At their best, religions comfort and support people in the face of suffering. But sometimes the reasons religions offer for suffering can make things worse. If religious communities are to be places where those who suffer are able to communicate the truth of their reality and receive the support they need, the religious stories we tell need to be spacious enough to hold the grief, loss, and despair that accompany traumatic experiences like living with life-threatening illness. And for Christians, one way to do this is to take on the typical storyline and let it breathe.
Most renditions of the Christian story begin with creation and the fall, then quickly move on to incarnation and redemption. But spending time in the psalms can help us see that the biblical story is less plot-driven and more complex than a tidy, linear, sin-redemption storyline often makes room for. Because Old Testament writings are Christian Scripture too (four-fifths of Christian Scripture, in fact, a reality often overlooked by Christians), prayer practices of the Psalms belong in any version of the Christian Story being told to those who are undone.
In Psalm 77, the psalmist cries out, “I am so troubled that I cannot speak.” Placing experiences of living with serious illness within lament psalms and other irresolute spaces within the biblical story allows us to explore what it means to be undone by illness before God. The central character in these biblical stories is God, the One who creates and calls human beings into relationship with the divine and with one another. It’s important to note, as preacher Thomas Long does, that questions of God’s existence are not really on the table within the biblical text. The characters in the Bible do not ask, “I am undone by illness, I wonder if there’s a God?” Instead they cry out, “O God, why illness?” These moments are important not just because they open up space for those undone by serious illness to express their grief and anger. They’re also important because they speak to God’s relationship with and response to the people enduring illness and the trauma related to it.
The psalms help us see that there is space to protest toward God, to be angry at God, to complain to God over suffering that simply is but that we desperately wish would not be. While some people who express such emotions do so because of a loss of or rejection of faith, the psalms help us see that such emotions are also belong inside the experience of faith. “I cry out and you do not answer me,” complains the psalmist in Psalm 22.21. Making more visible the spaces within religion for interrogation of God can be crucial for those who tend to view challenges to God as unfaithful. If people who are angry at God are given more opportunities to consider that their protest and anger can actually be part of a close, resilient relationship with God, they might be able to come to terms with protest as an aspect of a faithful relationship with God rather evidence of a lack of faith.
One psalm that deserves more attention by those undone by trauma is Psalm 88, the most irresolute of all psalms. The psalmist’s soul is full of troubles (v. 3), buried under the weight of isolation brought on by psychic, spiritual, and emotional distress. There are repeated petitions to God, pleading for some sign of divine responsiveness: But I, O Lord, cry out to you; in the morning my prayer comes before you. O Lord, why do you cast me off? Why do you hide your face from me? This calling God to account emerges in response to testimony throughout the biblical narrative that the character of God is One who will always present, without fail.
But the insistent questioning of God throughout the psalm indicts any attempt to cram suffering in a tidy framework. Why such suffering? Why doesn’t God respond? The questions hang suspended, unanswered.
Even though experiences of the absence of God fill the prayers of the psalms and are so ubiquitous that even Jesus himself cannot avoid them, this particular kind of affliction often fails to get the attention it deserves. Biblical testimony of human beings’ relationship to God illustrates that the experience of God’s absence is much more than a momentary phenomenon for those who are struggling. From Solomon’s testimony in I Kings that God dwells “in thick darkness” to the lament in Psalm 88 over the hiddenness of God’s face, the people of God give voice to that anguished experiences of God’s apparent silence over suffering we so wish were not a part of our lives.
Praying the psalms opens up pathways for those living with serious illness to see themselves as more than simply victims of the disease. Praying the psalms gives voice to the intense connection between the disease in our bodies and the inner turmoil of the heart. Praying the psalms gives voice to protest and anger and grief that accompanies life with serious illness, but it does so within the larger context of a relationship to the God who hears and responds to such anguished prayers. Lamenting together, to God, can open a way for the unendurable to be endured.
Each of our lives bear the marks of suffering. And when we face intense experiences of suffering, we crave explanations for the “Why?”—answers for why things happen the way they do. Knowing why reassures us that we live in an orderly world that operates according to understandable laws. We want life to make sense. We want things to happen for a reason.
It is not surprising, then, that dominant versions of the cancer story strive for meaning by placing life with serious illness in a moral framework. Those of us who live with cancer are cast in the role of warriors called on to battle our cancer with all we’ve got. Telling cancer stories through the use of military images provides a certain logic to illnesses like cancer: cancer is cast as an evil invader, and we are called to take the moral high ground by fighting and ultimately defeating it.
A moral framework often remains in place when the cancer story meets up with the Christian story. The question of Why? becomes an insistent one. Why would a good God who overcomes moral evil allow illnesses like cancer to exist? Where’s the justice in such a diagnosis? We crave answers from a religion built around just conceptions of God.
But when we pay attention to the lives of those with life-threatening illness—whether they are religious or not—the most insistent question tends less to be “Why?”—for so many of us, there’s simply no logical explanation as to why we were stricken with serious illness—than “How?”—as in how do I live into this reality that is now my life? And for those of us who claim the Christian Story as our story, the question becomes: how does the Christian story offer a framework of meaning to this cancer-filled life where meaning is constantly under threat?
When events like a cancer diagnosis occur in the absence of any clear explanations as to the why, we are confronted with an unordered, unstructured, even lawless sense of the world. Unexplainable evil, or that which seems to be unexplainable, threatens the sense we try and make of our lives. What’s needed is more space in the tellings of the Christian Story—as well as in communal enactments of that Story and the living out of the Story’s call to care for those who suffer—for the unexplainable that comes from living with serious illness.
In the 1990s, life-threatening illness was added to the list of events and conditions that can cause post-traumatic stress disorder (PTSD). In so doing, psychiatrists were acknowledging that the threat to life and bodily integrity due to cancer or other serious illnesses can precipitate deep senses of fear, devastation, a lack of control—all symptoms of PTSD.
But applying a post-traumatic stress diagnosis to those who live with life-threatening illness remains an unsettled issue. There are ways in which trauma associated with illness does not fit neatly into the framework of post-traumatic stress. While conventional understandings of traumatic events focus on extraordinary occurrences in the past and have a beginning, a middle and an end, trauma associated with illness typically does not arise from a single event but from recurring events extending from diagnosis through treatment and beyond, possibly throughout the rest of a person’s life. Given this reality for people living with serious illness, researchers wonder whether those living with cancer can ever become “post-trauma.”
Even as important similarities exist between the ways trauma works in the lives of those who’ve endured traumatic acts of violence and the lives of those who live with life-threatening illness, a key difference is this: rather than an enemy invasion or threat from the outside, illnesses like cancer are primarily internal threats. As Augustus Waters, the teen-aged character dying of cancer in John Green’s The Fault in Our Stars, wonders out loud, “What am I at war with? My cancer. And what is my cancer? My cancer is me. The tumors are made of me. They’re made of me as surely as my brain and my heart are made of me. . . .” That our cancer is “us” creates a distinctive way of experiencing trauma related to living with an internal reality that threatens to destroy us from the inside out.
Applying the lens of trauma to those living with life-threatening illness deepens our understanding of the range of emotional responses that occur when living with cancer; talk of trauma opens up more breathing room for those who live with cancer, and it offers those who care for people who are really sick a broader framework in which to offer that care. Sociologist of illness, Arthur Frank, argues that when those of us who are ill get to tell our stories and have them really listened to, the potential for healing increases. The language of trauma helps us resist versions of the cancer story and the Christian story that are too tidy, too resolute. Instead, making space for trauma allows us to acknowledge our not-yet-resurrection reality. And acknowledging where we really live can empower us to tell our messy, irresolute stories, and move into a space where healing becomes possible.
I have stage IV breast cancer and I blog about it. But I’m not the only one—with the disease or with a blog. Lisa Adams, metastatic breast cancer patient and blogger with a national profile, recently became a touchstone for national debate about the use of social media in publicly chronicling a serious illness. In early January, two journalists, one at the New York Times and one at the Guardian, wrote pieces critical of some of Adams’ treatment choices as well as the way she lets readers into her life with cancer via blogs and tweets. Outrage over Bill and Emma Kellers’ pieces (who happen to be married) was swift and fierce, not just for the critical questions they raise about Adams’ choices but for inaccuracies in important details (like getting the number of Adams’ children wrong, or how long she’d been living with metastatic breast cancer) and in including quotes from private correspondence with Adams without permission, prompting the newspapers’ opinion editors to publish pieces alternately apologizing for and defending the journalists (if you want to read more, here’s one place to start: The Guardian website).
Perhaps the most controversial aspect of Bill Keller’s “Heroic Measures” column is his not-so-subtle suggestion that Adams should consider going more quietly into that dark night rather than aggressively treating the metastasizing cancer. In weighing the alternatives, he contrasts the treatment regiment of Adams to his own father-in-law’s “unplugged” death from cancer in Britain last year. Here Keller is wading into much-larger debates about not just how the U.S. apportions its medical dollars but how and when those of us with advanced-stage cancer (and other really bad conditions) should embrace the inevitability of death. I’m keenly aware of these debates, as they often play out in my own head. When I learn “my” cancer has metastasized from the bones to the liver or the lungs, how much aggressive treatment will I opt for? How are we supposed to decide when enough’s enough?