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A cancer diagnosis occurs in a moment, but the losses it brings come in slowly yet steadily, like a tide pushing against the shoreline, again and again. In the days after my own diagnosis, I sometimes felt resignation rather than anger or protest. “I’m not the center of the universe, after all,” I told a friend. “The world will continue just fine without me.” But that was just for some moments. Particularly as I considered the implications of this incurable cancer for my wife and 1- and 3-year-old children, the cry of the psalmists spoke my prayer, even before I was ready to pray it:

He has broken my strength in mid-course;
he has shortened my days.
“O my God,” I say, “do not take me away
at the mid-point of my life,
you whose years endure
throughout all generations.” (Ps. 102:23-24)

The psalms have been ­– and continue to be – my steady companion on this journey, showing me how to bring joy and grief, gratitude and protest before the Lord. In addition, the psalms have increasingly shaped the way I approach the tough questions about God’s providence in the midst of tragedy.

Searching for “The Reason”

At times, I’ve sensed that there must be a reason this cancer has hit me. Even if it’s not a good reason – even if I am to blame – I wanted to know the reason. Did I neglect my health in some way, so that I’m getting my due with this cancer? My oncologist said absolutely not. We just don’t know what caused this cancer. Did I get this rare cancer as a test of my faith? If so, what happens if I fail the “test”? Open questions sting, even if they are not new questions. Why did I get this life-threatening cancer? For no reason accessible to me. Why did Job suffer? Even though God himself appeared to respond to Job’s plea, Job was given no reason accessible to him. Why does the psalmist suffer and cry out? Some psalms offer repentance to God: “Wash me thoroughly from my iniquity, and cleanse me from my sin” (Ps. 51:2). But the vast majority of lament psalms do not assume that God is punishing or disciplining for sin through the suffering. Why does the lamenting psalmist suffer? For no reason accessible to the psalmist.

[pullquote type=”left”]The Spirit frees us to cry out in grief and protest and hope.[/pullquote]It can be difficult to leave these raw questions open and unanswered. In some ways, it would be easier to succumb to false answers, such as some I will consider below. But the false answer is not the path that the book of Job or the psalmists take. Indeed, as Paul speaks of “groaning” for the new creation in the Christian life and as Jesus laments in the gospels, we see that the Father of Jesus Christ does not silence our questions of lament. Instead, the love and power of the covenant Lord are mysteriously displayed to those who offer such open questions in trust. Yet while God is the almighty, sovereign Lord, sometimes we need to trust in the dark as we wait for the fulfillment of God’s promises in the dawn.

Monocausal fatalism

One false answer to the problem of suffering is an approach to providence that I call monocausal fatalism. This position rightly confesses that God is active in the world and that the psalmist implicates God in the midst of crisis. From this, it concludes that God is the sole actor in history and that every event comes in a direct, unmediated way from God. The technical term “monocausality” means that God is the sole cause for all that occurs – directly and immediately causing each event. This approach fails to recognize the agency of creatures who have a will that is distinct and often opposed to God. The monocausal approach is condemned as an extreme position by a wide range of theologians – patristic, medieval and Reformation-era; Arminian and Reformed alike. But in contemporary Western Christianity, this extreme is surprisingly common. It dares to speak of God as active and imminent, but it does so in a fatalistic way.

Momentary flashes of this extreme can appear among Christians today when offering prayers for healing. When praying for cancer patients such as myself, they scold those who have prayed that God would work through the chemotherapy. Instead, they ask for immediate healing – for that is the only way that it could truly be shown as the act of God. They rightly assume that God is active but think that God is active in a way that leaves humans inactive – that God does not use instruments (such as doctors, medicine, etc.) to bring healing.

A broader monocausal approach often shows up as a corruption of the key biblical theme that God is sovereign – God is King – even in the midst of suffering. A pastor friend of mine was talking to a couple who had just lost a child by a miscarriage. The husband offered no tears. No emotion. Just the words “It was what God ordained.” In this stoic response, he thought he was holding strongly to a Reformed view of providence. But he wasn’t. He rightly confessed that God is King but missed the place of lament and protest – that the fullness of God’s kingdom is not yet here. “Thy kingdom come, thy will be done, on earth as it is in heaven.” Indeed, as Paul writes, both “the whole creation” and “we ourselves” are ones who “groan inwardly as we wait eagerly for our adoption to sonship, the redemption of our bodies.” We yearn and groan for that day – because we’re not there yet. In the words of one Reformed confession, the Bremen Consensus (1595), God’s permission of sin and evil is not “as something pleasing to God – but as something God hates” (quoted in Jan Rohls, “Reformed Confessions,” Westminster John Knox, 1998). (On this point, I disagree with John Calvin’s rejection of the “active/permissive will of God” distinction – instead, I side with Reformed confessions such as the Belgic, Westminster, Dort and others which affirm that broadly catholic distinction.) God hates for a mother and father to lose a child. God hates the corruption of his good creation. God hates sin. God hates abuse. And so should we.

In order to avoid monocausal fatalism, we need to hold these two biblical truths together: the world – even the most difficult circumstances that we face in it – is in the hands of God the King, and things are not yet the way they should be. Hence, rather than responding to tragedy stoically, the Spirit frees us to cry out in grief and protest and hope: “Thy kingdom come” and “Come, Lord Jesus.”

Another extreme: open theism

On the other hand, the pendulum can swing to an opposite extreme that (unintentionally) undercuts biblical lament as well: open theism. Key advocates of this view, such as John Sanders, are responding to genuine tragedy in their own lives or the lives of others. And quite rightly they seek to say that God hates evil. They are right, too, to move against the stoic misinterpretation of classical Christian doctrine in the example above. But rather than living in the midst of the mystery that God is loving and yet also almighty, thus leading to lament when his promises appear to be in peril, they let God off the hook: God’s power is such that God could not prevent the tragedy. Figures such as Sanders thus assert that God has a general purpose leading to good in giving humans freedom, but in specific instances of tragedy “God does not have a specific purpose in mind” (“The God Who Risks: A Theology of Divine Providence,” IVP Academic, 2007). Specific tragedies are examples of “pointless evil,” Sanders asserts – pointless not just from a human perspective but from God’s standpoint as well. Sanders rejects the classical notion that God could “permit” evil because it implies that God intentionally permits a particular tragedy, which he insists is “pointless.” (In “The God Who Risks,” Sanders repeatedly presents a choice only between open theism and the monocausal view of providence. In my view, this is a false choice – in my own “Rejoicing in Lament,” I advocate a third way that does not fit with either open theism or monocausality.)

In seeking to be sympathetic to those who are suffering, open theism unintentionally cuts the nerve of lament – which trusts God’s goodness and power to the point of holding God responsible in the midst of the calamity. The psalmists keep asking, questioning and petitioning because they believe God is the almighty Lord. In his “Hurting with God: Learning to Lament with the Psalms” (Abilene Christian University Press, 2012), Glenn Pemberton describes the psalmist’s perspective well: “Why does an all-powerful king suddenly and inexplicably no longer bless, no longer order life, and no longer hold things together? If a person did not believe that God was sovereign, there would be no cause for lament.”

I believe we need to follow the lead of the psalmist who trusts in God’s almighty power and goodness – and who because of this trust wrestles with God: “How long, O Lord? Will you forget me forever? How long will you hide your face from me?” (Ps. 13:1). If the psalmist did not believe that God remembers his covenant, that God’s face would bring deliverance because of his goodness, then the psalmist wouldn’t bother to cry out. Because we take God’s promises seriously, we are called to wrestle with God when they do not seem to be coming to fulfillment. Yet the psalms of lament also suggest that we should not be triumphalistic when we respond to the suffering of others. It is no reassurance to those in grief or anger to declare, “This is just God’s perfect plan!” Yes, the Triune God is King, but Christ’s kingdom is not yet uncontested. Until that kingdom comes in fullness, the Spirit will be groaning with the creation – complaining, grieving and protesting that this is not the way things are supposed to be: “How long, O Lord? Will you forget me forever?” and “Come, Lord Jesus.”

Joining the resistance: lament and the kingdom

What are the implications of leaving the problem of suffering an open question before God? It means that we bring our anger, confusion and grief in response to suffering before God in prayer. But it also relates to our life of witness in the world: acting in a world in which God is King yet groaning and waiting for his kingdom to come in fullness.
When I was a seminary student, I had a friend who was a chaplain at a children’s hospital. He was counseling a nurse who was facing what we might call “compassion burnout.” She wanted to help people. Perhaps, like many today, she wanted to try to change the world. But instead she found herself going into one hospital room after another, providing care for young children with terminal illnesses. They were not likely to live more than a few years. What good was this doing? Was this really changing the world?

My chaplain friend responded to the nurse’s plight in a striking way: He suggested to her that, rather than serving only if she could change the world, she should continue her service as an act of witness and protest. How do we respond to a world with dying children? That is not the way things are supposed to be. He said she should continue her compassionate action as a lament that witnesses that things in this fallen world are not the way they are supposed to be. In the words of Paul, we are in a “struggle” against “the powers of this dark world” (Eph. 6:12) that deal out alienation from God and neighbor and deal out death. We struggle to “stand firm” (v. 13) and bear witness to Jesus Christ, the victor over sin, the devil and the powers. His victory is secure, but his reign of peace and shalom has not fully come.

[pullquote type=”left”]Because we take God’s promises seriously, we are called to wrestle with God when they do not seem to be coming to fulfillment.[/pullquote]Seen this way, the point of compassionate action is not to change to world. It is to be faithful and to bear witness in word and deed to a different kingdom: that of King Jesus. As our lips say “Thy kingdom come,” we pray – and act – as revolutionaries who protest against the darkness in this “present evil age” (Gal. 1:4). As Karl Barth says in “The Christian Life: Church Dogmatics,” “The law of prayer is the law of action,” for when we pray for God’s name to be hallowed and God’s kingdom to come, we “cannot come to terms and be satisfied with the status quo” (“Lecture Fragments,” Eerdmans, 1981). We are to “revolt and fight” against “the disorder which inwardly and outwardly controls and penetrates and poisons and disrupts all human relations and interconnections,” Barth says. Christians have “a binding requirement to engage in a specific uprising,” for in “sighing, calling, and crying ‘Thy kingdom come,’” Christians enter into a “revolt against disorder,” he says. God’s good creation is still good, but it has been corrupted and alienated – and God’s reign has not reached its final culmination.

Compassionate witness to the true king

Behind the common expression that God’s kingdom is “now but not yet” lie paradoxes that run deeply through God’s self-revelation in Scripture. God is the only, true, sovereign King. Yet what we see around us – a world with cancer and death, sin and alienation – is not his consummated kingdom. The Triune God conquers sin and the devil in the sending of the Father’s Son to live, to die and to be raised again, all through the Spirit’s power. Yet the creation still groans (Rom. 8). We are still in a battle, requiring the armor of God “against the rulers, against the authorities, against the cosmic powers of this present darkness, against the spiritual forces of evil in the heavenly places” (Eph. 6:12). God’s present reign is a kingly, sovereign reign. Sin and the “powers and authority” only have temporary power through permission of the King. For in Paul’s words, at “the end,” when those who belong to Christ are raised, Christ will have “destroyed every ruler and every authority and power. For he must reign until he has put all his enemies under his feet. The last enemy to be destroyed is death” (1 Cor. 15:24-26). Until then, we protest against God’s enemies – death, sin and the devil – as we bear witness to the present and future King, our God, Father, Son and Holy Spirit.

Compassionate witness in the mode of lament and protest against sin, death and the devil does not imply that the problem of evil has been answered. To the contrary, the question of suffering is approached as one that requires not a theoretical answer but our practical response. Indeed, a theoretical answer to “why this suffering exists” can actually harden our hearts rather than lead us to compassionate action. While working in a homeless shelter for five years, I could have used scores of reasons to explain away the suffering I saw around me: We can’t help them because they suffer from mental illness and addiction. We can’t help them because they are too broken. We can’t help them because they are too stubborn. We can’t help them because no one will hire them. We can’t help them because they are not healthy enough to receive help. All these reasons point one direction: The present state of the world – with homeless sufferers – is the way things must be. Indeed, perhaps some would say that because this is the way things are, it’s the way that God the King wants them to be. But to claim this would be to answer the theodicy question in a way that excuses our indifference and apathy in response to the homeless and other sufferers around us (see Daniel Castelo, “Theological Theodicy,” Cascade, 2012). It would be to miss the radical nature of the Christian faith that prays, “Thy kingdom come on earth,” because although God is the sovereign King, his promised reign on earth is not yet fully present.

Trusting in more than our own faith

I believe that prayers of lament are interconnected with acts of compassionate protest and witness. Yet, in the midst of my cancer journey, I’ve faced a temptation: it’s not to deny God’s goodness, but to say that I’m too weary and weak to trust that the new creation is coming. A hope and trust in God’s promise is essential to maintaining a persistent prayer of lament and a life of compassionate protest in “this dark world” (Eph. 6:12) – protesting that this is not the way things are supposed to be. When a hopeful trust in God’s promises is in short supply, it can feel like trying to run a race when you’re short on oxygen: You slow down, you pant, you gasp for air. As strange as it sounds, the psalmist can bring anger, frustration and protest to God precisely because the lament is rooted in hope. If you don’t hope that God is good and sovereign, you don’t bother to bring your lament and thanksgiving to the Lord. Sometimes I feel too weak to hope, too tired and despairing to even lament.

My cancer is incurable, and stubborn. Others face stubbornness in their circumstances as well: the nurse discouraged by the stubbornness of childhood terminal illness; those working with people under the slavery of addiction; the Christian who prays for years that a loved one will come to faith in Christ. Why would God not respond to such prayerful petitions and the actions of witness that go along with them? Is the kingdom of Christ’s peace really coming? How do we keep up the courage of asking, again and again, “Thy kingdom come?” Sometimes I’m tired of “revolt,” as Barth calls it. I’m tired of hoping.

When the psalmist cries out for rescue, “O guard my life, and deliver me” (Ps. 25:20), the poet is not just “trying to revive hope” as an act of self-help – he calls to God for deliverance. In his commentary on this psalm, John Calvin suggests that we are to pray that God “would increase our hope when it is small, awaken it when it is dormant, confirm it when it is wavering, strengthen it when it is weak, and that he would even raise it up when it is overthrown” (Calvin Translation Society). We don’t hope in our own ability to keep on hoping. We hope in God, who can make dry bones of hopelessness live again (Ezek. 37) – the God who raised Jesus Christ from the dead can surely resurrect my hope from the ashes, for we have something better to trust in than ourselves, better than our own heroic “faith.” We have a God who does not forsake his work in us, because it is, after all, his work and his covenantal promise to be our God.


J. Todd Billings teaches at Western Theological Seminary, Holland, Michigan. This essay includes material adapted with permission from his Rejoicing in Lament: Wrestling with Incurable Cancer and Life in Christ (Brazos, 2015).

Photo by Matt Juriado/Flickr; used under Creative Commons License.

J. Todd Billings

J. Todd Billings teaches theology at Western Theological Seminary in Holland, Michigan. He is an ordained minister in the Reformed Church in America and author of six books, most recently, The End of the Christian Life: How Embracing Our Mortality Frees Us to Truly Live (Brazos, 2020).