In his book Mortality, the great essayist Christopher Hitchens wrote of what it was like to be struck with esophageal cancer. He went to bed one night feeling normal and woke in the morning barely able to breathe. His heartbeat was off, his energy was low, and it took most of his strength to cross his room to the telephone and call for an ambulance. It was a jarring way to wake, and he wrote that the world it ushered him into was a world from which there was no return.
It was, he wrote, “a very gentle and firm deportation. . .from the country of the well across the stark frontier that marks off the land of malady.” Hitchens’ image is a striking one: he was fine, living in the country of the well, and then came the emergency services crew to load him onto a gurney and carry him off to the land of malady. Forever after he would be a sick person, a patient, a mortal in the land of other mortals who had had any other illusions cruelly stripped away. The land of malady would be Hitchens’ new home. He tried to get used to it with his typical keen observation and sharp wit.
“This new land is quite welcoming in its way,” he wrote. “Everybody smiles. . .[and] an egalitarian spirit prevails. . .” So there were some things that he found to be lovely while under the care of strangers in the hospital. But, he said, “the humor is a touch feeble. . .there seems to be almost no talk of sex, and the cuisine is the worst. . .” Hitchens carried on from there and described, in an almost out-of-body way, the intensely physical experiences he underwent. At the beginning of the book, he was still sharp, as the treatment had not yet taken its toll. But from one page to the next he grew a bit more tired. The last chapter contained only bits of notes that he had scratched out, uncollected thoughts and pieces from a man who lived very fully until the day he died.
Christopher Hitchens wrote from the M. D. Anderson Cancer Center in Houston just a couple of miles from where I lived at the time. I read the columns that turned into his book with great affection, for I had long been a fan of his literary criticism and at least portions of his philosophy. Though Hitchens was a critic of institutional religion, I often found myself saying a morning prayer for him. It was the prayer of an English major for an admired writer, the prayer of a liberal minister for a public intellectual, the prayer of a former chaplain for a present patient, made mostly of quiet mumblings for existential strength and courage. I had learned, as a chaplain, minister, and patient myself, that the line between the land of the well and the land of the sick was about as permanent as a line drawn in the sand on a windy day. And I knew that crossing from one to the other could happen as quickly as making that two-mile trip from the quiet home where I said morning prayers to the massive medical complex where Hitchens lay dying. I learned about that line by walking it with others and by listening to what they said.
This sermon isn’t about me, but I should at least note that my introduction to the line came from my father, who, like Hitchens, was fine until he wasn’t. He began to feel badly at the age of 47, was quickly diagnosed with pancreatic cancer, and died two months later after my mother, my sister, and I took care of him in our home. It was the thinnest of thin places and it was then that I learned that when one person is carried into the land of malady, then everyone who loves them is also carried into a new place, not the land of malady exactly, but the land of caregivers, which is desolate and exhausting in its own way. I continued to walk the line as a professional hospital chaplain for a few years after seminary. I spend most of my time in Oncology, Intensive Care, and the Emergency Room. There are too many stories to tell about that except to say that daily I was impressed by closeness of calamity. The suffering I saw darkened my view in some ways, but the solidarity was equally strong. And what I always carried away was the incredible energy of hundreds, maybe thousands of people, spending all their time and creative energy trying to save each other. It left me speechless sometimes. All of us, together, fighting a common enemy with a thousand names.
And though it might seem that I learned about living with illness from my father or from those years in the hospital, my real learning took place at the congregational level. There I first began to know people outside of the critical care context, and I saw their ordinary courage, day in and day out. I saw how people didn’t want to be relegated to the land of malady, but kept crossing back over to the country of the well to demand their place. I saw people coming to church, going to work, caring for each other, and doing what had to be done with kindness, grace, grit, and humor. So it was people in our church in Houston and people in our church in Charleston that have taught me about the spirituality of living with illness. It’s a spirituality that understands that there may or may not be a cure for our bodies; indeed, ultimately there will not be. But there is a cure for our minds, a way of letting go of our illusions so that we can see more clearly and live more fully.
In his recent book Being Mortal, Dr. Atul Gawande reminds us that there is more than one way to be ill. He speaks of three patterns of decline: the first is that of a terminal disease that people fight but understand where it is heading, the second is that of a chronic disease that is treatable over a long period of time but is not curable, and the third is that of old age, the frailty that comes naturally as part of the life cycle. All of us will meet one or more of these patterns of decline, Gawande says, and it would help us to consider this truth and be honest in our conversations about it. Gawande writes as a physician who has seen unnecessary suffering on the part of those who have not considered their mortality. He urges us to think through questions of illness and aging as a way of getting ready for them. In his own way, he is inviting the question of spirituality. If we know that we will one day become ill or if we already have become ill, then how do we talk about that in ways that are honest and present? How do we avoid denial, illusion, and wishful thinking? More importantly, what would it mean if we did?
Rebecca Solnit writes that it might mean learning to tell the stories of who we really are. She includes in this our hopes and fears, our most vulnerable selves, the deep truths that we stumble into when we really pause to consider that we are finite. An illness jars us, she writes, which is not necessarily a bad thing. It may “invite [us] to rethink, to restart, to review what matters. . .and in breaking [us] from the past it offers the possibility of starting fresh. An illness is many kinds of rupture from which [we] have to stitch back a storyline of where [we’re] headed and what it means.” Listening to so many of you over the past three years, I have heard that again and again. Through illness or injury, we have been broken open, have been invited to rethink our lives, have seen them for the shining gifts they are, and felt the wonder of the present moment, wishing only for its continuance. It’s a beautiful, transparent spirituality rooted in the here and now, the dwelling place of all that holy. Or at least the only place we can see it.
It brings to mind the words of the old psalmist, words the lectionary assigned us for today. Psalm 84 has become one of my favorite psalms, but not for the reasons people might guess. It is, at heart, a song of praise and a celebration of the temple. The old Hebrew poet sings of a sort of happy homecoming when he reaches the worship space. And that’s good. But the text evokes other images, deeper provocations and associations as we trace its lines. A first is that of the nesting bird. In the fourth verse of his description of the temple, the psalmist speaks of a sparrow up in the rafters. She has found a home there and nested; her smallness stands in contrast to the other descriptions of grand courts and altars. Her size reminds me of our own, her frailty like ours. And maybe even her limited vision. Every time I read this I think of the sparrow in the temple as each of us in the universe; we are a part of something grander, more elaborate and sacred than we know. Yet we make a home in our little corner, we walk the rafters with little sense of scale. The sparrow also conjures the words of Jesus, who spoke of birds and lilies when he taught us not to worry. And the temple brings to mind other words, too, like those of the early Christians, who said that our bodies themselves were temples, places for the holy to dwell. So a bird nesting in the temple touches on a number of truths.
Yet there is a second part of the psalm that is even more relevant to anyone living with illness. In the seventh verse, we are told of the pilgrims’ journey to the temple. Most versions render it in sunny language, our TANAKH translation reads as follows:
They pass through the Valley of Baca
regarding it as a place of springs,
as if the early rain had covered it with
This is a poetic translation, almost a romantic one, making the journey sound easy. But Hebrew scholar Jon Levenson brings something much deeper in his translation. “The Hebrew [here]. . .is quite garbled,” he writes, “one can only guess at its meaning.” But “if I render it accurately [it reads] ‘They pass through the Valley of Tears’. . .” So for Levenson the pilgrimage to the holy place is a journey of tears, the only way to reach the temple involves a measure of suffering through which illusions are shed. He calls it both a natural and a spiritual transformation; natural in the sense that the images are of valleys crossed then climbing into mountains and spiritual in the sense that the tears of the pilgrims are somehow turned into rich, life-giving springs. Could that really be the way to the temple? To the dwelling place of all that is holy? The Valley of Tears? The path of some suffering?
It would be dangerous to say that that is the path, that suffering is required. But it would be truthful to say that many of us have suffered, that all of us will suffer at some point, and that we understand that as a part of the journey. Even more, the suffering may come to inform our spirituality. Perhaps the psalmist’s song is so sweet because he has been through the ringer. Perhaps the sparrow’s chirp is so charming because she is, in fact, so frail. Which brings us back to the spirituality of living with illness.
In his book My Bright Abyss, poet Christian Wiman writes about his own experience and reaches a conclusion about faith. Through illness he has come to understand that:
Faith is not some hard, unchanging thing you cling to through the vicissitudes of life. Those who try to make it this are destined to become brittle, shatterable creatures. Faith never grows harder. . .[it] changes. . .[it] is folded into change, is the mutable and messy process of our lives, rather than any fixed mental product.
And Wiman leaves it there. Faith is not fixed, but is messy and changing and vulnerable and real. It is, in some way, the shedding of illusions, the cure for the common misperceptions that we hold about ourselves and our world. And what are those illusions? I have learned three from friends living with illness. They are illusions that keep creeping back and that illness or injury shake off. It is up to us to see past these illusions or see through them in faith.
The first illusion is the idea that there is some kind of divide between the physical and the spiritual or the body and the mind. So much of our Christian tradition was based on ancient Greek philosophy that divided and separated things. And many of us have spent much of our lives living in our heads, barely aware of our bodies until something goes wrong with them. But illness jerks us back into the truth that we are embodied people and there is no separating our spiritual journey from our physical one. What happens to our bodies happens to our minds and vice versa. The pilgrimage we are making is one of blood and bone, our spoken prayers pushed into the air by lung and larynx. The Hebrews were better at this than the Greeks; they had rules for physical living, they set stones as markers, they were travelers and tribespeople who looked for the holy close at hand.
The second illusion is that we have time. We assume that since we have always been here, at least in our own memories, that we will always be, though we know on some level this is not the case. But we slip constantly into the idea that there will always be time for this or that, that we will always feel well, that tomorrow will come and we’ll be here to enjoy it. But illness and injury teach us that the only time we have is the present moment. We may have many, many more years. Or we may not. The gift is each breath. The gift is each hour. We dare not waste them. Or put off what we mean to do. I think everyone who has been ill has realized this. There is something undone that needs to be done. Something unsaid that needs to be said. I thought I had time, we say. And then the scales fall away and we quickly pick up the phone to call that person. Or get off the couch to do that thing. Because we are gifted with a new awareness.
And the third illusion may be our value systems themselves, or at least what our culture has taught us to value. And while it is cliché to say you can’t take it with you, it is true to say that so often illness or injury bring with them the recognition that all we really want is what we already have, that what matters most is life itself and the love we share with those dearest to us. I never met a patient in the hospital who spoke in conventional terms or status symbols. No one mentioned their brand of shoes or car or where there house was or how high they had climbed in their career. No, everyone was just a person in a gown. Rather came the questions of a life lived meaningfully and well. Have I shown the ones I love that I love them? Have I told the truth about who I am? Have I given something back? Have I asked what really matters? These are deeply spiritual questions often brought to us by illness, and whether we are ill or not, we should welcome them. We should ask what we value most.
These are hard-edged truths to tell and perhaps for that reason we rarely tell them. But I offer them today in the hope that they will be an existential gift. For if we embrace the spirituality of living with illness or living as caregivers to those who are injured or ill, then we might find ourselves broken open to the beauty of the here and now. We might find ourselves cured of the illusions that hold us back and keep us from living freely and fully. We might find ourselves newly open to those around us who are ill, listening to the wisdom they have to share and holding it in gratitude.
I remember the day that Christopher Hitchens died. I read the sad news and followed the ritual taught to me by African friends. I walked outside with a glass of top shelf whisky and raised it in the direction of the medical center. Then I poured the first sip into the dirt in gratitude. It wasn’t quite a psalm of praise. But I was standing in a temple of sorts. Birds in the branches above me. And I thanked Hitchens for the reminder.
 Christoper Hitchens, Mortality (New York: Twelve, 2014), 2.
 Ibid., 3.
 See Marcia Angell’s review, “A Better Way Out” in The New York Review of Books, Jan. 8, 2015, accessed online at: http://www.nybooks.com/articles/archives/2015/jan/08/better-way-out/
 Rebecca Solnit, The Faraway Nearby (New York: Viking, 2013), 137-138.
 Matt. 6.25-29.
 1 Cor. 3.16.
 Psalm 84.7, TANAKH translation.
 Jon Levenson, Sinai and Zion: An Entry into the Jewish Bible (San Francisco: HarperSanFrancisco, 1987), 177.
 Christian Wiman, My Bright Abyss: Meditation of a Modern Believer (New York: Farrar, Straus and Giroux, 2013), 17-18.