So we do not lose heart. Though the outer self is wasting away, our inner self is being renewed day by day (2 Cor 4:16, ESV).

In several of his books, Henri Nouwen recounts how the severely physically and mentally disabled residents of Daybreak, a L’Arche community founded by Jean Vanier, became his spiritual mentors. Nouwen saw, with the eyes of faith, what many could not: the Spirit is not hindered by human frailty, and great saints who are in continual, hidden converse with God may also be bedridden and need their diapers changed.

How can we understand this? Baptism, as usual, is the place to start.

Baptism

When the church baptizes an infant, we acknowledge that a relationship with God doesn’t depend on the state of one’s body or mind; baptism is an outward and visible sign, in word and water, of an inward and spiritual grace. An infant is capable of only the most basic bodily functions and lacks language necessary for complex mental processing. But from the moment of baptism the new child of God is in intimate relationship with the Father, through the Son, in the Holy Spirit, even though that relationship may not be experienced by the body or perceived by the mind.

Ideally, the body and mind grow to participate more fully in this relationship throughout life, but not always. Developmental difficulty, accident, or illness may limit physical and mental participation. But these do not hinder the essential spiritual relationship, which is hidden and ongoing, and which transcends both body and mind.

This sacramental understanding has important pastoral implications not just for infant baptism, but also for those in advanced states of physical or mental decline and for their families. It offers a way forward into and through the difficult questions that face every pastoral caregiver in every nursing home, rehab unit, Alzheimer’s facility, and hospice room. It offers the Gospel in decline, good news not just for the world to come but for the world here and now.

The Outer Self

When the outer self is wasting away, the good news concerns the inner self, which is being renewed day by day. When the human mind is too diminished to engage the world, the Christian hope is that our spirit prays – and the Holy Spirit prays – though the mind is unfruitful. We can see only the body, which might be functionally disabled by injury, ravaged with disease or lying in a coma. We falsely equate the person with the mind – a mind that might be cognitively idle or perhaps wandering in long forgotten or even imagined pathways. But in the midst of impaired bodies and minds, our sacramental faith assures us that the spirit is alive and engaged with God in mysterious and holy ways to which we are not privy. Though often hidden from external witnesses, Spirit ministers to spirit, prayer ascends, worship proceeds, and inner renewal is a reality. So even this state of diminished physical and mental life is holy and precious. All of life, from conception to natural death is holy and precious because the Spirit is at work in ways we cannot always perceive and, at best, can only dimly imagine.

Rich Mullins used to whisper his prayers to Madeline, a severely disabled child whose parents were repeatedly told by the doctors that Madeline wouldn’t survive the next day, the next week, the next month, the next year. Rich was convinced that Madeline took his prayers to God and that God gladly bent low just to hear Madeline when she prayed. It’s there in one of Rich’s classics, Madeline’s Song. The flesh is weak, but the spirit is willing and able.

The Gospel Everywhere

The Gospel can be present in every nursing home, every rehab unit, every Alzheimer’s facility, and every hospice room, and must be addressed by every pastoral caregiver. Like many difficult pastoral issues, they are better addressed long before they arise, in the context of ongoing spiritual formation through worship, instruction, and spiritual direction. But still there is a word of hope that may be offered to the child of God and to those who love him even in the midst of the moment.

I once knew a great and ordinary saint, advanced in age and in bodily decline. For years she had helped clean the church to supplement her meager retirement income; now she could no longer lift the vacuum cleaner. “I can’t do much anymore,” she confided to me. “But I’m not complaining; I don’t mind. That gives me more time to pray for you.” Her outer self was wasting away, but her inner self was being renewed day by day. She was living ever more fully into her baptismal identity not in spite of her bodily decline, but precisely because of it. This is the Gospel, the good news of hope, in decline.

Communicating the Gospel in Decline

How do we as pastors communicate this good news? Early and often is best, starting with catechesis. As we prepare candidates and sponsors for baptism and as we receive new members, we explore fully the sacramental, theological, and pastoral implications of baptism for the whole of human life. We emphasize ongoing spiritual formation through worship, prayer, study, and spiritual direction. The spiritual renewal intentionally fostered by these disciplines now is that which continues when body or mind declines. All this is essential, preparatory pastoral care.

But what about pastoral care in the midst of decline? We act on and model what we believe. We treat the saint in decline as a saint, as someone who is in deep and ongoing spiritual relationship with God, regardless of the outward state of mind or body. We respect what God is doing at every stage in life, and we do what we can, also. We pray for and with our brother or sister. We sing psalms and hymns and spiritual songs. We read Scripture aloud even if others assure us that our brother cannot hear us or no longer understands what is said. We share Christ’s body and blood with our sister, if she is able to receive them. And, as much as anything, we simply show up to marvel at and to honor the glorious work of God in the lives of his saints; the ministry of presence is powerful witness to the Gospel.

Brussels Sprouts and The Fall

Brussels sprouts are sure signs of the fall, I think. Yet, when I (am forced to) eat them, I am inwardly nourished and physically renewed in hidden ways. Likewise, physical and mental decline or injury are truly signs of the fall. Yet, even in the midst of such decline, the one baptized in the name of Father, Son, and Holy Spirit is inwardly nourished and spiritually renewed in hidden and holy ways. This is the Gospel – the good news – in decline.

Photo: Doctor with Patient by andyde via http://www.flickr.com/photos/andyde/4762068019/