Introduction.
Everyone, whether or not he is a Christian, must expect a certain amount of sickness and discomfort to enter his life. Physical pain is universal; no one escapes it. Therefore, how much we suffer from illness, or how intensely, does not matter so much as how we understand these infirmities. The understanding is all.
If a man supposes that life should be one long, luxurious "vacation," then any amount of suffering that comes to him is unbearable. But if a man views life as a time of sorrows, correction, and purification, then suffering and pain become not only bearable, but even useful.
Saint Ambrose of Milan says of the Christian attitude toward sickness: "If the occasion demands it, a wise man will readily accept bodily infirmity and even offer his whole body up to death for the sake of Christ... This same man is not affected in spirit or broken with bodily pain if his health fails him. He is consoled by his struggle for perfection in the virtues" (Exegetical Works). Hearing this, the man of the world is quite likely to exclaim: "What an idea! How can a man 'readily accept' illness and disease?"
To an unbeliever this is indeed an incomprehensible thing. He cannot reconcile the fact of human suffering with his own idea of God. To him, the very thought that God would allow pain is repugnant; usually he sees every kind of suffering as evil in an absolute sense.
Without the aid of Divine Revelation man cannot understand the origin and cause of pain, nor its purpose. Many people, not having help in understanding, are haunted by fear of pain, terrified at the thought of a lingering illness, and quick to seek medical relief because they believe illness is only the result of "chance."
If it is true that infirmity comes through mere "bad luck" (which even common sense tells us is not so, since much disease is the result of immoderate living), then indeed it is permissible and even desirable to use all means to avoid the pain of illness and even the illness itself. Furthermore, when a disease becomes irreversible and terminal, worldly wisdom teaches that it is acceptable to end the life of the patient—what is called euthanasia, or "mercy killing"—since, according to this view deathbed suffering is useless and cruel, and therefore "evil."
But even in everyday life we know that suffering really isn't "absolutely evil." For example, we submit to the surgeon's knife in order to have a diseased part of the body cut away; the pain of the operation is great, but we know that it is necessary in order to preserve health or even life. Thus, even on a strictly materialistic level, pain can serve a higher good.
Another reason why human suffering is a mystery to an unbeliever is because his very "idea" of God is false. He is shocked when the Holy Fathers speak of God in the following way: "Whether God brings upon us a famine, or a war, or any calamity whatsoever, He does so out of His exceeding great care and kindness" (St. John Chrysostom, Homily 7, On the Statues).
The God-bearing Elder Macarius of Optina, in 19th-century Russia, wrote thusly to a friend: "Being weak in health as you yourself are, I cannot fail to feel much sympathy for your plight. But kind Providence is not only more wise than we are; It is also wise in a different way. It is this thought which must sustain us in all our trials, for it is consoling, as no other thought is."
Wise in a different way... Here we can begin to see that the Patristic understanding of God's ways is contrary to the world's view. In fact, it is unique: it is not speculative, scholarly, or "academic." As Bishop Theophan the Recluse has written: "Christian faith is not a doctrinal system but a way of restoration for fallen man." Therefore, the criterion of faith—true knowledge of God—is not intellectual. The measure of truth, as Professor Andreyev wrote, "is life itself ...Christ spoke of this clearly, plainly, and definitely: I am the Way, the Truth, and the Life (John 14:6). That is, I am the Way of perceiving the Truth; I am Myself the incarnate Truth (everything I say is true)...and I am Life (without Me there cannot be life)" (Orthodox Christian Apologetics). This is very far from the wisdom of this world.
We can either believe or disbelieve Christ's words about Himself. If we believe, and act upon our belief, then we can begin to ascend the ladder of living knowledge, such as no textbook or philosopher can ever give: Where is the wise? Where is the scribe? Where is the disputer of this world? Hath not God made foolish the wisdom of this world? (I Cor. 1:20)
One of the difficulties in compiling a handbook of Patristic teaching on illness is that sickness cannot be strictly separated from the general question of pain (e.g., psychological pain and the suffering which results from war, famine, etc.). Some of what the Holy Fathers have to say here about illness also establishes a foundation for their teaching about adversity, which will be the subject of the fourth book in this series.
Another difficulty is that the Orthodox Fathers sometimes use such words as "sin," "punishment," and "reward" without limiting themselves to the meanings our modern society gives them. For instance, "sin" is a transgression of the Divine Law. But in Patristic thought it is also more than this: it is an act of "treachery," a faithlessness to God's love for man and an "arbitrary violation of [man's] sacred union with God" (Andreyev, Ibid.). Sin is not something we should see within a strict legal framework of "crime and punishment"; man's faithlessness is a universal condition, not limited to just this or that transgression. It is always with us, for all have sinned, and come short of the glory of God (Rom. 3:23).
God's dealings with man are not limited to our legalistic ideas about reward and punishment. Salvation, which is the ultimate goal of Christian life, is not a "reward," but a gift freely given by God. We cannot "earn" or "merit" it by anything we do, no matter how pious or self-effacing we think ourselves.
In everyday life we naturally think that good deeds should be rewarded and crimes punished. But our God does not "punish" on the basis of human standards. He corrects and chastises us, just as a loving father corrects his erring children in order to show them the way. But this is not the same thing as being "sentenced" to a "term" of pain and suffering for some misdeed. Our God is not vindictive; He is at all times perfectly loving, and His justice has nothing to do with human legal standards.
He knows that we cannot come to Him without purity of heart, and He also knows that we cannot acquire this purity unless we are free from all things: free of attachments to money and property, free of passion and sin, and even detached from bodily health if that stands between us and true freedom before God. He instructs us, through both Revelation and correction, showing us how we may acquire this freedom, for Ye shall know the truth, and the truth shall make you free (John 8:32). As St. John Cassian teaches:
God "leads you on by a still higher step to that love which is free of fear. Through this you begin effortlessly and naturally to observe all those things you originally observed out of fear of God and punishment, but now you do them no longer from fear of punishment, but from love of Goodness itself, and delight in virtue" (Institutes).
Keeping in mind this deeper spiritual meaning of such words as "sin," "reward," and "punishment," we can proceed to study the divinely-wise discourses of the Holy Fathers on the subject of illness, thanking God that "our Faith has been made secure by wise and learned Saints" (St. Cosmas Aitolas), for "truly, to know oneself is the hardest thing of all," as St. Basil the Great writes. The Holy Fathers point the way. Their lives and writings act, as it were, like a mirror in which we may take the measure of ourselves, weighed down as we are by passions and infirmities. Illness is one of the ways by which we can learn what we really are.
1. The Origin and Cause of Pain.
For we know that all creation groans and travails in pain until now. (Rom. 8:22)
"The way of salvation which leads to eternal life is narrow and hard (Matt. 7:14). It is appointed both by our Lord's holy example and by His holy teaching. The Lord foretold to His disciples and followers that in the world, that is, during their earthly life, they would have tribulation (John 16:33; 15:18; 16:2-3)... From this it is clear that sorrow and suffering are appointed by the Lord Himself for His true slaves and servants during their life on earth" (Bishop Ignatius Brianchaninov, The Arena).
But why is this? Why are "sorrow and suffering," together with attendant ills, actually "appointed" for together with attendant ills, actually "appointed" for us? The teaching of the Holy Fathers shows how suffering is to be understood in the context of man's first-created state and his subsequent fall into sin.
In the beginning, there was no pain, no suffering, no illness or death. Man was a "stranger to sin, sorrows, cares, and difficult necessities" (St. Symeon the New Theologian, Homily 45).
If Adam and Eve had not transgressed, "they would in time have ascended into the most perfect glory and, being changed, would have drawn near to God... and the joy and rejoicing with which we then would have been filled by fellowship one with the other would, in truth, have been unutterable and beyond human thought" (Ibid.). Since there would have been no suffering, there would have been no illness, and consequently no need for the science of medicine.
"But when man had been deceived and beguiled by the wicked demon...God came to man as a physician comes to a sick man" (St. John Chrysostom, Homily 7, On the Statues). God descended to Eden in the cool of the day, and called out, Adam, where art thou? (Gen. 3:9). His first manifestation to man after the sin of disobedience was not as a vengeful Judge, "for God, when He finds a sinner, considers not how He may make him pay the penalty, but how He may amend him and make him better" (St. John Chrysos-tom, Ibid.).
Man, the creature, had succumbed to the temptation to be like unto God the Creator—something against all reason or possibility. This, the first sin, brought with it not "godhood," but pain, disease, and death—and not by "chance," but for a specific corrective reason: in order that man might know without doubt and for all time that he is not "as God."
Therefore the Heavenly Physician "made the body [of man] subject to much suffering and disease, so that man might learn from his very nature than he must never again entertain the thought" that he could be like unto God (St. John Chrysostom, Homily 11, On the Statues). God said to Eve: in sorrow thou shalt bring forth children (Gen. 3:16); and to Adam: Cursed is the earth in thy word; with labor and toil shalt thou eat thereof all the days of thy life. In the sweat of thy brow shalt thou eat bread until thou return to the earth (Gen. 3:17, 19).
It is extremely important to understand this at the outset, for if we do not grasp this truth about the nature of fallen man, nothing else the Holy Fathers teach on this subject will have any meaning. On the other hand, "if we can understand this, we will be able to learn about ourselves and we shall be able to know God and worship Him as Creator" (St. Basil the Great, Hexaemeron). "Sin breeds evil, and evil breeds suffering," writes Professor Andreyev; "yet this very suffering, which originated with Adam and Eve, is a blessing for us all because it forces us to realize how harmful to our souls, and even to our bodies, our faithlessness to God is" (Orthodox Christian Apologetics).
2. The Purpose of Illness.
But if we are sons, we are heirs also: heirs indeed of God and joint heirs with Christ, provided, however, we suffer with Him that we may also be glorified with Him (Rom. 8:17).
Our Saviour and the God-bearing Fathers teach that our only concern in this life should be the salvation of our souls. Bishop Ignatius says: "Earthly life—this brief period—is given to man by the mercy of the Creator in order that man may use it for his salvation, that is, for the restoration of himself from death to life" (The Arena). Therefore, we must "look upon everything in this world as upon a fleeting shadow and cling with our heart to nothing of it...for we look not at the things which are seen, but at the things which are not seen; for the things which are seen are temporal, but the things which are not seen are eternal" (St. John of Kronstadt, Spiritual Counsels). For Orthodox Christians, the center of our life is not here, but there, in the eternal world.
How long we live, what disease or illness accompanies our death—such things are not the proper concern of Orthodox Christians. Although we sing "many years" for one another at Namesdays and other celebrations, this is only because the Church in her wisdom knows that we indeed need "many years" to repent of our sins and be converted, not because a long life has any value in itself. God is not interested in how old we are when we come before His Judgment, but whether we have repented; He is not concerned about whether we died of a heart attack or cancer, but whether our soul is in a state of health.
Therefore, "we should not dread any human ill, save sin alone; neither poverty, nor disease, nor insult, nor malicious treatment, nor humiliation, nor death" (St. John Chrysostom, On the Statues), for these "ills" are only words; they have no reality for those who are living for the Kingdom of Heaven. The only real "calamity" in this life is offending God. If we have this basic understanding of the purpose of life, then the spiritual meaning of bodily infirmity can be opened for us.
In the preceding chapter we learned how the all-wise God allowed suffering to enter the world in order to show us that we are but creatures. It is a lesson still not learned by the race of Adam which, in its pride, ever seeks to be like "gods": for every sin is a renewal of the sin of the first-created ones, a willful turning away from God towards self. In this way we set ourselves in the place of God, actually worshipping self instead of the Creator. In this way the suffering of illness serves the same purpose today as it did in the beginning: for this reason it is a sign of God's mercy and love. As the Holy Fathers say to those who are ill: "God has not forgotten you; He cares for you" (Sts. Barsanuphius and John, Philokalia).
Yet, it is difficult to see how sickness can be a sign of God's care for us—unless, that is, we understand the relationship that exists between body and soul. Elder Ambrose of Optina Monastery spoke of this in a letter to the mother of a very sick child:
"We should not forget that in our age of 'sophistication' even little children are spiritually harmed by what they see and hear. As a result, purification is required, and this is only accomplished through bodily suffering... You must understand that Paradisal bliss is granted to no one without suffering."
St. Nicodemos of the Holy Mountain explained that since man is dual, made up of body and soul, "there is an interaction between the soul and the body" (Counsels), each one acting on the other and actually communicating with the other. "When the soul is diseased we usually feel no pain," St. John Chrysostom says. "But if the body suffers only a little, we make every effort to be free of the illness and its pain. Therefore, God corrects the body for the sins of the soul, so that by chastising the body, the soul might also receive some healing... Christ did this with the Paralytic when He said: Behold, thou art made whole; sin no more, lest a worse thing come unto thee. What do we learn from this? That the Paralytic's disease had been produced by his sins" (Homily 38, On the Gospel of St. John).
On one occasion a woman was brought to St. Seraphim of Sarov. She was badly crippled and could not walk because her knees were bent up to her chest. "She told the Elder that she had been born in the Orthodox Church but, after marrying a dissenter, had abandoned Orthodoxy and, for her infidelity, God had suddenly punished her... She could not move a hand or foot. St. Seraphim asked the sick woman whether she now believed in her Mother, our Holy Orthodox Church. On receiving a reply in the affirmative, he told her to make the sign of the Cross in the proper way. She said that she could not even lift a hand. But when the Saint prayed and anointed her hands and breast with oil from the icon-lamp, her malady left her instantly." Behold, thou art made whole; sin no more, lest a worse thing come unto thee!
This connection between body and soul, sin and sickness, is clear: pain tells us that something has gone wrong with the soul, that not only is the body diseased, but the soul as well. And this is precisely how the soul communicates its ills to the body, awakening a man to self-knowledge and a wish to turn to God. We see this over and over in the lives of the saints, for illness also teaches that our "true self, that which is principally man, is not the visible body but the invisible soul, the 'inner man'" (St. Nicodemos of the Holy Mountain, Christian Morality).
But does this mean that the man who enjoys continual good health is in "good shape" spiritually? Not at all, for suffering takes many forms, whether in the body or in the mind and soul. How many in excellent health lament that life is not "worth living"? St. John Chrysostom describes this kind of suffering:
"Some think that to enjoy good health is a source of pleasure. But it is not so. For many who have good health have a thousand times wished themselves dead, not being able to bear the insults inflicted upon them... For although we were to become kings and live royally, we should find ourselves compassed about with many troubles and sadnesses... By necessity kings have as many sadnesses as there are waves on the ocean. So, if monarchy is unable to make a life free from grief, then what else could possibly achieve this? Nothing, indeed, in this life" (Homily I8, On the Statues).
Protestants often "claim" health in the "Name of Christ." They regard health as something to which the Christian is naturally entitled. From their point of view, illness betrays a lack of faith. This is the exact opposite of the Orthodox teaching as illustrated by the life of the Righteous Job in the Old Testament. St. John Chrysostom says that the saints serve God not because they expect any kind of reward, either spiritual or material, but simply because they love Him: "for the saints know that the greatest reward of all is to be able to love and serve God." Thus, "God, wishing to show that it was not for reward that His saints serve Him, stripped Job of all his wealth, gave him over to poverty, and permitted him to fall into terrible diseases." And Job, who was not living for any reward in this life, still remained faithful to God (Homily I, On the Statues).
Just as healthy people are not without sin, so too, God sometimes allows truly righteous ones to suffer, "as a model for the weak" (St. Basil the Great, The Long Rules). For, as St. John Cassian teaches, "a man is more thoroughly instructed and formed by the example of another" (Institutes).
This we see in the Scriptural case of Lazarus. "Although he suffered from painful wounds, he never once murmured against the Rich Man nor made any request of him... As a result, he found rest in the Bosom of Abraham, as one who had accepted humbly the misfortunes of life" (St. Basil the Great, The Long Rules).
The Church Fathers also teach that illness is a way by which Christians may imitate the suffering of the martyrs. Thus, in the lives of very many saints, intense bodily suffering was visited upon them at the end, so that by their righteous suffering they might attain to physical martyrdom. A good example of this may be found in the life of that great champion of Orthodoxy, St. Mark of Ephesus:
"He was sick fourteen days, and the disease itself, as he himself said, had upon him the same effect as those iron instruments of torture applied by executioners to the holy martyrs, and which as it were girdled his ribs and internal organs, pressed upon them and remained attached in such a state and caused absolutely unbearable pain; so that it happened that what men could not do with his sacred martyr's body was fulfilled by disease, according to the unutterable judgment of Providence, in order that this Confessor of Truth and Martyr and Conqueror of all possible sufferings and Victor should appear before God after going through every misery, and that even to his last breath, as gold tried in the furnace, and in order that thanks to this he might receive yet greater honor and rewards eternally from the Just Judge" (The Orthodox Word, vol. 3, no. 3).
You who believe when you are well, see to it that you do not fall away from God in the time of misfortune.—St. John of Kronstadt.
3. Illness and prayer.
Our Saviour has taught us: Ask and it shall be given you; seek and ye shall find; knock, and it shall be opened unto you. For everyone that asketh, receiveth (Matt. 7:7-8).
Therefore, when we are in pain we must pray for understanding of our malady, patience to bear it, and deliverance from it, if such be God's holy will. We are also expected to ask for the prayers of others and especially of the Church, for the effective fervent prayer of a righteous man availeth much (James 5:16).
"Anyone who is sick should seek the prayer of others, that they may be restored to health; that through the intercession of others the enfeebled form of the body and the wavering footsteps of our deeds may be restored to health... Learn, you who are sick, to gain health through prayer. Seek the prayer of others, call upon the Church to pray for you, and God, in His regard for the Church, will give what He might refuse to you" (St. Ambrose, On the Healing of the Paralytic).
The great public prayer of the Church for those who are ill is the Service of Holy Unction. This Service, which is long and exceedingly rich in readings from Scripture, and contains numerous allusions to biblical figures who were healed by the power of God, gives, in concentrated form, the Church's teaching about healing.
This Service identifies Christ as the "Physician and Helper of the suffering," and invokes upon the sick person, through anointing, the grace of the Holy Spirit, Who heals both souls and bodies. Since God "mercifully gave us command to perform Holy Unction upon Thy sick servants," Christ Himself is spoken of as the "incorruptible chrism" Who in old times had chosen the olive-branch to show Noah that the Flood had abated. (From ancient times olive oil was used in the making of Holy Oil.) At the time of the Flood, the olive-branch symbolized tranquility and safety; so now the priest prays that the Saviour will, through the "tranquility of Thy mercy's seal [the anointing with oil]," heal the sufferer.
Acknowledging that illness sometimes comes through the activity of demonic powers, the priest asks: "Let no interposition of malignant demons touch the senses of him who is marked with Thy divine anointing." Showing that the Church also understands the connection between sin and suffering, the priest prays that through this anointing the "suffering of him who is tormented by the violence of passions" may be washed away.
This healing service explores many aspects of sin, suffering and healing; it is a profound and very exalted service of prayer and intercession. One very important point should be made here: During Holy Unction we beg God to remove the sickness—but, in place of illness, we ask Him to give "the joy of gladness" (anointing itself is spoken of as the oil of gladness in the Psalms), so that the formerly sick person might now "glorify Thy divine might." Therefore, one of the purposes of healing is to enable the sufferer to resume his healthy and active service to God. In token of this, the Saviour's healing of Peter's mother-in-law is spoken of: whereupon the fever left her, and she arose and ministered unto them. This is very important for us to remember: When we are set free from the torment of bodily sickness, we are expected to fill our mouths with praise of God and serve Him by amending our sinful ways and living from henceforth only for God and the world to come, counting this world as nothing.
Many do not discover prayer until they are on a sickbed. And those who have all of their lives piously participated in the public prayer of the Church, discover during illness that they have sadly neglected the treasures of private or interior prayer. St. Gregory Nazianzen, a great man of prayer even when his health was good, exclaimed during his last illness: "The time is swift, the struggle is great, and my sickness severe, reducing me nearly to immovability. What then is left but to pray to God?" (Letters).
During illness, prayer is capable of revealing true and lasting treasures, "for if you have bodily strength, the inroads of disease stop any joy you may have had from that source... because anything that belongs to this world is liable to damage and is unable to give us a lasting pleasure. But piety and the virtues of the soul are just the opposite because their joy abides forever....If you pour out continued and fervent prayers, no man can spoil you of their fruit, for this fruit is rooted in the heavens and protected from all destruction because it is beyond mortal reach" (St. John Chrysostom, On the Statues).
Two incidents from the lives of the saints show how simple yet incorruptible this prayer can be. In the life of Elder Hieroschemamonk Parthenius of the Kiev Caves Lavra we learn that in his final illness, even after he had been given Holy Unction, he continued to perform his daily prayer rule of reading the entire Psalter. The day before his repose he said to his spiritual children:
"Soon, soon I shall leave. Yesterday I already could not complete my Psalter—only half of it."
"Is it possible, Father, that until yesterday you read all of your customary rule?"
"Yes, the Lord helped me; after all, I now do it by memory; I cannot do it with my lips; there is nothing to breathe with; but yesterday I could not complete it even by memory, for my memory is leaving me. Only to the Jesus Prayer and to the praises of the Mother of God do I cling unceasingly" (Orthodox Life, no. 3, 1969).
And in the life of St. Abba Dorotheus we read about the touching death of his disciple, St. Dositheus, who had been in the monastery only five years, but "died in obedience, at no time and in nothing having done his own will and having done nothing out of attachment." He had always practiced the Jesus Prayer, and when his illness became severe, St. Abba Dorotheus said to him:
"Dositheus, take care over the Prayer; see that you be not deprived of it."
"Very well, Father," replied the monk, "only pray for me."
When he had become still worse, St. Abba Dorotheus said to him:
"Well, Dositheus, how is the Prayer? Does it continue as before?"
He answered him: "Yes, Father, by your prayers."
When, however, it became extremely difficult for him and the illness became so severe that he had to be carried on a stretcher, Abba Dorodieus asked him:
"How is the Prayer, Dositheus?"
He answered: "Forgive me, Father, I cannot keep it up any longer." Then Abba Dorotheus said to him:
"And so leave the Prayer, only keep God in mind and represent Him to yourself as if He were before you" (The Orthodox Word, vol. 5, no. 3).
Finally, we see a glorious and inspiring example of the place of prayer in times of illness in St. Gregory Nazianzen's account of his own father's illness:
"He suffered from sickness and bodily pain. The time of my father's sufferings was the season of the holy and illustrious Pascha, the Queen of Days, the brilliant night which dissipates the darkness of sin. Of what kind his sufferings were, I will briefly explain: his whole body was on fire with a great and burning fever; his strength failed him, he could take no food, his sleep had departed from him, and he was in the greatest distress. His whole mouth was so ulcerated that it was difficult and even dangerous to swallow even water. The skill of physicians, the prayers of his friends, earnest though they were, and every possible attention, were alike of no avail. In this desperate state his breathing was short and fast and he had no perception of present things.
"The time of Divine Liturgy was come, when all due order and silence is kept for the solemn rites. At this moment my father was raised up by Him Who quickens the dead. At first he moved slightly, and then more decidedly. Then, in a feeble and indistinct voice, he called a servant by name to bring his clothes and support him with his hand. The servant came in alarm and gladly waited upon him while he, leaning upon the servant as upon a staff, imitated Moses on the mountain and arranged his feeble hands in prayer...
"He retired again to his bed and, after taking a little food and sleep, his health slowly recovered so that on the first Sunday after the Fest of Pascha he was able to enter the church and offer thanksgiving...
"During this sickness he was at no time free of pain. His only relief was Divine Liturgy, to which his pain yielded, as if to an edict of banishment" (On the Death of His Father).
The acknowledgment of oneself as deserving temporal and eternal punishment precedes the knowledge of the Saviour and leads to knowledge of the Saviour.
—Bishop Ignatius Brianchaninov.
4. The Christian view of medicine.
When St. Basil the Great was asked if going to a doctor and taking medicine were in keeping with ways of piety, he replied:
Every art is God's gift to us, making up for what is lacking in nature... After we were told to return to the earth from which we had come [at the time of the Fall], and were joined to a pain-ridden flesh that is destined to die, and made subject to disease because of sin, the science of medicine was given to us by God in order to relieve sickness, if only to a small degree (The Long Rules).
Therefore we may have recourse to physicians and take medicine, for this science is a gift from God. "God has given the herbs of the earth, and its drugs, for the healing of the body, commanding that the body, which is of the earth, should be cured by various things of the earth....When man fell from Paradise, he came immediately under the influence of disorders and maladies of the flesh....God therefore gave medicine to the world for comfort, for healing and care of the body, and permitted them to be used by those who could not entrust themselves completely to God (St. Macarius the Great, Homily 48).
When to go to the doctor, and how often, should be a matter of common sense. But when we go, we should "not forget that no one can be cured without God. He who gives himself up to the art of healing must also surrender himself to God, and God will send help. The art of healing is not an obstacle to piety, but you must practice it with fear of God" (Sts. Barsanuphius and John, Philokalia).
To put our hope in the hands of a physician is the act of an irrational animal. Yet this is precisely what happens with those unhappy people who unhesitatingly call their doctors their 'saviours'....On the other hand, it is surely foolish to entirely reject the benefits of the medical art" (St. Basil the Great, The Long Rules).
Elder Nektary of Optina advised that we should go to doctors not to be "cured" but just to be "treated"—recognizing that in this life we can never be perfectly "cured" or "healthy." And writing to the friend of a seriously ill man, Elder Macarius of Optina said:
"Give him [the patient] my warmest greetings and best wishes for a speedy recovery. Tell him too, that even if his hope and faith are strong, he should not despise the help of a physician. God is the Creator of all men and all things: not of the patient only, but also of the physician, the physician's wisdom, medicinal plants, and their curative power."
St. Basil the Great teaches that "we should definitely not place our hope for relief from pain in medicine, but trust that God will not allow us to be tried beyond that which we can bear." Here he was addressing himself to those who run to a doctor on every pretext, and who forget this important guideline: "Whether or not we make use of the medical art, we should hold to our objective of pleasing God and helping the soul, fulfilling this precept. Whether you eat or drink or whatsoever else you do, do all to the glory of God (cf. 1 Cor. 10:31)..."
This Holy Father also explains that "sometimes, when God judges it best, He cures us secretly, without visible means [such as a doctor and drugs]. At other times He wants us to use medicine for our sicknesses."
Therefore, "when we suffer the blows of illness at the hands of God, we should first ask understanding of Him, so that we might know why He has inflicted this blow. Secondly, we must ask Him to deliver us from our pains or, at least, give us the patience to endure them." Having this attitude, we can in good conscience seek medical treatment.
However, for those whose trust in God is very deep and strong, there is a higher calling: for those souls, realizing their sins and what is the purpose of life, "bear all of the afflictions which are sent in silence and, if possible, without recourse to medicine, in keeping with these words: I will bear the wrath of the Lord because I have sinned against Him (Micah 7:9)" (St. Basil the Great, The Long Rules).
This way of complete abandonment to God's Providence is very high and very difficult, and it is not given to all men. But we need to at least know about it so that we can avoid self-satisfaction and "contentment" with our own attitudes. We see this way of abandonment and supreme confidence in the will of God in the lives particularly of monastic saints. The following incident from the life of Elder Macarius of White Shores Hermitage shows how the righteous monk disdained earthly medicine for a heavenly medicine:
"After twenty-eight years of severe monastic struggles, the untiring Elder's strength began to weaken. At the end of 1839 he had already experienced significant attacks of illness, but he did not complain and did not turn to medical help. When his teeth hurt him, Fr. Macarius had the custom to sit down at the table where there was a basket with remains of bread picked up from dinner. Out of it he took small crusts and ate up the last soft part of it. One time the cellarer compelled him to reveal why he nibbled the crusts. 'The holy fathers,' said Macarius, 'ate these crusts with prayer, and I, a sinner, touching these crusts with my sinful mouth, beseech the Lord that He, by His mercy, heal my suffering teeth, and by the prayers of the holy fathers my teeth become better' " (Orthodox Life, no. 6, 1971).
Such child-like trust in God is common among great souls. A similar simplicity may be seen in the life of Schemamonk Mark of Sarov:
"Towards the end of his life, Elder Mark suffered very much due to his legs—from lengthy standing at prayer and the extremely laborious walks through the wilderness, the Elder's legs became dropsical, swollen, and covered with wounds, so that for a certain time he was unable to walk. Certain of the Sarov brethren, feeling compassion for the Elder in his ailment, advised him to turn to the help of earthly doctors.
"The Elder, however, did not pay attention to this advice and gave himself completely over to the heavenly Healer of souls and bodies. With faith he took some oil from the lamp which burned before the icon of the Most Holy Mother of God of the Life-giving Fount, located in the cathedral of the Sarov Hermitage, and venerated as a miraculous icon, and anointed his ailing legs with this oil. To the general amazement of those who knew of his disease, he was soon completely healed from it through the grace-given help of the Mother of the Lord, who did not put his hope to shame" (Orthodox Life, no. 6, 1970).
Shortly after he went to Sarov Monastery, St. Seraphim of Sarov fell ill. According to his Life, "his whole body became swollen, and he lay motionless in great pain on his hard bed. There was no doctor and the malady responded to no treatment. Apparently it was dropsy. It lasted for three years, and half of that time the sufferer spent in bed. But he never murmured; he had surrendered the whole of himself, body and soul, to the Lord, and he prayed to Him unceasingly. Fearing that the illness might prove fatal, the Superior, Elder Pachomius, firmly proposed to send for a doctor. But the Saint, with even greater firmness, refused medical help.
"'I have surrendered myself, holy father,' he said, 'to the true Physician of souls and bodies, our Lord Jesus Christ and His Immaculate Mother. But if your love sees fit, supply me, for the Lord's sake, with the Heavenly Remedy [Holy Communion]." Shortly after this he was healed by the Mother of God who appeared to him in a vision together with the Apostles Peter and John.
Living only for God and the life which is to come, repenting each day, and striving constantly to acquire the Holy Spirit of God, righteous men and women are able to use their suffering to mount still higher on the ladder of virtue, as did Hieroschema-monk Parthenius of the Kiev Caves:
"A suffocating cough gave him no rest, and all of his bones ached. But he continued to lie down as before on the narrow and harsh bench and with good-hearted patience bore his grave infirmity, giving thanks to God for his illness. Often he used to say: 'What shall I give to the Lord in return for His having sent me an illness, in addition to His other blessings?'" (Orthodox Life, no. 3, 1969).
A sorrowless earthly life is a true sign that the Lord has turned His face from a man, and that he is displeasing to God, even though outwardly he may seem reverent and virtuous.
—Bishop Ignatius Brianchaninov
5. Illness and the work of perfection.
The desert ascetic Father, St. Abba Dorotheus, exhorts his disciples to "take the trouble to find out where you are: whether you have left your own town but remain just outside the gates, by the garbage dump, or whether you have gone ahead little or much, or whether you are half way on your journey, or whether you have gone two miles, then come back two miles, or perhaps even five miles, or whether you have journeyed as far as the Holy City and entered into Jerusalem itself, or whether you have remained outside and are unable to enter" (On Vigilance and Sobriety).
Illness helps us to see "where we are" on life's road: "Sickness is a lesson from God and serves to help us in our progress if we give thanks to Him" (Sts. Barsanuphius and John, Philokalia); "for the one rule we must observe is to bear every stroke of illness thankfully; for these are sent to us because of our sins" (St. John Chrysostom, Homily 38 on St. John).
No one may use illness as an excuse for resting from the labor of spiritual living. "Perhaps some might think that illness and bodily weakness hinder the work of perfection since the works and accomplishments of one's hands cannot continue. But it is not a hindrance" (St. Ambrose, Jacob and the Happy Life).
In the life of Riassophore Monk John, latter-day disciple of St. Nilus of Sora, we see how bodily infirmity is not allowed to interrupt the struggle for salvation. Riassophore-monk John was a cripple; because of this he had been compelled to leave the Monastery of St. Cyril of New Lake. Feeling sorry for himself, he shortly afterwards was standing for an all-night vigil in the deep of winter. "Suddenly he saw an unknown Elder in schema come out of the altar to him and say: 'Well, apparently you do not wish to serve me. If so, return to St. Cyril.
"At these words, the Elder struck him with his right hand quite strongly on the shoulder. Noting that the Elder exactly resembled St. Nilus as he is depicted on the icon over his relics, John was filled with great joy, all his grief disappeared, and he firmly resolved to spend the rest of his life in the Saint's skete" (The Northern Thebaid).
Even if we are bedridden, we are to continue the struggle against the passions, producing fruits worthy of repentance. This work of perfection demands that we acquire patience and longsuffering. What better way to do this than when we lie on a bed of infirmity? St. Tikhon of Zadonsk says that in suffering we can find out whether our faith is living or just "theoretical." The test of true faith is patience in the midst of sufferings, for "patience is the Christian's coat of arms." "What is it to follow Christ?" he asks. It is "to endure all things, looking upon Christ Who suffered. Many wish to be glorified with Christ, but few seek to remain with the suffering Christ. Yet not merely by tribulation, but even in much tribulation does one enter the Kingdom of God."
To those who suppose that they can only progress in the spiritual life when all else is "well," St. John Cassian replies, "You should not think that you can find virtue when you are not irritated—for it is not in your power to prevent troubles from happening. Rather, you should look for patience as the result of your own humility and longsuffering, for patience does depend upon your own will" (Institutes). Towards the end of his life, St. Seraphim of Sarov suffered from open ulcers on his legs. "Yet," as his Life tells us, "in appearance he was always bright and cheerful, for in spirit he felt that heavenly peace and joy which are the riches of the glorious inheritance of the saints."
"You are stricken by this sickness," the Holy Fathers say, "so that you will not depart barren to God. If you can endure, and give thanks to God, this sickness will be accounted to you as a spiritual work" (Sts. Barsanouphius and John, Philokalia). Bishop Theophan the Recluse explains: "Enduring unpleasant things cheerfully, you approach a little to the martyrs. But if you complain, you will not only lose your share with the martyrs, but will be responsible for complaining besides. Therefore, be cheerful!"
In order not to lose heart when we fall sick we are to think about and mentally "kiss the sufferings of our Saviour just as though we were with Him while He suffers abuses, wounds, humiliations... shame, the pain of the nails, the piercing with the lance, the flow of water and blood. From this we will receive consolation in our sickness. Our Lord will not let these efforts go unrewarded " (St. Tikhon of Zadonsk).
The patience we can learn on a sickbed cannot be overemphasized. Elder Macarius of Optina wrote about this to one who was ill:
"I was much pleased to hear from your relation how bravely you are bearing the cruel scourge of your heavy sickness. Verily, as the man of the flesh perishes, so is the spiritual man renewed."
And to another he wrote: "Praised be the Lord that you accept your illness so meekly! The bearing of sickness with patience and gratitude is reckoned highly by Him Who often rewards sufferers with His imperishable gifts.
"Ponder these words: Though our outward man perish, yet the inward man is renewed."
St. Ambrose of Milan compared an infirm body to a broken musical instrument. He explained how the "musician" can still produce God-pleasing "music" without his instrument:
"If a man used to singing to the accompaniment of a harp finds the harp broken, and its strings undone... he puts it aside and instead of calling for its notes he delights himself with his own voice.
"In the same way, a sick man allows the harp of his body to lie unused. He finds delight within his heart and comfort in the knowledge that his conscience is clear. He sustains himself with God's words and the prophetic writings and, holding these sweet and pleasant in his soul, he embraces them with his mind. Nothing can happen to him because God's graceful presence breathes favor upon him... He is filled with spiritual tranquility" (Jacob and the Happy Life).
Quite often the most God-pleasing spiritual "music" of all is produced in anonymity, by unknown or nearly-unknown saints. But such holy "melodies" are all the more sweet because they are heard by God alone. One such modern sufferer who lived an angel-like life in spite of advanced and terrible sickness was the holy New Russian Martyr, Mother Maria of Gatchina. Her story is known to us only because it pleased God to providentially arrange for one of her visitors, Professor I. M. Andreyev, to record his memories of her.
Mother Maria suffered from encephalitis (inflammation of the brain) and Parkinson's disease. "Her whole body became as it were chained and immovable, her face anemic and like a mask; she could speak, but she began to talk with half-closed mouth, through her teeth, pronouncing slowly and in a monotone. She was a total invalid and was in constant need of help and careful looking after. Usually this disease proceeds with sharp psychological changes, as a result of which such patients often ended up in psychiatric hospitals. But Mother Maria, being a total physical invalid, not only did not degenerate psychically, but revealed completely extraordinary features of personality and character not characteristic of such patients: she became extremely meek, humble, submissive, undemanding, concentrated in herself; she became engrossed in constant prayer, bearing her difficult condition without the least murmuring.
"As if as a reward for this humility and patience, the Lord sent her a gift: consolation of the sorrowing. Completely strange and unknown people, finding themselves in sorrows, grief, depression, and despondency, began to visit her and converse with her. And everyone who came to her left consoled, feeling an illumination of their grief, a pacifying of sorrow, a calming of fears, a taking away of depression and despondency" (The Orthodox Word, vol. 13, no. 3).
"Thus God has acted. Like a provident Father and not like a kidnapper has He first involved us in grievous things, giving us over to tribulation as it were to schoolmasters and teachers, so that being chastened and sobered by these things we may, after showing forth all patience and learning, all right discipline, inherit the Kingdom of Heaven" (St. John Chrysostom, Homily 18, On the Statues).
Prayer of our Holy Father St. Ambrose, Bishop of Milan
St. Ambrose attributed this prayer to the Apostle Matthew, upon the occasion of the Apostle's conversion.
Thee alone I follow, Lord Jesus, Who heals my wounds. For what shall separate me from the love of God, which is in Thee! Shall tribulation, or distress, or famine? I am held fast as though by nails, and fettered by the bonds of charity. Remove from me, O Lord Jesus, with Thy potent sword, the corruption of my sins. Secure me in the bonds of Thy love; cut away what is corrupt in me. Come quicldy and make an end of my many, my hidden and secret afflictions. Open the wound lest the evil humour spread. With Thy new washing, cleanse in me all that is stained. Hear me, you earthly men, who in your sins bring forth drunken thoughts: I have found a Physican. He dwells in Heaven and distributes His healing on earth. He alone can heal my pains Who Himself has none. He alone Who knows what is hidden, can take away the grief of my heart, the fear of my soul—Jesus Christ. Christ is grace, Christ is life, Christ is Resurrection! Amen.
