Introduction

In the study conducted by Neimeyer et al. (2011), persons who are confronted by mortality, more specifically, those who are advancing in age and facing life-threatening illnesses, are prompted toward “serious life review, sobering self-reflection, and hopeful recourse to deeply held religious or spiritual beliefs.” This finding resonates with the thoughtful remarks of Pope John Paul II in his apostolic exhortation, promulgated during the early years of his pontificate, Salvifici Doloris (1984): “Within each form of suffering endured by man, and at the same time at the basis of the whole world of suffering, there inevitably arises the question: Why?”. Confronted by illness, suffering, and the impending end of life, human beings’ experiences of powerlessness, limitations, and finitude, depending on the severity of the disease, are unraveled. In their visceral reactions, some are led to anguish, despair, self-absorption, and even revolt against God (Pope John Paul II 1984; McTavish, 2016). This is exacerbated in today's culture, where pleasure, convenience, and immediate satisfaction are magnified as supreme values and where suffering, pain, and discomfort are seen as evils to be shunned. (Ragozine, 2024).

The above mentioned reflections put into perspective the tremendous suffering of many people from all walks of life because of the COVID-19 global pandemic. The staggering number of deaths left many grieving for the passing of their loved ones to the point of leading others to think that this experience of suffering is God’s punishment (Pope John Paul II 1984; Galchutt et al., 2022). In such contemplations, questions inevitably arise about the nature of illness and suffering. Are those afflicted bearing the weight of sin or facing divine retribution? Is suffering a signal of forthcoming negative events? Should suffering be seen as an inherently undesirable aspect of life that we ought to avoid? These questions are worthy of reflections that will help us understand the mystery of suffering and lend us a healthy outlook on suffering as an effect of illness. These questions, among others, testify to John Paul II's claim about human beings as the only creatures who wonder why they suffer, but more than that, as a creature in quest for a satisfactory answer to one of life's profound mysteries (1984).

This paper primarily aims to broaden and deepen the understanding of suffering as a phenomenon that all human beings are bound to experience. To achieve this, it discusses the following major themes: First, it investigates the sufferings experienced by individuals who contracted COVID-19 during the global pandemic. Studies indicate that some patients perceive their suffering as divine punishment for their misdeeds. Second, it draws from John Paul II’s Salvifici Doloris to explore a theology of suffering that transcends the common misconception of suffering as merely punitive. In this context, suffering is viewed as redemptive, an invitation to God's mercy, and a pathway to conversion. Third, it links the concept of redemptive suffering in the experiences of those who contracted COVID-19. Overall, the paper seeks to acknowledge suffering as an inherent aspect of human existence. While unavoidable, suffering serves a purpose by inviting us to partake in the experience of Christ's suffering, thereby rendering it redemptive.

Methodology

To offer a contextualized understanding of suffering as redemptive following John Paul II’s SD, this paper employs the See-Judge-Act method outlined by Pope John XXIII in his encyclical Mater et Magistra as a practical suggestion for translating the teachings of the Church into action. First, “See” examines the concrete situation; second, “Judge” forms a judgment on a concrete situation in light of the teachings of the Church; and third, “Act” decides what in the circumstances can and should be done to implement these teachings (John XXIII, 1961).

Concretely, this paper undertakes the initial “See” phase by investigating the different types of suffering experienced by persons with COVID-19 as lifted from medical and scientific journals. The subsequent phase, “Judge,” analyszes the understanding of the concept of suffering based on Pope John Paul II’s SD and scriptural evidences. Lastly, the “Act” part proposes a redemptive and transformative meaning of suffering for persons who contracted COVID-19, which can serve as a paradigm for the development of virtues and pastoral care for persons who are suffering from illnesses.

Results and Discussion

This paper undertakes the initial "See" phase by examining the various types of suffering experienced by individuals with COVID-19, as documented in scientific journals. The subsequent "Judge" phase analyzes the concept of redemptive suffering through the lens of Pope John Paul II’s Salvifici Doloris. Finally, the "Act" phase proposes a transformative understanding of suffering for those who contracted COVID-19. A reflective framework of this paper on suffering during COVID-19 in relation to Pope John Paul II’s Salvifici Doloris and its redemptive and transformative meanings is summarized in Fig. 1.

Fig. 1
figure 1

Reflective Framework of Suffering During COVID-19 in Relation to Pope John Paul II’s Salvifici Doloris

Full size image

I. See: Insights into the Weight of Suffering Among Persons who Contracted COVID-19.

The Origin of COVID-19

In December 2019, an unknown cause of pneumonia occurred in Wuhan, Hubei Province, China. On January 7, 2020, a novel coronavirus, named severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was identified in the throat sample of one patient (Ge et al., 2020). The World Health Organization (WHO) announced the epidemic disease caused by SARS-CoV-2 as coronavirus disease 2019 (COVID-19) and was declared a public health emergency of international concern on January 30, 2020. It was categorized as a pandemic by March 11, 2020, and has spread worldwide, affecting millions (Sohrabi et al., 2020). At the time of this writing, 775,431,269 confirmed cases of COVID-19, including 7,047 741 deaths, were reported to WHO (2024) in its regularly updated dashboard. The following are the common experiences endured by patients affected by the COVID-19 virus:

Somatic and Psychological Suffering Amid Uncertainty

The physical burden of the disease presents as mild, moderate, or severe in terms of clinical manifestations. The mild disease may be characterized by body aches, coughs, or mild fever. In its moderate form, the disease may present with mild pneumonia and other symptoms. The severe form of the disease may be characterized by severe pneumonia and hypoxia. Critical cases with significant hypoxia and organ failure may need admission to the intensive care unit (ICU) and mechanical ventilation support. Extrapulmonary manifestations and major organ dysfunction, such as acute kidney injury, heart failure, and thromboembolic manifestations, may likewise ensue. Alongside these features, the disease is highly transmissible and offered no standardized treatment regimens until recently and poses a high mortality rate in some communities (Elrobaa & New, 2021).

In one qualitative study of patients affected with COVID-19, the majority reported symptoms of discomfort brought about by high fever, often accompanied by hallucinations and sleeping problems, cough, shortness of breath, dizziness, nausea, fatigue, weakness, exhaustion, gustatory dysfunction, and weight loss. Household remedies against infections and over-the-counter antipyretics often had insufficient therapeutic effect (Hofstetter et al., 2022a, 2022b).

In addition to the heavy physical symptoms, many patients felt mental strain. Many feared the possibility of death and of having to be transferred to the ICU for intubation. Likewise, many felt a sense of uncertainty and fear arising from the stress of diagnosis and the succeeding examinations. Patients would frequently call the doctor or nurse when in discomfort. Many also experienced nervousness, even regarding symptoms unrelated to COVID-19 (Sun et al., 2021).

lsolated Suffering Due to Physical and Emotional Seclusion

Most patients with COVID-19 also felt stressed and anxious because of quarantine. This was caused by separation from their families, social disruption, and life changes. The patients were mostly confined to their beds and reported that doing nothing felt grueling and wearisome. They also suffered from being restricted in their movements due to attached medical equipment and by distance and isolation measures. A majority of them required sleeping pills to cope with the psychological strain. Some were even guilty of causing trouble to their close contacts (Hsiao et al., 2021).

For many patients, the impact of COVID-19 did not end with their hospital release. According to recent global analyses, the cumulative prevalence of long-term COVID seems to range between 9 and 63%, and is up to sixfold higher than that of similar post-viral infectious conditions (Lippi et al., 2023). Long‑COVID primarily encompasses the presence of long-term symptoms developing three months after the patient falls ill with COVID-19. This may include fatigue, breathlessness, and cognitive dysfunction (i.e., confusion, forgetfulness, or a lack of mental focus or clarity) (WHO, 2023).

Many patients, after hospitalization, remained tired, with some reporting that they could not do anything but sleep for days. The relief of returning to their families and the happiness of overcoming the infection often outweighed the burden of tiredness. Little to no physical activity resulted in the loss of strength and muscle mass. Dealing with everyday tasks quickly led to exhaustion and shortness of breath. Some experienced uncertainty about their recovery. Many worried about disease recurrence and increased vulnerability to other infectious diseases. (Hofstetter et al., 2022a, 2022b).

In a study examining the mental health of COVID-19 survivors, a notable prevalence of posttraumatic stress was observed, particularly among those who had experienced symptomatic illness. Mild depressive symptoms and anxiety were found to be common as well (Jafri et al., 2022).

Spiritual and Religious Suffering from an Apparent Absence of God

Moreover, patients with COVID-19 experienced a range of spiritual distress and religious struggles. In a study done in Iran on spiritual dryness among 362 respondents during the COVID-19 pandemic, the general experience of spiritual dryness was perceived often to regularly by 27% of participants and occasionally by 35%. That prayers go unanswered was experienced often to regularly by 28%, distance from God often to regularly by 16%, while the feeling of being abandoned by God was experienced often to regularly by 24%. Being “spiritually empty” was experienced often to regularly by 28%, and the perception of not being able to emotionally “give” any more by 22% (Büssing et al., 2021a, 2021b). In another study based on the chaplains’ accounts, patients and families experienced significant distress due to COVID-19 restrictions. Family members who could not be present during critical moments or even on deathbeds felt emotional suffering and guilt. Chaplains encountered instances where family members considered the possibility of religious punishment, particularly when multiple family members faced hospitalization (Galchutt et al., 2022).

Indeed, the sufferings of patients with COVID-19 have been a collective interplay of physical, emotional, mental, social, and spiritual pain. But within these trials, remarkable resilience of the human spirit that can witness a profound sense of purpose may be witnessed. The path that redemptive suffering will lead us to is the hope of soaring above adversity, finding profound meaning, and unveiling a spirituality that may transcend the finite boundaries of our physical existence.

II. Judge: Understanding of Suffering in Salvifici Doloris

We can sketch a basic understanding of suffering from John Paul II's SD. His theology of suffering builds from the bible story of Job (Job 1–2), where he discusses the passage from the experience of suffering as a consequence of evil that demands punishment, to the concept of suffering without guilt, which arises from the suffering of an innocent man (1984). This motion toward grace ushers us to the understanding of suffering as an invitation to mercy and a pathway to redemption.

Understanding Suffering as a Consequence of Evil that Demands Punishment

John Paul II sheds light on the understanding of suffering by stating two main points: First, suffering always has the nature of punishment, and suffering can only have meaning as a punishment. Second, suffering is sent by the absolutely just God. In the Old Testament, suffering is viewed as a punishment for transgression, sin, or a crime against God. Suffering manifests an objective moral order that demands punishment for transgressions. In this context, God epitomizes justice and order: God repays good with good and evil with evil. Thus, to go against His divine design is equivalent to transgressing God’s benevolence and an offense against Him. When God created the world, everything was good according to His divine plan. However, because of the sin of the First Adam (Gen 3:16–19), disorder came, and death and suffering entered the world (Catholic Church, 2000). Pope John Paul II (1984) elaborates this by saying, “The conscious and free violation of this good by man is not only a transgression of the law but at the same time an offense against the Creator, who is the first lawgiver. Such a transgression has the character of sin, according to the exact meaning of this word, namely the biblical and theological one.” Therefore, suffering is understood as an immediate consequence of man’s deviation from God's intended plan. This is clearly admonished in Deuteronomy 30:19–20 where God presents us with the choice between life and death, blessing and curse, urging us to choose life by loving the Lord, obeying Him, and holding fast to Him. Pope Francis (2020), in a World Day of the Sick message, points out that this reality implies the creatures’ dependency on God.

Suffering Without Guilt: The Suffering of an Innocent Man

From the Bible story of Job (Jb 1:8–12; 2:3), John Paul II exposes the suffering of an innocent man. Herein, he clarifies that suffering is not always the consequence of a fault. In other words, the suffering that Job, the innocent man, experiences is not a punishment but a test to demonstrate his righteousness. Most importantly, Job's suffering ushers us to an understanding of the passion of Christ. Therefore, in foreshadowing the suffering of Christ, the suffering of an innocent man carries a redemptive significance. Although humanity might not entirely grasp the full meaning of suffering, to take hold of its purpose, we must shift from the Old Testament's interpretation of suffering to the perspective offered by the New Covenant.

The Suffering of Jesus as a Manifestation of God’s Mercy and Love

Building on the idea that suffering is a consequence of disorder, a punishment for a transgression, John Paul II teaches us that we need God’s infinite mercy to be restored to our original goodness and purpose. God's mercy ultimately manifests in Jesus Christ, who restores and heals through an encounter. By encountering Christ, suffering finds its meaning. Jesus Christ was incarnated, suffered, and died on the Cross to restore what was lost due to the disorder. In 1 Peter 2:24, it is said that He bore our sins on the Cross so that we might die to sin and live for righteousness, and that by his wounds we are healed. Thus, suffering takes on a new meaning in the context of Christ’s passion. He endured suffering not due to sin but as a manifestation of His profound love for humanity. God demonstrated his love for us by sending Christ to die for us while we were still sinners (Rom 5:8).

Thus, John Paul II presents two critical points. First, humanity needs liberation from the transgression of Adam and Eve, which marked the entry of death into the world. Second, people are born with a fallen nature and are estranged from God. But God, driven by His boundless love for humanity, willingly and compassionately sent Jesus Christ to endure human suffering to redeem and reconcile humanity. It must be pointed out that while Jesus' suffering departs from the Old Testament's typical understanding of suffering as punishment, it does not sever its connection to suffering in the context of sin. Christ's suffering remains intertwined with the original sin, not as a consequence but rather as a ransom for that sin. This underscores that even as Christ redefined the meaning of suffering, He did not compromise any moral principle that transcends the established moral order.

Suffering as a Pathway to Redemption

Christ's suffering has reshaped the Old Testament's perception of redemption within the framework of justice. He established that love is the driving force behind God's decision to send His only Son. To truly grasp the profound transformation of the meaning of suffering, one must delve into the underlying reasons for Christ's suffering to redeem humanity.

According to Pope Francis (2020a, 2020b), "Only those who personally experience suffering can comfort others." Christ's life was intricately connected with human suffering. Right from the moment of His conception, He faced threats. His birth took place in a humble, homeless setting. His upbringing occurred not in the opulence of a royal palace but in a carpenter's household. Throughout His public life, He bore the weight of criticism and doubt, and endured the burdens of fatigue, hunger, and betrayal, culminating in His crucifixion and death. Remarkably, fully aware of what awaited Him, Jesus Christ wholeheartedly embraced these sufferings not out of affection for suffering itself, but because of the profound significance His suffering held for humanity. This could be shown in different occurrences in the Scriptures. In one account, Jesus reprimanded Peter, who disapproved of Christ's way of suffering and even called Him Satan. Jesus Christ said, “Get behind me Satan! You are a stumbling block to me; you do not have in mind the things of God, but the things of men” (Mt 16:24). On another occasion during His arrest in the Garden of Gethsemane, Jesus Christ again told Peter not to interfere and put his sword back in its place, and said, “Shall I not drink the cup that the Father has given me?” (Jn 18:11). This is precisely why in SD, Pope John Paul II emphasizes that the suffering of Jesus was God’s way of striking the roots of evil. Pope John Paul II (1984) writes: “Precisely using his Cross, he must strike at the roots of evil, planted in the history of man and in human souls. Precisely by means of his Cross, he must accomplish the work of salvation. This work, in the plan of eternal love, has a redemptive character”.

Pope Francis (2017) marks this redemptive act as a reason for gratitude to Jesus. Out of obedience to the Father, He was incarnated and endured suffering and death on the Cross for the salvation of humanity. Through suffering, Christ “struck the roots of evil” and forever transformed its significance and nature into something redemptive. His suffering serves as the means to absolve the sins of humankind. Sin wounds man's nature and harms human solidarity, but Jesus heals and restores these wounds while bearing the burden of the price they demand (Congregation for the Doctrine of the Faith, 2020).

SD explains that because of Jesus' relationship and oneness with the Father, “He could take upon himself, accept them with that love for the Father which overcomes the evil of sin; in a certain sense, He annihilates this evil in the spiritual space of the relationship between God and humanity and fills this space with good” (Pope John Paul II, 1984). In this context, the duality of Jesus Christ's humanity and divinity becomes evident. Despite His suffering, His divine nature, being consubstantial with the Father, allowed Him to “embrace the measure of evil contained in the sin of man” (Pope John Paul II, 1984) and eventually nullified it. No wonder John the Baptist called Jesus “The Lamb of God who takes away the sins of the world” (Jn 1:19). Humanity has been redeemed through His suffering. The prophet Isaiah prophesized this by saying, “Therefore I will give him a portion among the great, and he will divide the spoils with the strong, because he poured out his life unto death, and was numbered with the transgressors. For He bore the sins of the many and made intercession for the transgressors” (Is 53: 12). Just as an unblemished Lamb served to atone for sins during Passover, Jesus, the only begotten Son of God, willingly and blamelessly endured suffering to redeem us from sin. In doing so, He transformed the significance of suffering and restored humanity to God's loving arms.

Suffering as a Perspective of Faith

Furthermore, SD conveys the message that to comprehend the profound redemptive significance, one must move forward to the resurrection of Christ. The power of Jesus Christ's resurrection reveals the redemptive meaning of suffering. St. Paul eloquently expresses this truth: “For if we have been united with him in a death like his, we shall certainly be united with him in a resurrection like his” (Rom 6:5). Echeverria (2023) states that just as Jesus willingly embraced suffering, eagerly anticipating the boundless joy of resurrection (Heb 12:2), so too can faithful Christians anticipate, that if we share in His suffering, we will also share in His glory (Rom 8:15–17).

Pope John Paul II (1984) beautifully articulated that the Resurrection provides humanity with an entirely new light, guiding us through the profound darkness of humiliation, doubt, hopelessness, and persecution. In their Second Letter to the Corinthians 1–5, the apostles likewise remind us: “For as we share abundantly in Christ's sufferings, so through Christ, we share abundantly in comfort too.” According to the Holy Father, our participation in Christ's suffering involves the imperative of faith. Faith is how we grasp the salvific nature of Christ's suffering, shedding new light and meaning on our tribulations. This involvement in Christ's suffering through faith encompasses our intellectual affirmation of its authenticity and a personal encounter with this truth. Our faith is not merely a theoretical understanding of God but a genuine, personal experience of God Himself. It calls for a “supernatural charity” (Congregation of the Doctrine of Faith, 2020), a type of generosity that identifies oneself with everyone who is ill. It involves putting our beliefs into action, a deliberate act of our will to establish a personal relationship with God within the context of our suffering (Palado, 2023).

The encounter with God through suffering involves recognizing the mystery within it. Christ's redemptive suffering is both partially known and sometimes beyond comprehension. It calls us to transcend our usual ways of thinking. When we engage in Christ's suffering through faith, we recognize the necessity of transcending, prompting a leap of faith. This personal limit of our human existence is not insignificant, rather, it helps us realize something infinite that only faith can grasp (Palado, 2023).

Suffering as Man’s Participation in Christ’s Salvific Act

John Paul II tells us that the sufferings of Christ brought about the world's redemption– an inexhaustible and infinite good to which nothing can be added. However, through the mystery of the Church as Christ's Body, human suffering has, in a sense, been linked to His redemptive suffering as people share in Christ's afflictions (Pope John Paul II, 1984). Christ's profound connection with the Church has extended the reach of His redemptive suffering. It encompasses all manifestations of love within human suffering. Within the realm of love, the redemption that has already been achieved is, to a certain extent, continually unfolding. When viewed from a particular perspective, it implies that "the afflictions of Christ" are not yet fully realized and still await completion. In contrast, "Christ's afflictions" encompass future collective suffering. Since the body of Christ is united with Him as its head, their sufferings are His, and His sufferings are theirs (Echeverria, 2023).

Therefore, suffering is not useless, as sharing in the suffering of Christ brings with it the interior certainty that the suffering person "completes what is lacking in Christ's afflictions." This certainty lies in the belief that, within the spiritual dimension of redemption, like Christ, the suffering individual is serving the salvation of their brothers and sisters (Pope John Paul II, 1984). Suffering is a valuable gift that can heal, cleanse, make amends, and bring divine blessings. For example, a mother's suffering can guide a troubled child back to the right track. Even the suffering of someone with a severe illness like cancer, when offered to God, can be used by Him to produce positive outcomes in unexpected ways (Echeverria, 2023). Thus, to suffer in loving union with Christ, is to be an apostle, a missionary, and an active laborer in the vineyard of the Lord. Suffering then is present to unleash our true being, that unselfish compassionate love that we can sincerely give especially to those who are suffering (Palado, 2023). Pope John Paul II envisions that in the messianic program of the Kingdom of God, suffering is present in the world to release love and give birth to works of love toward our neighbors. By transforming human civilization into a culture of love, the salvific meaning of suffering is completely accomplished and reaches its definitive dimension (Pope John Paul II 1984).

III. Act: The Salvific Meaning of Suffering in COVID-19 and its Transformative Experience

Instead of approaching suffering as a problem that needs a solution, we can embrace it as a profound mystery that transforms into something good and meaningful. Rather than being passive victims, each person is urged to make an active and personal offering of his life through his experience of suffering. While Christ has fully accomplished our redemption, our participation in this process unfolds in our own time. Through this active involvement, we become intimately connected with Christ's redeeming love within His Body, the Church. Thus, suffering is not without purpose. It thereby becomes transformed into a life-giving force that can be offered for one's redemption and the redemption of others (Swantek, 2019).

Spiritual and Character Development through Growth in Virtues

The sense of closeness to God that envelops us during times of suffering may find its roots in our ability to identify with Christ, who endured suffering himself. In doing so, we align ourselves with His example and find hope that some greater good can emerge from our tribulations. It is believed that God allowed His Son, Jesus Christ, to endure suffering for the sake of a higher purpose. Similarly, by uniting our suffering with Christ, and presenting it to God as self-sacrificial love, we emulate Christ's selfless offering, with the ultimate goal of attaining the promise of eternal life. This path is imbued with mystery and necessitates unwavering faith and trust in God. Just as the world's salvation emerged from Christ's profound suffering on the Cross, He made all suffering a means and source of grace and salvation for humanity. In doing so, Jesus invites us to view our own sufferings not as a dark, tragic, unwelcome experience but as opportunities for grace and transformation.

Amid the illness, loss, uncertainty, and other challenges posed by the pandemic, many experienced a deepening of their spiritual lives. Drawing inspiration from Pope John Paul II's concept of the redemptive value of suffering when united with Christ, individuals found solace, strength, and purpose in their suffering during COVID-19.

In an online survey among COVID-19-diagnosed individuals who experienced profound spiritual encounters during their illness, several key themes emerged, including impacts on relationships, shifts in personal spirituality, and viewing COVID-19 as a spiritual phenomenon. Surprisingly, despite adversity, many saw these encounters as wake-up calls, reinforcing the value of relationships and deepening their spiritual connection. In a follow-up survey, a substantial number confirmed the pandemic's spiritual impact--feeling drawn closer to God or a broader spiritual presence, and confirmation of a higher spiritual power. Amidst despair and loneliness, some viewed this phase as a "dark night of the soul," an essential element in their spiritual growth journey (Schmidt & Stockly, 2023).

Suffering is also a potent catalyst for personal growth and the cultivation of inner strength. Just as patience is honed through enduring trials and challenges, true strength emerges when we are tested and pushed beyond our comfort zones. Much like physical exercise builds physical strength through resistance and effort, life's interruptions, distractions, and trials contribute to developing our spiritual resilience. In the words of St. James, testing one's faith gives birth to perseverance, ultimately leading to spiritual perfection and wholeness. When one can patiently endure life's adversities, they find themselves endowed with a profound spiritual strength that manifests in numerous ways, igniting a powerful sense of hope and even moments of joy amidst ongoing struggles. This was clearly highlighted in one study that showed increased character strength during COVID-19. Surveying 1,700 participants before and during the pandemic, the study found a general increase in character strengths, with notable but small increases in specific strengths such as love, prudence, curiosity, forgiveness, gratitude, honesty, hope, judgment, leadership, humility, and zest during COVID-19 (Naddaf & Lavy, 2023). Because we know that God has some good reason for allowing us to suffer, we respond to this suffering by seeking to learn what He is trying to teach us. As Pope John Paul II (1984) remarks, “Suffering must serve for conversion, that is, for the rebuilding of goodness in the subject, who can recognize the divine mercy in this call to repentance.”

Cognizance to Building a Positive Internal Disposition and Increase in Spirituality

Suffering can be transformative by opening our spiritual eyes to gratitude. Just before His crucifixion, Jesus shared the Last Supper with His disciples. He offered a prayer of thanksgiving as He broke bread and shared wine, despite knowing the impending pain. St. Paul advises us to give thanks in all circumstances and abound in gratitude. When we give thanks amidst hardships, we gain spiritual insight and healing by understanding the suffering's meaning. By finding meaning in our suffering, we avoid getting trapped in pain, and instead appreciate unexpected growth. Disease often directs attention toward symptoms and relief, narrowing one's focus. Paradoxically, it can also heighten awareness of moments of well-being, meaningful interactions, and compassionate care, fostering gratitude and joy. Gratitude expands our outlook beyond illness, allowing us to embrace the positive aspects of our personal and interpersonal experiences, even when faced with adversity. This was seen in a study done in Germany on 2,573 participants regarding the experience of gratitude and awe among patients with COVID-19. Individuals with a religious background and those engaged in more intense meditation or prayer practices reported higher levels of awe and subsequent gratitude. While these experiences did not shield against pandemic-related burdens, they facilitated a heightened appreciation for positive aspects of life, including the beauty of nature, silence, contemplation, spirituality, and relationships, reflecting a more profound sense of connectedness with both the world and the Sacred (Büssing et al., 2021a, 2021b).

In a study that explored how individuals who lost loved ones to COVID-19 navigated their grief with faith and spirituality, the redemptive element of suffering was clearly seen. Their faith in Christ grew stronger as they saw Him as a symbol of resilience in the face of suffering and death. Christ's teachings encouraged them to confront pain and mortality bravely, using prayer and His wisdom to process negative emotions, including channeling anger into prayer. Faith and spirituality provided a framework for finding meaning in adversity, believing that the victims of COVID-19 had a higher purpose beyond earthly suffering (Biancalani et al., 2022). Similarly, in a study done on patients who recovered from COVID-19, most believed that religious beliefs, seeking divine help, and trust in divine power were important factors in overcoming the disease and regaining their health (Karimi et al., 2021). Other studies on other serious diseases in different cultures also confirmed the impact of religious factors, appealing to spirituality and trust in God as an important source of support and hope for overcoming their illnesses (Sajadan & Montazeri, 2011; Stanton et al., 2002). These studies underscore the idea that suffering indeed not only has a redemptive process when viewed from the lens of faith but leads to personal transformation as well. Redemption here is not due to any inadequacy in Christ's sacrifice. Instead, it is a component of God's divine plan for individuals toward their righteousness, that is, to share in salvation through their experiences of suffering. This is reflected in St. Paul's letter to Colossians 1:24: "Now I rejoice in my sufferings for your sake, and in my flesh, I am filling up what is lacking in Christ's afflictions for the sake of his body, that is, the church." The verse highlights St. Paul's experience of joy amidst suffering, which stems from the profound significance of being connected with Christ, who serves as the head of the church and contributes to her salvation. His joy arises from the conviction that suffering is purposeful and is not in vain. As Pope John Paul II (1984) notes, “Faith in sharing the suffering of Christ brings with it the interior certainty that the suffering person ‘completes what is lacking in Christ’s afflictions.”

Suffering for Christ carries great honor when viewed from the divine perspective. It provides an opportunity for personal growth in faith, character, and love for God. It also allows us to honor and glorify God by maintaining our connection with Him amidst our trials, thereby accumulating an immeasurable reward for the life hereafter. While we do not actively seek suffering, the aspiration to share in Christ's sufferings is a noble pursuit.

A Buttress for Pastoral-Medical Care

Healthcare providers, such as doctors and nurses, are pivotal in translating salvific suffering into pastoral care. Integrating the concept of salvific suffering into pastoral care practices offers a profound opportunity to provide holistic support to patients experiencing physical, emotional, or spiritual anguish. SD addresses the question of suffering by using Christ's redemptive suffering as a lens to see the meaning of one's distress, pain, and anguish (Pope John Paul II, 2023).

“If God so loved us [in Christ], we ought to love one another” (1 Jn 4:11). Indeed, having united our suffering with the sufferings of the crucified Christ, we are impelled to love our neighbor. The parable of the Good Samaritan belongs to the Gospel of suffering. It indicates what our relationship must be toward our suffering neighbor (Pope John Paul II 1984). Yet there is more to this relationship with my neighbor than an obligation because we must also be internally disposed to be sensitive and compassionate to the suffering of others (Echeverria, 2023). John Paul II says, "If Christ, who knows the interior of man, emphasizes this compassion, this means that it is important for our whole attitude toward others' suffering. Therefore, one must cultivate this sensitivity of heart, which bears witness to compassion toward a suffering person. The Holy Father insists that Christ’s revelation of the redemptive meaning of suffering should in no way be identified with passivity, docility, and resignation to human suffering. Therefore, the proper human response to suffering is twofold: heartfelt compassion and the imperative of faith. Pope John Paul II further emphasized that suffering can be redemptive not just for the sufferers but for the world: “In light of Christ’s death and resurrection, illness no longer appears as an exclusively negative event," he said. "Rather, it is seen as…an opportunity to release love… to transform human civilization into a civilization of love" (Wong, 2023).

This redemptive element of suffering was elucidated in one study on the meaning of healing among health professionals. Healing was defined as the personal experience of the transcendence of suffering. Suffering can be transcended by accepting the necessity to suffer and by finding meaning in the threatening events. Creating interpersonal meaning and melding life stories between the patient and physician produce a connectional relationship. It is a mutual experience that results in a sensation of wholeness, and consequently of healing (Egnew, 2005).

Thus, healthcare providers who walk alongside their patients during their struggles with illness and genuinely empathize with their suffering engage in a redemptive and pastoral role. When examining the positive spiritual responses of nurses in hospital settings providing COVID-19-related care, it becomes evident that themes such as heightened respect and appreciation for the sanctity of human life, an increase in compassion and humility, and a strengthened inner spirituality, all hold the potential to enrich the practice of pastoral care (Taylor et al., 2023). Nurses who develop a more profound respect and appreciation for the sanctity of human life are likely to approach their patients with greater empathy and reverence. This perspective can translate into a more patient-centered care, where each individual's unique journey and value are acknowledged and respected. Likewise, humility and compassion foster an attitude of openness and receptivity to the patient's spiritual and emotional needs. Increasing their spirituality will also help them better understand the meaning of suffering in the patients they care for.

Similarly, empathy among physicians has increased during the pandemic. Physician empathy is understanding the patient's concern and comforting him/her of anxiety. One study found high physician-reported empathy scores toward their patients during the COVID-19 pandemic. This was significant as empathy is critical to patient-centered care and satisfaction (Raja et al., 2022). In one particular commentary, a resident physician reflected on a harrowing experience of isolation his patient underwent during the pandemic. This evoked more empathy and helped him understand his patients' needs (Lee & Chavez, 2020). Indeed, empathy is the cornerstone of effective pastoral care, as it enables physicians to deeply understand and validate their patients' emotional and spiritual needs. Through empathetic listening and understanding, they can build trust and provide tailored support that aligns with the patient's values, needs, and beliefs. This compassionate connection forms the basis for addressing spiritual questions, facilitating healing, and helping patients find meaning in their experiences.

In another study on spiritual care providers (SCPs) during the COVID-19 pandemic, SCPs acknowledged newfound motivation to serve those in need despite the challenges the pandemic posed to their routines. Given the significant stress overload and emotional burden experienced by SCPs related to confronting multiple concurrent deaths, moral distress, helplessness, and adapting to sanitary restrictions, they continued to view their service as a "sacrifice." It is guided by faith through divine intervention, underscoring the importance of a holistic approach and spiritual care, mainly when medical cures were unavailable (Domaradzki, 2022). The SCPs demonstrated their commitment to caring for others by embracing a sacrificial mindset. They reflected their pastoral mission's selfless and compassionate aspect, mirroring Jesus' teachings and actions on the Cross.

Reverberating the Call of the Church

In Dignitas Infantas (2024) from the Dicastery of the Doctrine of Faith, every human person possesses an infinite dignity, inalienably grounded in his or her very being, which prevails in and beyond every circumstance, state, or situation the person may ever encounter. This dignity inherent in each person’s body, participates in its own way in being in Imago Dei (in the image of God). Even in its sorrowful state, human life carries a dignity that must always be upheld, that can never be lost, and that calls for unconditional respect. Thus, this corresponds with the enduring responsibility to appreciate the needs of the sick person: care needs, pain relief, and affective and spiritual needs. This upholding of one’s dignity is likewise articulated in the letter Samaritanus Bonus (SB), issued by the Congregation for the Doctrine of the Faith (2020). SB emphasizes the importance of a “healing community” for those patients with critical and terminal cases. The community is called to support the sick, the weakest, and the vulnerable so that they can encounter the merciful love of God through the compassion of Jesus on the Cross. In the context of COVID-19 patients, they must not be deserted or neglected, and care should still be provided through spiritual and emotional support, especially if physical contact is not possible.

Pope Francis (2023) points out that “illness is part of our human condition, yet, if an illness is experienced in isolation and abandonment, unaccompanied by care and compassion, it can become inhumane.” The document SB and the messages for the World Day of the Sick call for a common invitation to do an apostolate of presence and accompaniment. Emotional and psychological suffering brought about by the absence of people, especially loved ones, aggravates the pain endured by patients with COVID-19. In situations where nothing is certain but pain and suffering, the presence of others is greatly needed.

The World Day of the Sick Messages (2014–2018) consistently mentions the Blessed Virgin Mary, known as the Health of the Infirm and the Comfort of the Afflicted, as a model for standing by those who suffer. While the Church may not be an expert in providing medical care and physical healing to the sick, it can emulate Mary’s example, who stayed and endured suffering with Christ from conception to Calvary. Christians are called to constantly become a sign of God’s presence for the sick. The Holy Mother Church must be seen as a spiritual hospital that gives strength and hope to the suffering.

Limitations of the Study

There were no human subjects involved in this research. Thus, the paper did not require ethical approval from the institution. Hence, there is no ethical violation in the process of doing this research.

Conclusion

The COVID-19 pandemic has generated many diverse forms of suffering for humankind. It has brought physical afflictions as individuals grapple with the health impacts of the virus. The mental toll has likewise been significant, with pervasive stress, anxiety, and isolation affecting people's psychological well-being. Social challenges triggered by lockdowns and economic difficulties have likewise exacerbated the burden of many. Moreover, a profound spiritual crisis has emerged as people confronted existential questions about the meaning of life and the profound limitations of human control in the face of suffering. In this context, the words of John Paul II in Salvifici Doloris offer a guiding light. The mystery of suffering can lead to the discovery of more profound meaning through the lens of faith. It is an invitation to respond with loving trust to what is true and to draw closer to Christ. Christ's transformative act of raising human suffering to the level of redemption provides a profound framework for understanding and approaching suffering with hope and consolation. When individuals, following the example of Christ, respond to suffering with love, it becomes an opportunity for spiritual growth and maturity in virtues. The redemptive potential of suffering is a testament to humanity's remarkable capacity to participate in Christ's redemptive work through their trials. A person who comprehends and fully embraces suffering becomes someone who aligns their pain with Christ's, marking the ultimate destination of the journey of suffering.

Furthermore, this redemptive understanding of suffering extends an invitation to provide pastoral care and healing to fellow human beings. While Salvifici Doloris offers profound insights into the spiritual significance of suffering in the context of redemption, it also reminds us not to overlook the complexity of physical, psychological, and emotional suffering. To avoid the risk of over-spiritualizing suffering, we must acknowledge and respect the unique experience of each individual's suffering. This calls for the provision of holistic pastoral care that addresses all dimensions of a person's pain and distress. It calls for acts of compassion and love, moving individuals to take action to alleviate the pain of others. Every act of love directed toward one's neighbor, especially those in the depths of suffering, is ultimately an act of devotion to Christ Himself. These acts underscore the profound truth that in every instance of suffering, Christ is the one who experiences love, and He is the recipient of help when it is extended to any suffering person, as His salvific suffering underpins all human suffering. For in every gesture, Christ's salvific suffering resonates as the cornerstone of all human pain and redemption.