Cancer stage 4

Glaciers, Mountains, Fireweed and My Wife

donaeley7 Comments

This vantage point for the Mendenhall Glacier in Juneau is one of the most photographed views in Alaska.  This spot, which I could see from my office when I served in the Coast Guard, offered insight and reassurances as I watched my wife deal with metastatic cancer.

In the foreground is the muskeg meadow; wet, nutrient-rich, verdant, home to vast clumps of fireweed, Alaska’s state flower.  In the background, framed by the glacier, are the Mendenhall Towers; mountain peaks rising 1.3 miles straight up from near sea level.  These are young mountains, exposed as the vast icefield encasing them began to recede in the 1700’s.  First scraped clean by the ice field and continuously swept clean by snow, ice and wind, these peaks have little of the life of the fireweed meadow they preside over.

So different – the fireweed meadow and the rock pinnacles – yet no one would argue successfully that the meadow is more beautiful than the peaks, or vice versa.

The meadow produces; the peaks stand in testimony.  The fireweed meadow shows Alaska’s nurturing hand; the peaks show signs of Alaska’s harshest nature: hurricane force winds, snow and ice.

Like fireweed, many of us bloom because we happened to take root in the most accommodating and nurturing of soils.  Like the Mendenhall Towers, some of us are scraped clean by the harshness of life, whether it be our environment, disease, or tragedy.

Turning the comparison of the meadow and the peaks slightly in another direction, I can write that nearly all of us start in the bloom of youth and over time evolve to a form more pronounced, bearing the marks of the ice and wind of this world, still beautiful as God’s image bearers, but deeper, more complex, weathered and polished.

I watched Dona deal with a serious cancer since early 2014.  Most cancer sufferers are described as ‘fighting cancer’ or ‘enduring a long struggle with cancer.’  I appreciate the spirit and determination those descriptions signal.  But Dona did not fight her cancer, she let her oncologist do that.  Dona seemed to maneuver her cancer, somehow positioning the disease at a place where she could learn, grow, even flourish.  With each setback – a disappointing scan or lab report, a quality-of-life diminishing side-effect – I saw Dona maneuvering, adjusting, and finding a way to grow a little higher, like the Mendenhall Towers of Juneau; perhaps scraped and scoured a bit, but nonetheless ultimately towering over her disease.   

Where does this come from? 

As much as I would like to give her full credit I cannot.  I was with Dona for 43 years.  This is a new spirit.  She has always had many attractive traits: thoughtful, kind, empathic but, also, a relentless planner, troubleshooter; dedicated to seeing peril around the corner and making big plans to counter the threat.  Once she stored $2000 in a box after reading a report that cyber-terrorists could easily shutdown the electric power grid, making banks and ATM’s inoperable.  But once she faced her worst and most real crisis, she became less anxious, more relaxed, less out to prove something to herself.  When scan reports were not good, Dona took the news with courage, dignity, grace, humility; always encouraging and thanking her health care providers.

And she liked her ‘new metastatic self’.  She wrote about it on more than one occasion. 

I would not call this new outlook serenity.  A more serene person would have done less on-line shopping.  It was not stoicism either.  We were still quite anxious during each visit to the hospital.  As we waited for our oncologist to enter the treatment room, I would read her dumb jokes from the internet as a disruption. 

I am still struggling to define and understand the change.

Recently, I have described this change as Dona’s confidence in God’s big plans for her future.  Fear revolves around our thoughts about the unknown future and our imagining the worst of that which is unknown.  But she was convinced that she had a future, and it was a good one.  We prayed for a miracle of healing, for longevity.  That is not granted, but no matter, we still have a future, and it is glorious.

Tim Keller writes, “We are future-oriented beings, and so we must understand ourselves as being in a story that leads somewhere.  We cannot live without at least an implicit set of beliefs that our lives are building toward some end, some hope, to which our actions are contributing. We must imagine some end to life that transcends.”[1]

But that is not the whole story.  Hope and faith are essential, but we need some external help.  If it depends only on our personal resolve or insight we are back where we started – some of us succeed through a gift of temperament or fortitude, some not.

And we boast in the hope of the glory of God.  Not only so, but we also glory in our sufferings, because we know that suffering produces perseverance; perseverance, character; and character, hope. And hope does not put us to shame, because God’s love has been poured out into our hearts through the Holy Spirit, who has been given to us. Who shall separate us from the love of Christ? Shall trouble or hardship or persecution or famine or nakedness or danger or sword? No, in all these things we are more than conquerors through him who loved us. For I am convinced that neither death nor life, neither angels nor demons, neither the present nor the future, nor any powers, neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord.

Romans 5:2b-5; 8:35, 37-39

It can only be the Spirit of God that vitalizes life, communicates God’s truth, and reassures of his eternal plan for us through the grace of Christ. 

What was great about this external strength was that when hardship came, I did not worry that Dona would not be able to endure it because it did not depend solely on her. I trust I will be able to draw on that same strength.

I so deeply miss her.

Dave Eley

[1] “Making Sense of God: An Invitation to the Skeptical” by Timothy Keller.

Cancer and Character Development

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Suffering has allowed me to empathize with the suffering of others more deeply.  This new level of compassion is both heart-breaking and life-giving in equal measure.  I am grateful.

I occasionally get questions that at first glance may seem impertinent or insensitive when posed to a person with Stage 4 cancer.  But I am not startled or offended.  Afterall, I write unreservedly in my blog about my mortality, and, most gratifyingly, my friends ask questions out of genuine concern and a desire to understand more fully what I am going through.

Recently, a close friend asked:

“Dona, you ever wish that you had died suddenly from an accident or heart attack instead of going through these years of suffering, not knowing when the medical team has no more resources to keep you alive?”

An insightful question I have been pondering ever since. 

There was a time when I would have said absolutely, I would rather die suddenly than go through cancer treatments. After all, what other illness fills us with dread as we wonder about lumps, difficulty swallowing, or unrelenting back pain?

Another friend, a physician, told me about a patient that showed up at his medical practice with grave concerns about a skin condition. The doctor’s diagnosis was chronic, severe psoriasis. He told his patient the condition would cause pain, discomfort, interfere with sleep, and make it difficult to concentrate. There would be no cure. The patient relied, “Thank God it’s not cancer!”

We do not walk around fearing heart attacks, gallbladder attacks, car accidents, lupus, or sundry illnesses that can be very devastating and even fatal. It is cancer that fills us with fear. Within literature or human discourse there is no other disease used as a personifier of something malignant, evil, or spreading. (“Bitterness grew like a cancer until it consumed her.” “His hunger for power was a cancer that could not be stopped until he destroyed everyone in his way.”) We use the word cancer because it is a word loaded with all kinds of imagined suffering and dread of when and how it will take our lives. And unlike the animal kingdom we humans have existential angst and future awareness, realizing we are mortal and will leave behind loved ones, future dreams and plans and meaningful work.

Getting back to my friend’s question……

Early on when I discovered I had metastatic breast cancer I wrote a blog post titled “I like the new metastatic me.” It had nothing to do with being masochistic or pathological.  It had all to do with welcoming the change of perspective on what was, and what was not, important in life.  Consequently, I found a greater peace of mind because I had less things that I was holding onto and less to become anxious about. The new metastatic me simplified life and found me focusing on joy and gratefulness.

Although my cancer had progressed from Stage 3 to Stage 4, I was happy to find that my character development had moved from stage 1 to stage 2.  Well, maybe Stage 0.5 to Stage 1.

That was then, this is now.  In the last four years there certainly has been more suffering than I would have anticipated when I was first diagnosed with metastatic cancer.  But I can say with confidence that after 4-5 years of living with this awful disease that I’m thankful I was not taken suddenly.

I am more others-centered now than 4 years ago. My character development has moved from stage 2 to stage 3. Well, maybe 1 to 2. You get my intent. I am trying to walk the line between braggadocios and false humility. The point is that I have more empathy and heart sickness when I hear of others suffering, whether from the terror-stricken children of Ukraine, the starving children of Somalia, or the grieving parent of a loss child or husband. I used to avoid reading BBC international news (I have an app). Too much tragedy. Now, I read and pray because it disrupts my own suffering and allows, what Mother Theresa called, “my heart to be broken with what breaks the heart of Christ.”

And this suffering somehow reminds me of the Great Hope.

“Not only so, but we also glory in our sufferings, because we know that suffering produces perseverance; perseverance, character; and character, hope.”

Romans 5:3-4

Before unpacking this, I must reiterate that the grace of God has been apparent every step away.  He deserves the credit and glory.   

Suffering can breed empathy:

When people are faced with a terrible diagnosis there is a choice that must be made. Will the rest of life be driven by bitterness and anger; resenting the unfairness? As I have heard on more than one occasion, “I took good care of myself: ate healthy, exercised frequently, managed stress, and even served God so how did this happen to me?”

As I noted above, there is an aspect of my chronic suffering that has bred empathy and compassion for those who suffer, whether from cancer, other ailments, heartbreaks, betrayals, extreme losses.  My prayer life has been richer and more spontaneous as I read the news or talk with people who are hurting. And for those times I forget I have cancer as I focus on them.

I do not know why suffering has produced empathy, but I have a couple of theories.

The God of the cross

We have a God that suffers with us.  The late John Stott, theologian and pastor of All Souls Church in London often said he could not worship a God who had not experienced extreme suffering.

“The fact of suffering undoubtedly constitutes the single greatest challenge to the Christian faith and has been in every generation. Its distribution and degree appear to be entirely random and, therefore, unfair. Sensitive spirits ask if it can possibly be reconciled with God’s justice and love.”

I could never myself believe in God if it were not for the cross. The only God I believe in is the One Nietzsche ridiculed as ‘God on the cross’. In the real world of pain, how could one worship a God who was immune to it?

John Stott, The Cross of Christ, pp. 335-336

In summary, my metastatic cancer first gave me a new perspective on what, and what was not, important in life.  Consequently, I found a greater peace of mind because I had less things that I was holding onto and less to become anxious about. The new metastatic me simplified life and found me focusing on joy and gratefulness.

Second, suffering has allowed me to empathize with the suffering of others more deeply.  This new level of compassion is both heart-breaking and life-giving in equal measure.  I am grateful.

My character development has moved from Stage 1 to Stage 3!  Will I ever get to Stage 4?  Not in this earthly tent!

And this brings me, finally, to the point of all this.  The end result of suffering is not character development but hope.  (Romans 5:3-4)  Hope in what?  Eternal life and that time when Christ will “make all sad things untrue.”1  A cold, pitiless universe, full of random disease and tragedy, without God provides little or no incentive to develop character or hope. 

If only for this life we have hope in Christ, we are of all people most to be pitied.

1 Corinthians 15:19

Yes, oh yes, I am thankful, suffering or no suffering, for every moment the Lord had graced me with!

1Originally spoken by Sam to Gandalf in J.R.R. Tolkien’s, The Return of the King.  Often quoted by Tim Keller and NT Wright in their reflections on the resurrection.

The View from the End of the Rope

donaeley5 Comments

6:45 pm, Monday, August 8, 2022

It has been a long day.  I just finished chemo.  I am in the Roswell Cancer Institute imaging clinic, waiting to be called for a brain scan MRI. David left to get groceries and prepare a late supper.  I am disappointed, discouraged, teary-eyed, and, to make matters worse, a bit embarrassed.

7:00 pm

As I wait, I take the advice I gave to clients for years and have blogged about more than once: start journaling about the angst.

Confession:

I have been complemented by family, friends, and medical team on how well I’ve handled an abundance of difficulties throughout this process. And yes, I have felt validated respected and brave for my “handling it all so well.”

And yes, I have attributed my persevering, positive attitude to my dependence on God’s faithfulness towards me no matter what happens.

But over the last two days something started to emotionally unravel. It started with overreacting to my husband’s innocuous comments yesterday but thankfully having it all resolved quickly, more thanks to him than me.

I want to blame this emotional roller coaster on the steroids I am taking to heal the liver from an unfortunate turn in the immunotherapy treatment.

But…. Something other than steroid-craziness is going on.

My ‘end-of-the-rope’ was bound to come but I thought it would come at the ‘end-of-the-road’ when all treatment options have been tried and failed, therefore reclassified as terminal. Another counselor told me once that when you reach the end-of-your-rope – the point where you cannot climb back up but cannot lower yourself further – it is time to let go and trust in God.  I love that image.  I have rehearsed that end-of-rope/end-of-the-road moment too many times to count. In that future scenario, when told there is nothing else that modern medicine can do for me, I picture myself demonstrating great faith and even love and gratitude for my wonderful medical team. I become some kind amazing hero of faith in my eyes and in others. Ah, the follies of ego!!!

But I am having an end-of-rope moment now.  This morning, I had an unexpected call from my oncologist to come in for an unscheduled visit. I was hoping he wanted to discuss weaning me from steroids. The opposite happened as my liver enzymes had gone up. He has increased, slightly, my steroid dose; meaning less sleep and immunotherapy still off the table.

I had an unexpected reaction to the consultation. I got visibly frustrated and hurt. Tears!

The irony and hypocrisy of the reaction is that yesterday I had complained to friends of hearing of cancer patients reacting similarly, being unreasonable and unfair to their medical providers.

Not that I went ballistic.  Hospital security was not called.  But I had tears of frustration, and I over-questioned my healthcare providers. I argued about use of words.  “You say ‘increase’ in liver enzymes but I say, ‘slight uptick’ when I look at the graphs.”   After spending more time with me than I deserved I patted my oncologist on his hand as he was leaving, an apology, of sorts. But it did not end there: as I was led to the chemo chair, I was told that my oncologist had just ordered in addition to the chemo an hour of saline for low sodium before the infusion. Come on! My feet were already in a crazy swollen state of discomfort I questioned the purpose of this. I asked the infusion nurse several times to call the oncologist finally reconsidered and gave me what I wanted. (If the low sodium was acute, he would have won that skirmish for sure).

8:00 pm

Back in the imaging waiting room, the technician finally called my name for the MRI.  As we are walking to the imaging room, he said the scan would not take an hour, as I assumed, but only 15 minutes.  That simple correction somehow, in some way, flipped the mood switch. Delighted, I became my friendly chatty self as I sensed that joy was beginning to take hold again. 

The Lord heard my lament and gave me hope. David is thankful to see the smile back on my face!

9:00 am, Tuesday, August 9

But I cannot leave it at that.  It is tempting to think of God smiling at us with approval when we are behaving graciously and mercifully to those around us especially when we are suffering and amid disappointments. Conversely, we imagine him clucking his tongue when we are miserable, irritable, and faithless. The thing about that is that it does not typically lead to a heart change. Why? Shaming is not affirming or inspiring. It gets us stuck in a spiritual arrested development. Spiritual maturity on the other hand fills us with the knowledge of God’s love that surpasses our understanding (Ephesians 3:19).

He made us to trust in his unfailing and never changing love. It is who he is, and the operative word is grace (unmerited favor).

Neither you or I can make God love us more or less by what we do when we have already thrown our hat in the arena of God’s faithfulness. And in a mysterious, wonderful way we are changed and willingly motivated to continue the good fight of our faith.  (1 Timothy 6:12)  We can let go of the end of the rope.

And, as Paul writes, “No eye has seen, and no ear has heard, and no mind has imagined the things which God has prepared for those who love him.” 1 Corinthians 2:9

This is something to fight for, something to live for!

From FOMO to JOMO

donaeley8 Comments

What cancer has taught me about the joy of missing out (JOMO)

dog restingAs it turns out an antidote for the subject of my most recent post, FOMO (fearing of missing out), is JOMO (joy of missing out). JOMO is basically saying “no” to the push to stay busy and connected with whatever presents itself in order to say more ‘yeses’ to activities that are more in-line with our values and interests. Many are jumping on the JOMO wagon. Productivity gurus are incorporating JOMO in their training. Stressed out working moms have self-help books to achieve JOMO. CEOs are trying to find balance and enjoyment within the pressures of fierce business competition. It’s all part of a new cultural phenomenon – searching for peace and joy within a world of relentless busy-ness, competition, and high expectations.

At first blush the acronym, JOMO, seemed forced and naive to me; but then I realized that it was exactly what David, my husband, and I were attempting to do since my diagnosis of stage-4 cancer. Doubling down on the present and embracing joy is integral to the 3-part strategy my husband and I developed to cope and grow.

1. Pursue the best possible treatments for the best possible outcomes.
2. Double down on the present. Experience joy where we can find it.
3. Think deeply about eternity.

I highly recommend you read his post, For Whom the Bell Does Not Toll: Stage 4 cancer patients have another definition for victory.

And there is evidence that we are doing just that. Laughter has always been coveted in our relationship but there is now more of it as we appreciate grandson antics and their hilarious comments. There is more laughter as we look for the amusing in ourselves and others; reminding ourselves to not take ourselves too seriously. There is more laughter as we retell shared funny experiences. There is joy as we actively pursue our passion to see marginalized people treated with God-given dignity and value. There is joy as we worship in church. There is joy as we enjoy the natural beauty around our creek cabin. There is joy of family and friends. There is so much joy and delight in our lives that we’ve been blessed with. We are grateful. But ….

• This is easier to do if I’m not in pain
• This is easier to do when I have had some distance from a disappointing oncology appointment.
• This is easier to do because it is my story and not a loved one’s.

In other words, there is within the JOMO movement a limitation. There is an exclusion clause, unspoken but nonetheless imbedded in its good intentions. Stopping to smell the roses sometimes leads to being stung. Being stung too many times can lead to anaphylaxis. Smelling a rose must give way to getting help to breathe. There are life experiences that leave us limping along, breathless from the sheer pain and exhaustion of life’s journey. Sometimes I feel like that. JOMO becomes elusive at best and downright annoying at worst. And so I cry. (See: More on finding comfort from God.)

It’s here that the 3rd part of our strategy takes dominance over the “doubling down on the present.“ Thinking frequently and intentionally about eternal life with the God who loves me is fundamental to any nod of acceptance and significance that I give to JOMO.
“So Heavenly-minded that a person is no earthly good” is not born out in the course of my life nor for countless others. It’s quite the opposite: becoming more heavenly-minded has prompted the Jesus-committed to do what can be done to effect positive change in this world while at the same realizing that Christ will ultimately set all things right. And some have made great sacrifices to that end.

But what about the fear of missing out on all the beauty and companionship of this world?

flowering dogwoods texasMany years ago, my two young daughters and I were riding our bikes together in our neighborhood. The balmy gentle breeze of a Virginia springtime with its blooming azaleas and dogwoods, greening weeping willows, and scented pine and magnolia underscored the laughter of my girls. I was filled with an inexpressible Joy. I remember silently thanking God while at the same time bemoaning that it wasn’t going to be ours for long. A transfer to another location in the country was imminent.

I longed for permanence in beauty and perfection. It was then that I realized for the first time that the aroma of magnolias and the music of a child’s laughter were only clues and hints of glory – not yet fulfilled nor meant to be. He has placed “eternity in our hearts”. (Ecclesiastes 3:11) The permanent, perfect, and pure in love and beauty would my inheritance. I think I can wait. Lord, help me wait.

‘Death Cafes’ and Me

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“Death Cafes” are springing up in cities throughout the world to address the subject of death and how-to live with death’s inevitably.

Apparently, the movement was started to give people a “safe place” to talk about death without being accused of morbidity. Billed as a philosophical inquiry on mortality, people looking for a grief support group will be disappointed. “Eat cake, drink tea and discuss death”, is the benign motto. The decor includes mugs, teacups and posters with creepy skulls, skeletons, and ravens painted on them. I admit that I’m put off by the skull mugs in the Death Cafes. death mug

But these venues and discussion groups deserve more than half a point. The vast majority of Americans live in the mythical state of immortality. ‘Mythical immortality’ (my term) is the belief that other people die, I don’t. (See, ‘I Like the New Metastatic Me’) When we do think about death it is in the context of avoiding it. Anne Patchett writes:

“The fact is, staving off our own death is one of our favorite national pastimes. Whether it is exercise, checking our cholesterol or having a mammogram, we are always hedging against mortality……Despite our best intentions, it (death) is still, for the most part, random. And it is absolutely coming.” 1

Death cafes, though they deal with an inevitability ignored by most, do not capture rightly the travesty of death or the Christian hope of triumph over it.

The point of Death Cafes is to make death less fearful in an age of anxiety. I get it.  But the death mug approach to the subject does not capture the travesty of death. I say travesty because the Bible makes it clear that death is an enemy that is finally destroyed with the coming of the new heavens and earth at the culmination of time. And that is where the Christian hope comes in. The story is not over with our deaths. There is the hope that Christ ushers us into his glorious presence where every tear is wiped away and grand reunions are still to come. So maybe what I could benefit from would be a café whose moniker is “death does not have the last word”. A safe place where my faith tradition is shared with others so that I hear stories about people who have died well within the confidence of being on the threshold of an eternal reality. Granted my death café sounds a bit exclusive as it would possibly not be very attractive to secularists or folks from other faith traditions; but at the end of the day, with facing my own mortality I want to hear a café filled with conversations about hope, faith, courage, love and forgiveness. I want to hear and talk about Jesus. I want to live life in the moment with increasing gratitude. Hearing stories about people who lived well up to the moment of their deaths is my cup of tea and I will happily eat some cake while doing so.

 

  1.  Ann Patchett, “Scared Senseless,” The New York Times Magazine, October 20, 2002.

Intimate News

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I made an unusual request of my oncology team. I told them that when I returned the following week to hear the results of the radiologist report and the status of cancer progression, I wanted them to tell David first. I would be in the waiting room to hear from him. He Patient to doctorwould sit with me and go over the results.  We might pray together, then we would go the clinic room together to have the results further explained by the team and have our questions answered.

Weird, cowardly, childish, weak, faithless, avoidant, dramatic, insensitive to my husband by putting him in this position? All those descriptors passed through my mind as the day approached. On the actual day, I decided to forget the elaborate scheme and face up to the news without preamble. But my husband gave me a word picture that took away the shame.

“Dona, you are going to have to eat the whole sandwich (the radiologist’s report) at some point but how you want it presented – open-faced, garnished, toasted – is completely up to you. You’re the one going through this. Do it the way that makes it most tolerable.”

And my team completely understood, or at least acted like they did.  As my lead doctor said,

“Dona is the one with cancer, not me.  We do it her way.”

Intimacy

So, what was going on, aside from fear? It is intimacy and trust – intimate knowledge coming through my most trusted person. I wanted news from the person whose life would be most affected by this personal and significant information and from the person who knows me better and loves me more than any other.

An example from a long-ago happy event:
Who was the first person I told when i discovered I was pregnant? Life changing information that only made sense to share with the person most invested in our lives together. And whose lives would change dramatically as a result? Mine and his.
Again, intimate personal information shared within the most intimate of relationships. It’s really (in my mind) not so different from news about a disease notorious for causing pain, disability and death. I wanted to hear it from my husband no matter what it was.
But fortunately, intimacy doesn’t stop there.

Intimacy with God

David’s intimate relationship with God was ultimately what I was counting on in anticipation of hearing news related to my survival. If the scan and test results were disappointing, then I trusted David to tell me the facts along with the crucial caveats and realistic encouragements that would calm my fears and reorient me once again to the hope I profess in Jesus in all and every circumstance of life. I imagined praying together in those moments – intimacy with God would always and forever be at the heart of my life’s purpose and hope, even in life’s major disappointments.

The obvious

What if there was no husband or one that was willing to participate in my plan? Or what if there wasn’t a substitute like a trusted pastor or friend who could lead me to “the shepherd of my soul”?  Would I have fallen apart? Fallen into a pit of despair of which I couldn’t climb out?

I don’t imagine so. And here’s why:  Betsy Ten Boom who died at Ravensbrück for her participation in hiding Dutch Jews during WW2 said,

“There is no pit so deep that God’s love is not deeper still.”

I cling to that with gratitude.

Thankful Postscript
My test results were encouraging: “Skeletal cancer stable, metastatic liver disease showed marked improvement.”

Of course, this begs the question, would I write this same post if the news was not good? I hope so, I pray so. Again,

“There is no pit so deep that God’s love is not deeper still.”

 

 

 

Scans: It’s that time again :(

donaeley5 Comments

Medical scans make known the presence of disease. That can be terrifying. But there is another kind of knowledge.

ct scanIt’s that time again. I have metastatic breast cancer and so every 3-5 months I have nuclear imaging (bone scan) and a CT scan (vital organs) to determine whether the cancer has progressed. I had the dreaded scans a few days ago and now I await my appointment with the oncology team to review the results.

The whole ordeal feels like entering enemy territory without defenses. My peace is rattled as I sense a power and authority to direct the course of my life. But this is ridiculous. Scans have no power and authority. They are not an enemy. Scans are, essentially, objective knowledge; knowledge of the presence of disease. Scans are a kind of friend but a friend I don’t like or trust to make me feel good. I want friends to tell me what I want to hear. Scans tell it like it is. There is no sugar coating the truth of my physical innards. They may or may not reveal a need for surgery, chemicals and/or radiation to eradicate the sometimes-silent killers – the terrorist cells of the inner space. They can reveal news of intractable corruption and devastation that medical science is powerless to stop. Who wants friends like these? I don’t but yes, I do, but not really. Yes, really, I do. (Terrifying ambivalence!) What to do with such a truth-telling no-holds-barred friend? How am I to get a good night’s sleep the day before such a “friend” encounter? How do I calm down a nervous system that has been designed to be alert to threat? How do I calm the raging mind storm as the machines move up and down the body exposing and objectifying me as they take pictures of bones and organs?

Spiritual application:
In the New Testament the word of God is described as a type of scan – a scan of the heart and soul. And it’s that scan that I truly need to pay attention to. God’s in charge and I am his charge.

“For the Word that God speaks is alive and full of power [making it active, operative, energizing, and effective]; it is sharper than any two-edged sword, penetrating to the dividing line of the breath of life (soul) and [the immortal] spirit, and of joints and marrow [of the deepest parts of our nature], exposing {and} sifting {and} analyzing {and} judging the very thoughts and purposes of the heart.”
Hebrews 4:12

There are two types of scans that I have agreed to submit to. They both have authority over me. They both have knowledge of me. But as Lord Byron wrote long ago, “The Tree of Knowledge is not that of Life.”
According to Nicky Gumble of Holy Trinity Brompton in London there are different types of knowledge, and they are not all equally valuable. In French, there are two different words for ‘to know’. One (savoir) means to know a fact, the other (connaître) means to know a person. It is never enough simply to have knowledge of facts. To love a person, one must ‘know’ the person. Love resides in the ‘Who’ not the ‘What.’

Medical technology scans have authority in diagnosis that exceed my own, my doctors, my loved ones – anyone. They have a knowledge that transcends blood tests and feeling states. Scans are designed to guide a path of medical intervention. They don’t cause the problem; they expose the problems so that wise decisions can be analyzed and recommended.

But scans offer no hint to a meaningful existence beyond the body. Medical scans do not reveal corruption of the soul and a cure for it. Scans give no promise of redemption nor power for resurrection. Scans offer no love. And they certainly can’t inspire awesome wonder and respect. Christ fulfills all that and more.

So, this Thursday the door of the consultation room will open, my team will walk in, and my senses will be as alert as a gazelle listening for the approach of a lion. I will be comforted and loved by the faithful husband next to me, and by a medical team who truly care for me. And in that room the Holy Spirit (the Counselor, Comforter and Friend) will be present whether I sense His presence or not. I am known! I am loved! I will be ultimately loved and comforted no matter what

Does facing incurable cancer scare the hell out of you?

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I’ve always been interested in theological discussions and debates concerning the nature of hell among evangelical theologians. I have my “hard and fast” opinions about this serious matter but that won’t be the topic of this post. Sorry, for anyone out there who thought this was going to be a very provocative diatribe from an untrained non-seminarian theologian who admits to having strong opinions that she’s accustomed to changing. If you are interested, a report by the Evangelical Alliance Commission on Unity and Truth Among Evangelicals (ACUTE) called ‘The Nature of Hell’ outlines the differing opinions in clear and concise language.

Philosophical thoughts about cancer and mortality are frequent speculations. Recently, I looked for studies about what people with incurable cancer thought about hell. My cursory search didn’t turn up much, but I did come across a website for people voicing their thoughts about their diagnosis of terminal cancer. Hell was not a major topic, but one comment written over a year ago was difficult to read and generated a lot of responses from other sufferers. The commenter began with the following, “I have been told that I have 4 months to live and I am so afraid I am going to hell.” The responses were quick, empathic, and supportive. This woman’s heart-wrenching, brutally honest attempt to explain why she was in this frame of mind included her offenses to her family and specifically to her young daughter since her diagnosis. She felt conviction over the mess she had made of her life before diagnosis. But the real source of her anguish was the angry lashing out and jealousy towards healthy family members and friends.

I was moved by two observations. The first observation was the compassion extended by terminally ill responders who were compelled to try to make this woman feel better. Why were these fellow sufferers so compelled to help? Speaking from my own experience, there seems to be enough suffering to the illness as well as the grief of anticipated losses without added dread of future condemnation and alienation. That is unbearable. Like the others I was touched and wanted her to be at peace.

The second observation concerned the content of the responses. They ranged from:

1. On one end, “Forget about it, hell is a human construct that started in the middle ages by the church to secure their control and power over people,” to the other end,

2. A detailed lengthy comprehensive gospel presentation which was actually good if the sufferer could take it all in, to

3. The middle majority, which encouraged the writer to seek forgiveness from and reconciliation with those she admitted to hurting.

These posts were over a year ago. This woman may not still be alive, and the site did not show her response to the comments her original plea generated. Did she find peace? I hope so. If I had responded a year ago, I like to think I would have written:

“None of us are good enough to meet the holy standard of God. None of us. Thus, God himself in Jesus appeared 2000 years ago with a mission for securing our forgiveness. By simply trusting in his sacrifice by faith we are found perfect and acceptable before a perfect and holy God. Nothing is more liberating for the guilt-ridden. I know this. Then Christ fills our heart with gratitude and out of this grows the humility and courage to trust God to ask forgiveness from those we have offended.”

I hope she took the best of the advice and received the grace through Christ who forgives it all. I can’t imagine that if she sought her family’s forgiveness that she did not receive it from them. If she  did not, well, peace with God trumps all to secure her peace for eternity.
A recently composed hymn, “His Mercy is More,” says it beautifully. It was inspired by a sermon by John Newton, the creator of “Amazing Grace”.

“Our sins are many, but His mercies are more: our sins are great, But His righteousness is greater: we are weak but He is power.”

– John Newton

A Dangerous Cancer Diagnosis Revealed Surprising Parallels to the Good News

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A surprising diagnosis of metastatic breast cancer in December left my nerves frayed and my capacity to see the positive challenged. That is not quite accurate. Anybody who knows me well knows that my capacity to see the negatives in a situation is formidable. I like to refer to myself as a troubleshooter who can sniff out DANGER with remarkable neurotic accuracy, a source of endless frustration to a husband, who is a natural optimist.

My first consult after a series of scans taken 3 months into treatment was tense (you think!). Theresa, my oncologist’s right-hand nurse practitioner, read me the radiologist’s report which sounded alarmingly ambivalent to my ears and apparently my facial expression exposed my alarm.

“Dona, what is going on? I’m not encouraging you. I can tell by looking at you. “

All I was hearing was something like this little tune, “Cancer here, cancer there, a little cancer sprinkled everywhere.”

She tried again to give me the report’s findings with more color commentary and positive caveats. No dice, I just couldn’t hear what was good in the report.
Finally, Theresa looked at David, “David, help me out, why am I not able to encourage Dona?”

They started talking about the way I process new information as if I wasn’t in the room. I finally said, “OK, Theresa, bottom line – should I be happy from what I’m hearing? It sounds confusing and unconvincing.”

Theresa’s response helped, “Dona, you should be ecstatic!”

I breathed my first deep breath. But as David explained, I still needed to process (David, gets me and most of the time he is supernaturally patient. Bless him). I hounded him the next few days with a ton of questions. I wanted to understand and emotionally experience the good news of this first 3 months of treatment on a new drug.  Since that day I’ve wondered about my reactions and wondered whether there were spiritual parallels.

Life and death information takes serious processing
I, like most people, want straight forward explanations. If people are like me, they want a simple dopamine rush of good news; end of story, no caveats and no qualifiers.
I was confronted with a report about life or death. If ever there was a time to seek clarification and interpretation wasn’t that the moment? I can be forgiven for not being easily placated considering the gravity of my health situation. There was another problem. I was mentally and emotionally dense to the language, descriptions and vocabulary of this serious diagnostic report. I needed help to figure this out. Where was the good news? I kept asking until it finally seeped in, but it was a struggle.

There was another time long ago when good news didn’t sound immediately like good news. When I was an undergraduate, I was walking a dorm hall and was roped in to a bible study in a dorm room. By the time I left I was handed my first New Testament. I read and read and read. The good news that these dorm Christians were talking about was escaping me. The more I read the worst I felt about my spiritual condition and how little my life reflected the teachings of Jesus. I wasn’t getting this good news thing. In retrospect, I was feeling the bad news of being a sinner. The good news – relief from disappointment and guilt – was only a whisper at that point. I entertained chucking it for something spiritually benign, mellow and nonjudgmental. I tried transcendental meditation but continued private reading of the New Testament. Jesus was compelling, but he said some things that I didn’t understand or even like. Some of what was written provoked an angst that was akin to despair. I wanted to read something that made me feel good and accepting of where I was with no changes required. Where was this good news? This New Testament document was serious. There was an alarming truth that intuitively felt like I was being confronted with life and death. I got that far but I was stuck.

Clarification and interpretation are needed
I needed help with the vocabulary and concepts of the New Testament. I had questions, tons of questions, with no one to go to but books that I read while sitting on floors of book stores and libraries. Eventually I found smarter, wiser and older people than me to throw all my questions. I was a dog on a bone; stubbornly holding on but growling along the way, refusing to be distracted or relaxed. Accepting this Good News about Jesus without fully understanding would not stand the test of time. Giving up on the whole thing was a viable option – too much cognitive dissonance. But in hindsight that ‘dog on a bone’ compulsion was a gift of the Holy Spirit. I had to face and humbly accept the bad news about myself to get to the good news: that through believing in Christ, his sacrifice and resurrection, I could be forgiven and receive the peace I had been longing for. Ultimately, I received the good news, ended the growling and began to enjoy and relax within the joy of my “bone”.

Final parallel: Discipleship can feel like medical treatment
Long term Christian discipleship, all those moments of your life after you receive the Good News, many times is like reviewing the reports of full body scans and looking for malignancies. The news can be bad. We may realize there is more work to be done. Questions and doubts will come up. A treatment plan may need to be developed and rigorously implemented in ways that are not comfortable. However, we will have the Great Physician treating and encouraging us to “fight the good fight” for knowledge of the truth and then persevering (2 Timothy 4:7) until that one day when we rest in the presence of God forever.

Guest Post: I Gave Her Bad Advice

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The following post is from my husband, David.

Can a positive attitude affect breast cancer survival? No. It can even hurt.

Since we learned that Dona’s cancer had returned and spread, I have encouraged her to stay positive, think positive, be optimistic. I told her studies have shown that a positive attitude is linked to survival. img_3576

As it turns out, I was wrong. I was giving her bad advice; advice that was not just unhelpful but potentially harmful.

A 9-year study of nearly 1100 cancer patients by the University of Pennsylvania School of Medicine found no relationship between positive outlook and cancer progression and death. At least two additional well designed and implemented studies support these findings. Based on what researchers know now about how cancer starts and grows, there’s no reason to believe that negative emotions can cause cancer or help it grow.

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Not always the best plan

And, as I learned, encouraging a cancer sufferer to stay positive can be anti-therapeutic. It can hurt, particularly when the ‘encourager’ links positive outlook to longevity, like I did.  I placed an additional burden on Dona, who has enough on her plate managing fear, side-effects, and me. Although she never said so, I was likely creating guilt and discouragement during the times she was unable to muster up a positive attitude.

But the impulse is natural. We want to believe that we have the will-power to control the outcomes of a serious illnesses.

Moreover, amongst Christians, we link healing to faith. On the extreme end, the ‘health-and-wealth gospel’ purveyors contend that healing can only come from the certainty of our belief in God’s promise of physical well-being. Without knowing, I may have been playing in to this.

Do I believe that God can heal Dona miraculously? Yes, I’m praying He will. Do I believe He must heal if she or I have unwavering faith? I can’t convince myself that is true. God can heal anyone, anytime, with or without my faith. Linking the certainty of my faith directly and solely to healing places too much burden and power on me. But at the same time, I’m reminded that Jesus told us to believe that we will receive whatever we ask for in prayer (Mark 11:22-24; Matthew 21:19-22). I’m asking Jesus to take my mustard seed of faith and use it however He wants. (Matthew 17:20) If this sounds like I’m waffling, I am. Looking at my own weakness, I take comfort in the father who asked Jesus to heal his child who was afflicted with terrible seizures. He told Jesus, “Lord, I believe, help me in my unbelief.” (Mark 9:21-29)

And then, almost a companion piece to the name-it-and-claim-it Christians is the typical American temperament which ignores mortality and promotes self-determination.

“Fix it, avoid it, or fight it. It is entirely within your control. You can prevail!”
“Cancer won’t win. Just believe you are going to beat it! Be a fighter!”

Dona hates the term, ‘she was a fighter’. She asks, “What’s the corollary for someone who dies of cancer? She was a loser?”

The way forward

Dona is not at death’s door. She has a cancer that is not curable, but it is treatable. She is getting the best treatments for the best possible outcome.

But delusional optimism, that positive thinking will control cancer, is, well,  delusional. Living with hope, however, is essential.  Author and pastor, Tim Keller says,

“The way you live now is completely controlled by what you believe about your future.”

Our pastor, Steve Schenk, told us in a recent sermon:

“Despair is believing there is no way forward. Hope, for the sufferer, is believing there is a path forward.”

How does Dona see a way forward in hope with metastatic cancer? She combines deep theology with practical behavior. To date, I have watched her employ over a dozen different techniques in constructing a path ahead. I would like to list them, but Dona nixed that. She reasons that, one, it would make this post over 2000 words and, two, it places undo emphasis on her behavior.  Fair enough.

But I will write that her efforts, habits, and musings promote hope and joy. And experiencing joy where we can find it has been one of our objectives since we started this journey.  Joy, as we Christians know it, has less to do with our circumstances and more to do with a settled assurance that God knows our condition and that nothing: cancer, grief or even death itself, can separate us from his love. (Romans 8:35-39)

So, how can I help Dona? I asked her and she told me,

“Pray for me, read scripture to me, point me to the reason for my existence, remind me that this reality is not the only reality, and have fun with me. And do these again and again and again and again.”