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This article was originally published by the Christian Medical Fellowship in 2015. You can download a PDF version of it here.

We don’t know what the future holds for Christian healthcare professionals, but challenges and dangers seem to abound. The pressures on the NHS seem to increase year on year from a toxic mix of economic, demographic, organisational and political forces. There is growing hostility to Christian influence in healthcare from a small but highly effective group of secularists. There is the very real threat that assisted suicide or other forms of medical killing may become institutionalised. Meanwhile, the inspiring example of Christian medics and nurses confronted by Ebola has reminded us of what faithfulness to Christ may cost in a time of plague. An ancient proverb says simply, ‘Those who would be a Christ must expect a cross’. So I think we have to prepare ourselves for more opposition and more suffering.

Suffering is not exactly a dominant theme in contemporary Christian worship and teaching. Yet it’s a strand that runs through the New Testament. The apostle Paul in particular highlights a profound and mysterious connection between suffering and the Greek word koinonia.

Koinonia is one of those deep biblical concepts that translators struggle to put into common language. The word occurs more than 15 times in the New Testament and it is variously translated as ‘fellowship’, ‘participation’, ‘sharing’, and ‘communion’.

Koinonia – three dimensions

koinonia has three dimensions. Firstly, koinonia is about the inner life of the Trinity – it is at the heart of the Godhead. Our God is a God of koinonia. Every time we say the Grace we are referring to it. ‘May the grace of our Lord Jesus Christ, the love of God and the koinonia of the Holy Spirit be with us all’ (2 Corinthians 13:14). Augustine famously called the Holy Spirit ‘the kiss between the Father and the Son’. In a mysterious way the koinonia between the Father and the Son is enshrined in the person of the Holy Spirit.

Theologians tell us that at the heart of the Trinity is union and communion. Union is about merging, oneness, identity. Communion, koinonia, on the other hand, is about difference. The Father is different from the Son and yet the persons are in communion.

The very differences between the persons of the Trinity are part of the richness of the Godhead. That is part of the contrast between the God we as Christians worship – God as revealed in Jesus – and Allah. As I understand it, in Islamic theology Allah is alone, pure unity. So the idea of communion with Allah would be seen as blasphemous.

Secondly, koinonia is about the new community of God’s people. In some extraordinary way, the koinonia that is within the Godhead is meant to be expressed in the Christian community. We, too, are called to express union and communion in our life together. ‘So if we walk in the light as he is the light, we have koinonia with one another and the blood of Jesus his Son cleanses us from all sin’ (1 John 1:7). We are to be united in Christ; but we are a community, a koinonia of different, diverse and unique individuals. So in some remarkable sense our Christian fellowship, is meant to reflect the unity and diversity of the Godhead.

Thirdly, and mysteriously, koinonia is related to suffering. In particular Paul speaks of koinonia with Christ’s suffering. ‘That I may know him and the power of his resurrection and the koinonia of his sufferings, becoming like him in his death, that by any means possible I may attain the resurrection from the dead’ (Philippians 3:10–11).

This seems to reflect a strange reality of the Christian life, that in suffering there is a koinonia; a deep communion. In the natural world suffering so often leads to isolation, it leads to people being pushed apart, separated, alienated from others. But in the mystery of God’s love there can be a koinonia of suffering; koinonia between those of us who are experiencing suffering, koinonia for those of us who are trying to be there, to care for those who are suffering; and also – amazingly and wonderfully – with the suffering Christ himself.

It’s part of the reality of the body of Christ – if one member suffers, then all suffer. As we pray for and support persecuted believers, as well as those closer facing personal tragedies and losses, we experience something of koinonia – we are together sharing the suffering of the whole body of Christ. And it seems mysteriously that suffering goes right into the heart of God.

Koinonia and the incarnation

In the Old Testament we hear the laments of suffering believers, godly men or women pouring out their anger and pain to God. Lament is a very significant part of the Psalms – the faithful believer expressing pain to a God who, so often, seems silent. But in the person of Jesus, God comes into the world, and he takes on to his own lips the words of lament. He laments over Jerusalem, he weeps at the grave of Lazarus and sweats drops of blood in Gethsemane. Then on the cross he takes on the awful lament of Psalm 22, ‘My God, my God, why have you forsaken me?’

So it seems that lament is taken into the heart of God. God the Son is lamenting to God the Father. On the cross Jesus experiences total abandonment and isolation, so that we can be brought into koinonia. God is present but he’s also a co-sufferer, suffering with us. Even now the glorified Lord Jesus carries the scars and is identifying with us in our sufferings and identifying with his suffering Body. The worst evil of the world is penetrated by God’s suffering love.

At some point in life most of us are hit by tragic, inexplicable evil and suffering. But there is nothing we can experience which cannot by God’s grace be turned in some strange and wonderful way into blessing and healing. God loves to take the very evil thing itself and turn it into a means of blessing.

God’s mysterious plan for this age is not to abolish suffering; he has promised that he is going to do that in the new heaven and the new earth. But his plan for this age is to redeem it; to transform it from its evil, destructive impact, into blessing and healing. God takes delight in transforming the broken and damaged part of our lives, our failures and our sins, sufferings and losses, and he uses those very things to bring blessing and healing, if only we will allow him to work in these parts of our lives. Nothing is wasted and nothing is lost.

I think this has something to do with the motherly compassion of God. In the Hebrew language, the compassion of God is a motherly word. It’s very closely related to the word for ‘womb’. Part of what mothers do is scurry around making sure that nothing is wasted. ‘I’m sure we can use that food from yesterday … I’ll keep that piece of material in case it’s useful in the future.’ God is a motherly God who is able to take the debris, wreckage, mistakes and sins of our lives, so nothing is wasted, nothing is lost. It can all be transformed.

But the path from suffering and loss to healing and blessing is not one that happens automatically. Suffering can be destructive rather than redemptive. It requires our humble acceptance of God’s working in our lives and our co-operation with his love and power.

GK Chesterton said there were two equal and opposite sins against Christians hope: the sin of presumption and the sin of despair. I have to confess that at different times in my life I’ve been guilty of both sins. At times I’ve been presumptuous that God is going to bless me, yet at other times I’ve been despairing and hopeless. These are both sins. In contrast there is the daily discipline of Christian hope, setting our minds and hearts on the hidden realities of God’s kingdom and purposes, whatever evil, suffering and loss we to face.

What will be the cost of being faithful to Christ in the future as the Christian Medical Fellowship? Perhaps for some this koinonia will include suffering. But we must resist the temptation to anxiety and despair. We need to remind ourselves that in the deep mystery of God’s loving purposes we are being called to union and communion with one another, and with the suffering Christ himself.