By Kathryn Butler is a trauma and critical care surgeon. Her book on end-of-life medical care through a Christian lens is anticipated in 2019 (Crossway). She writes at Oceans Rise.
Weeks of chemotherapy eroded the lining of her mouth, mangled her immune system, and culminated in an hours-long surgery to carve out a tumor the size of a grapefruit.
Throughout, friends and loved ones lifted up a heartfelt but singular prayer: Heal her, Lord. She wrapped herself in their words as if girding herself in armor. Afterward, she pointed to a line on the pathology report that described dead cells at the center of the tumor, and she praised God for his mercy. She reasoned that the chemotherapy had killed the tumor before her surgeon ever put knife to skin, and the healing for which she prayed was at hand.
But those dead cells didn’t promise cure. Rather, they indicated a cancer so aggressive that blood vessels could not tunnel to its center. The tumor was growing so rapidly that it could not support its own middle. Months later, the cancer not only returned, but spread, clogging her lungs and dotting her brain.
As the delicate balance of her organ systems teetered and collapsed, prayers for a cure became more ardent, from her church as well as from her own lips. Her doctors recommended home hospice, but she clung to her conviction that God must melt away her disease, and insisted upon last-ditch chemotherapy instead. Still, the cancer continued its deadly march. Fluid ballooned her limbs and saturated her lungs. One awful night, with ICU alarms sounding her elegy, her heart quivered and lurched to a stop.
Wholly unprepared to lose her, her family reeled in grief. They agonized over how to endure without her, and struggled to reconcile this flickering out of a beloved, faithful life, against their continual appeals to God for cure. How had this happened? they lamented. Had God noticed their prayers? Had he even listened? Did they not pray enough? Was their faith too meager? How could God ignore her, when she was so faithful to him?
God made heaven and earth, catapulted the planets into motion, and assembled the scaffolding of our cytoplasm. Surely, he could also eradicate our cancer, realign our bones, or restore blood flow to areas that mottle.
God can and does heal. In my own clinical practice, he used a patient’s improbable recovery to draw me to himself. Throughout Jesus’s ministry, he performed miraculous healings that glorified God and deepened faith (Matthew 4:23; Luke 4:40). The Bible encourages us to pray in earnest (Luke 18:1–8; Philippians 4:4–6). If the Spirit moves us to pray for healing, whether for ourselves or our neighbors, we should do so with fervor.
Yet while we pray, we must attend to a critical distinction: although God can heal us, we must never presume that he must.
Death is the consequence of the fall (Romans 6:23). It overtakes us all, and most commonly recruits illness as its vehicle. When Christ returns, no disease will blot God’s creation (Revelation 21:4), but for now, we wait and groan as our bodies wither. We may perceive our healing to be the greatest good, but God’s wisdom surpasses even the most impressive reaches of our understanding (Isaiah 55:8). We cannot bend his will to resemble our own.
Time and again the Bible depicts instances when God does not immediately eradicate suffering, but rather engages with it for good (Genesis 50:20; John 11:3–4; Romans 5:3–5). “A thorn was given me in the flesh,” the apostle Paul writes of his own physical affliction. “Three times I pleaded with the Lord about this, that it should leave me. But he said to me, ‘My grace is sufficient for you, for my power is made perfect in weakness’” (2 Corinthians 12:7–9). God responded to Paul’s prayers for healing not by curing him, but rather by working through Paul’s suffering to draw him nearer to his glory. In the most exquisite example, through his suffering and death, Christ redeems us from our sins and pours grace out upon us (Romans 3:23–25; Ephesians 1:7).
When we ignore God’s work in suffering, and cleave breathlessly only to our hope for a cure, we forsake opportunities for closure, fellowship, and spiritual preparation at the end of life. Research warns that those of us within a religious community are more likely to pursue aggressive measures at the end of life, and more likely to die in an ICU. If we set our eyes only on a cure, rather than on the reality of our physical mortality, we may chase after treatments that not only fail to save us, but which also rob us of our capacities to think, communicate, and pray in our final days. We forget that if our healing is not within God’s will, we will need fortitude, peace, and discernment to endure. And if cure does not come, a single-minded focus on healing leaves ourselves and those we love with unsettling doubts about the validity of our faith.
The gospel offers a hope that exceeds the reparation of our bodies. This side of the cross, even as our vision darkens and the world closes in, we need not fear death. Christ has overcome, and through his resurrection death has lost its sting (1 Corinthians 15:55–57). Death is but a momentary breath, a transition, a heartbeat before we reunite with our risen Lord (2 Corinthians 4:17–18). In the wake of the cross, death is not the end. Through Christ’s sacrifice for us, through God’s overflowing and sufficient grace, we have spiritual healing to sustain us through eternity, even while our current bodies warp and break.
When life-threatening illness strikes, by all means pray for healing if the Spirit so moves you. But also pray that, if cure is not according to God’s will, he might equip you and your loved ones with strength, clarity, and discernment. Pray he might grant us all peace to endure— through the pain, through the infirmity, with eyes cast heavenward even as fear drives us to our knees. Pray that as the shadows encroach, and the light within us dwindles, that the Light of Jesus might illuminate our minds and hearts, drawing us toward himself in our final moments on this earth. Pray we would know in our hearts that our end on this earth is by no means the end.
However dark death seems, it is fleeting and transient, a mere breath before the eternal life to come.
I Corinthians 15:52 — In a flash, in the twinkling of an eye, at the last trumpet. For the trumpet will sound, the dead will be raised imperishable, and we will be changed.
support us all the day long of this troublous life,
until the shadows lengthen, and the evening comes,
and the busy world is hushed,
and the fever of life is over, and our work is done.
Then, Lord, in thy mercy,
grant us a safe lodging, a holy rest,
and peace at the last. Amen.
–John Henry Newman (1801-1890)