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JETS 46/3 (September 2003) 449–
“SO WHAT ARE YOU DOING HERE?”
THE ROLE OF THE MINISTER OF THE GOSPEL IN HOSPITAL
VISITATION, OR A THEOLOGICAL CURE FOR THE CRISIS
IN EVANGELICAL PASTORAL CARE
michael a. milton*
i. a modern parable of pastoral visitation of the sick
Here is a true story—a parable, if you will—about a freshly minted min- ister’s experiencing his first charge. 1 I will not use the real name here, but the new minister was serving as a chaplain at a large metropolitan hospital. On one of his first calls, he went in to see a newly admitted patient who was to have surgery that day. Dressed in clerical attire—his uniform of the day— he arrived in that patient’s room without any guesswork as to who he was. The patient, a middle age man, frowning as he watched the freshly minted minister stroll in, looked right in the eyes of the chaplain and barked out, “Yeah, Chaplain, can I help you?” The minister replied, “I am a hospital chaplain.” The patient lowered himself back into the covers. “I figured that much, Chaplain.” The grumpy patient then recovered a bit and sat up. “Chaplain, tell me something.... This morning, the surgeon who will per- form my surgery came in. He marked me all up on my chest where he plans to cut away at my breastbone to get at my heart. I knew why he was here. Then, in came a nurse. She hooked me up to these I.V.s. I knew why they were here. A little lady came in shortly before you arrived to fix me up with a bedpan, if I needed it. Now, I even know why she was here. But, Chaplain, the question I have of you and every other fellow like you in that dog collar is this: ‘What in the _____ are you doing here?’ ” Our clerical friend said that he stood there for a second that seemed like an eternity. Then, it came out almost automatically: “Actually, I am here be- cause God sent me to see you.” He had not planned to say that and had no idea, really, what one should say at such a time as that. Years later, the minister would confess that it was actually one of the most profound things he had ever said but it was uttered in abject fear and with no one else around to hear it except that perturbed patient!
(^1) From personal notes taken from a lecture by Dr. G. Wade Rowatt at The Suicide Prevention Clinic for United States Military Chaplains, The Menninger Clinic, Topeka, Kansas, July 19, 2000.
- Michael Milton is senior pastor of First Presbyterian Church, 554 McCallie Avenue, Chatta- nooga, TN 37402.
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The chaplain’s prophetic response, though, hit the man hard. It was the right answer. O.K., Chaplain, O.K., I guess I get it. All right, so I know why you are here. Pardon me for putting it the way I did, but, I am the Chief of Psychiatry at this hospital and for thirty years I have always wondered why you people were here. I may not believe what you believe, but I guess I know why you think you must be here. At that the chaplain felt braver. “So, tell me Doctor, how are things with you and God?” The psychiatrist was sort of stunned at the question, but then re- laxed, and thoughtfully replied, I will tell you this: I’ve seen a lot of simple operations get a little fouled up over the years. My operation will be open-heart surgery. I know full well that if something were to go wrong... well, I guess I’m saying... I’m not sure about God. “Go on,” the young chaplain whispered. “Well, what does that Bible say about what happens when you die?.. .”
ii. modern problems in pastoral care of the sick and dying
Whether the minister of the gospel is a solo pastor with an older congre- gation (who gets more than his fair share of hospital visits) or the senior pas- tor of a mega church, or even a professor of a college or seminary who may also serve on the staff of a suburban congregation, all ministers usually wind their way into hospital parking lots, hopefully locate that most serendipitous of locations—a vacant space in the Clergy Parking Area—and climb stairs and maneuver endless corridors to enter the room of people in hospital beds. Some of them the minister will know quite well. Others will be friends or rel- atives of the congregation, and the minister will have never met them. Few clergy would dispute the proposition that hospital visitation is a nec- essary part of the minister’s work. The biblical references on the matter are so many and so clear that pastoral visitation of the sick and dying is an ex- pected work of the minister of the gospel in carrying out a biblically faith- ful pastorate. Now Naaman, commander of the army of the king of Syria, was a great and honorable man in the eyes of his master, because by him the LORD had given victory to Syria. He was also a mighty man of valor, but a leper. Now bands from Aram had gone out and had taken captive a young girl from Israel, and she served Naaman’s wife. She said to her mistress, “If only my master would see the prophet who is in Samaria! He would cure him of his leprosy” (2 Kgs 5:1–3). 2 “I was naked and you clothed Me; I was sick and you visited Me; I was in prison and you came to Me” (Matt 25:36). “I was a stranger and you did not take Me in, naked and you did not clothe Me, sick and in prison and you did not visit Me” (Matt 25:43).
(^2) All Scriptural quotations are from the nkjv unless otherwise noted.
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suggest that liberalizing tendencies in modern pastoral care, as well as ordi- nary but errant pastoral identities, require professors of practical or pasto- ral or applied theology to recognize the persistent possibility of crisis in this important aspect of the pastor’s work and to be intentional in re-orientating 7 future pastors toward a biblically faithful, vocationally satisfying, and histori- cally evangelical approach to the visitation of the sick and dying. An impor- tant caveat to be made at this point is that this paper is primarily concerned with raising and addressing concerns about the visitation of the sick by gen- eralists—generally speaking, parish ministers—not specialists such as hos- pital or military chaplains (although what I propose in this paper would, I think, be of some value to them as well).
- Liberalizing tendencies. “So what are you doing here?” should pro- voke a prompt and decisive answer. There have been a variety of helpful theologians and pastors and writers who have helped form our response. 8 Most of the great patristic figures have answered this central question about the role of the minister in caring for the sick. Among them, we would name Tertullian, Origen, Chrysostom, Cyril of Jerusalem, and the great Augustine. Classical catholic voices such as Ambrose, Gregory, and Thomas Aquinas have answered the question. Classical Protestant voices such as Luther, Calvin, Bucer, Herbert, Gouge, Bunyan, Owen, Baxter, and Wesley have weighed in. Modern voices like Kierkegaard, Niebuhr, Barth, Bon- hoeffer, Geoffrey Nuttal, and Thomas Oden have added their comments. We shall consider some of them momentarily. But, amazingly, in the presence of so many of those voices saying remarkably similar things about the work of pastoral visitation of the sick, there have been answers that could only be described as novel. These voices might be characterized as liberalizing ten- dencies in the work of pastoral visitation. These voices have tended to pare the theological edge off of a distinctively evangelical or perhaps we should say, “classical” response, in favor of a new voice. This new voice carries with it the familiarly unbiblical echoes of the modern psychological movement. Among these new voices Thomas Oden lists the following: “... Stolze 1940), Waterhouse (1940), Goulooze (1950), Bergsten (1951), Johnson (1953), and Hiltner (1959).” 9 The force of their teaching, while offering much that would surely be welcomed as helpful by evangelical pastors, was to supplant the sufficiency of Scripture with an unhealthy and unwise dependence on the teachings of modern psychology. Frederic Greeves, author of Theology and the Cure of Souls and an eminent British pastoral theologian, visited the United States in the late 1950s and remarked (and I quote from C. W. Brister) “that ministers ‘are primarily consulted as psychologists’ rather
(^7) The term “re-orientation” is a helpful one suggested by the Anglican Martin Thornton in his Pastoral Theology: A Reorientation (London: S.P.C.K., 1964). (^8) Thomas C. Oden has provided excellent bibliographical starting points for further study of pastoral visitation and care of souls in his Pastoral Theology: Essentials of Ministry (New York, NY: Harper & Row, 1983); see pp. 185 and 203 as well as his bibliography. (^9) Ibid. 204.
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than as pastors.” 10 Indeed, Seward Hiltner, who may be called the father of the “modern pastoral care movement” in seminary education, relied heavily on the behavioral science work of Karl Menninger and, indeed, was a profes- sor at the Menninger Institute in Topeka, Kansas, in 1957. He was also the chief spokesman for a distinctively Rogerian form of pastoral care. Carroll Wise, another prominent member of this school, taught that “[w]e ministers do not solve anybody’s problems.... We are simply a means by which a per- son is enabled to work out his own destiny.” 11 I will not go into his thoughts on preaching, but his statement that “exhortation... may do a lot of harm
.. .” 12 fairly represents his assessment of the older Biblical approaches to pas- toral care and, particularly, the role of the minister in visiting the sick and dying. After Hiltner, the name of Dr. Howard Clinebell, who labored as Professor of Pastoral Psychology and Counseling at the School of Theology at Clare- mont, Claremont, California, must surely rank as the key teacher of these innovative ideas about the ordinary work of the pastor in cure of souls. There was nothing ordinary and certainly little that was biblical in this man’s work. Clinebell, in his Basic Types of Pastoral Care and Counseling (in the 1990 eighth printing of the 1966 original), which emerged as a primary textbook in pastoral counseling in many mainline seminaries, proposed that a key goal of a pastoral counselor was to help parishioners to “develop and cherish a nurturing interaction with our great mother—Mother Nature.” 13 Drawing from feminist theology, Clinebell encouraged an “androgynous wholeness” to the self as a goal of pastoral counselors. 14 Clinebell is helpful to the evangelical only in this: he records the history of what he calls the “contemporary flowering of this ancient ministry.. .” [of cure of souls] by listing the chief pioneers. 15 He includes “Richard Cabot, Anton Boisen, Philip Guiles, [and] Russell Dicks.. .” 16 I say this is helpful to evangelicals, be- cause in listing the names he exposes the progenitors of the false doctrines. Other than this, his textbook, which is grounded in psychology, feminist the- ology, and liberation theology, with limited references to Scripture and the casuistic practices of most of Christian history, the book has no value for the work of an evangelical minister. Yet, many evangelicals in mainline de- nominations were educated in it. All of this is to say that there was enormous synergy between psycholo- gists, philosophers, and psychiatrists and the modern pastoral care movement
(^10) Frederic Greeves, Theology and the Cure of Souls (Manhasset, NY: Channel, 1962) as quoted in Brister, Pastoral Care pp. 66–67. (^11) Carroll Wise, A Clinical Approach to the Problems of Pastoral Care (Boulder, CO: Western Interstate Commission for Higher Education, 1964) 87. This is quoted in footnote 4 in Jay Adams, Competent to Counsel (Philipsburg, NJ: Presbyterian and Reformed, 1970) 91. (^12) Wise, Clinical Approach 87. (^13) Howard Clinebell, Basic Types of Pastoral Care and Counseling: Resources for the Ministry of Healing and Growth (Nashville: Abingdon, 1990) 32. (^14) Ibid. 37. (^15) Ibid. 41. (^16) Ibid.
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default settings that some ministers might have in their minds concerning hospital visitation. 19
a. Therapist. I begin with the false identity of therapist. Given what we have seen is the ground of the modern pastoral care movement, it is little wonder that pastors might be tempted to assume the role of therapist as they go into the hospital room. Ralph Turnbull wrote encouragingly:
Some pastors fear that greater emphasis on psychology will lead to confusion by eliminating theology as the basis for the pastoral ministry. The pastor must always remember that the nature of his work as comforter is defined by the ba- sic concepts of the Christian gospel rather than by modern psychology. 20 The modern pastoral care movement is born, not of divine revelation, but out of at minimum a syncretism of received traditions in the Church with what Scripture refers to as the “wisdom of this world” (1 Cor 1:20; 2:6; 3:19). 21 At its worst, in the case of Clinebell, it is a wholesale replacement of infallible biblical injunctions, principles, and traditions with broken, sen- sual, and even idolatrous world views. It is easy to see that when the role of the minister of the gospel becomes that of therapist, he is then competing, if you will, with other care-giving professionals. His “ministry,” if that is an appropriate term, has been re- routed from prophet-priest-pastor, ambassador of Jesus Christ, to dispenser of psychological techniques whose traditions are shallow in terms of history and public recognition. I listened to the testimony of one parishioner: a seventy-five year old Pres- byterian man from a conservative denomination, a deacon, and a life-long follower of Christ. 22 The incident happened in 1996 in a the cardiac ward of a large and well-respected hospital in a Midwestern city. The patient said the hospital chaplain came into the room, did not offer to pray or to read Scrip- ture, but proceeded along this line:
Chaplain: “So how do feel about being here.” Patient: “I am ready to go home, I guess. But, I know my old ticker needs a little repair, so I’m just trusting in the Lord.”
(^19) I want to credit Dr. G. Wade Rowatt for his lecture at the Menninger Clinic on July 19, 2000. His observations and line of thinking helped me formulate these thoughts. My notes indicate to me that several of the names of these assumed clerical identities come directly from his insights. (^20) “The Pastor as Comforter” in Ralph G. Turnbull, ed., Baker’s Dictionary of Practical Theology (Grand Rapids: Baker, 1967) 299–300. (^21) “Where is the wise? where is the scribe? where is the disputer of this world? hath not God made foolish the wisdom of this world?” (1 Cor 1:20); “Howbeit we speak wisdom among them that are perfect: yet not the wisdom of this world, nor of the princes of this world, that come to naught” (1 Cor 2:6); “For the wisdom of this world is foolishness with God. For it is written, He taketh the wise in their own craftiness” (1 Cor 3:19). All citations here are from the kjv. (^22) The testimony came from a pastoral interview conducted with Mr. Oscar Bogusch in the Spring of 1996. He described his experience at St. Luke’s Medical Center, Kansas City, Missouri. The chaplain under consideration was the “on-duty” hospital employed chaplain for the shift on a given day during his stay.
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Chaplain: “So, you’re feeling isolated.” Patient: “Actually, my wife comes and goes. I think I’m fine.” Chaplain: “How do you feel about being out of control at this time in your life?”
You can see what was happening. The chaplain, using Rogerian therapeutic techniques, engaged the patient, with the apparent hopes of guiding the pa- tient to get in touch with his feelings. Now, there is something commendable in all of this—as it touches upon empathy and an incarnational approach to the visitation. However, particularly in the case of a believer, this approach is entirely insufficient and unsatisfactory to the patient. They expect an am- bassador of Jesus Christ, not a therapist. They crave, as he related to me, a minister of the gospel to speak the comfortable words of Scripture, to in- quire as to the work of the Spirit in his soul, and to perhaps lead him in prayer.
b. Medical expert. Another assumed false identity for the pastor is med- ical expert. John Wesley, of course, along with many of the Methodist preach- ers, was instructed in and practiced a sort of lay medicine in his day. Doctor Martin-Lloyd Jones was a trained surgeon from St. Bartholomew’s in Lon- don before surrendering to a call to preach. But, apart from these unusual instances—one historical and probably unlikely to be necessary again and the other a unique vocational path—the rest of us should stay clear of offer- ing medical advice in hospitals. In training ministers and observing them in clinical settings, as well as in my own experiences on visitations, I can tes- tify to the tendency to spend valuable moments on the visitation of the sick and dying in questioning the parishioner on their ills, diagnosing their symp- toms, and this most common malady, to offer received wisdom on the vari- ous medical devices in the room. It usually goes like this:
Minister: “How are you doing?” Patient: “Well, they got me hooked up to these tubes. I don’t know what they are.” [At this point, the minister could empathize with the patient over the need to surrender our lives to God in such time, or to thank God for the blessings we don’t even understand. Or, the minister could proceed to be a medical expert.] Minister: “Well, let me see. I’ve been on many pastoral visits, you know. [He puts his glasses on, bends over to investigate the device.] I’ve practically lived in hospitals for the past twenty years. I know all about these contraptions. Yes, that’s what I thought.. .”
At that, the Minister, then assuming the role of medical expert based on years of observation, offers his advice and counsel—not on the ways of God and man—but on medical technology. The problem with falsely assumed iden- tities is not just a sort of professional malfeasance, which is resented by the real professionals, but, once more, the sacrifice of valuable pastoral opportu- nity to present the gospel, apply the gospel, and bring the healing which only the gospel can appropriate.
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often do more than a multitude of words.” 23 Fairbairn reminds the minister of the gospel:
... the thing chiefly needed is to get the heart first to know itself, and then to apprehend and grasp by a living faith, as suited to its wants and weaknesses, the word of God’s faithfulness and truth’ when this is done, all in a manner is gained. And very commonly, as I have said, it will be most readily gained, not by lengthened addresses, or by long prayers; but by tenderness of spirit, sympa- thetic feeling, discriminating fidelity; faith mingling with all, and giving point and impressiveness to the sayings it brings forth from the oracles of God. 24
e. Shaman. Finally, I would suggest that there is a wrong identity as- sumed which Dr. G. Wade Rowatt calls “Shaman.” 25 This is the Minister who comes in with incantations and religious paraphernalia hoping to rid the room and the body of evil through the use of such. In some charismatic tra- ditions this may involve the naming of demons and the laying on of hands to rid the person of them. Alternatively, the Shaman may be a clergyman of a sacramental tradition where ritual is dispensed without the benefit of the Word to the specific situation, and what may simply be called “a human touch.” Often, the James 5:13–16 passage is used as a model for the Sha- man’s visitation. The famous passage reads:
Is any one of you in trouble? He should pray. Is anyone happy? Let him sing songs of praise. Is any one of you sick? He should call the elders of the church to pray over him and anoint him with oil in the name of the Lord. And the prayer offered in faith will make the sick person well; the Lord will raise him up. If he has sinned, he will be forgiven. Therefore confess your sins to each other and pray for each other so that you may be healed. The prayer of a righ- teous man is powerful and effective (James 5:13–16 niv).
Calvin’s view was that the text is a guide for the people of God to seek out the ministry of the presbyters. He saw the practice as an extraordinary work of the apostolic church but says: “The design of James was no other than to commend the grace of God which the faithful might then enjoy, lest the benefit of it should be lost through contempt or neglect. For this purpose he ordered the presbyters to be sent for.. .” 26
(^23) “Pastor as Comforter” 301. (^24) Ibid. (^25) According to my notes from his lectures at the Menninger Clinic on July 19, 2000. (^26) John Calvin, Commentary on James (Grand Rapids: Baker Books, 1993 reprint), 355–56. The commentary at this point reads: The design of James was no other than to commend the grace of God which the faithful might then enjoy, lest the benefit of it should be lost through contempt or neglect. For this purpose he ordered the presbyters to be sent for, but the use of the anointing must have been confined to the power of the Holy Spirit. The Papists boast mightily of this passage, when they seek to pass off their extreme unction. But how different their corruption is from the ancient ordinance mentioned by James I will not at present undertake to shew. Let readers learn this from my Institutes. I will only say this, that this passage is wickedly and ignorantly perverted; when extreme unction is established by it, and is called a sacrament, to be perpetually observed in the Church. I indeed allow that it was used as a sacrament by the disciples of Christ, (for I cannot agree with those who
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We have thus far made a case that there is a need today to clarify the role of the Minister of the Gospel in the work of visitation of the sick. We have seen indications from the writings of some in the modern pastoral care movement, which might lead some to conclude that there is a possible wide- spread orientation toward the psychological-therapeutic model in pastoral visitation of the sick and dying. We have also considered five possible false identities for the work of visitation of the sick and dying.
iii. biblically faithful methodologies, identities,
and tasks in the visitation of the sick
My concern at this juncture is to consider a reorientation to biblically faithful methodologies and identities for conducting the work of visiting the sick and the dying.
- Biblically faithful methodologies for shaping pastoral identity and tasks in the visitation of the sick and dying. If we assume that twenty- first-century evangelicals agree that visitation of the sick and dying is an ordinary work of the gospel ministry (perhaps not as confident an assump- tion in today’s entrepreneurial-managerial approach to ministry, but I leave that “boundary” for another paper and another time 27 ), a pressing question remains. If we reject the modern pastoral care movement as a candidate for a faithful biblical methodology (and I would urge that we who are evangel- icals have no other choice), then where do we turn? I would propose that we “remove not the ancient landmark” (Prov 22:28 kjv) and recover faithful methodologies, importing their biblically forged values and tried-and-true approaches into our own generation of ministry. I offer two: English Puritan casuistry and a distinctively evangelical sacramental ministry.
a. English Puritan casuistry. English Puritan casuistry—the process of arriving at God’s wisdom for a given situation through questions and an- swers of a given case—was practiced by such luminaries as Joseph Hall (1574–1656), Jeremy Taylor (1613–1667), William Perkins (1430–1495) and
(^27) I would also urge the reading of Eugene Peterson’s works on pastoral theology, particularly Five Smooth Stones for the Ministry (Atlanta: John Knox, 1980), Under the Unpredictable Plant (Grand Rapids: Eerdmans, 1992), and Working the Angles (Grand Rapids: Eerdmans, 1987).
think that it was medicine;) but as the reality of this sign continued only for a time in the Church, the symbol also must have been only for a time. And it is quite evident, that nothing is more absurd than to call that a sacrament which is void and does not really present to us that which it signifies. That the gift of healing was temporary, all are constrained to allow, and events clearly prove: then the sign of it ought not to be deemed perpetual. It hence fol- lows, that they who at this day set anointing among the sacraments, are not the true follow- ers, but the apes of the Apostles, except they restore the effect produced by it, which God has taken away from the world for more than fourteen hundred years. So we have no dispute, whether anointing was once a sacrament; but whether it has been given to be so perpetually. This latter we deny, because it is evident that the thing signified has long ago ceased.
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Sacrament (optional and used according to tradition; ordinarily the Sacrament of the Lord’s Supper would not be administered on routine hospital visits, but when accompanied by someone from the local congregation with arrangements having been made for the special service)
- Biblically faithful metaphors for shaping pastoral identity and tasks in the visitation of the sick and dying. As I approach this section, I com- mend the reading of John Stott’s Preacher’s Portrait in the New Testament. 31 The work of the Minister in visitation of the sick and dying in our genera- tion must also be re-oriented to scripturally faithful metaphors. We should reject psychological identities (and metaphors of the business world as well) for biblically faithful metaphors.
a. Shepherd. A basic biblical identity of the minister of the gospel is pastor. For instance, Paul charges the Ephesian elders (Acts 20:28) to shep- herd the Church of God (poimai vnein thvn ejkklhsÇan touÅ qeouÅ). In Eph 4:11, 32 which is the only place in the Bible where certain members of the Church are actually called “pastors” (or “pastor-teachers” or “pastors and teachers”: poi- mevnaÍ kaμ didaskavlouÍ) the apostle, again, employs the motif of “shepherd” as a governing identity of the minister of the gospel. The work of the min- ister of the gospel as a shepherd to the soul of the sufferer is a lovely motif reminding the faithful of the presence of Christ, the Chief Shepherd. 33 The identity drives the methodology in all of the cases. In the case of Minister as shepherd on the visit, there is gentle guiding the sick or dying to the comforts of Jesus Christ in Word, Sacrament, and Prayer.
b. Ambassador. Likewise, the Minister is the ambassador of Christ, the spokesman from heaven with a “Word from Another World.” 34 So, we read that: “A wicked messenger falls into trouble, But a faithful ambassador brings health” (Prov 13:17). The minister of the gospel is in the hospital room to
(^31) John R. Stott, Preacher’s Portrait in the New Testament (Grand Rapids: Eerdmans, 1964). (^32) Kaμ au˚to;Í e ßdwken tou;Í me;n ajpostovlouÍ, tou;Í de; profhvtaÍ, tou;Í de; eu˚aggelistavÍ, tou;Í de; poi- mevnaÍ kaμ didaskavlouÍ (Eph 4:11). The titles are in the predicate accusative. (^33) For example: “As a shepherd seeks out his flock on the day he is among his scattered sheep, so will I seek out My sheep and deliver them from all the places where they were scattered on a cloudy and dark day” (Ezek 34:12); “I am the good shepherd. The good shepherd gives His life for the sheep. But a hireling, he who is not the shepherd, one who does not own the sheep, sees the wolf coming and leaves the sheep and flees; and the wolf catches the sheep and scatters them” (John 10:11, 12); “I am the good shepherd; and I know My sheep, and am known by My own” (John 10:14); “And other sheep I have which are not of this fold; them also I must bring, and they will hear My voice; and there will be one flock and one shepherd” (John 10:16); “Now may the God of peace who brought up our Lord Jesus from the dead, that great Shepherd of the sheep, through the blood of the everlasting covenant” (Heb 13:20); “For you were like sheep going astray, but have now returned to the Shepherd and Overseer of your souls” (1 Pet 2:25); “and when the Chief Shepherd appears, you will receive the crown of glory that does not fade away” (1 Pet 5:4); “for the Lamb who is in the midst of the throne will shepherd them and lead them to living fountains of waters. And God will wipe away every tear from their eyes” (Rev 7:17). (^34) This is the wonderful title frequently used for the Bible by Dr. Robert L. Reymond.
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bring health in a way—a spiritual way, a redemptive way—that the physi- cian of the body usually does not address.
c. Spiritual Director (Curator of Souls). Of all the terms used for the work of guiding our people to the throne of grace and to the succor available in our living Lord Jesus, I have found none that is more helpful than the more Anglican phrase, “Spiritual Director.” In Eugene Peterson’s classic little book on Pastoral Theology, Working the Angles , 35 he reminds us that a minister only does three things (thus “the angles” of ministry): Word, Prayer, and Spiritual Direction. This identity requires diagnosing the soul, and treating the soul with Word and wise shepherding.
d. Prophet. This is simply announcing God’s Word for today. It is the work of expositing the universal truths of the gospel and applying it to the life before you in the bed. Nothing is more difficult yet nothing could possi- bly be more helpful to the sick than to hear God’s Word says something to them and to their situation.
e. Priest. By this, as an evangelical and a Presbyterian, I certainly do not mean a Roman or even Anglo-Catholic understanding of the word. I mean to say, rather, that the evangelical pastor is a “priest” in that he is, at the moment of his pastoral visitation, the incarnational repository of sacred tradition and ritual and comfortable prayers and hymns. He is the mediator of the treasure-chest of the Church’s services through the centuries to the sick and the dying.
f. Evangelist. This is a controversial identity for some. Yet, the apostolic injunction for pastors remains to “do the work of an evangelist, discharge all the duties of your ministry” (2 Tim 4:5). According to Richard Baxter, the visitation to the sick and dying always carries with it the opportunity to point people to the condition of man and the grace of God in Christ. 36
iii. the true identity of the minister of the gospel
in the care of the sick and dying
In no less an authoritative source than the Journal of the American Medical Association , Dr. Bruce D. Feldstein, a former senior physician in the emergency care department at Kaiser-Permanente Medical Center in Santa Clara, California, told of how he came to see the importance of pastoral care. He learned the hard way. In his article, Dr. Feldstein related how he had just come on duty for the night shift. 37 He took over a case from another physician. The patient, an 86-year-old woman, named Mrs. Martinez in the article (not her real name), was in room 17 suffering from “nausea, vomiting,
(^35) See Baxter’s Practical Works , Introduction by J. I. Packer, Vol. 1 (Ligonier, PA: Soli Deo Gloria, 1990). (^36) Bruce D. Feldstein, M.D., “Toward Meaning,” JAMA 286/11 (2001) 1291. (^37) Ibid. 1291–92.
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