The Rev. Scott Schmieding sat in an examination room at the MD Anderson Cancer Center in Houston 13 years ago as a surgeon examined a malignant tumor in the center of his tongue.

The tumor was spreading rapidly, the doctor told him, and most or all of the preacher's tongue would need to be removed. He might never be able to swallow on his own. His speech would likely be unintelligible.

In that moment, Schmieding was not afraid of death or the physical ordeal that he faced. But he wondered about his calling if he survived: How could he spread the word of God if he couldn't speak?

Schmieding asked God to either make him whole or take him to heaven. Ultimately, God would do neither.

Schmieding survived the cancer, but he lost his entire tongue. In the years that followed, he retrained himself to speak using a special retainer and a muscle from his abdomen that surgeons transplanted into his mouth.

Two months ago Schmieding took on a new ministry as pastor of Immanuel Lutheran Church, a congregation of the Lutheran Church-Missouri Synod. Though his speech is difficult to follow at times, the awkwardness of his speech has, in fact, brought more power to his words, parishioners say.

Jana Leppien, who was on the Immanuel selection committee, recalled how one person put it best: "If someone is willing to work that hard to speak, after going through what he went through, I'm going to work twice as hard to listen."

Schmieding had never smoked or chewed tobacco and he had no family history of cancer. But in 1997, five years after his ordination, he noticed a sore in the back of his tongue. In an 11-hour operation, surgeons in Houston sliced open Schmieding's neck from ear to ear and removed his tongue through his throat. Then, they reconstructed the cavity in his mouth with a muscle from his abdomen.

During rehabilitation, he suffered from blisters in his mouth from intense radiation, making his speech therapy sessions agony. He calls it "the most painful part of the entire ordeal."

For eight months, he had to breathe through a hole in his neck, and he ate through a feeding tube. Doctors told Schmieding they feared he would choke to death if he tried to swallow food, and that the feeding tube might be permanent.

The loss of his tongue meant Schmieding permanently lost almost all of his sense of taste. Radiation treatments to his head eliminated the ability to produce saliva. When he did learn to swallow, it was with the help of gravity to push both solids and liquids—with a quick toss of the head backwards—to the back of his throat.

He had to learn how to replace the sounds of consonants in his speech—making the "T" sound, for instance, by shooting air at his retainer, which acts like a megaphone and replicates the traditional sound of the tip of the tongue touching the roof of the mouth.

Having survived surgery and radiation, Schmieding was determined to return to parish life. His first public act as a pastor after his ordeal was to give a sermon at his former church in Baton Rouge and celebrate the baptism of his newborn son.

Despite his zeal, Schmieding did have some misgivings. He confided to his speech therapist: What if parishioners could only understand half of what he said during a sermon?

Her reply? "Isn't that true with most pastors?" he recalled, laughing.

Schmieding says now that he never asked why he was struck with tongue cancer, but for what purpose. In the 13 years since his diagnosis, he said, he found the answer.

"I have become an expert at adversity," he said, noting that he also lived through five major hurricanes in Louisiana. "I know what people are feeling when they face trials and tragedy."

Schmieding was among some 60 candidates considered by the church, and the search committee knew of his challenges when they invited him to visit.

"After about five minutes, we began listening to the content of what he said, rather than how he said it," said Alaina Kleinbeck, Immanuel's director of Christian education and a member of the search committee.

"The fact that some of his words were a little more difficult to make out didn't matter."

After some initial hesitation among some members, Immanuel offered the job to Schmieding and he arrived last fall. So far, the congregation has been supportive and has benefited from Schmieding's message of perseverance, Kleinbeck said.

"So many people have big hurts in their lives, so to have someone stand up there and reveal how they almost lost their vocation in life—that's inspiring for people," she said.

Schmieding believes strongly that he's been able to reach more people without a tongue than he would have had he not had cancer.

"The history of the Bible is the story of God using imperfect people for his perfect purposes," he said. "I'm just one in a very long line of imperfect people being used by God."

Tim Townsend writes for The St. Louis Post-Dispatch in St. Louis, Mo.

Related Elsewhere:

Previous Christianity Today articles related to health and cancer include:

When the Pastor Suffers | Matt Chandler comforts an anxious church following his Thanksgiving seizure. (December 14, 2009)
Three Gifts for Hard Times | What I've learned as life has taken a turn for what most people think is the worst. (August 28, 2009)
Cancer's Unexpected Blessings | When you enter the Valley of the Shadow of Death, things change. By Tony Snow (July 20, 2007)