Theology from the Hospital Bedside

This summer, Abigail has been completing an intensive unit of Clinical Pastoral Education (CPE), an interfaith professional training for chaplaincy, at a hospital in the Los Angeles area. In her CPE program, as in most, students work as chaplain interns in the hospital, fulfilling the requirement of 300 clinical hours through seeing patients and 100 class hours through group sessions with their cohort for 1 unit of CPE.

I have been working on the floor of my hospital which contains Labor and Delivery, the Neonatal Intensive Care Unit, and the OB/GYN ward, which includes women with gynecological cancers, surgeries, and more.

I have seen the gasping of a mother about to give birth, the fragile body of a premature infant snuggled into an incubator, the shaking outstretched hand of a grandmother with terminal cancer as she reaches the end of life.

I have seen parents cradle the body of their dead newborn and mothers sit, still and shocked, after a miscarriage, hands still cupped around their stomach, where life had been growing.

I have seen suffering.

And again and again in the hospital, it comes: “Why does God let this happen?” “Was this part of God’s plan?” “Was it meant to be?”

As hospital chaplains, we are not meant to have all the answers. But we do have to reflect on what our theology about this kind of suffering—and these kind of questions—is.

In my program last week, we had to share our theologies of suffering. Some explained it as a result of our fallen nature, our mark of original sin. Others as the result of karma, missteps from lifetimes ago.

I turned to process theology.


The basic idea of process theology is that God is dynamic and relational, rather than all-powerful and unchanging. The God of process theology is panentheistic, which means that God is the universe (including you and me and everything in it) and is also something more—something transcendent of the material world. God is all and holds all, a comic consciousness, an infinite web of connection. In process theology, God is in relationship with all of the universe, “beckoning” us all toward God’s dream of a reality of love, beauty, and complexity. Rather than controlling the universe or carrying out a plan, God is in a co-creative relationship with all beings, an ongoing process where together we engage in creative transformation to make the sacred dream a reality.

So, what does all this mean for suffering?

We can start with the obvious. If, according to process theology, God does not control us, then we humans have the ability to make choices—the familiar idea of “free will.” We can make choices that cause suffering—and we certainly see enough of that in the world, from wars to drunk driving accidents to abuse. However, there are also forms of suffering that do not directly arise from conscious human choices, from natural disasters to freak accidents to the situations of so many of my patients. Like a recent patient with a stillbirth, where something had gone wrong deep in her body, in the blood vessels and bone and ribosomes transcribing DNA on the cellular level, that had caused her fetus’ heartbeat to cease.

How do we answer to that kind of suffering? Perhaps the best way to express process theology’s view on this is to tweak Alfred Lord Tennyson’s familiar adage of “Better to have loved and lost than never to have loved at all” to “Better to have lived and suffered than never to have lived at all.” According to process theology, God wants for us all the fullness and abundance of life. Process theologians affirm the evolutionary process as part of God’s call, a process calling forth ever-more-complex forms of life with with ever-more-complex experiences of life and self-consciousness.

As leading process theologian John Cobb writes, “[T]here was no suffering before the advent of life, but with every advance in sensitivity, suffering increased.” It would be easy, in a world barren of life, for there to be no suffering. Yet God provided the possibility for life to spring forth and evolve (in process theology, God provides myriad possibilities in every single moment—a new creation in every second—but God does not select which possibility will come about, just as electricity coursing through a circuit does not determine when the lamp gets switched on). With this possibility for life came the possibility for pleasure and love and connection and laughter and art—but also the risk of pain.

A helpful metaphor for this is likening God to a mother. When a mother chooses to bring a child into the world, she usually wants the best for her offspring—a full and fulfilling life. However, a mother also knows that she cannot safeguard her child, with their own free will, from all the suffering in the world. The choice she must make, then, is if the goodness her child might experience in life makes it worth having the child, despite the suffering the child might also face.

Like a parent, God also suffers with us and celebrates with us, according to process theology. As Cobb puts it, saying that God is of no use if God cannot prevent suffering “would be like saying that if parents cannot save their offspring from all suffering, they are of no ‘use.’” Yet even in suffering, the tender arms of a parents holding us can provide comfort. In the same way, God holds us—always with us and within us, accompanying us through suffering as well as joy.

For my recent patient, I believe that she was being held by the divine in that moment, in her pain—God within her, God within me, God within our relationship, God unseen around us everywhere. As I spoke with her, she smiled as she talked about her other children. Even in the midst of suffering, I saw a glimpse of the joys she had also experienced in her life. Better to have lived and suffered than never to have lived at all.

Along with other process theologians, I do not see suffering as redemptive, the way some Christian theologies do. However, I do think that the experience of suffering, when it does happen, can deepen our empathy for others, enhance our appreciation for life and love, and help us realize our inherent interdependency (as the Unitarian Universalist Seventh Principle puts it, “the interdependent web of all existence of which we are a part”).


In our different traditions, we all have different answers for suffering’s root. Yet a common theme among my cohort of fellow chaplains-in-training was this—regardless of the why of suffering, the question we must ask now is, What can we do about it?

Suffering is. Pain is. Brokenness is. As one of my Jewish classmates put it, just as God tells Moses in the Hebrew Bible that “I will be what I will be,” suffering will be what it will be. It is there—not just in the hospital, but in our larger world as well.

Even if we have different understandings of what causes suffering, the truth is that all of us experience it. And all of us must determine how to face it. This, for me, is the true interfaith work. How to nurture healing and growth and flourishing across religious and theological lines, whether it is me talking to a woman of a different faith on my floor or our society determining our immigration policies toward refugees across the globe.

There is much to be done.

What will we do?

All quotes from John Cobb from “Theodicy,” published by the Center for Process Studies at Claremont School of Theology. 

Image: Public Domain, Pixabay

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