Ms. Satterwhite Stevenson is the assistant to the chairman in the department of pediatrics at the University of Rochester, New York. She is also a member of the board of directors of the National United Cancer Council.
This article appeared in The Christian Century, April 24, 1985, pp. 419-420. Copyright by The Christian Century Foundation; used by permission. Current articles and subscription information can be found at www.christiancentury.org. This material was prepared for Religion Online by Ted and Winnie Brock.
Clergy are often among those guilty of making comments to patients and family members that are more harmful than helpful, the most maddening of these is "What has happened to you is God’s will." Clergy must become much more involved in the healing ministry.
About 870,000 people in the United States were diagnosed last year as having some type of cancer. Breast cancer alone was discovered in more than 100,000 women. Cancer strikes terror in the hearts of patients and their families. Though the 1984 cure rate was 52 per cent, the diagnosis frightens people, who equate it with pain, disfigurement, debilitation and death.
When my husband’s cancer was diagnosed in 1964, I was devastated, but responded stoically, as our culture expects. I experienced all the usual anger (why my husband, my family?), guilt (why didn’t I make him stop smoking, and why him instead of me?), and frenzied activity (I immediately sought out and found a very time-consuming and demanding job). Because I did not give in to grief, I experienced psychogenic symptoms. I felt an immense responsibility to maintain stability for my three teenaged children, to "put on a happy face" for my husband, and to act bravely. Despite a gloomy prognosis, he lived eight more happy and productive years before a recurrence brought about his death. I firmly believe his reprieve was at least partly the result of his own faith and inner strength. As time passed during those last years, we almost forgot about the prediction of imminent death. And then he died. Again I stoically underwent the same emotional turbulence. I became a workaholic, effectively postponing and compartmentalizing my grief. I wrote prolifically, worked longer hours than necessary, and served on boards of many organizations. I idealized my marriage as, in the words of playwright Robert Anderson, "a picnic without mosquitoes" ("Notes of a Survivor" in The Patient, Death and the Family, edited by Stanley B. Troup and William A. Greene [Scribner’s, 1974], p. 82). I elevated my deceased husband to a level of perfection far above the reach of any other man. It was ten years before I was ready to move on to a new life and marriage.
In retrospect. I believe that I would have regained my "wholeness" sooner if I had cried more, if I had vocalized my anger, if someone had told me that it wasn’t crazy to set the table for him by mistake or to talk to him in my empty bedroom, if I had not been so brave and stoic. If only someone had reminded me -- not once, but often -- that for everything there is a season . . . a time to weep . . . a time to mourn . . . a time to break down and a time to build up" (Eccles. 3:1-9).
Such help can and should come from our clergy. As elders in our Presbyterian church, my husband and I were committed, involved Christians. But we did not ask for help, and visits from our ministers never got past "acceptable conversation." Conversations with many cancer patients and their families through the years have indicated that their experiences have been similar: both they and their clergy were uncomfortable in talking about life, death and concomitant feelings. I now wish we had been more open with our pastors, for clergy cannot know all the needs of all their parishioners.
My own experience as a patient began in the spring of 1983 when, in a routine mammogram, breast cancer was found. The three weeks between diagnosis and a modified radical mastectomy were traumatic, for the prospect of being permanently "maimed" overshadowed all other fears. Surgery was followed by a year of chemotherapy. I was fortunate in having had few side effects, and I have recently learned that I am disease-free. However, I know that for the rest of my life I will have to undergo bone scans, chest X-rays and physical checkups.
Having cancer was difficult in other ways. I wished I had received one humorous get-well card amid all those with hearts and flowers. In the supermarket I saw acquaintances turn their carts around and go the other way when I appeared in the aisle. I still have to deal with comments that indicate that I must be "terminal": "You look fine, but how do you really feel?" "I’m a good friend you can tell me how you really are.’’ I share the feelings of Sandra Hansen Tonte, who wrote, "Worst of all, I’ve had to contend with people who think I am going to die" ("I Will Get Well. If You Will Let Me,’’ Newsweek [May 21. 1984], p. 13). And finally, I was and continue to be called a "cancer patient." People with other serious diagnoses are not labeled "patient" for the rest of their lives. I would like to be thought of as a person who had cancer; the statistics for my chances of survival are not all that bad! Besides, even those people with gloomier prospects would wish to be viewed primarily as living human beings rather than as patients.
Clergy are, unfortunately, often among those guilty of making comments to patients and family members that are, I believe, more harmful than helpful. One of the most maddening of these is, "What has happened to you is God’s will." I could not possibly function in a pediatric department of a teaching hospital if I thought that God "wills" cancer on children. I believe in a benevolent God, but one whose eye may not always be on the sparrow. Others offered consolation: "God doesn’t give people more than they can bear." But such comments only angered me, for those who could not bear their suffering are no longer here! And the comment I heard often after my husband’s death: "When one door shuts, another opens." People, trying to be helpful, would go on to add, ‘‘Look at what you have made of what happened to you." My response has been, ‘‘But what might we have done together if that door had not closed?"
There is a general need for more understanding, comfort and expertise on the part of the clergy in their ministry to patients with cancer and to their families. Many resources are available to help clergy relate more effectively in such circumstances. For instance, many teaching hospitals have potentially helpful clinical pastoral education courses. In Rochester, the United Cancer Council, the University of Rochester School of Nursing, and the Sudden Infant Death Syndrome Center jointly sponsor an annual bereavement seminar for care providers. Agencies or institutions in other communities might sponsor something similar. Local cancer centers could sponsor a teaching day for clergy involved in counseling patients and families. There is also much good literature on the subject (cf. Richard Dayringer, editor, Pastor and Patient: A Handbook for Clergy Who Visit the Sick [Aronson, 1982]).
Clergy are in a unique position to help cancer patients and their families. The minister can interpret what has happened in the context of faith, and can help show families that the church or synagogue is a loving support system. Clergy can, for example, be empathic listeners, and can ask questions that will encourage people to express their feelings, no matter how "crazy." One might say, for instance, "Some people feel that God is punishing them; have you ever felt this way?" And ministers can be there to hold a hand or to say a prayer for healing. Clergy are a "presence," a link between patients and God. They must find ways to be advocates in prayers for healing, wellness and/or acceptance.
Clergy can also be hopeful, if there is hope. Lawsuits against physicians have forced them to present the "worse case" side effects of procedures, and they often tend to volunteer more information than the patient and family may be able to manage. Clergy can help by emphasizing the positive.
There are also many more mundane ways in which clergy can aid those with cancer. For instance, they can, with a patient’s permission, ask the physician how they can be of help. They can caution people against reading obsolete literature on cancer. Many people consult their public libraries for medical information. But with the strides being made in the treatment of cancer, such information is apt to be obsolete or inaccurate, causing unnecessary stress to the reader. Many cancer centers have up-to-date libraries and reading lists to which clergy can direct families.
It must be remembered that physicians can overestimate a patient’s understanding, and that, because of emotional stress. a patient may hear but not understand. Patients and family members can reread written materials when they are ready and able to absorb the contents. Clergy can also encourage patients to make a list of questions they would like their doctor and nurse to answer. In the doctor’s office, patients under stress may forget to ask questions -- especially those over which they have been brooding. In addition, clergy can familiarize themselves with community and national resources, so that when patients are ready to seek help, information will be readily available.
Perhaps the most helpful ministry would be to encourage church or synagogue members to provide practical assistance. Assistance with baby sitting, meals and transportation will remind patients and families that they are cherished by their fellow parishioners. Such concern sometimes comes too late, and disaffected or estranged patients and families end up leaving their congregation because of feelings of isolation fostered by the illness.
Furthermore, pastors can encourage and help outreach parishioners (i.e., deacons, elders, lay parish counselors) in their ministry to these families. The minister can make topics like "Helping Cancer Patients and Their Families" the focus of special seminars for an adult education class or even a sermon. Whatever the means, the subject must be brought into the open, where people can deal with it, rather than fear it: Clergy can also work to make the church facilities architecturally accessible by installing wheelchair ramps as well as making bathrooms accessible to wheelchairs.
As a body of concerned professionals, clergy are in a unique position to be agents of change in their communities. They can become involved in starting a local United Cancer Council or American Cancer Society chapter or a bereavement center if none exists. These agencies can provide excellent support groups for patients. Although most communities have many helpful resources for cancer patients and survivors, people often do not know about them. Bereavement centers provide verbal and written information, educational programs and appropriate referrals.
In, summary, clergy must become much more involved in the healing ministry, becoming bona fide members of the team that heals the bodies, minds and spirits of cancer patients and those who love them.