The COVID-19 pandemic revealed the distorted view of health and illness in our society. Jean-Claude Larchet would pin that distortion on the reduction of illness to a purely physiological or material phenomenon “somehow independent of the afflicted person” (11). Because all in our culture, Christians and unbelievers alike, have to some degree internalized this view, the disparate reactions to the pandemic were inevitable. Some turned to doctors as high priests with infallible authority and medical technology as The Only Hope. This, in turn, caused others to react against medicine as a whole, inadvertently or practically treading into Darwinist territory in insisting on “natural” remedies only or coming dangerously close to putting the Lord to the test.

Jean-Claude Larchet’s masterful work, The Theology of Illness, offers a remedy to this confusion by considering illness theologically. Published in French in 1991 and translated into English in 2002, Larchet’s work pushes back against the slow but steady detachment of illness from an anchored theological perspective. The Theology of Illness is worth a look for Lutheran pastors who have a special interest in illness as they tend to the sick within their congregations.

Larchet writes as an Orthodox Christian, and Lutheran readers should not be surprised to find a number of significant theological objections in the work. For one, Larchet’s incredibly extensive reliance on patristic sources at times overshadows the Scriptures, although Larchet is clearly at home in the Bible and especially in the Gospels. More problematically, Larchet casts the spiritual benefits that might be derived from illness and suffering into the broader Orthodox scheme of salvation via theosis or the deification of man, whereas Lutherans would categorize these things in the realm of sanctification or belonging to God’s work in suffering as expressed by the theology of the cross. Larchet is also squarely in the realm of Orthodoxy in treating grace as a substance that is dispensed sacramentally to aid believers on the path to perfection. And Lutherans will raise an unfriendly eyebrow at his frequent recourse to asceticism and near-talismanic practices including anointing with holy oil or water or mystically making the sign of the cross over a sick person.

That being said, Larchet’s work remains a powerful corrective to the standard view of medicine found in society and almost equally at home in the church. His book is divided into three parts, the first of which deals with the origin of illness. Here, Larchet is very helpful as he moves readers away from an atomistic split of the person that conceives of illness only in biological terms. As Hermann Melville’s Captain Ahab had a torn body and gashed soul that bled into one another, Larchet would have us acknowledge that illness is not purely a material phenomenon, but is ultimately rooted in the spiritual realm as a consequence of sin. Larchet carefully ties illness to sin without leaving room for a simplistic misunderstanding that would conceive of a particular illness as punishment for an individual sin, the same error the disciples fell into and Jesus had to correct in John 9. But Larchet is insistent that Christians recognize illness as one of the consequences of the Fall that affects all people. This connection between sin and illness is certainly the biggest missing piece of the puzzle for American Christians. Only by understanding the metaphysical cause of illness can one truly make sense of it, and then endeavor to treat the whole person spiritually as well as physically.

Having tied sin and illness together, the second part of Larchet’s work addresses the spiritual meaning of illness. Here Larchet brings in a number of concepts that Lutherans would categorize under the theology of the cross. Health is good in general, since it is the way God initially created us, yet good health can do greater harm if it causes one to forget about the Lord. Likewise, illness, while it is bad in itself and never to be sought, remains one of those chastisements or disciplines by which the Lord can bring about spiritual good and growth among his children. After all, Larchet notes, illness reveals the true nature and consequence of sin, confronting the sick person with human fragility and limitation, and ultimately with his or her mortality. Like the paralyzed man lowered through the roof, a Christian who endures illness and sees these things recognizes how desperately he needs the forgiveness of sins. He is forced to cast himself on the Lord in prayer and given a prime opportunity to learn and practice patience as he waits on the Lord to deliver him.

The third part of Larchet’s work moves into the realm of healing. Here, Larchet offers careful analysis of the charismatic gift of healing in the early church. He defends the early retreat of such spiritual gifts as evidence that faith was being deepened beyond the need for such signs as the apostolic era drew to a close and the church received the New Testament. Larchet is also quite attentive to Christ’s activity of healing in the Gospel, and his discussion of Christ’s concern for healing the body makes for profitable reflection for preachers. As Larchet notes, Christ’s miracles of healing not only reveal his divinity but also foreshadow what Christ’s saving work brings about: the full restoration of human life that all will enjoy at the resurrection of the dead.

One of the most valuable discussions occurs towards the end of the book, as Larchet parses how Christians should approach the use of secular medicine. Larchet handles the existence of maximalist positions in the church, i.e., Christians should avoid all medicine, and finds such positions rare and reactionary. In addition, they proved problematic, as they inevitably led to pride and a sense of superiority, and ran the risk of putting God to the test. Thus Larchet argues that, since Christ came to save both soul and body, Christians are free to use secular medicine, while always being careful to acknowledge that healing comes from God. Larchet is also quick to point out the limitations of human understanding in the realm of medicine, which needs to be kept in view in an age when humility is sorely lacking among so many in the field of healthcare. Lutherans would want to add a discussion of vocation as the appropriate language for Christians working through these issues: healing comes from God through doctors.

Larchet’s work stands to profit pastoral care by helping pastors keep their heads straight about these two things. Anytime someone falls ill, that person will be confronted with sin, guilt, limitations, and mortality. We stand as sinners who are first and foremost in need of Christ’s forgiveness, which we graciously receive from our Lord and Savior in Word and Sacrament. And anytime someone is healed or recovers from illness, it is a foretaste of all that Christ won for us and what we will enjoy when he raises our bodies from the dead.

I recommend this book for all Lutheran pastors. Larchet’s careful analysis will help pastors to avoid accidentally turning into functional Calvinists at the sickbed, with little more to offer than appeals to God’s sovereignty, the feeble comfort fare of “God has a plan.” Lutheran pastors should be quick to turn illness into an opportunity for repentance and a time to receive the forgiveness of sins, together with the promise of ultimate healing on the day of Christ’s return. That makes for Gospel-centered care at the hospital bedside.

That being said, a significant challenge facing pastors is to instill this understanding of illness as more than a physiological problem in the people we are serving. Asking someone on the sickbed, “Are there any sins you would like to confess?” might confuse the sick person, at least at first. But as anyone who has been laid up in bed by an illness knows, those moments when we are forced to be with ourselves tend to be quite uncomfortable. They have a way of bringing sin and guilt to light. Our people will benefit greatly if we have our heads about us and can bring Christ in Word and Sacrament to those who feel their need by the affliction of their bodies. Jesus is quite capable of healing torn bodies and gashed souls.