Brewer Eberly: I’d love to start at the beginning, with God—how did Beauty come to be a divine name? Why is that act of naming important for the church in general and Christians in health care in particular? 

Natalie Carnes: There’s this idea deep in Greek thought that beauty is the other face of goodness, which is the other face of truth, which is the other face of unity. And this is taken up by a number of Christian thinkers, becoming especially significant for Western theology through two theologians in particular, Augustine and the person we call Dionysius or Pseudo-Dionysius. You might remember, if you’ve read Augustine’s Confessions, he famously prays, “Late have I loved you, O Beauty so ancient and so new.” That’s Augustine using beauty to invoke God in prayer. 

In the case of Dionysius, he’s deeply influenced by fourth-century theologian Gregory of Nyssa, who thinks about beauty as a name for God. He names God Beauty in two contexts. One is his exegesis of the Song of Songs as he reflects on Christ as the beautiful bridegroom. Another is when he tells the story of Moses’s ascent up Sinai. Who is it that calls Moses up Sinai? It’s Beauty. Beauty is the name for the God who calls him into the unknown—the luminous darkness at the top of the mountain. 

Naming God Beauty is relevant to health care because if God is beauty, what does it mean that the God-who-is-beauty is revealed most powerfully in the Christian tradition on the cross? What does it mean to think about a beauty that has been wounded, that has suffered, that’s been tortured, that’s died? What does this intimacy of beauty and suffering suggest for Christians? 

Brewer: It connects to a question I wanted to ask you about this tension between light and dark, between idols and icons, and the church’s discomfort with art over time. The Theology, Medicine, and Culture Initiative launched The Healer’s Vocation: A Small Group for Christians in Health Care in late 2025, where we lean into the via pulchritudinis, “the way of the beautiful,” not only as a design principle but also as a spiritual posture. We explicitly name beauty early, inviting Christians in health care to gather over prayer and Scripture and shared meals, and to contemplate beautiful things like visual art, poetry, and music. We’ve been delighted to hear how this awakens the imagination and nourishes the heart of health-care workers who join these groups. I grew up in the Southern Baptist tradition and lived within the Reformed world in college. I’m now Anglican. It’s been fascinating to me, as an amateur artist and clinician, to trace this tension over integrating beauty, art, and Christian practice. Can you give us a brief overview of that tension between idolatry and iconography? And more to the point of this conversation, how does Christianity’s love-hate relationship with sacred art affect our relationships with the poor and the sick and with the ugly and the broken? 

Natalie: I think it’s so interesting that making images is almost coterminous with the Christian tradition—and so is the worry about those images. The anxiety never really goes away, either. There are many different ways that this worry about images is framed. One of them is an Augustinian framing, where all of creation, particularly in its beauty, can be a sign for God. But also, for Augustine, all of creation, particularly in its beauty, can become an idol. Any part of creation can become an idol that seduces our desires away from God and toward that created thing as an end in itself. So that’s one version of the worry about images. 

Then, second, there’s the more Dionysian worry about idolatry: If God is bigger than any representation, then the danger is getting stuck on one representation, one image, one concept. You stop ascending the mountain and start thinking that there are terms like “light” that can actually contain divinity. This is a mistake about how signs work, the way everything that tells us something about God is more unlike than like the God it signifies. 

But then there’s the type of worry about idolatry that you might have grown up with in a Southern Baptist church, which is the more Calvinist-influenced worry that the heart is a factory of idols. This third image anxiety fixes on the human heart as, in its depravity, bent toward a kind of idolatry. Images, especially religious images, are just always going to be occasions for expressing and fortifying that depravity. 

Finally, there’s a fourth worry, one you see expressed at some points in the Christian tradition, like when Bernard of Clairvaux, a medieval theologian and abbot, writes about how beauty and art and the love of those things can be alloyed with the love of social status, with the love of a kind of socio-economic hierarchy. This fourth worry is resonant with philosopher and mystic Simone Weil’s observation that the horror of poverty is essentially a horror of ugliness. We could say something similar about the horror of affliction, the horror of suffering, the horror of disease; they are all ways of drawing back from something we find revolting. 

Christians have thematized this horror in the stories of some of our most important saints. One of them is St. Francis of Assisi. Another is St. Catherine of Siena. Both saints have moments when they see someone who is suffering from disease—from leprosy, in the case of St. Francis, or a woman with an infection in her breast, in the case of St. Catherine—and experience revulsion. But instead of following their revulsion to move away from the afflicted one in front of their eyes, they overcome their revulsion by drawing near the suffering person in an intimate act of mercy. Their revulsion dissipates. And it doesn’t just dissipate, actually. It transforms into a new way of perceiving the person who’s right in front of their eyes. They see the person as Christ. 

Brewer: Everything you just said, especially invoking St. Francis, makes me think about your essay “Embracing Beauty in a World of Affliction,” in which you write, “Beauty seems . . . caught in a trap. It is problematic for drawing too near poverty and problematic for staying too far away.” You trace a powerful through line of intimacy between beauty and suffering—a world of “loving embrace.” Can you speak about that intimacy more and draw our attention to what you would have health-care workers see? 

Natalie: In the Christian tradition, we have a picture of a God who is beauty and a God who is constantly going out to what is not God, a God who goes out even to the most unbeautiful parts of the world. Gregory of Nyssa refers to this vision of a God who goes out as he’s defending the incarnation against people who say, “How unfitting that the Most High God would become human.” Gregory writes, in contrast, that God becoming human is actually deeply consonant with who God is. After refuting the various objections against the incarnation, Gregory writes, “What could be more fitting than that God would come to the aid of those who are in need? For our nature was sick and in need of a doctor.” For him, philanthropia, philanthropy (love of humanity), is the mark of the divine nature. I think that’s really interesting—that he draws on this picture of God as a doctor to suggest who God most fundamentally is. And for him, these two are the same: God is the doctor; God is beauty. These are two different pictures of who God is. It’s not unsurprising, then, that he gets caught up in his older brother Basil’s program of starting the first hospital. 

Brewer: I want to hear more about that connection to the first hospital. Three of our fellows in the Theology, Medicine, and Culture Initiative—Phifer Nicholson, Brendan Johnson, and Kayal Parthiban—just published a wonderful essay alongside theological ethicist Brett McCarty titled “Pursuing Excellence in Health Care: Using Fourth-Century Wisdom to Transform Modern Medicine.” They draw on the ancient example of the first hospital, the Basileais, founded by St. Basil, to bear a kind of disruptive witness to what medicine considers excellence today. Both Basil and Gregory were mothered, as I understand it, by their older sister Macrina, who suffered from a wound in her breast. Can you say more about that? How St. Basil’s glorious “new city” of the first hospital, as a deeply inspiring and transfigured site of health care, was influenced by his younger brother Gregory’s vision of the beautiful and his older sister Macrina’s woundedness? How did a Christian vision of beauty and suffering shape the first hospital from which, however faint, our current medical institutions still echo today? 

Natalie: The hospital was built during a time of famine, and it did not separate sickness from poverty or hunger. All those things were wrapped up in the hospital, which was called a “new city” because it was a kind of new work of the Holy Spirit, a site of the Spirit’s work. What I think is really interesting about Gregory’s famine sermons is that he’s trying to call people to acts of mercy. He’s aware of all the ways we can go awry in our relationships with one another. One way we can go awry is that the people who are not hungry, who are not in need, can just ignore the suffering of those around them who are. Another is that they can see the hungry as subhuman and so minimize the claim these suffering ones have on them. Yet another is that they can turn their suffering into a kind of spectacle for their own entertainment. Gregory’s famine sermons are really complex attempts to resist all those ways that our relationships can go wrong. He’s intent on showing the people who are living with need in the fullness of their lives. On the one hand, he writes, look at how these people are beautiful and bear the image of God. On the other hand, look at how they have been made to suffer, how they’ve been excluded from resources. Look at how this has made them have to live the way beasts live. And look at the way this has affected their bodies. But then, look at how your way of looking at them has, in fact, turned them into people who have to spectacle-ize their suffering just to get you to pay attention, to give them money. In the midst of this, Gregory also calls the rich to look at themselves, to look at who they become in their resource hoarding, the way they, too, are living like beasts. He moves back and forth between all these ways of looking, provoking people to reflect on their own vision, calling them to beauty as the site of mercy, where the people who are bloated by their own greed meet the people whose bodies are wracked by their hunger. Acts of mercy are acts of mutual healing. What could be more beautiful than mercy for Gregory? As I said earlier, mercy is the mark of the divine character. Mercy is the picture of the incarnation of God coming to us in need. That we are then able to participate in the healing of other people through acts of mercy is a way that we can reflect the beauty of God. 

Brewer: Thank you—this is so beautiful and convicting. You’re making me think of my own formation as a physician. I don’t know that I can recall a single time the word “mercy” has come up as an explicit goal of medicine. I’m sure it came up in talking about charity care or some conversation around that topic, but never as an explicit perspective that medicine trains us to see people from. 

With that in mind, I’d love to hear your experience interacting with the medical humanities world, insofar as the medical humanities tries to take up this conversation. Medicine has, I think, a somewhat complicated relationship with the beautiful. Medicine’s been looking to the humanities to “heal thyself” for at least a century. I would venture to guess that today most medical schools in the United States have some kind of initiative or elective in the arts and humanities. And yet, at the same time, more people than ever bemoan medicine’s mechanization and obsession with efficiency, precipitating a crisis around vocation and even the very language of “calling” itself, especially over the last few years. I’d love to hear about your experience watching fields like the health humanities take up these questions. 

Natalie: I have had a number of medical humanities students over the years, and I have found them to have a real sense of vocation. I imagine that’s true of a lot of undergraduates who are pursuing medicine. Maybe not all, I don’t know. I imagine medicine gets really caught up with pursuing status too. But if medicine is looking to arts and humanities to solve its problems, then it’s a striking irony, because the arts and humanities are themselves in a crisis and have been for the last couple decades. 

There is, of course, really good training that can happen in the arts and humanities, training that does have something to do with care. Humanists are trained to look at and engage with a text or an artifact with sympathy and with criticism—to really be able to look and attend well in a way that has analogies, I imagine, with what you’re doing in medicine. But ultimately it’s formation into intellectual virtue, not moral virtue. So there’s only so much that the arts and humanities will be able to do to create more merciful physicians. They can train physicians into a kind of gazing, a “paying attention” akin to mercy, that can prepare for mercy—but it’s not mercy. And it’s very easy to stop at this intellectual analogue to mercy. You can look at the ranks of arts and humanities professors and probably learn that we’re not as a class more virtuous than any other set of people just because we study texts and artifacts that are beautiful and worthy of attention. Something else needs to happen for a person to grow in virtue. While there may be real work that the humanities and arts can do, they’re not going to solve the problem of mercy’s absence in medical humanities training programs. That’s a moral problem, and while our institutions and schools like to talk about formation, they get nervous about addressing actual morality. 

Brewer: This is fascinating to me for so many reasons. One reason is because of Elaine Scarry’s book On Beauty and Being Just, which changed my life as a med student. She writes that what we pay attention to, and the forms of the beautiful we submit ourselves to, has an inevitable ability to move us—so beauty literally does kind of push us onto the moral curve. On the one hand, beauty makes us want to step into the thing we are witnessing, or to merge with it in some way—to reach out and touch it. On the other hand, because the thing is so beautiful, we have this impulse of choosing not to touch. Wounds echo that weird tension. Sometimes a patient will present to me and the pain is such that all I want to do is reach out, but then there’s also this impulse of wanting to pull back. Responding to this dual impulse requires something more like discernment. So here is my question: On the one hand, I hear this renewed interest in kalos and kalon, the beautiful and the good—their interchangeability—and how witnessing beautiful things seems to have an inevitable influence on whether we go forth in the world as more just and merciful creatures. And on the other hand, I recognize this tension that I’ve read in folks like Bence Nanay and his little book on aesthetics, in which he says quite directly that aesthetics is never about what we are to do; it’s simply the study of what we pay attention to. He just flat out refuses to support this idea that aesthetics has ethical import. Can you help us unpack that—seemingly back to where this conversation began with divine names? 

Natalie: Elaine Scarry’s two most famous works are On Beauty and Being Just and The Body in Pain. I remember her describing her teaching and writing on beauty as fortifying her to do her teaching and writing on pain, and I think the interaction between those two streams of her work is really interesting. Again, I think that beauty does work. But that doesn’t mean beauty is going to replace our will or, in Gregory’s way of putting it, eliminate the need to ascend into the luminous darkness of Sinai. 

One way to think about the work beauty can do would be through analogy with John Calvin’s discussion of the sacraments. He tries to mark a position that’s neither the Catholic perspective nor a purely symbolic view, in which the sacraments aren’t actually effective. Calvin wants to say, “No, look, the sacraments are effective. I realize that people take the sacraments and are still bad people. But people also go to sermons and hear the Word of the Lord preached and then still go and decide to do bad things. Does that mean that the Word of the Lord is not effective? No!” For Calvin, the fact that a person can take the Eucharist and remain ensnared to sin means that we are given the capacity to say no to the Lord. That’s a gift that God has given us—the ability to reject God’s gifts. We might think of beauty in the same way. Beauty is an invitation to transformation. Beauty gives us a possibility of transformation. But we can choose whether to step into that transformation. We can choose whether to turn that invitation to beauty into a deflection from the problems of reality. We can try to turn beauty into something that we can master and control—or we can try to say yes to the Beauty who continues to call us up the mountain into the luminous darkness, into a place where we are not in control, where we are before the holiness that is so much greater than ourselves. It is just an invitation—and we’re free to say no. 

Brewer: You said something about deflection from reality that I’d love to tug on: the healer’s relationship with reality and some of these tensions to escape reality rather than engage it, wanting to hold it at bay because we sense there’s a kind of threat or a cost. Ben Lerner, a poet and novelist, went through open-heart surgery for an aortic valve replacement in November of 2025. He wrote an incredible piece titled “Cardiography” in the New York Review of Books in which he writes, “My only defense against reality: to transform it into literature.” That line reminded me of something philosopher Charles Taylor writes in A Secular Age: “We give ourselves frissons, while still holding the reality at bay.” (Frissons are aesthetic chills or the goosebumps you get in the face of something achingly beautiful.) I think about poets like Jane Hirshfield, Christian Wiman, and Wendell Berry, who don’t write about defence from reality or holding reality at bay so much as facing reality and stepping deeper into it, accompanying it through its groanings. Are the arts and humanities seen by health-care workers as a tool for endurance, or are they seen as something that reorients our movements through the world? I’ve heard the humanities deployed both as a kind of escape and as a tool for endurance. I recognize that transforming reality into literature is a kind of accompaniment to the deep groanings of creation, but I can also see how it can be a way of escaping the call that beauty makes on our lives. 

Natalie: I think part of what you’re getting at is the way defending against reality and leaning into reality can be difficult to disentangle, and maybe they aren’t always as opposed as they seem to be. It’s similar to what we do sometimes with trauma, when we need to narrate it, to make a story from it. A terrible thing happening to you can just be a chaotic assault on your nervous system, right? And literature, in one way, holds that trauma or difficulty at bay, but holds it out so that you can see it, so that you can narrate it, so that you can find an “I” again and find a shape to your story. And then multiple things can happen. You can hold it apart in a way that denies or minimizes what has happened, or you can hold it in a way that allows you to make meaning from it and find a way through it. I think literature can function both ways. There is a real possibility in the ways that literature and art in general help us move through suffering, not by denying it, but by helping us find our subjectivity through it. 

Brewer: Thank you. I’d love to ask one more question. For some corners of Christianity, the names C.S. Lewis and J.R.R. Tolkien are quite familiar. A name that does not enjoy as much recognition is Robert Havard—physician to Tolkien, Lewis, and Lewis’s wife Joy, as well as a member of the famous Inklings. I’m a Lewis nerd, so I geek out about this stuff, but there’s some exciting scholarship coming out from a physician-scholar named Sarah O’Dell in her forthcoming book, The Medical Inkling, in which she unpacks Havard’s influence on the imaginations of Tolkien and Lewis, and vice versa: how Lewis and Tolkien’s respective imaginations as Christian artists may have bled back into Havard’s practice of medicine. I like to imagine Lewis and Tolkien talking shop about art and theology, only to have their general physician Havard join them at the table, sparking a conversation between theology, medicine, and the arts. It seems to me that there has been a robust conversation between theology and the arts for several decades—one that you have been instrumental in shaping alongside folks like Jeremy Begbie, Ben Quash, Makoto Fujimura, David Bentley Hart, Dietrich von Hildebrand, and so on. And there has also been, as we just talked about, long-standing attention to medicine and the arts. And so here is the question I’d love to hear you talk about as a constructive theologian: If you were sitting down at a table with an artist and a physician, where would you want to see that conversation go between theology, medicine, and the arts? 

Natalie: That’s a great question. I’m thinking a lot about creativity right now and the way it’s connected with a kind of whole vision of flourishing. So, not creativity as it’s often popularly thought of, caught up with romantic and colonialist legacies of an autonomous man without any dependencies who comes and leaves his mark of genius upon the world, but a different vision of creativity that also exists in our philosophical and cultural traditions. Creativity in these other traditions is a “greening,” one of Hildegard of Bingen’s words for thinking about the vitalizing work of the Spirit in our creation and also for naming the work of flourishing that plants and humans do. It’s a word that captures the fecundity of “life life-ing.” I’m interested in how this image of creativity as the greening connects many different types of work that we do. How can it help us, for example, think about the work of a physician as entailing a kind of creativity? The greening creativity there is not that of the creative subject who exists over against the non-creative object of the patient. It is a creativity that is responsive to the creativity of the patient, including the patient’s body, how the patient’s body is involved in its own kind of creative work that the doctor participates in. What kinds of conversations, lives, and artifacts are possible when we imagine ourselves in this world where we’re all called to creativity? What might it mean to be called to respond to the Creator God, to be called to a vocation of creativity together with a whole world—a vision of all creation that is already, in its own ways, expressing creativity? What relationship between the physician, artist, and patient is made possible when we approach creativity in this way? 

Brewer: That’s so lovely, thank you. It inspires much—as medicine endures a kind of crisis of trust, just even entering the room, approaching the patient in a spirit of creative co-labouring, a sense of brooding over the potential to heal, or the potential to build something together in a tangible way. Virginia Sweet draws on the greening in her book God’s Hotel, about the way that patients near the end of life will have, at times, a kind of greening in the hospice and palliative space. What does it mean to become healers who can recognize these tender, budding moments that are still eager for new creation and life, even as life may be fading? 

This brings me to a final question, from a member of our audience, psychiatrist-theologian Warren Kinghorn: “How do you understand the relationship between beauty and care? What is it about care and about giving or receiving care that evokes beauty? And what can clinicians learn from this?” 

Natalie: I really appreciate the framing of this question, which is that care itself evokes beauty rather than beauty being a kind of prerequisite for care. In the examples I was pulling from earlier, St. Catherine and St. Francis, it’s the care that then generates a new form of perception, that begets a form of seeing beauty. Elaine Scarry talks about beauty and care from the other direction: She describes beauty as promoting a regard for the beautiful object. When a person finds something is beautiful, she wants to take special care with it, and that regard, Scarry notes, can move out laterally. So a person sees a beautiful vase, falls in love with this beautiful vase, wants to take care of this beautiful vase—and perhaps from that experience notices all vases differently, as the regard moves out to inspire care for similar or adjacent objects. Similarly, Scarry describes a person enamoured of the beauty of the Lord being moved to regard what’s adjacent to the Lord, the Lord’s mother. The person may then see the beauty of the Lord’s mother and be inspired to offer her special care as well. So beauty can promote care, but treating something with care can be transformative to our capacities for perception as well. When we treat something with care, as the Lord treats it, then we enter more deeply into the possibility of seeing things as the Lord sees them; we see them in their beauty. And so I think there is an interesting mutuality between beauty and care; it doesn’t just run one way. But what can clinicians learn from this—I don’t know. What do you think? 

Brewer: My immediate thought was just the sheer number of interns and medical students who when asked, “Why did you choose medicine?” almost invariably reflect on some act of care that in its beauty made a claim on them. But that’s barely the start of an answer. 

Natalie: I guess maybe one thing is, if beauty and care are mutual, being a physician is an invitation into a new relationship of attention with your patients. But I imagine that, as in any other job, you just get used to doing the things you do. Experiences that used to be wondrous or horrific become muted over time. But maybe if you’re willing to risk vulnerability by moving into postures of attention-laden care with your patients, then that vulnerability can yield transformed perception. But I realize that to be a physician, risking vulnerability is risking a lot. 

Brewer: Medicine is asymptotic, you know: You never quite arrive, you’re never quite done. And maybe this is the family doctor in me coming out, as opposed to, say, discrete surgical needs that really do sort of resolve. But that sense of following a patient as they unfurl before you, and being willing to be claimed by that process, which I often experience as similar to letting a work of art, or a piece of literature, or a poem, or a piece of music, make a claim on me. That’s what comes to mind. Often the most practical decisions, for the sake of the patient’s healing and health, come out of that process of sitting and beholding.