A gifted pastoral leader has the wisdom and inner resources to know when to walk in front of the flock, and when to walk alongside us, and when simply to receive care.

Martin Copenhaver, pastor of Wellesley Village United Church of Christ in Massachusetts, has a beautiful essay in a recent issue of “The Christian Century,” an excerpt from his forthcoming book co-written with Lillian Daniel, “This Odd and Wondrous Calling” (Eerdmans). It is a first-person account of a medical scare that included an ER visit and hospital stay due to an irregular heartbeat. It is aptly titled “Role reversal,” since Copenhaver writes confessionally as a parish minister who is resistant to allowing the parish to care for and minister to him. He lets the reader walk alongside him as he struggles to be a good patient and finds moments of grace, new insight, and humor. Copenhaver writes that pastors, with all good intentions, often conceive of their role as self-sacrificial, and how social pressures and patterns of congregational life make the role difficult to sustain.

Perhaps this essay is so exciting because of my own work with Duke’s Clergy Health Initiative. It will come in handy with laypeople or religiously unaffiliated health professionals whom I regularly encounter who wonder what the point is of focusing on the health of Christian clergy per se. Don’t all Christians need to be more healthy? (and all people for that matter?).

From the opening paragraph, both patient and the minister struggle (even in the latter’s role of visiting pastoral caregiver) to maintain dignity and agency in the “strange and alien land” of the hospital and especially in the powerful presence of the doctor. Copenhaver’s doctor struggles more as he asks, “How can caring for souls be stressful?” But even ministers—expected to know their way around the hospital room as caregivers—struggle to provide the sort of pastoral presence Copenhaver himself longs for when he’s in the patient’s bed.

I’m not sure whether to think the doctor is especially sensitive or remarkably insensitive. He recognizes stress as a health-risk factor, which is good. But then he presumes to know what ought and ought not to stress his patient out: not so good. He prescribes prayer as cardiac therapy, which is appropriate to his patient’s spiritual orientation. But he fails to note what Copenhaver sees: the paradox of fitting a half-hour of uninterrupted prayer into an already too busy daily schedule. “Pray or else!” is not too comforting.

In a focus group held by our office last year, a pastor remarked that a bout with cancer (a relatively mild and treatable cancer, to be clear) turned out to be a great blessing to his life and his ministry. It provided a blunt reminder of his own impermanence, and the fact that a full calendar and a long To Do list are not the ultimate measures of faithful ministry. Copenhaver presents his illness as that sort of experience: at first scary and disorienting, but then re-orienting and renewing.

When Copenhaver lists stressful aspects of ministry—things that distract or detract from soul care—all of them involve interpersonal conflict. He does cite budget shortfalls, a familiar problem nowadays, but much of the stress of emergency re-budgeting involves the specter of staff cuts or other impacts on people and relationships. Many pastors seem to be wired to dread conflict. Yet faithful leadership inevitably entails confronting certain issues and behaviors and thereby risking conflict. For many pastors, the greatest leadership challenges will be the greatest challenges to health and wellness.

Postscript: Trace Haythorn of the Fund for Theoogical Education makes a connection between Copenhaver’s account of his illness and the health care reform debate. It’s worth noting that in his “unfortunate episode” (his phrase) , Rev. Copenhaver was, happily, not burdened with the question of how to pay for his treatment. Many pastors, probably the majority, are not so fortunate. Many lack health insurance, and even many who are insured face painfully high deductibles in the event of a serious illness. This is an instance where many pastors are, perforce, walking alongside the vulnerable members of their communities.

John James is Research Coordinator for the Clergy Health Initiative, a seven-year project of Duke Divinity School that seeks to promote the health of United Methodist clergy in North Carolina.