. I walk those same old paths, re-tread those familiar footsteps – the inevitability of my own imperfection is ever before me.

But what if I peered out of the window at the daybreak of every Monday morning and found that there was snow? That I was held in a liminal moment – less sure of what the coming week would hold. What if I could always watch yesterday’s path being gently erased, and always have another chance to make new? Ideas such as this are at the heart of the Christian hope. In the Bible, the Psalmist writes that God does not treat us as our sins deserve, nor repay us according to our mistakes. Instead, God takes them away so infinitely that they are: “as far as the East is from the West.” They are gone, from red as scarlet to as white as snow.

I suppose snow every Monday would be inconvenient. But snow on Blue Monday felt like a kindness – a gentle rendering of the familiar into the unfamiliar, allowing me to see things anew, to reflect, to reconsider, to redirect my steps in certain ways. As I write, there is more snow falling. Later I shall have to go out with the shovel and the grit, but I won’t do it yet. If I leave it for now, then when my boys return from school in a few minutes time, they too can tread one more time with awe across a fresh, unbroken expanse of white.