Rhetoric, Medicine, and Ministry
Editor’s note: Professor Glenn Nielsen is on a partial sabbatical this year, maintaining his vicarage/internship responsibilities, but catching up on reading and writing occasional reflections on those readings. This is the second of these reflections.
In my previous piece about my visit to the ER, I wrote these paragraphs:
I wonder if those highly trained medical personnel are able to practice the art of medicine in the ER. Why do I ask that? Because during my visit to the ER (and the Urgent Care Center), the only times I was physically touched was to start an IV, put on my wristband, take my blood pressure and insert the catheter. I was not physically examined, which may have made a difference as to when the needed procedure took place. Everything was done after technology had done its work: lab results, culture done, CT scan read. But the human factor of diagnosing and moving forward seemed missing.
I mentioned this to a nurse I know, and she said that is what frustrates so many doctors. They aren’t allowed to practice the medical art. They have to punch into the computer the symptoms, lab results and then wait for the plan of action to be given to them. I suppose that protects the hospital from law suits, human error, and the like. But in my case, it kept me from the relief I needed, and I shudder to think what could have happened if the fluids had continued to build up in my bladder. In my case, it appears to me that the doctor had become a technician rather than one who practiced the art of medicine.
I have a degree in rhetoric. Throughout its history, rhetoric has had to fight to maintain its status as a practical art and not become mere, well, rhetoric. As mere rhetoric it is reduced to a variety of techniques to persuade an audience. “Just tell me what works when I’m communicating so I can push my agenda” is mere rhetoric. But it is more.
I teach at Concordia Seminary. Occasionally I will hear, “I didn’t learn that at the seminary.” Implied in that statement is that the seminary should spend most of its time in the practical realm of how to do things. Make him a leader. Be sure he can preach well. Give him counseling skills. Teach him how to teach confirmation class. Eliminate any personality quirks. And so the list goes. But the ministry is more than just knowing how to do certain activities technically well.
In Aristotle’s Rhetoric, he certainly admits and spends much time on the various means someone can use to persuade an audience. Many know of his three artistically created forms of proof: logos, pathos and ethos. He goes into detail in each of these areas, including spending time on different emotions and how to appeal to them. But his definition of rhetoric moves to a bigger and broader realm, that of a practical art: “[Rhetoric’s] function is not [absolutely] to persuade, but to discover the available means of persuasion in a given case.”  The key word is “discover.”
Another way to say this is that the artful rhetorician does more than persuade, although that is one of the goals of rhetoric. The practical art involves the capacity to determine which means should be used. It’s the ability to look at a case to discern what can be done, even what should be done. The art comes in the wise discernment, not merely the results. Roman rhetoric certainly organized and systematized the various means to be used (Cicero!), but that artistic definition can be seen in this quotation from Quintilian concerning the perfect orator: “[H]e is a good man and after that he is skilled in speaking.” 
A recent book helps to place the ministry into this realm of the practical art. Richard Osmer’s Practical Theology  describes a practical art (phronesis) as wise judgement.
It is the capacity to interpret episodes, situations, and contexts in three interrelated ways: (1) recognition of the relevant particulars of specific events and circumstances; (2) discernment of the moral ends at stake; (3) determination of the most effective means to achieve these ends in light of the constraints and possibilities of a particular time and place. 
Good character and wise judgment, thus, are bound together. Moreover, since wise judgment involves the ability to sift through and evaluate particulars, it requires experience, making it rare among the young…. Wise judgment, for example, is necessary to determine when an action is courageous, not reckless, and the available means to pursue courageous action in a given time and place. It is also required when choices between various goods must be made, since circumstances make it impossible to achieve them all. As a virtue, or moral capacity, rooted in the character of a person, prudence has a deep connection to spirituality. 
Did you bristle when he said it is rare in the young? You shouldn’t. Reread Walther’s third thesis in Law and Gospel, where he talks of the ability to distinguish between Law and Gospel as the most difficult and highest Christian art taught in the school of experience by the Holy Spirit. Osmer, as well, connects the Law/Gospel distinction to the practical art of the pastoral ministry.
Practices of discernment, thus, are crucial to the work of the interpretative guide (pastor). They provide a point of connection between God’s Word of judgment and grace in Christ Jesus and the specific social conditions, events, and decisions for which congregational leaders provide normative guidance day by day. 
The reason I bring all this material together in this piece is because I’ve long appreciated an old word that is often used for carrying out the ministry: habitus. The understanding I’ve usually given to this word is: The capacity or disposition to bring together theological knowledge, past experience, one’s own strengths and weaknesses, the situation’s particulars, and the example of good models to provide acts of ministry for God’s people. Yet that word has lost its impact from lack of use or, perhaps, the tendency to turn the ministry into a series of technical skills rather than a rich growth into the practical art it is. Whatever the reason for its relegation to a dusty shelf, it’s good to remind ourselves that the ministry is, as is medicine and rhetoric, a practical art, a habitus. It is more than that, of course, but not less than that.
My wife, Sue, is a nurse and works for the Missouri Regional Poison Center. She’s done this for many years. She takes phone calls from distraught parents whose child has swallowed a glow stick on Halloween, ingested grandpa’s blood pressure medicine, or been playing with a bottle of insecticide in the garage. She has the computer on and has specific protocols for these situations as well as dozens of others, including calls from emergency rooms who have patients that have overdosed on multiple different medications. But she also listens carefully. Asks questions patiently. Respects the callers’ privacy and emotional state. Withholds judgement. I could name other qualities, but I’ll just add that she helps save people’s lives. Yet she does this with both professionalism and a personal touch. Interacting with people on the phone in moments like this calls for wise judgment. Stern with one caller; sharing a family story with another. Judging whether to send someone to the ER or just watch things at home. Knowing much about various drugs, yet carefully charting everything. She exhibits a habitus, a practical wisdom, which goes far beyond just giving information from a computer screen.
While my visit to the ER was technologically advanced, clinically professional, and ultimately (but not timely) successful, I now look back and wish that someone had gone beyond the lab tests and scans to interact with me, assess the situation and move forward with wise judgment. A habitus, not just technical skills.
All this brings me back to seminary education, and “You didn’t learn that at the seminary.” No, we cannot teach everything at the seminary. You will not learn all the “that’s” (whatever those may be) here. You will learn many “that’s.” You can ask my Homiletics 1 students about that. But what we do strive to do here is form students in the habitus needed to address those “that’s” in such a way that it leads to acts of ministry. We give the theological knowledge from which faithful judgments can be made. We provide field education and vicarage through which good models can be observed and supervised activities can give pastoral experience, both of which are needed for wise judgments. We offer courses on leadership, counseling, teaching, worship and preaching to help develop technical skills. But these courses do more than just teach skills. They, along with other seminary classes, push students to a theoretical/biblical/theological understanding as to why to do something one way and not another. We desire spiritual growth in those aspiring to this office so that judgments flow out of a more sanctified servant.
And we hope that this formation in the pastoral habitus continues after graduation. In 1990 I began my teaching career at Concordia Seminary. That year I was instructed to sit in on a class to see how Homiletics 1 was taught. I was the new instructor being instructed. The professor, William Schmelder, said one thing that has stuck with me ever since, and I’ve repeated it to most every class. “You will graduate with a Master’s degree from here, but you won’t have mastered anything yet about the pastoral office.” I’ve been at this now for almost 27 years, and I find that statement still true. My preaching changes. My teaching changes. I change. I haven’t mastered anything. But I have grown in that habitus, that capacity to make wise decisions in particular situations, especially, I believe, when it comes to directing the vicarage and deaconess internship programs.
So I pray that beyond the techniques and helpful methods you are appropriating at or after seminary, you see the practical art the pastoral ministry is. And seek to grow in that habitus as of significant importance.
 Lane Cooper, The Rhetoric of Aristotle (Engelwood Cliffs, NJ: Prentice-Hall, Inc., 1932), 6.
 James Golden, et. al., The Rhetoric of Western Thought, 3rd ed. (Dubuque: Kendall/Hunt, 1967), 77.
 Richard Osmer, Practical Theology (Grand Rapids: Eerdmans, 2008).
 Osmer, 84.
 Osmer, 85.
 Osmer, 139.
Harold L Senkbeil November 17, 2016
An excellent reminder that pastoral work is an art (Seelsorge) in the application of a science (theology). Your experience with modern medicine is echoed in this TED talk by a physician who laments that his profession has lost the most significant component in proper diagnosis and cure: the human touch. https://www.ted.com/talks/abraham_verghese_a_doctor_s_touch