Sunday, July 08, 2018

Suffering Through Dialysis: A conversation in three scenes (Scene 2)

For my Doctor of Ministry class on "Suffering, Meaning, and Spirituality," I had to write a dialogue about suffering.  I decided to share that paper here because it became a meaningful way to process the past year.  Please take note, many things in the paper are real, but Pastor Bubba is NOT--rather, I chose to use Pastor Bubba as a "composite" of the awful things that we sometimes like to say to people. This is the second of three segments. 


Scene II
Time:  Six months have passed since Scene I.
Setting: Patient Wife is sitting in the dialysis unit’s waiting room while her husband completes a dialysis treatment.
Characters:
Patient Wife                Pastor Bubba               Kathleen Norris
James Cone                 Viktor Frankl              Dorothee Soelle

Patient Wife: Thanks for stopping by to check on Patient. He is doing much better.  Dialysis is miserable, but he is making the best of it.
Pastor Bubba: I am sure that God is using him for great things!  He just needs to keep a smile on his face and a song of praise in his heart!
Patient Wife: My prayers are for his strength to return and for him to endure each treatment.  This is a miserable place with so many hurting folks. Suffering abounds here!
Pastor Bubba: Well, as long as we pray, God works through us.
Patient Wife: Please, just say a prayer for us.
Pastor Bubba says a prayer and leaves.  Seated near Patient Wife are four persons.  They are Victor Frankl, Kathleen Norris, James Cone and Dorothee Soelle.
Kathleen Norris: We noticed that you are alone and thought you might appreciate some company.
Patient Wife: Thank you. Did you overhear my conversation with that Pastor?  He is a friend of my husband who always seems to show up and think he has all the answers. I’m not sure there are any good answers to suffering—especially the suffering in this place.
Kathleen Norris: What exactly do you mean by suffering here?
Patient Wife: Suffering includes physical pain, but it is more than that. Dialysis is a dehumanizing process and the suffering it creates is beyond the bodily affliction. Suffering is even greater when a person thinks he or she is going to be destroyed.[1] 
Viktor Frankl: Yes, in my experience, often the physical is not what is most painful.  Rather, injustice causes us mental anguish.[2]
Dorothee Soelle:  I find this interesting. Suffering happens when a person thinks they will be destroyed, but can’t it also be where one finds strengthening?  Isn’t this exactly what Jesus endured in the garden of Gethsemane?  When a person is conscious of dying and experiencing pain, they can come to new understandings of their faith.[3] When we can truly face this pain and uncertainty, we can move beyond fear about what is to come. When we embrace our suffering, we can be strengthened.[4]
Kathleen Norris: Yes, I think that you are on to something here.  It is in watching the suffering of Jesus in Gethsemane that we can learn how to live in our own suffering. Jesus is a model as he feels abandoned by his friends and by God.  “In that gruesome and interminable night, waiting revealed itself as a true ally, a bulwark against fear. And Jesus became the most radically free and dangerous man of all, the one who embodies hope in the face of death and is afraid of nothing.”[5] Jesus shows us how to face death.
Viktor Frankl: I don’t know about Jesus but I think I understand the psychological principles here. Even when we are fearful, if we have hope for the future or some purpose or reason for living, we can hold on. When a person loses hope for the future, they are doomed.[6]
James Cone: I would agree with you both, Soelle and Frankl. Suffering is a part of life especially for those within oppressed communities. What allows the sufferer to endure the pain is having an encounter with God’s presence.
Patient Wife:  Well, I believe that my husband is encountering God in new ways through his suffering.  His suffering continues, but it has changed. It is almost as if he has heard all of your advice about finding meaning and purpose as well as joining his suffering to Christ’s suffering.
On a communion Sunday, he heard words spoken by the preacher about how the chalice was a vessel of grace which held blood. Upon hearing those words, he realized that the dialysis machine was a vessel of grace which held his blood. Because of that machine, he was alive.  As a result of that encounter with the Holy Spirit, he began to anoint the machine with a bit of frankincense essential oil before each dialysis session.  He also would anoint himself as he sat down in his chair for dialysis. 
As the days went by, his nurses and other staff members began to ask what he was doing.  When he explained that he was blessing and anointing the machine and himself, they began to request a blessing as well.  Then other patients started to ask for a blessing.  Now, when he enters the room for dialysis, he goes to the chair of each patient and asks them if they would like to receive a blessing and be anointed.  Most do.  He anoints their heads and they often share their prayer concerns for that day.  This has been a transformative experience for him.
Viktor Frankl:  This is what I was telling you!  We can change our attitude toward life. We have to stop asking why and begin to think about what life is asking of us. Finding meaning in suffering is about how we can we adjust our attitude to make meaning in our life.
Kathleen Norris: He is making meaning and he has linked his suffering to Christ’s suffering! Because of this, his suffering has become a redemptive gift to him and others!
James Cone: I would agree when we endure suffering, it can become transformed into an event of redemption.[7]
Patient Wife: Yes, what he is doing is also relieving the suffering of the other patients. It may not be changing their physical circumstances, but their mental anguish may be somewhat relieved.  Many of them are likely to stay on dialysis all of their lives.  They are old and often come into the dialysis center on stretchers, unable to even walk.
James Cone:  This sounds like suffering can be endured and transformed into an event of redemption for them almost as a community.  It is within the community which suffers that meaning can be created and the experience can best be understood.  As they suffering together, their shared experience creates meaning.
Patient Wife: It definitely seems that my husband has been creating some meaning out of the suffering that he and the other patients endure together. In so many medical settings, patients are just numbers to those who offer treatment. So often their dignity is not respected.
Viktor Frankl:  And yet, people have the choice of how they will respond to the indignities that they endure. People have a choice in their actions and attitudes. People “can preserve a vestige of spiritual freedom, of independence of mind, even in in such terrible conditions of psychic and physical stress.”[8]
James Cone: Yes, for those who suffer, the question of whether they remain faithful despite the suffering can be the greatest challenge to their spirits.
Viktor Frankl: “When a man finds that it is his destiny to suffer, he will have to accept his suffering as his task; his single and unique task…. His unique opportunity lies in the way in which he bears his burden.”[9]
Dorothee Solle: When we embrace suffering—not just our own but when we willingly join ourselves to the suffering of others—we move from suffering to dying to self and finally to a receptiveness to God.[10] In this way we are attaining the image of Christ. We can only to this when we remain with the oppressed and the disadvantaged.[11]
James Cone: Yes, it is within community of the oppressed that we can best understand suffering. The community creates meaning and interprets the experience.
Viktor Frankl: I do not believe that the community is essential for the individual to find meaning.  Individuals can find meaning in suffering on their own. In fact, the meaning of suffering for each person is different.
Patient Wife: Many of the dialysis patients may have feel that no one sees their pain and suffering.  I can’t tell you how many times in the hospital I have heard patients yelling from their rooms for a nurse.  Rather than use the call button, they vocalize their need.  They yell sometimes because it seems that is the only way that someone will respond.  By visiting each patient and asking if they would like a blessing and/or praying with them, my husband is offering them dignity and being Christ’s representative.
James Cone: Suffering is transcended through giving each person their dignity. It is when the sufferer knows that God sees their suffering that they can bear the suffering itself. But this is about an encounter with God. Knowing that God sees our suffering is important! 
Patient Wife: I hear what you are saying.  By visiting each patient and listening to their needs, my husband is seeing their suffering and perhaps they are experiencing God’s presence.
James Cone: The answer is not in an assent to the belief that God sees, but an actual experience of God seeing the sufferer.
Patient Wife: Is it truly necessary for God to be the one seeing the sufferer?  There are arguments for an “emphatic witness” who offers recognition of our suffering and because of that the sufferer can gain meaning and pain can be lessened.[12]
James Cone:  Perhaps your husband’s presence might bring a sense of God’s presence, but it is the encounter with God that is important.  “An encounter with God is the ultimate answer to the question of faith….”[13] In this, God is with the victim.  God identifies with the victim and suffers with the victim.
Dorothee Soelle: Yes! Because God is either with the victim or God is the executor of injustice! If God is love, then surely God is not the Executioner.  God is with the victim. Suffering can become meaningful when we are standing with those who are oppressed.[14]
Patient Wife:  As we have talked through this, I am not convinced that suffering needs to be seen by another person in order for it to be healed. If the suffering one believes that God sees their suffering and continues to love and care for them, they may find relief from their suffering. 
(Just then, the door opens and Patient comes out from the dialysis unit.)  It is time for me to go. Once again, this has been an enlightening conversation. Even still, there is much that remains to be discussed. I hope that we will meet again.






[1] Eric J. Cassel, “The Nature of Suffering and the Goals of Medicine,” New England Journal of Medicine 306, no. 11 (March 1982), 640.
[2] Frankl, 23-24.
[3] Soelle, 82.
[4] Ibid., 86.
[5] Norris, 222.
[6] Frankl, 74.
[7] James H. Cone, The Spirituals & the Blues: an Interpretation (Mary Knoll, NY: Orbis Books, 1991), 56.
[8] Frankl, 65.
[9] Ibid., 77-78.
[10] Soelle, 97.
[11] Ibid., 132.
[12] Pamela Cooper-White, “Suffering,” in The Wiley-Blackwell Companion to Practical Theology, ed. Bonnie J. Miller-McLemore, (Chichester: Wiley-Blackwell, 2012), 30.
[13] Cone, 56.
[14] Soelle, 126.

Saturday, July 07, 2018

Suffering Through Dialysis: A conversation in three scenes (Scene 1)

For my Doctor of Ministry class on "Suffering, Meaning, and Spirituality," I had to write a dialogue about suffering.  I decided to share that paper here because it became a meaningful way to process the past year.  Please take note, many things in the paper are real, but Pastor Bubba is NOT--rather, I chose to use Pastor Bubba as a "composite" of the awful things that we sometimes like to say to people. I will post this in three segments. 

Scene I
Time:  Current time.
Setting:  At a modern, University Research Hospital, Patient Wife sits in the waiting room outside the Surgical Intensive Care Unit (SICU). She is waiting to visit her husband, Patient, who is in SICU after having the first of two emergency surgeries.  As a result of the surgery, he is now on dialysis. The doctors are waiting for his condition to stabilize so that they can continue surgery. Pastor Bubba, a friend of her husband. is seated with her.
Characters:
Patient Wife                            Doctor                                     Pastor Bubba               Viktor Frankl 
Lady Philosophy                     Kathleen Norris                       Dorothee Soelle

Patient Wife:  Why did this happen to my husband?  He has had so many health problems.  He was born with his kidney issues which required many surgeries.  What did he ever do to deserve such awful health difficulties?  I know that he hasn’t always taken the best care of himself. His diabetes has made everything worse and his heart disease is a result of the diabetes. But this just happened so suddenly. 
Pastor Bubba: I am sure the doctors are doing everything they can.  We just need to trust God. Let’s claim his full recovery!  You and I agree on that, so God will make it happen!
Doctor comes into the waiting room to find Patient Wife in order to give her an update.
Doctor: Your husband is holding his own.  He isn’t in any pain right now.  We have him stabilized.
Patient Wife:  I am glad that he isn’t in pain, but he is suffering! He has tubes coming out from all over and he is surrounded by machines which are keeping him alive. People are poking and prodding him. You aren’t even sure that he can undergo any more surgery.
Doctor:  Well, we are doing all we can for him. (With that comment, the doctor leaves.)
Patient Wife:  Yes, they are doing all they can for his physical needs, but he is suffering. Why did God let this happen?  How can this be God’s plan? This is simply awful! They haven’t really finished the surgery. They had to stop and wait until his potassium went down and now I’ve had to sign the papers for dialysis to help his body cope.  He will be so upset when he wakes up. That is if he wakes up!
Pastor Bubba:  God has a plan. Even if he dies, he is a Christian and will go to heaven. Heaven is great and he will be just fine.
Patient Wife (staring at Pastor Bubba in disbelief): Was that supposed to be comforting? I think that you just need to say a prayer and let me alone.
Pastor Bubba says a short prayer for healing and then leaves. Once Patient Wife is alone, she falls asleep from exhaustion.  When she awakes, she finds that she has been joined by several others in the waiting area. Kathleen Norris, Viktor Frankl, Lady Philosophy and Dorothee Soelle are seated around her.
Patient Wife:  I am sorry. I was dreaming. Was I talking in my sleep?
Frankl: Not really talking. You mumbled something about suffering. I think.
Patient Wife: Well, I was just struggling with the suffering my husband is experiencing, and why this is happening? He has endured so much suffering in his life!
Lady Philosophy:  God has a plan even when someone is suffering. The world is not “merely a string of random events but the result of divine reason.”[1]
Patient Wife: So, you are saying God caused this?  Why would God cause this to happen to him now?
Lady Philosophy:  Yes, surely everything happens as a part of God’s plan.  “If the true causes of something are not understood,…it can appear to be random and confused. But although you cannot understand the way things are ordered in the universe, you can rest assured that a good governor does indeed keep order and has a plan. You should not doubt that everything happens as it should.”[2]
Patient Wife: So, we should just accept the way things are because that is how God has planned it?  How can God be good and allow such suffering to happen?
Dorothee Soelle: I also question this!  Lady Philosophy, I’m not sure you understand what you are saying!  You seem to be saying that God is a Sadist.  How can God be good and inflict suffering on people?
Lady Philosophy: God’s plan offers suffering as correction and self-knowledge. God can use suffering for a good purpose.[3]  “Every kind of fortune, whether pleasing or painful, is granted to men for the purpose of rewarding or testing good men, or else of punishing or correcting those who are bad. Every kind of fortune is good, then, because it is just or useful.”[4]
Dorothee Soelle: Useful or just? I cannot agree with you! If God either directly or indirectly causes suffering, then we truly are in danger of seeing God as sadistic![5]
Patient Wife: I don’t believe in a sadistic God! If I understand you correctly, Professor Soelle, you are saying that if God causes suffering, then God cannot be good and loving.
Dorothee Soelle: I am willing to give up God’s omnipotence to preserve God’s loving nature.
Lady Philosophy: Surely God is good and loving! God is the highest and most perfect good that there is![6]
Patient Wife: But, that takes me back to my first question! Why would a good and loving God allow suffering?
Dorothee Soelle: Surely, Lady Philosophy will tell you again that suffering is part of God’s plan, Providence. I, on the other hand, do not believe that there is a satisfactory answer to your question.  There really is no answer when people ask “Why?”[7]
Viktor Frankl: I must agree with Professor Soelle here.  When suffering occurs, we often feel compelled to ask “Why?”  But, my question to you is whether answering that question will help your husband to improve?
Patient Wife: I hadn’t thought about it like that. No. Probably not.
Viktor Frankl: No, probably not. Because whether we know why or not, we still have to deal with suffering. “Suffering is an ineradicable part of life, even as fate and death. Without suffering and death, human life cannot be complete.”[8] 
Patient Wife: Well, if God doesn’t cause suffering, then what purpose does it serve? This suffering seems meaningless right now.  What is good or useful in his suffering?
Viktor Frankl: When you ask about the meaning in suffering, I think you are on the right track. The best questions to ask include “What can I learn from this?” and “What meaning can I gain from this?”
Lady Philosophy: See, this actually sounds like what I was saying about God sending suffering for corrections—so that we can learn from it!
Viktor Frankl: This is where I actually believe we differ, Lady Philosophy.  I do not believe there is some intrinsic meaning to suffering, but that we can make meaning from suffering.
Patient Wife: Well, what do you suggest can be learned from what is happening to my husband?
Viktor Frankl: That is a harder question, because the answer is different for each person. One way that a person can find meaning in her life is by the attitude she takes toward unavoidable suffering. 
Patient Wife: Well, this suffering was definitely unavoidable.
Viktor Frankl: When we are facing a fate that cannot be changed, meaning in life can still be found. “For what then matters is to bear witness to the uniquely human potential at its best, which is to transform a personal tragedy into a triumph, to turn one’s predicament into a human achievement. When we are no longer able to change a situation,…we are challenged to change ourselves.”[9]
Patient Wife: Change ourselves? At this point, changing anything about this situation seems impossible. Right now, it is merely about surviving another day.
Kathleen Norris: I think I understand where you are because I lost my own husband. Through that experience, I learned much about dealing with suffering. “Disasters will strike, and great blessings will come. Our difficult and glorious task is to live through it all.”[10]
Patient Wife: This sounds like a very nice platitude and I would like to believe that. This disaster has struck and my husband is surviving. Where is the glory and blessing? He still is suffering.
Kathleen Norris: If your husband can see Christ suffering with him, then he can experience a redemption of the suffering.  “Christianity teaches that the trials in our lives can be linked to Christ’s suffering and ‘redemptive gift’ if we intend that they should.”[11] 
Patient Wife: That sounds great but in this moment I am not sure how either he or I can do that!
Kathleen Norris: My husband, David “never called his many afflictions his share of the sufferings of Christ. But ultimately that is what it was for him, and this gave him strength.”[12] 
Patient Wife: Maybe this is something that will come in time. I am not sure how I create meaning in this moment or how he can create any meaning when he is sedated. It is horrific to watch him attached to machines that are keeping him alive.  I have no doubt that he would be dead if those machines were not breathing for him and if they weren’t dialyzing him. Watching him suffer is difficult and unnerving. He is a good and decent person. He is a servant of God and has given his life serving God in the church.  This suffering has isolated him. Where is this God who he has served?
Viktor Frankl: This is not a question that I’m willing to discuss. My concern as a psychiatrist has to do with surviving suffering, not issues of faith and religion.
Kathleen Norris: Where is God? That is a question that I wrestled with as my husband was dying. There were times I couldn’t even pray. I may not have felt God’s presence but I still believed God was present. “I believed in the reality of God’s providence and love, even when I did not sense its presence in my own life.”[13]
Lady Philosophy: Yes! Providence! God is present through the working out of Providence!
Kathleen Norris: Lady Philosophy, I am not sure that I completely agree with you about your idea of providence. However, where I sensed God’s presence was through the gift of Christian community. “If God did not seem to be there for me, it was enough to know that God was active in the lives of others.”[14]
Dorothee Soelle: Yes, community helps us through suffering. For surely, “all extreme suffering evokes the experience of being forsaken by God.”[15] Mystical theology helps us to understand that God is present in the suffering. 
(Just then the doors to SICU are unlocked for visiting hours.)
Patient Wife: I have to see my husband now, but I hope we will talk again. It doesn’t feel like we have finished this conversation.





[1] Boethius, The Consolation of Philosophy, trans. David R. Slavitt (Cambridge, MA: Harvard University Press, 2008), 25.
[2] Boethius, 129.
[3] Ibid., 138-9.
[4] Ibid., 141-2.
[5] Dorothee Soelle, Suffering, trans. Everett R. Kalin (Philadelphia: Fortress Press, 1975), 26.
[6] Boethius, 87-88.
[7] Soelle, 155.
[8] Viktor E. Frankl, Man’s Search for Meaning, (Boston: Beacon Press, 2006), 67.
[9] Frankl, 112.
[10] Kathleen Norris, Acedia & me: A Marriage, Monks, and A Writer’s Life (New York: Riverhead Books, 2008),
 222.
[11] Ibid., 251.
[12] Ibid, 246.
[13] Ibid., 237.
[14] Ibid.
[15] Soelle, 86.

Friday, February 16, 2018

Valentines and Broken Hearts

12 Yet even now, says the Lord,
   return to me with all your heart,
with fasting, with weeping, and with mourning;
13   rend your hearts and not your clothing.
Return to the Lord, your God,
   for he is gracious and merciful,
slow to anger, and abounding in steadfast love,
   and relents from punishing.
14 Who knows whether he will not turn and relent,
   and leave a blessing behind him,
a grain-offering and a drink-offering
   for the Lord, your God? 

Joel 2:12-14



Broken Hearts seemed an appropriate theme for Valentine’s Day. How many of us have been broken hearted on Valentine’s Day?  Lots of people!  I saw a tweet yesterday that read, “I’m giving up Valentines for Lent!”

Perhaps Valentine’s Day presents such problems for us, because the advertising industry has convinced us what the day should include--candy, cards, flowers and jewelry!  With such a romantic ideal, of course broken hearts will result!

In the passage from Joel, God is encouraging the people to “return to me with all your heart…. rend your hearts and not your clothing.” Rending is about our hearts being broken so that God can enter into them.

Several years ago I went on a Walk to Emmaus retreat. Over the first twenty-four hours, I was having a hard time listening and really opening myself to the movement of God. Then, I got a phone call.. You know it has to be an emergency if they let you take a phone call as a pilgrim at Emmaus!  My husband, Ron, was calling to tell me that one of my co-workers had been killed in an auto accident. She was a young woman, with young children and a husband. She was someone whom I had loved.  My heart was broken.

Because of my grief, my heart was broken wide open, and I let God in. God’s love and mercy and grace flooded in because my heart was broken.

Our hearts get broken in a myriad of ways from a bad break up in a relationship to the death of someone we love. When our hearts our broken, sometimes it makes a way for God to come in.  However, the opposite can happen as well.  When our hearts our broken open, we can allow them to fill with anger and resentment. Rending our hearts is about allowing God in instead of allowing our hearts to harden with bitterness.

Whatever the brokenness in our lives, God wants to redeem it. God invites us to rend our hearts and return to the God who loves us.

So, I invite you to a Holy Lent—a time of heart-rending and a time to allow God to break open our hearts that we might know the movement of God’s Spirit in our lives!

How is your heart today?
Is it hardened?
Or Is it being broken open so that God’s Spirit can enter in new ways?
Prayer: Gracious God of broken hearted souls, move in my heart this day that I may feel Your Spirit drawing me ever closer to you. Amen. .