The Teaching
of the Holy Fathers
on Illness

(Part 1 of 2)

Adapted from a booklet distributed by the Nicodemos Orthodox Publication Society, Etna, California. Author unknown.

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, suffering and pain become not only bearable, but even useful.

St. Ambrose of Milan says of the Christian attitude toward sickness: "If the occasion demands it, a wise man will 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 teacher 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 very great, but we know that it is necessary in order to preserve health or even our 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 nineteenth century Russia, wrote thus 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? (1 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.

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 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 of Aitolia), 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.

The Origin and Cause of Pain

For we know that all creation groans and
travails in pain until now
(Rom. 8:22).

Strait is the gate, and broad is the way, that leadeth to destruction, and many there be which go in thereat. (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 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, no 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 to Adam and Eve, Where art thou? (Gen. 3:9). His first manifestation to man after the sin of disobedience was not as a vengeful Judge, but as a wise Physician, searching out His patient, "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 Chrysostom, 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 "godhead," 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 that 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 ground for thy sake; in the sweat of thy face shalt thou eat bread, till thou return unto the ground (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).

The Purpose of Illness

The spirit itself beareth witness with our spirit,
that we are the children of God;
and if children, then heirs;
heirs of God, the joint-heirs with Christ;
if it so be that we suffer with him,
that we are the children of God
(Rom. 8:17).

Our Savior 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 namedays 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 worshiping 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" (Saints 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. Nicodemus 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 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, and 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. Nicodemus 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 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 a monarch is unable to make a life free of grief, then what else could possibly achieve this? Nothing, indeed, in this life" (Homily 18, 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, whether 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 1, 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 the 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" (Orthodox Word, vol. 3, no. 3).

Illness and Prayer

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

Our Savior 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 a 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 Savior 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 of Holy Unction 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" (the 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 Savior's healing of Peter's mother-in-law is spoken of: Immediately the fever left her, and she ministered unto them (Mark 1:31).

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).

End of Part 1.
For Part 2, see the October 2001 - January 2002 issue

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