Today I am reading the entries on Joel in the Ancient Christian Commentary Series.
Pacian of Barcelona, a 4th century bishop, writes on (what the editor calls) "The Surgery of Forgiveness."
Another disease is added to the original cause and a new wound inflicted, and all that is contrary is , all that is dangerous is drunk. Under this evil especially does this brotherhood toil, adding new sins on top of old faults. Therefore it has burst forth into vice, and more grievously still, is now racked by a most destructive wasting disease. What then shall I now do, I who as a priest am compelled to cure? It is very late in such cases. But even so, if there is any one of you who can bear to be cut and cauterized, I can still do it. Behold the scalpel of the prophet: "Return," he says, "to the Lord your God and together with fasting and weeping and mourning rend your hearts." Do not fear this incision, dearly beloved. David bore it. He lay in filthy ashes and had his appearance disfigured by a covering of rough sack-cloth. He who had once been accustomed to precious stones and to the purple clothed his soul in fasting. He whom the seas, the forests, the rivers used to serve, and to whom the bountiful land promised wealth, now consumed in floods of tears those eyes with which he had beheld the glory of God. This ancestor of Mary, the ruler of the Jewish kingdom, confessed that he was unhappy and wretched.This word speaks to the closeness of the Lord. And it speaks to how deep one may feel they are in the pit or how far one assumes they are from the Lord, the scalpel of forgiveness is the hand of the Lord to the deep and the far one.
-ON PENITENTS 8.2