Kill to Make Alive: A Hippocratic Oath for Pastors
In this episode of Headwaters Journal, host Arndt Braaten welcomes back Pastor Randy Freund, a friend of more than a decade and a fellow voice in the Lutheran tradition. Arndt opens by framing that tradition as a set of proposals offered to the whole church rather than a rulebook for Lutherans alone, and he invites listeners from every faith to respond and point out what he and Randy might be missing. Randy then shares a portion of a recent conference talk built around a provocative question. What would the Hippocratic Oath look like if pastors took it?
What Would a Hippocratic Oath for Pastors Look Like?
The oath asks physicians to either help or do no harm, and Randy admits it struck him as surprisingly minimalist for a profession we expect to be bold. When he applied it to pastors, swapping “disease” for “sin” and “patient” for “parishioner,” a colleague pushed back: if the pastor’s main tool is the Word of God, and that Word kills in order to make alive, how can a pastor promise to do no harm? Randy took the challenge seriously. A Word that created the world, he argues, is meant to do far more than leave people in slightly better shape.
Pastoral Care vs. Pastoral Counseling: Why the Words We Use Matter
Randy points to a quiet shift that took hold between the 18th and 20th centuries, when “pastoral care” was gradually renamed “pastoral counseling.” The change happened largely because counseling sounded more acceptable in academic circles, and pastors, eager to be seen as credentialed professionals, went along with it. He says this with some humor, but he believes the shift reshaped how pastors understand their unique office. Since words are really the only medicine in a pastor’s kit, even a small change in vocabulary deserves attention.
When “You Got This” Isn’t Enough: Optimism vs. Hope at the End of Life
Randy shares the story of his younger sister, who was diagnosed with leukemia while packing to move to Arizona and died in December 2023 despite Randy being her stem cell match. Her hospital room was filled with encouraging signs reading “You got this,” and they genuinely helped her for a long time. Then one day, alone with her brother, she looked at those signs and confessed that she didn’t have this. In that moment Randy could offer something deeper: permission to die, grounded in a hope tied to the person of Jesus Christ rather than to circumstances. He pairs this with a scene from the show ER, where a dying police officer begs a chaplain for real words of forgiveness and receives only vague questions, a reminder that withholding the needed word can itself do great harm.
Harm That Heals: What “Kill to Make Alive” Means in Christian Ministry
Arndt asks Randy to unpack the idea that a pastor might need to wound in order to heal. Randy compares it to a doctor pressing on a sore spot to find what is wrong, noting that naming self-centeredness in a marriage counseling session is never welcome but often necessary for deeper healing. Arndt grounds the conversation in Scripture, pointing listeners to the Song of Hannah in 1 Samuel 2:6, Deuteronomy 32:39, 2 Corinthians 3:4-6, and Hebrews 4:12, where the Word is described as sharper than any two-edged sword (or, as Arndt likes to say, any scalpel). Drawing on C.S. Lewis, Randy suggests that the gospel always arrives as a threat to our own will before it can be received as a promise.
What Is Sin? Rethinking a Lost Diagnostic Category
Arndt observes that “sin” has almost disappeared from conversations about healing, a decline psychiatrist Karl Menninger chronicled in his book Whatever Became of Sin? The two explore it from several angles: as being curved in on oneself, as the Greek hamartia (an archery term for a good arrow that falls short of the mark), and as the multi-directional alienation of Genesis 3, which fractures our relationships with God, ourselves, each other, and creation. Randy offers a simple handle for counseling: notice the “I” at the center of the word, because if you start with yourself, you will end with yourself.
Both hosts stress that sin is only a bearable diagnosis when a cure is offered alongside it, much like a cancer diagnosis lands differently when treatment exists. Arndt shares a line from pastor and theologian George Hoyer, quoting a patient who said he didn’t know how sick he was until he got better. Randy illustrates this with a high school volleyball player who believed her whole worth depended on a scholarship and found real freedom in learning that no identity ranks higher than “child of God.”
Spiritual Counseling vs. Secular Therapy: Where Do They Intersect?
The ER scene raises a broader question about the distinct roles of a therapist and a chaplain or pastor, and Arndt notes that ordinary viewers seem to sense the difference. He announces that future case-based episodes will carry a disclaimer: spiritual counsel offered at Headwaters is not meant to replace work with a psychologist or secular counselor. Borrowing an image from Dr. Paul Martinson, he describes the great traditions and secular counseling as railroad tracks that are neither identical nor entirely separate, converging around shared experiences and then diverging again. Arndt closes with John Donne’s Holy Sonnet “Batter my heart, three-person’d God” and previews upcoming conversations with a psychiatrist, a poetry professor, and his daughter Katie about middle school cliques and identity.
Notable Quotes
“Happiness and optimism is tied to circumstances. But joy and hope is tied to a person despite the circumstances.” (Randy Freund)
“Words are really the only thing in our toolkit, our medicine kit.” (Randy Freund)
“I don’t got this.” (Randy’s sister, as shared by Randy Freund)
“The gospel itself has to be a threat before it can be a promise.” (Randy Freund)
“If you start with yourself, you’re going to end with yourself.” (Randy Freund)
“You don’t hit an identity higher than child of God. That’s the glass ceiling that can’t be broken.” (Randy Freund)
“The Word of God is living and active, sharper than any two-edged sword, and I often say sharper than any scalpel.” (Arndt Braaten)
“Oh, I didn’t know how sick I was until I got better.” (A patient quoted by George Hoyer, shared by Arndt Braaten)
