Suffering Work: Pastoring With Cancer

Four Things I’ve Learned

Derek Sweatman / 9.14.23

This is my story of pastoring a church while fighting cancer. All of us leaders have something we’re struggling against, be it a disease or addiction or a suffering mental state, so my particular circumstances are just part of the larger reality that all leaders face: being human. That said, I have learned some things these last few years about myself, about the church, and about what it means to lead while dragging along.

Here’s What Happened

In the fall of 2020 I was diagnosed with stage 3 colon cancer. If there was a good time to get that news, it was during the heart of the COVID lockdown. Nothing else was happening, at least not in person, at least not for us. Our church closed its doors for nearly 18 months, so in a way I was able to deal with my cancer without having to be around a lot of people on the weekends. I went through 12 rounds of chemo and 28 days of radiation, followed by a short break, followed by my surgery in the spring of 2021. I woke up from surgery, attended church the next day from the hospital (we were a Zoom church during lockdown), and then the next day I threw up in a way that concerned everyone involved. My insides basically unraveled and whatever was in my stomach shot through my whole body. Not good. They put me in a medically induced coma, during which there were two emergency surgeries to save my life and repair my body. I don’t remember any of it, I was busy dreaming some very strange dreams and wondering why I couldn’t wake up.

After 2+ weeks in a coma, I did wake up. I don’t remember a time in my life when I felt so much joy to be present and to see and to talk to people. I had a lot of questions, and I was saying things that didn’t make a lot of sense, but I was at peace with my wife by side. I couldn’t walk or even sit up; I lost all that strength in the ordeal. I dropped 35 pounds, which thrilled me, but standing up was temporarily impossible, and I spent weeks in the hospital relearning to function at all the basic levels from eating to grabbing things to walking.

Piedmont Hospital, 2021

Six months after I went home, I had a scan and my oncologist told me that he was “concerned” about some things, and that it looked like the cancer had spread. Mind you, the surgeons had told me they “got it all,” a phrase many doctors are now admitting shouldn’t be said to any cancer patient, because you never really know. I asked him what the situation was and he said, “We don’t really treat this sort of thing to cure it, but we’ll do the best we can.” With that, I walked out of the hospital feeling very heavy and without much hope. I didn’t know what to say to my wife, my kids, my associate, much less my church. We had a leadership meeting shortly after that visit, and I shared with my team what was happening. At the time we decided to keep things quiet until I was into the treatment schedule far enough to know more of what was happening and what exactly to communicate.

I restarted chemo in the winter of 2022 and have gone every two weeks since. A few months into treatment, I let the church in on the situation, and from there almost everything about my job began to change. I would now stand in front of everyone as a broken person. We’re all broken, of course, but this brokenness would go unhidden. We pastors talk often about suffering and troubles in our sermons, but I would now embody those realities in front of my people, suffering in public, struggling in view.

After almost 16 months of treatment, I’m still here! And along the way I’ve learned some things about pastoring with limitations, about living with hope, and a few things about the church, too.

Here are my top four:

Reverse Pastoring

I was nervous about telling my people what was happening. There was a fear that I would be seen as someone no longer worth investing in, at least not as far as the church was concerned. Getting a younger, healthier leader made sense to me, that’s for sure. Who wants to attend a church whose pastor is up against the wall with cancer?

I sent the church-wide email update from the chemo lab, actually, thinking that would stave off the anxiety since I was already sitting there quite distracted by treatment and all the beeps and sounds of a place like that.

Then the replies started rolling in, and quickly. My phone was lighting up with text messages and voicemails. Lot’s of people saying “I love you” and “We’re here for you.” People weren’t leaving me behind, they were coming in closer, they were starting to minister to me. They were breaking the rules of church life. After 16+ years of pastoring this one parish, it was strange to feel all that ministry come back at me, all that support and concern and love.

In a line of work where the leader is often lonely and not as relationally connected as people might imagine, it’s been good to experience a more normal participation in parish life apart from just being its pastor. I have been enjoying being a member of this body.

Less Concerns

Obvious as it may be, when you’re in this situation, you start to care less about things that used to bother you, and this has been true for me. And in terms of pastoring and leading a church, that shift has found its way into my leadership, too.

I used to carry around a lot of anxiety about how we were doing as a church, and whether or not we were succeeding as an organization. I still have interests in these questions, but it’s different now. There’s no longer a sleepless obsession over matters of ministry that are ultimately out of my control. Often what we pastors obsess over can become a source of stress for the congregation, and I didn’t want to be in a church that was always on edge about something.

Call it selfish, and perhaps it is, but one of the shifts we made early on in my journey with cancer was that our church would no longer be place of anxiety and stress. Church shouldn’t be stressful for anyone — it should be a breath of fresh air in a world that’s already redlining. Sure, things happen and stresses come along, but they would no longer be the norm.

We still learn and try new things, we still respond to growth appropriately, and we still stay focused on our calling and values, but with a more patient and merciful posture.

Asking For Help

Chemo is hard. People often ask what it’s like and I say, “Well, the first two or three rounds are fine, it’s the next forty or so that hurt.” Chemo treatments vary in their effects, but for me I’ve had to contend with a battered nervous system (my feet always hurt and I can no longer wear my favorite Berks), chronic fatigue, pain, infections, weight gain (there are two types of chemo: the kind that makes you skinny, and the kind that weighs you down, and that’s the one I got), hair loss, dehydration, and feeling generally unwell a lot of the time.

I have never missed a Sunday, and other than treatment days, I am at work as normal. But it’s hard. There are times when I don’t have the strength to do the things that I used to do, like carry tables or set up the stage or deliver donated items to the shelter. I miss doing summer camp, but right now I can’t even imagine. Often my associate will tell me to take a nap in the youth room, and I do, but I feel guilty about not working.

Asking for help is not easy for me, but I’m learning how. I’m learning to turn to people and say, “I can’t do this?” It’s a good lesson for me, and for you.

Sundays Are Life

Partly related to what I said about building a parish life that isn’t stressful, our Sunday mornings have shifted to an even more joyous setting than before. We’ve always been a church that laughs and sings and such, but over the last few years there’s been an intentional shift towards ensuring that the Sunday service is filled with hope.

Yes, we have settings and workshops and book clubs that explore more nuanced and hard subjects around culture and faith and scripture and the like, but those are environments people move into on their own. The Sunday service is reserved for the lifting up of a people, for reminder and recall of the grace and mercy of God, and for the communion, that counter-cultural table that is for everyone. No one should feel trapped in a service that the pastor uses to forward their own peeves and agendas. It’s the Gospel that should be heard.

For me, I wanted to make sure that I desired to attend my own church, which again can sound selfish. But I wasn’t going to waste my remaining years on a gathering that bummed me out. And it’s opened my eyes to the other people in the room, that they, too, aren’t there to be scolded or convinced or made to feel less than. They want to leave, as the benediction says, “in peace.”

I don’t know how many Sundays I’ll have with my people; no one does, not even my oncologist. We’re hopeful, and we’re pushing forward and holding out for the best. And it’s important to me to have a parish community that I enjoy, and that they enjoy, too.

The world has enough trouble of its own.  – Jesus

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4 responses to “Suffering Work: Pastoring With Cancer”

  1. David Zahl says:

    I’m just so incredibly grateful for you and for your ministry, and for this incredible article, so full of hope and perspective and wisdom. Thank you Derek. You are a treasure. I really, really want to come down and spend a Sunday morning at Atlanta Christian Church:

  2. Fran Turner says:

    Thank you for sharing this wonderful article. It points out that grace and blessings are present – even in a crisis.

  3. So moving. Well said. Thank you.

  4. Sarah says:

    I am grateful for these sharp and poignant observations. Thank you, Derek.

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