Column

Culture

Eating

Hospitality

1 April 2024

6 min read

We could all benefit from hospitality’s bear hug

In a compelling series, The Bear offers a richer and nuanced redemptive journey.

Krish Kandiah

Krish is a social entrepreneur partnering across civil society, faith communities, government and philanthropy. He founded The Sanctuary Foundation.

A tired-looking chef turns around to look across his shoulder.

Jeremy Allen White plays Carmy.

FXP.

I only need to watch a few minutes of Gordon Ramsey’s Hell’s Kitchen to remind me that toxic environments not only still exist, but all too often are glorified. From bitter previous experience I know that employers can bully, lie and manipulate those beneath them, and apparently get away with it. I have sadly seen how the Christian virtues of turning the other cheek and forgiving your enemies can serve to collude with a toxic environment. However, I also dare to hope that another Christian virtue – that of hospitality – can foster quite a different environment. I have been thinking about this a lot recently as it tallies with themes explored in another chef show - the global smash-hit multi-award-winning US TV series, The Bear.

The drama is set in the high-intensity world of the Chicago hospitality industry. The story revolves around a character called Carmy, played by Jeremy Allen White. Carmy has made his name in gastronomy and has won and retained multiple Michelin stars. But when his beloved brother Mikey commits suicide, Carmy returns to Chicago to take over his brother’s failing sandwich shop called “The Beef.”

Putting a grieving world-class chef in the middle of a bankrupt dysfunctional sandwich shop in the cheap side of Chicago is a great concept for an intense drama. It is set up to be a classic rags-to-riches journey and so we wait to see how, with a bit of spit, polish and hard work, transformation against the odds is possible. Although, inevitably, the narrative arc of the show does follow the well-trodden American Dream theme of outsiders whose hard work turns things around, this is not a simple tale. There’s a richer and more nuanced redemptive journey offered in this compelling series.

The show has won critical acclaim and I believe it is due in part to the fascinating combination of three important overlapping hospitality themes that each offer us some signposts for changing the culture of toxic environments. They also happen to point to how Christian hospitality teaching is as relevant today as ever.

The vulnerability of hospitality

“The more I learn about Michael, the less I understand.”

Ebraheim

Everyone in the relational ecosystem of this television show has a major flaw. There are no messianic figures. Everyone is carrying great deal of pain and vulnerability. The ever-anxious Carmy is a recovering addict and finds solace in total immersion in his work. The rising-star sous-chef, Sydney, played by Ayo Edebiri, is grieving the loss of her mother and the serial failures of her previous businesses. The emotionally illiterate cousin, Richie, played by Ebon Moss-Bachrach, is becoming alienated from his wife and his daughter and as a result causes physical or relational chaos everywhere he goes.

Watching this show is a journey to the dark side. The pyscho-social dysfunction of the characters matches the organisational and financial mess of the sandwich bar itself. Everything goes wrong: crumbling walls, failed safety inspections and the self-sabotage of the staff team. It’s great viewing at the end of a difficult day: any minor chaos I am experiencing is relativised by the all-consuming disarray of The Beef.

Despite their flaws, we find ourselves rooting for the characters. Hollywood seems to have borrowed this idea from the Christian faith: never underestimate the underdogs. From its earliest days the church was made up of a seemingly socially impossible group of people: a suspicious collaborator, a trouble-making insurgent, as well as other socially stigmatised men and women. You don’t have to spend long in a local congregation of Christians to encounter the same social paradoxes. The unlikely, often uncomfortable gathering of believers from different walks of life is both the beauty and the bane of the church. People are both sharp and sweet, weird, awkward and challenging and yet somehow there’s not only something irresistibly moreish about their company, but the persistent belief that these are the ones who will ultimately be vindicated, honoured and rewarded.

The hope of hospitality

“I think this place could be so different from all the other places we’ve been at.”

Sydney

The continuous omnishambles of The Beef feels like a mirror of our own political moment. Swapping the leader at the top does not resolve the systemic problems. There is no overnight transformation. In fact, things must get worse before anything changes for the better. Personal existential demons need to be faced before the restaurant can begin to be turned around, and, even then, they still need an end-of-season miracle.
So much of our public life, whether it is in the politics of the church or the politics of our nation, looks like the early chaos of The Beef. A fancy new menu, a charismatic new leader, a new shiny piece of technology or even a quick-fix new work regime cannot take away the anger and the misery and the brokenness. What does seem to pay dividends in the show is the gradual inculcation of a culture of dignity, respect and commitment to one another.

Every employee at The Beef begins to refer to one other as “Chef.” This recognition of the value of the other, the regular voicing of the importance and equality of your fellow employees is part of a gradual culture change in the restaurant. The change in language is not a magic bullet for the transformation but rather a small, but important, expression of new culture of dignity that is being established. This same kind of culture change is urgently needed in our church and nation. Finding ways to express respect to one another might not be a bad place to start.

It becomes one of the highest honours for the cooks to prepare the “family meal” where the staff gather for food together after the shift is done. It turns into a moment of communion and reconnection in the chaos of the day. It reminds me of how the Lord’s Supper was always meant to be – a reason to come together and remember and hope.

The power of hospitality

“I’m gonna fix this place.”

Carmy

Season 2 tells the story of creating a Michelin-Star-worthy restaurant in the transformed shell of what had been The Beef sandwich shop. Most of the dysfunctional characters go on a series of journeys of discovery and transformation. One of the chefs goes to Denmark and learns the power of discipline and how to produce micro-cuisine. Another goes on a weeklong haute cuisine boot camp at the highest quality restaurant in the world. Beginning with the simple task of washing forks he is gradually inducted into the culture of excellence and service of the restaurant, where nothing is too much trouble in their aim to give guests an unforgettable experience of hospitality. Richie’s 45-minute make-over is the worst and best episode. The transformation is too complete too quickly, but its message is clear: there is hope for even the most dysfunctional person.

“You have this minute when you’re watching the fire and you’re thinking: If I don’t do anything, this place will burn down and all my anxiety will go away with it. And then you put the fire out. Then you put the fire out.”

Carmy

As I binge-watched this series, I found myself thinking long and hard about the church. I have tasted the toxicity that too often seeps in and spreads pain, causes harm and thwarts whatever good they are trying to do. I have also tasted the opposite, when the church has extended welcome to the homeless, refugees or children in care, and people encounter hope and transformation. When I feel like giving up on the church, I remember how delicious that really is and am re-motivated to do whatever I can to make it the best place in town.

Article

Assisted dying

Care

Culture

Death & life

13 November 2024

8 min read

The deceptive appeal of assisted dying changes medical practice

In Canada the moral ethos of medicine has shifted dramatically.

Ewan Goligher

Ewan is a physician practising in Toronto, Canada.

a doctor consults a tablet against the backdrop of a Canadian flag.

Once again, the UK parliament is set to debate the question of legalizing euthanasia (a traditional term for physician-assisted death). Political conditions appear to be conducive to the legalization of this technological approach to managing death. The case for assisted death appears deceptively simple—it’s about compassion, respect, empowerment, freedom from suffering. Who can oppose such positive goals? Yet, writing from Canada, I can only warn of the ways in which the embrace of physician-assisted death will fundamentally change the practice of medicine. Reflecting on the last 10 years of our experience, two themes stick out to me—pressure, and self-deception.

I still remember quite distinctly the day that it dawned on me that the moral ethos of medicine in Canada was shifting dramatically. Traditionally, respect for the sacredness of the patient’s life and a corresponding absolute prohibition on deliberately causing the death of a patient were widely seen as essential hallmarks of a virtuous physician. Suddenly, in a 180 degree ethical turn, a willingness to intentionally cause the death of a patient was now seen as the hallmark of patient-centered doctor. A willingness to cause the patient’s death was a sign of compassion and even purported self-sacrifice in that one would put the patient’s desires and values ahead of their own. Those of us who continued to insist on the wrongness of deliberately causing death would now be seen as moral outliers, barriers to the well-being and dignity of our patients. We were tolerated to some extent, and mainly out of a sense of collegiality. But we were also a source of slight embarrassment. Nobody really wanted to debate the question with us; the question was settled without debate.

Yet there was no denying the way that pressure was brought to bear, in ways subtle and overt, to participate in the new assisted death regime. We humans are unavoidably moral creatures, and when we come to believe that something is good, we see ourselves and others as having an obligation to support it. We have a hard time accepting those who refuse to join us. Such was the case with assisted death. With the loudest and most strident voices in the Canadian medical profession embracing assisted death as a high and unquestioned moral good, refusal to participate in assisted death could not be fully tolerated.

We deceive ourselves if we think that doctors have fully accepted that euthanasia is ethical when only very few are actually willing to administer it.

Regulators in Ontario and Nova Scotia (two Canadian provinces) stipulated that physicians who were unwilling to perform the death procedure must make an effective referral to a willing “provider”. Although the Supreme Court decision made it clear in their decision to strike down the criminal prohibition against physician-assisted death that no particular physician was under any obligation to provide the procedure, the regulators chose to enforce participation by way of this effective referral requirement. After all, this was the only way to normalize this new practice. Doctors don't ordinarily refuse to refer their patients for medically necessary procedures; if assisted death was understood to be a medically necessary good, then an unwillingness to make such referral could not be tolerated.

And this form of pressure brings us to the pattern of deception. First, it is deceptive to suggest that an effective referral to a willing provider confers no moral culpability on the referring physician for the death of the patient. Those of us who objected to referring the patient were told that like Pilate, we could wash our hands of the patient’s death by passing them along to someone else who had the courage to do the deed. Yet the same regulators clearly prohibited referral for female genital mutilation. They therefore seemed to understand the moral responsibility attached to an effective referral. Such glaring inconsistencies about the moral significance of a referral suggests that when they claimed that a referral avoided culpability for death by euthanasia, they were deceiving themselves and us.

The very need for a referral system signifies another self-deception. Doctors normally make referrals only when an assessment or procedure lies outside their technical expertise. In the case of assisted death, every physician has the requisite technical expertise to cause death. There is nothing at all complicated or difficult or specialized about assessing euthanasia eligibility criteria or the sequential administration of toxic doses of midazolam, propofol, rocuronium, and lidocaine. The fact that the vast majority of physicians are unwilling to perform this procedure entails that moral objection to participation in assisted death remains widespread in the medical profession. The referral mechanism is for physicians who are “uncomfortable” in performing the procedure; they can send the patient to someone else more comfortable. But to be comfortable in this case is to be “morally comfortable”, not “technically comfortable”. We deceive ourselves if we think that doctors have fully accepted that euthanasia is ethical when only very few are actually willing to administer it.

We deceived ourselves into thinking that assisted death is a medical therapy for a medical problem, when in fact it is an existential therapy for a spiritual problem.

There is also self-deception with respect to the cause of death. In Canada, when a patient dies by doctor-assisted death, the person completing the death certificate is required to record the cause of death as the reason that the patient requested euthanasia, not the act of euthanasia per se. This must lead to all sorts of moments of absurdity for physicians completing death certificates—do patients really die from advanced osteoarthritis? (one of the many reasons patients have sought and obtained euthanasia). I suspect that this practice is intended to shield those who perform euthanasia from any long-term legal liability should the law be reversed. But if medicine, medical progress, and medical safety are predicated on an honest acknowledgment about causes of death, then this form of self-deception should not be countenanced. We need to be honest with ourselves about why our patients die.

There has also been self-deception about whether physician-assisted death is a form of suicide. Some proponents of assisted death contend that assisted death is not an act of deliberate self-killing, but rather merely a choice over the manner and timing of one's death. It's not clear why one would try to distort language this way and deny that “physician-assisted suicide” is suicide, except perhaps to assuage conscience and minimize stigma. Perhaps we all know that suicide is never really a form of self-respect. To sustain our moral and social affirmation of physician-assisted death, we have to deny what this practice actually represents.

There has been self-deception about the possibility of putting limits around the practice of assisted death. Early on, advocates insisted that euthanasia would be available only to those for whom death was reasonably foreseeable (to use the Canadian legal parlance). But once death comes to be viewed as a therapeutic option, the therapeutic possibilities become nearly limitless. Death was soon viewed as a therapy for severe disability or for health-related consequences of poverty and loneliness (though often poverty and loneliness are the consequence of the health issues). Soon we were talking about death as a therapy for mental illness. If beauty is in the eye of the beholder, then so is grievous and irremediable suffering. Death inevitably becomes therapeutic option for any form of suffering. Efforts to limit the practice to certain populations (e.g. those with disabilities) are inevitably seen as paternalistic and discriminatory.

There has been self-deception about the reasons justifying legalization of assisted death. Before legalization, advocates decry the uncontrolled physical suffering associated with the dying process and claim that prohibiting assisted death dehumanizes patients and leaves them in agony. Once legalized, it rapidly becomes clear that this therapy is not for physical suffering but rather for existential suffering: the loss of autonomy, the sense of being a burden, the despair of seeing any point in going on with life. The desire for death reflects a crisis of meaning. We deceived ourselves into thinking that assisted death is a medical therapy for a medical problem, when in fact it is an existential therapy for a spiritual problem.

We have also deceived ourselves by claiming to know whether some patients are better off dead, when in fact we have no idea what it's like to be dead. The utilitarian calculus underpinning the logic of assisted death relies on the presumption that we know what it is like before we die in comparison to what it is like after we die. In general, the unstated assumption is that there is nothing after death. This is perhaps why the practice is generally promoted by atheists and opposed by theists. But in my experience, it is very rare for people to address this question explicitly. They prefer to let the question of existence beyond death lie dormant, untouched. To think that physicians qua physicians have any expertise on or authority on the question of what it’s like to be dead, or that such medicine can at all comport with a scientific evidence-based approach to medical decision-making, is a profound self-deception.

Finally, we deceive ourselves when we pretend that ending people’s lives at their voluntary request is all about respecting personal autonomy. People seek death when they can see no other way forward with life—they are subject to the constraints of their circumstances, finances, support networks, and even internal spiritual resources. We are not nearly so autonomous as we wish to think. And in the end, the patient does not choose whether to die; the doctor chooses whether the patient should die. The patient requests, the doctor decides. Recent new stories have made clear the challenges for practitioners of euthanasia to pick and choose who should die among their patients. In Canada, you can have death, but only if your doctor agrees that your life is not worth living. However much these doctors might purport to act from compassion, one cannot help see a connection to Nazi physicians labelling the unwanted as “Lebensunwortes leben”—life unworthy of life. In adopting assisted death, we cannot avoid dehumanizing ourselves. Death with dignity is a deception.

These many acts of self-deception in relation to physician-assisted death should not surprise us, for the practice is intrinsically self-deceptive. It claims to be motivated by the value of the patient; it claims to promote the dignity of the patient; it claims to respect the autonomy of the patient. In fact, it directly contravenes all three of those goods.

It degrades the value of the patient by accepting that it doesn't matter whether or not the patient exists.

It denies the dignity of the patient by treating the patient as a mere means to an end—the sufferer is ended in order to end the suffering.

It destroys the autonomy of the patient because it takes away autonomy. The patient might autonomously express a desire for death, but the act of rendering someone dead does not enhance their autonomy; it obliterates it.

Yet the need for self-deception represents the fatal weakness of this practice. In time, truth will win over falsehood, light over darkness, wisdom over folly. So let us ever cling to the truth, and faithfully continue to speak the truth in love to the dying and the living. Truth overcomes pressure. The truth will set us free.