The Paradoxical Comfort of a Painful Belief

Countenancing beliefs unlike mine is one thing; that is what legit chaplains do. But listening without protest to beliefs that cause suffering, physical or otherwise, to the believer is another. I remember Sarah, who would not take pain medications because she believed God meant for her to feel pain as a way to atone for her sins. And I think about Manny, who thought the cause of his cancer was divine punishment. They were not the exception; plenty of my patients attributed their disease and their impending death to moral failures—they did not attend church often enough, they were not religious enough, they were not good enough.

You, who may be free of such torturous thoughts and rejoicing in good health, may be dismayed if not appalled that I do not put up a fight when I hear such sentiments. Doesn’t passively listening have its limits? Isn’t it cruel to let someone think cancer is a punishment? Naturally my heart yearns to shout at those patients, “NO! You don’t have to torment yourself this way!” Problem is, it wouldn’t work. I am sitting pretty, far far from the shadows of death, while they are coping with it hurrying towards them. Not only that, having a reason, even an absurd one, comforts most people. There is nothing more terrifying to them than staring in the Void of having absolutely no reason at all.

Someone wrote to me recently who does think of disease as punishment. Because he is not on hospice and had indicated that he is open to debate, I said something along the lines of, “Suppose a baby has a terminal disease. What is it being punished for? Even if the parent were being punished, then you still would have the blameless baby also being punished.”

Now suppose he is won over and says, slapping his forehead with the folly of it all: “Oh, of course, silly me! How could I think such a thing?” He very correctly could go on to say, “But what good answer to unavoidable suffering could I replace this with?” That is, he does not want to conclude that there is no reason for his suffering beyond the literal physical consequence of a body going out of whack. No matter how vociferous his objection, I still must maintain that there is no moral reason for the suffering per se. My own view, based on my own previous experience with unavoidable pain, is that despite its purely physical cause it can in fact serve a spiritual purpose. Mainly, pain has reminded me of the delicate balance of all things in my body. It has also made me ponder how forcefully the body can act to fight off anything that threatens that balance, and it has made me puzzle over the mystery of my finiteness.

This post is of course a very terse answer to a question with miles and miles (kilometers and kilometers) of “what ifs” and “buts”. Let us continue the discussion through commenting below. I furthermore invite you to look at my related article:

6 thoughts on “The Paradoxical Comfort of a Painful Belief

  1. Consuelo M Beck-Sague, MD says:

    “Rabbi, who sinned, this man or his parents, that he was born blind?”
    Even the enigmatic rabbi from Galilee could not resist speculating… after gracefully dismissing such a grisly explanation (“Neither this man nor his parents sinned,” said Jesus, “but this happened so that the works of God might be displayed in him.”) The terrifying truth is that either with mythology, religion, epidemiology or public health, really, WHATEVER mythology… it’s always guilty… with an explanation. He smoked, he was a heroin addict, she was promiscuous… It’s so scary to walk away from those half (quarter? tenth?-truths), so scary. But just try it, face the iron law of pediatric HIV medicine or oncology: IF God is the one that metes out disease, THEN… God TRULY hates babies, and has devised a million tortures for those who never even got a chance to sin… ELSE… God does not mete out illness. It is part of my religion to believe in miracles. But I’m not going to worship a God that would allow this s@$%. I will resist the temptation of my 61 years to believe this: Lead us not into temptation! And DO talk the patient into taking the pain meds. Turns out pain control really revs up the cell-mediated immune system and improves sleep. Trust me.


    • To do your comment justice would take at least 5 more posts, if not a book or two. So I will comment on what is most pertinent to the chaplain’s role. You said to talk the patient into taking the pain meds. Of course I understand that the pain meds would do many wonderful things, as you described, and let’s assume in this case there are no big negative side-effects. The nurse’s and doctor’s job is to do everything short of force to convince the patient to take them. My job is to help the patient articulate her own inner logic as to why she does not want to take them. I help make this possible by providing a rare thing: interaction as free of my agendas as I am able. If I were to urge her with various arguments to take the pills, not only would I be saying I am not listening to her, I would just be providing a wall for her to push against even more strongly. If I listen without any motive but to understand, she might even pay attention more to herself; to how she sounds to herself saying her beliefs out loud. The feeling of being heard and understood itself can pave the way for change. At a minimum, such a feeling reduces emotional, spiritual and possibly even physical pain in of itself.


  2. Consuelo M Beck-Sague, MD says:

    I love this blog. The more I read and reread what you write, the more I ponder the experience of making sense of illness, why this kid and not another… I realize how much of a struggle it is to keep on trying to struggle against the comfort of these oppressive notions. I think about your words for days. OK; thanks!


  3. Such encomiums can’t be beat! [The etymology of “encomium” by the way refers to praise upon a Greek hero’s return!] So, how do you and other health care professionals reading this deal with “why this kid and not another?”


  4. This is a tough one, Chaplain K. I’m sure that you are often asked what *your* view is. Many times, when someone says these things, they are looking for a response or some comfort, maybe even another point of view that may give them a bit more peace. When I hear someone state some sad belief about punishment or whatever, I will raise an eyebrow, frown or sigh. If it seems appropriate, I may even say aloud, “Well, I don’t think so.” Why not say it? If we cannot be honest with a person at the edge of death, when? We KNOW the origin of suffering and death, don’t we? A person may believe God is causing the suffering for some (cruel) purpose, but I don’t think a Chaplain has to support that in any way. This is delicate, and I know you walk into sensitive areas, but as your story states, people “believe” or “think” these things are true. The truth of the evidence, however, is a suffering person physically lying before you at the door of death. Facing ultimate concerns with honesty seems the healthiest path, does it not? (as you know, if a person does not accept a Chaplain’s honest thoughts on these matters, perhaps we are not the appropriate Chaplain for them at this time).


    • Right you are, this is a tough one. Oftentimes, when I could not resist the urge to “comfort them with another point of view,” I got the impression that the patient thought I was not listening to them or taking them seriously. So I still say, the first step is for them to feel understood, and then changes might follow subsequently. If a patient, however, were to ask me point blank what I believed personally, then I would go ahead and tell them.


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