Status, grievance and resentment: C.S. Lewis on the surprisingly modern business model of hell

60 years after its author’s death, The Screwtape Letters image of hell as an unscrupulous business is still relevant. Simon Horobin tells how C.S. Lewis came to author the influential bestseller.

Simon Horobin

Simon Horobin is Professor of English Language & Literature, Magdalen College, Oxford University.

A comic book style cartoon of a small squat devil looking quizzed in hell.

A scene from Marvel Comic's version of The Screwtape Letters.

November 22nd is the sixtieth anniversary of the death of C.S. Lewis, an event that was overshadowed by the assassination of JFK on the same day. Although he is best known today as the author of the Narnia stories, the obituary that appeared in The Times newspaper a few days later noted that it was in fact The Screwtape Letters which sparked his success as a writer.

Initially published as a series of letters in the church newspaper The Guardian, The Screwtape Letters appeared in book form in 1942. The idea came to Lewis during an uninspiring sermon at Lewis’s local parish church in the Oxford suburb of Headington, in July 1940. Provisionally titled ‘As one Devil to Another’, the book would form a series of letters addressed to a novice devil, called Wormwood, beginning work on tempting his first patient, by an older, retired devil, called Screwtape. In finding Screwtape’s voice, Lewis was influenced by a speech given by Adolf Hitler at the Reichstag and broadcast by the BBC. What struck Lewis about the oration was how easy it was, while listening to the Führer speaking, to find oneself wavering just a little.

Lewis dedicated the volume to his friend and fellow Oxford academic, J.R.R. Tolkien. After Lewis’s death, having read an obituary in the Daily Telegraph claiming that Lewis was never fond of the book, Tolkien noted drily:

‘He dedicated it to me. I wondered why. Now I know.’

Despite Tolkien’s misgivings, the public devoured the work and it quickly became a bestseller. Although, as Lewis pointed out, numbers of sales can be misleading. A probationer nurse who had read the book told Lewis that she had chosen it from a list of set texts of which she had been told to read one in order to mention it at an interview. ‘And you chose Screwtape?’, said Lewis with some pride. ‘Well, of course’, she replied, ‘it was the shortest’.

Not all readers approved of its sentiments. A country clergyman wrote to the editor of The Guardian withdrawing his subscription on the grounds that much of the advice the letters offered seemed to him not only erroneous but positively diabolical. The confusion no doubt arose from the lack of any explanation surrounding their circumstances; in a later preface Lewis gave more context, though refused to explain how this devilish correspondence had come into his hands.

Its publication by Macmillan in 1943 brought Lewis to the attention of readers in the United States; when Time magazine featured an interview with him in September 1947, it carried the title ‘Don v. Devil’. A picture of Lewis featured on the magazine’s cover, with a comic image of Satan, complete with horns, elongated nose and chin, and clutching a pitchfork, standing on his shoulder.

For Lewis, the war did not present a radically different situation, but rather aggravated and clarified the human condition so that it could no longer be ignored.

The Screwtape Letters are the product of the war years, during which Lewis wrote many of his most popular works. It was in 1941 that he delivered the first of his broadcasts for the BBC Home Service, which launched his career as a public apologist for the Christian faith. In 1942 Lewis published Perelandra, the sequel to his first space travel novel Out of the Silent Planet (1938), in which his hero, Elwin Ransom, a Cambridge philologist – another nod to Tolkien – is summoned to Venus to prevent a second fall. Although it was published in 1950, The Lion, the Witch and the Wardrobe begins with four children being evacuated to the countryside to escape the London blitz. In setting his stories in outer-space or the fantastical world of Narnia, Lewis could be accused of writing escapist fiction that avoided the realities of a world in conflict. Lewis, however, believed that the war had not created a new crisis, but rather brought into clearer focus an ever-present struggle between good and evil.

For Lewis, the war did not present a radically different situation, but rather aggravated and clarified the human condition so that it could no longer be ignored. As he remarked in the second of his Broadcast Talks:

‘Enemy-occupied territory – that is what this world is. Christianity is the story of how the rightful king has landed, you might say landed in disguise, and is calling us all to take part in a great campaign of sabotage’.

The key point, writes Screwtape, is to fix the patient’s attention on ‘real life’ – but don’t let him question what he means by ‘real’.

Lewis’s message to a country living in fear of occupation by German troops was that the invasion had already happened. They had been summoned not to their country’s defence, but to its liberation. When the Pevensie children stumble into a snow-covered Narnia under the control of the tyrannical White Witch, they are told in hushed whispers of the rumours of Aslan’s return: ‘“They say Aslan is on the move—perhaps has already landed.”’ It is a reminder that Aslan enters Narnia as a rebel, intent on overthrowing the Witch and installing the rightful kings and queens on the thrones of Cair Paravel.

The Screwtape Letters do not ignore the war during which they were written; Wormwood’s patient is killed in the London bombing. But, for Screwtape, a war is of no value unless it results in winning souls for his Father Below. His advice to his nephew is concerned with diverting the patient from engaging with universal questions by distracting him with everyday preoccupations and sense experiences. While these might involve the immediate conflict, they could also be the excitement of a new romance, a falling out with a friend, the prospect of promotion, or an obsession with food. If the patient should begin to speculate about spiritual matters, Screwtape advises Wormwood to deflect him with academic theories and philosophies that avoid confronting the question of whether the Christian faith might actually be true. The key point, writes Screwtape, is to fix the patient’s attention on ‘real life’ – but don’t let him question what he means by ‘real’. It is ironic, Screwtape observes, that, while mortals typically picture devils putting ideas into their minds, their best work is done by keeping things out.

Despite numerous requests for sequels, Lewis was reluctant to twist his mind back into the ‘diabolical attitude’ and revisit the spiritual cramp it produced. Numerous spin-offs have appeared to fill the void, with Screwtape emails, audio and stage performances and even a Marvel comic book adaptation. Despite this, readers continue to turn to the original work. After all, Lewis’s depiction of hell as an unscrupulous business concern, whose employees are perpetually concerned about their own status, nursing grievances and resentment, speaks to our modern age just as much as it did to Lewis’s own.

Article

Care

Change

26 July 2024

6 min read

Are we forgetting how to care?

The profound act at the heart of nursing.

Helen Cowan

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A nurse bends beside a bed and talks to a patient

Marie Curie.

Recently, at a nursing leadership programme in Oxford, attendees focused on the fundamentals of care. Have we forgotten how to care? What can we re-learn from those who pioneered an ordinary yet profound act that affects millions?

Anam Cara is an old Gaelic term for ‘soul friend’, a person with whom you can share your innermost self, your mind and your heart. It is a term that Tom Hill, former chief executive at Helen House Hospice in Oxford, used to describe the relationship between his staff and the thousands of children and their families who passed through their ‘big red door’ in its first twenty-five years. The hospice (or ‘loving respice’ as it became known) had been founded by Sister Frances Dominica in 1982.

Other care in this country can also trace its religious roots. Between 1048 and 1070 in Jerusalem, the Order of St. John was founded for the purpose of helping pilgrims (“our Lords, The Sick”) who had become lost, weary, or beset by other difficulties while on their way to the Holy Land. Today, in the United Kingdom, the British Association of the Order has extended care to older people first in almshouses and later in care homes. A trustee for ten years was John Monckton, a man of ‘considerable talent, enormous integrity and deep religious conviction’; his tragic murder in 2004 led to the creation of the John Monckton Memorial Prize, which recognised and rightly celebrated commitment to care by care workers.

Today, across the world, seen and unseen, nurses, carers and families continue to provide compassionate care. “Assisting individuals, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge” is the very essence of nursing, captured by ‘architect of nursing’, researcher and author Virginia Henderson in 1966. Meeting more than basic needs such as breathing, eating, drinking and eliminating bodily waste (which are of essential importance), Henderson recognised the role of the nurse in enabling humans to communicate with others, worship according to their faith, satisfy curiosity and sense accomplishment.

In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care?

An uncomfortable truth brought out in healthcare reports such as the Final Report of the Special Commission of Inquiry (The Garling Report) 2008, and the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (The Francis Report) 2013 is though that this type of nursing is too often done badly or even missed, leading to pressure injury, medication errors, hospital-acquired infection, falls, unplanned readmission, critical incidents and mortality. According to nurse scientist and scholar Professor Debra Jackson, “missed care occurs much more frequently than we might think”. She cites a systematic review in which ‘care left undone’ on the last shift ranged from 75 per cent in England, to 93 per cent in Germany, with an overall estimate of 88 per cent across 12 European countries’.

In one offensively-titled paper, “Shitty nursing - the new normal?” (in which the authors apologise for the title but not the questions raised), real-life pen portraits are drawn of patients lying for hours on hospital trolleys, immobile through infection or injury, ignored by staff. Whilst acknowledging contextual factors for poor care, such as a shortage of nurses and resources, the authors argue that circumstances cannot be the sole cause of missed nursing care.

A report published by the University of Adelaide, School of Nursing, has called for nurses to ‘reclaim and redefine’ the fundamentals of care. It asks whether the cause of the problem (of missed nursing care) lies “deep in the psyche of the nursing profession itself?” “Has something happened to the way modern nursing views and values caring?” it continues. “Indeed, is nursing in danger of losing its claim to care? In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care? Or is this a broader social pattern where individuals are less inclined to show kindness, compassion, and care for others even if it is a necessary requirement of the job?”

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness.

Writing in the British Medical Journal, Professor of critical care medicine Peter Brindley and Consultant in intensive care Matt Morgan wonder whether doctors also “too often default to high-tech and low-touch” when patients are dying – a time “when community and connection matter most”. They powerfully begin with a mother’s comment: “Humans are gardens to tend – not machines to fix.”

Professor Sir Al Aynsley-Green, the first National Clinical Director for Children in Government and former Children’s Commissioner for England, and past president of the British Medical Association, suggests that we as a society need a “momentum for compassion”. Struck by the extremes of compassion witnessed during his wife’s treatment in the last years of her life, Sir Al wants to see a cultural transformation in healthcare: for compassion to be a key operating principle in NHS and care settings, led by the Chief Nurse’s Office; for every organisation to promote the importance of compassion at the professional level; for the views of patients and families to be sought regularly; for much earlier and better focus on compassion in undergraduate and postgraduate teaching programmes for all staff; for compassion to be inspected against by the Care Quality Commission; and for a willingness to encourage staff at all levels to expose poor practice as well as celebrating excellent care.

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness. “It’s putting yourself into somebody else’s shoes – and doing something about it.” Recently appointed the UK’s first Visiting Professor in Compassionate Care at Northampton University, at the age of 80, Sir Al certainly is doing something about it. He has made it his new purpose in life to “embed compassion into every aspect of care”.

Like Sir Al, Queen Elizabeth II, the UK’s longest serving monarch, espoused compassion, in word and deed. Living a life of compassionate service, the Queen made clear that her Christian faith was her guiding principle. She speaks of Jesus Christ as ‘an inspiration,’ a ‘role model’ and ‘an anchor’. “Many will have been inspired by Jesus’ simple but powerful teaching,” she said in her Christmas Broadcast, 2000. “Love God and love thy neighbour as thyself – in other words, treat others as you would like them to treat you. His great emphasis was to give spirituality a practical purpose.”

When nurses do unto others as they would have done unto themselves, and act as role model to colleagues, not only do patient experiences of care and their outcomes improve – but so does job satisfaction for nurses: a critical factor in nurse recruitment and retention – the biggest workforce challenge faced by healthcare organisations. Across the UK, there are currently more than 40,000 nursing vacancies, and thousands of burnt-out nurses are leaving the profession early. Whether nurses decide to stay or go is driven in part by their daily experience at work. The late Kate Granger, Consultant in medicine for older people, inspired Compassionate Care Awards in her name, envisioning that such a legacy would drive up standards in care - and surely also help retain nurses, through restoring a sense of pride, achievement and fulfilment to the nursing workforce.