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Translation
King James Version
Forsake me not, O LORD: O my God, be not far from me.
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KJV (with Strong's)
Forsake H5800 me not, O LORD H3068: O my God H430, be not far H7368 H8799 from me.
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Complete Jewish Bible
Don't abandon me, ADONAI! My God, don't be far from me!
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Berean Standard Bible
Do not forsake me, O LORD; be not far from me, O my God.
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American Standard Version
Forsake me not, O Jehovah: O my God, be not far from me.
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World English Bible Messianic
Don’t forsake me, LORD. My God, don’t be far from me.
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Geneva Bible (1599)
Forsake me not, O Lord: be not thou farre from me, my God.
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Young's Literal Translation
Do not forsake me, O Jehovah, My God, be not far from me,
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Study This Verse

SUMMARY

Psalms 38:21 presents a deeply poignant and desperate plea from David, who is suffering intensely from the physical consequences of sin, spiritual anguish, and social abandonment. This verse encapsulates his profound fear of being utterly forsaken by God and expresses an earnest longing for the divine presence and active intervention. It is a raw, honest cry for God's unwavering closeness amidst overwhelming distress, appealing to both God's covenant faithfulness and His intimate, personal relationship with the psalmist, underscoring a profound reliance on divine proximity for solace and deliverance.

CONTEXT

  • Literary Context: Psalm 38 is one of the seven traditional Penitential Psalms (alongside Psalms 6, 32, 51, 102, 130, and 143), characterized by confession of sin and lament over suffering. The psalm opens with David's urgent cry for God not to rebuke him in anger (Psalm 38:1), immediately establishing a tone of intense suffering and divine chastisement. He graphically describes his physical ailments as a direct result of God's displeasure and his own folly (Psalm 38:3-8), the scorn and malicious plots of his enemies (Psalm 38:12), and the painful desertion of his closest friends and family (Psalm 38:11). Amidst this multifaceted anguish, David consistently acknowledges his own transgression (Psalm 38:18) and places his sole hope in God's merciful response. Verse 21, "Forsake me not, O LORD: O my God, be not far from me," serves as the climactic and most fervent supplication in his desperate prayer, immediately preceding his final declaration of trust in God's promised deliverance (Psalm 38:22). This verse encapsulates the core tension of the psalm: profound suffering met with desperate, yet hopeful, appeal to God's character.

  • Historical & Cultural Context: While the specific historical occasion for Psalm 38 is not explicitly stated, its attribution to David suggests a period of significant personal distress, possibly related to the consequences of his sin (e.g., the Bathsheba affair and its aftermath, as described in 2 Samuel 11-12). In ancient Israelite thought, suffering—especially physical illness and social ostracism—was often perceived as a direct consequence of sin, either personal or corporate. This perception would have led to a deep sense of shame, guilt, and isolation for the afflicted individual. As king, David's afflictions would have been particularly acute, as his well-being was often seen as intertwined with the nation's. Cultural norms dictated that those suffering from severe illness or perceived divine displeasure might be avoided, intensifying the psalmist's anguish and feelings of abandonment. David's appeal to "O LORD" (YHWH, God's covenant name) and "O my God" (a personal address) reflects the deep-seated understanding of God's covenant faithfulness to His people, even when they stray, and the expectation that He would respond to the cries of His chosen king. The geographical setting is likely Jerusalem or its vicinity, where David would have experienced both his royal duties and personal trials, making the social abandonment particularly painful.

  • Key Themes: This verse powerfully contributes to several overarching themes within Psalm 38 and the Psalter as a whole, offering profound insights into the human-divine relationship. Firstly, it highlights the theme of Divine Presence and Proximity, underscoring the psalmist's fervent desire for God to remain near and actively involved in his suffering, recognizing that God's closeness is his ultimate comfort and strength. The fear of God's absence is palpable, making His nearness the paramount request. Secondly, it exemplifies Absolute Dependence on God, as David, facing overwhelming adversity and abandonment by others, acknowledges his complete reliance on the LORD for deliverance and sustenance. His plea is an admission that without God's active involvement, he is utterly lost and without hope. This theme is echoed throughout the Psalms, where the righteous consistently turn to God as their only refuge (Psalm 46:1). Thirdly, the verse is a prime example of Honest and Heartfelt Prayer in Distress, validating the expression of deepest fears, anguish, and perceived abandonment directly to God. It encourages believers to voice their raw emotions to the One who hears, demonstrating that faith does not require suppressing pain but bringing it transparently before the Lord (Psalm 62:8). Finally, it touches upon the universal Fear of Abandonment, resonating with the human dread of being left alone, especially in times of weakness, and directs this profound human need towards a God who promises never to leave His own (Deuteronomy 31:6).

EXPOSITION AND ANALYSIS

Key Word Analysis

  • Forsake (Hebrew, ʻâzab', H5800): This verb (H5800) is a primitive root meaning "to loosen, i.e. relinquish, permit, etc." In its negative imperative form ("Forsake me not"), it conveys a desperate plea for God to maintain His active presence and protective care, not to withdraw His sustaining hand, or to abandon the psalmist to his enemies and suffering. It implies a profound fear of being left utterly alone and helpless in a dire situation, emphasizing a desire for God's continued commitment and support.
  • LORD (Hebrew, Yᵉhôvâh', H3068): This is the sacred, covenant name of God (H3068), often transliterated as "Yahweh" or "Jehovah," meaning "(the) self-Existent or Eternal." Its use here emphasizes God's faithfulness to His covenant promises and His unchanging character. David appeals to God not merely as a generic deity, but as the personal, covenant-keeping God who has historically demonstrated His loyalty and commitment to His people. This name invokes trust in His steadfast love (חֶסֶד, hesed), appealing to His very nature as the faithful One.
  • My God (Hebrew, ʼĕlôhîym', H430): This term (H430) is the plural of אֱלוֹהַּ, used here in its possessive form (אֱלֹהַי, 'Elohai). While ʼĕlôhîym can refer to "gods" in a general sense, it is specifically used here (with the possessive suffix) of the supreme God. This possessive form underscores the intimate, personal relationship David has with God, expressing a deep sense of belonging and personal claim on God's attention and care. By combining "O LORD" and "O my God," David appeals to both God's universal sovereignty and His particular, personal relationship with him, intensifying the urgency and intimacy of his plea.
  • Far (Hebrew, râchaq', H7368): This verb (H7368) is a primitive root meaning "to widen (in any direction), i.e. (intransitively) recede or (transitively) remove (literally or figuratively, of place or relation)." In the negative imperative ("be not far from me"), it is a plea for active proximity and engagement. It's not just a request for God not to abandon him, but for God to draw near, to intervene, and to demonstrate His presence in a tangible, helpful way. It complements "forsake me not" by emphasizing the desire for active, helping closeness rather than passive non-abandonment.

Verse Breakdown

  • "Forsake me not, O LORD": This opening clause is a direct, urgent, and deeply personal appeal to God, using His sacred covenant name, YHWH. David, feeling utterly alone and overwhelmed by his physical and spiritual distress, pleads for God's enduring presence and non-abandonment. He is asking God not to withdraw His support, protection, or favor, recognizing that God's active involvement is his only hope for survival and restoration. This reflects a profound fear of divine absence and a desperate longing for His steadfast love and faithfulness in a time of extreme vulnerability.
  • "O my God, be not far from me": This second clause reinforces and intensifies the first, employing a different, yet complementary, aspect of God's character—His personal relationship with the psalmist. The plea "be not far from me" is a request for God's active, intervening proximity. It's a cry for God to draw near, to be intimately involved in his suffering, and to demonstrate His power and care tangibly. The repetition of the plea for divine closeness underscores the depth of David's anguish and his absolute dependence on God's immediate and personal presence, emphasizing that mere non-abandonment is not enough; he yearns for active, compassionate engagement.

Literary Devices

The verse "Forsake me not, O LORD: O my God, be not far from me" employs several powerful literary devices that amplify its emotional and theological impact. Most prominently, it utilizes Synonymous Parallelism, where the second clause reiterates and amplifies the meaning of the first. "Forsake me not" is echoed by "be not far from me," and "O LORD" is paralleled by "O my God." This repetition serves to intensify David's desperate plea, emphasizing the singular, urgent desire for God's unwavering presence and active intervention. The direct address to God using both His covenant name ("O LORD") and a personal, possessive address ("O my God") is an example of Apostrophe, lending a profound sense of intimacy, reverence, and urgency to the prayer, as the psalmist speaks directly to the divine. Furthermore, the strategic use of Negative Imperatives ("not forsake," "not far") highlights the psalmist's deep-seated fear of abandonment and his fervent desire for the precise opposite—God's constant, active proximity and help. The entire verse functions as a powerful Supplication or Lament, characteristic of the genre of Psalm 38, expressing raw human emotion and absolute dependence on the divine in a moment of profound distress.

THEOLOGICAL AND THEMATIC CONNECTIONS

This verse powerfully articulates the human experience of feeling utterly vulnerable and abandoned, yet simultaneously demonstrates an unwavering faith in the character of God. The tension between the psalmist's profound feeling of being forsaken and the theological reality of God's faithfulness is a central theme in biblical spirituality. It teaches us that authentic faith does not suppress raw emotion but brings it honestly before God, trusting that He is big enough to handle our deepest fears and doubts. David's cry for God not to be "far" from him resonates with the omnipresent nature of God, yet acknowledges that in human experience, especially in times of intense suffering or the weight of sin, God can feel distant. His appeal to "O LORD" (YHWH) invokes God's covenant name, reminding us of His steadfast love and unchanging promises, while "O my God" underscores the deeply personal and relational aspect of faith. This verse thus becomes a model for prayer when we feel isolated or overwhelmed, reminding us that our ultimate hope lies in God's promised presence, even when our circumstances or emotions suggest otherwise, affirming that God's faithfulness is not contingent on our feelings.

REFLECTION AND APPLICATION

Psalms 38:21 offers profound comfort and guidance for believers navigating the complexities of suffering, the weight of sin, and the perceived divine distance. It grants us explicit permission to voice our deepest fears and sense of isolation directly to God, without pretense, theological sanitization, or fear of judgment. When life's burdens feel overwhelming, when the weight of our own transgressions seems to separate us from God, or when friends and family fail us and we feel utterly alone, this verse provides a timeless template for authentic, heartfelt prayer. It reminds us that our personal, covenant relationship with the "LORD" and "my God" means we can always appeal to His faithfulness, His unchanging character, and His promise of presence, even when He feels far away or our circumstances seem to contradict His nearness. Our faith is not strengthened by denying our feelings of abandonment, but by honestly bringing them into the radiant light of God's steadfast love and trusting that He hears, He cares, and He will never truly abandon those who call upon Him. This verse encourages perseverance in prayer, fostering a deep, abiding reliance on God's active, intervening presence as our ultimate source of strength, comfort, and hope in every trial.

Questions for Reflection

  • How does David's raw honesty in prayer resonate with your own experience of suffering or feeling distant from God?
  • In what specific areas of your life do you most need to experience God's active presence and intervention, and how might this verse guide your prayer in those situations?
  • How can remembering God's covenant faithfulness (invoked by "O LORD") and His personal relationship with you (invoked by "O my God") strengthen your prayer and trust in times of profound distress or perceived abandonment?

FAQ

Why does David feel forsaken if God promises never to forsake His people?

Answer: David's cry in Psalms 38:21 reflects a deeply human experience of feeling abandoned, rather than a theological statement that God has actually broken His promise. In times of intense physical pain, emotional distress, and social isolation, even the most devout believers can feel as if God is distant or has forsaken them. The Psalms, particularly the laments, serve as a divine invitation to express these raw, honest emotions to God. David is not declaring God's unfaithfulness, but rather desperately pleading for God to manifest His promised presence and help. It's a prayer for God's active nearness, born out of a profound need, acknowledging that while God is always present, His felt presence can fluctuate based on human experience and the weight of suffering. This aligns with God's compassionate nature, as He welcomes our genuine cries and fears, even when they seem to contradict His promises, because He knows our frame and remembers that we are dust (Psalm 103:14).

Is it acceptable for believers to pray such desperate and seemingly faithless prayers?

Answer: Absolutely. The Bible, particularly the Psalms, provides ample evidence that God not only permits but invites such desperate and honest prayers. David, a man after God's own heart, frequently poured out his deepest fears, doubts, and feelings of abandonment before the LORD (e.g., Psalm 13:1). These prayers are not a sign of a lack of faith, but rather an expression of profound trust that God is big enough to handle our raw emotions and that He cares enough to listen. They demonstrate a radical dependence on God, acknowledging that without His intervention, we are lost. Such prayers are a testament to the intimate, personal relationship God desires with His people, where every emotion, every fear, and every need can be laid bare before Him. They are an act of faith, believing that God hears and will respond in His perfect timing and way, ultimately drawing us closer to Him.

CHRIST-CENTERED FULFILLMENT

David's anguished cry, "Forsake me not, O LORD: O my God, be not far from me," finds its ultimate and most profound fulfillment in the person and redemptive work of Jesus Christ. While David experienced the feeling of abandonment due to his own sin and suffering, Jesus, the sinless Son of God and perfect Lamb, truly experienced the ultimate divine abandonment on the cross. His agonizing cry, "My God, my God, why hast thou forsaken me?" (Matthew 27:46, quoting Psalm 22:1), reveals the horrific spiritual consequence of bearing the world's sin. In that moment, the perfect fellowship of the Trinity was, in a mysterious yet real way, ruptured as the Father poured out His righteous wrath on sin upon His beloved Son, so that we, who believe, might never be truly forsaken. Through Christ's vicarious experience of abandonment, believers are now assured of God's permanent, indwelling presence by the Holy Spirit, who is our Helper and Comforter (John 14:16-17). Jesus promised, "I will not leave you comfortless: I will come to you" (John 14:18), and the New Testament affirms with glorious certainty that nothing "shall be able to separate us from the love of God, which is in Christ Jesus our Lord" (Romans 8:38-39). Thus, David's desperate plea is transformed into a triumphant reality for those in Christ: because Jesus was forsaken, we never will be. His continuous intercession at the right hand of the Father (Hebrews 7:25) ensures our perpetual nearness to God and our secure standing in His grace (Romans 5:2).

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Commentary on Psalms 38 verses 12–22

In these verses,

I. David complains of the power and malice of his enemies, who, it should seem, not only took occasion from the weakness of his body and the trouble of his mind to insult over him, but took advantage thence to do him a mischief. He has a great deal to say against them, which he humbly offers as a reason why God should appear for him, as Psa 25:19, Consider my enemies. 1. "They are very spiteful and cruel: They seek my hurt; nay, they seek after my life," Psa 38:12. That life which was so precious in the sight of the Lord and all good men was aimed at, as if it had been forfeited, or a public nuisance. Such is the enmity of the serpent's seed against the seed of the woman; it would wound the head, though it can but reach the heel. It is the blood of the saints that is thirsted after. 2. "They are very subtle and politic. They lay snares, they imagine deceits, and herein they are restless and unwearied: they do it all the day long. They speak mischievous things one to another; every one has something or other to propose that may be a mischief to me." Mischief, covered and carried on by deceit, may well be called a snare. 3. "They are very insolent and abusive: When my foot slips, when I fall into any trouble, or when I make any mistake, misplace a word, or take a false step, they magnify themselves against me; they are pleased with it, and promise themselves that it will ruin my interest, and that if I slip I shall certainly fall and be undone." 4. "They are not only unjust, but very ungrateful: They hate me wrongfully, Psa 38:19. I never did them any ill turn, nor so much as bore them any ill-will, nor ever gave them any provocation; nay, they render evil for good, Psa 38:20. Many a kindness I have done them, for which I might have expected a return of kindness; but for my love they are my adversaries," Psa 109:4. Such a rooted enmity there is in the hearts of wicked men to goodness for its own sake that they hate it, even when they themselves have the benefit of it; they hate prayer even in those that pray for them, and hate peace even in those that would be at peace with them. Very ill-natured indeed those are whom no courtesy will oblige, but who are rather exasperated by it. 5. "They are very impious and devilish: They are my adversaries merely because I follow the thing that good is." They hated him, not only for his kindness to them, but for his devotion and obedience to God; they hated him because they hated God and all that bear his image. If we suffer ill for doing well, we must not think it strange; from the beginning it was so (Cain slew Abel, because his works were righteous); nor must we think it hard, because it will not be always so; for so much the greater will our reward be. 6. "They are many and mighty: They are lively; they are strong; they are multiplied, Psa 38:19. Lord, how are those increased that trouble me?" Psa 3:1. Holy David was weak and faint; his heart panted, and his strength failed; he was melancholy and of a sorrowful spirit, and persecuted by his friends; but at the same time his wicked enemies were strong and lively, and their number increased. Let us not therefore pretend to judge of men's characters by their outward condition; none knows love or hatred by all that is before him. It should seem that David in this, as in other complaints he makes of his enemies, has an eye to Christ, whose persecutors were such as are here described, perfectly lost to all honour and virtue. None hate Christianity but such as have first divested themselves of the first principles of humanity and broken through its most sacred bonds.

II. He reflects, with comfort, upon his own peaceable and pious behaviour under all the injuries and indignities that were done him. It is then only that our enemies do us a real mischief when they provoke us to sin (Neh 6:13), when they prevail to put us out of the possession of our own souls, and drive us from God and our duty. If by divine grace we are enabled to prevent this mischief, we quench their fiery darts, and are saved from harm. If still we hold fast our integrity and our peace, who can hurt us? This David did here. 1. He kept his temper, and was not ruffled nor discomposed by any of the slights that were put upon him or the mischievous things that were said or done against him (Psa 38:13, Psa 38:14): "I, as a deaf man, heard not; I took no notice of the affronts put upon me, did not resent them, nor was put into disorder by them, much less did I meditate revenge, or study to return the injury." Note, The less notice we take of the unkindness and injuries that are done us the more we consult the quiet of our own minds. Being deaf, he was dumb, as a man in whose mouth there are no reproofs; he was as silent as if he had nothing to say for himself, for fear of putting himself into a heat and incensing his enemies yet more against him; he would not only not recriminate upon them, but not so much as vindicate himself, lest his necessary defence should be construed his offence. Though they sought after his life, and his silence might be taken for a confession of his guilt, yet he was as a dumb man that opens not his mouth. Note, When our enemies are most clamorous it is generally our prudence to be silent, or to say little, lest we make bad worse. David could not hope by his mildness to win upon his enemies, nor by his soft answers to turn away their wrath; for they were men of such base spirits that they rendered him evil for good; and yet he conducted himself thus meekly towards them, that he might prevent his own sin and might have the comfort of it in the reflection. Herein David was a type of Christ, who was as a sheep dumb before the shearer, and, when he was reviled, reviled not again; and both are examples to us not to render railing for railing. 2. He kept close to his God by faith and prayer, and so both supported himself under these injuries and silenced his own resentments of them. (1.) He trusted in God (Psa 38:15): "I was as a man that opens not his mouth, for in thee, O Lord! do I hope. I depend upon thee to plead my cause and clear my innocency, and, some way or other, to put my enemies to silence and shame." His lovers and friends, that should have owned him, and stood by him, and appeared as witnesses for him, withdrew from him, Psa 38:10. but God is a friend that will never fail us if we hope in him. "I was as a man that heareth not, for thou wilt hear. Why need I hear, and God hear too?" He careth for you (Pe1 5:7), and why need you care and God care too? "Thou wilt answer" (so some) "and therefore I will say nothing." Note, It is a good reason why we should bear reproach and calumny with silence and patience, because God is a witness to all the wrong that is done us, and, in due time, will be a witness for us and against those that do us wrong; therefore let us be silent, because, if we be, then we may expect that God will appear for us, for this is an evidence that we trust in him; but, if we undertake to manage for ourselves, we take God's work out of his hands and forfeit the benefit of his appearing for us. Our Lord Jesus, when he suffered, threatened not, because he committed himself to him that judges righteously (Pe1 2:23); and we shall lose nothing, at last, by doing so. Thou shalt answer, Lord, for me. (2.) He called upon God (Psa 38:16): For I said, Hear me (that is supplied); "I said so" (as Psa 38:15); "in thee do I hope, for thou wilt hear, lest they should rejoice over me. I comforted myself with that when I was apprehensive that they would overwhelm me." It is a great support to us, when men are false and unkind, that we have a God to go to whom we may be free with and who will be faithful to us.

III. He here bewails his own follies and infirmities. 1. He was very sensible of the present workings of corruption in him, and that he was now ready to repine at the providence of God and to be put into a passion by the injuries men did him: I am ready to halt, Psa 38:17. This will best be explained by a reflection like this which the psalmist made upon himself in a similar case (Psa 73:2): My feet were almost gone, when I saw the prosperity of the wicked. So here: I was ready to halt, ready to say, I have cleansed my hands in vain. His sorrow was continual: All the day long have I been plagued. (Psa 73:13, Psa 73:14), and it was continually before him; he could not forbear poring upon it, and that made him almost ready to halt between religion and irreligion. The fear of this drove him to his God: "In thee do I hope, not only that thou wilt plead my cause, but that thou wilt prevent my falling into sin." Good men, by setting their sorrow continually before them, have been ready to halt, who, by setting God always before them, have kept their standing. 2. He remembered against himself his former transgressions, acknowledging that by them he had brought these troubles upon himself and forfeited the divine protection. Though before men he could justify himself, before God he will judge and condemn himself (Psa 38:18): "I will declare my iniquity, and not cover it; I will be sorry for my sin, and not make a light matter of it;" and this helped to make him silent under the rebukes of Providence and the reproaches of men. Note, If we be truly penitent for sin, that will make us patient under affliction, and particularly under unjust censures. Two things are required in repentance: - (1.) Confession of sin: "I will declare my iniquity; I will not only in general own myself a sinner, but I will make a particular acknowledgment of what I have done amiss." We must declare our sins before God freely and fully, and with their aggravating circumstances, that we may give glory to God and take shame to ourselves. (2.) Contrition for sin: I will be sorry for it. Sin will have sorrow; every true penitent grieves for the dishonour he has done to God and the wrong he has done to himself. "I will be in care or fear about my sin" (so some), "in fear lest it ruin me and in care to get it pardoned."

IV. He concludes with very earnest prayers to God for his gracious presence with him and seasonable powerful succour in his distress (Psa 38:21, Psa 38:11): "Forsake me not, O Lord! though my friends forsake me, and though I deserve to be forsaken by thee. Be not far from me, as my unbelieving heart is ready to fear thou art." Nothing goes nearer to the heart of a good man in affliction than to be under the apprehension of God's deserting him in wrath; nor does any thing therefore come more feelingly from his heart than this prayer: "Lord, be not thou far from me; make haste for my help; for I am ready to perish, and in danger of being lost if relief do not come quickly." God gives us leave, not only to call upon him when we are in trouble, but to hasten him. He pleads, "Thou art my God, whom I serve, and on whom I depend to bear me out; and my salvation, who alone art able to save me, who hast engaged thyself by promise to save me, and from whom alone I expect salvation." Is any afflicted? let him thus pray, let him thus plead, let him thus hope, in singing this psalm.

Matthew Henry (1662–1714) — Commentary on the Whole Bible. This section covers verses 12–22. Public domain.
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Ambrose of MilanAD 397
Commentaries on the Twelve Davidic Psalms
(Verse 21.) And yet, although he follows righteousness, he does not consider it to be of his own virtue, but of heavenly grace, if he is not forsaken by Christ; and for this reason he prays more earnestly, saying: Do not forsake me, O Lord my God; do not depart from me; that is, men have forsaken me, my friends have attacked the one who is dear to them: they have not drawn near. They fled from me as though I were dead, and they abhorred me; because I desired to confess my sins to you, and to confess; because I offered myself to be wounded by your scourges; because I chose the scars of wounds over the feasts of kings, and the boasting of rulers: you alone do not forsake me, you cleave to your servant, who raises up the needy from the earth, and lifts up the poor from the dunghill. Relying on your company, I will esteem myself more highly among the surrounding peoples. Indeed, my scars have healed, but I still long for the scars of your wounds, which are covered by healed injuries, so that no wound may appear later. Good are the scars of triumphant wounds, with which the victors of this earthly combat boast. How much more glorious are the wounds which, for the sake of faith and the glory of your name, appear to be exempt! This is the scar that opens heaven, acquires a kingdom, and finds immortality. Therefore, brothers, this is the blessed wound, because blessed are those who have washed their robes in their own blood. Thus the robe began to be of glory, the flesh of death (Romans 7:24): in which even Paul himself, chosen by God, was in danger unless he had asked to be delivered from this mortal body, as we read.

And therefore, as we are in this body of death, let us pray that the good and beloved physician of God does not leave us, whom even the patriarch David prayed not to be separated from. Let us entrust ourselves to Him, prepared to be treated with whatever remedy He sees fit. No one tells their own body's physician how they should be treated. The physician knows what medicine is appropriate for each wound, by which festering sores should be amputated with a knife, lest the ruin spread to the entire body. If a doctor were to say to the sick person the type of medicine by which he ought to be cured, and if the sick person despise it, the doctor leaves and abandons the sick person. See him who desires to be cured, by acquiescing to every type of doctor; pay attention to the order. He first reveals his wounds to the doctor, and says: Treat me, but I beg you not in your anger, because my weaknesses cannot endure harsh medicine. The medicine of Christ is correction; for the Lord corrects whom He wishes to convert. Therefore Paul also says to the physician: Rebuke, exhort, rebuke (2 Timothy 4:2). So, one who asks to be rebuked does not refuse to be healed; rather, he wants to be relieved of the punishment so that he may not be rebuked in anger and be taken by the force of anger.

And watch the process. First, seek to be accused; afterwards, to be corrected, which is greater. Then not only confess your sins, but also list them and accuse yourself; for you do not want your faults to be hidden. For just as fevers, when they are deep-rooted, cannot be alleviated; when they break out, they bring the hope of ending: so the disease of sins, while it is concealed, grows more intense; if it is revealed through confession, it evaporates. Therefore, a righteous accuser is at the beginning of discourse, before the contagion of the ulcer spreads internally; for the memory of sins burdens the conscience unless a remedy is sought. And if the doctor delays, the sick person should offer themselves so that they may be cut as quickly as possible; just as David offered himself in the lashes of the Lord saying: Render to me double the sins, as long as these are avenged; do not abandon me, do not turn your face away from me; do not disdain and recoil from the stench of my wounds. And Job, your servant, was struck with ulcers from his feet to his head, and he found a remedy for his health; although that wound was of virtue, this one of error. They celebrated wounds that doctors could not heal. You spoke, Lord, the mysteries of your sacraments, you revealed the venom of the serpent; and the wounds of your servant were healed by the medicine of your word alone, because you did not abandon him; and do not forsake me, Lord, do not depart from me. People have forsaken me; because my wounds disgust them, which I thought should be revealed to your mercy. They say: Leave us, for you are a sinner; depart, so that you do not defile us. But you, Lord, care and do not defile; you help and do not contaminate; for you are the God of my salvation, Lord, and your hand does not destroy, but is accustomed to heal.

We have completed the psalm, along with its interpretation, a verse which some Greek manuscripts have, but not all the Latin ones. For before the next response, the verse is, 'And they cast me forth as a dead thing abhorred'; that is, those who repaid me evil for good. But you, O Lord, do not forsake me, nor depart from me; for this follows; that is: You do not forsake the one accustomed to caring for the dead and decaying. Finally, we have this in the Gospel. For when he had come to the tomb of Lazarus, and said, 'Take away the stone,' Martha said, 'Lord, by this time he stinketh, for he hath been dead four days.' Jesus saith to her, 'Said I not to thee, that if thou believe, thou shalt see the glory of God?' Then He cried with a loud voice, 'Lazarus, come forth.' And he that had been dead came forth, bound hand and foot with grave-clothes. Let us therefore also believe, that our wounds may obtain the healing medicine of salvation, and future glory.

Therefore, in prayers and supplications, when repentance is to be sought with sorrow and tears, so that we may deserve to see the glory of God. Let it not move you that grief, pain, and physical affliction are very severe passions; although they seem very severe, nevertheless such passions are unworthy of the coming glory, as the apostle Paul testifies to you (Rom. VIII, 18). Therefore, let us not be reluctant to bear lighter burdens here, so that there we may be able to obtain full praise and glory, bringing eternal rewards for temporal things through the Lord Jesus: to whom be praise, honor, glory, perpetuity from age to age, now and forever, and for all ages, Amen.
Ambrose of MilanAD 397
Commentaries on the Twelve Davidic Psalms
Lord, you heal and are not polluted; you help and are not contaminated; for you are a God who saves. Your hands, O Lord, do not lose those that are your own but heal them.
Augustine of HippoAD 430
Exposition on Psalm 38
"Forsake me not, O Lord; O my God, depart not from me" [Psalm 38:21]. Let us speak in Him, let us speak through Him (for He Himself intercedes for us), and let us say, "Forsake me not, O Lord my God." And yet He had said, "My God! My God! Why have You forsaken Me?" [Matthew 27:46] and He now says, "O My God, depart not from Me." If He does not forsake the body, did He forsake the Head? Whose words then are these but the First Man's? To show then that He carried about Him a true body of flesh derived from him, He says, "My God, My God why have You forsaken Me?" God had not forsaken Him. If He does not forsake You, who believest in Him, could the Father, the Son, and the Holy Ghost, One God, forsake Christ? But He had transferred to Himself the person of the First Man. We know by the words of an Apostle, that "our old man is crucified with Him." [Romans 6:6] We should not, however, be divested of our old nature, had He not been crucified "in weakness." For it was to this end that He came that we may be renewed in Him, because it is by aspiration after Him, and by following the example of His suffering, that we are renewed. Therefore that was the cry of infirmity; that cry, I mean, in which it was said, "Why have You forsaken Me?" Thence was it said in that passage above, "the words of mine offenses." As if He were saying, These words are transferred to My Person from that of the sinner.
Source: Quotations drawn from early Church Fathers and historical Christian theologians (AD 100–1500). Some quotes address the surrounding passage context rather than this verse alone.
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