Caring for the Chronic Post-Covid

If you watch any of the medical dramas on TV, they are mostly about the exciting, the pioneering, and the high-tech. They are also nearly always about the acute. The plot revolves around an unexpected and terrifying crisis which gets fixed quickly by the brilliant skills of the medical team, just in time for the end of the programme.

But a lot of medicine just isn’t like that. That’s because the person doesn’t have an acute problem but a chronic one that won’t go away easily or swiftly.

The same is true of pastoral care. Indeed, in pastoral settings chronic problems may never go away this side of heaven.

Just like doctors who need special training to care for the chronically ill, so pastors need help when dealing with individuals, or even whole churches, where things aren’t going to get better quickly. These are things that are chronic and not acute.

In March 2020, many thought the coronavirus pandemic would be acute. A brief glitch and we would be back to normal. Instead, it is a chronic problem and normality isn’t returning quickly.

I think we might see more chronic problems amongst church members as we come out of lockdown than we did before. So how do you care for the chronic problems you face?

I have a doctor friend who is helping GPs to deal with very similar feelings to my pastor friends: burnout, lack of motivation, and feeling ground down and overwhelmed. Here are three insights I have gleaned from him that may help you as you deal with chronic problems in your church and your own ministry.

Understand the person

Everyone has a back story. There is no substitute for knowing the people you care for. Understanding how that back story might be shaping what is happening now is vital. Perhaps something from decades ago left such a deep impression that it is still affecting, even debilitating, them.

The great physician, Sir William Osler’s most famous quote is: “It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.”

As pastors, we need to understand that reactions to illness and life events vary enormously.

For some, the diagnosis of a chronic problem leaves them dumbstruck or angry because there is no simple “pathway” out of it to follow. Introverts might want to be left alone and engage with just a few very close to them. Others want to talk about the problem while others resign themselves to it. Some need a lot of reassurance. We need to remember there is not a ‘one size fits all’ pastoral approach but we do need to know our people.

Chronic illness can lead to a lot of frustration. Perhaps the diagnosis came slowly and is still unexplained, despite everyone’s best efforts. You will meet people in the course of pastoral care and you can’t get to the bottom of what is really wrong - they are always tired, worn out, or feeling neglected, but no one can fathom why. This can frustrate them – and you.

For some people, the diagnosis of a chronic problem becomes all-consuming to them, and perhaps to you, as you seek to care for them. They worry that it will just drain them of all of life’s good things. They, and you, fear that you won’t be able to cope as things drag on, or go slowly downhill.

There may be the deep-down loss of a hoped-for future. This may be compounded by multiple uncertainties about relationships, money, homes, work, support, benefits, and even role or place in the church.

Dame Cicely Saunders talks of the concept of ‘total pain’, by which she means that a person could be suffering much more than physical problems. We have seen some of this during the pandemic with an increased awareness of loneliness, mental health issues, fears, and anxieties.

As pastors we want to fix these things and can feel a failure if we can’t. Rather than engaging with chronic problems we can be tempted to move to acute cases which may respond to pastoral words more quickly. We need to be more patient than that.

Any caring pastor will need to recognise that chronic illness and chronic problems need an extra level of care.

It is no good viewing them as irritations and distractions from the ‘normal’ functions of being a pastor. This is what pastoral care is. We need to cancel the dream about swooping down in a helicopter to solve a problem in two hours as if you were in a TV medical drama.

Stick with the suffering

There is a massive benefit of being in a long-term position where you can take time to get to know people. This helps you journey with them along the tough pathways. That’s what people want because they know there is no easy fix. But your presence will be one of the great ways that someone can live with a chronic problem. Don’t resent that.

On that journey, make sure you are an active listener who asks good questions. Osler again: “Use your five senses. Learn to see, learn to hear, learn to feel, learn to smell, and know that by practice alone you can become expert.”

Oswald Chambers said: “He will keep you in contact with human stuff, and human stuff is very sordid; in fact, human stuff is made of just the same stuff as you and I are made of; do not shut yourself away from it. Beware of the tendency to live a life apart and shut away. Get amongst men…We have to go to school amongst human souls and we have to educate ourselves with Bible facts…God has a word and a revelation fact with regard to every life you come across…the worker must live amongst human facts, men and women, not theories. Do not let us tell ourselves what men and women are like, let us find out what they are like.”¹

As you find out more, you can enter into someone’s life.

Dr Ian McWhinney comments: “Recognition of a person’s suffering sounds like a simple thing, yet we hear so often that it is not forthcoming from doctors. In this regard, we cannot use lack of time as our excuse, for it is a question more of manner than of time. Patients are very quick to recognize indifference to their suffering in even the briefest of encounters.”²

Perhaps that is a word in season to pastors, too?

McWhinney goes on to tell of George Eliot’s story, ‘Janet’s Repentance’ where the following is said about the help she received from a vicar: “Mr Tryan hesitated again. He saw that the first thing Janet needed was to be assured of sympathy. She must be made to feel that her anguish was not strange to him; that he entered into the only half-expressed secrets of her spiritual weakness, before any other message of consolation could find its way to her heart. The tale of Divine Pity was never yet believed from the lips that were not felt to be moved by human pity.”³

We can always offer hope, even if not a cure. And how much more hope can pastors offer than a GP?

We can always nudge people towards ‘health’ in a spiritual sense, even if that means them being thankful for what they have, not regret at what they might have lost. We can help develop that perspective when we lift our voices to heaven with them.

And the greatest thing you can do is stick with people through it all. We are not hired hands who disappear at the first sign of trouble but are servants of the good shepherd who laid his life down for his sheep.

And we try to imitate him who said, “Just as a nursing mother cared for her children, so we cared for you. Because we loved you so much, we were delighted to share with you not only the gospel of God but our lives as well.” (1 Thessalonians 2:7-8)

Care for yourself

I imagine many who are reading this are chronically worn down, especially by all that Covid has brought to the church you serve. Many pastors (and doctors) are reporting that.

What do you do if you feel bereft of the ‘normal’ blessing of the job – contact with people, conversations about the Lord and his promises, and the many small encouraging contacts that brighten up people’s days?

Recognise fatigue and learn to overcome it

Many pastors have become used to the phone, Zoom, the computer, and the study. It is becoming such an effort to meet real people that we can dread it. Perhaps a real meeting feels draining, so you try to avoid it.

I’d encourage you to fall in love with meeting others again. It was for the love of God and for the love of people that you came in the ministry, wasn’t it? Let renewed contact with God’s love for you rekindle that love. Let his love for you grow your love for others.

Recall the Apostle’s words:

“I pray that that out of his glorious riches he may strengthen you with power through his Spirit in your inner being, so that Christ may dwell in your hearts through faith. And I pray that you, being rooted and established in love, may have power, together with all the Lord’s holy people, to grasp how wide and long and high and deep is the love of Christ, and to know this love that surpasses knowledge – that you may be filled to the measure of all the fulness of God.” (Ephesians 3:16-19).

Note that – rooted and established in love – not yours for him, but his for you (see 1 John 4:10, 11). Like a great tree, we can put deep roots down into his love for us.

Maybe, as we come out of yet another lockdown (and who knows if it is the last?) you need to take time to look after yourself spiritually. You need refreshment in Christ, more than a longer to-do list. It is not selfish to come closer to Christ for yourself before restarting some of your pastoral ministries.

Recall one of the great dangers of the pandemic

Lockdowns have meant that we all have become a bit more wrapped up in ourselves, haven’t we? We can forget that our ministry is a calling to give ourselves away.

Amy Carmichael famously said, “You can give without loving. But you cannot love without giving’. Osler puts it like this, “We are here to add what we can to life, not to get what we can from life.”

Or better still, the Lord Jesus, “For whoever wants to save their life will lose it, but whoever loses their life for me will save it.” (Luke 9:24) We are called to show what that means to the sheep we care for.

Osler also noted, “He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all.” He could be talking to pastors about books, study, and people! Our calling is about God and people – all the other things we are skilled in, even the handling of the Word, are means to helping people love God.

Let me encourage you to allow Jesus’ people to fascinate you and interest you. Call on your best resources to aid the flock, rather than seeing ‘church’ as an organisation you have to just run week after week.

Keep recalling the purpose of all of you do as a pastor – to present this bride to Jesus – who loves his bride infinitely and for all eternity. What a wonderful moment that will be! Purpose is also one of the things we need for our own wellbeing.

Remember to look after your whole self

There are some things we can do to care for ourselves better. Practice a good diet, get regular exercise and keep up patterns of sleep. Revisit purpose and enjoy relationships. The pandemic may have cut some of these things down or led to poor habits developing. Take time to redevelop them.

Do not neglect that healthy trait of having wider interests and hobbies. Lloyd-Jones always maintained his interest in medicine – he would read the British Medical Journal on Saturdays to keep his mind fresh. Just don’t get stuck in the study all the time, hooked onto a computer! Add some fun and downtime.

I remember the late Bob Horn, first editor of Evangelicals Now, telling me to keep playing hockey “for as long as I can”. I’m still going!

You won’t be much good at helping others if you don’t look after the whole of you, and the whole of your family.

In conclusion, I hope that my doctor friend’s wisdom about acute and chronic will encourage you to be the pastor-teachers God wants you to be, helping those who are soldiering on to their eternal home. It has certainly helped me.