It’s been a year since my good friend of 35 years died, despite the best available medical treatment, after a three-month battle with cancer, and I miss him. He had been courageously fighting ITP, a blood disorder, for several years, but then in late February I had lunch with him and he complained of bad back pain. He was obviously struggling.
A few days later at my mother’s funeral, his wife told me that his doctors suspected cancer, her voice breaking. He was quickly hospitalized and suffered severely for several weeks in uncertainty before the doctors were able to tell him that he had a very rare form of cancer that was incurable. They couldn’t do anything more, and he opted for palliative care at home rather than more chemo or radiation.
After he got home from the hospital, I visited him. Propped up in a recliner, he was weak. He talked, slowly. I listened. I hoped to see him daily, or as much as possible week to week. We prayed for him and his wife throughout each day, but his decline was unrelenting.
Why did he suffer so much and die so young despite all our prayers?
When Christians suffer disease or troubles, they often ask “Why is God doing this?”—as though God is the only agent in the world.
“When Christians suffer disease or troubles, they often ask ‘Why is God doing this?’—as though God is the only agent in the world.”
God the Creator isn’t the author of death but the author of life (Ps. 68). God gives life and wanted the children of Israel to enjoy a long life, as made clear throughout Deuteronomy. Was Christ, the great physician, fighting against God when he healed or when he raised Lazarus?
It is Satan who “holds the power of death” (Heb. 2:14). Psalm 139:16 (“All the days ordained for me were written in your book,” NIV) can very reasonably be read as God’s knowledge of our days, rather than his determination.
As someone who demonstrated power over disease and death through his miracles and healings, Jesus speaks to these questions with credibility. Jesus identifies two agents, or spiritual realities, we should recognize as the cause of death, disease, and destruction.
A Fallen World
The fallen world is a general condition of the entire world. “For the creation was subjected to frustration…in hope that the creation itself will be liberated from its bondage to decay….We know that the whole creation has been groaning as in the pains of childbirth…” (Rom. 8:20-22). Death is not natural. From free will came human sin that corrupted the created world (Gen. 2-3; Rom. 5), bringing death for everyone (Rom. 8, 1 Cor. 15). C.S. Lewis put it well in Mere Christianity,
“If a thing is free to be good it is also free to be bad. And free will is what has made evil possible. Why, then, did God give them free will? Because free will, though it makes evil possible, is also the only thing that makes possible any love or goodness or joy worth having. A world of automata—of creatures that worked like machines—would hardly be worth creating.”
Frustration and decay include many of the causes of suffering: day-to-day annoyances, and pain, and things going badly wrong, like tornados, lightning strikes, collapsed bridges, and cancer cells. We suffer from injustice caused by sin. “A poor man’s field may produce abundant food, but injustice sweeps it away” (Prov. 13:23). We suffer from simple but grievous human error, including the deadly car accident while the driver was texting, or the farming accident that took the life of a 10-year-old boy. Even Christ suffered when he entered the fallen world: “In anguish, he prayed more earnestly, and his sweat was like drops of blood falling to the ground” (Luke 22:44). The fallen world best explains the brokenness all around us.
“The fallen world best explains the brokenness all around us.”
This is confirmed by another reality of the fallen world: risk. A real element of this fallen world is the possibility of death, disease, or injury that God will not protect us from. Scripture repeatedly refers to it; David, Joseph and Mary, and Paul fled to avoid evil and the threat of death. Christ warned his disciples about the risk of death and destruction (Matt. 10). There is no sense of que sera sera (whatever will be will be) in Scripture. Instead, it is good to live and not die. It is good to escape the effects of the fallen world. There is moral purpose in saving human lives and fighting death and disease in the face of the Fall.
A Cruel Enemy
In addition to the general domination of the Fall in this world, there is a specific, personal agent, Satan, who is intentionally acting to destroy. If you’re inclined to scoff at the notion of Satan (also called the tempter and the devil from time to time), study all that Jesus had to say about Satan. Jesus told us a lot about Satan. Jesus took Satan seriously, twice calling him the “prince of this world” (John 12:31; 14:30). Jesus understood him as an active presence for evil in the world. Jesus confronted him personally. Satan tempted Christ intensely in John 4. Jesus attributed a woman’s suffering from an 18-year illness to Satan. “Then should not this woman, a daughter of Abraham, whom Satan has kept bound for 18 long years, be set free on the Sabbath day from what bound her?” (Luke 13:16).
“Jesus understood him as an active presence for evil in the world. Jesus confronted him personally.”
Christ taught that Satan can hinder or prevent someone’s salvation or sanctification. Jesus warned, “The devil comes and takes away the word from their heart, so that they may not believe and be saved” (Luke 8:12; Mark 4:15; Matt. 13:19). And the apostle Paul referred to Satan as “the ruler of the kingdom of the air, the spirit who is now at work in those who are disobedient” (Eph. 2:2).
What Satan did to Job is more famous than what he tried to do to Peter and the apostles. Satan petitioned God to destroy Peter, just as he sought to destroy Job. “Satan has asked to sift all of you as wheat, but I have prayed for you, Simon, that your faith may not fail” (Luke 22:31-32). These two strikingly similar episodes, together with what we know from other Scripture, show that Satan already knew he had the power to destroy human beings—Jesus referred to him as “a murderer from the beginning” (John 8:44). In Job and Luke, Satan was fishing for the boundaries; he wanted to know what his limits were.
Satan works through deception, which means we must be discerning. “Satan himself masquerades as an angel of light” (2 Cor. 11:14). And his destructive work is arbitrary and capricious: “Be self-controlled and alert. Your enemy the devil prowls around like a roaring lion looking for someone to devour” (1 Pet. 5:8).
“Satan works through deception, which means we must be discerning.”
That arbitrariness, captured in the metaphor of the roaring lion who “prowls around,” perhaps explains a lot: why “Bill Smith” survived World War II but not Charlie DeGlopper, why two people survived that bombing in Baghdad but ninety died and ten are crippled for life, and why my friend got cancer but others didn’t. That destructive power may also be intentional—for example, intending to kill one in order to destroy the faith of others. Perhaps that is the greatest risk of death and disease.
What Gives Me Confidence
During our prayers for my friend before his death, I had no doubt that God could do a miracle and completely cure my friend. The reality of God’s power to heal is exemplified by Christ’s many healings. But that would mean a miracle, and we know from Scripture that death is dominant in the fallen world, and miracles are not the norm but the exception. Lazarus eventually died a second time. We seek a physical redemption in this fallen world—an exemption from the general effect of the fallen world—but God long ago promised a spiritual redemption for those who accept Christ as their Savior and his atoning work.
After looking at the horror of the fallen world and the terror of Satan’s power, the thing that gives me confidence is God’s goodness and the teachings of Christ ( “the ministry of reconciliation,” 2 Cor. 5:18). I can’t say I would think this rationally if I was given the same cancer report. But however I might react, my feelings might obscure but could not cancel the reality of an infinite, loving God, the teachings of Christ, and the reality of this fallen world.
“After looking at the horror of the fallen world and the terror of Satan’s power, the thing that gives me confidence is God’s goodness and the teachings of Christ.”
Scripture repeatedly tells us to seek understanding (discernment). But my understanding is limited because my intellect is limited. And when I don’t understand, I have to trust God for his goodness (even better than his control) and his promises, based on all that Christ taught about His Father.
God’s goodness and Christ’s promise of eternal life are the source of confidence that my mother—who died of the effects of Alzheimer’s in February 2021—is home, and my friend is too. Very different deaths, but no matter the means, Paul said, “to live is Christ, to die is gain.”
Well done, thou good and faithful servants.
 C.S. Lewis, Mere Christianity (New York: HarperOne, 2001), 48.