One of the last times a man may feel like singing is when he’s sick. Yet when he’s sick, it’s the words of good songs (usually ones he’s learned when he was well) that might make the difference. We can be thankful for Psalm 6 for just such occasions.

Certain illnesses are vicious. They shove us down physical and emotional stairs, left-right, kathump-kathud. The body and soul are connected; loss of health in one area often saps health in the other. The worse the shape, the the lower the hope. Then comes the “Why me?” or “What did I do to deserve this?” or “Where’s God?” The cocktail of pain, sadness, and questions can sow sleeplessness. Some seeds yield harvest. Sleeplessness rakes perspective. Top it all off with the community’s criticism; foes (and sometimes friends) know better than you that it’s all your fault.

Spurgeon once said, “I dare say the greatest earthly blessing that God can give to any of us is health, with the exception of sickness.” If you have never really been sick, this psalm is like preventative melody. If you have been sick, this song will ring your memory belfry. If you are sick, you may not yet be ready to call it a blessing. You need these lyrics because being heard by God will work wonders.

David was the sweet psalmist of Israel (2 Samuel 23:1), and one reason that his poetry is powerful because he knew sickness and sorrow; he’s singing our language. This is another one of his releases to be produced and directed by the Choirmaster . It was written from an individual’s perspective and was meant for corporate benefit.

Most commentators classify this as a lament psalm and we’ve seen a lot of lamenting only six songs into the Psalter. There are many more sad songs to come and, while we may feel as if there are too many minor chord numbers, remember who ultimately arranged and gave the Psalter to us: God. These words of a sick man are the very words of God to us. There must be something profitable.

Psalm 6 was intended to be sung with stringed instruments (as was Psalm 4). Some instrumentation fits better with certain moods; the medium and message should play nice together. This particular song was also according to the Sheminith . You may have a note in your translation that says the Sheminith (a transliteration of the Hebrew word) is “probably a musical or liturgical term.” While we don’t know for certain, the word appears to be connected with “eighth,” concerned with an octave scale (not an instrument with eight strings, contra NASB; see 1 Chronicles 15:21 for leading with a lyre according to the Sheminith, not a Sheminith lyre). Perhaps the meaning is to modulate this an octave lower (Keil & Delitzsch, Cragie). The strings pull the heart slowly and the tone goes down. The music matches the lows of the words—lyrical lows.

The song is divided into three stanzas, not equal in length. They are identifiable by identifying the addressee. Verses 1-5 address the Lord, five times “O LORD.” Verses 6-7 may be to the Lord, but are more of a first person comment and the Lord’s name isn’t mentioned. Verses 8-10 address enemies, “you workers of evil” and “the LORD” is referred to three more times.

His Questioning Invocation to the Lord (verses 1-5)

David invokes God, appealing to His mercy and asking for rescue.

O LORD, rebuke me not in your anger,
nor discipline me in your wrath.
Be gracious to me, O LORD, for I am languishing;
heal me, O LORD, for my bones are troubled.
My soul also is greatly troubled.
But you, O LORD—how long?
Turn, O LORD, deliver my life;
save me for the sake of your steadfast love.
For in death there is no remembrance of you;
in Sheol who will give you praise?
(Psalm 6:1–5, ESV)

The early church used Psalm 6 as one of seven penitential songs, that is, songs to be used during confession of sin (see VanGemeren). The reason for using the psalm for repentance purposes stems from verse 1 and the use of terms such as rebuke and discipline . Psalm 38 starts almost the same way except that by verse 3, David explicitly acknowledges that his bones have no health “because of my sin,” and “my iniquities have gone over my head” (verse 4).

There are a few reasons why I believe it’s unnecessary to take Psalm 6 as a song of confession. First, if David knew that sin caused his problems, he does not mention it. Second, David never asks for forgiveness, even though he does ask for mercy. Third, by the end of the song the shame is reversed onto his enemies. If he deserved the pain because of his sin, why should the shame be transferred to them?

Another possibility is that David begins his prayer song asking Yahweh not to rebuke and discipline him for wanting something other than sickness. He knew God controls his life, the sickness must be what God wanted for him. Imagine if a caricature of the apostle James time-travelled, “Count it all joy, David. God means this for His glory and your good. Suck it up and stop feeling sorry for yourself.” That’s true, God ordains illness and agonies, but that doesn’t mean that we can’t ask to be better.

David seems especially concerned about the LORD’s anger and wrath . He’s not feeling well. He hasn’t gotten much rest. Others are telling him it’s what he deserves. And he begins to believe that God is against him. Doubt fights dirty. Doubt says that the trial is not only hopeless but worthless. God’s mad at you. Don’t believe doubt.

David describes his trouble as languishing , from a root meaning to be weak or “faint” (NIV), “pining away” (NAS), withering like leaves or flowers. He says, my bones are troubled . Illness has drilled into the deepest parts of his body. Skin and muscles are pliable, bones aren’t supposed to hurt. His heart also hurt. My soul also is greatly troubled . Troubled , the word bahal used twice, is not just disturbed but “dismayed” (NAS), in “terror” (HCSB). His bones, his very being rots and it causes him to question.

O LORD, how long? He doesn’t even complete the thought, though we know that David wonders if the trouble will ever be over. In the moment of tight-chested sweat, there is no end of the tunnel. Where is God? Does He care?

David argues for healing based on God’s character and God’s purposes. Do it for the sake of your steadfast love . The LORD is “both threat and hope” (Gerald Wilson), sovereign Giver of the sickness and the Healer of it. And do it for in death there is no remembrance of you; in Sheol who will give you praise? I understand that the Old Testament concept of resurrection and heavenly life with God was not complete. Neither was it non-existent. The oldest book in the OT, Job, anticipates bodily life given by the Redeemer (Job 19:25-27).

For most the afterlife was probably fuzzy and not a great spring of hope. They believed, as we should too, that life here and now should be maximized for God. But more than a theology of what happens in the grave, this is an indicator of how low David got. His sickness was so painful that he was thinking about death. What he wanted, though, was for God to return him to health so that he could praise, especially with the community of God’s people.

A Consuming Illustration of His Losses (verses 6-7)

The song hasn’t gotten to the lowest point yet, and the second stanza illustrates the intensity.

I am weary with my moaning;
every night I flood my bed with tears;
I drench my couch with my weeping.
My eye wastes away because of grief;
it grows weak because of all my foes.
(Psalm 6:6–7, ESV)

Moaning , weeping , wasting, and weakening; a tumble down the stairs of infirmity. He is not just discomforted, not just debilitated, not just in distress (severe agony), he is in despair (hopeless agony). He feels so hopeless that he cannot sleep and, as we know, without sleep any hope that may have remained is soon drained. Consider the consuming nature of the sorrow. Every night , so this has been going on a while, I flood my bed with tears . The illustration is hyperbole. Flood means “to swim in,” so it sketches the room filled with enough water to float the bed. And I drenched my couch with my weeping , or “I dissolve my couch” (NAS) as the tears drip. He moves from his bed to his couch to find a comfortable position and he soaks it too. He is drowning his furniture in grief.

Then he says, My eye wastes away because of grief; it grows weak because of my foes . This seems to be a way to talk about loss of perspective. The persistence of the pain, topped off with criticisms remove David’s hope. He can’t see it anymore. His hope is sunken into the sockets. He’s lost sleep and perspective.

A Confident Injunction to His Enemies (verses 8-10)

There is no bridge, no connector between his weary, weeping, and weakness and now his bold, rebuking, faith. David injuncts, he gives an authoritative order and warning.

Depart from me, all you workers of evil,
for the LORD has heard the sound of my weeping.
The LORD has heard my plea;
the LORD accepts my prayer.
All my enemies shall be ashamed and greatly troubled;
they shall turn back and be put to shame in a moment.
(Psalm 6:8–10, ESV)

David rallies with a focus on the criticizers. Sort of like the Elihu does to Job’s counselors, David puts his enemies in their place by fighting with faith that God has heard the sound of my weeping , he has heard my plea (completed), he accepts my prayer (currently).

Nothing, at least as far as we’re told, changes about his condition. Except, as he prays through the stanzas his faith returns and gets stronger. The process of praying has rekindled some perspective, which he had all but lost. David isn’t necessarily better in body, he may have another night of waterworks, but three times David states the the LORD hears him. He believes that Yahweh heard him. Just knowing that we’re being heard by God is an important step in being healed.

The enemies yasebu yebosu (“shall turn back ashamed”), a reversal in the consonants just as in the context.

Conclusion

There are a few significant footnotes given to us as New Testament believers as we learn this song for low tides of health and hope.

First, all who believe in Christ will be disciplined and yet we never need to fear God’s wrath. Jesus came and bore the Judge’s anger on our behalf. As a Father He disciplines His children whom He loves, but never out of rage. Don’t let doubt seduce you otherwise.

Second, all who believe in Christ will be susceptible to criticism. Blind men will be glad to point out our pain and problems, even diagnosing how much we deserve it. What’s worse is when the criticism comes from fellow Christians. Let us be careful to keep our Calvinism sweet and never fatalistic. We believe that God controls everything but singing songs to troubled hearts is like vinegar on soda or taking away a garment on a cold day.

Third, all who believe in Christ will receive an eternal weight of glory beyond all comparison (2 Corinthians 4:17). We may be sick, sleepless, sorrowful, slandered, and it is light and momentary by comparison to what’s coming. Our hope is in The Resurrection.

Even though we know what’s coming, this Psalm urges us to recognize our time here as a time for praise. There is nothing wrong with asking God to give us strength to sing. And it’s important to sing when we’re well so that we’re ready to endure when we’re not. When we’ve lost perspective, we must go to God.

We need mercy before medicine. Medicine can be part of His mercy, yes, but it cannot replace it. Obamacare can’t fix the heart. Knowing that God hears us is why we need songs like Psalm 6 when we’re suffering.