Cancer and Humility: Moving from “Why” to Hope

Abstract

If God cares and is present, can God use pain and suffering in my life? Absolutely. Does this mean that God planned, ordained, or designed the pain (or cancer) to be instrumental in my life for some sort of higher spiritual purpose? If so, why? Why does God allow cancer to invade and interrupt one’s life? There are no theologically sound or definitive answers to these questions. Although asking such questions is basic to our humanity, as we will observe in various passages of Scripture, the answers will always remain elusive. Instead of seeking to answer the question “why?”, I will suggest two areas for theological and pastoral reflection with respect to those facing cancer: humility and hope. Enduring cancer, from diagnosis through treatment, requires humility in mind and body before our Creator and before our caregivers. Cancer also provides an opportunity for Christians to embed themselves in the hope of resurrection and new creation. Resurrection hope is also not reduced to hope beyond death but hope that is manifested now through embodied resurrection “signs” and actions of human sacrificial love, both received and practiced by the patient undergoing illness and by the patient’s caregivers, family, and friends.

1. Introduction

We all know that illness is a part of life. All of us have faced it to some degree and will most likely face it to advanced degrees in the days to come. Sometimes illness cripples us from hope, especially if that illness involves a devastating diagnosis and a less than optimistic prognosis. We all realize that we will die, but the radical interruption of illness abruptly puts us face-to-face with the fragility of life and our mortality. As followers of Christ, we believe in the hope of resurrection, but we also want to keep hope alive for physical healing in the present. We want to experience long life in the here and now, having time with our friends or spouses, our children, and our grandchildren—we desire to reap the benefits of life today.

In view of this, I will offer some pastoral-theological reflections, stemming from a “lived theology.” In September of 2016, I was diagnosed with an aggressive cancer: double-hit, diffuse, large B-cell, non-Hodgkin’s lymphoma. I went through a series of six inpatient, 96 h, five-day chemotherapy treatments, followed by a 22-day hospital stay for an autologous stem cell transplant. At one point following my discharge early in March 2017, I came very close to death’s door. In the following months, I continued to recover and have since been cancer-free in full remission.

When confronted with severe illness, some ask: Why? Why me? Why now? Why is God putting me through this? When such questions are asked, most of us do not wish for these questions to remain questions. Answers are sought. Some attempts provide theological answers that, in my view, are less than satisfying. Such answers may sound something like “God has a plan for you with this illness” as an attempt to redeem the illness. In so many words, it is like saying, “God caused this, so accept that it is for a greater purpose.” John Piper wrote an essay, “Don’t Waste Your Cancer.” His first major point is “you will waste your cancer if you do not believe God designed it for you” (Piper 2006)1. While I applaud Piper’s desire to acknowledge God’s sovereignty during his own struggle with cancer, I struggle to understand cancer as God’s design for life. Cancer works through the body to suffocate life and deprive the body of active, vibrant physicality. Cancer cannot be redressed to be good. God is good and God is always present, but cancer is bad. Illness points to the corruptibility of our bodies that are groaning and longing for new creation, but that does not make illness or cancer itself good.

But when cancer, COVID-19, or whatever other illness invades our life, the illness can work as a pointer toward the hope of healing. And, while anticipating healing (to use a phrase from Wendell Berry, borrowed by Eugene Peterson) we “practice resurrection” (Peterson 2010, p. 8).2 As Peterson applies this expression he says, “The resurrection of Jesus establishes the conditions in which we live and mature in the Christian life and carry on this conversation: Jesus alive and present. A lively sense of Jesus’ resurrection, which took place without any help or comment from us, keeps us from attempting to take charge of our own development and growth. …We live our lives in the practice of what we do not originate and cannot anticipate” (Peterson 2010, p. 8).

Like Peterson, I affirm that everything, good or bad, illness or good health, is not absent from God’s awareness. I am also persuaded that God is always good and present through illness (and any sort of public or private devastation), and I believe that the crucible of the cross and the fragility and corruption of the body will be triumphed by resurrection. But in the meantime, the “why” questions persist.

2. Asking Why

2.1. Asking Why Is Basic to Humanity

So, why do we ask “why?” Perhaps it is simply basic to humanity. We are inquisitive, interpretive beings who desire to know the meaning and purpose of our existence. With that desire, we embed ourselves within a narrative that provides us with meaning or purpose for our life and life’s pursuits. If something distorts or challenges our understood narrative, we ask ourselves and (perhaps) others “why” this is the case. As Steven Chase puts it: “Ever since suffering entered the world, men and women have asked, why? This is not so much the question “what was the cause of this?” but rather a protest against some profound injustice or lack of logic in the world” (Chase 2013, p. 32). For the theist, this line of questioning is often directed toward God. For persons in the midst of suffering or illness the question becomes more acute. The insistent “why” questions often come in the face of crisis.

One may be aghast with delight if she gains sudden prosperity but rarely asks others, or God, the question “why” such fortune is bestowed. Good things happen because we were fortunate enough to do the right things, make the right choices, or be in the right places. God may still be invoked in times of ease and good health, but rather than asking God “why?” God is credited with providing blessing.3

On the other hand, when life presents us with complications, such as a cancer diagnosis, while we have made efforts to live in devoted service to God, we may ask “why” we face such challenges. Why me? Why us? Why is God putting me through this problem, situation, or disease? Even agnostics may avail themselves of this understood human privilege to ask these “why questions” of a God that they usually deny, at least in everyday practice.

2.2. Asking “Why?” in Scripture

This is not simply a general, experiential observation; we see the depth and agony of the “why” question in Scripture. One classic line is found in Habakkuk 1:2:

O Lord, how long shall I cry for help,

 and you will not listen?

Or cry to you “Violence!”

 and you will not save?4

As we often see in the Psalms, when God’s people are suffering, the prophets ask God why God is not providing rescue from oppression, devastation, and violence. For instance, in Psalm 44:24, we read:

Why do you hide your face?

 Why do you forget our affliction and oppression?

Why is God not listening to his people in distress? In Habakkuk’s case, we may say that the pain of the community was ultimately due to their own “wickedness” and a result of neglecting “fidelity to their God” (Thomas 2018, p. 61).

The book of Job is nearly one long discourse on the question “Why God?” but this time from one who endured suffering not in any way linked to his own disobedience. Job’s cry of “Why” stemmed from a life of obedience and faithfulness to God. In his misery, Job wonders why he did not simply die at birth (3:11, 16). He believes he has been faithful, but his suffering does not make sense. So, he doubts himself and begs God for pardon:

²⁰If I sin, what do I do to you, you watcher of humanity?

 Why have you made me your target?

 Why have I become a burden to you?

²¹Why do you not pardon my transgression

 and take away my iniquity?

For now I shall lie in the earth;

 you will seek me, but I shall not be.”

(Job 7:20–21)

On the cross, Jesus himself asks the Father “Why?” in his appropriation of the words of Psalm 22 crying out, “Eloi, Eloi, lama sabachthani?”—“My God, my God, why have you forsaken me?” (Mark 15:34; also see Matt. 27:48b; cf. Psalm 22:1–4). It is difficult to imagine the unmistakable emotional agony of separation Jesus experienced at this point that was only compounded by the physical agony he was enduring. Even Jesus, God in flesh, asks “Why,” yet a direct answer from the text remains unanswered.

The Apostle Paul no doubt asked God “why” he had to endure, and why God would not remove, the “thorn” in his flesh,” whatever it was. But rather than providing an answer, he was instructed by God that God’s grace was sufficient in Paul’s weakness (2 Cor 12:7–9).

Of course, the list may go on. But it is certain that asking the “why” of suffering and the “why” of God’s apparent silence in the midst of suffering was not only consistent throughout Scripture but has persisted through the centuries. William Placher expresses this well when he writes:

Some of the greatest of Christian mystics, from John of the Cross to Mother Teresa, report experiences of God’s silence, the eclipse of God, and the dark night of the soul. Such experiences are not, they insist, signs that they have lost their way or turned aside from God but part of the path that will lead them to God, a somehow necessary stage in coming to know the fullness of God’s love. How much more this must have been true of Jesus on the cross.

(Placher 2010)

But coming to realize or have confidence that God makes “everything suitable for its time” is not the same thing as having answers to the “why” questions or understanding “what God has done from the beginning to the end” (Eccles. 3:11). God’s ways remain God’s ways, and the answers are unattainable. This does not mean that we cannot ask the “why” questions, but we must realize the limits of human, proverbial wisdom (even wisdom provided in Scripture), without insisting on a response from God that satisfies our desire to understand why God allows what God allows (Placher 2010).5

2.3. Asking Why and Giving Answers

I will briefly mention two popular-level evangelical theological answers that have been provided in recent years by D.A. Carson and John Piper. In his book, How Long, O Lord? Reflections on Suffering and Evil, D.A. Carson is careful to say that it would be “pastorally insensitive and theologically stupid” to suggest to those in deep distress or illness, that their condition is the result of a particular sin in their life. Carson does not, however, dismiss the notion that some illnesses may indeed be the cause of sin, and even goes as far to say that “illness and death … are of course tied to our rebellious condition” (Carson [1990] 2006, p. 101). Further, he also claims that pain and suffering may have positive results for the person with faith, suggesting that this may indeed be the case with God’s discipline (Carson [1990] 2006, pp. 102–3). I will not contest Carson on this point, but I nevertheless think this is moving in the wrong direction. His answer attempts to provide some sort of justification for illness based ultimately on humankind’s waywardness and sin. Indeed, Carson may be right on this, as creation and humankind live in brokenness, but his view presupposes a particular view of death as reduced to physical mortality without considering other possibilities.6

As I mentioned above, John Piper submits that one must not “waste” a cancer diagnosis because God has “designed it for you” (Piper 2006). Piper is genuinely attempting to provide pastoral exhortation to others, as one who has struggled with cancer himself, to embrace cancer as part of God’s purpose for one’s life and may be used, among other things, to focus on God and provide a witness to others. I respect Piper for his intentionality in coping with cancer through the lens of faith and robust view of God’s sovereignty. I also appreciate how he sees opportunities to testify to God’s glory in the midst of cancer. Experientially, I found both to be true during my own cancer treatments. God is sovereign, God’s glory is unimaginable, and through devastating illnesses, God provides opportunities for us to give witness to God’s greatness and God’s gospel. But this is not the same as saying that God “designed” cancer for us.

Where Carson seems to accent the overall theological cause of illness based on the Fall, Piper underscores his belief in God’s intentional, even direct, purposes for illness for the sake of Christian growth and witness. In either case, I think the emphases are misdirected for the brief reasons I suggested. I also find it doubtful that these emphases provide the existential pastoral hope and personal resilience necessary to fully embrace God’s presence in the midst of enduring pain, illness, or the process of death. Both of the above approaches may morph into a theodicy that ultimately silences the voice of those suffering, which Job is most certainly against, as seen in his response to his accusers. Job does not remain silent, but no theodicy is offered. God does not offer an explanation to Job, and the explanations given to him by his friends are found illegitimate (Brown 2014, p. 97).

3. From “Why?” to Humility

3.1. Job and the Absence of Theodicy

The book of Job is the paradigmatic narrative of innocent suffering in Scripture. But if we look for a theodicy, we will be frustrated. Job himself seeks a theodicy but fails to discover one. John H. Walton says it quite succinctly: “Job receives no explanation for his suffering, and the book does not fill that void for readers either” (Chase 2013, pp. 34–35).7 After Job’s rhetorical interchanges with his friends and after denying their charges against him, he “attempts to elicit a response from God, not in the form of a prayer or plea. In swearing by God, Job aims to compel God” (Brown 2014, p. 97).8 William Brown refers to this as Job’s “negative confession,” which he submits is “typical of ancient Near Eastern legal oath lists” but Job’s is “more comprehensive and specific” than “the psalmic protestations of innocence” (Brown 2014, p. 97). Job implores God to grant him vindication because of Job’s proven integrity (Brown 2014, p. 101). In Job’s confidence in his own integrity and demand of God’s vindication; however, it appears that Job’s humility suffered. Through this intense, painful process, Job learned it was inappropriate for him to define the conditions for God during his lack of understanding of God’s ways. God disregarded Job’s demands to know, and Job remained without answers (Peake 1983, pp. 106–7).9

For some, this remains unsatisfactory. We want answers. Even if God’s ways are beyond our understanding, we believe that we must nevertheless seek the best answers we can. After all, we reason, seeking truth and understanding God’s causes and effects are important to “correct” theology. This was Job’s plight, even with direct dialogical access to God. But God did not provide the answers that Job was seeking. Eventually, through humility, Job realized his presumptuousness in demanding vindication from God (Walton and Vizcaino 2012, pp. 431–32). Job learns to embrace the mystery of God’s ways and the unknowable predicaments and agonizing tragedies of life.

We must guard against making the outcome of Job’s life a paradigm for our own. We may face intense suffering in life without any glimpse of earthly prosperity in the end or promise that we will recover everything that we lose (Walton and Vizcaino 2012, p. 436). Like Job, we do not know how God, or life in general, operates. But we must rest in the wisdom of trusting that God is wise, caring, and all good. Realizing our limits is no small part of human wisdom before God. This does not take away pain and suffering, “but it does help us to avoid the foolish thinking that might lead us to reject God when we need him most.” (Walton and Vizcaino 2012, p. 437). In giving up our relentless pursuit of understanding the “why” of illness, disease, and evil, we may nevertheless embrace God’s living, active presence that is often expressed in the midst of the presence of others.

3.2. Embracing “Not-Knowing” and Human Vulnerability

Humility is about recognizing how much we do not know; it is fundamental to Christian wisdom and character. James Calvin Davis observes that this is evident throughout wisdom literature in Scripture and throughout Christian theological history (Davis 2017, pp. 29–32).10

Upon receiving a cancer diagnosis (or other life-threatening conditions), one is faced squarely with her finitude and mortality, beginning an intense journey of “not knowing.” Usually, one does not know nor cannot discover “why” one has such a condition. One may learn some things about her condition and the science behind her treatment plan, but by no means will these come close to the knowledge of the medical professionals guiding the care. For adequate care, one humbly puts trust in the medical professionals and also in the staggering complexities of medical technology. The patient becomes dependent upon family, friends, co-workers, nurses, physicians, administrative personnel, and others, for medical treatments, care, guidance, and appointments. Thomas Reynolds (speaking primarily to the context of disability) insists that the “strange logic” of the “Christian witness” is one that displays strength “through weakness” and “wholeness that manifests itself in brokenness, “a power that “reveals itself through vulnerability” (Reynolds 2008, p. 19). Further, one’s medical condition and consequent dependency on others are humbling and provide opportunities for practicing humility in relationship to those that are serving the medical patient. Stanley Hauerwas aptly expresses this aspect of human vulnerability in illness and the opportunities it provides for displaying the body of Christ:

Suffering and pain make us vulnerable, and often we try to protect ourselves by attempting to be “self-sufficient.” The willingness to be present as well as to accept the assistance of others when we need help is a gift we give one another. The trick, of course, is to be the kind of community in which such a gift does not become the occasion for manipulating each other, for trying to obtain through our weakness what we cannot get others to give us voluntarily.

(Hauerwas 2004, p. 39)

Asking questions while refusing to seek a theodicy, embracing the limits of our knowledge, and practicing vulnerability are all important factors in humble posturing needed to embrace hope during the emotionally desperate times of serious illness.

4. From Humility to Hope

In the “pause” of life through illness, we are reminded of our dependency on God and on others, and we are also reminded of our overall contingency of being human. But given this contingent existence, space is created to embrace and manifest hope of bodily resurrection both now and in the future through embodied actions of human sacrificial love received and practiced by the cancer patient and the cancer patient’s caregivers. (medical professionals: doctors, nurses, technicians, family members, and caring and praying friends). Perhaps ironically, the provision of care may also come from the patient to those with whom she closely relates during treatment. Hope is thus embraced and practiced in the display of mutual hope-filled practices of grace and love.

I do not intend for this to sound trite. Acts of love and compassion towards others require intentional, disciplined action, especially in the midst of illness or suffering. The hope this brings is not abstract, as in the hope for a pie-in-the-sky, disembodied escape from the ills of life, but it includes hope for at least eventual healing of the body. Drawing upon the work of Alasdair MacIntyre, Stephan Kampowski submits that human dependency and “bodliness” are often ignored in philosophical history from Descartes, Husserl, Kant, Hume, and Heidegger. But we must not, as Hans Jonas puts it, “forget the body,” because if we do, we neglect to keep our vulnerability central. Vulnerability and humility are both essential aspects of being human in Christ (Kampowski 2018, pp. 19–20).11 And it is this vulnerability and humility that also anticipates the hope of resurrection and new creation. If hope is extricated from hope of bodily restoration, it is hope ill-conceived in terms of Christian eschatology. Hope must not simply be about hope of escape from physicality but hope in view of physicality. This is what resurrection is all about.

Even in the midst of illness, we rehearse Jesus’ inauguration of new creation as God’s image bearers to a world still embedded in corruption and decay. Those enduring cancer or severe illness have unique opportunities to reflect the hope of new creation. N.T. Wright vividly expresses this in his Surprised by Hope: “Every act of love, gratitude and kindness; every work of art or music inspired by the love of God and delight in the beauty of his creation; … every act of care and nurture, …will find its way, through the resurrecting power of God, into the new creation which God will one day make” (Wright 2007, p. 219).

This does not mean that physical healing will come prior to the resurrection of the body. It may or it may not. The hope of resurrection does not remove physical pain or illness, nor does it provide us with the answers that are often demanded with a theodicy. Any theological explanations, including those that embrace hope, do not, as Kelly Kapic puts it, “nullify or justify the pain” (Kapic 2017, p. 23). However, in the midst of physical brokenness God offers us hope that can endure the suffering, a hope that may also be expressed in lament. As Kapic again adds: “He teaches us hope, and within that hope we use lament to speak to God of the painful delay of peace. All laments ultimately go to God, with whom we wrestle and rest” (Kapic 2017, p. 31).

Reflecting bodily hope to others is part of joining in God’s re-creation even with broken and hurting bodies. But through the pain, we embrace Jesus’ living presence, knowing he can use us in our hurt to show his life and promise of new creation, which has already begun through us and will continue until resurrection and the joining of heaven and earth in renewed creation.