St. John Climacus ("John of the Ladder") was a monk who, according to the only ancient Life of him, by Daniel of Raithu (which scholars put little trust in), was born in Syria and, at the age of sixteen, came to St. Catherine's Monastery on Mount Sinai. After his mentor, Martyrius, died, he went into isolation in a hermitage for twenty years; when he was about sixty-five, the monks of the monastery persuaded him to be their hegumen (abbot). According to the Life, he became so famous that Pope St. Gregory the Great wrote to him to ask for his prayers, and sent money for the guesthouse at Sinai. Whether the details of his life are accurate, he is better-known for his writings than his deeds. His famous work--and the one from which he acquired his name--is the Ladder of Divine Ascent, written at the request of John, Abbot of Raithu Monastery. This spiritual guide for monks became one of the most popular books in the Eastern Church, so much so that the Fourth Sunday of Lent is dedicated to it. (St. John also has a separate feast day on March 30.) Besides the Ladder, St. John wrote another, smaller, less-known work, To the Pastor, a short guide for abbots. Below are the first four chapters of the work (skipping the very short prologue), which center on the image of the pastor as a doctor, with the analogy being stretched to great detail in Chapter II, with its analogies of various medical implements.
He is properly a pastor who brings the lost rational sheep back to life through guilelessness, through his own eagerness, and through prayer, and who is able to set them straight again. He is a pilot who, having received noetic strength from God and from his own hardships, is able to draw the ship back, not only from the triple wave, but even from the abyss itself. He is a doctor who has acquired an unsickened body and soul, and is not lacking even a single plaster for others. He is truly a teacher who, provided with the noetic tablet of the knowledge of God by a finger, or rather, by the energy of illumination from Him, through himself, and not lacking other books; it is unseemly for teachers to teach from copies and for painters to be marked by changes; you who educate those below, learn from the heights above; and be educated by something other than the sensible form; do not forget the One saying that he is teaching doctrine not from men nor through men (Gal 1:1). For He did not bring forth the things below to ever serve the things of earth; the good pilot saves the ship; and the good shepherd gives life and heals the sickened sheep. However many sheep follow the shepherd, advancing without pausing, so much will he have to give an account of them to the housekeeper. Let the shepherd be stoned by word and the sheep are departing through sluggishness and gluttony; for this is the proof of the good shepherd, whensoever the sheep begin to slumber in soul because of the flame of the furnace, or rather the body, then the shepherd, looking towards heaven, keeps greater watch over them. For, in time, they become accustomed to this heat, many being eaten by wolves; but if those among the sheep who are outside, having beheld the type, turn the head of their soul, in time, from the fire below the earth, then we have the One saying, A crushed and humbled heart God will not spurn (Ps 51:17); the passions of darkness and night overtaking the flock, order the dog to howl immovably towards God, in the nightly watch; nothing distracting your mind, you will think of the destruction of the wild beasts.
Our good Lord also made this a peculiarity of nature, that the sick, seeing the doctor, would rejoice; equally so, if he is lacking nothing; and you, O wondrous one, acquire plaster, dessicants, eye-salves, drinks, sponges, antiemetics, blood-letters, cauterizers, ointments, sleeping pills, knife, bands. But if we turn away from these, how will be display knowledge? In no way at all; for rewards are given, not for words, but for deeds. Plaster is the healing of visible passions, rather, those of the body. A dose is the healing of interior passions, and the emptying of unseen filth. A dessicant is stinging to dishonorable things, and curing to a rotting of opinion. Eye-salve is a cleansing of the eye of the noetic soul, troubled by the turbid temper. A drink[1] is an astringent rebuke, and is curing, after a little while. A blood-letter is a brief removal of unseen illnesses;[2] a blood-letter is, properly, an intensive and abrupt assault for the salvation of the sick. A sponge is, after blood-letting or surgery, a service or refreshment for the sick one, through the doctor’s soft and gentle words and tender touches. A cauterizer is a boundary and price for repentance, giving for a time out of love for mankind; an ointment is an exhortation laid upon the sick one after the cauterizer, either through a word, or through a small consolation. A sleeping pill is for receiving the burden of obedience, and for bestowing on him, through the command, rest and sleepless sleep and holy blindness, to not see his own beauties. Bands are for making firm and for tightening those drawn to death and puffed up by vainglory and by obstinacy. And, last of all, the knife is a boundary and condemnation to cut off limbs psychically put to death and rotted, so that they might not spread their own mange to the rest. Blessed antiemetics are the passionlessness of doctors and leaders; for those who are not nauseated in all treatments of illness act without hesitation; and they are able to resurrect every deadened soul. And this has been one of the prayers of the leader himself, to sympathize and have compassion on all, according to their worth; to not, like Jacob, injure his beloved and his companions;[3] for he was wont to suffer this, since he had not yet perfectly acquired the denuded senses of the soul, to distinguish the good, the middling, and the evil.
Great is the shame of the leader asked to give something to his subordinate which he has not yet acquired. As those who have seen the king’s face, and have been given his friendship, are therefore able to let all his ministers, and those ignorant of him or his enemies, whomever they so will, to enjoy his glory, so also should you think about the holy things: friends reverence and obey the most intimate friends. And they are equally constrained by them; evil is it for noetic friends to acquire friends; for no one thus unites us to virtue. One of the friends of God has described to me how always, but especially on the yearly feasts and those of the Lord, God exchanges gifts with those serving Him.
Perfectly ought the doctor to strip off these passions, so that, at the proper time, he might be able to explain some, then others, and especially wrath. For unless he thrust them away to the utmost, he will not be able to plunge into them passionlessly. I saw a horse, still little, serving without training, who, led by a bridle, and bearing it silently, suddenly overthrew his lord, he having relaxed the bridle a little; the present problem generally comes about as result of two demons; those willing to seek for them, let them seek laboriously.[4]
Footnotes: [1]This probably refers to a concoction designed to induce vomiting; the Latin translation renders this term, in the earlier list, as “purgations.”
[2]The word for “illness” here is a strange one, ὀζωδία. I can’t find the word in this form in dictionaries; etymologically, it seems to relate to “branches” or “offshoots,” but here it seems to refer to diseases or illnesses, as the Latin translation also reads it.
[3]The idea is probably that, if Jacob had been a better leader and kept better watch over his sons, then Joseph—his beloved—would not have been sold into slavery, and all the subsequent evils would not have befallen his family, such as Jacob’s other sons (his companions.
[4] The editor of the Greek text gives numerous scholia, where commenters have tried to identify the two vices (“demons”) spoken of at the end; one gives three vices—vainglory, gluttony, and sexual immorality; another gives irascibility and sexual immortality; a third gives gluttony and sexual immorality.
Source: Patrologiae Cursus Completus, Series Graeca Prior, ed. J.-P. Migne, Tomus LXXXVIII (Paris: J.-P. Migne, 1864), 1165B-1173A. [PG 88:1165B-1173A]