A glimpse into my sense-making
of working with suffering people in a damaged government health system.
Gone are the days of my reckless naivety, when I openly criticised
those health professionals who fled the public sector for the grassy pastures
of the private world. I looked down upon people who could no longer stand to
work in a broken system and thought them weak and passionless. How wrong I was.
I realise now that many of those health professionals made the choice
to leave the public sector with a very heavy heart, knowing that they could
have helped thousands of underprivileged people through their work. They
weren’t passionless, cold-hearted, or selfish. They moved to save themselves
from the pain they had to witness daily: the unnecessary suffering of unfortunate
people in a failing organisation. This is my painful reality.
I seem to survive by existing somewhere in the middle of passionate
perseverance, disillusioned madness, frustrating resilience and dejected
apathy.
There are days when the overwhelming “bigger picture” fractures the
very centre of my heart and I am left a defeated mess trying to figure out the
reason I am still here. I listen to stories of unnecessary suffering at the
hands of health professionals who just don’t seem to care; of overworked staff
who have become numb to the pitiful cries of their patients; of corrupt
departments who have ‘lost” millions of Rands; of dysfunctional systems where
people are lost in a depressing cycle of referrals; of situations that have
caused great disability or death when that needn’t be the case. Once in a while
I am able to help, but more often than not, the situation is destitute and I
find myself fighting a useless battle against a monster that has already won.
How much suffering can one person witness before they too become part of the
problem?
But then there are days when I force my heart and mind to focus on the
restorative aspect of one-on-one interactions. Where my role in the life of a
particular person is one of value and worth. It is in these rare precious
moments that my soul is retrieved from its dark, fearful hiding place and I am reminded
that I can find hope, meaning and life in what has become more than a job for
me. I wish those days would last forever.
Earlier this year I received an email from a highly respected South
African occupational therapist. The questions she asked me have niggled in the
back my mind ever since….
Can the unchangeable really be changed?
How does one know when it is time to fight and when it is time to let
go?
How do I remain true to my convictions in a broken, unjust system?
How far should I push without losing myself along the way?
I seem to have come a full 360 degrees since I first started
practicing OT. I started out young, passionate and hopeful; I lost myself
somewhere along the way as the numbness spread like an icy poison; I am now
thawing out and learning to melt the cold walls around my heart so that I can
better understand the pain I witness. I can’t quite pinpoint the moment I
cracked and could no longer cope with the weight of other people’s sufferings. Maybe
it was when a thirty year old patient of mine passed away from pressure sores
he didn’t have when he arrived at the hospital. He was a father of a
happy-go-lucky three year old. Or maybe it was when I listened to the pleading
cries of another man as he begged to be discharged from “this place of death.” Or
maybe it was the time when I heard about how some of the elderly community
members marched from our local township to the nearby government buildings in
protest of the lack of basic health care that is afforded to their fellow citizens
– the hospital is killing their friends. It could have also happened after I
met a man who had a simple shoulder dislocation that, due to poor medical
management, has now caused him to lose the entire functioning of his right arm.
He is a right-handed painter who can no longer earn a living. These are just a
few of the many moments that could have caused for the growing ache within my
soul.
I begged God to change the path of these, and many other people’s,
lives. I pleaded with him to end the painful stories I kept hearing and help me
to stop feeling so ridiculously helpless. I was angered that my loving God
could allow such suffering to take place and do nothing about it. Where was God
in all this suffering?
Through a process of reflection, prayer and a whole lot of grace, I
have started to realise that the suffering I witness has less to do with a silent
God and more to do with a broken world. I have begun a journey of understanding
pain; of learning why exactly there is suffering in the world and how the heck
I can cope with it. Much of what I have learnt comes from the Biblical book of
Job as well as the musings of Christian writer, Philip Yancy in his books
“Where is God when it hurts?” and “Soul Survivor.” His words, alongside those
of other authors such as C.S Lewis (The Problem of Pain) and Dr. Paul Brand
have helped me to begin to piece together some sense in my seemingly bleak reality.
The reflections below outline my process of sense-making and are by no means imposed
upon anyone else who reads this. I do not expect you to agree with me and I
realise that the problem of pain is one of the major stumbling blocks in
Christian theology. It is my hope and prayer that whoever decides that this is
worth reading, will consider their own understanding of pain and suffering and
be challenged to look past them to an unmistakable hope and freedom beyond.
Here’s what I now believe about the relationship between pain and God:
(this may very well change in years to come – understanding pain is a gradual process.)
1.
Pain is a gift – it shows us when we have a
problem and without it, we would never change the way we are living.
2.
God created a perfect world, put humans in it,
we messed up and now live on this disordered earth, groaning under the strain of
our own actions.
3.
Focusing on the cause of suffering will likely
only cause more pain, confusion and bitterness; the more pressing matter is to
focus on how we react to the circumstances in which we find ourselves. The
Bible consistently changes the questions we bring to the problem of pain. It
rarely, or ambiguously, answers the backward-looking questions “Why?” Instead,
it raises the very different, forward-looking question, “To what end?”
4.
We are not put on earth merely to satisfy our
desires, to pursue life, liberty and happiness. We are here to be changed, to
be made more like God in order to prepare us for a lifetime with him.
5.
Suffering can provide an opportunity for growth
that will add extra layers of depth to life – it has a sense of “soul-making” to
it, if we choose to respond to it in a particular way.
6.
God, because of his character, cannot possibly
desire atrocities such as the Holocaust but these events still happen. His
apparent lack of action in these circumstances should not be aligned with an
apparent lack of power. God loves us and has chosen to give us free will – the
power to love others as well as the power to inflict pain and suffering. God’s
love is deeper than the sloughs of human depravity.
7.
At the instant of pain, it may seem impossible
to imagine that good can come from tragedy. We never know in advance exactly
how suffering can be transformed into a cause for celebration. But that is what
we are asked to believe. Faith means believing in advance what will only make
sense in reverse.
I am amazed by some of the perspectives of some (but not all) of my
patients. While they have undergone intense suffering and pain, become
emotionally isolated and physically helpless, they seem to have used that pain
to deepen their spirituality and appear to have a new lease on life. They seem
to exude a quality of strength that most of us privileged, healthy South Africans
will never get to experience. One
patient, a paraplegic with an insurmountable perseverance, recently told me,
“I’m grateful that this has happened to me – it has made me a better person.” Another
patient who lost 4 fingers on his dominant hand in a nasty farming accident
sought me out after many months just to tell me how the accident was a
blessing in disguise as it forced him to turn to God and focus on the more
important things in life. These patients’ reactions are not unique to the
problem of pain – we can meet millions of others who now cherish their times of
suffering as they have produced in them stronger characters, persevering faith
and brighter perspectives of life. These are the types of people which bring me
hope and joy amidst insurmountable suffering.
Martin Luther once said, “Christianity has always insisted that the
cross we bear precedes the crown we wear.” It is through our sufferings that we
turn to God and become more like him. Pain, suffering and poverty can serve as
instruments for God’s greater purpose – to teach us the value of dependence and
therefore the humbling experience of grace. While God is not the cause of our
suffering, He is able to use it for our good, if we choose to respond to it in
the right way. Without suffering, we may never understand the power of God.”
As I have muddled through the problem of pain and suffering, I have
come to realise I am first a Christian, then an OT. Sometimes just listening to
the stories of my patients and loving them in the moment is all I have to do. Further,
when I have the opportunity within my professional capacity, I can assist people
to regain a positive outlook after the event of a tragedy. Paul Tournier, a Swiss
physician, once wrote, “The right help given at the right moment may determine
the course of [someone’s] life.” I now understand why there was such an
emphasis placed on treating “the whole
person” at university – not just their physical ailments. We have an
obligation to help our patients channel their suffering as a transforming agent
by focusing on their emotional and spiritual needs as well as their physical
ones. As a Christian, an OT, and a fellow human being, my role is to keep the
suffering of painful circumstances from destroying hope and rather assist each
person to see that even the worst hardships open up potential for growth and
development.
I guess I started out this journey from a
vicarious perspective - to understand the suffering of others from
an outsider’s perspective. But as I went on, I was forced to confront my
own sense of suffering and pain (albeit minor to the suffering I
witness at work) which allowed me the truly gracious opportunity of
sense-making within my inarticulate feelings. I have been compelled to
turn away from my own sense of self-sufficiency and reconnect with God in a
new, incredibly humbling way. I have been forced to share my emotions with
those around me, lean on them for support and be reminded of the fragile nature
of life. I have had to remember the importance of daily gratitude for the life
I have and the way God intercedes in my weakness. Without this painful journey,
I wonder how much I would have changed, grown and developed as a person. Maybe
there is hope and joy in suffering after all.
“My grace is sufficient for you,
for my power is made perfect in weakness.” 2 Corinthians 12:9
