Pain’s scars and the difficult hope they demand

The tension of pain and hope is hard-wired into the human condition.

Trystan Owain Hughes

Trystan Owain Hughes is a theologian and vicar based in Wales.

A close up of the face of a bruised and bloodied cyclist with a large bandage on his forehead.

When I felt a twinge in my lower back at the age of 30, little did I know that this would lead to chronic pain for over 20 years and counting. Defined as persistent or recurrent pain that is present for more than three months, chronic pain can lead those of us who battle it to struggle to carry out daily activities or to socialise freely. Research shows that up to 15 per cent of the UK’s population live with pain that is moderately or severely disabling. Whether discal, muscular, arthritic, or related to auto-immune or other conditions, medical researchers inform us that we are facing a silent epidemic of chronic pain in our society.

In the past 20 years, pastoral work has opened my eyes to the fact that those of us who face the ignominy and anguish of chronic pain cannot claim a monopoly on suffering. No stranger to significant hardships himself, psychologist and Auschwitz-survivor Viktor Frankl suggests that all suffering should be taken with utmost seriousness, however brief or minor it proves to be. The “size” of suffering, after all, is relative. It is, he claims, like releasing gas into an empty chamber – it doesn’t matter how much gas is released, it will fill the chamber completely. In other words, it does not matter how great or small our sufferings are, they will always hold the potential to darken our hearts completely.

Behind even the brightest smiles and the most cheerful demeanours are the scars of a thousand cuts.

Suffering and struggle have been particularly marked in our society in recent years, with the twin-tribulation of the pandemic and the cost-of-living crisis leading to so much grief, illness, depression, loneliness, poverty, and isolation. Some years back, I undertook hydrotherapy at the local hospital. With each patient having endured various injuries, many quite serious, I was struck by the plethora of scars in the pool each week – on backs, shoulders, arms, knees, and ankles. The many years of struggle and pain in that pool was all too visible, but, as I undertook my aquatic exercises, I recall thinking to myself: if we could peer into the souls of those around us, how many more deep-seated scars would we notice? Behind even the brightest smiles and the most cheerful demeanours are the scars of a thousand cuts.

Neither should we fall into the trap of believing suffering merely impacts us as we age. While it is true that there is a correlation between age and bereavement, illness, and disability, the dark hand of suffering is not partisan to age or circumstance. Many children and young people go through all manner of serious trauma and illness, often hidden to those on the outside. Research is showing a sharp rise in chronic pain in young people, for example, while teachers bear testament to the impact of the pandemic on the mental health of so many of their pupils. Moreover, when I was a university chaplain, I saw how deeply young people were affected by incidences and events, even those that, to others, may have seemed trivial. Younger generations are certainly not immune to life’s struggles.

Like that tenacious and resilient tree breaking through the harsh concrete, we witness hope and promise shining out of the pages of his letters.

Christians, of course, have always been aware of the philosophical questions surrounding the existence of suffering. The book of Job in the Old Testament details one of the earliest attempts to consider theodicy, while numerous scholars down the ages have grappled with the “problem of pain” (C.S. Lewis) and the question of “where is God when it hurts?” (Philip Yancey). Their musings are well documented and discussed, but, as a Christian with chronic pain, I have become less interested in the “why?” of suffering and more concerned with the “what now?” In other words, I am increasingly interested in how faith responds when confronted with the crippling and dehumanising personal impact of pain, grief, illness, disability, relationship break-ups, depression, loneliness, poverty, or anxiety.

During a particularly acute flare-up of back pain recently, I took short walks around our immediate locality. We live in a concrete jungle – there are houses, streetlights, cars parked down both sides of the road, and vehicles driving up and down, especially at school drop-off time. In my pain, I was struggling to see any hope in the incarceration of a city. Then I noticed something on our road that I’d walked past on many occasions. It was a small, solitary tree, which is about twice my height. For a brief moment it lifted my heart and I thought to myself how wonderful that someone had planted that tree, just to give some greenery to this urban sprawl. But then I noticed that this beautiful little tree had not been planted at all. Rather, it had broken through the hard, unforgiving concrete, desperate to reach up to the sunlight and take in the oxygen in the air. That small tree is, in many ways, an apt metaphor for the Christian response to personal suffering.

From the book of Acts and his letters in the New Testament, it is clear that St Paul had walked the gruelling path of pain and struggle. He faced prejudice, persecution, and prison, not to mention his battle with a personal affliction, which he called a “thorn in my flesh”. Scholars posit this may have been an illness or a disability, such as blindness. Yet Paul does not allow his letters to become dark, depressing diatribes of fear and hopelessness. Like that tenacious and resilient tree breaking through the harsh concrete, we witness hope and promise shining out of the pages of his letters. Here was a man who knew suffering, but, through his vivid encounter of the person of Jesus, he had also grasped the profound meaning of hope. When we attend a funeral or a wedding, we will quite often hear uplifting passages of hope and joy written by him. Discussions around the tension in Paul’s epistles between “flesh” and “spirit” are well worn, but, when I read his letters, especially in light of the life and death of Jesus, it is the tension between “suffering” and “hope” that is most conspicuous.

“I have seen the light – it flickers on and off like a badly-wired lamp”.

Andrew Motion

This tension, of course, is not just prevalent in the Christian scriptures. It is hard-wired into the human condition. Just take the years of the pandemic, when people were either isolated, lonely, stressed, and anxious themselves or were journeying alongside others facing illness, grief, worry, and fear. During that period, I was a parish priest and would regularly visit people, standing socially distanced on their doorsteps. Yet, despite suffering seemingly being omnipresent during the pandemic, people did not generally regale me with their miseries. Rather, they wanted to inform me of moments of uplifting hope that had broken through their difficulties – the beauty of nature on their daily walks, the tireless care of the NHS workers, and the joy of meeting with friends and family, on zoom or outside in the garden. They seemed naturally aware that hope and suffering are inextricably linked. This fact is at the heart of our Christian experience – its recognition is one of those things that define Christians as Christian. After all, the very symbol that has come to represent the Christian faith – the cross – is both an emblem of torture and suffering and a symbol of liberation and hope.

Not that opening our eyes to moments of hope, love, and wonder is easy when we are going through difficult times. In the dark moments when my own chronic pain seems overwhelming and utterly debilitating, I am inspired by the words of the former poet laureate Andrew Motion: “I have seen the light – it flickers on and off like a badly-wired lamp”. There will be times when Christians will see God’s light clearly and its beauty and glory will dazzle daily. But there will also be times of doubt, grief, depression, anxiety, and physical pain. During those moments, we can learn to be sustained by the occasional spark of hope that will come to us, even in the very ordinariness and humdrum of our daily lives.

And so, in travelling through life’s dark moments, Christians recognise two powerful realities. One of these has long been championed by preachers and spiritual teachers – it is the presence of a kingdom to come in a heavenly future where there will be no more tears and no more suffering. The other one, though, can speak powerfully into the present predicament – it is the presence of a kingdom all around us now, breaking through the harshness and bleakness of life, like that small tree bursting through hostile concrete. Theologians refer to these two realities as “inaugurated eschatology” and they can also help us to recognise profound moments when transcendent hope breaks into our lives. Opening our eyes to compassion, beauty, wonder, and awe can help us transcend our suffering, which so often seems all pervasive, and can lead us into a strange new world of God’s providence.

In the soil that the broken concrete had revealed were little green, sprouting shoots. Hope had begotten hope.

So, Christians hold onto the hope of the “not yet”, confident in the hope of life after death. But, as the old Christian Aid advert put it, we also believe in life before death. However dark and long our journey seems, hope is birthed when we take time and space to notice strange and uplifting moments of beauty, grace, and guidance breaking through our daily lives now. In these, Christians find, in the words of theologian Karl Barth, “indications, intimations and parables” of the coming reign of God.

After 20 years of daily struggle, I have made peace with the fact that I am likely to battle chronic pain for the rest of my life. However, I have also come to recognise that hope is not all about smiles, sunshine, and flowers. Hope is often difficult and demanding. It is about delicately holding the joy and challenge of life in a wonderful balance. For the Christian, it’s about both recognising God’s kingdom in the beauty, awe, and wonder of his created world and glimpsing it in our very earthly, wearisome, and draining lives.

But there was also something else about that small, resilient tree that was breaking through the hard and unforgiving concrete. On another walk, a few weeks later, I noticed foliage growing around the base of the tree. In the soil that the broken concrete had revealed were little green, sprouting shoots. Hope had begotten hope. And it is certainly true that the more we open our lives to recognising hope, however brief it may be in our struggles, the more it can inspire us to bring moments of light and comfort to others. And thus we live out, in the words of Karl Barth, so many “little hopes”, and, by doing so, we scatter seeds of new life and resurrection as we go, trusting that God will water them and bring his “hope, faith, and love” to fruition in the world around us.

Article

Assisted dying

Care

Creed

Death & life

19 November 2024

5 min read

“Shortening death” sidesteps the real battle

We need to do more than protest bad deaths, we need to protest death itself, it's more than biological.

Tom Dove

Tom is a physician and completing a theology doctorate.

A hand drapes over the side of an object out of shot.

Michael Schaffler on Unsplash.

What is “death”? It’s surprising the term has received little attention in the assisted dying discussion so far, because more hangs on the answer than one might expect. At a press briefing, Kim Leadbeater MP stated that the assisted dying bill she is proposing is about “shortening death, not ending life.”

But what meaning does “death” have here?

The current bill defines neither “death” nor “dying.” Granted, it implies a biological definition. The bill speaks of administering approved substances to “cause that person’s death” and of capacity and decision-making around “ending life.” These fit the understanding of death with which the medical profession operates—death is the point in time when the combined functions required for human life cease. It is a one-time event, the end of physiology, and so is recognised by a combination of physical signs.

Death, then, is a diagnosis.

So, too, “dying”—though here the waters are murkier. Setting aside sudden deaths, medical talk of dying takes us out of binary territory. Dying speaks of a process, of the “terminal phase.” Within medicine a diagnosis of dying heralds the expectation that a person’s death will occur within hours or days. And so, the focus shifts. The task of care is no longer the coordinated work of investigation, preserving life, and treating symptoms. Now attention is on bringing relief to the process of dying.

The bill seems wise to much of this. Though definitions of death and dying are absent, the bill does define terminal illness—“an inevitably progressive condition which cannot be reversed by treatment” and from which the event of death “can reasonably be expected within 6 months.” And so, it clearly distinguishes terminal illness from biological death and, implicitly, from dying.

Of course, terminal illness and biological death are related. Terminal illness is irreversible, and where terminal illness leads is death. Or, you might say, it leads to the end of life. Apart from the timescale of six months, the same may be said of ageing: ageing is irreversible, and where ageing leads is death. This is why Kim Leadbeater’s comment was puzzling to me. I suspect what she really meant was “shortening terminal illness.” If so, this is confusing because, within the framework of the bill, “shortening terminal illness” and “ending life” are identical. It seems she was getting at something else.

“It seems odd that in the name of eliminating suffering, we eliminate the sufferer.”

Stanley Hauerwas

I suspect Kim Leadbeater was echoing a conviction at home in the Christian faith. That is, try as we might to keep death at a distance and restrict it to a faraway frontier, the life of human beings involves death. I don’t simply mean the biological death we witness—the deaths of friends, relatives, or even strangers. I mean death intrudes upon the way we experience life. Death is more than simply biological.

The fear of death belongs in this category. For some, the impending loss of relationships and joys casts a shadow over life, giving birth to apprehension. Death is not simply a factual matter but something that exerts power and influence. Or take disease and illness. Built into the notion of terminal illness is the idea that the sickness borne by a human body will ultimately bring about that body’s death. That body already speaks of its death. Death is making itself felt in advance.

And so, death is more than a biological event. Even living things can bear the marks of death.

This is no novel claim. The creation account recorded in the Bible says that in the beginning, there was good. But an intruder appears. In the wake of humanity’s choice to go its own way rather than the way of its Maker, death arrives on the scene. And death is an imposter—not simply a physiological fact at the end of the road, but a destructive and alien presence in God’s good world.

Understood in this way, death is not something that God intends humans simply submit to. Death is something to protest. This is why Kim Leadbeater’s comment gets at something important: this kind of death should be protested. The marks of death should not be accommodated, because they do not belong to the goodness of what God has made.

At the heart of the Christian faith is God’s own ultimate protest against the force of death. Christians celebrate that God himself came in the man Jesus to “destroy death.” This is plainly more than biological. Jesus came to free humanity from the entirety of death’s grip. Hence why, when Jesus speaks of “eternal life” he means more than endless biological existence. He means liberation from all the havoc that death brings to bear within God’s world. To the Christian imagination, the power of death must be protested because God protested it first.

The question is how to protest death. Within the framework of the bill, shortening death or terminal illness is identical with ending life. This is the only form protesting death can take.

But the Christian faith makes a far more radical claim: God alone overcame death by dying. This is the point: Jesus was the one—the only one—who emerged resurrected victor in the contest with the power of death. In seeing his death and resurrection, an unshakeable hope emerges. Death is not the victor. And this hope stands above our present experience of death—in whatever form—and, at the same time, calls us to join the protest.

Ethicist Stanley Hauerwas once wrote: “it seems odd that in the name of eliminating suffering, we eliminate the sufferer.” I have deliberately avoided discussing suffering, not least because it would take me too far afield. Yet Hauerwas has put his finger on what I’m getting at. Protesting death—in the big sense—belongs to the Christian faith. Protesting suffering and pain, economic and racial injustice, fractured relationships and broken societies, are all part of this protest. But can eliminating those who live within the shadow of death be part of this protest? I think not. The Christian faith believes there is only one who can overcome death in this way, and that is God himself—who has already done it.