On supporting a friend with cancer

After my own experiences of cancer diagnosis, treatment and remission, I more or less regularly receive requests from people whose friend, family member or colleague has just been diagnosed asking for advice on how they might best care for them. I thought I would post one of my answers (with permission) in case it is of some benefit to others.

Hi friend,

Good to hear from you, though sorry to hear about this news.

I guess the first thing I'd say, which may actually not sound very helpful at all, is that cancers are very different and the experiences of cancer patients even more diverse, so I would be quite hesitant to extrapolate too much from my own story.

Having said that, it is still possible to say a little more. Grief and suffering come in many forms (even in the same person) and bring with them various needs and opportunities. At times, silence is the best support; at others, the chance to talk to a sympathetic ear; at others, a word of comfort; at others, an act of silent service. In general, I guess I'd suggest that responsiveness is therefore key, being willing to play whatever role will be a blessing to those in need. While at times grief needs space, I suspect it rarely needs absence, so as a start, simply indicating your willingness to be there for them and to grieve with them is probably the best bet. If they have practical needs, then offers of help from trusted friends may well be appreciated (babysitting while parents go to some of the endless appointments these things seem to involve? Doing some housework? Frozen meals? The latter can probably be safely brought without being asked, as long as you stick to any known dietary requirements). Some people may find themselves with little energy for daily tasks like these. Others might throw themselves into them as a distraction and comfort.

Depending how wide and deep the pre-existing support networks of this family are, it may be that they are initially swamped with offers of help and sympathy. If you think this might be the case, you (or someone else) could perform the service of coordinating the practical support (putting together rosters for babysitting or frozen meals, etc.).

Don't neglect the partner of the patient, whose grief is double: grief for their partner's sake and for their own (potential) loss. And depending how old the kids are, they may need extra support from trusted family friends.

Again, depending how well you know them, then make your level and form of contact fit the relationship. If you are not close friends, then make contact through forms that can be ignored or noted and replied to later (email, letter, card, SMS). Only call if you know them well, because they might receiving a string of calls and probably don't want to be having the same conversation with dozens of people.

If my experience is anything to go by, they are likely to find themselves the target of more unsolicited advice than at any time outside of pregnancy. Although I know everyone meant well, I'd suggest keeping any crank miracle cures you've heard of or stories of amazing recoveries to yourself. It is actually not very encouraging to be told about someone's aunt who was cured simply by prayer and faith or someone's grandfather who drank only goji berry juice and lived to 100. Such stories are (a) irresponsible (I'm not a big fan of alternative medicine, nor of purely faith-based healing, for both scientific and theological reasons) and (b) sometimes contain an element of accusation in them ("if only you had enough faith, you too would be healed like my cousin").

Many cancer treatments become complex, and there is often a high volume of information to share with those concerned. One suggestion that a friend made to me (more unsolicited advice from a guy I didn't know well at the time, but of all that I received, almost the only piece of pure gold I got) was that it might be a good idea to set up a blog where interested family and friends can self-medicate on as much or as little information as they wish. This means that rather than having the same conversation fifty times after each appointment, I could simply write out a summary once and post it on the blog, then direct people to the blog. Mine is here (only updated very infrequently now).

I would also suggest keeping your theological comments minimal unless they raise it. I was probably unusual in that I'd just written my 4th year paper on suffering and the problem of evil just weeks before being diagnosed and so was (usually) quite happy to discuss theology with anyone who wanted. But not everyone is in that place, and for many, just retreating into survival mode is all they can handle for a while (once treatment started, my willingness to talk dropped rapidly as I just had little energy for anything).

I could write reams about my experiences of treatment, but here, the specifics of the cancer become most stark and what I say may bear little or no relevance to their situation.

They may or may not find it helpful to meet with other cancer patients, though I suspect that such groups will be available through the hospital, so you probably don't need to worry about that.

Finally, I'd suggest taking this tragedy as an opportunity to reflect upon your own mortality. Our society has hidden death and dying as far from view as possible and here is one place that the gospel truly does have good news (though not always easy news). Of all that I read, wrote and heard during the intense few months after diagnosis, the best was undoubtedly this talk by Stanley Hauerwas. It may or may not be appropriate to share with your friends (that is for you to judge), but it is almost certainly worth an hour of your time (if you can get past his braying cackle and Texan twang).

It hardly needs saying, but when words and wisdom falter, groans are also part of a faithful response to serious illness.

Grace & peace,
Byron

PS If you don't mind, I might post my reply (omitting your name and any other identifying details) on my blog since I have been asked this question quite a number of times (not that I mind being asked!) and putting it there will mean I can refer to it in future. Let me know if you'd rather I didn't.

"God is holy; life is not": euthanising greed with Hauerwas

On the irrationality of faith: "I do not use the term 'religion' because religion is the name for opinion that cannot be argued about. And I believe there is nothing more rational than theological claims about the kind of God Christians worship. [...] I think that the Christian tradition and the Jewish tradition [...] are the most intellectually demanding traditions that we continue to inherit and it would be silly to separate a person's strong convictions from how they understand the world."

On euthanasia: "I want to raise questions about the very language of sanctity of life. God is holy, life is not. So the question is how do you receive life as a gift in terms of how we relate to one another over our lives in a way that we do not in the name of compassion do terrible things to one another to relieve what we think is suffering. There are very important distinctions to be made between putting to death and not prolonging death and those kinds of distinctions can be developed in a way that can help us be with those who are dying in a manner that we don't ask them to abandon us because we haven't abandoned them."

On greed: "I think the church has concentrated on lust because we think we know when you get it wrong. It's interesting we seldom say anything about greed because it is not clear what it would look like. Two SUVs? What would greed [look like]? We have trouble naming in what way greed possesses our lives - and I use that language advisedly because I think that greed is a power that possesses your life - because as a matter of fact modern economies depend on us being greedy."

This is an intelligent and interesting conversation on a BBC Radio 4 programme about the place of religion in public discourse, covering euthanasia and dying, greed and consumerism, theocracy and the faith of political leaders, and the sources of morality and virtue. Panelists include: Stanley Hauerwas, Mark Warnock, John Gummer and Raymond Tallis. The discussion contains a typical smattering of Hauerwas quotable quotes, including the ones above. By the way, when Hauerwas says that life is not holy, he is making much the same point as my series on things worse than death. If you've never heard him before, this isn't a bad introduction.
H/T Graham.

New ABC Religion & Ethics portal

Augustine identified a similar pathology at work in the Roman elites, who indulged in various forms of luxury and illicit pleasures to distract them from the inevitability of death. He argued that the fear of death - the fear, in other words, that their lives would not be remembered - meant the Roman elites lived in fear of the loss of status and comfort. They were greedy for glory hoping by glory their lives might have significance.

- Stanley Hauerwas, "Can greed be a good?"

The Australian Broadcast Corporation has recently launched a new web portal for religion and ethics. It opens with pieces from Rowan Williams on refugees, Stanley Hauerwas on greed, Paul Griffiths on death and dying and much more. Keep an eye on it.

Life choices and regret

“Long story short: we don’t get to make our lives up. We get to receive our lives as gifts. The story that says we should have no story except the story we chose [...] is a lie. To be human is to learn that we don’t get to make up our lives because we’re creatures [...]. Christian discipleship is about learning to receive our lives as gifts without regret.”

- Stanley Hauerwas.

Hauerwas is not saying that choices are irrelevant, simply that they are secondary to living well. More important than choosing is receiving with thanksgiving. This is a very countercultural claim in contemporary liberal democracies, where everything is geared towards the assumption that only things we have chosen are valid and that we ought to be shielded from anything we haven't selected.

Hauerwas on illness, dying and medical idolatry

Quite some time ago, I included a small link to a talk by Stanley Hauerwas where he addressed themes of illness, dying and western society's often idolatrous attitudes towards the medical industry. The title of the talk was "Theology, Medicine and the Christian Community" and it was delivered on 19th August 2006. This fifty minute talk helped to shape my thinking during the period of my own illness and treatment, and I have recommended it to countless people since then. It was one of the inspirations for my series on things worse than death.

Since I found this talk so illuminating, and since the original no longer seems to be where it once was, I thought I'd link to it again in a new location (approx size: 20MB).

Hauerwas on suffering

"To ask why we suffer makes the questioner appear either terribly foolish or extremely arrogant. It seems foolish to ask, since in fact we do suffer and no sufficient reason can be given to explain that fact. Indeed, if it were explained, suffering would be denied some of its power. The question seems arrogant because it seeks to put us in the position of eating from the tree of the knowledge of good and evil. Only God knows the answer to such questions."

- Stanley Hauerwas, "Should Suffering Be Eliminated?" in The Hauerwas Reader, 565.

Hauerwas goes on to say that it is also a question that can't be avoided and ought to be asked. Yet it seems to me that some accounts of providence may illegitimately remove the sting of this question by attempting to give just such an answer. When a sufferer asks the "why" question and our answer seeks a response along the lines of "Oh, I see now why this and all suffering is justified and necessary", then we have removed all room for the strong scriptural theme (and healthy, indeed necessary, human practice) of lament. If we become so content with the present that we are not groaning for a healed world, then perhaps we have silenced the Spirit who groans with us.

All roads lead to...

...the Rome theology and philosophy conference, The Grandeur of Reason. At least, my road leads there this week. Speakers include Agamben, Hauerwas, Milbank and O'Donovan, as well as Myers, Russell and many more - should be a good week! Blogging will resume upon my return.

UPDATE: Conference programme now available to download [102KB], H/T Ben.

Godparenting and the church family

Today is the first anniversary of my godson's baptism. According to Stanley Hauerwas, godparenting is a formalisation of what ought to be true throughout the church: that raising children is the responsibility of the entire community. The congregation is the child's extended family, and rightly helps shoulder the privilege and burden of guidance, protection, love, rebuke and provision. However, we might, with growing awareness of the prevalence of abuse, be hesitant to affirm this. Yet while protecting the vulnerable ought to be given particular attention, I don't think restricting their care to immediate family is the solution. We need to strengthen the bonds of love and trust, not withdraw from them. This common task must include unmarried people, the infertile and all those without children, both for the sake of the children and for their own sake. There are to be no members of God's family not amply supplied with mothers, brothers, sisters - and children (Mark 10.30). Of course, not every individual will have an equal role in care, and the natural parents will usually take the lion's share. But children, like the rest of us, belong to the whole family. We have ownership of neither our own lives nor those of our children. We are baptised into Christ, and so into one another.
Speaking of that baptism a year ago, I noted at the time that my (lack of) voice was suited to becoming a godfather, the cause of which I discovered the next day. I saw my speech pathologist again today and she said I am her best case of (significant) recovery from vocal chord palsy.

What is forgiveness? I

Once more plundering a recent sermon, I'd like to explore the concept and practice of forgiveness under four contrasted pairs.

(i) Not ignoring, but confronting
To forgive doesn’t mean the problem is swept under the carpet. Jesus said “If a brother or sister sins, go and point out the fault, just between the two of you. If they listen to you, you have won them over.” (Matthew 18.15) Forgiveness doesn’t mean ignoring the problem, hoping it will go away, pretending it is not happening. If we are going to be peacemakers, we’ll need to be loving troublemakers. Jesus doesn’t make this optional. "If you have a grievance you must, you are obligated to, confront the one you believe has sinned against you. You cannot overlook a fault on the presumption that it is better not to disturb the peace. Rather, you must risk stirring the waters, causing disorder, rather than overlook the sin" (Stanley Hauerwas, "Peacemaking: The virtue of the church" in The Hauerwas Reader, 319).

Why? Because there is no such thing as a private grievance. Our lives are not our own. We in the body of Christ belong to one another. The sister or brother who sins is hurting not only us, but also themselves and the community as a whole. Not every minor irritation requires explicit mention, but if it is a genuine wrong (rather than merely a personality difference) ignoring it is a failure of love.

Of course, during the process of confrontation we may well discover that we have been mistaken, that our grievance is not well founded. That is a risk we must take. Or we may find ourselves in even deeper waters - our complaint is accepted and the fault repented of and now we must be reconciled. But that is our goal: to learn to swim in the ocean of genuine relationships of trust, not simply to paddle about in polite acquaintances that never extend beyond Sunday pleasantries. Whom do you need to confront, rather than ignore?
Twelve points for guessing the inner western Sydney suburb in the picture.
Series: I; II; III; IV; V.

Hauerwas on liturgy

"One reason why we Christians argue so much about which hymn to sing, which liturgy to follow, which way to worship is that the commandments teach us to believe that bad liturgy eventually leads to bad ethics. You begin by singing some sappy, sentimental hymn, then you pray some pointless prayer, and the next thing you know you have murdered your best friend."

— Stanley Hauerwas, The Truth About God:
The Ten Commandments in Christian Life, p.89.
H/T Alistair.

The alternative to a liturgical service is not a non-liturgical service. It is a service where the liturgy is entrusted to the whims and idiosyncrasies of the service leader. When done poorly, liturgy from a book can be cold, lifeless and boring. When done poorly, 'non-liturgical' liturgy can be vapid, misleading and deadly.

Psalms and lament

How long, O LORD? Will you forget me forever?
   How long will you hide your face from me?
How long must I bear pain in my soul,
   and have sorrow in my heart all day long?
How long shall my enemy be exalted over me?
   Consider and answer me, O LORD my God!
Give light to my eyes,
   or I will sleep the sleep of death,
and my enemy will say, “I have prevailed”;
   my foes will rejoice because I am shaken.        - Psalm 13.1-4

Our willingness to expose our pain is the means God gives us to help identify and respond to evil and injustice. For creation is not as it ought to be. The lament is a cry of protest schooled by our faith in a God who would have us serve the world by exposing its false comforts and deceptions. From such a perspective one of the profoundest forms of faithlessness is the unwillingness to acknowledge our inexplicable suffering and pain. ... "[Lament] leads us to the dangerous acknowledgement of how life really is. [It leads us] to think unthinkable thoughts and utter unutterable words. Perhaps worst, [the psalms of lament] leads us away from the comfortable religious claims of ‘modernity’ in which everything is managed and controlled. [We believe] that enough power and knowledge can tame the terror and eliminate the darkness. But our honest experience, both personal and public, attests to the resilience of the darkness."

- Stanley Hauerwas, Naming the Silences: God, Medicine,
and the Problem of Suffering (Eerdmans: 1990), 82-83.
Internal quote from Brueggemann.

We have a problem. Too often, we jump forward to the solution in an effort to avoid the full seriousness of our predicament. Too many attempts to discuss suffering end up making light of it, by making it merely a means to a beneficial end: it will teach us perseverence; it will build our community; it will chastise our faults; it will enable us to minister to others who suffer; it will bring glory to God. Any or all of these may be true - or true at least some of the time - yet any attempt to make positive outcomes into the purpose and meaning of all suffering is cruel. And it makes God cruel. There is no need to justify suffering through recourse to a 'greater good' that is served by it. God may bring from it greater - or lesser - goods, but these are not its meaning.

So let us first simply acknowledge that it hurts and is wrong, and let us lament and protest. The God we worship 'is not a God who needs protection from our cries and suffering.' (Hauerwas, 84)

Hauerwas on suffering and evil

For the early Christians, suffering and evil … did not have to be ‘explained’. Rather, what was required was the means to go on even if the evil could not be ‘explained’. Indeed, it was crucial that such suffering or evil not be ‘explained’ – that is, it was important not to provide a theoretical account of why such evil needed to be in order that certain good results occur, since such an explanation would undercut the necessity of the community capable of absorbing the suffering.

- Stanley Hauerwas, Naming the Silences: God, Medicine,
and the Problem of Suffering (Eerdmans: 1990), 49.

That there is no 'explanation' of suffering and evil does not mean that God has no response. There is no explanation in the sense that there is no exhaustive account of the origin and purpose of evil, how it fits into the world and plays a useful role. But God's response is found in the cross and empty tomb - and the promise that arrives with the Spirit as the first-fruits of a new age.

The focus for Hauerwas, however, is in the present gift of a community of grace that enables us to go on in hope.

Aquinas on Law and Gospel

There is a twofold element in the Law of the Gospel. There is the chief element, namely, the grace of the Holy Spirit bestowed inwardly. And as to this, the New Law justifies. Hence Augustine says "There (that is, in the Old Testament) the Law was set forth in an outward fashion, that the ungodly might be afraid; here (in the New Testament) it is given in an inward manner, that they might be justified." The other element of the Evangelical Law is secondary; namely, the teachings of faith, and those commandments which direct human affections and human actions. And as to this, the New Law does not justify. Hence the Apostle says: "The letter killeth, but the spirit quickeneth" (2 Cor 3.6), and Augustine explains this by saying that the letter denotes any writing that is external to man, even that of the moral precepts such as are contained in the Gospel. Therefore the letter, even of the Gospel, would kill, unless there were the inward presence of the healing grace of faith.

- Thomas Aquinas, Summa Theologica, I-II.106.2
Translated by Fathers of the English Dominican Province (New York: 1946)

Many associate Aquinas with natural law ethics, in which humanity is to do that which conforms to the law of nature and which can be known naturally. However, notice that here Aquinas 'assumes that an adequate theological ethics could not be limited to or based on an analogy with law.'*

I'd love to hear what people think of this quote. Do you agree? Is this what Paul is getting at in 2 Corinthians 3 when he speaks about the letter and the S/spirit?
*Stanley Hauerwas, "On Keeping Theological Ethics Theological" in The Hauerwas Reader, eds. John Berkman and Michael Cartwright (Durham: 2001), 71. The earlier Kant quote was also cited in this essay. Please don't get the impression that my recent enforced convalesence is being hugely productive in terms of reading. This is the final essay we're reading for the reading group I mentioned a while ago. We'll try to decide this morning what to read next.

Worse than death? IV

Death is not the focus of life
I asked recently how do you want to die? and received a large number of very interesting responses.

As Christopher pointed out, Stanley Hauerwas likes to ask this question in order to point out that our common answers as Westerners (quick, painless, sudden/in sleep) are basically the opposite of what Christians of an earlier age might have answered.* Indeed, the Anglican Book of Common Prayer includes a petition asking for deliverance from a sudden death. They feared what we crave, because they wanted time to prepare for death, to ensure they were reconciled with God and neighbour. While this might partially be attributed to a medieval Roman Catholic lack of assurance and the importance placed on the sacrament of Last Rites, the modern desire to avoid death - or rather dying - by all means possible reveals a deep fault line in our culture. We are petrified of death and either obsess over it, or (more commonly) simply avoid all mention and thought of it.
*For those interested in chasing up this thought from Hauerwas (and many others he offers on Western attitudes to illness, dying and medicine), check out this podcast. Skip the first five minutes of intro if you already know who he is. If you're new to his work, he can be difficult to listen to and moves around quickly, but there are many gems in this hour-long talk to make it worth the effort. Much of the rest of this post is indebted to thoughts from this talk.

We have medicalised death so that physical health becomes the primary paradigm through which we understand it; the hospital the primary location of death; the doctor takes the role of priest and research our hope in the face of death.

Fear of death dominates our culture, either explicitly, or implicitly. This is what drives the present fear of terrorism: the idea that dying at the hands of a suicide bomber is the worst possible outcome, justifying the erosion of well-established social institutions and freedoms.

But if Christ is Lord of the living and the dead, if Christians hope for life to come again to our mortal bodies by the Spirit, if death's sting is drawn, then it is possible to live and die without death dominating our existence. Life is a good gift and every breath is a reason to rejoice, but we are not to let the task of staying alive take centre stage. If there are things worse than death, there are things better than life:

Because your steadfast love is better than life, my lips will praise you.

- Psalm 63.2

Series: I, II, III, IV, V, VI.

Hauerwas on just war and pacificism

While we think just warrior are wrong, they might not be - another way of saying that we think the just war position as articulated by an Augustine or a Paul Ramsey is a significant challenge to our own Christian pacificism and is theological to its core. Just warriors and pacificists within the Christian church must be committed to continued engagements that teach them not only to recognize their differences but also their similarities, similarities that make them far more like one another than the standard realists' accounts of war that rule our contemporary culture and that have taken a firm hold in the church.

- Stanley Hauerwas, 'Courage Exemplified' in The Hauerwas Reader, 303.

I thought Stanley might offer an apt reminder in these conflicts over how Christians can conflict. Keep it up everyone.

Must Christians be pacifists? I

A new series by Andrew Errington
I: The Shalomite position
In a number of recent posts (1, 2, 3) on Ben Myers’ superb Faith and Theology, Kim Fabricius has argued clearly and forcefully that Christians ought to be pacifists, or what he has recently called Shalomites. The reasoning for this position should be read in Kim’s original stimulating posts; but briefly, his argument runs along the following lines.

Christian ethics flow from our understanding of who God is; and we know who God is above all through the cross. There we see God not ruling with a rod of iron, but humbling himself unto death. Therefore, nonviolence is essential to Christian discipleship, because, “it is the very heart of our understanding of God.” (Stanley Hauerwas, quoted in Why I am a Shalomite). As Kim himself puts it: “You see I am a Shalomite – and I believe that at least all Christians and, in principle, all people should be Shalomites… because of something I know about Jesus’ (William Willimon) and because of something Jesus knows about God: namely, that God is a God of Shalom, that (to adapt what St John says about God and light and darkness) God is non-violent and in him there is no violence at all.” (Why I am a Shalomite).

Thus, “[T]he Christian pacifist argument turns on the nature of the triune God; and the normative criterion of the nature of the triune God is the Christ event… If there is violence in this God – in this Jesus – the case for pacifism falls.” (Propositions on peace and war: a postscript).

God cannot be other than who he is in Jesus Christ. Since there is no violence in Jesus, there is no violence in God. Old Testament references to a violent deity must therefore be viewed in a new light, and cannot be made to prop up an ethic which lacks the essential ingredient: a Christological basis. In the light of the nonviolence of God in Jesus, Christians are compelled to be nonviolent themselves.

But is it true to say that there is no violence in God? Does the pacifist position innevitably end up with a Jesus who dies but is not then exalted? This is where we are headed.
Andrew is an old uni friend of mine. He will continue this series over the coming days in between whatever else I manage to post while preparing for my final exam. As mentioned earlier, I remain fascinatedly undecided on these issues. Ten points for the city in which this statue can be found. Series: I; II; III.

Ways of Judgement - and reading groups

Thoughts on books and reading groups
Just started a course today at college on 'Social Ethics' with Andrew Cameron. I'm really looking forward to it. I didn't realise until today (shows how on top of my studies I am) that the textbook is Oliver O'Donovan's The Ways of Judgment. I'll try to include posts on it as I work my way through. Love to hear feedback from others who've read it, and/or who might want to read it with me this semester.

Also, one of my reading groups has decided to embark upon The Hauerwas Reader by Stanley Hauerwas. Not quite sure which bits we should focus on (at 729 pages, we're assuming we'll be taking the highlights tour: recommendations?).

O'Donovan and Hauerwas: it will be fun to read them simultaneously. This particular reading group has a history of great books, starting back in 2000 and meeting fairly continuously every fortnight or so:*
Jesus and the Victory of God by N. T. Wright
Exclusion and Embrace by Miroslav Volf
The Resurrection of the Son of God by N. T. Wright
Suspicion and Faith by Merold Westphal
The Desire of the Nations by Oliver O'Donovan
God's Politics by Jim Wallis**

Reading groups (especially this one) have been formative in many ways for me over the last five or six years. If you've never been in one, try starting one - it's a great way to read a book and share thoughts. Highlights from other groups have included:
Theology of Hope by Jürgen Moltmann
Church Dogmatics IV/1 by Karl Barth
Adversus Haereses by Irenaeus
Overcoming Onto-theology by Merold Westphal
The Holy Spirit by Basil
The Spirit of Life by Jürgen Moltmann
Confessions by Augustine (current)

* We've probably averaged monthly over the years, but fortnightly has always been the aim.

** I highly recommend all these books, except Wallis. I broadly agree with his politics and basic thesis (the right doesn't 'own' moral or Christian discourse (and neither does the left)), but his theology was very disappointing. I'd include all the links to these books and authors, but I'm sure you're all smart enough to type them into Wikipedia or Amazon your local book publisher.