Keeping the Heart Open in Hell

The question in the face of suffering is not, what can we say? but what can we bear to hear? ~Herb Anderson

I wanted to run away from this man, his situation, his suffering. Bill had been one of my patients for nearly a year, and providing him spiritual care turned out to be one of the greatest challenges of my career as a chaplain. Helping care for Bill pushed me far beyond anything that I had been trained to do or say as a ministry “professional.”

There were no more comforting words to be uttered, therapeutic questions to be asked, soothing Scriptures to be read, or healing prayers to be said. There was only Bill’s hell to be encountered, his suffering to be entered into with mercy and compassion. Would I be able to stay present and bear witness with an open heart?

From my experience, Bill was one of the very few exceptions as a hospice patient whose suffering could not be alleviated by the hospice team’s comprehensive approach to symptom management. Bill had advanced lung disease which left him painfully short of breath as he slowly died from lack of oxygen.

The team scored a short-term victory some months into his care when Bill was put on a round-the-clock IV pain pump. For a time, the liquid morphine provided an ease of breath that he hadn’t had for months. But Bill’s symptoms returned with a vengeance, even after massive increases in his pain medication.


It is clear, however, that Bill’s suffering was as emotional and spiritual as it was physical. For most of his life, Bill endured severe bipolar disorder which he often attempted to self-medicate by abusing alcohol. Married and divorced numerous times, Bill had a child he hadn’t seen for over twenty years.

In his own telling, Bill was abusive to the ones who tried to love him, and he pushed away all those who got close to him (upon his admission to our hospice program, it took our team over three months before he would allow anyone but me to visit him). Other than the hospice team and nursing home personnel, Bill had not a soul to visit him or a person that he could come close to calling a friend.

I will admit something that so-called “compassionate” caregivers are not supposed to say: Bill could be an exceedingly difficult man to like. With his rough exterior, sailor’s vocabulary, and negative disposition toward virtually everything and everyone, Bill had a way of generating hostile reactions. Even on his better days, Bill’s caregivers often left his room feeling drained and discouraged.

Over time, however, Bill began to inch his way into our hearts. Little by little, as we continued to provide him consistent, competent care and support, cracks started to appear in his well-defended armor. A veteran, he told me once that he trusted absolutely no one – including himself. Merely the fact that Bill began asking members of the hospice team to visit more regularly was itself a minor miracle.

In the months when Bill’s physical symptoms were under control, he showed us sides of himself which were funny, gentle, even compassionate. It was usually my custom to pray with him near the end of my visits. On one such occasion, as I was concluding my prayer, Bill shocked me by asking me whether he might also pray out loud. I agreed, of course, and Bill went on to offer a profound prayer of gratitude for all of those who cared for him and came to see him. “I will never be able to tell you how thankful I am for you and the hospice workers, David,” Bill said to me with tears running down his cheeks.


Those are the moments when caregiving has its rewards. Most of the time, I readily admit that I receive far more from my patients and their families than I am able to give back. But what about those occasions when visiting seems like a chore, when being a compassionate presence becomes a clenched-jaw struggle – as many of my recent encounters with Bill were?

I agree with Steven Levine that what blocks us from meeting the suffering of others with mercy is our fear of having to meet our own neediness in the process. When I truly seek to come alongside the suffering of one I cannot “fix,” change, or control, then I am brought face to face with my own powerlessness and vulnerability. It’s fine and dandy when I can walk away from an encounter feeling good about “my” ability to buoy spirits and bring comfort. But what happens when my words are met with dismissive grunts, my soft smile by a pained grimace? What if my well-constructed (and carefully charted!) interventions cease to be “useful?”

I get terrified and run away, that’s what.

Bill taught me to remember one of the hardest lessons of my own journey: the path to spiritual freedom and authentic connection with others is always by way of brokenness. It is only when I first get in touch with my own need for grace that God’s healing power can begin to change me from the inside out.

Paradoxically, admitting my brokenness allows me to embrace the wholeness, the shalom, God intends for me. From that place of wholeness, I am then empowered to reach out to others in their own state of need, not as a “fixer,” but as a fellow pilgrim along the Jesus Way of healing, justice, and love.

This way of doing ministry is as disruptive and scandalous now as it was in Jesus’ day. Admitting brokenness totally goes against what we are taught by our culture and often by the church. Brennan Manning tells the story of a public sinner who was excommunicated and forbidden entry to the church. He took his woes to God, “They won’t let me in, Lord, because I am a sinner.” “What are you complaining about?” said God. “They won’t let me in either!”

Carl Jung, the great psychiatrist, illuminated the problem of Christian “helping” in a letter he wrote to a Christian friend:

I admire Christians, because when you see someone who is hungry or thirsty, you see Jesus. When you welcome a stranger, someone who is “strange,” you welcome Jesus. When you clothe someone who is naked, you clothe Jesus.What I do not understand, however, is that Christians never seem to recognize Jesus in their own poverty. You always want to do good to the poor outside you and at the same time you deny the poor person living inside you. Why can’t you see Jesus in your own poverty, in your own hunger and thirst? In all that is “strange” inside you: in the violence and the anguish that are beyond your control! You are called to welcome all this, not to deny its existence, but to accept that it is there and to meet Jesus there.

Remember with whom Jesus spent his days? Prostitutes, traitors, criminals, illegal immigrants, drunkards, riffraff, rebels, crazy people – the “trash” of Palestine. Why? Because, according to Jesus, the Kingdom of God shows up first and foremost among the weak and the foolish and the crazy and the despised. Why is that? Because those in the back alleys and detox cells and prison yards and concentration camps and cancer wards and crack houses and dementia units and homeless shelters KNOW what it means to be hungry forGod

Who does Jesus really annoy? The “good”, “moral,” upright, law-abiding, model religious people. Why? Because they have no room in their nice, ordered worlds for a Savior who turns everything on its head and tells them that they are broken and that they have to lose everything to find God.


One of the gifts that people in addiction recovery often have is the ability to meet the broken and outcast as equals. This gives them the credibility to offer God’s love in ways that are more likely to be received than if they were “helping ”from a position of superiority.

We see Jesus working this way when he encounters the outcast, adulterous, Samaritan woman at the well. Jesus does not condemn her for “living in sin” but gently invites her to acknowledge her brokenness and to drink from the “living water” that is his reconciliation and transformation.

Jean Vanier recalls this when he writes about a chronically-relapsing alcoholic who said to him:

“Now I understand. There are two women living inside me. The one who drinks and the one who, when she is not drinking, refuses to look at the wounded part of me, as if it was too dirty for God to love. I deny that that part exists and I only speak to God about the bright side of me. I understand now that I have to let God meet the wounded, broken, woman inside of me and let him enter into all the dirty places inside me” (Vanier, Befriending the Stranger).

As a supposed follower of Jesus, can I find ways to imitate Jesus’ all-embracing love for the most disgusting, offensive, and broken parts of those I encounter in my daily life? If I understand Vanier and Jung correctly, the answer is “yes” – but only if I first have the courage to face, befriend, and love those most frightening and revolting shadows in myself.

As I sought to keep my heart open in the hell that was Bill’s long suffering and slow dying, it helped me to remember that his terror of dying and fear of living and agony of losing control are also my own. And by the same token, the Love that connects me to life and frees me from fear and makes me whole also belonged to Bill. Indeed, wonder of wonders, that Love belongs to us all.

My prayer tonight is my version of the “Loving-kindness” blessing from the Buddhist tradition:

Oh, Beloved Christ, may Bill and me and all sentient beings dwell in your Heart of Love. May we be free from the suffering of our fears and unfulfilled longings. May we be healed from our brokenness and awaken to the beauty of your Love. May we know Peace – the Peace that makes us whole and invites us to dwell in Love’s Heart forever. Amen.

2 thoughts on “Keeping the Heart Open in Hell

  1. You very eloquently express the helplessness I have felt in some of the hospital calls I have made to parishioners in the past. It also applies to living with those who are beyond their own control at times. I am thinking of students with whom I walk during the school week. Folks who have a disorder beyond their control. As they struggle with the acceptance and compromise that it demands, I struggle with loving them. Kids who move as if there is a car engine powering them without hope of a brake pedal. Kids who have to learn to recognize emotions in others like identifying trees in the woods because they lack the instinctual knowledge that many of us so take for granted. It hurts at times, but I understand the privilege you describe in being able to serve Christ and neighbor through such a ministry. Thanks, David.


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