Lecture 4: Pastoral Care to the Sick
Pastoral care, where we have been focusing and talking a lot about getting into people’s lives and homes. Part of getting into people’s lives and homes is also sometimes getting into hospitals and helping people.
People will get sick. We all get sick, we all get injured. We notice that Jesus devoted a fair portion of his ministry to the sick. He made it clear it is not why he came. Sometimes people wanted to conform him to become their healer. In Mark chapter 1, as I mentioned in the last lecture, his ministry could have devolved easily into just doing that. People would have probably lined up forever at Peter’s home, but Jesus made it clear that was not why He came.
Nonetheless, just because of who He is and His compassion and love, He ministered to the sick. He entered into their world, even sometimes when they did not invite Him into their world. I think a classic case is the paralytic in John chapter 5, a man who in my estimation anyway, and we will meet people like this, who love to be the victim, who love in a sense to always be sick. Some people want to be that for attention. Most people are not like that. Most people face maladies.
A. Part of being a shepherd is ministering to people when they are sick
It is going to be important that if you are shepherds - we are back to our definitions again – and you are serving your congregation, that whether it is you, that you are insuring that person does not go through this difficult journey alone.
II. Ground Rules
Some ground rules I would like to go through.
A. Know your theology
The first one, and this is so critical, that skillful counsel and care must go hand in hand with sound theology. I say this because we get kind of wacko when it comes to healing and sickness. We must be aware of how to do it.
There are several positions when it comes, for example, to the issue of healing. There are some that take healing as not normative today, that we should not expect it, more of a cessationist approach to healing. There are a fair amount of people who take that position, that healing as an example, was part of sign gifts, sign gifts were part of the early church to authenticate the ministry of Jesus, but it does not really serve a purpose today.
There are others who believe, on the other extreme, that healing is the birthright of every believer, that we should all expect to be healed. Jesus said, “Greater things will you do” John 14:12. That we should therefore expect to even have a greater healing ministry than Jesus. Or, 1 Peter 2:24, the classic verse often used, “By His wounds we have been healed.” People have quoted that verse to say that at the cross Jesus did the work on the cross so that by his wounds, my wounds can be healed, so we should expect that. Of course, what you set up if you take that position, is that if healing doesn’t happen, then it’s not God’s fault, it is your fault, our fault.
Somewhere there is a third position that is somewhere between those, that believes that God continues to heal, I should say always, that God is always doing a healing work, but it may not always be physical. God will heal what will accomplish his purposes. Sometimes God wills that someone is physically healed, sometimes he does not. Not that he doesn’t care in some people’s cases, He is just doing something more important.
Part of our task is to tell people, healing is not the end-all, it is not the most important thing. There may be other things God is doing. We do know this, Ephesians 3:20, 21: “Now to him who is able to do beyond what we ever think or imagine.” So, can God do this? Yes, there is no question. Will God do this? That is another matter.
It is not for me as a pastor to say what God will or will not do in people’s lives. I am not God. I have learned that God does a lot of things I did not anticipate and some things I did. If someone says, “I don’t think there is miraculous healing today” I would say that you probably haven’t gotten very far out into people’s lives, or you certainly haven’t traveled globally where the Gospel is spreading and lots of healing happens.
So we must be aware of different theological positions when we step into a situation and we need to work through our own theology. Where do we stand? How do we approach healing? If we are going to have invitation at the end of a service for people to come forward for healing, what are we saying by that? Are we just going through the motions and saying that we all know God doesn’t do that today, but it will feel good if we do that? Or, are we setting ourselves up to say that if you come forward today, I just heard from God and God is going to heal your life physically. We can’t say that, I don’t believe anyway, though some theologies will and it may be your orientation. I have found that if I accept that as my expectation, I would have had a number of disappointed lives.
So we need to help people approach their needs with sound theology. We should not limit God, but we should not expect that God will heal where there is faith because sometimes faith is not the issue at all. It certainly was not the case of the paralytic in John 5. Jesus did not say to him, “If you have faith, God will do this.” I think it is an interesting story because he does not show any faith at all in the story.
Another danger is if we say, “If you have enough faith.” Yes, God does use faith, we know this. If we go too far in the other direction, if there is not healing, then we can cause people to think, “It is my lack of faith.” In other words, we didn’t really intend to do this, but in terms of pastoral care, we have just added more burdens to people’s lives, rather than take burdens away.
I always remember when I was doing my doctoral work at Dallas. There was this lovely family, they converted their garage into a one-room apartment for students and I was living there the year I was doing my work. Her name was Mrs. Killebrew and she was this Godly, wonderful woman. She would make me breakfast sometimes. She would share her life. One day I came home from school and she called me and she said, “Can you come over?” She was crying. I knew that she had come down with cancer. I remember, she gave me this letter from her sister who lived in nearby Ft. Worth, who said in a sense, “You know you could be healed if you had faith.” If there is anyone who had faith, it was this woman. But she was made to feel completely inadequate. She was made to have a sense of guilt.
We have to be careful with this assumption. It can raise false hopes sometimes. It can again, overlook the fact that God may be using our illness to teach something greater. A lot of pain we go through, God could easily have removed that pain. But he always knows that sometimes that pain is just what we need.
God is never interested in taking us back to where we were, but he always is interested in taking us where we need to go. It is not about just helping restore something people had, it is about discovering where God is taking us next. He is more interested in our holiness than our wellness. I don’t mean to say that with any sense of lack of compassion. But we have to tell people this so that they can see things in perspective. Also, it misunderstands the text when they expect healing. John 14:12, I believe Jesus is talking about things that transcend the physical, that we will do greater things, I don’t think He was talking about the physical. When Peter is referring to “by his stripes we are healed” he is talking about spiritual healing, the context is not physical. Christ died for our sins, not our sickness and sickness and sin are not synonymous. Sickness is part of a fallen world. It is like as we get older and our mortality, it is not because we are bad people or lack of faith. It is part of living in a fallen world. What must we do? We must help people with shepherd hearts that give wise counsel.
What have I done with people who are sick? I always encourage them to get the best medical help they can find and to do it wisely. I also say that with the intent not to make the medical the main hope. Medical is a wonderful thing and technology is a wonderful thing. Sometimes it may go too far. Part of this line of when we are extending life and when we are extending death is something people have to navigate. Sometimes it will require us to give some Godly counsel, to say, “Maybe you don’t need to do this. It is just going to extend your dying.”
So we have to encourage people to make use of technology if it is good. There is a lot of wisdom we need to exercise, just because a doctor says we should do something. The opioid crisis I think in large measure is because too many pharmaceutical companies and doctors have teamed up to give people way beyond what they need. I find when I have gone in for procedures or when I have gone through pain, the first question is always, “Tell me the intensity of your pain” which therefore translates into “then I’ll know what medication to give you.” Sometimes we really should not have medication. Sometimes it creates more problems. I’m not a doctor, so I’m not going to play doctor in people’s lives, but I think in terms of this first point, encouraging the people to use the best medical procedures, to do that with wisdom and with care, to know that sometimes it is good to get second opinions. Sometimes it is good to just say, “I could have this treatment, but it may not be the best thing for me.”
Secondly I think we also need to encourage people to pray fervently for healing. In terms of helping people, we can encourage people to pray for their own healing. They don’t need to wait for someone with the gift of healing or the prayer of healing.
This is a big one. Not a lot of people do it. We also need to encourage people to call the elders. It is Biblical. James 5: “If anyone is sick…” Let’s look at the text a moment. In James 5 he gives these words, verse 13: “If anyone among you is in trouble, let him pray. Is anyone happy? Let him sing songs of praise. Is anyone among you sick? Let them call the elders of the church to pray over them and anoint them with oil in the Name of the Lord.” There is something God uses here that I think we need to be attentive to. He says: “…and the prayer offered in faith will make the sick person well, the Lord will raise them up.” Is that a promise? I think so, but I think we need to make sure our definitions go beyond physical. Notice what he also says: “If they have sin, they will be forgiven. Therefore confess your sins to each other and pray for each other, so that you may be healed. The prayer of a righteous person is powerful and effective.” What this seems to be saying is that meeting with the elders is not just simply saying, “We’re going to gather and lay hands on you and pray that you will get well.” If you take this passage together, it is a very pastoral text, which goes beyond the physical. It means asking some probing questions that we might go, “Oh, I don’t know if I’m comfortable, that might be offensive.” Actually, it might be the very thing they need.
Sometimes I have said to a person who has come for healing, “Is there anything going on in your life spiritually, emotionally we should be aware of?” Because sometimes those things can affect us physically. I wonder sometimes when I walk on a floor of the hospital, how many people are there that didn’t really need to be there if they were taking care of themselves, if they were emotionally healthy, if they were spiritually healthy, if they got certain habits under control. You never know what the answer is going to be, but I think particularly what is helpful is to read this text, so they understand that we are not trying to probe or be judgmental, we are trying to safely carry out what this text calls us to do. So, we want to see you healed, but we are not declaring that you will be physically healed because of our prayer. However, prayer is always doing something, right? It is always doing something. We don’t know what this prayer is going to do, but we believe God is going to use these prayers. We hope he heals you, but it may be God is doing something greater than your physical healing and you are here tonight to pray that whatever that is, transcends, it goes beyond.
People need to know our primary concern is their spiritual soul. We are physicians of the soul, so to speak. That is why we are in a hospital room. Never, ever feel like you don’t have value or worth compared to medical doctors. I think you can actually build a Biblical argument that our role is even more important because we are going deeper. We are going to the heart. We are going to the soul.
We have to help the hurting with wise counsel, giving good advice about medical procedures. We are talking to them about healing itself, theologically encouraging them to call for the elders, because some may be reaping what they have sown. Galatians warns about that in chapter 6 verses 7-9. There may be destructive choices that have led to physical consequences.
I have to be really careful with what I’m going to say here, but sometimes there might be spiritual issues going on. There might be fingerprints of the adversary on this situation that we need to pray over. I’m thinking of Luke 13. This text here is worth pondering, verse 10. It is the story where Jesus was in the context of healing. “On a Sabbath Jesus was teaching in one of the synagogues and a woman was there who had been crippled by a spirit for 18 years. She was bent over and she couldn’t straighten up. When Jesus saw her, He called her forward and He said, ‘Woman, you are set free from your infirmity.’” She didn’t necessarily demonstrate faith, she didn’t ask for anything. But Jesus called her forward . He put His hands on her and immediately she straightened up and she praised God. Indignant because Jesus had healed on the Sabbath, the synagogue leader said to the people, “There are six days for work, so come and be healed on those days, but not on the Sabbath.” Such compassion. The Lord answered, “You hypocrites.” They were looking again strictly in physical terms. Jesus said, “Doesn’t each of you on the Sabbath untie your ox or donkey from the stall and lead it out to give it water? Then should not this woman, a daughter of Abraham, whom Satan has kept bound for 18 long years.” All of a sudden something is introduced here. Shouldn’t she be set free? When He said this, they were humiliated. But the people delighted in the wonderful things He was doing. What does that tell us? It tells us that there might be something of the adversary at work here. We need to pray against that.
I remember reading this text to my son. I have a son, Nate, who has Asperger, part of that autistic scale. With Asperger he can’t read faces. He sees the world only in black and white. He does not intuit. He seems rather normal on the surface, but you get to know Nate very well, and it is quirky. He does not have an EQ. He can hurt you, but he wouldn’t know it. I’m still praying that God gives him a wife someday with Asperger, they will both hurt each other and never know it. It will be a great marriage. I remember once on a plane I said, Lord, if there is anything of the devil’s fingerprints on my son, I want you to remove them right now. Because we know the devil is always up to mischief. We know that if he wants to hurt us, he will often work through those we love the most. I think that is part of the prayer elders do. I think it is part of what pastors do. When somebody says, “Pastor, I’ve had this pneumonia, it won’t go away and I prayed for healing,” or cancer or whatever, I’m shortchanging them if I don’t also say, “I’m going to pray more deeply and wider, can I do that?” So, “Lord, if there are some life choices, if there are some sin issues in this person’s life, then Lord, expose them, help this person to come to grips with them. And Lord, if there is something of the adversary going on in this person’s life, I pray that you, by your authority, remove it in the Name of Jesus. And if you would be so kind as to physically heal, Lord, if it would be part of your will and your pleasure, then I ask you to do that.” That is pastorally what we owe people. This is what pastors do. It is our task. We are not Benny Hinns just trying to bring healing physically. We need to then encourage people to trust God whatever the outcome. That is part of faith.
Notice here another major point I make in the notes, is that pastoral care does not wait passively for the sick to come to us. I sort of already underscored that in the last lecture. We have to come to people. When we find out people are sick, we need to go to them. The greatest misery of sickness can be solitude. We have all been there and there is nothing more lonely than to be disengaged from life because of illness and to begin to feel like all the world is going on but you. It is a lonely time.
Ten years ago this last Thanksgiving my wife had a subarachnoid hemorrhage, like an aneurysm. If Emergency people didn’t get to our home in the eight minutes they got there, she would not have survived. I remember that night, walking the hospital corridor, wondering if she was going to recover. That is a very lonely moment. People we minister to, we don’t know how many people are going through a very lonely journey. Sickness, impairment, health issues can be the loneliest. We don’t wait passively, we come alongside because we realize illness constitutes a certain crisis that transcends the physical. It can be a crisis of the soul, beginning to doubt God or, I always thought God was good, perfectly good, but I don’t see good in this illness. I thought faith would change things and I do have faith, but I am starting to waver. Or, self- esteem. I used to feel really great about myself, but I don’t feel so great. Like the woman I talked about last hour who came to feel she had no worth anymore. For 57 years I was an avid, competitive tennis player until my hip had to be replaced. I went through a little season because I found a certain worth in competition. It is nice to go through that with a pastor, that needs to be there.
Let me talk a little bit about good judgment in a hospital room in particular. Be really careful to use just the right words, to not be like Job’s friends who were always trying to provide a remedy. “You don’t have to be, you wouldn’t be here…” We would all like to think we do not want to be like Job’s friends, but there is a little bit of that in us. There is a little bit that says, “I really wonder why this happened. I wonder if there is something going on in her life.” So we have to be really careful.
We also have to be timely. By timely means things like this, I’m going to get into something real practical. It means that one of our most important meetings with people, particularly let’s say going through surgery, is to be there with them ahead of surgery. Another really lonely place is when you come in for prep and you are waiting for an hour and you are dealing with a lot of fear. That is a great pastoral moment to seize. It is calling and saying, “What time do they have you scheduled to come in for pre-op?” Say, “I’ll be there.” So, meeting ahead.
On the other side is coming to extend care on the post side at the right time, which means not right after surgery. Sometimes we think, “I just want him to know I’m right there and I care for him.” I don’t know about you, but when I have come out of surgery, I don’t really want to see anybody, that includes the pastor. Another little thing is to avoid mornings. That is when I find doctors and nurses are doing a lot of their checking in, testing, blood work, etc. You are a distraction and interruption.
This is also really important. It means choosing the right time to come, coming maybe in the afternoon or in the early evening. It’s like visitation, not extending your stay, especially if they have had a succession of guests. I have always tried to keep it no more than 10-15 minutes, no matter how much they want to talk because they need their rest. Otherwise, they would be home.
Come with a certain expectancy that God is going to use you. You never know. David Fischer ?_____(25:31.8) is a pastoral theologian, one of my friends, he has taught numerous courses for me. He told me about a pastor who came and visited a woman in the hospital. He was making his rounds, kind of doing his perfunctory duty. This woman had come in for I-don’t-know-what sickness, but she had been in really bad shape. He said, “Ann, just before I leave, I want to pray over you.” Ann said, “Thank you, Pastor.” So he said, “Lord, I pray that you would help Ann to recover and restore her strength and her vitality and bring healing and relief.” He finishes praying and she goes, “That felt good. I feel really great.” She got out of bed. “I feel the best I have felt in I can’t remember.” David tells the story that when this pastor went back to his car, he stopped and he said, “God, don’t ever do that again.” Sometimes we go through the motions, not really expecting that God may do something, right? Sometimes God will do something. Really, simply we are going as a representative. We are the church again. We are Jesus. So we step in saying, “Lord, I want to be Jesus here. I want to be the church.” It is not about us. We are bringing presence. We are bringing representation.
Again, we are listening. Don’t be surprised. People will do odd things. I can’t remember how many people wanted to go, “Let me show you my surgery.” It is like people want you to see their war wounds. It’s like, I didn’t really need to see that. People will do odd things.
Don’t be afraid to touch, to take their hand. Touch is so important. Just to hold their hand, to pray over them. Be sensitive. Often the family is going to be there. Just remember, you are also ministering to them. Sometimes you will get questions that you will need to try to answer.
Prepare for the moments God will take you down this road, too, to give you another side of what it feels like and looks like, so you will be more effective in the process.
Questions, thoughts about healing, this pastoral care work that we do that is so important.
Question: You were a pastor of a really large church. How do you do pastoral visitation for the sick when you have on any given Monday 100 people who are sick?
Dr. Johnson: I think you are intentional to know, and people know in a large church that it would be an unfair expectation that you are going to see everybody. I think it is intentional . You can start to cull the number down a little bit by, who are in life-threatening situations? That narrows it a lot. I don’t want to miss life-threatening situations, someone who has just been in a serious car accident. For those, you have to be prepared in the middle of the night to be there. Again, in a larger church you are doing it with maybe somebody like, I had a pastor of care. He took the lion’s share of it.
Again, I didn’t make the mistake. I could have said, “I have someone else to do that, I can delegate that.” There is something that is needful for my role as the pastor to be there. It puts things in perspective. It puts my life in perspective. I don’t want to sound too consumeristic, but it is chips in the bank. Pastors have a certain amount of chips. Every time you say, call for change or do something difficult, that is what I call withdrawals. When you preach a great sermon, that is a deposit. When you visit a hospital and see people who are in difficult situations, that is a lot of deposits, if you will. People may not remember any of the sermons I have preached this last year, but they will remember if I was there when they were in a very difficult situation.
This is where I would often say to Bob Walker, who was my pastor of care: “Bob, who are the people I need to see? Who are the people you would say, ‘John, in terms of visitation or hospital, you need to be there.’” He was really good to say, “I have Jim covered, he is on his way to recovery, he is doing just fine” or “but you really need to see Alice, she needs you there.” That helped me a lot.
Question: What about those people that have been in your church for 30 years, so they have a sense of entitlement, that if it is not the senior pastor coming, don’t even come through the door. I only want John Johnson to help me with my hangnail today.
Dr. Johnson: I think again, if Bob would say to me, “John, he really wants you to be there” then I wasn’t too busy, frankly, to miss that. I am going to be careful how I say this. I used to have a pastor who said, “I would like to get together with you, John, how is your March schedule?” I’m super busy. My thought is, No you’re not. We make priorities with where we want to spend our time. I know some pastors who are out of control. I think pastors who are very intentional know how to make priorities. If it is important enough, I’ll be there. I can move things around. That is my take. There is going to be a little bit of that, but I really frankly did not face much of that. I think with some people you end up seeing maybe often, they are on a long journey. I had a woman in our church at Village who went in for a simple procedure and they ended up having to amputate her leg. Talk about being totally thrown. I would stop by every Monday, I would stop by to see her because she was on a long recovery and I wanted her to know that I was on this journey with her. There was a great endearment as a result.
I think we have to be prepared sometimes to say, “I am really sorry. I know I should have been there and I’m sorry I wasn’t there.” Hopefully, that is backed up with some pretty good reasons.
Sometimes people think you can read minds, too. “What do you mean you didn’t know I was there?” I didn’t. Nobody told me. Sometimes they expect you to be all-knowing. Sometimes from the pulpit you need to say, “I’m going to disappoint all of you somewhere along the journey, just as you are going to disappoint me. We all have expectations. Here is one expectation, that I will always be there for every event. I won’t always be there at the birth of your child. I won’t always be there (especially if he has a fairly large church.) But I will try to. You can help me a lot by communicating when you are going to face something, so that I can make sure I am there for you.”
It is a big area and it’s going to be increasingly a big area with the aging of our population. A lot of us are going to be thrown more and more into eldercare issues where again, people need a lot of wisdom because hospital care keeps extending. That is the good side, but it comes with a downside too. We need to help people through the aging process.
You know you are in the aging process when you hang out with people your age and all they talk about is their last surgery. I’m getting to a place with my age that when I get together with my friends, I go, ”Okay, I’ll tell you what. I’m not going to tell you about my physical issues if you don’t tell me yours.” Because generally if you tell your physical issue, I just had my hip replaced, I have a retina issue, I have vertigo, you can tell people are going, “Really? I didn’t realize that. How can I pray for you?” or “What is that like?” But most people when you get to this age, are listening like, “When he gets done, then I have my story.” I don’t know what that has to do with anything, except be prepared for that aspect as well.