I found that to embrace God’s greatness, to say “Thy will be done,” was painful at first and then, perhaps counterintuitively, profoundly liberating. 

I have spent a good part of my life talking with people about the role of faith in the face of imminent death. Since I became an ordained Presbyterian minister in 1975, I have sat at countless bedsides, and occasionally even watched someone take their final breath. I recently wrote a small book, On Death, relating a lot of what I say to people in such times. But when, a little more than a month after that book was published, I was diagnosed with pancreatic cancer, I was still caught unprepared.
On the way home from a conference of Asian Christians in Kuala Lumpur in February 2020, I developed an intestinal infection. A scan at the hospital showed what looked like enlarged lymph nodes in my abdomen: No cause for concern, but come back in three months just to check. My book was published. And then, while all of us in New York City were trying to protect ourselves from COVID-19, I learned that I already had an agent of death growing inside me.
I spent a few harrowing minutes looking online at the dire survival statistics for pancreatic cancer, and caught a glimpse of On Death on a table nearby. I didn’t dare open it to read what I’d written.
My wife, Kathy, and I spent much time in tears and disbelief. We were both turning 70, but felt strong, clear-minded, and capable of nearly all the things we have done for the past 50 years. “I thought we’d feel a lot older when we got to this age,” Kathy said. We had plenty of plans and lots of comforts, especially our children and grandchildren. We expected some illness to come and take us when we felt really old. But not now, not yet. This couldn’t be; what was God doing to us? The Bible, and especially the Psalms, gave voice to our feelings: “Why, O Lord, do you stand far off?” “Wake up, O Lord. Why are you sleeping?” “How long, O Lord? Will you forget me forever?”
A significant number of believers in God find their faith shaken or destroyed when they learn that they will die at a time and in a way that seems unfair to them. Before my diagnosis, I had seen this in people of many faiths. One woman with cancer told me years ago, “I’m not a believer anymore—that doesn’t work for me. I can’t believe in a personal God who would do something like this to me.” Cancer killed her God.
What would happen to me? I felt like a surgeon who was suddenly on the operating table. Would I be able to take my own advice?
One of the first things I learned was that religious faith does not automatically provide solace in times of crisis. A belief in God and an afterlife does not become spontaneously comforting and existentially strengthening. Despite my rational, conscious acknowledgment that I would die someday, the shattering reality of a fatal diagnosis provoked a remarkably strong psychological denial of mortality. Instead of acting on Dylan Thomas’s advice to “rage, rage against the dying of the light,” I found myself thinking, What? No! I can’t die. That happens to others, but not to me. When I said these outrageous words out loud, I realized that this delusion had been the actual operating principle of my heart.
The cultural anthropologist Ernest Becker argued that the denial of death dominates our culture, but even if he was right that modern life has heightened this denial, it has always been with us. As the 16th-century Protestant theologian John Calvin wrote, “We undertake all things as if we were establishing immortality for ourselves on earth. If we see a dead body, we may philosophize briefly about the fleeting nature of life, but the moment we turn away from the sight the thought of our own perpetuity remains fixed in our minds.” Death is an abstraction to us, something technically true but unimaginable as a personal reality.
For the same reason, our beliefs about God and an afterlife, if we have them, are often abstractions as well. If we don’t accept the reality of death, we don’t need these beliefs to be anything other than mental assents. A feigned battle in a play or a movie requires only stage props. But as death, the last enemy, became real to my heart, I realized that my beliefs would have to become just as real to my heart, or I wouldn’t be able to get through the day. Theoretical ideas about God’s love and the future resurrection had to become life-gripping truths, or be discarded as useless.
I’ve watched many others partake of this denial of death and then struggle when their convictions evaporate, and not just among the religious. I spent time as a pastor with sick and dying people whose religious faith was nominal or nonexistent. Many had a set of beliefs about the universe, even if they went largely unacknowledged—that the material world came into being on its own and that there is no supernatural world we go to after death. Death, in this view, is simply nonexistence, and therefore, as the writer Julian Barnes has argued, nothing to be frightened of. These ideas are items of faith that can’t be proved, and people use them as Barnes does, to stave off fear of death. But I’ve found that nonreligious people who think such secular beliefs will be comforting often find that they crumple when confronted by the real thing.
So when the certainty of your mortality and death finally breaks through, is there a way to face it without debilitating fear? Is there a way to spend the time you have left growing into greater grace, love, and wisdom? I believe there is, but it requires both intellectual and emotional engagement: head work and heart work.
I use the terms head and heart to mean reasoning and feeling, adapting to the modern view that these two things are independent faculties. The Hebrew scriptures, however, see the heart as the seat of the mind, will, and emotions. Proverbs says, “As he thinketh in his heart, so is he.” In other words, rational conviction and experience might change my mind, but the shift would not be complete until it took root in my heart. And so I set out to reexamine my convictions and to strengthen my faith, so that it might prove more than a match for death.
Paul brand, an orthopedic surgeon, spent the first part of his medical career in India and the last part of his career in the U.S. “In the United States … I encountered a society that seeks to avoid pain at all costs,” he wrote in his recent memoir. “Patients lived at a greater comfort level than any I had previously treated, but they seemed far less equipped to handle suffering and far more traumatized by it.”
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