To Die is Gain: A Theological (re-)Introduction to the Sacrament of Anointing of the Sick for Clergy, Laity, Caregivers, and Everyone Else by Roger Nutt. Steubenville, OH: Emmaus Academic, 2022. 216 pp. $29.95 Hardcover.
Suffering and illness can be our greatest teacher. According to the Catechism of the Catholic Church, illness and suffering “can lead to anguish, self-absorption, sometimes even despair and revolt against God,” or it “can also make a person more mature, helping him to discern in his life what is not essential so that he can turn towards that which is” (1501). Roger Nutt’s work is a welcome introductory reflection upon the sacrament of the Anointing of the Sick, which focuses on the Pauline exhortation that calls us to remember “to live is Christ, and to die is gain” (Philippians 1:21). In a culture that has forgotten about the wisdom of the ars moriendi (“the art of dying”), this book offers wisdom on why and how to prepare for death in light of the underappreciated sacrament of the sick.
Life Responds to Death
Death is an uncomfortable reality that the world tries to turn away from at every possible opportunity because it brings about discomfort and unease to confront the limitations of our “mortal coil.” Whereas the pre-modern world had no problem contemplating death in tandem with immortality, the modern world has become only increasingly hostile towards death. The eclipse of God that has been advocated by modern philosophers, such as Nietzsche and Sartre, is one of the main roots of this tendency to reject the true value of life and to flee from death. Nutt contends that “the reality of God provides some response to the problem of death, but God also gives meaning any purpose to life.” Consequently, “if there is no God, or if God is pushed to the margins, then the meaning of things in relation to God disappears” (16). Living and dying well are inseparable realities. The triumph of individualism and technology within our post-Christian culture has introduced an artificial separation that focuses only on a narrow view of “life.”
Saint Teresa of Calcutta is highlighted by Nutt as model of the integrated view of Christian understanding of the human person that unites death and life together in light of our creation by and for God: “For Mother Teresa, it was not dying that was the ultimate tragedy but dying without knowing that one is loved, especially by God” (27). Saint Teresa was a sign to the world of how to love the sick, the poor, and the dying because to live and to die well are rooted in knowledge that we are first and foremost known and loved by God. Healing in the modern world has been limited to a physical cure. In light of the Gospel, healing is directed first and foremost at the triumph over sin and eternal death. Death for the Christian is not the end, but the beginning of eternal life for those who have united their lives and deaths to Christ through grace. This proper understanding of the relationship between death and eternal life is the foundation for a proper theology for understanding the significance of Anointing of the Sick.
Yet, the Paschal Mystery illuminates the darkness of suffering and death. The suffering, death, and resurrection of Jesus Christ offers insight into the meaning of our own lives and deaths. This is essential to understand the theological background of the Sacrament of the Sick (Chapter 2). In his well-known kenosis hymn, St. Paul proclaims that Christ in his humility became “obedient unto death” (Philippians 2:8). This is an essential practice for all followers of Christ, who are called to imitate this humble obedience to the cross and beyond. Salvation history attests to God’s fidelity to those in need and distress (Psalm 34). The Old Testament promises a suffering servant, who will bear our griefs, our sorrows, and our sins (Isaiah 53:4-5, 11). Even when humanity seems to be abandoned in the midst of suffering and affliction, God promises to remain “always near to those who are helpless, and able to redeem his children from every situation, even if there is no apparent avenue for escape or deliverance” (50). The Old Testament testifies to the steadfast faithfulness and love of God for all of humanity, which prepares the way for the ultimate “man of sorrows,” Jesus Christ.
The love and compassion that the Father has for the sick and the suffering is made incarnate in the Person of Jesus Christ. Throughout his public ministry, Jesus heals the sick, but the greatest illness from which he has come to deliver us is our sins. As the divine physician (Luke 5:31-32), Christ “has both the power and wisdom to meet the needs of our sinful human condition, which go well beyond the ailments that afflict the body” (55). Christ’s healing ministry has passed over into the sacraments of the Church and finds its scriptural support in the Letter of St. James: “Is any among you sick? Let him call for the elders of the Church, and let them pray over him, anointing him with oil in the name of the Lord; and the prayer of faith will save the sick man, and the Lord will raise him up; and if he has committed sins, he will be forgiven. Therefore confess your sins to one another, and pray for one another, that you may be healed” (5:14-16; emphasis added).
Nutt underscores the eschatological implications of this passage by noting that the Lord will “raise up” the recipient of this sacramental anointing, which is clearly accompanied by special prayers recited by a priest. Nutt also notes that the use of “save” in the passage above implies that this sacramental rite is directed towards a spiritual and not simply a physical healing.
The Fall introduced the disorder of suffering and death, which has been inherited universally by all of humanity. Even in spite of the gift of redemption, the inclination towards sin remains part of the constant tension that the person experiences in struggles against the captivity to the “law of sin” (Romans 7:23). Drawing upon the theological anthropology of St. Paul, Nutt notes that we can live either “according to the disorders of the flesh, which feeds the fallen and disordered appetites for destruction,” or we can cooperate with grace and live “according to the sprit” (76). In Baptism, we are reborn in the new life of grace that is bestowed upon us through the work of the Holy Spirit. The struggle against sin and suffering must constantly be conquered by grace and virtue. Anointing of the Sick offers recipients the grace by which “God faithfully and gently heals and strengthens against bodily vices that may afflict those who are seriously ill” (80). This sacrament continues to offer the healing grace of redemption and eternal life, which were given in Baptism. Baptism initiates a person into the Kingdom, whereas Anointing of the Sick serves as further (or, as the case often may be, final) preparation for full entrance into the Kingdom that occurs only after death.
Soul and Body
These first two chapters (outlined above) offer a robust context for his treatment of the Sacrament of the Anointing of the Sick (Chapter 3) and the effects of the sacrament (Chapter 4). Nutt outlines clearly who can receive the sacrament of the Sick. In response to a frequent abuse of the sacrament, Nutt notes this sacrament is not simply intended for people who have the common cold or flu, and that administering the sacrament to those who are not seriously sick or dying is “misleading and spiritually harmful” (87). Since the Anointing of the Sick was once referred to commonly as the more dire-sounding “Extreme Unction” or “Final Anointing” (see 87-90), Nutt carefully establishes a continuity between the old and new name for the sacrament. For, since all who are sick are not actively dying, Nutt writes that “the change in name and the administration of the sacrament early in the dying process in no way decouples the sacrament from grave illness” (88-89). The development in the administration of the sacrament is not limited merely to the point at which a person is in extremis (“at the point of death”).
The Roman Ritual provides clarity that eligible recipients of the sacrament include those about to undergo surgery for a serious illness, any elderly person who has become notably weakened, a seriously sick child who has reached the age of reason, or those who have lost consciousness or their mental faculties but who otherwise would have requested the sacrament (92-93). Nutt also addresses the difficult cases involving the dead, the unconscious, infants, and the mentally disabled. The author concludes the chapter with a careful distinction between the Sacraments of Penance and Anointing of the Sick. The differences between these sacraments is highlighted by his citation of the theologian Romanus Cessario, who notes that Penance is “ordered to spiritual health inasmuch as this sacrament brings healing from the illness of sin, whereas Holy Anointing restores robustness to a fatigued spiritual life” (104). These two sacraments of healing, Nutt concludes, work distinctly and in tandem to bring about a healing from sin and its effects.
Although most people may think the first grace of the Anointing of the Sick is physical healing, the real first grace is the gift of strength, peace, and courage to face the temptations that accompany illness and the approach of death. For, as all sacraments do, through the Anointing of the Sick, the recipient is brought into closer communion with Christ, who conquered death. Thus, Nutt proclaims that administration of this sacrament is “an evangelical proclamation of Christ’s victory over death to those who are facing it” (113). The Sacrament of the Sick offers the recipient grace to become like the Suffering Servant mentioned above. Drawing upon the insight from St. John Paul II’s apostolic letter Salvifici Doloris, Nutt notes that the sick person’s suffering can become redemptive and bring about grace for other members of the Church. Suffering can be made fruitful for the faithful person, who is able to embrace suffering and to conform his life to Christ.
The Anointed One
Christ uses the Sacrament of Anointing to prepare the sick and the dying to enter into the peace and joy of eternal life. The graces of this sacrament “are intended by Christ to bring the whole of life of grace to completion and eternal rest” (131). In a certain sense, this sacrament marks the consummation of what began with the Sacraments of Initiation. Consequently, the Eucharist is given as Viaticum with Anointing of the Sick and Penance as it bestows the grace to receive and enter into the glory of communion with God and the communion of the saints.
Anointing is closely related to Penance insofar as it expiates sin and its effects. Nutt emphasizes the sacramental principle revolving around our disposition towards the sacraments: “Anointing of the Sick…does not heal from sin souls who have not sought, in any way, to live lives of conversion and penitence” (134). The healing bestowed by this sacrament is available to those who are disposed to penance and forgiveness. Grace is only freely given to those who are free to accept it.
Nutt offers a succinct sacramental theology of rites to contextualize the Rite of the Anointing of the Sick and its appeal to our human nature (Chapter 5). The words of the rite that accompany the anointing of the forehead and the hands signify the unity the suffering and dying have with Christ through the grace of the forgiveness of sins. Nutt emphasizes the symbolism behind the particular senses of the forehead and hands that may be source of weaknesses that lead to sin. The head is symbolic of the intellect which may be tempted by the memory of past sins or the sin of despair. The hands are symbolic of touch, which have often lead to varying kinds of sin.
The diversity of the conditions and contexts for when and how a person may be ill and sick is accounted for by the varying scenarios in which the rite may be celebrated. The rite may be celebrated within a communal context within the celebration of the Mass. There are also different forms for celebrating the rite of Anointing outside of Mass: either with the “Continuous Rite of Penance, Anointing, and Viaticum,” or to employ a “Rite for Emergencies” when there is not enough time to celebrate all three sacraments with the full “Continuous Rite.” With respect to the minister of the sacrament, Nutt affirms the reservation of the sacrament to bishops and priests because the anointing within this sacrament is a priestly “consecration to Christ of the sick person in their weakened condition” (153). The Anointing of the Sick is reserved only for priestly ministers who assist members of the common priesthood to complete and consummate the living sacrifice (Romans 12:1) of their life to Christ for all eternity.
Finally, Nutt brings his reflection to a close with a balanced approached to death (Chapter 6). Death is not a good in itself, even though the Risen Christ has redeemed it. Death brings about sadness, suffering, loss, and separation from loved ones. Nutt affirms that mourning is a natural human response that is not reducible to a “denial of Christ’s victory or eternal life” (159). Mourning is simply the acceptance of an undesirable situation that cannot be changed in the present circumstances: we are deprived of the company of those we loved. Consequently, the Church in her wisdom encourages us to pray for the dead and to remember that Christ has conquered death such that life is merely changed and not simply ended.
This brief treatment of the Sacrament of the Anointing of the Sick should be read by anyone engaged in health care or the pastoral care of the sick because of its singular focus on treating suffering and death in light of the Paschal Mystery. Health care workers will find the book particularly valuable because Nutt also examines some key bioethical principles for addressing end of life issues. During a time in which patients are often treated like customers or consumers, this book offers a welcome perspective. Nutt’s work should also be used in seminaries to form future priests and permanent deacons to help them in understanding the evangelical proclamation of the Gospel Life that is not well articulated. Because To Die Is to Gain contains a sharp Christocentric focus, it stands as an important witness to St. Paul’s claim that “whether we live or whether we die, we are the Lord’s” (Romans 14:8).
Roland Millare serves as vice president for curriculum and program director for clergy initiatives (a continuing education and formation program for priests and deacons) for the St. John Paul II Foundation, Houston, TX, and as an adjunct professor of theology for deacon candidates for the Diocese of Fort Worth and at the University of St. Thomas School of Theology at St. Mary’s Seminary, Houston, TX. Roland earned a doctorate in sacred theology (STD) at the Liturgical Institute/University of St. Mary of the Lake, Mundelein, IL. He is the author of the book A Living Sacrifice: Liturgy and Eschatology in Joseph Ratzinger (Emmaus Academic).
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