Wednesday, August 2, 2017

A Reminder of Higher Things: The Rites of Sickness and Death

I was honored to give this presentation to the Thomistic Institute Conference, co-sponsored by the Diocese of Providence these days. I present it here for the benefit of our readers.

Several months ago I took part in a pilgrimage to Lourdes with thousands of Knights and Dames of Malta from all around the world.  Typically, this Malta chaplain was taught many things during that pilgrimage, but first among the lessons God taught me was what it means to be sick.

I met an orthopedic surgeon in Lourdes, a newly minted Knight of Malta, whose first contact with our Order came from first being a malade.  A wildly successful and prosperous surgeon he seemed to have life on a string and it was very good….until they noticed the spot on his brain scan.  A few weeks later the headaches would wake him up in the middle of the night.  And all of a sudden he went from being the doctor with the highest success rate in complex hip replacements, to an old man so weak that he could not stand without the assistance of his wife.

He quickly found out what it meant to be sick.  It meant he was not longer in charge.  He was no longer driving the bus, even of his own life.  Someone else was in charge.  At first, it was just aggravating.  Not having enough energy to do what he wanted to.  But it progressed to needing help to get to the bathroom, and sometimes just standing there like an infant, peeing in his own pants.  And then he started to tremble so much that more food ended up in his lap than in his mouth.

What did it mean for him to be sick?  It meant he was in longer in control.

“But you know," he told me one night as we went out for a walk, “that’s the greatest gift I could have ever received.  Even better than eventually getting rid of the brain tumor and returning to health.  Getting so sick like that was the greatest gift of my life.

“‘Cause the real sickness I had was thinking that I was in control.  That the purpose of my life was being successful, respected and rich.  And I was really successful, and have a whole wall full of awards and diplomas and three houses, four cars and a really big boat.

“No the real sickness was not the one that started with the headaches.  The real sickness was the one that tempted me to forget to pray to God and rely on my own resources, seeking my own pleasure and patting myself on the back for all my wonderful successes.  I was a really sick man.  Not so much in the head, as in the soul of me…way down deep where its only you and God.

“I had forgotten what I learned from the Catechism as a little kid:  That the whole reason God made me was to know him and love him and serve him in this world, and be happy with him in the next.

“And it took that cancer…that blessed cancer…to bring me back to what really matters.

“I remember one night,” he told me, “when I was convinced the cancer was going to kill me.  That night I went to bed and, maybe for he first time in my life, I asked myself the question: What’s this all about?  My life.  My career, My religion.  My marriage,  My kids.

“And it all came flooding in…the truth that its all about the Cross, about that man up there on the Cross and about picking up my crosses and trying to love like him: a self-sacrificing, self-emptying love.  That life is not about what we take, but what we give.  And that all suffering, all sacrifice and even sickness itself is but an opportunity too love…to respond to Jesus after we nailed him to the cross, when he looked down at us and said: Love one another as I have loved you….just before he gave his last breath for love of us.

He touched me, that malade turned Knight, and he taught me what sickness is: a blessed state, which calls me out of the mundane murkiness of my self-confirmed, self-centered life, and calls me to higher things.

The Gift of Sickness
The praenotanda to the rites for the Ordo Infirmorum, or Pastoral Care of the Sick and Dying is one of the most theologically and pastorally insightful introductions to the post-conciliar liturgical books, and one of its most striking statements is found at the end of the third paragraph:

“…the role of the sick in the Church is to be a reminder to others of the essential or higher things. By their witness the sick show that our mortal life must be redeemed through the mystery of Christ's death and resurrection.” (1)

Is there any disease more virulent or more prevalent in our day than the sense that God is irrelevant and that we, the center of the universe, must full heartedly embark on a lifelong search for pleasure, consumption and self-aggrandizement?  

What else could explain the hysteria of the media at the announcement of John McCain’s brain tumor?  Two narratives seemed to predominate.  One was that McCain was an old warrior who would defeat the cancer like he defeated his wartime captors.  The other was that the neoblastoma was so powerful, there was little hope and this explained his confused questioning of the former Director of the FBI.

But McCain himself took a different tack.  He did not dwell on the disease, but flew from his hospital bed to the Senate floor to get back to work.  And in a heartfelt address he called the Congress to what he saw as their role, concluding in humility and honesty:

“It’s a privilege to serve with all of you. I mean it. Many of you have reached out in the last few days with your concern and your prayers, and it means a lot to me. It really does. I’ve had so many people say such nice things about me recently that I think some of you must have me confused me with someone else. I appreciate it though, every word, even if much of it isn’t deserved…I’m going home for a while to treat my illness. I have every intention of returning here and giving many of you cause to regret all the nice things you said about me. And, I hope, to impress on you again that it is an honor to serve the American people in your company.”

Without this serious illness, Senator McCain may have been preoccupied with the TV cameras or the possible primary challenger or the verdicts of the pundits. But whether you agreed with him or not, he was a free man these past few days, made free by a neoblastoma and imbued with a new sense of humility and passion for the truth.

He reminded me of the extraordinary nineteenth century English preacher Charles Haddon Spurgeon, who as the gout, the rheumatism and the failing kidneys slowly wore him down wrote: “Health is a gift from God, but sickness is a gift greater still.”

Anointing at 2 am
Even the sickness of another hits us up the side of the head and wakes me up. I think the one thing I miss the most about being a parish priest is the calls at two o’clock in the morning to go to the nursing home or the hospital bed of someone about to die. It was always the same, as I drove out into the darkness, bleary-eyed and yawning: I was profoundly conscious of my weariness and all the things I had to worry about…especially the unfairness of the fact that I had the 7 am Mass and a full day ahead and how unfair God was to have them call me at 2 am when I had all this stuff I was going to be doing for him, the ungrateful deity…And then there were all the things I was worrying about, from how I was going to find money to fix the leaky roof to that lady who yelled at me after the parish council meeting…. I typically fumed all the way to the hospital.

Until I got there, and began to pray for awhile, at the altar of this old lady’s suffering hearing her gasp for air and lightly grasp the hand of her middle-aged daughter and son…as with tears and gasps and medication…and now with prayers…she prepared to walk through that door to the other side.

Rites of Commendation
The preponderance of the Church’s prayers as we prepare to die are from the Scriptures. Scriptures which remind us that we were joined to Christ's own death in Baptism, that as Our bodies were washed in the waters of the font, and that we have been inserted into the Paschal dying of him whose grave is the portal to eternal life. Old familial readings which remind us that we are separated from those who have died for but a little while, and so with "sure and certain hope" we commend their bodies to him, waiting like the women at the tomb for them to be raised for judgment in the fullness of time. Familiar texts which reassure us that each day we wait in joyful hope for the coming of our Lord Jesus Christ who will raise these mortal bodies of ours and clothe them in an incorruptibility born of his divinity.

And then there are the prayers, sometimes short and repeated, sometimes extended, but all preparing for the last prayer, the Profiscere, “the oldest and most characteristic part of the prayers for the dying,” (2) spoken with the commanding tone of an exorcism or the presentation of the light at Baptism.

The Profiscere is actually divided into two forms in the 1972 commendation for the dying, the first of which is taken from the opening and closing lines of the 9th century Gelasian sacramentaries:

“Go forth, Christian soul, from this world
in the name of God the almighty Father, who created you,
in the name of Jesus Christ, Son of the living God, who suffered for you,
in the name of the Holy Spirit, who was poured out upon you,
go forth, faithful Christian.
May you live in peace this day,
may your home be with God,
with Mary, the virgin Mother of God, with Joseph,
and all the angels and saints. Amen.”

The command to go forth parallels, in a rather direct way, the command given in the Rite of Baptism, which takes on a special meaning now that the grown up neophyte is about to walk through the door from this life to the Kingdom of Heaven: “Walk always as children of light, that persevering in faith you may run out to meet the Lord when he comes with all the Saints in the heavenly court.” (3)
Notice the parallels between the command to go forth and to run out to meet the Lord, as the commendation of the Order Infirmorum is profoundly Baptismal in its imagery.

Also inspired by the Profiscere is the third form of commendation, which is a prayer of deliverance, again not unlike the libra nos prayers of the Rite of Exorcism begins by asking God to deliver the dying man from every distress, and then becomes more specific, providing examples of those who have been delivered by God’s mercy:

as you delivered Noah from the flood
as you delivered Abraham from Ur of the Chaldees
as you delivered Job from his sufferings
as you delivered Moses from the hand of he Pharaoh
as you delivered Daniel from the den of lions
as you delivered the three young men from the fiery furnace
as you delivered Susanna from her false accusers
as you delivered David from the attacks of Saul and Goliath

Noah, facing a devastated world, lifeless and soaked with hopelessness.  Like the old lady with the oxygen tube in her nose who, after the pneumonia, is not allowed to get out of bed.  It’s all blinking lights and dinging machines, but no sign of her couch and her cat and the crucifix before which she prayed her rosary each morning.  And she keeps gazing out that window, looking for a little bird with an olive branch in its mouth.

Or Abraham, born in the Ur of the Chaldees, God calling him out to the land of Canaan and from there making of him the Father of all Nations.  Like the old man who spent over thirty years of his retirement going to the 7 am Mass, having coffee with the guys at MacDonald’s, going home for a grilled cheese sandwich and a nap and having supper with his daughter’s family.  And then he was at Saint Elizabeth’s Hospital, lying there in the bed, knowing way down deep that God was calling him out of Brighton into a land he had long been promised, where he would witness far greater things than even Father Abraham.

Or Job in his despair, like the parents of little Charlie, frustrated by bureaucracies and impending death.  But never losing Faith,

Or Moses, boldly plodding through the waters of death at God’s command, like the seminarian struggling with alcoholism who even in his youth has the courage of a son of God, because God knows he is calling him to great things.

Or Daniel facing the Lion, like the teenager at Children’s Hospital facing Leukemia, trusting that God will give him the courage and strength to face he deadly beast.

Or the three young men in the fiery furnace, singing God’s praises from amidst the red hot coals, like the Father of three being wheeled in for open heart and the last thing he does before they put the mask on him is make the sign of the cross.

Or Susanna, so unjustly condemned, like the young mother with the double mastectomy, who trusts in God’s love for her and for truth and for perduring love.

Or little David, before the Goliath, who like the baby in the neonatal incubator baptized from a Dixie Cup with an eye dropper, who is great not because of his power, but wondrously beautiful because of God’s infinite love for him.

These nine types of God’s mercy are drawn from the fourteen such examples found in a variety of ancient manuscripts.  Earliest attempts to date this text found in these types a reflection of what was seen as funereal iconography in the catacombs.  Indeed, many of you recognize these images of Noah, Abraham, Job, the Red Sea. Daniel, three youths in the furnace, Susanna and David from your visits to the catacombs.

Later studies, however, suggest that while these images are present in the catacombs, and subsequently in the profiscere, it is not so much because they speak to death, but to the new life which catechumens are preparing to receive in Baptism.  Indeed, a study of our own Lectionary for Mass would reveal that a majority of the stories of these Old Testament witnesses are found in that repository of catechumenal formation we refer to as the Lenten Lectionary.  Thus the Profiscere reminds us once again the the meaning of our sickness and even our dying is to be found in our Baptism.  Or, put more specifically, the mystagogy of the first Paschal dying and rising never really ends until we celebrate the final passover from this world to eternal life.

This is confirmed by later studies which have found the earliest forms of this prayer in the third century pseudo-Cyprian exorcisms of catechumens. (4)

All of which is why I miss praying the Profiscere. I miss standing on the holy ground by a death bed. I miss those days because they were good for me. Because on the ride home I was suffused with the deep-down peace of a week’s retreat. Because there is no place you can see life more clearly than by the bed of someone who is about to die. All the little stuff suddenly seems so little, and almost comical by comparison to the ultimate, the higher things which are the substance and purpose of life. It’s as if God consecrates the space around a person seeking to walk through the door and into his arms…a space from which the common is exorcised and only eternal things remain.

Prayers for the Sick w
hich is also why we pray for and anoint the sick ..reminding them that they have been called to a new vocation in the Church…joined to and imitating the Passion of the Christ. As the Praenotanda and accompanying prayers of the Pastoral Care of the Sick and Dying reminds us, these rites keep calling us back to three inconvenient realities we would rather not think of. 

The first inconvenient reality is that we all get sick, and everyone in this room will die. That sickness shouldn't surprise us. It’s a friend we should expect and prepare for it by seeking out the leper and the crippled and the blind and the lame and the sinner and loving them. For inside each of us there is the leprous, the crippled, the blind and the sinful shadows which define so much of our being. And sickness provides us with the opportunity to see what’s really important and cling only to that which lasts: To Christ who heals, Christ who suffers and Christ who loves us through it all.

The lesson that all sickness ends in death is made clear by the very structure of the rites of the Ordo infirmorum, which begins with visits to the sick and ends with prayers for the dead. The last chapter in this book is always the same.

The second inconvenient reality is that sickness and death is something we should fight against, but not so we can get back to the grabbing-for-all the gusto existence of our prior life, but so we can get back to God, praising him at the Altar, feeding him in the poor and living a virtuous life.

This is why the prayers of the Ordo infirmorum make clear the purpose of this struggle. The very first of the Concluding Prayers for visiting the sick explicitly prays “restore their health that they may again offer joyful thanks in your Church.” (5) As the second option asks for “serenity and peace of mind” so that we may “rejoice in your gifts of kindness and use them always for your glory and our good.” (6)

The prayer for the sick before surgery unambiguously prays that “through the skills of surgeons and nurses your healing gifts may be granted to John.” And why do we pray that the surgery will be a success? The prayer is equally blunt: we pray that he might “respond to your healing” so that he might “be reunited with us at your altar of praise.” (7) Likewise, the second option for the Prayer After Anointing asks the Lord to heal our brother “and enable him/her to resume his/her former duties.” (8)

Even the first option for the Prayer After Anointing, which beautifully prays that John might know “comfort in his/her suffering.” courage when he is afraid, patience when he is afflicted and hope when he is dejected, ends with the prayer that when he is alone he might be assured “of the support of your holy people,” (9) a clear reference to the Eucharistic Assembly into which he was baptized and to which we pray he is destined to return.

Speaking of the Eucharistic Assembly, there are two great gatherings which play a role in all these prayers. One stands on this side of the door and one on the other. On this side, to use an older metaphor, is the Church militant, all the folks in the parish and the Church universal, with whom John prays and worships and celebrates the Sacraments through which he has been saved. It is to this great assembly that the Lord gives the Holy Eucharist which will be John’s Viaticum, that he might have the strength to pass over to the other side, where the saints and angels await him in glorious eternal praise of the Triune God.

We are destined for one great gathering or the other, in the mind of the Church rites, and the various prayers which the Church prays for the sick are designed to restore us to one or move us along to the other.

The third inconvenient reality is that only God is in control and it’s a waste of time beating myself up for something I can’t change. In other words, there’s usually little to be gained by lamenting our sickness and a whole lot of need for trusting in Christ.

Our only hope is to embrace the Cross and to allow Jesus to hold us very close. I’m sure you've heard the story of how Mother Theresa (Is it Mother Saint or Saint Mother?) once told an old woman who was crippled with arthritis “Whenever you suffer, it is really just Jesus loving you so much that he is holding you closer to his Cross.” “But could I sometimes ask him,” the woman responded, “not to hold me quite so close!?”

The Prayer After Anointing intended for instances of extreme or terminal illness (10) helps us here. Listen to the whole prayer.

Lord Jesus Christ
you chose to share our human nature,
to redeem all people, and to heal the sick.
Look with compassion upon your servant John
whom we have anointed in your name with this holy oil
for the healing of her body and spirit.
Support her with your power,
comfort her with your protection,
and give her the strength to fight against evil.
Since you have given him a share in your own passion, 
help her to find hope in suffering,
for you are Lord for ever and ever.

That prayer says it all, and clarifies the whole purpose of sickness and suffering: to receive a share in Christ’s own Passion, through which we find hope in suffering. It’s just like the prayer after anointing for the elderly, which includes that poignant description of those “who have grown weak under the burden of years,” and asks for strength that they “may give us all an example of patience and joyfully witness to the power of your love.” (11)

This is why we need the sick, to remind us, just like we needed Pope John Paul II, who was at his best as a pastor of the universal Church when he was weakest: stooped and broken, his hands shaking with sometimes slurred words, the Holy Father gave to the Church the greatest gift you could imagine.

Teaching me how to join my sufferings to the cross of Christ, to stand at the foot of the Cross, with the great Mother of God, to whom that most beautiful ancient Celtic prayer is inscribed on the walls of the Irish Chapel at the National Shrine: “There is no hound in fleetness or in chase, north wind or rapid river, as quick as the Mother of Christ to the Bed of Death of those who are entitled to her kindly protection.”

Thus do the prayers of anointing and visitation of the sick call us to these higher, if inconvenient realities which we so often strive to cast out from our daily lives. For when all this works, when the Church gathers and prays with voices, hearts and lives the ancient rites of the Church, then we, Priests of the one who offered the perfect Sacrifice on the Altar of the Cross, are given the privilege to witness the rites of Church perform miracles.

Like George and I did, probably twenty years ago, as we watched his wife Mary dying of cancer. George and Mary were two of the best Catholics I had ever known as a parish priest in Leominster. They gave their lives for the Church, day in and day out…whenever you couldn't find someone else to do it you could always call George and Mary.

Now they were old. Each week, for years, I would go to their house, as they aged and came up with increasingly unpronounceable diseases. It became something of a habit as, after I had given them Holy Communion, George would tell me about Mary’s newest diseases, then she would shush him and tell me that her aches and pains were nothing compared with what the Doctor said was wrong with George. And them he would shush her and ask how I was doing, and how I should take care of myself because “Father, you look tired. You need a day off.” And then we’d pray some more.

And then, finally, came the say when George and the kids and I were gathered around Mary’s death bed, and it was clear she didn't have too many minutes to go. We had prayed all the prayers several times over. She had gone to confession, professed her faith and received Viaticum. I had sung the Profiscere and even pronounced the Apostolic Pardon.

And then, as we all stood there, looking for all the world like a family at the ATS Security check saying goodbye to a departing loved one, Mary tugged on my sleeve. She was breathing irregularly and she signaled for me to come closer so she could whisper in my ear. And with her dying breath, she said, “Father, I want you to do something for me.” I looked at this dying Saint and said, “Anything Mary, what do you want.” Everyone in the room was staring at us, some with tears in their eyes. “In my bedroom, in George’s closet on the top shelf is a white box. I want you to find it when I die. Because in the box is a new white shirt that I want George to wear at the funeral, because I don’t want them saying I didn't do his laundry!”

I stood up and everyone looked at me to hear the profound last words of their beloved mother. And she looked up and winked at me. I told the story at the funeral.

Mary, in the face of her greatest trial had learned what sickness was about. That we are not made to fear the pain which threatens to swallow us up in the darkness of death. No, sickness and dying are the realm of higher things, where God is to be heard in the quiet stillness of the loving thought, the hopeful glance, the wink that says love lives! It’s not over, it’s just beginning. I still care for you. I will walk with you on your road of sorrows and through the door to the other side.

I need to remember that the next time I get the flu, and loudly lament to the heavens what did I do to deserve this! Or when I get a cold next week and curse the unfairness of a God who just does not realize how much important work I have to do. Or on that day when I will hear that the cancer is malignant, the heart valve irreparable or the virus resistant.

For on that day, in the words of Pope Saint John Paul II, I am called to see my sickness as something more than a personal tragedy, but as an opportunity “to release love, in order to give birth to works of love towards neighbor, in order to transform the whole of human civilization into a civilization of love.” (Apostolic Letter Salvifici doloris, n. 30)

I conclude with the simplest, but perhaps most moving of all the prayers of the Ordo, the Prayer after Anointing of a child, which might well be applied to each and every child of God who will ever be ill, including you and me!

God our Father, we have anointed your child James with the oil of healing and peace. Caress him, shelter him, and keep him in your tender care. We ask this in the name of Jesus the Lord. Amen. (12)


1 Roman Ritual, Pastoral Care of the Sick and Dying [PCSD], no. 3.

2 Damian Sicard, “Preparation for Death and Prayer for the Dying,” in Temple of the Holy Spirit: Sickness and Death of the Christian in the Liturgy, Matthew J. O’Connell, trans. (New York: Pueblo Publishing Company, 1983), 240.

3 Roman Ritual, Rite of Christian Initiation of Adults. no. 273.

4 Damian Sicard, “Preparation for Death and Prayer for the Dying,” in Temple of the Holy Spirit: Sickness and Death of the Christian in the Liturgy, Matthew J. O’Connell, trans. (New York: Pueblo Publishing Company, 1983), 244.

5 Roman Ritual, PCSD, Visits to the Sick, Concluding Prayer, 60b.

6 Roman Ritual, PCSD, Visits to the Sick, Concluding Prayer, 60c.

7 Roman Ritual, PCSD, Prayer After Anointing (Before surgery), 125e.

8 Roman Ritual, PCSD, Prayer After Anointing, 125b.

9 Roman Ritual, PCSD, Prayer After Anointing, 125a.

10 Roman Ritual, PCSD, Prayer After Anointing (In extreme or terminal illness), 125c.

11 Roman Ritual, PCSD, Prayer After Anointing (In advanced age), 125d.

12 Roman Ritual, PCSD, Prayer After Anointing (for a child), 125f.

Father Paul Heller, OP speaks to the assembled priests after dinner last night.

Father Thomas Petri, OP, an SJS Trustee, spoke on Bioethical challenges at this morning's session.