Cynics denounce it as a religious theme park. An Oxford don calls it a scene of mass delusion. But Lourdes -- the 19th-century shrine in southern France -- still pulls in the faithful at a steady rate of about 6 million people a year, thousands of them in wheelchairs.
The visitors seem unperturbed by jibes from outsiders.
The Lourdes grotto has withstood disparagement since its inception in 1858 when the Church itself challenged a peasant girl's visions of the Madonna. After a few years, though, the apparitions were declared genuine and the legend has persisted.
I was drawn there recently by simple intellectual curiosity, not by my status as a "fallen-away Catholic." I have always been intrigued at how this phenomenal site never goes away despite the secular age in which we live and the rise of medical science.
Physicist Freeman Dyson, addressing the larger debate between science and religion, pleads for an open mind. He has written that both camps are "one-sided, neither is complete, both leave out essential features of the real world. And both are worthy of respect."
Undoubtedly, at the very least Lourdes benefits today from an increase in attention to the sick and handicapped, ranging from sidewalk ramps to public parking spaces. The entire town has been constructed to make life easier for visitors needing special facilities to move about.
Yet try spending a few days there. The earmarks of a theme park, including long lines to see the grotto and a range of cheap souvenirs for the folks at home, are unmistakable. Oxford Prof. Richard Dawkins featured Lourdes in a recent British television documentary. The best he could find to say is that "delusions" can be comforting when experienced on such a grand scale.
Behind the scenes of adulation, however, cooler heads are wrestling with the fundamentals -- the contradictions between Lourdes' alleged healing powers and the realities of modern medicine. Confirmed extraordinary healings have dropped off steadily as medical science progresses, making certification of "miracle cures" increasingly difficult.
Only four cases of unexplained cures have been accepted by the church as "miraculous" in the past 40 years, compared to one every couple of years in the first hundred years. Many of the older cases were based on such disorders as tuberculosis and osteoporosis that are treatable now. As cures have developed, Lourdes cases are limited to such maladies as terminal cancers and multiple sclerosis.
And so the time has come to adapt, say the forward-thinking medical and religious leaders of the site.
First, they are concerned to apply science, thereby distancing themselves from such healers as fringe cults and television evangelists. Indeed, they downplay talk of miraculous properties of the waters, focusing instead on the palliative effects of the shared spiritual experience.
DR. ALESSANDRO FRANCISCIS, a Harvard-educated M.D. and son of an Italian father and American mother, is the new full-time doctor on the scene. An affable, relaxed protector of the scientific side of the site, he starts by telling me "I am not here to build 'miracles,'" wiggling his fingers in air quotes as he pronounces the M-word. "I am here to determine what happened."
Second, they believe in rigor. To this end, Dr. Franciscis maintains a structured investigative process to weed out attention-seekers, people who may be benefitting from previous medical treatment, and the delusional. In his first year, just completed, he personally interviewed 38 claimants, deciding to follow up just six or seven of them.
The follow-up process relies on scientific enquiry to determine whether a healing is explainable or not. It begins with Dr. Franciscis calling in the person who has had the experience. He or she is seated before an ad hoc panel of doctors -- some believers, some not -- who happen to be visiting Lourdes at the time. Dr. Franciscis presides.
"The questioning and the follow-up can be hard to bear," says Dr. Franciscis. "Some people choose not to subject themselves to it." Medical reports, x-rays and CAT scans from the individual's past are requisitioned, further examinations are required, and periodic tests are scheduled to confirm that the cure was real and lasting. Only if Dr. Franciscis feels something extraordinary has happened does he create a file and pursue the case.
Being a scientist, he withdraws from a case once his investigation is complete. If it passes his tests as a cure unknown in current medical literature, it becomes a religious question. Any prospect of declaring a miracle is the responsibility of the bishop in the patient's home diocese -- and many are reluctant today to take that controversial step.
A scientist by training, Dr. Franciscis strives to understand both sides. He declares religion to be "irrational, by definition" but says science alone cannot explain some of the occurrences at Lourdes either.
In our chat, while fielding several calls on his cell phone, he did his best to reconcile his expertise with claims of Lourdes recoveries. Echoing Freeman Dyson, he said he finds medical science and religion to be "somewhat fundamentalist." Reason, he believes, can be found in between. "They can enlighten each other."
He cites medicine's recent blind spots as the promise of the human genome project to cure disease, and the failure to find a cure for AIDS, "both of which were confidently predicted ten years ago and both of which have failed to deliver."
Freeman Dyson warns of the dangers of a dialogue of the deaf. "Trouble arises when either science or religion claims universal jurisdiction, when either religious or scientific dogma claims to be infallible. Religious creationists and scientific materialists are equally dogmatic and insensitive."
Meanwhile, Dr. Franciscis sees Lourdes staying relevant in today's cynical society. "I see something moving in the change of public attitudes," he said. "Society is putting the needs of the sick at the center of life."
The local bishop, Monsignor Jacques Perrier, feels that visitors gain spiritual comfort regardless of the medical outcome. He wrote in a recent book "Lourdes Today and Tomorrow" that Lourdes doesn't need miracles. In fact, he added, "miracles are now very rare but the number of pilgrims visiting Lourdes keeps on rising."