Today it has become almost commonplace to talk about the need for proper care of the terminally ill and dying and the special medical and pastoral problems associated with such people and their families. But it was not always so. When in the 1960's Metropolitan Anthony spoke to doctors, nurses and interested laymen about the pastoral care of people approaching death, he was one of the few who seemed to realize that there was much to be said and much to be learned. It was - and, of course, still is - necessary to stress again and again that suffering, when accepted, is a privileged position from which to draw near to God, and that dying is part of life and must be treated as such, Metropolitan Anthony gave the following talk to The Society of the Child Jesus in November 1971.

The purpose of this Society is to concern itself with children, but I think that whether we are dealing with children or with grown-ups, whether in pain or in anguish, we must never forget the people who surround them. Children have parents; grown-ups have wives and families. And it is not always the person who actually suffers who is the most distressed. At times the person who is physically suffering has enough to do with his suffering to fill his time, to use up all his spiritual opportunities, while the people who are around him, particularly when they feel helpless, have a very complex and distressing time. I would like to say something about suffering and about the death of children, but what I have to say also applies to a very great extent to parents, to friends, to people who are outside the actual suffering but are concerned with what is going on. For one thing, I don't think we can approach the question of suffering and death unless we have an idea, unless we have some sort of evaluation of suffering, of death - and of life. One of the things which makes us so helpless in the face of suffering - of children, more particularly, but also of grown-ups - is that we have no point of view on it. We face situations without having any idea of what we think of the predicament as such. Nowadays, for instance, it seems to be a commonplace to consider suffering as an evil and to think that suffering must be avoided, or alleviated, or pushed back as completely and as far as possible. The result of this is, I think, the growth of cowardice: people are afraid, and this fear of suffering at times is more disastrous than the suffering itself. I have spent ten to fifteen years of my life being a physician, so I have some personal experience of how things work in hospitals and outside them. What usually happens is that people are told, 'There is no reason why you should suffer - life should be smooth, things should be good, suffering is an evil.' And then when suffering comes our way, most of the people who surround us take it as an injustice on the part of Fate, as an event that should not take place. It is probably put together with the various things which are called 'acts of God' in insurance policies. This is, I think, a remarkable expression, because an 'act of God', if you try to define it from the list of things which are called by that name, are things so monstrous, so shocking, that no man would do them - it takes God to do them. In many cases, suffering is taken in that way. No human would inflict it, and yet God allows it. It is completely evil and wrong, and yet God does not do anything about it. In this way people are deprived both of a manly approach to suffering as such, and of the real help they could derive from God if they did not define him in the first place as the very person who is responsible for all evils. Sometimes people come to me and express distress at what their life is like. More often than not they explain why they react so wrongly to circumstances by saying, 'Well, God has allowed this and that; I would be a saint if God had not made my life unbearable'. Very often, before suggesting absolution, I tell the person, 'Now, before you receive God's forgiveness, are you prepared to forgive him for all his misdeeds? Because, from what you have said, quite obviously he is the cause of all evils'. Well, this is very much the way in which people react to their own suffering and to the suffering of others around them; and if that is the approach, then there is nothing to lean on anyhow. Now I do not consider suffering and death as good in themselves. But they are not an evil in themselves. Nor are they a one-sided act of divine cruelty: life on earth is something more complex than this. God - his will, his wisdom, and his love - plays a substantial part. The powers of darkness play their part, and man plays his part between the evil which can invade the world and the good that can conquer it. Man has the dread power of allowing either the one or the other to have the upper hand. So that whenever suffering or any other form of evil comes our way, it is not enough to turn to God either accusingly or miserably. We must realise that the situation is defined by human evil as much as by anything else. There is a collective responsibility for particular suffering which we must accept and face together. When grown-ups suffer, one can, more easily than with children, see the good it can do to them. It is against odds that character is built. It is in the face of suffering that we learn patience, endurance, courage. It is by facing other people's suffering that we can reach a depth of faith, a depth of surrender to which otherwise we could not attain. Not to rebel, not to protest, but to grow into harmony with the ways of God is something which we cannot achieve without challenge. You remember, probably, the Crucifixion: the way in which the Mother of God stood by the Cross and said not a word in defence of her divine son who was dying there. She did not accuse those who had condemned him. She did not turn aggressively against the people who, with curiosity or indifference, were surrounding the Cross. She said nothing. She accepted the death of her son with the same perfection of faith and surrender which she had shown when she accepted the Incarnation. This applies to all of us. The Mother of God in this respect should be for us an image and an example. Throughout the Gospel she is the one who allows her son to go his way. To enter into all the tragedy which is the destiny of the Son of God become the Son of Man. This is important for us when someone who is dear to us walks into pain, suffering, anguish. Now there is in the suffering of children something which is more puzzling, in a way, than in the suffering of grown-ups, because in the suffering of the grown-up we can see the good it might do if the person lived up to the greatness of his vocation. But what about the child? Can a child who suffers learn something which is of real and great value - patience and humility, courage and endurance, faith and surrender? I remember a child whose answer is recorded in the life of one of the French saints of the 18th century. The man asked a child of nine years of age how he managed to endure a very painful illness that eventually killed him, and the child said, 'Father (he was nine), I have learnt not to perceive today either yesterday's suffering, nor to anticipate tomorrow's'. This is something of which very few grown-ups are capable, because whether it is moral suffering, psychological distress, or physical suffering, what usually makes it so unbearable is that at every moment we seem to live and relive all those past moments of pain and anguish, and at every moment we expect that it will last for ever, will never come to an end, and we cannot face this sum total of all our past suffering and of our future suffering, while more often than not we could face the actual present suffering of our body or of our soul. This example concerns a child of nine. What about even smaller children, who cannot reason things out in this particular way? Can suffering do something for their eternal soul, or is it sheer nonsense and cruelty? We have a tendency to think that it is through our minds, through our conscious response, through our intellectual elaboration, that we grow in spirit. We imagine that our spiritual life is made of the lofty thoughts and deep feelings which we have developed. This is not our spiritual life. It is not the life of the Spirit. It is that intermediary part of us which is neither the body nor the spirit. I would like to draw an analogy to make myself clearer. We do baptise children. What do we expect, if we expect anything at all? What is the reason why we find it makes sense? Because, consciously or not, we believe that the living spirit, the living soul of this infant, is capable of meeting the living God face to face, apart from any psychological understanding, apart from intellectual or emotional response: a living soul meeting the living God. That the sacraments of the Church address themselves to this living soul which does not depend for its knowledge of God on intelligence, consciousness, and so on. But if this is true, then it applies also to all those things that happen in the body or soul of a child before it can be intellectually aware of things. As far as grown-ups are concerned, I think, from what I have seen, that it applies to people who are mentally ill, who are beyond reach, who seem to be completely separated from the surrounding world, and who may recover, and whom we meet no longer where we left them but as men and women who have matured and become greater than they were. It is as if behind this screen of folly, of madness, the life of the Spirit has continued, because God cannot be stopped or kept out by what is going on in our intellect or in our emotions. God has direct access. God meets a human being at the level of his soul, that is, ultimately at the level of silence and of those things which are beyond words, at the level of mystery, of those things which can be known within silence but which cannot be expressed by words otherwise than symbolically, which can only be hinted at. So if a child is ill at a time when we cannot expect that he will consciously be aware of what is going on, or that he will be able to learn those things which require will, intellect, maturity of emotion, an active faith, an active surrender, it does not mean that what is happening to him will not do something, will not be a positive event or a positive contribution to his eternal life. And that, I think, is particularly important for parents and grown-ups to realise when children are beyond reach, like certain intellectually deficient children. There is a limit to communication in words, but there is no limit to communication in other ways. Ultimately, a meeting between a soul and God takes place at the heart of silence. Any meeting between two persons takes place beyond words. It takes place where God is. In the Orthodox Church we insist that when a woman is pregnant she should make her confession, put her life right, receive Communion, pray; because the relatedness that exists between her and the child is such that what happens to her happens to the child. When the child is born, we expect the parents to pray over it. We give Baptism, Confirmation and Holy Communion to new-born babies for the reason which I have given before: because the living God can meet his living creature at a depth which is far beyond any ordinary means of human communication. When a child is ill, intellectually beyond reach, it still remains that this child can be prayed over, prayed about, held before God. It can also have participation in the sacraments of the Church. If parents and those surrounding such a child realised this more often, if instead of trying to break through a wall that cannot be broken through, they went to that depth where in God we all meet, then there could be a relatedness, and a perceptible relatedness, a relatedness of which they would be aware, which would be the beginning of an eternal relationship. And this applies also to death. God is not the God of the dead; he is the God of the living. If we live in God we live close to each other, and when a child has departed this life so often the parents have a double sense of distress. On the one hand, the child has died. This would apply also to a grown-up. There is no physical presence, there is no direct, physical relatedness. But also, in a strange way, we imagine that the child that dies, the baby that dies, remains, as it were, a baby for ever, remains out of reach, because on earth it did not evolve that intellect which allows communication and those emotions which bind us together. And yet, if this is a living soul, alive in and by the power of the living God, then if we could only reach out to the depth which is our own soul, our own spirit, we could without fear be certain that nothing can separate us. When the time comes when all things are fulfilled, we will not meet on the level of our psychological richness or poverty, we will meet spirit to spirit and soul to soul. And on this earth we need to be aware of it. Our relationship with those who have departed this life does not lie in the past; it is not in the future; it is in the present - that split second which the present is, and which is the meeting-point with eternity, that is with God. It is now that we are related to those who have departed this life, and it is in the category of eternity - and not of time - that this takes place. Yes, it is true that there is no physical sight, no physical touch; but this is not the level on which we communicate anyhow. Even as we are now, when there is between us a real relationship, it is not simply conditioned by our mutual understanding of words, of language, of symbols. We have understanding and relationship to the extent to which, soul in soul, we meet in silence, in depth. In a way, real communication begins where all the ordinary means of communication have been left aside. Real understanding is beyond words. When children suffer, we must make an act of faith concerning their ability, because they are living souls, to grow into an ever deeper intimacy with God, and we must be certain that what is happening to them is not lost for them. When they depart this life, we must also remember that God is the God of the living. One thing which I wanted to say and which I forgot to mention is the importance of touch. Touch in relationships. Physical contact. In practically every religious rite things are conveyed by contact. The laying-on of hands, a blessing - so many things are done physically. We should be aware of the spiritual quality of our bodies. Without our bodies we could not commune in the sacrament of the Body and Blood of Christ. We could not commune with him. It is through our bodies and because of what they represent, because of what they are, that we can have this communion with Christ and God. In human relationships touch plays an immense role. How much one can convey of compassion, of love, of tenderness by putting one's hand on another hand or on a shoulder, which will never be conveyed by words. And with sick children perhaps more than with anyone - or perhaps not, because when a person is ill, gravely, grievously ill, everyone becomes a child again - so much can be conveyed by human touch: sacramental, sacred or simply human (which is also sacred and sacramental). This is something which we must teach the parents of sick children: where words fail, when means of communication are not there, there is a mysterious way of conveying what cannot be conveyed, of expressing with certainty what one is incapable of expressing - love, tenderness, compassion, but also faith and life - by the way in which we treat a body. Well, these are perhaps disjointed thoughts, but I would like you to think about what I have said because we have to deal not only with the child who is ill, but also with those who around him are distressed. And they must learn, through faith - instead of being overcome by grief, instead of being conquered and destroyed - that they are sharing in a mystery, in a situation in which human power fails and divine Power is abroad, acting sovereignly, building a kingdom in which each child - and we are all someone's children - in which each child participates, one way or another, in the mystery of the Lord Jesus Christ, who was born into a world of time, out of eternity, in order to die, and through death to open to us unconquerable, eternal life. Sourozh 1984. N. 18. P. 6-16