Today’s piece is adapted from “Pastoral Care and Contagion” which originally appeared on Wesleyan Accent in 2014, when Ebola was wreaking havoc. It should not perhaps come as a surprise that while the disease may differ, the topic re-emerges in bleak relevance every few years. Certainly, it may seem counter-intuitive to consider church history in any discussion of outbreak, pandemic, or plague; we live in an era of hazmat suits, microbiology, and gallons of gelatinous hand sanitizer. But while our approach to disease containment and pathology is far different than you would find in rural Germany in the 1500’s – while we know so much more about the value of quarantine or the spread of disease – still, there is profound if sad wisdom and perspective in reflecting on the posture of faith communities in our past. These ancient faith communities encountered epidemics without access to antibiotics, antivirals, IV bags, or basic sanitation. The wisdom echoing through church history like a wail in the catacombs remains relevant partly because areas of the world still lack access to medical supplies, physicians, or hospitals; pastoral care during outbreaks is a quite urgent topic for many Christians. It is also instructive to note the panic that grips even people who do have access to health care best practices, because in the age of globalization, supply chains are vulnerable. Independent of actual risk, fear itself can cause markets to yo-yo or consumer hoarding to worsen shortages. Even if people are accustomed to relative health and ease – or especially if they are – it is impossible to insulate any life from certain realities: illness, vulnerability, lack of control, mortality. Pastoral care during outbreaks is in part the quiet calming of deep existential fears usually ignored, avoided, or drowned out by many people in the Western world.
Even though we are equipped to know more about disease outbreaks faster than ever before, human nature hasn’t changed: the response is still fear, even if the risk is much lower than it would’ve been a few centuries ago, even if fatality rates, while tragic, are relatively low. So in addition to hanging signs reminding guests to wash their hands, in addition to taking sensible precautions and exercising common sense and good cheer, we can outfit ourselves with wisdom from church history. Perspective is never so valuable as in a time of panic, warranted or unwarranted or somewhere in between. So let’s inoculate ourselves against denial, on one hand, and fear, on the other, with a visit to the Book of Common Prayer and a cantankerous German monk, Martin Luther. – Elizabeth Glass Turner, Managing Editor
In The Proposed Book of Common Prayer of 1689, under the blunt heading, “In the time of any common Plague or Sickness,” you can read this prayer: “O ALMIGHTY God, who in thy wrath did send a plague upon thine own people in the wilderness, for their obstinate rebellion against Moses and Aaron; and also, in the time of king David, didst slay with the plague of Pestilence threescore and ten thousand, and yet remembering thy mercy didst save the rest; Have pity upon us miserable sinners, who now are visited with great sickness and mortality; that like as thou didst then accept of an atonement, and didst command the destroying Angel to cease from punishing, so it may now please thee to withdraw from us, who humbly acknowledge our sins and truly repent us of them, this plague and grievous sickness; that being delivered we may glorify thy Name, through Jesus Christ our Lord. Amen.”
In 2014 the World Health Organization released a manual providing guidelines that aim to maintain cultural respect and religious reverence for the safe burial of Ebola victims, since a full 20 percent of transmissions occured in the burial process. Officials consulted with Muslim and Christian leaders to explore ways that burials could maintain the rites of religious faith while avoiding the washing of a body or the sharing of a loved one’s possessions that might be contaminated with the virus.
Despite my excellent undergraduate education preparing me for Christian ministry, despite my thoroughly-enjoyed seminary training, I don’t remember any discussions on how to provide pastoral care during outbreaks or what to preach during the plague. North America, take note: whatever your thoughts on travel regulations and disease transmission, Ebola and health care, pastors and laypeople everywhere have remembered something anew.
You are not immune.
And currently our sisters and brothers in several African nations (please brush up on your geography if you think Ebola has gripped the entire continent) are wrestling with very pragmatic issues of Christian love, urgent medical need and health and safety.
Re-read the heading of the above prayer: “In the time of any common Plague or Sickness.” What short memories we have. Plague and sickness, very present reminders of mortality abounded not long ago in our own nation. We’re a century away from the Spanish Influenza, antibiotics have been utilized for a few short decades and immunizations weren’t available when my Grandmother was a child. In a very little time, we have become shocked by cancer, appalled by heart attacks, distressed by dementia. And rightly so: they are horrible evils.
But we’ve become surprised by our own mortality.
“Have pity upon us miserable sinners, who now are visited with great sickness and mortality…”
How deeply does our surprise run? Search “priest” and “plague” on the internet and you’ll find plenty of references – to video games, some of which feature “plague priests” and “plague monks.” But as our featured image shows, the relationship between priests and plagues was something that used to be commonplace.
Hopefully, the [2014 Ebola] contagion is winding down; hopefully, the outbreak will continue to abate, running itself out in containment. Hopefully, it will no longer spread to other continents – this time, anyway.
Of all people, though, Christians must be conversant in the language of mortality, fluent in the evils of death and the beauty of resurrection, articulate in tragedy and triumph. What else is the rhythm of the church year for, but to practice us in the art of living the pattern of Kingdom life, of Christ-life, of birth, death, and resurrection? We must talk of these things if we have any hope of acting on them, putting hands to ideas. We must all find our inner Mother Teresa and touch the dying – even if you choose to wear three layers of gloves.
And in a moment of strangeness and perplexity, we do actually have some resources available for those who want wisdom in an outbreak, if you’re interested in the writings of one church reformer, Martin Luther. Yes, you may picture him as the rotund, angry reformer nailing his theses to a wooden door. But in the early 1500’s it wasn’t just outrage at the Roman Catholic Church that was sweeping Europe: it was the plague. So perhaps these principles will be helpful.
Luther wrote “to the Reverend Doctor Johann Hess, pastor at Breslau, and to his fellow-servants of the gospel of Jesus Christ,” on the very interestingly titled subject, “whether one may flee from a deadly plague.”
In other words, is it alright, as a Christian, to leave an area where people may need your help?
And he answers very pastorally, if bluntly – it depends. “Since it is generally true of Christians that few are strong and many are weak, one simply cannot place the same burden upon everyone,” explaining in rather kinder terms, “it takes more than a milk faith to await a death before which most of the saints themselves have been and still are in dread.”
But Luther puts a different burden on those in leadership in both the church and the state. About clergy, he advises:
“Those who are engaged in a spiritual ministry such as preachers and pastors must likewise remain steadfast before the peril of death. For when people are dying, they most need a spiritual ministry which strengthens and comforts their consciences by word and sacrament and in faith overcomes death. However, where enough preachers are available in one locality and they agree to encourage the other clergy to leave in order not to expose themselves needlessly to danger, I do not consider such conduct sinful because spiritual services are provided for and because they would have been ready and willing to stay if it had been necessary.”
Laypeople are not neglected in the discussion, however. “In the case of children who are orphaned, guardians or close friends are under obligation either to stay with them or to arrange diligently for other nursing care for their sick friends. Yes, no one should dare leave his neighbor unless there are others who will take care of the sick in their stead and nurse them.” This is tempered when he continues that if there is enough nursing available, believers have an “equal choice either to flee or to remain.”
Of course, he is not speaking here of mandated quarantine or other 21st-century realities (though quarantine is nothing new: the city of Venice used an island as a quarantine location when it faced the plague several centuries ago). The pastoral response in current contexts must also include care for others by not exposing them frivolously or lightly to that with which one may be infected.
But in a triage situation, many of the principles are still relevant: because before the CDC arrives, or before the world takes note but after your local doctors and nurses have fallen ill with the disease themselves, then what?
First, whether you stay or go, Luther would have you pray and commend yourself to God: “if he feels bound to remain where death rages in order to serve his neighbor, let him commend himself to God and say, ‘Lord, I am in they hands; thou hast kept me here; they will be done.’ If a man is free, however, and can escape, let him commend himself and say, ‘Lord God, I am weak and fearful. Therefore I am running away from evil and am doing what I can to protect myself against it.'”
This pastoral word essentially encourages believers – whether on the front lines or seeking safety – to acknowledge first and foremost that we are submitted to things beyond our control, and that we have committed our spirits to the Lord, aware of our own frailty and mortality. Pastoral care during outbreak begins with acknowledging what is in our control and what is out of our control.
Second, he gives a word of encouragement to those facing graphic horrors of contagious illness. “When anyone is overcome by horror and repugnance in the presence of a sick person he should take courage and strength in the firm assurance that it is the devil who stirs up such fear and loathing in his heart…[he] also takes delight in making us deathly afraid, worried, and apprehensive so that we should regard dying as horrible and have no rest or peace, [making] us forget and lose Christ…”
How comfortable are you around sick people? Certainly, take sensible precautions: wash your hands, cough into your elbow, take vitamins. But can you bear to be around those who are gravely ill? Are you prepared to walk through the valley of the shadow of death with them so that they are not alone? Does your faith give you the strength to sit next to the person receiving chemo? During a time of spreading disease, everyone is forced to confront dynamics that occur every day for people with multiple sclerosis or cancer or recovering from injuries sustained in warfare or car accidents. The point is sharply made when Luther writes, “this I well know, that if it were Christ or his mother who were laid low by illness, everybody would be so solicitous and would gladly become a servant or helper.”
And about burials – which the World Health Organization would appreciate – Luther simply says, “I leave it to the doctors of medicine and others with greater experience than mine in such matters to decide whether it is dangerous to maintain cemeteries within the city limits,” though he urges caution and suggests burial out of town.
So: hear sermons from the Word on how to live and how to die (Luther recommends – though currently in winter 2020, some congregations in other countries are restricted from gathering, due to public gathering limitations to curb disease spread); prepare for death in time to confess and take the sacrament, in time for reconciling with others (he further recommends); and if you want a chaplain or pastor at the time of your death, call them while you’re still in your right mind (he wasn’t a man short on words).
Are you comfortable with mortality? Are you ready to be around the dying?
It’s worth thinking about. It doesn’t matter if one pandemic scare fades away, allowing us to be (relatively) at peace again; whether or not there is emergent disease risk, we all have to grapple with mortality, limitations, and ill people in our communities who need our presence. We all have to reconcile ourselves to the fragility of life. Sometimes it’s just on the news more than usual.