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Job and Modern Disease

Updated: Jun 27


Understanding the theodicy revealed in the Book of Job informs a contemporary discussion of global disease and suffering. The reason for human suffering and its effects on religious belief gain increased relevance in times of suffering, and it is proposed, even more so when the suffering is global in its effect. The recent COVID-19 pandemic has killed hundreds of thousands in this country alone and many more worldwide. Many turn to their faith to sustain them, but the challenge for many others remains: how does a loving God allow such suffering?[1] “The task of Christian theology may be described as re-telling, retrieving and re-interpreting the story of God’s creative, nourishing, hurt, enduring, salvific, innovating and consummating love for that which God has brought to life.”[2] Job’s particular circumstance provides great insight into theodicy and the problem of evil as it relates to the innocent. It is proposed that applying the theodicy revealed in the Book of Job can provide insights not immediately obvious elsewhere and certainly not with the specificity and applicability offered here.

Suffering and Evil

When God describes His creation in Genesis, he says that it is “good”, and “very good.” From this it is logical to assume that suffering was not a part of God’s initial creative work. Some other event or force brought this suffering into the world. Suffering and the evil that causes it are the result of sin. While sin is not analogous to evil, they have a common origin. Paul wrote in Romans, “Therefore, just as sin came into the world through one man, and death through sin, and so death spread to all men because all sinned” (Romans 5:12, ESV). The freewill given to all men by God allowed Adam to choose sin. And while evil may not be the consequence of the sin of the sufferer, it is nonetheless the consequence of the corruption brought on by the events of Adam’s choice. As Mark McMinn wrote, “Sin is an original part of our character, a pervasive element of the human condition. Sin is our sickness. It is a sickness dating back to the Fall, when Adam and Eve chose to sin in the Garden of Eden."[3]

This sickness extends to the very earth itself and is the source of the natural evil that causes so much suffering and pain in the form of disease as well as earthquakes, floods, and fire. As Paul continued his letter to the church at Rome, he explained the pervasive effect of the fall, “For the creation was subjected to futility, not willingly, but because of him who subjected it, in hope that the creation itself will be set free from its bondage to corruption and obtain the freedom of the glory of the children of God. For we know that the whole creation has been groaning together in the pains of childbirth until now” (Emphasis Added, Romans 8:20-22, ESV). God’s perfect creation was corrupted “because of him who subjected it.” Whether direct, individual sin, or the cumulative sin that has plagued the earth since Adam, the effect has been felt by every element of the earth. Animals, plants, and the geology of the earth itself “reel from the effects of sin.” Satan has the power of death (Heb. 2:14) and is at work wherever death exists. But he has no power to cause the death of God’s servants without God’s allowance.

An early argument concerning natural suffering was related to the doctrine of “divine retribution.” In 1890, C. G. Montefiore described this. He described that “it takes the form of what are known as ‘judgments,’--- judgments on the nation and judgments on the individual in the form of national or personal calamities.”[4] He applied this principle to a nation where the king's or another individual's sins brought judgment upon the people collectively. References to retribution, or judgment, in the Old Testament abound. Jeremiah records that “the nations cannot endure [God’s] indignation” (Jeremiah 10:10). When Israel was freed from bondage in Egypt, there were those who rebelled against Moses and Aaron. As a result, “the earth opened its mouth, and swallowed them up, along with their households” (Numbers 16:32).

Ezekiel also carries the message of retribution when he states that “the one who sins is the one who will die” (Ezekiel 18:20). The implication is that death is the result of individual sin.[5] Carrying the doctrine to its logical conclusion, the Jews in Babylonian captivity believed they were suffering for their fathers’ sins. Sodom and Gomorrah demonstrate the punishment that may come to a people in the absence of personal righteousness. The apocryphal work Second Maccabees even suggests that the righteous may be required to suffer for the wicked (2 Maccabees 6:12).

This way of looking at suffering concerns the ability of individuals to hurt one another. The consequences of personal misdeeds may be explained by free will, but what of evil that affects the innocent, such as a pandemic? In the absence of individual acts that precipitate evil, where is God? This is where theodicy finds its greatest challenge today. This challenge must be accepted since it is at the heart of suffering related to diseases such as COVID-19.

It would be unrealistic to believe that God could not have anticipated that sin would enter the world when free will was given to men. As Alvin Plantinga wrote, “Now God can create free creatures, but He can’t cause or determine them to do only what is right.”[6] As painful as the reality of the origin of a fallen world may be, the importance of understanding this foundational principle cannot be overstated. God did not create the sinful world we live in. God’s creation was a perfect world. He described it as “good” and “very good.” It was without sin, and without suffering. Suffering entered the world as a companion to sin.


Natural Evil and Disease

Isaiah 45:7 says that God “makes peace and creates evil.” And in Lamentations 3:38, Jeremiah says that both “evil and good proceed out of the mouth of the most High.” The Hebrew word translated as evil here is ra’ah. This word carries the suggestion of calamity, disaster, misfortune, or hardship. This suggests an event that can hurt us or inconvenience us in a physical way. In contrast, we read in the Bible that God is good (Mark 10:18) and that his hands “are verity and justice” (Psalm 111:7). John says that “in Him is no darkness at all” (1 John 1:5).

Wickedness, or what we would associate as evil for our discussion is the Hebrew word rasha’. This is evil in a moral sense. This term is not the term used by Isaiah or Jeremiah. Rasha’ is never applied to God. David used the term in Psalm 1:1 when he wrote, “Blessed is the man who walks not in the counsel of the wicked [rasha’].”[7] From this we see that evil is the antithesis of God. Evil is not a created thing. It has no substance. So, although God is the creator of all things, he is not the author of evil, or of suffering.[8] It is often equated with emotional suffering or the pain of disease. As a result, William Lane Craig said, “Undoubtedly the greatest intellectual obstacle to belief in God—for both the Christian and the non-Christian—is the so-called problem of evil.”[9] The emotional nature of this kind of suffering causes a reaction not unlike fear. C.S. Lewis said of it, after suffering the loss of his wife, “No one ever told me that grief felt so much like fear. I am not afraid but the sensation is like being afraid.”[10] This emotional reaction, fear or grief, is often turned towards God. It is perceived as an evil originating with God, or perhaps simply allowed by God, calling into doubt both his goodness and his power.


Job and Natural Evil

When Satan received permission from God to afflict Job, Job’s suffering took on a new character. Where initially Job had been deprived of his wealth and family, now Satan pierced the innermost ring of Job’s protection and caused personal disease and suffering. “So went Satan forth from the presence of the Lord, and smote Job with sore boils, from the sole of his foot unto his crown” (Job 2:7). Throughout the Book of Job, his physical ailments are described with painful specificity. In addition to these boils, he had itching (2:8), changes in the skin on his face (2:12), loss of appetite (3:24), depression (3:24-25), nightmares (7:14), worms in boils (7:5), hardened skin and running sores (7:5), problems breathing (9:18), loss of vision (16:16), bad breath (19:17), rotting teeth (19:20), loss of weight (19:20 and 33:21), pain (30:17), restlessness (30:27), peeling and black skin (30:30), fever (30:30), and all of this lasted for several months. This disease sounds very much like a curse recorded in Deuteronomy 28:35: “The Lord will strike you on the knees and on the legs with grievous boils of which you cannot be healed, from the sole of your foot to the crown of your head.” It would be logical for Job and his friends to assume his disease was retribution for some wrongdoing.

When Job was confronted with a calamity, three advisors came to offer an analysis of his situation. In them we find counterparts to the arguments frequently offered today. These three individuals are Eliphaz, who lived in Edom near Job. Eliphaz presented the argument that good things happen to good people, and bad things happen to bad people. He was clearly a believer in the principle of divine retribution. Eliphaz began his comments to Job with a question, “Who that was innocent ever perished?” (Job 4:7). This question sought to put forward the false idea that the innocent do not suffer. The implication was that if Job suffered, he must have been guilty of something. As a solution to suffering from disease and God’s allowance of it, this argument offers little consolation. Considering how severe Job’s punishment was, Eliphaz concluded that his sin must have been substantial. With some finality, Eliphaz ultimately concluded that man is useless to God (Job 22).[11]

Bildad the Shuuhite was largely in agreement with Eliphaz, he suggested that if Job was not the sinner, it must have been his children (Job 8:3-4). He presented the argument that Job was being tested to receive a greater reward. Building upon the insults of Eliphaz, Bildad concluded that man’s integrity is of no value, and is in vain (Job 25).

Zophar the Naamathite seemed to believe that the greatest good is done by man when he has earned a pleasurable life and has the peace to enjoy it. He added to his companion’s observations in a somewhat more eloquent manner. He presented the argument that since God is just, Job must have done something to offend him. In God’s law the righteous are rewarded and the wicked are punished. His eloquence comes into full force when explaining the horror of the wicked, “They will suck the poison of asps; the tongue of a viper will kill them” (Job 20:16). He goes so far as to say that Job enjoys sin (Job 20).

These three are presumed to speak for God and to render His judgment upon Job. They had been called to console Job, but instead, they judged him mercilessly. Job’s initial reaction to all his suffering was to slip more fully into mourning. He decried his birth and questioned his own value and existence (Job 3:11). But after listening to these advisors turned accusers, he reoriented himself, and through the three sessions with Eliphaz, Bildad and Zophar, turned more and more directly to God. In each of the three rounds, where his accusers spoke about God, Job ultimately spoke to God. In spite of his earlier mourning, after hearing Eliphaz, Bildad and Zophar regale him, Job amended his earlier statement about his birth, and said to God, “All the days of my service will wait until my release comes. You will call, and I will answer you; you will provide for the work of your hands” (Job 14:14-15). In spite of his own lack of understanding, Job demonstrated his ultimate trust in God when he said, “For I know that my Redeemer lives, and at the last he will stand upon the earth. And after my skin has been thus destroyed, yet in my flesh I shall see God, whom I shall see for myself, and my eyes shall behold, and not another. My heart faints within me!” (Job 19:25-27). Job’s faith in the absence of answers had no effect on his companions, who continued to chastise him.

As independently valid as each of the arguments against Job (and by inference all who suffer from disease and other natural evil) appear to be, they are each individually, and all collectively, wrong. They possess a truth in absence of a greater truth. While God has stated His willingness to punish the wicked, and His desire and intent to bless the righteous, the claim that all suffering and disease are the result of individual wickedness is untrue and offers no insight in our attempt to reconcile a good God with suffering caused by disease in the world. Our search then, is the search for this greater truth.

The introduction of Elihu into Job’s narrative begins the process of unveiling this greater truth. Jurij Bizjak asks concerning Elihu, “Are the human intellect and experience able to add something more before the appearing of God?”[12] The younger Elihu defuses the tension created by Job’s antagonistic friends. He criticizes their arguments, and their delivery. He then moves on to Job. Elihu’s primary role is evident when he says to Job, “Bear with me a little and I will show you, for I have something to say on God’s behalf” (Job 36:2). He continues, “Hear this, O Job, stop and consider the wondrous works of God” (Job 37:14). Elihu occupies the no-mans-land between the three critics and God. While Job is the focal point of the events, the grandstanding by Eliphaz, Bildad and Zophar has upstaged the drama that had been developing. Their attempts to reconcile Job’s suffering with God’s goodness fall short, precisely because they do not understand God, nor the nature of suffering and disease. Their theodicy is hollow and flawed.

God speaks to Job, not in the still, small voice of Elijah, but in the whirlwind. Job had previously called upon the Lord, and stated that when the Lord called, he would answer. While what God says is important, the fact that He responded at all should not be minimized. God’s speaking defines the theodicy represented here. He does not answer the questions of Job, or his accusers. God answers the question Job did not know to ask. He reveals the greater truth. God declares, “Gird up your loins like a man, I will question you, and you shall declare me” (Job 38:3). The phrase “gird up your loins” is a call to prepare for something difficult or challenging. It originally referred to tucking the long robe worn by men into a belt, or girdle, so it would not hamper physical activity. Conversely, loosening the girdle implied laziness or resting (such as Isaiah 5:27).[13] Job was being instructed by God to prepare himself for difficult things, in this case principles and concepts that would test Job. God next lays the foundation for His response, “Where were you when I laid the foundations of the earth?” (Job 38:18). This may appear a putdown of Job but it is actually an important realignment of the discussion. Rather than addressing why bad things have happened, God changes the focus to the question of His role in the creation and ongoing existence of the universe, including humanity’s suffering. Job seemed to be getting the point when he responded, “See, I am too small; what shall I answer you? I lay my hand on my mouth, I cannot answer; therefore I will not speak twice” (Job 40:4-5). Job was encouraged once again to “Gird up your loins like a man…” (Job 40:7), whereupon God introduced Behemoth and Leviathan and all of His creative acts.

Job’s only reply was to confess, “I know that you can do all things, and that no purpose of yours can be thwarted…Therefore I declare that I do not understand things too wonderful for me, which I do not know” (Job 42:2-3). This response revealed that Job understood what may not have been immediately obvious to modern readers. He testified of God’s characteristic omnipotence and omniscience and reaffirmed his inability to understand. And yet, this seems sufficient for Job. The understanding of God’s role in creation, and the battle of evil raging in the universe did not cause Job to despair. He had done as God instructed and prepared himself for hard things, he had “girded up his loins.” Job concedes, “I had heard of you by the hearing of the ear, but now my eyes have seen you…Therefore I retreat and I repent in dust and ashes” (Job 42:3-6). What is Job repenting of? It has already been made undeniably clear that his suffering is not the result of his unrepentant sin.

Key to understanding God’s dialog with Job is his references to Behemoth and Leviathan. In their ancient context, these two real creatures, also represent the sinister forces of chaos, and evil. By demonstrating His power over these creatures, God addressed the issue of Job’s suffering by reminding him in a way he would understand that Satan is the author of the chaos (and disease) in the world, and Satan is an enemy that only God can subdue.[14] While the origin of evil is not addressed, Job is in the midst of this struggle between God and the forces of evil identified with the Leviathan.  Leviathan represented the chaos and evil brought on by Satan. When God arrived in the whirlwind, he came as a force determined not to destroy Job but to demonstrate His willingness to be Job’s powerful ally and defender. God is not the enemy. God further demonstrated his ability to subject Satan, and chaos, when he asked Job, “Can you draw out Leviathan with a fishhook or press down his tongue with a cord?” (Job 42:1). Through this discussion, “God is affirming that the chaos monster is still very much a part of this world…despite this, God is very much in the midst of the chaos.”[15] The chaos is not in control, God is able to lead him around, by the hook.

This understanding is key to the applying the lesson of Job. This is what required Job’s repentance. Job, like his friends, had placed God in a box. They saw God just as Satan did. They saw a God willing to reward those who were righteous and punish those who were wicked, without any acknowledgement of Satan’s role in their suffering. In spite of individual experiences to the contrary, there was no acknowledgement of the great struggle underway external to them. They did not understand the true nature and origin of suffering. In Job we see God in the midst of the evil that afflicts the world. And he is engaged in the battle. As N.T. Wright wrote, God getting his “boots muddy” and “his hands bloody” in order to “put the world back to rights” is what is required.[16] This is most clearly seen in the Redeemer Job clung to in the midst of his trial. N.T. Wright states, “Jesus on the cross towers over the whole scene…the point where evil of the world does all that it can and where the Creator of the world does all that he can. Jesus suffers the full consequences of evil…in the downward spiral hurtling toward the pit of destruction and despair.” Wright continues, we are presented “not a philosophical explanation of evil, what it is or why it’s there…but the story of an event in which the living God deals with it.”[17] The defense for the suffering caused by disease in the world comes not in justifying it, but in identifying its source, and understanding our relationship with our champion, the Creator God and His Son, Jesus Christ.


Healing…The Promise of God

As God concludes His words to Job’s advisors, He implies they are guilty of a greater sin when he instructs them to offer up a burnt offering and tells them that only Job’s prayers for them will prevent their own punishment for their misdeed. First Elihu, and now God Himself have dispelled the theodicy presented by Eliphaz, Bildad and Zophar. God says of their behavior, “for you have not spoken of me that which is right, as my servant Job has done.” (Job 42:8). Their misrepresentation of God had risen to the level of sin.[18] Their presumption that they spoke for God required repentance. They mischaracterized the nature of “divine retribution” and made God into a bully. "When God speaks of the vastness of the creation he is not avoiding the issue. God is teaching Job the wisdom of bearing the pain than can neither be avoided nor abolished but can be shared when there is a whole creation to absorb it."[19] Lacking the understanding that had now come to Job, rather than admit their ignorance, they pretended wisdom. In spite of their actions, Job did pray for them, and God restored all that Job had lost twofold.

The philosopher Ludwig Wittgenstein asserts, “You can’t hear God speak to someone else, you can hear him only if you are being addressed”[20] When Job has this experience, he stated with finality, “Therefore I retreat and I rent in dust and ashes” (Job 42:6). While on its surface this may seem a defeatist comment, in reality, it is the statement of a man now fully aware of who his advocate is and is satisfied with the role he plays. His responsibility is to become fully aligned with his warrior-God in this fight against the evil forces in his world, including those that afflicted him with such physical suffering and disease.

The Prophet Isaiah presented the concept of the “Remnant,” the portion of Israel that would be spared judgement because of their humility, and turning to God (Isaiah 10:20-21, 4:3-4 and 29:19). God is not deaf to the suffering of His children. When the children of Israel were captive in Egypt, the Lord said, "I have surely seen the affliction of my people who are in Egypt and have heard their cry because of their taskmasters. I know their sufferings,” he continued “and I have come down to deliver them out of the hand of the Egyptians and to bring them up out of that land to a good and broad land, a land flowing with milk and honey” (Exodus 3:7-8, ESV). He did not simply see their suffering, he provided deliverance. And when the people repented of their worship of false gods in the times of the judges, the Lord “became impatient over the misery of Israel” and sent an unlikely deliverer in Jephthah, the son of a prostitute (Judges 10-11). God hears the cries of His people. He does not bring the evil, but He is able to vanquish it.[21]

Jumping ahead in the story will provide hope through the journey to understand it. As this writer studied and pondered the incredible suffering the pandemic had caused so many, and the personal, emotional cost to all, it was important to keep the conclusion in mind. Just as the anxious reader who must jump ahead to the conclusion to ensure the hero survives, and then can return to the narrative with comfort in the process, a review of how sin and suffering are resolved can provide comfort. In Revelation 21:4, we receive the promise. As the events of this world are winding up, John sees the finale and records, "He will wipe away every tear from their eyes, and death shall be no more, neither shall there be mourning, nor crying, nor pain anymore, for the former things have passed away.” At the conclusion, in spite of the sin, suffering, and disease in the world, Jesus Christ will remove the burden of that sin and bring comfort.

“Thus God’s answer to the problem of suffering not only really happened 2,000 years ago, but it is still happening in our own lives. The solution to our suffering is our suffering!”[22] As difficult as enduring can be, it is another example of God turning all things to our good. Once again Paul’s letter to the church at Rome provides insight. He wrote, “And we know that for those who love God all things work together for good, for those who are called according to his purpose” (Romans 8:28). There are practical benefits to suffering and evil in the world. Sometimes it warns us from behaviors that could cause us physical harm or take us further away from God. And perhaps even more importantly, suffering, disease and emotional evil can turn us towards God.[23] When we realize that our only hope to overcome suffering is to turn to Him who already suffered, and alone can provide comfort, we gain strength. When the Apostle Paul was tormented by some evil, he took it the Lord. The response he received was “’My grace is sufficient for you, for my power is made perfect in weakness.’” And Paul concluded, “Therefore I will boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me. For the sake of Christ, then, I am content with weaknesses, insults, hardships, persecutions, and calamities. For when I am weak, then I am strong” (2 Corinthians 12:9-10). This is the miracle of Christ’s gift. He provides strength in weakness, and peace in turmoil. The suffering has not departed from us, nor has it defeated us.  



Job’s realization that God was with him in his sickness came as a revelation to him and was ultimately salvific. Rather than decry his sickness, he repented “in dust and ashes” (Job 42:6). His sickness became a blessing that brought him to God in a new way and caused him to humble himself before God as he never had. This is the blessing that God desires for each of us when disease and sickness afflicts us.

While many in the Christian world seek to place motivations on God, not unlike the advisors of Job, their interpretation of events are usually misplaced. In calling the pandemic “God’s Judgement” they fall victim to the retributive justice argument that defeated Job’s friends. COVID-19 has challenged the faith of many, while strengthening that of many others. As with another recent pandemic that has afflicted humanity, “In order to address the suffering related to the HIV/Aids pandemic we need to locate our lives within this story – God’s story.” When placed within God’s plan, the opportunity to recognize God’s ability to turn all to good is at the heart of a Christian approach to this pandemic. Job saw it in his extremity and when God’s power was seen, simply covered his mouth in awe. Job’s experience can inform that of modern Christians as they navigate the theological questions raised by the suffering caused by this pandemic that is humbling the world.


[1] Amy Hale-Smith, Crystal L. Park, and Donald Edmondson. “Measuring Beliefs about Suffering: Development of the Views of Suffering Scale.” Psychol Assess. 2012 December; 24(4): 855–866.

[2]  Ernst M. Conradie, “HIV/AIDS and Human Suffering: Where on Earth is God?” Scriptura 89 (2005), 428.

[3] Mark R. McMinn, Psychology, Theology, and Spirituality in Christian Counseling. (Carol Stream, Illinois: Tyndale House Publishers, 2014), 163.

[4] C. G. Montefiore, J. Edwin Odgers, and S. Schechter. "The Doctrine of Divine Retribution in the Old Testament, the New Testament, and the Rabbinical Literature." The Jewish Quarterly Review 3, no. 1 (1890): 1-2.

[5] James L Crenshaw. et al (eds). Theodicy in The Old Testament. (Philadelphia: Fortress Press, 1983), 43.

[6] Kaldoun A. Sweis, Christian Apologetics: An Anthology of Primary Sources. (Zondervan Academic, 2012), 421.

[7] Brown, F., Driver, S & Briggs, C. The Brown-Drivers-Briggs Hebrew and English Lexicon. Peabody. (Massachusetts: Hendrickson, 2006).

[8] Stephen Menn, Descartes and Augustine. (Cambridge University Press, 2002), 174.

[9] William Lane Craig, Hard Questions, Real Answers (Wheaton, IL: Crossway Books, 2003), 75.

[10] C. S. Lewis, A Grief Observed (New York: Harper Collins, 1961), 15.

[11] Christopher Ash, Job. (Illinois: Crossway Publishing, 2014).

[12] Jurij Bizjak. A Key to Job: Translation, Interpretation and Structures of the Book of Job. (Jerusalem: Tantur. 1991), 89.

[13] Kevin J. Vanhoozer, et al (eds). Dictionary for Theological Interpretation of the Bible. (Grand Rapids, Michigan: Baker Academic, 2005).

[14] David B. Burrell, Deconstructing Theodicy. (Grand Rapids, Mich.: Brazos Press, 2008), 126.

[15] Ronnie P. Campbell, jr., Worldviews & the Problem of Evil: A Comparative Approach. (Bellingham, Washington: Lexham Press. 2019), 247.

[16] N. T. Wright, Evil and the Justice of God. (Downers Grove, Ill.: IVP Books, 2006), 59.

[17] Ibid, 92-93.

[18] Leo G. Perdue and Gilpin, W. Clark (eds). The Voice from the Whirlwind: Interpreting the Book of Job. (Nashville: Abingdon Press, 1992), 218.

[19] Kizito Usoma Ndugbu, “Human Experience as the Point of Departure in the Wisdom Literatures: A Demonstration with the Book of Job’s Engagement with the Problem of Human Suffering and Theodicy.” The American Journal of Biblical Theology 21(24) (June 14, 2020), 9.

[20] Ludwig Wittgenstein, Zettel. (Oxford: Basil Blackwell, 1967), 717.

[21] Gustavo Gutierrez, On Job: God – Talk and the Suffering of the Innocent.  (Maryknoll, New York: Orbis Books, 1988).

[22] Conradie, 446.

[23] Ying Zhang, "Reading the Book of Job in the Pandemic." Journal of Biblical Literature 139, no. 3 (2020): 607-12.

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