Most of us experience relatively good health. Occasionally we might get sick, then recover a couple of weeks later and return to normal life with no lasting ill effects.
But what happens when you’re struck with an ongoing health issue that doesn’t go away—not two, three, six months or even a number of years later? What impact does an ongoing illness have on your physical health, mental health and even your spiritual health?
In this episode, Peter Orr is joined by Andrew and Kath Bruce. Andrew is the rector of St Peters Anglican Church in Sydney and his wife Kath is a GP. Together, they help us think about chronic health from a personal, theological, medical and practical perspective.
Links referred to:
- Our August event: Affluent and Christian? Material goods, the King and the kingdom with Michael Jensen (21 August 2024)
- Support the work of the Centre
Runtime: 46:34 min.
Transcript
Please note: This transcript has been edited for readability.
Introduction
Peter Orr: In this episode, we’re going to be thinking about chronic health issues. We’re joined by Andrew and Kath Bruce. Andrew is a minister in Sydney, and he has suffered from some significant chronic health issues for many years, and Kath is a GP.
I hope you find this episode helpful as Andrew and Kath enable us to think about chronic health from a personal, theological, practical and medical perspective.
I hope you enjoy the episode.
[Music]
PO: Welcome to Moore College’s Centre for Christian Living podcast. Today I’m joined by Andrew and Kath Bruce. Andrew and Kath, it’s great to have you with us. Maybe you could introduce yourselves: Andrew, tell us about yourself—particularly how you became a Christian—and then I’ll hand it over to Kath.
Andrew Bruce: Thanks, Pete! Nice to be here. I’m currently the rector of the parish of Cooks River, which is at St Peters, just south of where we are now. We’ve been there 13 years. Becoming a Christian: I suppose there were two main parts in my life that were pretty significant. My mum is a Christian and I grew up going to Sunday school and church and those sorts of things. When I was in first grade, there was an older lady who taught us Scripture. She told us we had to do a memory verse: John 3:16. Then she said, “Who wants to be friends with Jesus?” and I said, “Yeah, I want to do that,” and if you did that, you got a Bible. So she gave me an RSV Bible, which it took me until the end of Moore College to be able to read well.
I think at that point, I really did only have an understanding of the gospel in terms of being friends with Jesus. It didn’t really make any impact in my life: I treated Jesus like a Get Out of Jail Free Card like in Monopoly.
When I got to university, I met some Christians. They were genuinely Christians, and I realised that if both of us were calling ourselves “Christian”, clearly one of us wasn’t being consistent with it, and that was me, and I had to change. So I decided to read the Bible. I thought, “If I’m going to be a Christian, I should read it.” I started by reading a book that I didn’t know: I started reading Isaiah. I remember getting to chapter 6 and seeing the vision Isaiah had of the temple, and just thinking, “Man, I’m a man of unclean lips and I’m in a world of trouble.” That played on me.
I read a chapter a day for the next two years, and then the week after my 21st birthday, I was walking across a park in Yarramundi in north-west Sydney on surveying camp, and I just had this absolute moment of clarity, where I had to make a decision. I had to get in or out of the boat: either Jesus was my Lord or he wasn’t. From that point on, I would say I was properly Christian and came to seek to serve the Lord. After a long chain of events, we wound up here.
PO: That’s wonderful. Kath, what about you?
Kath Bruce: Yeah. Thanks, Pete. I grew up in a Christian household. There’s not really moment, like Andrew had, but I do remember at a holiday camp in Year 5 realising that I wasn’t a Christian just because mum and dad were Christians, and I had to decide whether it was something for me. I thought that it was. Over time, God’s been gracious in bringing amazing Christians into my life and helping me grow in reading his word. I’ve continued in that walk ever since.
PO: Wonderful!
Struggling with a chronic health issue
PO: Today we’re talking about living with chronic health issues. Andrew, you’re in pastoral ministry. Kath: you’re a GP. You’re both uniquely qualified to speak about this issue—particularly Andrew, since this is something that you struggle with. Do you want to tell us a little bit about the kind of chronic health issue that you’ve struggled with recently, and even before that?
AB: Yeah. Thanks, Pete. So I suppose this was a little bit of a long time coming for me, although I didn’t know it at the time. At the end of 2017, I had, I suppose, again, a moment of clarity: I was in a rheumatologist’s office and he made me take off my shoes. He looked at my toenails and my fingernails and said to me, “You have psoriatic arthritis”, which is a psoriasis arthritis that is related to that, but I didn’t get the psoriasis, so it took them a long time to diagnose me, because I didn’t really present in a normal way.
It’s an autoimmune arthritis, so it’s different to, say, osteo. Osteo is where you wear out joints. An autoimmune arthritis is like rheumatoid: most people know about that. Psoriatic is similar to that. It’s pretty debilitating: it’s a systemic kind of arthritis. I have it in every joint in my body—every vertebrae, jaw—everywhere. Basically only my shoulders don’t get it: they’re the only ones I don’t notice it in. It’s pretty rough, to be honest. For the 18 months before I got my diagnosis, I felt like I was actually grinding to a halt: I couldn’t look over my shoulder. When I was driving the car, I had to turn around to see things behind me.
So that was a turning point. Since then, it’s been difficult to try and figure out how we move forward with it. It has multiple aspects of how it affects you: it can affect you with fatigue; there’s the pain itself; there’s the lack of mobility; there’s a lack of energy that comes with it; and to a varying degree, mental health can be a significant issue related to it.
But that’s, I think, true of a lot of chronic health issues. Chronic health issues are a bit like, they say, Pringles: you can’t have just one. They all intertwine. If you’ve got a chronic health issue, the chances of you having mental health issues and other things going along with it, they all intertwine. That’s why it can be quite complex to try and unravel those things as well.
Realistically, I can think back: it started when I was 14. I had unexplained swelling in joints and that kind of stuff. I played a lot of football, so I just thought it was that. Then at each major stage in my life, as autoimmune diseases are related to stress, every time you stepped up a level, like taking on a new job, it would get a bit worse. Getting married was a whole new thing. It got a little worse. Then I took on another new job, and then I came to college, and then I went into ministry, and then we had kids. Each one of these steps probably turned the ratchet up a bit. Then in 2017, it just was completely unavoidable. Anyway, we got a diagnosis for that. Since then, we’ve been trying to figure out how to live with it.
On chronic health issues
PO: Kath, what is a chronic health issue? What makes it different from other health issues? And what are the complexities associated with a chronic health issue?
KB: Yeah, totally. A chronic health issue: I haven’t looked up the definition, but I imagine it would be anything over about six months. But also a chronic health issue is something that is ongoing. A cold, a flu or even a pneumonia or infection is going to be over and done with in some amount of time, whereas a chronic health condition is something that we’re not going to cure, we’re going to manage, and it’s probably going to be with you for the rest of your life, and we’ll manage it.
Of course, that comes with all sorts of issues, as Andrew has already said. Mental health is number one. Pretty much anyone with a chronic health condition will have some anxiety and depression purely related to that, even if it’s a chronic health condition that doesn’t cause pain. Andrew’s chronic health condition does cause pain, so that’s an added reason for anxiety and depression going hand-in-hand with that. They use very similar neuro-chemical pathways—that is, pathways in your brain—so chronic pain and mental health are very interlinked through pain. I guess that’s the difference: management versus the cure is the best way to say it.
Andrew’s was particularly tricky to diagnose: it’s not the most common cause of arthritis—particularly, as he said, he didn’t get any of the skin issues, with the psoriasis. He had no classic patches on his elbows, and that kind of stuff. So it was quite difficult to diagnose. I was quite surprised when we got the diagnosis, and that was a bit hard for me as a medical practitioner [Laughter]; I thought I should have worked it out! But as it turned out, it was quite tricky. Also, he gets a variety where his joints aren’t damaged much, so when we’ve done scans and x-rays and things, his joints looked okay. But the tendons where they insert onto the bone around the joints are really very inflamed in his case. So his case was quite tricky to diagnose.
That can be a really tough part of chronic health conditions and autoimmune conditions. “Autoimmune” is a massive umbrella for anything where the immune system—your own body—is attacking the normal tissues of your body. There is a whole raft of things: there’s thyroid disease and gastrointestinal illnesses, and so on. Autoimmune is a very big umbrella, but they can be trickier to control. Does that answer your question? [Laughter]
PO: Perfectly!
Life post-diagnosis
PO: So Andrew, in 2017, even though you’d been suffering before then, you received this diagnosis. What has life looked like since then?
AB: Yeah. Diagnosis is a good thing, and that’s useful, because at least you’ve got a name on it. Up until that point, it was difficult: I genuinely felt like I was grinding to a halt. I felt like, “Maybe I need to slow down a little bit,” and the more I slowed down, the worse things got, and the more I slowed down, the worse things got. So it was really hard to work out what was going on.
Getting a diagnosis was good, because one, it made me feel like I wasn’t out of my mind, I wasn’t being a hypochondriac and I wasn’t being soft—and other thoughts that tended to go through my mind, like “Maybe I’m being whingey” or “Maybe this is just middle age”. I thought, “No, this is pretty rugged.” That helped. Having a name on it helped. Also, the diagnosis helped me understand and go, “You do need to manage yourself and you do need to manage this issue.” I can’t expect to be doing what everyone else is doing; that’s just not an option for me. I can’t do things in the same way. I’ve got to do things differently. So that helped.
But just because you’ve got a diagnosis doesn’t mean you’ve got a plan of management. That process has been awful, to be honest. It’s … six plus years now, and I think we’re just starting to get to the point where it’s kind of manageable. Through that process, there’s been all sorts of meds they put you on, and some of them are brutal—different processes, different diets, different whole bunch of stuff. I reckon three out of four of them have made me worse, not better—made me really sick. It’s been pretty rough. It’s not an easy path. I’ve felt, most of the time, like I was swallowing spiders to catch flies.
By the time I got to 2019, I thought, “If I don’t put a circuit-breaker in here, I might not be in ministry much longer.” I took my long service leave—all of it. I had a whole term off. That gave me a little bit of breathing space. We went away for three weeks. I’d do something with the kids in the morning, and then in the afternoon, I was done. It wasn’t a very exciting long service leave for a family [Laughter]. But I want to finish well. I don’t want to have to drop out of ministry. I think what I do is important and I enjoy it. I think it’s worthwhile. So I just have to think differently about how to do things.
We did that, and that helped and bought a bit of space. Now we’re kind of at the point where it’s managed a bit. But I just have to be very realistic about my capacities. Also, what people say about autoimmune diseases is they’re incredible variable. They’re not a “set and forget” thing at all. It’s as variable as the weather in Katoomba [Laughter]: one moment it’s boiling hot, the next moment it’s freezing cold and misty, like the other day when we were up there and everyone had to go home, because it got too misty. It’s like that: you wake up in the morning and you feel great; by lunchtime, something’s gone horribly wrong. All sorts of stuff impacts on it, so every time I get something like a flu shot or a COVID booster, because it kicks off your immune system, over the next week and a half, I get horrendous arthritis through my body. So I have to be realistic about how to manage that at those times.
You have to be relentless and non-negotiable on what you do with yourself—with your diet, your time, your energies—and you have to be really, really clear in your mind about what are your absolute priorities? What are the “It would be nice”s? What must you do in order to do your role? Then where you work outwards from there if you’ve got more energy? I think me being me, I’m pretty wired that way—to having clarity over what I want to do and what I think I should be doing with my time. So I think that has been an enormous benefit to me in this context.
Basically by the time I do working life and family life, that’s it: I’ve got no energy left. If I have a big event, I have to then plan to have a little bit of a quieter time, doing something else. I can do reading or whatever.
The best way of describing it is it’s like ageing prematurely. I was saying to my mum, “I got a handwritten Christmas card from my pharmacist.” [Laughter] Right? What does that say?
KB: For the second year! [Laughter]
AB: And my mum was complaining because she got one for the first time. I said, “Yeah, but you’re eighty. I’m fifty!” That’s the best describer I can give you: it’s like suddenly you’ve aged overnight, and so you just have to be really in tune with where you’re at, and wise—really wise—with how you spend your time and where you invest the energies you do.
The difficulty of treating autoimmune disorders
PO: Kath, can you speak from a medical point of view: why is it so difficult to treat? Why can’t we just take a pill and fix it like so many other conditions?
KB: Because you don’t want to wipe out your immune system. It’s really helpful [Laughter] for lots of other things! You can put people on steroids, and they get roid rage, they gain weight, and everything else goes to pot. It’s just that the immune system is really important, and it’s part of every body process, and you can’t just turn it off. You’ve got to work out how to turn it off.
Now, psoriatic arthritis is tricky in that it does seem to be more variable than some of the other autoimmunes. For example, thyroid autoimmune disease is really easy: you just take stuff out, add a bit of thyroxine, and you’re good to go. Kind of: it’s not quite that simple, but it’s much more straightforward. But this is much more tricky.
So as Andrew said, he’s tried three injectables and a tablet. We went through the whole range of those that are on the PBS. The other thing is, in Australia, you’re limited by what is on the PBS—the Pharmaceutical Benefit Scheme—that is, what the government is happy to reimburse, so we don’t have to pay ten thousand dollars a month for our medication, which makes a massive difference. You also have to go through a process: you’ve got to do this, then do your methotrexate, which was terrible, and do various things before you can even get to that medication. You’re trying to turn off the bit of the immune system that’s causing the problem, but we don’t really know what that is, and how to turn it off, and we can’t turn the whole thing off. It’s just really tricky.
AB: I should say there as well that one of the good things about medicine is its great skill is in treating acute issues; it’s not quite as strong in treating chronic health issues. For me, it’s turned out to be really quite driven by food intolerances. But if you go to a rheumatologist, they’re not interested in that. It’s not their area. You go to a dietician and they say, “Well, we’ll just put you on a keto diet” and you go, “Okay, but that actually makes me worse.”
PO: And so you almost have to manage the specialist, because each of the specialists—
AB: A hundred per cent.
KB: Totally!
AB: What I’m trying to say is that you actually need to be your biggest advocate. I read somewhere where a guy said, “If you’ve got a chronic health issue, that’s your job. You get up every day and you manage your chronic health issue, and then you do other things if you can.”
Dealing with a chronic health issue like it’s your job
PO: So how have you done that? We’ve got a GP in the room. Have you used Google? I know GPs love it when patients use Google.
AB: Yep. [Laughter]
KB: Well, we don’t mind it as long as we all come with an open mind to the conversation! [Laughter]
AB: I think that’s one of the upsides of our age is that you can get on and you can watch a lecture from a professor of John Hopkins University. You can educate yourself, and you need to.
PO: And do you find that helpful?
AB: Oh, a hundred per cent! You have to. You have to have an advocate for your issue. I can say this because I’ve spent a lot of time around doctors and dealt with a lot of doctors at family things and whatever [Laughter]. But the truth is—and in a wider sense—doctors are mechanics for the body. They’re just a mechanic. When you take your car to the mechanic and you say, “It squeaks when you turn like this,” and they go, “Oh, we couldn’t find it,” and they send you on your way, and you drive around the corner and it goes again, right? [Laughter]
KB: It squeaks!
AB: The medical system is under a lot of pressure. They’ve got short times and they are trying to get as many patients seen as they can. The system is under a lot of pressure. So chronic health doesn’t fit the system. This means you have to be your own advocate, or find someone who’s really useful with you.
I have had a pretty rough time navigating the medical system, and I’ve got the best inside track anyone can have, right? Kath can explain it to me and say, “No, no. We’re not going to that person. Let’s go to that person.” I’ve found it an incredibly complex and difficult thing. What I want to say is that if you do have that, it is your number one priority, because if you fall apart with your health, you can’t do anything. So you as a person—and in my case, a husband, a dad, a Christian, a minister of the gospel—that all goes down the plug hole if your health goes. No one benefits. So I’ve got to be relentless. And you do have to be absolutely relentless: if you’re not getting an answer, you don’t have to be adversarial. But you’ve got to go in and get the answer.
PO: And understand that maybe the person you’re talking to might not have the answers and you’ll have to go to somebody else, and that’s not necessarily writing off that person.
AB: Yeah, no.
KB: And because there’s no money in studying diet, because no one’s going to get a patented medication out of it, no one studies the impact of diet on chronic diseases, so it’s a little bit his and miss. It’s been really tricky to navigate because there’s not what I would consider good medical information about it; it’s kind of “I tried this and it worked.” “Okay, let’s try that.” That makes it difficult from a medical point of view.
Impacts on mental and spiritual health
PO: Let’s move to the mental side of it—the emotional side of it—but also particularly the Christian faith side of it. I’ll start with you, Kath: how have you found supporting Andrew? You’re married to someone going through something pretty traumatic that’s ongoing; how have you found that?
KB: It has its ups and downs! [Laughter] It’s tough, because you have to watch someone you love go through a lot of pain, and you can’t help them. I’ve said this to Andrew before, I’m a bit more at peace with it now, but in the beginning, I felt like I should be able to fix it. That’s what I do: I fix things for people. I couldn’t fix it, and I found that really, really difficult. You’ve just got to take it to the Lord in prayer: there’s no other option. You just have to support as best you can.
I think for Andrew as well, he is something who likes to do that research stuff, and so supporting him in that and navigating that together has been a good way that I’ve been able to support him. But it’s tricky, and it can be tricky as well because, if Andrew’s having a bad day, he can’t take the kids to sport. That can be a little bit unreliable sometimes. Now we’re much more on track, but certainly in the beginning, I’d have to do a lot of that physical hands-on stuff in terms of parenting, which was tricky.
But it’s really tough to watch the person you love be in pain and not being able to fix it for them. You’ve just got to bring it to God and know that he’s sovereign, and I’m not. I don’t understand it, but you try to drop that trying-to-understand part of your brain and just be there to support him.
Also, keep communicating. What do you need? What can we do? How can we change things? Being flexible. Also, and maybe this comes more into the ministry sphere of things, realising that we’re not going to be a family that looks like other families. We never were, because we’re us and we’re in ministry, and that’s different to start with. But realising that our family is going to look different, and that’s okay.
PO: Just to ask you a little bit further on that, as a minister’s wife, was that something that you—because you can’t do as much as, maybe, other ministry families—is that something you particularly wrestled with, or early on, were you able to say, “Look, I can’t. I’ve got to give up any ideas of living up to peoples’ expectations”?
KB: Yeah, I think maybe God had prepared us for that: our youngest was diagnosed with autism before we got Andrew’s diagnosis, so we already had—that word “capacity” is really helpful—we already had a decreased capacity. Particularly when he was younger, it was very difficult for us to have people over to church, because he had had enough of people and he just needed to go and run around, and it was really difficult to do that for him. I think for us, now that I think about it, maybe God had been kind in giving us that timing, where we already had a different capacity, because of our family.
I think it helps that we’re at quite a small church, so there’s a not lots of people to have to minister to. We don’t have to have stacks of people over all the time who we don’t know very well; we know everyone really well from church. I think there’s lots of things that God in his kindness has given us to help that. But, yeah, you can’t do as much and, as I said, that’s just what it is.
PO: Having preached at your church a few times and spoken to the people there, I know how much they appreciate the way that you love them.
[Music]
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PO: The world is becoming wealthier and wealthier. Since the turn of the century, the net worth of many countries in the West and in Asia has tripled, poverty rates have fallen, and life expectancy has increased by more than six years.
At the same time, the divide between rich and poor has increased, with the richest one per cent owning almost fifty per cent of all the world’s wealth. Five to ten per cent of people still live in extreme poverty, even in the most affluent nations. Furthermore, while money can buy happiness, it can only do so up to a certain point, and wealthier people are more likely to be less generous and less kind to others.
How as Christians should we think about affluence? Is material prosperity a blessing or a curse, or both? Given the state of the world and income inequality, what are we to do with the riches God has given us? We’d love you to join us on 21 August when Michael Jensen, rector of St Mark’s Anglican Darling Point, will help us to see our earthly treasure the way our heavenly Father does.
And now let’s get back to our program.
The emotional side and the faith side of chronic illness
PO: Just to Andrew in particular, we’ve talked about the physical side of things and we’ve touched on the mental side. Do you say a little bit about your seven years of difficulty? Jacob would have married Rachel by this time (Gen 29:18) [Laughter] or Joseph would be out of prison (Gen 39:20-41:40), or whatever. But you’re still dealing with it. Do you want to talk about the emotional side, but also the faith side?
AB: Sure. The emotional side, Pete! [Laughter] I only have one emotion: it’s varying levels of anger. [Laughter] No. So on the emotional side: I suppose I’m a fairly practical kind of guy, and so I never had that “Woe is me!” or “Why is this happening?” stuff. I think part of it is once you get to a certain age and you deal with ministry—so when we were at St Peter’s, St Peter’s is a place where people in their brokenness are pretty up front. It’s a certain area of Sydney that’s not hidden behind a veneer of middle class suburbia. People are pretty up front and broken. I think having been in ministry for 15 years or whatever to this point, you know that people are broken and brokenness happens, so I’ve never had this point where I’ve gone, “Oh, woe is me and why is this happening?”
To be honest, I was kind of relieved. I went, “No, that makes sense.” For me, it’s not so much that it is; it’s that it doesn’t make sense; that’s the part I find difficult. Why are all these things happening? All the symptoms made no sense until you put this one thing in the middle and you go, “Wow! This was running from one end of the spectrum to the other: it covered everything”, and all these weird ailments that you thought were unrelated were suddenly related and made sense to me.
That sort of thing I don’t think was ever an issue. I think probably it was more of an issue in terms of capacity. I think that’s where it’s hard not to feel guilty about things, where you go, “I should be doing more and I want to be doing more.” There are times when I’m rearing to go, but my body can’t. It just can’t. And you go, “That sucks.” I used to measure how bad it was: could I walk to the shops, which are about a kilometre away? Could I walk around the block? Could I walk to the letterbox? I had numerous times when I couldn’t walk to the letterbox, it was that bad. Admittedly our letterbox is 50 metres; it’s a big property. But still, it’s not very far. It was that bad. I had to learn how to do things differently.
The best way to describe it is imagine having inflammation everywhere: it just goes crazy. So sometimes it’s in the back of my eyes and my vision goes a little bit, and so I can’t read or write. You just have to find different ways of doing things. Audio stuff has been a great blessing for me. Fortunately I’m someone who can write a talk in my head. I’ve had times where I’m just curled up on the floor, writing my sermon in my head, and come Sunday, I’m ready to go: “Okay, let’s do it.” It has been difficult that way.
In terms of faith, I think it’s practical applications where I’ve had to rejig how to do things. Some days, I find it really difficult to physically read a Bible, which is why we’re in such a blessed age where you can do podcasts instead that day. You can even find people doing morning and evening prayer, if you want to do that. There’s so many options in such a way, so I’m really thankful for that. We’ve just got to do things differently.
In terms of my Christian faith, I’m going to relate it to ministry: one of the upsides of being at a small church is you have very few resources. Having been in a bigger church when we first came out of college, I actually think that’s kind of easier, because you’ve got enough resources that if you make a little bit of a mistake, it’s okay. A family leave and that’s not good, but life goes on. Whereas when you’re a little church, you’ve got no resources. You’ve got no backup. You can’t make a mistake. You lose a family and then suddenly you’re in a big hole. So you’ve got to have massive clarity over what’s really important, what do we really need to do, what are we going to say no to? Having the courage, first above all, to say no to a lot more things is not easy to do, and you don’t want to do it, but you need to do it if you’re going to do the important things. You’ve got to say no to these other what are apparently urgent things. So in a ministry sense, that related to my physical health. I had to say no to a lot of things so I could do the things that I knew were really important.
But then also, having limited energy, it gave me a chance to reflect on the very essence of being a faithful Christian. What does that look like? What does it look like for me? What is the very essence of being a faithful minister of the gospel in this parish? What must I do if I’m genuinely going to do this? What would be nice, but we’re not doing it right now, or we’ll do it differently? In some ways, it was actually very clarifying. I think it really helped me to let go of worrying about what other people may think about it—not that I’d suffered particularly badly from that, but we all want to do well, because we like what we do, we think it’s important. I think we all care what our colleagues think, and rightly: there’s an appropriateness to that. There’s obviously limits to it as well. But I just got used to it going, “It’s not going to look like anyone else’s. But that’s okay, because in the end, this is what the Lord’s given me, so this is what I should serve with. There’s no point complaining about it. There’s no upside to it.”
I remember Peter Jensen saying that he used to plan out each day, and he used to try and remember whoever worked through his door was the person the Lord had given him to serve. There’s an element to that: trusting in the sovereignty of God and his providence. You go, “Did God give me a small parish to match the illness, or did God give me the illness to match a small parish?” [Laughter] It doesn’t matter, in the end. By nature, I’m a person who likes to crack on with things and change things and whatever. But in God’s grace, I’ve probably been a better minister at that location because of it.
But also, I would say, it’s helped me grow in my understanding of the Scriptures and the gospel—particularly, I think I finally get the Psalms now. Unsurprisingly, I’m not naturally a poetry kind of guy, and I always wanted to love the Psalms, because I saw older Christians I regarded well having a deep love of the Psalms, and I kind of wanted that. Now I appreciate them at a level that I didn’t before.
You’re aware of this, because I’ve talked to you about it, but it’s interesting how you read the Scriptures with a different lens now. We’re halfway through a series in the Book of Acts and we’re coming back to it this year. I read how many times they get it wrong—they get beaten, stoned, thrown out of town, they choose the wrong place, the Holy Spirit stops them from going in there—and think about the fact that we all talk about the church growth bits and how it went from five thousand to eight thousand, and we all talk about that side, but no one talks about the other side of the coin. Most of the time, it was disappointing. Most of the time, Paul had to go back. They’re immature. People left them. Persecution came. I think we read it with a certain lens and maybe that’s not entirely the most accurate, historical kind of thing. I think it’s given me a new lens for that. I think I’ve matured in my understanding of the Scriptures and how they relate to being faithful before the Lord.
In the end, that’s what matters. It’s nice that other people think well of your Christianity, and I mean that in terms of Christianity, not what they think of me, if I can make that little bit of a distinction. But that’s not what drives me. If you’ve been given this by the Lord, then that’s how you should serve. Be as faithful as you can with what you’ve been given, and that’s it. That’s all you’ve got.
Chronic illness and loss
PO: Andrew, you and I sat next to each other at Moore College for four years. There’s a sense in which you’re at college, you’re preparing for ministry, you’re excited, you want to go out and change the world. I presume a sense of loss happens to all of us as our ideals have to give way to reality. But was that more acute for you as you realised all the things you thought about at college about what you would do and what you would achieve gave way?
AB: Yeah. We were at college at a particular time as well. We finished in 2007; 2008-2009 was the great age of the church planters, and everyone was going to be a church planting church planting church. [Laughter] Everyone was going to take on the world, and evangelicalism was the flavour of the day. My how the world has changed in the last 16 years, or whatever it is!
Yeah. Everyone was a bit influenced by that, and it was a really positive time. We came through college when it was a real high water mark of students: we had 110 in our first year. We had 30 plus candidates for ordination in our year. It was an exciting time. It was under Peter Jensen, when we were talking about mission and what we’d be doing. It was a really optimistic time.
I think having home church, having been at Christ Church Gladesville and having been there when the evangelical church had been planted up the coast, coming through with a cohort who came into college—it was a fantastic time. It was really an immense blessing. So this is the other side of life under the sun, I think. But I think I’m more maturer and wiser because of it.
I think it helps you to see things as they really are. Like I said, I think you take off the rose-coloured glasses a bit. I think the danger of it—without it consciously being so—is there’s a real danger of a success mentality, which is a slightly refined version of the prosperity gospel. It’s not the crassness of the 80s—“The more you give, the more you live”. It’s not just “Live your best life now with Jesus”. It’s that “If you do all these things and you’re really faithful, then Jesus will bless your ministry, and if it’s not growing, there’s something wrong.” I think God helped me to grow up a bit.
One of the things I’d really encourage people to do is read biographies of previous Christians. I tend to not read modern books. In fact, the only modern book I’ve read in research time is the biography of Marcus Loane, which I highly recommend to people. Again, it’s just sanctified common sense from outside your age. I think our age suffers a little bit from a lack of personal piety. I think that’s assumed and that’s a bad assumption. I think there was a genuine sense to them of their standing before the Lord—a sense of their faithfulness that maybe we’ve lost a little bit. That’s what mattered, not what the world thought, and not success in the world’s eyes. Now, every age has its weaknesses. But that’s one of their strengths that can speak to our age, which is good.
PO: Do you think your experience helped you feel the value or grasp the value of that?
AB: Yeah. I just think it helps you grow up. You realise stuff like when you’re kid, you want to be a footballer and have the world’s adulation. Then you grow up a bit, and you see those grown men now who were younger than us, but children in men’s bodies. There’s something very juvenile about that life. Needing the affirmation of strangers is really quite juvenile, and yet that’s been the story of social media. All these people you don’t know affirm you, whereas the people under your nose—the relationships you’ve been given—that’s where the Lord’s put you to serve. So it doesn’t have to be pretty or impressive in the world’s eyes; it’s just got to be a genuine expression of your relationship with God and with the people around you.
I think it did help that, and like I said, I think, in a weird way, I aged prematurely. But there’s a certain point in your life when you realise you’re not longer a person of great potential. Do you know what I mean? [Laughter] When we were at college, we were still people of potential, and suddenly you go, “No, I think we’ve maxed out here. I’ve run out of time. I’ve run out of energy. I’ve got kids. I don’t have time to chase that. I can’t be as obsessive about something that, at that time, would have been important, and now it’s relatively trivial. So I think for me, I’ve jumped forward a little bit. Premature ageing is probably the best way of describing it. I think it has brought a level of maturity.
On Sunday mornings, each Sunday, there are 90-year-olds who come, and Maureen comes in and we have a chat about how bad her arthritis was this week and what medication she’s on this week, and it brings a level of genuine empathy. It’s like you know having kids will be difficult, but you know it a whole lot more differently this side of it. Similarly, I think I’m much better at empathising with people in their challenges and difficulties, and the brokenness of this world in a way that I didn’t really understand before—which doesn’t mean you back away from the importance of what the Lord calls us to, standards and those sorts of things. But I think it gives you a capacity to be truly gracious in a way that maybe I certainly didn’t have the same level of maturity to do that in the past.
Caring for others with chronic health issues
PO: Let’s think about caring for friends and family who might suffer similarly from chronic health issues. Kath, what are your tips and recommendations? If listeners have friends or family members, how should they think about caring for other people?
KB: Yep. I think the first thing, as Andrew’s been saying, is that suffering is a normal part of living in this broken world. Whether it’s come early or come later, you need to realise that it’s part of living in a broken world. I think that helps just to normalise it. Is that a good phrase? Just to care for them as people.
The other thing is find yourself a good GP. Find yourself a good whatever you need—physio, dietician, etc. Find those health professionals who can help and who understand what that person is going through. For us, it’s been an amazing chiropractor who’s really helped Andrew move. Find those people to support people in their walk.
The other thing is communicating: what do you need? Don’t impose “This is what I think would be helpful”, but “What would you need?” Walking at their speed.
AB: Literally.
KB: [Laughter] Yeah, I know: I had to slow down how fast I walk! [Laughter] But yeah, walking with him. Maybe they can’t do bush walks like we used to. But that’s okay: let’s find another way. Let’s have coffee overlooking the bush—or whatever. Find other ways of doing things that are still enjoyable and still relating, even if they’re physically not able.
I guess that’s physical health. Mental health is a different kettle of fish in that sometimes people don’t know what they want or need, and so sometimes you just need to do something. Even if it’s not the right thing, if you do something, sometimes that gets things moving. They may not want to go and talk to someone about it, and you might just need to drive them to the GP and put them in that room. That’s going to be a good thing in the long-run.
Yeah, it’s difficult. But keep communicating. I think that’s probably the best thing to say for the carer. Keep asking, “What can we do? What can we change?” and be okay with things not being what you thought they were. As Andrew said, let’s grow up. I’m not going to be a professional swimmer—not that that was ever on the cards. But that’s life; these things happen, and that doesn’t make the relationship any less, just because the person has different physical capabilities than they used to.
Practical first steps to dealing with chronic ill health
AB: I was going to just quickly say to that as well, on the mental health side of things—well, just your health generally—there are some really practical first steps. The most important thing is what is your sleep like? If your sleep is no good, the chances of your mental health failing are higher—much higher. So if you’re having trouble sleeping and you’re not feeling great, see what you can do to sort that out. That’s the number one thing you can do.
PO: Is that something that has been true in your case?
AB: Well, I think it’s worth saying, I haven’t particularly struggled with anxiety or depression, although people with my condition do. I have a particular medication that didn’t go well—that pushed things that way—and as soon as we stopped that, I was like, “Okay.” So I’m probably a little different that way.
But in my case, my poor sleep was absolutely making the autoimmune worse. Absolutely. Nothing is improved by bad sleep in life. Nothing! Honestly. I would say that even for people, if you’re just feeling a bit rundown—not even if you classify yourself as someone with mental health issues—sleep hygiene is so important. It’s getting worse when people are spending time on screens and all those sorts of things.
Second thing is getting a little bit of exercise, and by getting outside—getting in sunlight, fresh air, walk around. Even walking around, your eyes scan and that triggers your vagus nerve and it will help you relax. There’s something about that physical getting outside and getting moving—exercise and sunlight and all that—particularly as you start to age, or if you do have some sort of chronic health issue.
Diet is really important: I can absolutely make myself sick in a moment. If you gave me a really sugary thing, I could put my hand in front of you now and it would swell on the table. It’s that bad. But again, as you age, your body just doesn’t deal with things the way it used to. So there’s a wisdom in taking some time. When you’re in your twenties, you can eat whatever you like. When you’re in your thirties, you just don’t worry about the weight that you’re putting on. Then suddenly you need to think about that.
The fourth one is the importance of social relationships and face-to-face social relationships, not this online sort of stuff all the time. We’re social beings, and it’s so important for your mental health. There’s so many times where you get out and spend time with people, and you just feel a bit better because of it, even if you weren’t feeling great on the way in.
Those things, I would say, most of us of a certain age probably need to think about—have a bit of a plan for those things anyway, but especially if you’re really struggling with something you think is either a chronic health or heading that way. Do that.
The last thing I want to say in terms of caring for people who have it, I think being patient, listening, helping advocate for them, because sometimes they’re not going to be able to be able to do it for themselves; they have just not got the energy to deal with a doctor. If you’ve got a spouse who’s dealing with an issue, it might be really good if you can go with them—particularly if you go to a specialist, because specialists just download a bunch of information on you [Laughter]and you go, “Hang on a second. I’m just dealing with the fact you told me I have a disease” and you walk out and you don’t remember the next hour—particularly if it’s something like cancer or something serious. Going with them so you can help go, “No, no, that’s not what they said. They said this, this and this”—that really helps—that little bit of support and advocacy.
Finally, I know it’s well-meaning, but don’t try and offer people solutions that you’ve found [Laughter]
PO: Googled.
AB: If one more person tells me to take turmeric [Laughter], there’s going be a serious laying on of hands! I’m on some serious medication. I’m aware of, yes, there’s those options, but I’ve done more research on it than, to be honest—
PO: Most specialists.
AB: Well—
AB and KB: Yes!
AB: —particularly—and I appreciate I’m only trying to solve case #1, right. They’ve got to go, “What works in 90-95 per cent of cases?” But if you’re in the five or 10 per cent, you don’t care what works in the others. I’m just trying to solve one problem, and I know what things work, at this point, after six years of spending a lot of my time thinking about it, dealing with specialists and finding [inaudible]. That’s all I’d say.
I know it comes from a well-meaning place. But if someone’s having a rough week, it’s like your wife doesn’t necessarily want you to solve her problems; she just wants you to listen. [Laughter] It’s that kind of thing. Don’t. Because it doesn’t help. [Laughter]
Pastoring people with chronic health issues
PO: Final question for you, Andrew: just to take a slightly different angle, there are some pastors who listen to this podcast. As a pastor, what would you say to other pastors in terms of how they might pastor people in their congregations with chronic health issues? Is there anything you want to say to them?
AB: People often ask about specialist pastoral ministries. Being at St Peter’s, we’ve had a reasonable amount of experience, say, with transgender issues and same-sex attraction as well, to some degree. People ask, “How do you minister to them?” You go, “Well, pastoral ministry isn’t complicated; it’s just be gracious, listen to what they’ve got to say—so you can understand their story and the context they came from—be gracious. Don’t be afraid with the word of God, but be gracious in it. Ask yourself, “How do I help this person follow Jesus and follow the best they can, and well?” That’s all it takes.
Chronic health: it’s very difficult to convey to someone how crushing it can get—to the point where—like I said, I’ve never suffered depression as such, but I’ve certainly had a medication that, basically, was I had to take this injection and then the next week, I was, “I can’t go on. This is terrible.” It was rough. I’m assuming that’s pretty close what to depression feels like, which is terrible. It’s pretty crushing. So be gentle and be patient. It’s not going anywhere in a hurry, so be gracious.
I also think one of the important things to do in any of these situations is to relate at a distance that you can maintain. There’s no point in saying, “Right, I’m going to jump in and I’m going to do everything for this person for two weeks,” and then disappear out of their life. That’s the danger with, say, someone who is widowed or whatever: everyone’s there for the first three weeks after the death, and then they’re on their own.
I think choose a relational distance that you can go the distance on. It’s like running a marathon: you don’t run like you’re running 200 metres. Pick a level of engagement that you can maintain. It might be “Look, I give you a call every second week”, or it might be a call every week, or I might see if I can drop by on the way home—whatever your thing is. Just those little levels of contact that say, “Hey, I’m here. How are you going? You can talk to me if you need to.” It opens an opportunity for them to talk, because, more often than not, they don’t even have the energy to deal with life, let alone trying to start up conversations. So I think just being gracious and taking the initiative, and understanding that there’s not always going to be a good response or an immediate response.
But in the end, that’s pastoral ministry, isn’t it. We’re just trying to help people follow Jesus faithfully. It’s not that complicated generally.
Also, knowing the limits of that: you’re not a psychologist. You’re not a GP. You’re not there to do those things. Quite often people come along with depression or whatever and the first thing I say to them is, “Have you spoken to your GP? Have you done this and this? Can I help you do those things?” And then we start talking about things in the Christian faith. They’re quite surprised and say, “Oh, I didn’t expect this to be that sort of conversation.” A lot of people still have a kind of platonic split-up of themselves as a person—like, spiritual here and material there—and you go, “That’s not really the biblical view of personhood”. So just caring for a person is not overly complicated that way.
KB: Can I add to that? This is just reminding of—I know I’ve been saying, “Listen to the person and see what they want.” But I remember listening to a podcast, and I apologise to the people involved; I can’t remember who it was. I think it was Australian. Anyway, someone with chronic fatigue said, “Sometimes, actually, I don’t know what I want, and occasionally a friend drops in and just cleans the bathroom for me without asking, and that’s wonderful.” Some of it is listening; some of it is watching. Just being prepared to step in and do something, if it seems like that would be helpful. They can always say, “Please don’t do that.”
Conclusion
PO: Andrew and Kath, thank you for very much for being on the podcast. It’s been very helpful, and we appreciate your time with us today. Thank you.
KB: Thank you!
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PO: To benefit from more resources from the Centre for Christian Living, please visit ccl.moore.edu.au, where you’ll find a host of resources, including past podcast episodes, videos from our live events and articles published through the Centre. We’d love for you to subscribe to our podcast and for you to leave us a review so more people can discover our resources.
On our website, we also have an opportunity for you to make a tax deductible donation to support the ongoing work of the Centre.
We always benefit from receiving questions and feedback from our listeners, so if you’d like to get in touch, you can email us at ccl@moore.edu.au.
As always, I would like to thank Moore College for its support of the Centre for Christian Living, and to thank to my assistant, Karen Beilharz, for her work in editing and transcribing the episodes. The music for our podcast was generously provided by James West.
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