Chapala Theological Seminary Counseling Situations

Surgery

"I am with you and will keep you wherever you go" (Genesis 28:15). Surgery confronts a person with their own frailty — and the pastor's task is to walk with them through fear, waiting, and recovery.

The Situation

A member is facing surgery — perhaps a routine procedure, perhaps something grave, perhaps an emergency with no time to prepare. Surgery is one of the most common reasons a pastor is called to the hospital, and it carries its own particular weight. To go under anesthesia is to surrender control completely, to place one's body in the hands of strangers, and to brush up against the truth most of us spend our lives avoiding — that we are mortal, frail, and not finally in charge. Even a "minor" operation can stir major fear, and the pastor must never measure the size of a person's anxiety by the size of the procedure. There are really three distinct moments the pastor ministers to, and each is different: the before — the fear and waiting of the days and hours leading up to it; the during — the long, anxious vigil of the family in the waiting room; and the after — the pain, vulnerability, and sometimes the strange emotional letdown of recovery. The wise pastor learns to serve in all three, bringing not medical expertise, which is not his to give, but the presence of God and the steady companionship of the church into a frightening and disorienting experience.

The Ten Steps, Applied to Surgery

Step One · Stage 1

Determine the Time and the Place

With surgery the timing largely chooses itself, and the pastor's discipline is to be present at the moments that matter most: a visit before the day, when there is time to talk and pray unhurried; a presence with the family during the operation, in the waiting room where the hours crawl; and a return after, in recovery and at home. The hospital is a hard place to minister — noisy, interrupted, with nurses coming and going and little privacy — so the pastor learns to be flexible, to make good use of a few quiet minutes, and to come back rather than trying to do everything in one rushed visit. Honoring the standing safeguard, when visiting someone of the opposite gender he keeps the door open or ensures others are present. Simply showing up, especially before the surgery and during the long wait, preaches a sermon no words could: you are not facing this alone.

Step Two · Stage 1

Listen

The pastor listens for the particular fear, because surgery frightens different people in different ways. One fears the anesthesia and the loss of control; another fears what the surgeons may find; another fears pain, or dependence, or a long recovery; another, beneath it all, fears death itself. Some carry shame about their condition, or guilt that they brought it on themselves, or worry over the cost and the burden on the family. The pastor does not assume he knows which fear it is; he draws it out gently and lets the person name it. He resists the strong temptation to rush in with reassurance — "Oh, you'll be fine, it's nothing" — which, however kindly meant, tells the person their fear is foolish and shuts down the very conversation they need. Far better to listen long enough to hear the real fear, so that whatever comfort he brings actually meets it.

Step Three · Stage 1

Clarify the Situation

The pastor comes to understand the shape of what the person is facing — without ever pretending to a medical knowledge he does not have. Is this a routine, low-risk procedure, or something serious and life-threatening? Is it planned, with weeks to dread it, or sudden? Is it the patient's first surgery or one of many? What has the doctor actually told them, and how much do they understand of it? Often a person is frightened partly by confusion — they have not grasped what the surgeon said, or have filled the gaps with their worst imaginings. Here the pastor can gently encourage them to ask the medical team their real questions, for clear information from the right source often shrinks a fear that thrives on the unknown. The pastor's role is not to interpret the medicine but to help the person face the actual situation rather than the monster their fear has built of it.

Step Four · Stage 1

Investigate Previous Counseling

The pastor learns the person's history with illness and with God in hard times. Have they been through surgery or serious illness before, and how did they come through it? What has sustained their faith in past trials? Who is around them — family, friends, the church — and are they supported or largely alone? He also stays alert to deeper needs that surgery can surface: a person whose fear is overwhelming and unmanageable may need the help of the medical team's own resources; a person whose surgery is grave may be wrestling with mortality in a way that opens the deepest spiritual questions. And he is honest about the boundary of his role — he is there for the spiritual and emotional care, while the medical team carries the medicine, and the two work best side by side. Knowing the history helps him bring the right comfort and recognize when more help is needed.

Step Five · Stage 2

Responsibility

In surgery, this step is gentle and never about blame. A person facing an operation is not at fault for being ill, and the pastor must guard against any hint — or any self-accusation in the patient — that the sickness is a punishment. Rather, "responsibility" here is the quiet, freeing work of helping the person take up what is actually theirs to do: to trust the medical team they have chosen, to follow the doctor's instructions before and after, to do their honest part in recovery, and — most of all — to entrust what they cannot control to God. There is a real responsibility in surrender itself: the deliberate choice to release the grip of anxiety and place oneself, body and soul, in the hands of God and the care of those trained to help. The patient cannot guarantee the outcome; no one can. But they can choose where to rest the weight of it, and the pastor gently helps them lay it down.

Step Six · Stage 2

Model the Role

By his own calm, unhurried, unafraid presence, the pastor models the peace he is pointing the patient toward. Fear is contagious — but so is steadiness, and a person about to face surgery watches the faces around them closely. The pastor does not put on a false, breezy cheerfulness, which rings hollow in a hospital; he brings instead a settled, honest calm that does not deny the seriousness yet is not ruled by it, because his trust rests in God. He models how to pray honestly in fear, how to speak of hard possibilities without panic, and how to hold hope and realism together. The family in the waiting room, too, takes its cue from him; a pastor who sits with them steadily, unhurried and unafraid, lends them a composure they cannot summon on their own.

Step Seven · Stage 2

Review the Alternatives

Though the decision to have surgery is a medical one the pastor does not make, there are real choices in how a person faces it, and he helps them see these. They can face it consumed by dread, rehearsing every catastrophe — or they can face it with trust, doing what is within their power and releasing the rest. They can isolate, hiding the fear and going through it alone — or they can let the family and the church carry them, accepting prayer, visits, and practical help. They can let the experience drive them from God in anger and fear — or let it draw them nearer, as trials so often can. There are practical helps, too, to lay before them: honest conversation with the medical team, the support of loved ones present, Scripture and prayer to steady the hours, and the simple comfort of knowing the church is praying. The pastor helps the person see that while they cannot choose the diagnosis, they can choose, in large measure, the spirit in which they walk through it.

Step Eight · Stage 2

Explore the Outcomes

Here the pastor must be especially careful, for the great temptation in surgery is to promise an outcome he cannot guarantee. He must never say "everything will be fine" or "the surgery will succeed" — for he does not know, and if it goes badly, such a promise wounds terribly and can shake a person's faith in God along with their faith in the pastor. What he can hold out is a hope that does not depend on the outcome: that whatever happens, God will be present; that the person is held, in life or death, by a faithful God; that they are surrounded by love and prayer; and that they need not face any result alone. He helps them look honestly at the real possibilities — including, where the surgery is grave, the hard ones — not to frighten but so that hope is built on truth rather than on a denial that can shatter. The deepest comfort is not the promise that nothing bad will happen, but the assurance that nothing, not even the worst, can separate them from the love of God.

Step Nine · Stage 2

Supply Information — the Presence of God

The pastor brings the Word of God to steady the frightened heart — chosen with care and never flung as a slogan. The great theme for surgery is the presence of God in the place we cannot control: "Even though I walk through the valley of the shadow of death, I will fear no evil, for you are with me" (Psalm 23:4); "Fear not, for I am with you" (Isaiah 41:10); "When you pass through the waters, I will be with you" (Isaiah 43:2). He brings the truth that we are in God's hands whatever the surgeon does — "my times are in your hand" (Psalm 31:15) — and that nothing in all creation, neither life nor death, can separate us from the love of God in Christ (Romans 8:38–39). For the believer he brings the deeper assurance that even death has been defeated, so that the worst the surgery could do is not the final word. And he prays with the person — simply, honestly, naming the fear to God and asking for His presence, His steadying peace, skill for the surgeons, and grace for whatever comes. Often it is the prayer, more than any other moment, that the patient carries with them right up to the door of the operating room.

Step Ten · Stage 2

Provide Closure

Closure in surgery is not a single moment but care that spans all three stages — and the pastor must remember the one most often neglected: the after. The visits and prayers cluster before the operation and during the wait, but recovery can be a lonely, discouraging stretch, marked by pain, slow progress, dependence on others, and sometimes an unexpected emotional letdown or even depression once the crisis has passed and everyone else has moved on. The faithful pastor comes back — in the recovery room, on the ward, and at home in the weeks that follow — to encourage, to listen, to mark the progress, and to help the person give thanks where there is cause and persevere where recovery is hard. He makes sure the church continues its practical care: meals, rides, visits, help at home. And he watches, gently, for the recovery that is not going well, physically or emotionally, ready to connect the person to further help. Closure here is the promise, kept over time, that the church's care does not end when the surgery does.

A Word on Faith and Medicine

Surgery sometimes raises a question in a believer's mind: does trusting God mean I should not rely on doctors? The pastor should be ready with a clear and freeing answer: no. Scripture never pits faith against medicine. The God who heals made the body, gave human beings the wisdom to understand it, and works through ordinary means as readily as through miracles — Isaiah prescribed a poultice for Hezekiah, Paul told Timothy to take a little wine for his stomach, and Luke, the beloved physician, was Paul's companion. To submit to surgery is not a failure of faith but can itself be an act of faith, receiving God's care through the hands He has gifted and trained. The pastor frees the patient from the false and crushing idea that needing a surgeon means failing to trust God, and instead helps them see the surgeon's skill as one of the good gifts of the God in whom they trust. Faith and medicine are not rivals; they are allies, and the believer may lean fully on both.

The short-answer questions are for your own reflection: write your answer, then press Reveal model answer to compare. Unit completion is based on the multiple-choice questions.