Treatment Options (Missional Cancer, Part 3)

The treatment for my thyroid cancer was done before I even knew I had the disease.  The thyroid and all the cancer was surgically removed from my body.  I need to take thyroid hormones for the rest of my life, but I’m well.  If the cancer had been bigger or not as contained, I would have required more treatment (with radioactive iodine).  Whenever one is faced with cancer, there are choices.  In my case, the choices were relatively easy to make, but they weren’t without risk.

After returning from a “Turn-around Church” conference with Bill Easum near his home in Port Aransas, TX, I gave my session a report — the results of a massive assessment of the congregation including the prognosis of  a “healthy” turn-around in both discipleship and mission.  ”It’s just like we’ve been to the doctor, the diagnosis is in, and the test shows we have cancer,” I told them.  ”Now we have a choice to make about what kind of treatment, if any, we want to choose.”

All of the possible treatments, I believe, fall into one of three basic paths: 1) radical treatment with the possibility of a cure; 2) treatment that may or may not cure the illness, but will prolong life for a time; 3) palliative care that makes the inevitable death as comfortable and “faithful” as possible.  And, of course, there’s always the option of doing nothing.  Depending on the type of cancer or illness, one or more of the paths may not be an option.

It’s important that we realize any of the available options can be “faithful” options.  For a congregation, it’s up to the congregation to decide when faced with the reality, which treatment option is best for them.  It should be done prayerfully, and considering the advice and leadership of the pastor and the presbytery.  But it is the responsibility of the congregation to discern, to pray, and to live faithfully into the new future story they choose.

1) Radical Treatment

Radical Treatment in the church is sometimes called “congregational transformation.”  It requires a great deal of energy, a willingness to take risks and to make life altering changes; and the “cure” may, in fact, kill us.  Radical treatment of cancer may require every penny we have, an amputation, or a total change in lifestyle.  These are radical changes.  In the church it may mean selling a building and moving to a new location, and that would require all of the energy and missional conviction of starting a new church.  It may mean inviting immigrant faith communities into the fellowship of the congregation and transforming from a racially homogeneous congregation to a multi-cultural church.  It will undoubtedly mean having to give up something that many of your members hold dear, often the building, an style of music, etc.  Congregations choosing this option need to realize that transformation isn’t only about the congregation’s building or structure, but it effects every member and participant in the community.  Congregational transformation begins with personal transformation, so it requires individual commitments to grow spiritually, to change habits, to take on new responsibilities, etc.  But, if willing, the congregation could experience a resurrection that is beyond their imagination.

Radical treatment like this is a viable option when the patient has the financial resources, the mental stamina and hope, and is otherwise relatively healthy.  For a congregation transformation is a faithful option when there is a spiritual readiness to surrender personal preferences for the well-being of the kingdom, significant financial resources from the congregation, highly committed and dedicated leaders ready to devote a great deal of energy and time to the transformation of the congregation, and an otherwise healthy congregational system (not a high-conflict congregation for instance).  It’s also important to note that a decision to proceed with this kind of radical treatment does not guarantee a cure.  As much as we have anecdotes of congregations successfully turning around or transforming … we cannot “plan” it or even “do” it.  God is the “cure” giver and God is the one who brings new life.  We can only prepare the soil and surrender ourselves to God’s Spirit and see what God will do with us.

2) Treatment to Prolong Life

There are times when the diagnosis or the health of the patient calls for a treatment that probably won’t “cure” the cancer, but it will significantly increase both the length and quality of life.  In the Future Story Project that my colleague, Mary Marcotte, and I developed in the Presbytery of New Covenant, we described this option as the “Path to Faithful Renewal.”  This treatment option allows the congregation to develop a “new normal” so to speak.  Instead of working to become a congregation of  300 members with a full Sunday School and youth group, for instance, it may mean coming to a new understanding of what a healthy and vital small church looks like.  How do the 55 members of the congregation who are here be a  spiritually alive missional faith community?

This option frequently involves new forms of pastoral leadership, possibly including one or more elders seeking to be commissioned as a lay pastor.  It may mean a change in the place of worship: selling the building, sharing space with another congregation, meeting in homes, etc.  It always means focussing on the spiritual development of the members and being attentive to the mission, vision, and call of the congregation.

For congregations who don’t have the spiritual energy or the leadership or financial resources to attempt the radical treatment above, this option allows the congregation to focus on the spiritual health of its members.  In time, a “renewed” congregation may decide the time is right to try something radically different, or that the time is right to change to treatment option 3, palliative care.

3) Paliative Care (or Hospice)

Individuals and families are often faced with making the very difficult decision of choosing hospice care for themselves or a loved one.  Most everyone I know who has chosen the care of a hospice have been blessed by the experience, even though the loss is painful.  There are times when acknowledging an impending death becomes the most courageous thing we can do.  The same is true for a congregation.

When a church lacks the leadership, financial resources, and, most of all, the energy for options 1 or 2, it may be time to make the courageous decision to request dissolution of the congregation.  When done faithfully, the path to dissolution can be one of celebration, close community, healing and reconciliation and a time of great hope.

Every one of these options can be  a huge step of faith.  Every one of them can be a story of resurrection.  Most everyone I know who has been through a struggle with cancer, or some other significant illness, says that coming through it has changed them for the better.  When we face a major obstacle in our lives, we may say we only want to go back to the way it was … but we know that isn’t going to happen.  The cure, no matter what, is going to change us not merely restore us.

If you want help with your congregation in facing reality or making a choice of “paths” or “treatments” please call for help.  No one should make these kinds of decisions on their own.  Your presbytery should have the resources and tools available to help your congregation make a faithful decision about its future.

Your Church May have Cancer if … (Missional Cancer, Part 2)

If you were to give your congregation a quick health screening, what kind of symptoms would you look for?

Here’s my “Your Church May Have Cancer if …” check list:

1. The congregation rarely laughs during worship.
2. The congregation would not be missed by their neighbors if it ceased to exist.
3. Former members of the congregation who have been away more than ten years would find that little or nothing has changed in the Sunday worship experience since they left.
4. The congregation hasn’t received a new member in more than a year.
5. It’s rare to have a first-time visitor to worship who is not related to a member.
6. The congregation hasn’t baptized a baby in more than two years.
7. The congregation hasn’t baptized an adult in more than three years.
8. The congregation hasn’t ordained an elder or deacon to office in more than two years.
9. The nominating committee cannot find willing and able elders/deacons to present a full slate of qualified officers each year.
10. There is no functioning nominating committee.
11. The congregation has trouble paying its bills.
12. The congregation has been unable to pay the pastor’s salary on time at least once in the past year.
13. The congregation has not submitted its annual congregational statistics for more than 2 years.
14. The congregation cannot afford a pastor.
15. 70% or more of the congregation’s yearly budget goes for building expenses and/or salaries.
16. The church building is empty (other than church staff) most of the week.
17. The congregation is not able to maintain insurance on the church building.
18. The congregation has not added new or updated its technology (sound, video, internet, computers, etc.) in the past three years.
19. Most members of the congregation have not asked someone to a church function (including worship) within the past six months.
20. Members of the congregation do not have a strong prayer/devotional life.
21. The congregation stopped having a “Children’s Moment” because there aren’t any/enough children.
22. In order to meet their expenses, the congregation has used not only earnings, but some of the principle, of its endowment during the past year.
23.  “One or two more deaths” could mean financial crisis for the congregation.
24. The demographics of the congregation (age, ethnicity, race, socioeconomic class, etc.) are very different from the neighborhood surrounding the church.
25. The congregation seems more interested in “survival” than it does in mission to the community.

This is no more than a check-list or a screening.  There may be some really good (and healthy) reasons why one or more of these 25 items would be true of your congregation.  The reality is, though, that any one of these items could be a symptom of missional disease in your congregation.  See my next post for things to do if you think your church may have a kind of missional “cancer.”

Everyone has Lumps in Their Necks (Missional Cancer Part 1)

I had cancer once — Thyroid cancer.  I had no symptoms.  Well, except for the tennis ball sized lump in my throat.  Of course, it didn’t start as a tennis balls sized lump, and the lump, itself, was not cancer at all.  It was a goiter; my thyroid was growing, not malfunctioning, just growing.  I didn’t even notice it until a member of my church who DID have thyroid cancer said that it had started with a lump in her throat on the side of her neck.  I felt my own neck and said, “everyone has lumps in their necks.”

Well, they don’t. Healthy people don’t have walnut sized lumps on the left side of their necks.  I had never noticed.  My goiter was growing so slowly and without interfering with my swallowing, breathing, eating or singing I never noticed it.  Luckily, I went to the ENT and had it looked at.  At that time, there was no cancer, but it was growing.  I put off the surgery for a few years … it wasn’t interfering with my life, so we just kept an eye on it.

In 2001 the goiter had grown to the size of a tennis ball.  I was still not having problems with breathing or swallowing, but we thought it would be good to remove it.  Another routine screening was done for cancer which showed a possibility of cancer, so we removed the whole thyroid.  They tell me the thyroid did have a small cancerous growth in the right hemisphere.  So … I’m a cancer survivor who never knew she had cancer until it was removed.

I tell this story because I believe many churches are like me … there’s a cancer growing, but it has grown so slowly and we’ve managed to adjust.  We change to a little different sleeping position to enable better breathing, and we don’t even see the tennis ball sized lump in the side of our necks.  If we can live with the symptoms, sometimes we never see the disease.

For some churches it’s a cancer of leadership, for others it’s a cancer of membership decline or aging membership.  For some it’s a cancer of financial sustainability, and for others it’s a cancer of spiritual atrophy.  Having cancer is never a good thing, but it’s rarely our “fault.”  Even when it is caused by years of smoking or poor eating habits … it’s a consequence exacerbated by certain behavior, not a moral failure.  Cancer is made much worse, though, if we deny our symptoms, are ashamed of our symptoms and/or delay screening and doing something about it.

So how do you screen to see if your church has missional cancer?  I’ll put that in my next post titled, “Your Church May have Cancer if …”