BIG IDEA: We live in a city of highly educated and astute thinkers, yet there still seem to be certain elusive ideas that even the best minds continually struggle to grasp. At “The Bear & the Butterfly Open Forum” we highlighted one such beautiful, yet elusive, idea and openly grappled with it from perspectives of faith, science, and philosophy. Bioethicist and Pediatrician Dr. Tyler Tate and Pastor David Evanger led a discussion on Suffering in the 21st Century. Dr. Tate has written extensively on the subject and is about to begin a Fellowship in Palliative Care to focus more on the science and medicine of alleviating suffering within the medical field. This was an interactive forum where we used faith, science and philosophy to try to shed light a little light on one of the most challenging parts of our shared human experience.
The Bear & the Butterfly – An Open Forum on Suffering: The Bear & the Butterfly is what we’re calling what we hope to be a series of open forums on big/difficult/beautiful subjects (butterflies) that we as humans (bears) have great difficulty grasping. The following is a summary of Dr. Tyler Tate and Pastor David Evanger’s discussion.
Qualifications: both Dr. Tyler Tate and Pastor David Evanger are Christians, so everything that they have offer on the subject of suffering is framed by those beliefs, and their experiences do not make them experts on the subject.
- Tyler Tate: A pediatrician, finishing his masters in Bioethics from the UW. Dr. Tate has known suffering firsthand from seeing it in Mexico on a church trip and seeing kids who were sick and suffering with diseases that we don’t have in the United States, from when his best friend committed suicide, and when a close family friend was diagnosed with ALS and slowly passed away. While Dr. Tate was in medical school, he worked on a 10-year-old boy, whose name was also Tyler, who came into ICU and was coded for about an hour before he passed away while his father broke down in the corner. Dr. Tate has seen a lot of death and suffering in pediatrics. As he’s working on his fellowship in ethics, he has worked on exploring ways to talk about suffering with patients and from a philosophical perspective.
- Pastor David Evanger: As a pastor, people often invite Pastor David into their lives through suffering. In his own life, he grew up with very little suffering as possible for the first 20 or so years. Then ten years ago, his older sister, who was healthy as could be, was hit by a semi-truck while riding her bike and was killed instantly. That has been the greatest suffering in his life.
- A Broken World: We all know and sense from our experiences of suffering that there is something deeply wrong with the world. And out of that sense, we also begin to wonder if there isn’t something deeply wrong with our beliefs as Christians. Especially when we hear prophecies of healing that don’t come to fruition, or at least not in the ways that we expect them to. So that the question arises: As Christians, what do we do about suffering?
- What is “suffering”? It’s a word that, at least in medicine, is thrown around a lot. It can be insensitive towards those who are actually suffering. Suffering is inseparable from human life. Can we even understand what it is to live the lives we’ve been given without suffering? No. We are constrained by bodies and the knowledge that we’re going to die and that the people we love are also going to die and probably before we do. We are bounded by suffering.
- Human Identity: We think about ourselves and our identities in three ways, and suffering is related to these identifiers:
- Relationship to other people: the most important part of our lives is often our relationships (spouses, family members, friends, etc.). We are who we are because of the relationships that have molded us. Who we are is tied up in our relationships.
- The Roles we take on as people: this can be our careers. If you’re a doctor, you are identified by how well you perform your role as a doctor. Same goes if you’re a mother or a father.
- Our lives as stories: we look our past and identify time-points that define who we are today. Those can be good things, but they can also be deeply shameful or times of regret or loss. We conceive of ourselves as having stories. We do this when we look to the future, too. We decide certain things about our future selves: what I’ll say to my grandchildren, that I will be married at some point, that my body won’t fail me.
- Suffering is injury to one of those three areas of our lives that disables us and doesn’t allow us to live our lives as fully as we deemed necessary or as we had hoped to have lived. It’s when your child dies, and you lose that relationship and how you defined yourself as a person because of that relationship. It’s when you’re an athlete, and you lose a limb after a bad car accident, changing the way you thought about yourself and how you can perform your role in life. It’s when you had planned a life where you became a parent and you find out you’re unable to have children, and your personal narrative is injured.
- Suffering is also general bad feeling. There’s a shroud of darkness that accompanies it.
- What’s the difference between suffering and pain? There are two main questions in suffering: why and what? Why does suffering occur and what can we do about it? Not all pain is suffering. We can’t point to someone else and say that they’re suffering. We can’t look at a situation in which we are not the sufferer and say that those in the situation are suffering because suffering is subjective. Pain is not suffering. If you’re training as an athlete, you undergo a lot of pain, but you’re not suffering. You’re training because you want to be training. Or as a doctor, you see patients enduring painful treatment, but some of them are so full of joy, and they don’t appear to be suffering. Now, pain can be suffering. So, the distinction between pain and suffering is that suffering is largely about meaning. We attach meaning to everything in life, and suffering can be about how we interpret pain. Suffering is an individual, subjective experience.
- Why is it so important to understand suffering? It really depends on your religious understanding of the world because that gives specific meaning to how you interpret life and death.
- For everyone regardless of religious belief or lack thereof: suffering is obviously still important because, well, it’s just horrible. Human beings cannot exist outside of the suffering experience. If we evolved, we evolved through the milieu of suffering. We came to understand humanity through each other’s experiences of suffering. This is how, through suffering, we come to realize that we are, down to our bones, dependent creatures, who fundamentally require help from other people. By experiencing our own suffering and seeing the suffering of others, we realize that we’re not the autonomous agents that we sometimes feel we are promised to be. Especially in Western culture, we believe that we can do whatever we want whenever we want and that we truly may never die. Suffering reminds us that we need someone to help us. We forget that fact during the times when things are going well. We will all experience a time during which we will not be able to survive without the help of others. We cannot do whatever we want because we are bounded by suffering.
- For the Christian: We believe that the Christian life is an ethical life. Ethics are everyday: what am I going to do, how am I going to live my life, am I going to go to my job, am I going to answer the phone when that person I kind of know is wanting to talk, when someone on the bus looks sad, etc? As Christians, God calls us to act. It’s in the Bible (tend to the widows and orphans). As Christians, other people have claims on us. We cannot do whatever we want whenever we want because we are called by God to reach out and tend to those who are suffering. Our lives are not our own. We are fundamentally, inextricably bound by God to serve those who are hurting. Living in that understanding has to potential to revolutionize our lives.
- Lament: Romans 8:18-26
- Theology of Lament (groaning): the idea of lamenting is a very biblical concept, but Christians have become truly terrible at lamenting and recognizing the lamenting of others. When we encounter suffering, we become disoriented because we recognize that something in the world is not right. To lament in a healthy way, we need to understand both the intellectual and the existential sides of suffering.
- How do we intellectually understand suffering as Christians? God created everything, and it was good – nothing was broken. Then the Fall happened, and human beings chose to go their own way, thus breaking the world. But because God is a loving god, he redeems that which is broken by sending his son, Jesus, to live a perfect life and die for our sins, thus bringing reconciliation between God and man. We live in a time of suffering – the already but not yet – where suffering still exists, but we know that it will not last forever.
- Groaning: We groan within ourselves because of our own experiences, then we look at the world and groan because of the suffering we see in it, and God himself sees the suffering of all things, and he groans. Suffering is inescapable for all of creation, and we groan.
- What is “lament”? 1/3-1/2 of the Psalms are songs of lament. There is a whole book in the Old Testament called “Lamentations.” Jesus himself laments in the gospels. “Lament” is not despair. It is not grumbling or complaining. It is not self-pity. Lament is seeing the world as it currently is, in the already but not yet, seeing the pain and hurt in the world, and crying out loud to God, “this is not right. I don’t like it. Fix it, and make it go away.” It’s living with your eyes wide open. It’s a Christian practice, and we need to get back into the habit.
- Cry out, “how long, O Lord, until the suffering is gone?” We have seen a glimpse of life without suffering that God gives us, and we mourn that it hasn’t arrived yet.
- How do these ideas of suffering and lament play out in the medical world? At its foundation, medicine is coming alongside those who are suffering and helping them. There are a lot of professions in which we’re exposed to suffering, but there are two that seem likely to have the most exposure to suffering: the military and medicine. For those who practice medicine, they have a beautiful opportunity to be an agent and a force for healing. Practitioners of medicine are in a perfect place to speak comfort into all three of the places we feel injury: relationship, role, and narrative. They are available and there to let those who are suffering know that there is someone who cares about them deeply.
- Liminality: Liminality is the idea that a culture has a way of mythologizing life, but when that culture is exposed to technology and the enlightened thought of modernity, etc., it creates a tension between the old ways and the new ways. It’s when two radically differing worldviews whack up against each other and cause distress. Suffering drags us into that liminal space where those who are of a modern mind or have rejected God say, “that feels unjust, and why do I feel this way? Maybe there’s meaning in the world after all.” And when Believers encounter suffering, they stop and say, “maybe I was wrong, maybe there isn’t a good God because of the suffering I see in the world.” And just like that both sides are brought into this liminal space, this tension and anxiety. This feeling, on both sides, demands an answer. God answers that feeling with Jesus’ death on the Cross – it’s hope in the resurrection of God. It’s hope that there’s direction and meaning in all of this suffering.
- Is life with suffering worth living? If we think that life is only worth living if it is without suffering, then we are never going to be able to come along side of people who actually are suffering. Suffering is not a shameful thing. All life involves suffering. When someone dies at what we have deemed an early age (anywhere from infancy to even 70 years old), we often mourn the loss of potential, the loss of a longer life. We say, “how tragic that they died so soon.” But in reality, the very idea that someone could make it to even 60 years of age is relatively new. 500 years ago, the average life expectancy was 25 years at most. 50 years used to be a miraculous gift of God. But now we live with the expectation of living at least 80 years of life disease-free. We are not owed 85 years of health and happiness. We need to reorient ourselves to see the life of even an infant who dies hours after birth as a life worth celebrating, and we should thank God for that life. All life displays God’s glory, not just a life free of suffering. The blind man has no less a God-glorifying life than the sighted person. The old person who dies in their sleep peacefully is not the “appropriate” life lived. To ask for a life without suffering is to ask for wings because we are bound by bodies in time.
- How do we come alongside each other in suffering and lament well? We don’t want to pretend that suffering doesn’t exist by ignoring it or not acknowledging it, but we also don’t want to become a Pollyanna about it and just say, “all is well.” The only thing you can do with suffering is to suffer. Most of the time, there isn’t a way to fix the problem, so we need to learn to lament. Lament the existence of the suffering, in the existence of the problem that cannot be fixed. God is the perfect example of this. He got up and through Jesus, got close to us. We need to figure out how to do this well. Come close to the sufferers in their suffering.
Quotes on Suffering/Lament
- “I must add, too, that the only purpose of the book [The Problem of Pain] is to solve the intellectual problem raised by suffering. For the far higher task of teaching fortitude and patience, I was never full enough to suppose myself qualified nor have anything to offer my readers except my conviction that when pain is to be borne, a little courage helps more than much knowledge, a little human sympathy than much courage, and the least tincture of the love of God more than all.” – C. S. Lewis in The Problem of Pain.
- “Nothing really terrible occurs, but the taste of the whole thing is deadly. So with this, I see the rowan berries reddening, and I don’t know for a moment why they, of all things, should be depressing. I hear a clock strike and some quality it always had before has gone out of the sound. What’s wrong with the world to make it so flat, shabby, and worn out looking?” C. S. Lewis in A Grief Observed [On life after his wife had passed away]
- “Those who lament well are mourners who have caught a glimpse of God’s new day, and are not okay with it not yet coming.” – Nicholas Wolterstorff in Lament for a Son
- “Please don’t say, ‘it’s not so bad.’ Because it is. Death is awful, demonic. If you think your task as comforter is to tell me that ‘really, all things considered, it’s not so bad,’ you do not sit with me in my grief, but place yourself far off in the distance away from me. Over there, you are no help. What I need to hear from you is that you recognize how painful it is. I need to hear from you that you are with me in my desperation. To comfort me you, you have to come close. Come sit beside me on my morning bench.” – Nicholas Wolterstorff in Lament for a Son
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