By Kathryn Butler, January 11, 2025, at: desiringgod.org January 11,2025
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During my year in the ICU as I trained as a trauma surgeon, the threat of tragedy loomed daily. Every morning, I would tweak ventilator settings and titrate drips in desperate attempts to keep people alive. When all efforts failed, the afternoon would find me in a conference room, walking a tearful family through horrific news. My voice would crack as I explained the limits of our science, outlined the grim details of dying, and offered meager words of condolence. During the worst weeks, these meetings occurred three to four times a day.
Yet, even with the heaviness and grief these days in the ICU imposed, my greatest challenge awaited me on the nightly drive home. Every evening, I’d pass an exit for a highway leading to the mountains. I knew that down that road, miles away, a bridge spanned the Connecticut River. And every night, I’d fight the impulse to take that exit, drive to that bridge, and throw myself over the railing.
As a doctor, when depression first took hold of me, I knew what was happening. In medical school, I studied the signs and symptoms of the disorder. I understood the complicated interplay of neurobiology, life events, and mood, and I could remember specific patients I’d interviewed who left the hospital with renewed smiles after treatment. I knew the help I needed and how to access it.
Still, all that knowledge didn’t lessen the pain. Living felt like dying. I’d lost the capacity for delight, and the things that once thrilled my heart — a sunrise glowing on the horizon or a favorite song — lost their power. Daily, I struggled to complete the mundane tasks of getting out of bed and driving to work. Daily, I wrangled with a deep, gnawing emptiness and despaired over the words that repeated in my mind like a terrible refrain: nothing matters.
Although I knew remedies for depression, I had no antidote for these words. At the time, I did not believe God existed. And without him, indeed, nothing mattered.
This first — and worst — episode of depression was a fundamentally spiritual struggle. Depression runs in my family, and as one who tends to brood, I’ve always had a personality ripe for it. Yet it was a moment of existential crisis in the ER, about a year before my time in the ICU, that dragged me from melancholy into unrelenting darkness.
One evening during my residency, I cared for three teenagers who’d all been assaulted — one with a baseball bat, one with a knife, and one with a bullet. I fought to save all of them and failed each time. As I staggered out of the room of the last boy, my already flimsy belief in God blew apart like autumn leaves in a buffeting wind. How could God allow such evil? I thought. With no foundation in Scripture and no understanding of the gospel, I had no answers for such a troubling question. The next morning, I drove into the mountains, stood on that bridge spanning the Connecticut River, and tried to pray. When no words floated into my head in response, I decided God was silent because he didn’t exist.
Thereafter, depression dug its claws into my heart. I discerned no purpose in life, no meaning, and no hope. Everything seemed awash in gray, as if someone had siphoned away all joy and color. A withheld sob perpetually tightened my chest. The smallest of routines felt arduous, even agonizing. And every day, while I drifted through care for the dying, I dreamed of returning to the bridge in the mountains and giving up my own life.
Although I’d rejected God, he stayed faithful to me in lovely brushstrokes of grace. Every night when I fought the impulse to take that exit toward the river, he brought my loving husband, Scott, to mind. Although despondency clouded my thinking, I still had enough clarity to know my suicide would shatter him. And so, every evening when the exit sign tempted me, God reminded me of the kind, selfless husband who awaited me — and I would draw a breath and steer home.
Then, when I was at my lowest and life seemed a never-ending shadow, God gave me what my broken soul needed most: himself.
I was caring for a gentleman with a severe brain injury in the ICU, whom neurologists thought would never walk, talk, eat, or smile again. Against all our predictions and knowledge, he made a full recovery in response to a prayer in Jesus’s name. I still can’t explain this healing medically, but I know that, through it, God alerted me to his presence and sovereign power.
I dove into study of religious texts and finally, at Scott’s urging, turned to the Bible — where a reading of Romans 5:1–8 reduced me to tears. For over a year, questions of suffering had jettisoned my hope. Now, through an ancient book that sat neglected on my shelf for years, I encountered the living, almighty God whose steadfast love never ceases (Lamentations 3:23–24) and who works through suffering — even through the suffering of his beloved Son — for our good and his glory (Romans 8:28). (continued…)
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Romans 5:1-8 — Therefore, since we have been justified through faith, we have peace with God through our Lord Jesus Christ, through whom we have gained access by faith into this grace in which we now stand. And we boast in the hope of the glory of God. Not only so, but we also glory in our sufferings, because we know that suffering produces perseverance; perseverance, character; and character, hope. And hope does not put us to shame, because God’s love has been poured out into our hearts through the Holy Spirit, who has been given to us. You see, at just the right time, when we were still powerless, Christ died for the ungodly. Very rarely will anyone die for a righteous person, though for a good person someone might possibly dare to die. But God demonstrates his own love for us in this: While we were still sinners, Christ died for us.
Lamentations 3:22-24 — Because of the Lord’s great love we are not consumed, for his compassions never fail. They are new every morning; great is your faithfulness. I say to myself, “The Lord is my portion; therefore I will wait for him.”
Romans 8:28 — We know that in all things God works for the good of those who love him, who have been called according to his purpose.
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