There is no doubt that the sacrament of extreme unction, taking James 5:14 as its foundation charter, served to foster patience in the face of the trials and temptations of the death bed. The tidy bed in the fourteenth-century Florentine depiction of the sacrament speaks of the success of the rite in serving to help the dying overcome the disorder to our moral lives which suffering and death threaten.

And yet aspects of this scene point us towards problems with the practice of this rite and the moral economy of which it was a part. In the first place, the bed is not only neat, but rather magnificent. It is the finely appointed bed of a rich man, and by the later Middle Ages it was only the well-to-do who were likely to be able to command the services of the rite’s clerical practitioners. But in the second place, even for those who could afford the services of clerics, the professionalizing of the death bed bought what comfort it did by displacing the laity from the bedside.

In the late twentieth century it became commonplace to complain of the medicalization of death, but the three professionals hovering round this bed have clericalized death and displaced the dying man’s nearest and dearest as effectively as any modern-day hospital.

Although legend had it that Lucy received the last rites, in Caravaggio’s rendition of her martyrdom she has received them as part of a public death, not in a private ritual. Of course a martyr’s death is ideally a public one. A martyr is a witness—and, in order to be such, martyrs must themselves be witnessed, perhaps especially, as here, by those who have contrived their deaths.

But present at Lucy’s death are also the beleaguered Christian community. They stand with her under the vast and featureless vault, just as the Christians addressed by James exist under heavens which give or withhold their precious and sustaining rain in their own unfathomable time. But James does not imagine the community to which he speaks as mere bystanders, biding their time until things come right. They are to be patient to be sure, but their patience is an active not a passive project, and it is a joint not an individual one. They must ‘establish their hearts’ as a community (v.8), and doing so requires that they sustain and support one another through whatever trials they individually or collectively face. Caravaggio’s Christians form a compact phalanx, suggestive of their solidarity with each other as well as with Lucy as they abide under the trial of persecution and the laconic heavens.

AIDS threatened its victims with another sort of privacy in suffering and death—not the privacy of those wealthy enough to afford the care of professionals, but a privacy of neglect, created by fear and stigma. Gideon Mendel’s preferred medium may be the black and white photograph, but in the context of a project documenting what it means to live with AIDS, the sharp contrast of black and white suggests not only the battle between light and darkness which suffering can represent, but also the harsh moral judgements which afflicted the disease’s victims. Only an individual or community which had ‘established its heart’ (v.8) against fault-finding, fear, and intolerance, could overcome such sequestration of the sick—like the community James seeks to summon into being with his exhortation.

James is not legislating to establish a particular ritual, but is envisaging a rich social practice. The community which heeds his instructions will sustain itself and its members in difficult times by offering forgiveness, praying for healing, and hoping for the gentle rain of God’s compassion and mercy. Violet Mwinuka has raised up the dying man whom she tends, perhaps so that he may see the light which shines through the open door. But she also holds him up to us, the viewer, as the angels held up the dead and wounded Christ in the popular medieval image—not only supporting him in death until he receives new life, but asking whether we will regard his suffering and become with her a member of the community patiently and actively looking for the coming of the Lord.