As creative pieces go, the assignment probably didn’t classify as “high art” but it was quite striking and beautiful. The triptych (a three-paneled altar piece) was simple in construction and style, but the images were arresting and unexpected. On the furthest left panel was a woman in scrubs. In the middle was a loving Madonna, Mary the mother of Jesus, holding a baby. As I recall, the furthest panel was a hospital bed, with a female figure lying in it. If one looked closely, one could see that the figures were made up of tiny pieces of paper with words on them that had been torn, applied to the panels, and then painted. In front of the panel, the student placed a single votive candle.
As the final project for a medical ethics course, I invite students to respond to the material we have covered either in an academic paper or in a creative art project. This particular student was a nurse in a Neonatal Intensive Care Unit. While often a joyful job, she told the class about how she had to approach the mothers whose babies had just died with clipboard in hand, filling out personal information, line by agonizing line. She recalled how she loathed this cold task, how she couldn’t respond to their shock and sorrow. It was those forms, torn into small bits, that supplied the material of the triptych. “I never had the time to mourn for those mothers’ losses, never had the time or space to feel their sadness. I had to get on with my job.”.
In her vulnerability and willingness, she taught me much about the unique burden health care professionals bear as they tend to the needs of patients and bear witness to their pain. She also underscored the need for all Christians to engage in the ancient practice of lament before God.
Health care providers must enact Christian hope as they work and care for others. They must also lament the brokenness and pain they regularly experience. If they do not hold both of these elements together, they fail to fully image the One who invites them into his ministry of shalom. To understand how these elements come together in health care, we’ll first turn to Jesus. He modeled a hope that entails both compassionate action toward a broken world and vulnerable mourning of sin’s lingering effects. We’ll then consider how biblical lament violates the supposed need for health care workers to be “professionally detached” from their patients. Lastly, we’ll propose that biblical lament sustains Christian health care workers in faith, hope, and love.
Lament is a much-neglected Christian practice. Ellen Davis points out that while the majority of the psalms could be characterized as laments, our worship services seldom utilize them, preferring the upbeat language of praise and thanksgiving. Ancient Israel, however, “believed that the kind of prayer in which we most need fluency is the loud groan” (Davis 2001: 15; see for e.g., Psalm 6).
When I was a child, we were sometimes asked to quote the shortest sentence in the Bible: “Jesus wept.”. This line appears in John 11, amidst the fantastic story of the raising of Lazarus from the dead. In a quick reading of the passage, one might focus on the triumphant language of Jesus: “I am the resurrection and the life. Those who believe in me, even though they die, will live, and everyone who lives and believes in me will never die” (Jn 11: 25-26). This wondrous claim becomes reality when Jesus stands before the tomb – from which the stench of decay already seeps – and dramatically commands, “Come out!” Yet there it is, sandwiched between assurances of miracle and the unstoppable power of God: “Jesus wept.”
Why? Why would the Christ, the Lord of life and death who is utterly confident of God’s victory, become “greatly disturbed in spirit and moved” and break down, crying, even as he is about to perform one of his most spectacular miracles? Verse 33 notes that he sees Mary weeping as well those Jews who were with her. He responds by “groaning in his spirit” (v. 33 KJV).
Some assert that Jesus is grieved at the disbelief of the people. Such a myopic interpretation does not account for his attention to his close friend Mary’s distress, nor that some – such as Martha – clearly believe that Jesus is the Messiah who has come into the world (v. 27). In the shedding of tears, we have Jesus responding as the Fully Human One, as the One who perfectly enacts faithfulness to God. In this situation, such faith means shamelessly acknowledging the reality of losing someone to death. He admits by his weeping that he loves this world into which he has come, and love for another necessarily links us together in their pain. Jesus responds unflinchingly to this aspect of human life: he sheds tears of embodied grief.
Christ’s response to Lazarus’ death reveals how we, too, must respond. We must proclaim God’s triumph over disease and death; yet also openly acknowledge that before the kingdom comes fully, there is suffering and agony. If hope is to be thoroughly Christian, both the readiness to act for others’ healing and the willingness to lament sin’s real effects must be present.
Jesus’ actions in John 11 hold together the tension inherent in Christian hope. Although we might expect him to proclaim in word and deed only the triumph of God over disease and death, we are surprised that he offers himself to grief. In his ministry, Jesus spends himself, using time to speak and act in God’s power, sure of his conquest of death by the force of God’s love. But Christ also wastes his tears, displaying the weight of sorrow not only over a fallen world but over the very particular sadness of a close friend’s passing.
Undertaker and poet Thomas Lynch said, “Grief is the tax we pay on our attachments.” Yet this seems to fly in the face of the oft-repeated mantra: “Medical professionals need to maintain a professional distance from their patients.” How does such detachment square with my insistence that lament must be an aspect of Christian care?
Attachments seem to get in the way. Who wants an ER nurse so distraught over the mangling of a child in a car accident that he can no longer perform life-saving techniques? Or a missionary doctor immobilized by the meagerness of her aid compared with the massive needs of a disease-ridden community? We have all heard the assertion that health care workers must maintain professional detachment; it seems self-evident.
I assert that this is a false portrayal of what we want from health care workers; we actually need them to be attached to us. Detachment might well prevent them from making the connection to patients that fosters healing--and it places the providers themselves at greater risk for exhaustive burnout.
The commitment to caring focuses the provider, so that they can attend to a patient rightly, mercifully. Consider again Jesus the Great Physician, who like any good doctor regularly had to bracket his physical repulsion to decay, disease, and death. Caregivers work for healing despite how bad it all looks, smells, and feels. Love means digging in and treating the patient – sometimes even when the physical signals tell us it is a long-shot. Just as Christ’s response at the tomb of Lazarus was far from “disinterested,” so too the Christian health care provider sets aside their sensory responses to act in mercy toward the patient.
If we joke that some healthcare workers have a “God complex” – aloofness combined with a blithe confidence in their powers – then the god being imitated is not that of John’s Gospel. We need doctors and caregivers who do what Jesus does in John: Those who will confidently act, trusting God’s healing power made present through them, but also lament that suffering remains.
This world is filled with complex and devastating illnesses such as cancer or AIDS in which we make great strides but then also seem to suffer setbacks. We continue to battle obesity, cholera, or malaria; we watch as pollution, corrupt governments, and greed suck medical resources or mangle health care delivery for those desperate for aid. In response, some become embittered; others hide from such unpleasantness or finally despair.
As Christians, we need not shy away from such realities, for we know that this world is still being rescued. We know the end of the story, that heaven will one day fully invade the earth (e.g., “thy kingdom come on earth as it is in heaven”). But that kingdom is here-but-not-yet.
When we mourn, we do so as a sign and witness that this world is not the way our Lord intends. When our responses to disease and death are positive platitudes such as “It’s all good” or its Christianized equivalents “It’s all for the best,” or “She’s in a better place now,” we reveal an unwillingness to be vulnerable to others’ pain. As evangelicals (and unlike the psalmists), we sometimes seek to excuse God for the trauma of human life. We might think, “He’s gonna make it all ok, so I better let people know I am not losing my faith by seeming unmoved by disease and death.”.
Jesus does not seem to need an excuse to weep about losing a friend. He feels more than, “Hey, great, another opportunity for the kingdom.” He also feels, “Dear God, this world is one of tremendous sorrow, too great to bear at times.”
In a culture drowning in ads for things that will make us feel better (by rendering us more sexually appealing, smarter, healthier, hipper, etc.), there are people who wonder, “Are we all on the same planet? I am sad: about my illness, my divorce, my unfulfilled dreams, my family’s ugly past, the millions of AIDs orphans in Africa. Is there something other than the victory of decay and violence?” Health care workers can ill afford a superficial faith that denies or avoids such suffering.
Again, we see this in Christ, particularly in the Gospel of John. We know by looking at Jesus what it means to be a person of mercy and truth. He models for us a willingness to be vulnerable to others’ suffering. In the Lazarus story, we witness something we do not expect from the God-Man: grief. In the weeping Christ, we glimpse the surprising God who created the universe, but also takes humanity’s plight on himself.
But this vulnerability is not mere sadness at the human condition. Jesus offers himself to grief knowing that such hope relies on God’s power to redeem misery, to raise the dead; don’t forget those exultant phrases in John 11 about life! So when we participate in others’ sufferings through lament, we also proclaim the resurrection in small ways-- with one foot in eternity with Christ and in his victory over death.
The regular practice of mourning works against burnout. If others’ sadnesses have no place to go – if they are not rightly placed in God’s hands as the psalmist models – then we risk two equally dangerous outcomes. We might shut out others’ pain, becoming bitter, failing to see our patients as persons, and resenting their agony or discomfort. Alternatively, we might become overwhelmed by such sorrows. We may well crack under such false sense of importance, failing to tend to our own health or to other relationships that sustain us. We may become depressed or manic, tempted to use pleasures or people as a means of hiding or disguising our pain.
When I speak about the need for health care workers to lament, there is the obvious focus of patients’ illness and pain. Beyond that, we also mourn for our own human limitations, failures, or mistakes. We further regret the fractures of systems and institutions that do not serve patients effectively. With too many patients and too little time and resources, there’s no shortage of areas in health care that contain shadows.
I encourage health care workers – from doctors to nurses to administrators and chaplains – to integrate practices of lament into personal as well as communal practices. The psalms offer pre-phrased prayers as well as models for how to lament (and rage) before God. Sometimes we pray them on our own behalf and sometimes for others.
Such mourning can also be done communally when possible in churches, small groups, or even work places. One of my students served as a nurse in an overseas women’s hospital. Because the death of their children was relatively common, mothers placed amulets around their necks to ward off evil. Those who lost children often resisted shedding tears; their culture encouraged them to ignore their feelings and move on. As Christians who instinctively understood the dual nature of hope, the staff gently encouraged the women to grieve for their babies and offered to say prayers or simply sit with them while they cried or held their child.
It is through embodied practice of these two aspects of hope – compassionate action and active lament – that all of us proclaim the gospel, but health care workers do this in a unique way and with a sustained attentiveness few other jobs require. In this, they imitate the One who was full of mercy and truth, the Great Physician who entrusts to us his ministry of healing and hope, until His kingdom of shalom comes fully, and every tear is finally wiped away by his hand (Rev 7:17 and 21:4).
Brueggemann, Walter. “The costly loss of lament,” Journal for the Study of the Old Testament, no. 36 Oct 1986, p 57-71.
Davis, Ellen. Getting Involved with God: Rediscovering the Old Testament, Cowley (2001).
Hauerwas, Stanley. “Salvation and Health: Why Medicine Needs the Church,” reprinted in Lysaught et al, On Moral Medicine: Theological Perspectives in Medical Ethics (3rd edition), Eerdmans, (2012), pp. 43-51
Mohrmann, Margaret. Medicine as Ministry: Reflections on Suffering, Ethics, and Hope. Pilgrim Press, 1995.
Swinton, John. Raging with Compassion: Pastoral Responses to the Problem of Evil. Eerdmans, 2007.
Erin Dufault-Hunter is an Assistant Professor of Christian Ethics at Fuller Theological Seminary’s School of Theology. Before joining the Fuller faculty in 2006, she received several awards for excellence in teaching at the University of Southern California, where she earned her Ph.D. She is a longtime member of Pasadena Mennonite Church, where she regularly participates in the music team and occasionally preaches.