Lessons From Everywhere

Job and his “doctors”: bedside wisdom in the book of Job

BMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7276.1613 (Published 23 December 2000) Cite this as: BMJ 2000;321:1613
  1. Ilan Kutz, director (ikutz@netvision.net.il)
  1. Consultation-Liaison Services, Meir General Hospital and Shalvatah Psychiatric Center, Kfar-Saba, 44281 Israel
  1. Correspondence to: I Kutz, 56 Usishkin Street, Tel-Aviv, 62591 Israel

The book of Job has traditionally has been regarded as a philosophical or theological treatise on the nature of faith of a just man in an unjust world. Read by a modern clinician, the book becomes a treatise on adaptation to illness and loss, on doctor-patient relationships, and on the role of belief systems in the coping process.

Summary points

Viewed by a modern clinician, the book of Job unfolds as possibly the earliest description of patients and their healers struggling to cope with loss and illness

Job's lament contains all the recognised stages and elements of adaptation to calamity

Job's friends take on the role of healers, but, failing to recognise his needs, they blame their “patient” for his misfortunes and end up in a cycle of escalating empathic failure that renders them helpless

The failure experienced by Job's “healers” is not uncommon in modern doctors, who fail to recognise their own fear of helplessness and their own defensiveness

The assumed presence of a deity can provide coherence out of confusion for modern patients, believers and non-believers alike, and help them through the adaptation process, just as it did for Job

The book of Job, like an ancient mirror, reflects both the frail and heroic features of humans, which have changed little through the ages

Job's story

Job is a thriving livestock rancher, married, and the father of 10 children. Renowned for his piety, he is even praised by God in the angelic council. Satan, a sceptical archangel, offers an experiment to test whether Job's piety is really sincere or predicated on his God-given wealth. With God's permission, Satan sends a series of catastrophes, from economic disaster to the death of Job's children.

“The Lord gave, and the Lord hath taken away: blessed be the name of the Lord,” responds Job, adding, “Naked …

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