Pastoring In A World Of Pain

It’s been six weeks since I’ve eaten solid food. I’ve lost forty pounds and there doesn’t seem to be any end in sight.

I would like to tell you why.

Thirteen years ago I was diagnosed with a degenerative disk condition causing severe pain in my lower back. I say “condition” as there was no precipitating event and no apparent cause for the deterioration. At forty years of age I was simply the victim of my own constitutional weakness. Something my vaunted orthopedist underscored with the tact and sensitivity of a drill sergeant. “You have the spine of a 70 year-old man,” he asserted abruptly. His laconic manner suggested a lack of interest. An impression reinforced  by his sudden exit from the treatment room thus ending the initial consultation.

In a fugue state of shock, I found myself meandering around an adjoining parking structure searching for my SUV,  perseverating  his grim words and wondering what was I to do next? As fate would have it, just as I located my own ride, I spotted the good doctor making a mad dash for his expertly engineered, stylishly designed German automobile in iridium silver. I rushed over to ask for any glimmer of hope or clarification he might graciously have to offer.

What exactly was I to do with this blunt assessment? What, if anything, was the next step?

“The best option you have is surgery,” he said . . . and off he went.

To prove the point, the next twelve years of my life would involve physical therapy, acupuncture, pain specialists, heating pads, ice packs, topical ointments, poultices of various kinds, a bio-charger and other, shall we say, unconventional forms of eastern medicine. Then came the monthly epidural injections of steroids redounding to little more than two – perhaps three – days of relief. Meanwhile, more and more time was being spent supinely incapacitated with less and less facility for family gatherings, Sunday dinners, or any sort of social interaction requiring my being perpendicular to the ground for any extended period of time. In fact, work and lifestyle changes were instituted, intending to mitigate the damage that inevitably occurs with the normal wear of aging. Mornings would eventually become punctuated by noises no human should ever make, particularly as I made my way to the bathroom – an exercise I now execute with all the grace and ease of an obese, arthritic octogenarian.

And still, none of this even begins to address the social complications. On the one hand, the isolation can be suffocating. Apart from the very public aspect of delivering the Sunday morning message to my congregation (before racing home to peel off the prescription bottle’s child-proof cap), days, weeks, and months pass with me trapped inside a room. Or worse – trapped inside my head.

On the other hand, any occasion that affords the opportunity to be out of the house under normal circumstances is frequently marred by the heart-felt concern of well-meaning friends and the constant roundelay of “how do you feel?” or “how are you?” Their sympathetic tone dampening my spirit while reinforcing the sense that I’m not quite right. Don’t get me wrong, I am eternally grateful for their thoughts and prayers, but there are times I’d like to be normal and not be reminded of my condition.

Then there are those in my congregation who can’t help but question my faith as a result of their own unfulfilled prayers seeking the complete and comprehensive reversal of my circumstances. The truth is, I have never asked God to heal me per se, but rather to use my thorn in whatever outcome He decides upon for His own glory. I trust that while the Lord may not answer the requests made on my behalf precisely as-stated – He will continue to meet my need.

Others cast me as an unreconstructed skeptic of modern medicine for indefinitely putting off the arduous, eight-hour, double-objective, spinal restoration. They believe my hesitation to go under the knife is a thinly veiled excuse for tomophobia – the fear of invasive medical procedures. “You just need to trust God and get it over with.” As though the whole ordeal required little more consideration than ripping off the soiled remains of a tattered bandaid with a single abrasive jerk.  Never mind the fact that the odds of worsening my condition are identical to those of improving it. Hence, my view has always been: Why rush? Anyway, if God intends to use my physical deterioration for some divine purpose, no doctor would be able to change it’s course. Furthermore, what brings God greater glory, one who praises Him for healing? Or one who faithfully praises Him in spite of the pain?

Don’t misunderstand, I’m neither a fatalist nor a martyr. I am a sinner saved by grace. I, like many, have moments of human weakness when my faith is undermined by doubt, fear, self-loathing, or the simple desire for convenience. Every day brings a new challenge emanating from my own ineptitude or by the unfortunate malversation of a flawed health care provider.

Clinical visits, for example, only reinforce the piercing reality that my life has been forever altered. The unending conveyor belt of MRIs, drug screenings, blood tests, X-rays and handicap placards. Not to mention prescriptions from a palliative care system begrudgingly offering only the lowest level of pain medication possible. And any prescription one is fortunate enough to receive cannot be filled before running the gauntlet of pharmacies that refuse to honor it. Each making you a target for their derision with accusations of being psychosomatic, hypochondriacal, a  “drug seeker,” or worse. It’s humiliating – suddenly finding oneself treated by the system as a pariah unworthy of compassion or dignity.

So after years of doctor visits and being relentlessly importuned by the ever present question: “Have you yet decided to undergo surgery?” – in spite of the fact that surgery seemed a risky proposition at best (i.e. no one could explain to me how I ended up in this condition, so what assurances were there that surgery wouldn’t open a Pandora’s box of unintended consequences or that I wouldn’t continue to deteriorate irrespective of this highly-invasive solution?), in spite of the fact that back surgeries are notorious for being 50/50 propositions in the first place (better the devil you know than the devil you don’t); in spite of the growing litany of anecdotes passed on to me by family, friends and acquaintances recounting those who had either died or encountered near-death experiences during this self-same operation;in spite of all of it . . . I relented. I elected for surgery.

One year later (the recommended time for recovery), in addition to the original back pain being worse, I now have radiating bilateral sciatica; an additional misalignment of the mid-thoracic area of my spine causing a constant, sharp pinching between my shoulders; distressing, nightly ankle spasms inducing my left foot to turn, involuntarily, inward on itself; cramping, numbness, and spasms in my left foot with severe discomfort afflicting the arch, and toes – particularly the hallux. All of which have greatly increased my level of impairment not to mention the need for stronger pain medication. To be sure, I can no longer perform my work duties and am faced with the dire possibility of resigning my post.

Which brings me back to where I began. The only way I am able control the spiking pain or mitigate the abiding disability is by refusing to feed the inflammation, which is to say starvation.

Why?

Because the doctor refuses to provide a level of pain medication effective enough to offset the advancing anguish and agony. This, on the hypothetical basis that I might become addicted. A risk belied by the fact that I have taken opioids everyday for over a decade (with the sole exception of weeks-long periods of fasting), while numquam presenting even the slightest sign of psychological or physical dependency.

Don’t misunderstand, I am aware of the unprecedented opioid crisis in this country, not to mention the recent spike of opioid related overdose deaths attributed to the COVID-19 pandemic.  And it’s all well and good to stem the tide of these tragedies and addictions in principle, but to deny legitimately used opioid medication to innocent pain sufferers is criminally disingenuous – particularly for health care providers. Keep in mind that the CDC designed guidelines for opioid prescriptions as non-mandatory protocols for primary care physicians, yet some doctors (and pharmacy chains) have seized upon these guidelines and translated them into blanket limits of mandatory policy, notably when doing so can be used to manipulate a desperate patient into a second unwanted surgery – it’s Hobson’s choice.

Moreover, consider these three pertinent facts: Opioid prescribing is currently at an 18-year low . The rate of prescribing opioids has dropped every year since 2011. Yet opioid overdose deaths have skyrocketed since then with an overwhelming majority involving multiple substances used in combination, often including alcohol. In addition, many of those dying were not the intended recipient of the prescribed medication.

Meanwhile, honest, (often teetotaling) palliative care patients who live life in constant excruciating pain with no hope of alleviation are deciding that life (as they know it) is not worth living. Not because their minds have been affected, but because while modern medicine was adept enough to save or extend their lives, it is unable or unwilling to help them deal with the acute pain that faces them for the rest of an unforeseeable future.

And while it may not surprise you that, as a Christian minister, I oppose suicide on religious/moral grounds, not to mention the emotional toll it takes on loved ones; I am less sure an exception doesn’t exist for people with unremitting, excruciating pain. If that pain could be alleviated by painkilling medicines, and a paternalistic government and/or physicians (with their eye on their own cupidinous interests) deny them those medicines, it seems to me it is they, not those choosing suicide, who are morally culpable.

In the meantime, grateful for each day and submitted to God’s sovereignty, . . . I continue to endure. For the many others who have succumbed to this cruel, painful, and humiliating end – a very empathetic – may you rest in peace.

Terry Sweany has served as senior minister of Playa Christian Church since 2006. His education includes a MA in Marriage, Family, and Child Counseling from Hope International University and a BA from Cincinnati Christian University. He is author of the book Life In Ministry and his greatest joy is helping people deepen their relationship with God. Terry lives in Westchester, California  and is a member of the LAPD Pacific Division Clergy Council. He and his wife, Patty, have been married 34 years and have a daughter and grandaughter.

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