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.

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Faith

15 August 2024

4 min read

Faith is no longer a dirty word in publishing

Sarah Perry’s comments suggest a reawakening of concern for its observation.

George Pitcher

George is a visiting fellow at the London School of Economics and an Anglican priest.

A woman being interviewed gestures with a hand in front of her

Sarah Perry.

Waterstones.

If there’s one thing anyone who has ever written a novel can’t stand, it’s having to congratulate a successful novelist. So, it’s through gritted teeth that I warmly welcome the words of Sarah Perry (The Essex Serpent) that religious faith is ceasing to be a subject of embarrassment in published fiction.

It’s about time. Perry told the Edinburgh International Book Festival that, for her latest book Enlightenment, she was asked to put in more theology: “I assumed that everybody knew what the doctrine of predestination meant.” Bless.

The cause of my pathetic envy as I applaud her is that I had my first (and, to date, only) novel published in 2017, to almost universal disinterest. I like to tell people that it was well received – all three people who actually read it said they enjoyed it and only one of them was a family member. It actually did a bit better than that, but you get my drift.

It was an unashamedly religious psychological thriller, titled A Dark Nativity. Brace position, here comes a one-sentence synopsis: The narrator, Reverend Natalie Cross, is a frustrated former aid worker who undertakes a mission to Israel, is kidnapped and held hostage, murders her way to freedom, discovers she was the victim of an Anglo-American plot, wreaks her terrible revenge and (spoiler alert!) gives birth to a son of uncertain paternity.

See what I did there? As well as the latter-day Nativity resonance, thematically I was interested in what redemption looks like in Israel and Palestine. I know, I know – but even I thought it would be distasteful to try to cash in on what’s happened there since.

Enough of the plug for a seven-year-old novel. My point is that its religious themes actively militated against it at the time. Novels addressing Christian faith (or any other kind) occupied a particular publishing niche – a harsher word might be ghetto. To try to break out of it was pointless. The great Christian novelist Penelope Wilcock told me (very kindly) that my book was too religious for the secular market and too secular for religious readers.

Perry’s observation that faith is no longer a dirty word in publishing might yet suggest a reawakening of serious concern for its observation.

The restricted area to which religion was confined had its stylistic rules. There was the cathedral close romp, which authors such as Catherine Fox had made their own. The vicarly whodunnit (lately updated by Reverend Richard Coles). Magic realism with its daemons and Philip Pullmans. And anything, in the wake of Dan Brown’s The Da Vinci Code, involving ancient plots that might make a movie, with hooded figures walking in slo-mo through cloisters.

Vicars had to be evil or silly. I may be both those things at times, but I’d like to think there is other stuff going on here for cultural exploration. My narrator, Nat Cross, was driven, often funny and more than a little mad. So like a lot of Anglican clergy.

If she’s right – and I very much hope she is – it’s why what Perry has to say is so hopeful. Because it begins to suggest that religious faith is slowly beginning to be accepted back into polite society. Whisper it softly, it might even become a cultural norm. If Richard Dawkins can describe himself as a “cultural Christian” and the historian Tom Holland, in his book Dominion, can claim that Christianity is the entire foundation of western civilisation, then there is everything to play for. And, indeed, write for.

It’s not as if cathedral frolics and the revelation of Jesus’s wife in Leonardo’s Last Supper was anything other than a fictional diversion of post-modernism. Religion and specifically Christianity had been a staple of the novel in English.

I hesitate to mention their names in the same column as the authors above (including me, most obviously), but Graham Greene’s exposition of Catholic guilt in The End of the Affair and Evelyn Waugh’s of the impossibility of moral reformation in Brideshead Revisited are probably the best religious novels of the twentieth century.

Further back towards the birth of the English novel, the Reverend Edward Casaubon in George Eliot’s Middlemarch is perhaps the most tragic portrait of a clergyman who is neither evil nor silly. He stand as a warning from history to today’s Church of England.

And it’s to that, the established Church, that Perry’s remarks ultimately turn our attention. We’re told that there has been a five per cent spike in church attendance recently, but that of itself isn’t sufficient to suggest a renaissance in our religious culture. Our arts and culture will only ever really reflect what we care about.

Perry’s observation that faith is no longer a dirty word in publishing might yet suggest a reawakening of serious concern for its observation. If so, that’s good news for the religious, as well as for religious authors. And I might just get a sequel out of it.