Chapter III -- 50
Let us now turn to a related question, that of the status of the human soul when the body is damaged. St Gregory of Nyssa speaks to this matter systematically in On the Making of Man; it is an important part of his anthropology.
In Chapter 10, St Gregory asserts that the mind (nous) operates by means of the senses. We ourselves will have to expand this concept somewhat, in order to be able to fit the notion of contemplation into it. For we must accept that in the first instance the mind (nous) works by means of the senses, but that in order to attain to contemplation the mind (nous) must surpass the senses. This would not have troubled St Gregory, since he is one of the foremost theoreticians and practitioners of contemplation in the history of Christianity.
In Chapter 11, St Gregory asserts that the mind (nous) is not to be identified with the senses. We have already seen this point in Chapter I of the present work.
In Chapter 12, St Gregory addresses the question of where the mind (nous) is to be located. He rejects its localization in any of the likely places—in the heart, in the head, in the liver. In discussing these possibilities, he reflects on the fact that it is true that various diseases and even alcohol disturb the functioning of the mind. He then goes on to say in a crucial passage:
Having been taught that the intellectual operations [of the mind] are blunted or even completely unable to act in a certain disposition of the body, I do not make this a sufficient proof that the power of the mind (nous) is confined in a certain place, as if it would be shut out from its familiar wide places by the inflammations which occur in the parts of the body. For such an opinion is corporeal, that when the vessel is previously occupied by something which has been placed in it, then something else cannot find a place in it. For the intelligible nature neither dwells in the empty spaces of the bodies nor is it pushed out by the increase of the flesh. But, because the whole body has been created like some musical organ, just as it often occurs with those who know how to play music but are unable to show their skill when the uselessness of the organ does not accept their skill—for that which has been destroyed by time or broken by a downward fall or made useless by some rust and decay remains speechless and inactive, even if it is blown into by one who is thought to excel in the art of flute-playing—thus also the mind (nous), pervading throughout all of the organ [of the body] and touching each of the parts appropriately by means of its intellectual operations, according to its nature, operates its own familiar operation in those parts which are in a condition according to nature, but remains, however, unable to act and inoperative in those parts which are enfeebled in accepting its artful movement. For in a certain way, it is the nature of the mind (nous) to be familiarly disposed towards that which is in a condition according to nature, but to be alienated from that which has departed from this condition according to nature.
What St Gregory is saying here is this: The mind (nous) is not something sensible, and it cannot be assigned a location in the body. As we have already seen in Chapter I of this work, St Gregory and his sister, St Macrina agreed that the mind (nous) was an intelligible substance, not a part of the body or a functioning of a part of the body. It is important to understand this, for what St Gregory is saying is that the mind (nous) is not the nervous system, nor the functioning of the nervous system. It is an intelligible substance, and it does not belong to the realm of sensible things, neither does it obey the laws of sensible things. The relation, says St Gregory, of the mind (nous) to the body is that of the flutist to the flute. This is a Platonic notion. And just as when the flute is damaged, the flutist can make nothing of it, without for all that having lost his ability to play the flute, so when the body is damaged, then the mind (nous) cannot exercise its own native operations in the body, without, for all that, itself being damaged.
This position has enormous implications. For we have seen that the mind (nous) is the image of God in man. The mind (nous)—taken in a very broad sense not as the faculty of ratiocination in a man but as his spiritual nature—is what gives each man his dignity as an image of God. Let the man be decrepit with age, broken-down by bodily frailty and by injury to the brain, debilitated by disease—by cancer, by Alzheimer’s Syndrome, by the terminal stages of AIDS. Still he bears on his brow the image of God. Let Adam have fallen. Still he is the image of God. Still he has a dignity greater than all of creation. And that image of God rests upon the brow of each man.
Here is the problem. For the worldly man, especially living in a desacralized world such as the world today, cannot see the image of God. He sees the suffering; he sees the decrepitude, the weakness, the inability of the mind (nous) to express in the broken-down body the operations that it once had. He sees the monetary cost to the state, the emotional burden to the family, the cost in time and trouble to those who care for the decrepit man. And he says, for what? For the worldly man does not see the image of God in the broken-down man, but he considers the personhood to be the interpersonal relationships that now are silent in the silence of the person afflicted, to be the capacity, now lost, of the person to experience pain and pleasure, the capacity of the person to love and be loved, the capacity of the person to experience pleasure in his activities, to succeed, to go somewhere, to be someone. He does not recognize that we are all sons and daughters of God, that each man exists in relationship to God. ‘For all live in him.’ The man dying lives to God; he is preparing to meet his Maker. The man living lives to God; he too is preparing to meet his Maker, perhaps today, perhaps much later than tomorrow. The fact that each man bears the image of God upon his brow means that his whole being exists in context: yes, certainly, in the context of his personal development as a child; yes, certainly, in the context of his interpersonal relations; yes, certainly, in his capacity for human love and the treasuring of another’s company and love. But at the base of all he exists in context with God. For he is an image of God. That is what makes a man a son of God. And being a son of God, he exists in context to his Father at every moment of his life from conception: let him sin, the Father waits; let him turn to the Father, the Father runs to meet him. Indeed, the man necessarily, because he is the image of God, exists in context with God from his conception to all eternity. ‘For all live in him.’
This is an experience of the divine love in everyday life: we exist always in relation to God. This sense of the sacred aspect of everyday life has today been lost to the West. And so, today, when the person is suffering, when he is no longer able to play, to succeed, to get ahead, the thoughts turn to euthanasia. What is lost is the point that that person always existed in his life in relation to God and to all eternity will exist in relation to God. This dimension has been lost today in the West. The first interpersonal relationship is that between the person and God. That is a relationship which is never lost, however the person, sometimes, might try to break it. It is an interpersonal relationship that exists from conception to all eternity.
But since this dimension has been lost today in the West, when the person is decrepit whether through Alzheimer’s Syndrome or some other nervous disease, or else has been born with Down’s Syndrome or some other congenital disorder, an instrumental relationship is struck up with him and one considers how best to dispose of the problem. This is the fruit of the materialistic and mechanistic paradigm in biology when it is allowed to leave the laboratory and take a precedent position in ethics. From his conception a person always exists in relation to God. And when the person consciously understands that primary dimension of his existence, then his suffering is sacralized. Not in a sentimental way—we know the terrible suffering of a cancer patient—but in this way: a monk we knew personally, having been clearly informed by his doctors of the very poor prognosis of the cancer which had spread to his liver, said to the author of this work: ‘This is a very great blessing of our God. I wouldn’t have it any other way.’ A week later he was buried.
The assertion that the intelligible substance, the mind (nous), the image of God, is not disturbed by the malfunctioning of the body but merely cannot express its native operations has a very great significance for the practice of applying the concept of brain death to the patient who has suffered damage to his higher brain centres with a view to the removal of his organs. For if St Gregory is right, then the electrical trace of the cerebral cortex or other higher brain centres is irrelevant to an assessment as to whether the person is alive or dead. The mind (nous) is not localized in a place; it cannot be captured by sensible measurements. Hence, for us, there is a serious question about the dignity of the dying or damaged person: the utilitarian assessment that there is a greater net gain or consequential good to be had from the removal of the fresh organs so that others might live or live better whereas the patient suffers nothing fails to recognize that while he is still alive by more traditional criteria, the patient’s soul is still in his body, and that the practice of removing the organs is both an insult to the dignity of his person and the hastening of his death.
 Making G p. 35, l. 26–36, 9; = Migne 44, cols. 160D–1B.
 Luke 20, 38.