[ JBEM Index / Volume 10 / Number 1 ]

On the Saints’ Afflictions: A Primer

Dr. Caylor practices Family Medicine in Des Moines, Iowa.

“But Jews came from Antioch and Iconium, and having urn over the multitudes, they stoned Paul and dragged him out of the city, supposing him to he dead. But while the disciples stood around him, he arose and entered the city. And the next day he went away with Barnabas to Derbe. And after they had preached the gospel to that city and had made many disciples, they returned to Lystra and to Iconium and to Antioch, strengthening the souls of the disciples, encouraging them to continue in the faith, and saying, T’hrough many tribulations we must enter the Kingdom of God’ “

(Acts 14:19 22).

The Bible, being the revelation of God’s redemptive grace, is “The Book of Salvation.” But, it could with equal accuracy be called “The Book of Sorrows.” From Genesis to Revelation, the Bible brings before us the hardships, persecutions, illnesses, and deaths of the saints.

There is a relationship between salvation and suffering. Jesus commends a cross to would-be disciples (Mark 8:34) and promises tribulation to actual followers (John 16:33). John Calvin puts it this way: “For whomever the Lord has adopted and deemed worthy of His fellowship ought to prepare themselves for a hard, toilsome, and unquiet life, crammed with very many and various kinds of evil” (Institutes of the Christian Religion, 3.8.1).

Despite their excellence in suffering, however, the covenant people of God have always affirmed His loving kindness, righteousness, and power. In apologetics, a defense of this affirmation in the face of evil is known as a theodicy. Many people produce theodicies to vindicate God before the world. That is not my purpose here. My purpose is to strengthen believers and encourage them in the faith by instructing them in that providence which often seems most severe-the providence of affliction.


In December 1986, my wife, Nancy, gave birth to our third child, a son, Elijah Duane. It was her easiest labor and delivery, and although Elijah had a rash at birth-it seemed to be a common newborn dermatitis-he appeared to be a healthy baby. As time went on, however, rather than improving as expected, the rash worsened. Nancy spent hours each day washing bloodied sheets and applying creams and ointments to the large areas of alternately weeping and crusting skin on Elijah’s head, trunk, and diaper area.

When he was four months old, we took him to a dermatologist. The dermatologist did a biopsy, which revealed a benign skin condition for which there was no cure, but which was supposed to improve with time.

So Nancy renewed her ministrations.

Elijah’s condition worsened, however, and after several months, we consulted with a Christian pediatrician friend. A second biopsy was obtained. This time there was no benign skin disease. Elijah had histiocytosis X, a group of variably severe diseases often fatal in young children. The night we received the news, Nancy and I walked to my office to look for information on our son’s illness. As we walked, we talked about the possibility-the probability-of saying goodbye to our year-old son.

It was not to be as simple as that. Elijah turned out to have an extremely rare form of histiocytosis X, a form confined only to the skin and, therefore, non-lethal. Because of the rarity of his illness, Elijah was referred to the University of Iowa Hospitals and Clinics. Chemotherapy was initiated. After only a few weeks, our son seemed well. But, in July 1988, we experienced a setback when Elijah developed swelling behind his right eye. The swelling was evaluated in Iowa City, presumed to be indicative of systemic histiocytosis, and it responded quickly to a change in chemotherapy. So our son’s physicians were still optimistic about his prognosis.

Then on Labor Day, Elijah could not bear weight on his legs. We took him back to Iowa City, where he was diagnosed with an infection in his hip, and he was started on IV antibiotics. His white blood cell count dropped, evidence of overwhelming infection, and his antibiotics were changed. Still, Elijah remained gravely ill. Finally, after several weeks of negative blood cultures-his condition worsening, his fever high, his white blood cell count dangerously low-a bone marrow biopsy was ordered. His doctors expected to find histiocytosis. Nancy was with Elijah at the time; I was in Manchester, 70 miles away, working 80-100 hours weekly and trying to coordinate care for our two daughters.

Elijah had been uncomfortable for days and had not been sleeping well. Consequently, as Nancy had been spending nights in his room, neither had she. When the oncologist brought the results of the bone marrow biopsy to my sleep-deprived wife, and she learned that Elijah did have bone marrow disease, but not histiocytosis X. Elijah had leukemia.

Nancy called me with the news and said, “I demanded to see God.” I remembered Job’s cry, “But I would speak to the Almighty, And I desire to argue with God” (Job 13:3). So began eleven weeks of venipunctures, lumbar punctures, chemotherapy, tube feedings, and pain medications for Elijah. So began eleven weeks of vigilance for Nancy and me. On the first Sunday in Advent, 1988, Elijah died.

My son’s story is only one of many which could be told. I do not present it because it is atypical, but because it is so typical: It represents the trials we all endure. We all know some pain; some know more pain than others. The quantity of suffering is unimportant. It is the quality of our suffering that counts, and God is determined that we should suffer well.


If one were asked to give one reason for misery in the universe, I suspect that the reason most frequently given would be sin. And this answer would not be incorrect. All tribulation, disease, pain, frustration, and death can be traced back to the original transgression of our first parents. In this context, Donald Carson has called suffering “the effluent of the Fall.” All the evil that has flooded over the world flows from the pollution of Eden (Romans 5:15-20). The adversity which dogs us throughout our lives is a consequence of rebellion against a just and holy God (Genesis 3).

But, there is another reason for epidemic tribulation, a reason which is “before” sin, so to speak. It is the reason for all reasons. It is the providence of God. By providence, I mean God’s purpose and plan for the universe and His actions in history to accomplish the same, including the redemption of His elect. God’s providence precedes sin: It is prior to sin in what philosophers call an ontologic sense; that is, sin is dependent on providence, it derives from providence, it is included within providence. The Westminster Confession (5.4) addresses the relationship between providence, and thus:

“The almighty power, unsearchable wisdom, and infinite goodness of God, so far manifest themselves in his providence, that it extendeth itself even to the first fall, and all other sins of angels and men, and that not by a bare permission, but such as hath joined with it a most wise and powerful bounding, and otherwise ordering and governing of them, in a manifold dispensation, to His own holy ends; yet so as the sinfulness thereof proceedeth only from the creature, and not from God; Who, being most holy and righteous, neither is nor can be the author and approver of sin” (I Samuel 2:25; I Kings 22:19-23; Psalm 76:10, Romans 9:18; II Thessalonians 2:11).

Since all that happens is grounded in the providence of God, God himself is the guarantor of meaning for each and every event in our lives, including the painful events. God’s providence underwrites the promise that “all things work together for good to those who love God, to those who are called according to his purpose” (Romans 8:28). Only a God sovereign over all things can order all things for good. If even one were beyond his control, God could not make such a promise; for that one autonomous thing-animate or inanimate, of matter or energy, of space or time or spirit, or any combination thereof-could by its uncontrolled effects thwart God’s plan for you or me or the universe.

But God is sovereign: He providentially “works all things according to his will” (Ephesians 4:11; cp. Job 23:13; Psalm 115:3; 135:6; Isaiah 46:10). This promise should be a great comfort to us. Although we may not understand the mysterious workings of God in history, He has assured us that He is in charge of all that happens, and, because of this, all that happens does so for our good.


Affliction can teach us the gravity of sin around and within us. Thomas Watson writes, “in the word preached, we hear what a dreadful thing sin is, that it is both defiling and damning, but we fear it no more than a painted lion; therefore God lets loose affliction, and then we feel sin bitter in the fruit of it” (All Things For Good, p. 27). In such trials, we see just how far the curse is found and how much creation groans to be delivered from its futility (Romans 8:19-22). Continents quake; the nations war; farms and cities flood; our companies go bankrupt; our jobs are lost; our husbands, wives, children, and friends first fail us, then die. So we see that sin soaks everything in our world.

And not just our world, but ourselves, as well. We, too, are stricken, and stricken, often see within us a corruption of which we little imagined we possessed or, if imagined, little thought of. Suffering can expose the hidden malignancy of sin within us just as an x-ray can expose malignancy in our bodies. Those who do not recognize their sin will never know their need of God. Seeing ourselves for who and what we are, we may turn to the Lord and be healed (Psalm 41:4; Jeremiah 3:22; Hosea 6:1: cp. Isaiah 55:6-7; Ezekiel 33:11; Acts 3:19).

Suffering trains us to obedience and humility, conforming us to Christ. Christ, “although He was a Son ….learned obedience from the things which He suffered” and was thus “made perfect” (Hebrews 5:8-9). This passage does not mean that Jesus was in any way disobedient or impure. Rather, it means that in humbling Himself “to the point of death, even death on the cross” (Philippians 2:5,8), Christ fully experienced what it is like to be humanly obedient to God, and through that experience was perfected as an effectual mediator for us with the Father. Christ in humility and obedience bore affliction for our sakes.

It is the image of Christ in humility and obedience to which we are to be conformed (Romans 8:29). And not only so, but we are to be made like Him after the manner by which He was perfected for us. The disciple is not greater than the master (Matthew 10:24). Our Lord was humbled to obediently suffer for us; we must suffer to become humble and obedient like Him. That is why Paul desires to know “the fellowship of His sufferings, being conformed to His death” (Philippians 3:10). We should desire the same.

Suffering leads us to trust in God’s power and allows us to experience his faithfulness. When things are going well, we place trust in ourselves, our families, our friends, our environments. We forget that it is only God’s constant grace which sustains us. But as Thomas Watson notes, “When God lays men upon their backs, then they look up to heaven” (p. 56). Beset by evil, we quickly remember how frail we really are and how insignificant our resources. Calvin says that, “Thus humbled, we learn to call upon his power, which alone makes us stand fast under the weight of afflictions” (3.8.2.). By standing fast, we learn that God is faithful and that our “hope does not disappoint” (Romans 5:5).

Adversity may prepare us for use in the kingdom of God. There are many uses to which God can put us.

We may be afflicted that we may comfort others (II Corinthians 1:4). There is need in the church for individuals who know how to comfort the distressed or bereaved or diseased with the comfort of God. That knowledge is best obtained through personally experiencing God’s comfort. Affliction is, therefore, part of the instruction of a Godly comforter.

The saints’ afflictions are a witness to the world. That witness may be of judgment or of grace. Consider, for example, the prophets Jeremiah and Hosea. Their lives were lived as metaphors for the relationship of God with his rebellious people, Israel. To signify to the Judean kingdom the forthcoming judgment of God, Jeremiah, in an age when everyone married and children were a social necessity, was forbidden to marry. He was further forbidden from participating in the common life of his countrymen. And at God’s command, Jeremiah purchased land upon which he knew he would never live and from which he knew he would never benefit.

For his troubles, he was imprisoned, his life was conspired against, and he was thrown into a cistern. On the other hand, the trials of Hosea were gospel drama. God had Hosea take a prostitute for a wife, father children by her, love her despite her infidelities, and finally, as a prelude to restoring her as his rightful wife, buy her back from her harlotry. In their afflictions, Jeremiah and Hosea faithfully witnessed to the will of God. We are not prophets as they were, but we are called to the same faithful witness in suffering (James 1:2-4; I Peter 3:14-15).

The chief and highest end of man is to glorify God (Westminster Larger Catechism, Q.1.), and God is glorified in the suffering of His saints, whether in His deliverance of them from their woe or in His strengthening them to bear their tribulation. The deliverance of Israel from slavery in Egypt is an example of the former, as is also Christ’s healing of the blind man in chapter 9 of John’s Gospel. The latter is exemplified by Paul’s “thom in the flesh” (II Corinthians 12:7). So whether we are afflicted “that the works of God might be revealed” in our healing (John 9:3) or that Christ’s power be demonstrated through the weakness of our continued adversity (II Corinthians 12:9), our suffering will glorify God.

Adversity may come to us as discipline from God (Proverbs 3:11-12; I Corinthians 11:32; Hebrews 12:5-12). God chastens His own for benefit of their growth in Godliness. This chastening is not penal: Christ has paid the penalty for our sins; rather, it is remedial and corrective. This view is unpopular with moderns, but it is Biblical: “whom the Lord loves He reproves” (Proverbs 3:11; cp. Hebrews 12:6-8).

Suffering may wean us from an excessive love for and dependence upon the world (Calvin, Institutes, 3.9.1-2.). We are pilgrims progressing toward the Celestial City, but we are drawn to Vanity Fair. The things of this world distract us from Christ, on Whom our gaze should be fixed (Colossians 3:1-2; Hebrews 12:1-2). Adversity reminds us of the true nature of this life-that it is full of loss-and that our true home is with Christ. It engenders within us a kind of homesickness for Heaven. Calvin explains it this way: “Whatever kind of tribulation presses upon us, we must ever look to this end: to accustom ourselves to contempt for the present life and to be aroused thereby to meditate upon the future life …. For this we must believe: that mind is never seriously aroused to desire and ponder the life to come unless it be previously imbued with contempt for the present life …. Indeed, there is no middle ground between these two: either the world must become worthless to us or hold us bound by intemperate love of it” (Institutes 3.9.1,2.).

Calvin is not advocating escapism. In fact, the next section of the Institutes is titled “Gratitude for earthly life!” Rather, he is making a point about the relative values of this life and the next. There is a human tendency to subject eternal to temporal priorities, a tendency worsened by a life of ease. Tribulations enable us to correct our priorities and fix our eyes on things above. In this way, we gain a view of life from an eternal perspective, and this attitude transforms the way we look at the things which happen to us. Affliction can center us on God, and so centered, we gain a new view of our affliction.


Whatever the reasons) for personal suffering, we are ultimately left to confess by faith that God is good and to trust in that goodness. Although theological insight provides us with comfort, no matter how coherent and comprehensive our theology, there are times in life when the weight of existential pain seems unbearable. This position is not to malign theology. It is both profitable and necessary, but it is not enough. Theology alone is not adequate to deal with the pain of a lost child, of a spouse’s death, of a debilitating disease, of a divorce, of a traumatic childhood. God Himself is required for that. We must have Him or we will have no peace. (See Ed’s Note following.)

Job’s experience demonstrates this. In chapters 27-31 of job, he pleads his righteousness before God and demands to know why he has been afflicted: “Oh that I had one to hear me!/Behold, here is my signature;/Let the Almighty answer me!” (31:35).

But is it an answer to “why?” that job really wants? Is job seeking a theological argument? The ultimate theodicy? In the end, he receives no explanation for his suffering from God, yet satisfied, he repents of questioning and accusation (job 38-42). Why? Donald Carson, in his book, How Long, O Lord, gives this reason: “Those who do know God come in time to recognize that it is better to know God and trust God than to claim the rights of God. This is… the ultimate test of our knowledge of God. Is it robust enough that, when faced with excruciating adversity, it may prompt us to lash out with hard questions, but will never permit us to turn away from God?… When we suffer, there will sometimes be mystery. Will there also be faith” (pp. 174, 178).

Knowing God Himself is better than claiming the right to know what man cannot possibly know. C.S. Lewis learned this lesson after his wife’s struggle with and death from cancer. Like Job, like all of us, Lewis had many questions and doubts Some of these are recorded in a revealing little book, A Grief Observed. I will quote him here at length.

“What chokes every prayer and every hope is the memory of all of the prayers H and I offered and all the false hopes we had. Not hopes raised merely by our own wishful thinking; hopes encouraged, even forced upon us, by false diagnoses, by xray photographs, by strange remissions, by one temporary recovery that might have ranked as a miracle. Step by step we were `led up the garden path.’ Time after time, when He seemed most gracious He was really preparing the next torture. I wrote that last night. It was a yell rather than a thought. Let me try it over again. Is it rational to believe in a bad Gods Anyway, in a God so bad as that? The Cosmic Sadist, the spiteful imbecile?” (pp. 34-35).

Lewis eventually recognized the hyperbole of anger in his words and answered the above questions in the negative, but he continued to struggle. He questioned why his wife had to die when and how she did, and why it so affected his faith; he questioned the meaning of faith; he questioned the meaning of love for God; he questioned many other things and did not always find answers. But despite the persistence of some unanswered questions-the persistence of mystery-Lewis eventually found comfort in God. He wrote: “When I lay these questions before God I get no answer. But a rather special sort of `No answer.’…like a silent, certainly not uncompassionate, gaze. As though He shook His head not in refusal but waiving the question. Like `Peace, child; you don’t understand'” (p. 80).

And we don’t understand. But if God Himself is our solace, by His grace we will persist in faith: faith like the faith of job; faith like the faith of C.S. Lewis; faith like the faith of Habakkuk, who cried, “How long, O Lord, will I call for help,/And Thou wilt not hear?/I cry out to Thee, `violence!’/Yet Thou dost not save” (Habakkuk 1:2).


Faith does not make us passionless. We are not stoics or fatalists. Que sera sera is not the doxology of a Christian. To quote Carson once more: “There is no attempt in Scripture to whitewash the anguish of God’s people when they undergo suffering. They argue with God, they complain to God, they weep before God. Theirs is …a faith so robust it wrestles with God” (p. 193).

By faith, we cling to Christ despite the trials in our lives which would tear us away, despite bodies ravaged by disease, despite spirits broken by failure. As Jacob refused to release the angel (Genesis 32:26), we, too, must hold fast to our Lord. In the face of affliction, we are to be bulldogs of faith, not lambs of resignation. “Let us hold fast the confession of our hope without wavering…” (Hebrews 10:23).

“Though the fig tree should not blossom,
And there he no fruit on the vines,
Though the yield of the olive should fail,

And the fields produce no food,
Though the flock should he cut off from the fold

And there be no cattle in the stalls,
Yet I will exult in the Lord,
1 will rejoice in the God of my salvation.
The Lord God is my strength,
And He has made my feet like hind’s feet,
And makes me walk on high places”
(Habakkuk 3:17-19).

God grant us such a faith. Amen.

This article was a sermon, given at Sovereign Grace Fellowship, Des Moines, Iowa, June 25, 1995, with minor modifications.

All Bible quotes are from the New American Standard Bible.

[ JBEM Index / Volume 10 / Number 1 ]