The Song of Blessed Sickness

Psalm 41 is the last psalm of Book 1, so it’s fitting that it begins as Psalm 1 began: the word ashre, “blessed.” As a reminder, blessing in the Bible means enjoying the good life as defined by God. We could translate it as “happy,” although it’s a deep kind of happiness, the peak of human flourishing, the good life. Because Psalm 1 was likely written as an introduction to the whole book, it’s likely that the final editors and compilers of the Psalms picked up the term from Psalm 41 to provide literary bookends, a fitting balance. In Psalm 41, this blessing is for “the one who considers the poor.” The word “poor” includes someone’s financial status but can also refer to their health, their strength, their social status. These are the weak, the sick, the outcasts, the forgotten. To consider them means more than just tossing a few coins into their hands; it implies careful thought, insight to know how to help at a deeper level, practices and principles that protect the poor from exploitation. David places this kind of consideration for the poor as one of the highest expressions of righteousness because of all that it entails: generosity, justice, friendship, humility. To again frame it in relation to Psalm 1, blessed is the person who delights in the law of the LORD and whose delight overflows into careful care for the weakest in society. David then describes how God blesses this person, going back and forth between third person descriptions of God’s actions and second-person words directly to God: “In the day of trouble the LORD delivers him; the LORD protects him and keeps him alive; he is called blessed in the land; you do not give him up to the will of his enemies. The LORD sustains him on his sickbed; in his illness you restore him to full health.” This flow of thought is a bit surprising: the good life of blessing apparently includes days of trouble, suffering, and even severe sickness. There’s an interesting word picture with this image of a sickbed: restoring someone to full health, as the ESV renders it, is literally “you turn all his bed” in Hebrew. It’s describing the practice in healthcare of turning the bed over after a patient has been lying on it for days, and it’s a beautiful metaphor of God’s care for us. When we are too sick to move, too weak to care for ourselves, God the nurse comes in to change our sheets, give us a bath, feed us some soup, and restore us back to health. Blessed is the one who considers the sick, and blessed is the sick one whom the Lord himself considers.

The tone shifts in the middle of the psalm: “As for me, I said, ‘O LORD, be gracious to me; heal me, for I have sinned against you!’” Once again, as in several of the previous psalms, David has a guilty conscience for some sin, and he sees his present sickness as a direct result of his rebellion against God. Once he confesses his sin, he turns to others who are taking advantage of his weakness: “My enemies say of me in malice, ‘When will he die, and his name perish?’ And when one comes to see me, he utters empty words, while his heart gathers iniquity; when he goes out, he tells it abroad. All who hate me whisper together about me; they imagine the worst for me. They say, ‘A deadly thing is poured out on him; he will not rise again from where he lies.’” This is a horrible situation: David is lying on his sickbed, fighting for his life, and simpering sycophants visit him, whispering empty words of sympathy while they hope for the king to die. There’s utter hypocrisy and deception between their words, their motives, and their actions. Some scholars see these words that David reports his enemies saying as curses or even incantations of evil, like the term for “deadly thing” that came to mean the deadly power of the underworld or even demonic evil. Remember that David sees the cause of this sickness as the breakdown of his relationship with the LORD, so in a situation where David can’t trust his advisors who are plotting against him, it’s even more poignant that David sees God as his nurse. The sense of betrayal continues in verse 9: “Even my close friend in whom I trusted, who ate my bread, has lifted his heel against me. But you, O LORD, be gracious to me, and raise me up, that I may repay them!” The heel is a symbol for deception (it’s related to the name of Jacob, who was known for being a liar). We’ll come back to this verse in a moment. It’s highly unusual for David to pray that he himself could repay his enemies (usually the psalmists leave justice to God), but it’s likely that David is referencing his kingly authority to punish the wicked and protect the poor. Even so, there’s a tension here between justice against evil and grace for sinners, a tension that we’ve felt throughout the Psalms so far. At various times, we are the righteous and we are the wicked, and in both cases, we rely on the Lord’s mercy.

David may still be lying in his sickbed, but as is common in lament psalms, his confidence grows to the point of praise: “By this I know that you delight in me: my enemy will not shout in triumph over me. But you have upheld me because of my integrity, and set me in your presence forever.” There’s vindication and gratitude for a sense of renewed communion with God, the delight of God for us that upholds us, holds us, protects us. Repeatedly in the Psalms we’ve seen this appeal to one’s own integrity, which is never self-righteousness but an honest assessment that in general, David has lived in fellowship with God and obedience to his ways. Yes, we sin and repent, but there is always forgiveness and welcome for the one who humbles himself before the Lord. Finally, Psalm 41 and Book 1 ends with an outburst of praise: “Blessed be the LORD, the God of Israel, from everlasting to everlasting! Amen and Amen.” Each of the five books of Psalms ends with a doxology (Psalms 72, 89, 106, and 150), which is an important point that we can’t miss. These verses remind us that no matter the suffering and evil that the psalmists have experienced, we should always return to praise. The word for “blessed” here is baruk (a different word from verse 1), and it means adoring and worshiping God for all of his goodness and love. With this psalm, Book 1 comes to a close, so it’s worth looking back over the first 41 psalms and seeing what themes emerge. First, we have various pictures of what the blessed and righteous person looks like, someone who loves God and loves his neighbor, whose vertical worship and horizontal justice align. Second, there’s the theme of the king leading his people as a model, the ideal Israelite who shows us how to live, how to repent, how to protect, and how to worship. Lastly, there is the theme of suffering, which will get more and more pronounced in Books 2 and 3. A life with God is not an easy life as we wrestle with evils within and enemies without, with sickness and toil, with futility and doubt. Yet through it all, the LORD is eternal and constant, from everlasting to everlasting. And so all God’s people say, “Yes! Let it be so. Amen and amen.”