Every day, disease eroded her youthful loveliness.

Every minute, her mother stood at her bedside and cherished her.

My patient was a teenage girl, and when jaundice sallowed her face to mustard color, her mother massaged her skin with jasmine lotion. When her eyes, vacant and bloodshot, darted about the room in delirium, her mother papered the walls with photographs and piled favorite toys around her.

The ventilator creaked and sighed, and beloved songs filled the room. In language approaching poetry, her mother refreshed remote memories, moments alive with the seashore and laughter, afire with the distant vibrancy of the girl she treasured.

The day my patient died, her mother climbed into the hospital bed with her. She wrapped her arms around her and clutched her to herself, enfolding her in the same warmth she knew as an infant. With tears streaming, she gripped her, prayed, and issued promises into her ear. As we witnessed a heart flayed open, we abandoned all pretense of professionalism. All of us — nurses, doctors, physicians in training — cried with her.

What Is God Doing?

Years later, I still ache when I remember the depth of this mother’s love and the rawness of her grief. Yet in the midst of the tenderness, another memory haunts me.

The day before my patient died, her mother crumpled into a hospital room chair and held her head in her hands. Her eyes searched the ground. She knew the end was near. Her courage was fraying.

I put my hand on her shoulder. After a long silence, she spoke. “I keep begging God to take out my heart, to keep it from breaking,” she whispered. Her voice trembled. “But I don’t even know if he’s listening anymore. My family says this happened to her because I stopped going to church. They say God’s punishing me.”

She raised her eyes and pleaded with me: “What if it is all my fault?”

When I remember her anguish, I struggle with my own anger. Anger toward anyone who would destroy a woman already so crushed in spirit. I also regret that I did so little for her. That time of my life was mired in agnosticism, and so, although I held her and shared in her heartache, I could offer her no words of consolation. If I could return to that moment, I would pray for the Holy Spirit to reveal her preciousness to her. With my arms around her, I would pray for her to know the Lord not as a God of ruthlessness, but as one of boundless mercy, of sovereignty and grace beyond our imagination.

In crippling this fragile woman’s resolve, her family damaged her already tenuous relationship with God, and reduced suffering to a simplistic penalty-rewards system. They committed the same transgression as Job’s “miserable comforters” (Job 16:2), who for twenty-five chapters argue that Job suffered devastating losses as punishment for some great evil he refused to acknowledge. They rationalize that as God is both sovereign and just, he always punishes the wicked and rewards the righteous. If you suffer calamity, they reason, you did something to deserve it.

Is God Punishing Me?

At a cursory glance, this retribution theology may appear consistent with principles undergirding the fall (Genesis 3:14–24), Noah and the flood (Genesis 6:5–7), and the destruction of Sodom and Gomorrah (Genesis 19:24–25). In such narratives, punishment for depravity descends swiftly and violently. Solomon teaches, “The wage of the righteous leads to life, the gain of the wicked to sin” (Proverbs 10:16).

Unfortunately, these arguments ignore myriad instances in the Bible when God uses suffering not to punish, but rather to enact tremendous good. When Joseph’s brothers hurl him into a well and sell him into slavery, God raises him up beside Pharaoh and saves his people. “You meant evil against me,” Joseph says, “but God meant it for good, to bring it about that many people should be kept alive, as they are today” (Genesis 50:20).

Before restoring a man’s sight, Christ explains his blindness occurred not in penalty for sin, but rather “that the works of God might be displayed in him” (John 9:1–3). Christ delays traveling to his dying friend Lazarus, whom he loves, so that in raising him from the dead he might glorify God (John 111–4). Even in the case of Job, the introductory chapters reveal he is “blameless” in God’s sight, and that the calamity that befalls him occurs not as punishment, but as part of a divine plan to defeat the adversary (Job 1–2).

The Mystery of God’s Love

Passages like these warn that we must never presume to know God’s intent for someone in anguish. God has an infinite capacity to effect goodness in the midst of our inequity. No theorems hem in his glory. The cross reveals in luminous brushstrokes our Lord’s grace and his overflowing love for us, made perfect in the death and resurrection of his most beloved Son. In the most magnificent sacrifice the world has known, God granted suffering in order to save us.

With the peace of Christ upon our hearts, let us love our neighbors in their suffering. Let us flee from self-righteousness, and toward compassion, as our Lord has compassion upon us (Psalm 78:37–39). May we always seek to wrap our arms around the enfeebled, to clutch them to ourselves as if they were our own children. As they tremble, let our words be a tree of life rising through the desolate dark (Proverbs 15:4), a wellspring through scorched soil.