Visiting the Sick and Dying
The intention of this article is to convince Christians, and especially ministers, to risk physically visiting those ill with the coronavirus for the sake of their spiritual and eternal wellbeing. It is also a call to engage with hospital administrators and civic leaders to ensure that coronavirus patients will not die alone.
VISITATION AND ISOLATION IN THE BIBLE
To do so I want to start by considering the twin themes of isolation and visitation of lepers in scripture and church tradition. These two themes capture the complexities of the Christian response to those who are contagious and those whose obligation it is to care for those who are contagious. Leviticus 13-14 posits the separation and isolation of the leper for the sake of the health of the community. While passages such as these sound draconian to modern ears, it is important to note that, in an age without advanced medicine, and without hospitals, isolation was a necessary option to prevent mass infection of the Israelite community. Yet, such isolation was not forever, but only until the particular malady had run its course. Sickness in these accounts were symbols of sin: not that sin “caused” leprosy, but rather that physical ailments such as contagious diseases were signs and manifestations of sin. They were reminders that, because of sin, all are under the curse of Adam, fragile human beings susceptible to microscopic terrors that can hasten one’s inevitable death.
Paired with the isolation of lepers was their visitation, which in Biblical accounts usually entails their impending healing. Elijah’s healing of the leper and outcast Naaman and the various healings of the sick by Jesus, particularly of the leper in Matthew 8, are examples of the encounter with those who are ill and contagious. In the case of Jesus’ healings, they are signs that the curse of Adam will be broken through Christ, and that physical death will no longer be the final word for those who believe in Jesus. It is important to note that these are physical healings involving the physical presence of Elijah and Jesus. Jesus almost exclusively heals through physical presence and touch, as they are signs that the rescuing of sin from death is a physical restoration of the body. The scene in Matthew 8 would have been shocking to its original hearers: Jesus touches the leper, and as result, effects his cure.
THE PASTORAL TRADITION
We see thus a dual dynamic in scripture—one that emphasizes the isolation of the (potentially) contagious for the health of the community, while at the same time the impetus from certain members of that very same community to visit the sick for healing and comfort. These dual themes of isolation and visitation continue throughout the various plagues and pandemics in Christian history. The term leper became a kind of loose term for anyone infected with the most recent plague, and it was often recommended that victims of plagues, and those who were in close proximity to the infected, were to be quarantined (often for 40 days, most likely as a corollary to Biblical fasting). Such quarantines were at times quite severe, with houses forcibly boarded up for weeks until the disease had run its course.
And yet there was often one exception to this rule of isolation: the visitation of the sick and dying from a minister. Such a person was allowed to put themselves at risk of becoming infected in order to be present with the sick and dying, to hear final confessions, to celebrate and administer communion, and prepare them for the afterlife. This is an extension of the healing of the diseased by Jesus: the job of the minister was to pronounce the eternal healing of Jesus Christ as a final comfort to those who believed. As Jesus healed through physical means, visits were themselves physical. The minister did not shout prayers from outside a boarded house, but instead entered, at risk of their own lives, in order to touch the sick, to give them communion, and to comfort them, so that they might not fear the destruction of their earthly bodies. What we are currently experiencing with the outbreak of coronavirus should be seen as another plague in a long line of historical maladies, with the response being consistent with what is already demonstrated in Scripture and Christian history.
PRESENCE IN PAIN AND SUFFERING
Illness and suffering are physical manifestations of the consequences of sin, and they have the potential to drive the sufferer towards further isolation from God, others, and themselves. Pain is something that can never be fully shared by another—it is experienced inside the self. There is thus a temptation for the sick to turn exclusively inwards. Extreme suffering upends and discombobulates our existence—radically altering the tenor of our relationships, limiting our capacity for work and leisure, and leaving very little left of the things in life that often define us. As such it is a moment where one can either sink in despair or turn to God as the one who will not wither away with the temporalities of this earthly life. Suffering is a stirring of the soul, as Augustine says, capable of producing a foul or beautiful fragrance depending on the disposition of the sufferer.
Our medical system tends to exacerbate the isolation of those suffering. We extract the sick from their communities and place them in sterile hospitals, with frequent noises and interruptions that prevent the sustained silence through which God often speaks. The protocols being implemented by many hospitals in light of Covid-19, with extreme restrictions on visitations, will only compound this isolation.
Visiting the sick helps to close the isolation gap, reminding the suffering that they are not alone. It reminds the frail that their community is not comprised of impatient doctors and harried orderlies, but the body of Christ, a community that shares each other’s burdens. By offering confession, prayers, and communion, ministers remind the sick that death is not eternal separation from God for those who trust in Jesus Christ. Those who believe in Jesus as the resurrection and the life will be found to be like Lazarus: not dead, but only asleep, waiting for the words of Jesus to shout arise.
But a persistent question remains in our age of technological ubiquity: why risk contraction of a contagious disease when one can communicate through a glowing screen? Couldn’t a Facetime visit accomplish similar objectives while keeping all parties safer? The response to these questions is simple and intuitive: physical presence matters. To speak with someone over the internet is not the same as having them physically present. Millions of us are having to rely on video communication during the Covid outbreak, and it has revealed how different and substandard such communication is compared to being in the physical presence of another.
There is another, deeper reason why physical presence is so important: physical touch is the primary means by which we take on the suffering of others. God has created human beings physically dependent, and we are hardwired to ease each other’s suffering through physical contact. A child’s tears end with a parental embrace. The teenager cries on the shoulder of a friend after a breakup. A daughter holds their mother’s hand through the final breaths of life. Such contact enables a connection and transference of suffering which points to the moment where Christ took upon himself the suffering of the world on the Cross. To deny someone such contact at the last hours of life is a monstrous injustice.
It may be difficult for those who do not believe to see how the benefits of comfort outweigh risks of contagion. For Christians, health is a good, but not the final goal of human life, which is eternal fellowship with God through Jesus Christ in the power of the Holy Spirit. Millions of Christians throughout history, most notably the martyrs, have risked their own health so that others may obtain that higher goal of communion with Christ.
While most of us will not be called upon to take such enormous risks, there are practical steps that can and should be taken by Christians so that those suffering from coronavirus might not suffer alone.
First, those Christians who visit coronavirus patients should self-quarantine. In visiting the leper to alleviate their isolation, they take upon themselves the isolation of the leper for the health of the community. Such steps are already being taken by health care professionals around the world. This will be difficult, particularly for those who live in close quarters with loved ones. There are stories of doctors setting up temporary living quarters in their garage in order to protect their spouse and children. Ministers with families may be asked to make similar sacrifices for the sake of the suffering. In so doing, it also demonstrates solidarity with those in the medical profession and shows that Christians take seriously public health concerns.
Second, Christians must learn to navigate a multitude of institutional dynamics, from individual hospital protocols to state and federal laws. Christians should not passively accept injunctions prohibiting visitation, but instead engage with those in positions of authority and strive to work together to provide what is best for both the self-interest of the patient and the health of the community. Ideally this would involve intentional and direct conversations with doctors, hospital administrators, and local governing officials. If there comes a time when access to coronavirus patients is strictly prohibited, Christians might need to consider more confrontational approaches to defending the rights of the suffering. Let us pray that such situations need not come to pass.
I will give a brief example of what this looks like on the ground level. The lone hospital in my county recently announced a ban on visitations except under special circumstances. As I work with many nursing home residents, I wanted to be sure that any of those residents who have become gravely ill might still be able to receive a pastoral visit. I called my local hospital and asked if pastoral visitations from those gravely ill would be considered a special circumstance under their guidelines, and was informed that it would be. If for some reason pastoral visits were forbidden completely, I would have spoken to hospital administrators in order to address my concerns. I have done this preemptively, before any of my parishioners have become ill, in order to ensure that none those entrusted to my pastoral care might suffer alone. Pennsylvania has a similar guideline for nursing home facilities, allowing pastoral visitations in the case of any end of life situations.
Those who have access to larger hospital networks will have to navigate more complex bureaucracies. However, such hospitals also tend to have more detailed guidelines, as well as permanent hospital chaplains who continue to work during this pandemic. For example, the closest major hospital to me, UPMC in Pittsburgh, has listed clergy care as an essential service for their patients. Local clergy may visit at the request of any patient, provided they submit to a health screening before entering hospital buildings. I would encourage those in positions of authority in hospitals to adopt similar guidelines for their institutions, and those working with smaller hospitals to recommend similar policies (these guidelines can be found here: https://www.upmc.com/coronavirus/visitor-restrictions).
These examples highlight the need for ministers to be proactive in anticipation of the types of pastoral issues that might arise as this pandemic continues. In the wake of the coronavirus outbreak, hospitals have restricted access to those who are suffering and have placed the burden of receiving pastoral care exclusively on the patient. As such, Christians need to be aware of their rights to care and their need to explicitly request such care before they become ill. The more prepared we are, the greater likelihood that the suffering and dying around us will not have to experience their agony alone.
Christians are being called into isolation during this pandemic. They are called to presume that they may be carrying at this moment a contagious illness that threatens the health of the most vulnerable in our communities. As such, we are called into isolation to fast, to pray, and to hear God’s voice in the wilderness. Yet we may also be called to enter into the isolation of those suffering, to risk our own health so that others might remember that death is not the end of the story for those who die in Christ, and that those who share in the sufferings of the cross will also partake in the glory of the resurrection.
Mike Niebauer is the Rector at Incarnation Church in State College, PA. He holds a PhD in Systematic Theology from Duquesne University, focused on missional ethics, and is a longtime Greenhouse pastor with experience overseeing multiple nursing home congregations.