The Incarnation in the ICU 

Dec 29, 2021

​​​​​​​​​​​​​Photo: Shutterstock.

By Shannon Vowell

I spent much of last week sitting with a beloved family member, watching as he struggled for the next breath. His ankles had swollen to four or five times their normal size, and were the color of eggplants. His belly was also distended; the bruising there was even more vividly hued. Needles and tubes protruded from his arms; a cluster of tubes with caps on them dangled from his neck; a catheter emptied the contents of his bladder into a plastic container that hung bedside. He woke occasionally for disconcertingly mundane conversation – asking for a sip of Ginger Ale, requesting that his foot be more elevated, wondering whether “The Price is Right” was coming on soon. The surreal horror of it overwhelmed me.

“ICU psychosis” is a thing. It refers to a variety of madness that sets in after days on end in a place where nothing changes – incessant light, noise, and urgency interwoven with long spells of acute boredom – ICU psychosis is the logical response to being held captive by a broken body in a physical place of suspended animation.

ICU psychosis is marked initially by the patient’s inability to identify the date, month, year. It progresses from there to the inability to identify family members. It eventually swallows up recall of even personal identity.

What do such nightmarish facts have to do with Advent? Absolutely everything.

The physical brokenness on display in the ICU – the mental brokenness on display in ICU psychosis – these are windows into the unfathomable wonder of the Incarnation.

How so?

Jesus chose to inhabit a body whose potential for brokenness was as complete as that of any ICU patient. The colors of his bruises, the necessity of oxygen in his lungs, the fragility of his heart – Jesus chose these conditions.

And Jesus, Co-Creator of all that is or ever has been, chose to inhabit the physical realm of Creation – where time and space put boundaries on his omnipotence and omnipresence – where he could be subjected to all the suffering specific to creatures who live in time and space. He chose that vulnerability, that limitation, that smallness. Jesus, the Lord of Lords, who existed before the Universe was made, deliberately put himself in position to experience the time-tethered human consciousness that can devolve into ICU psychosis.

We often forget, in the colored-lights-and-hot-cocoa routines of our secularized celebrations, that Advent is about God’s choice to take on flesh – to be born, to live, and to die. The ICU re-orients our eyes to the incomprehensibly lavish affection behind that choice.

Paul spells it out in Philippians 2:5-8 that Christ Jesus, “being in very nature God, did not consider equality with God something to be used to his own advantage; rather, he made himself nothing by taking the very nature of a servant, being made in human likeness. And being found in appearance as a man, he humbled himself by becoming obedient to death – even death on a cross!”

That emptying – that “being made in human likeness” –ultimately found Jesus nailed to a wooden cross, enduring the same physical agonies as the criminals on either side of him even as he also endured the unimaginable and unrepeatable agonies of the cumulative burden of all human sin, conjoined with the unimaginable and unrepeatable agony of separation from his Father.

Jesus chose this.

Chose it for us, out of love for us, out of a love so infinite and holy and perfect that we can never come close to understanding it.

The Incarnation – Advent – Christmas – these are opportunities for remembering not just the beauties of angels in the night sky, but also the blood and sweat and risk of a teenage girl delivering a baby, and the impossible truth that her baby was God.

The Incarnation – Advent – Christmas – these are opportunities for remembering not just the Gift of the Christ-child in the manger, but the infinite costliness of that Gift – and the willingness of Christ-child, of Father, of Holy Spirit, to bear that cost for us.

The Incarnation – Advent – Christmas – these are opportunities for remembering not just the sweet traditions of family gatherings, favorite recipes, and sparkly presents under the tree, but also the Gift of Presence which Immanuel – God-with-us, Jesus! – gives in an ongoing way because of the Incarnation. Because of Christmas I pray that your Advent and Christmas unfold far, far away from the ICU.

But I also pray that your Advent and Christmas will be made richer and more truth-powered as you contemplate the truth about Jesus which the ICU makes clear: Jesus chose to be confined to human flesh. Jesus chose to be confined to time and space. Jesus chose vulnerability, poverty, betrayal, and pain – because He loves you.

Boundlessly.

Excruciatingly.

Eternally.

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