February 26, 2007 - Trouble Enough

I’ve been encouraged to learn, in recent days, about a new cancer-related service organization that will soon be opening a facility in our area. The Wellness Community is a national organization that provides supportive services to cancer survivors and their families. The new facility, The Diney-Goldsmith Center, operated by The Wellness Community of the Northern Jersey Shore, will open in Eatontown on April 1, 2007.

I’ve known about The Wellness Community (the national organization, anyway) for some time. I think I first read about it in comedian Gilda Radner’s cancer memoir, It’s Always Something. Gilda found a support system there, as she was coping with her ovarian cancer. The Wellness Community must have been a very significant place for her, because, at her death, her family asked that memorial contributions be made to the organization.

The local chapter’s newsletter speaks of “3,500 square feet of space ample enough for multiple support groups, light exercise, mind/body programs, educational workshops, nutrition and cooking demonstrations, social events and more.” These services will all be provided free of charge.

Visiting their website today, I find some material that applies to my particular situation, as a lymphoma patient in remission:

“Thanks to improvements in early diagnosis and treatment, some forms of lymphoma have become more of a chronic illness for some people. That means that perhaps you might have recurrent cycles of disease, treatment, then recovery. Relapse may occur in all types of lymphoma. A lot of people have shared that the fear of recurrence seems overwhelming, especially when treatment ends. The challenge is learning to live in the moment, balancing the fear of recurrence with the desire to enjoy health and wellness.”

“Relapse” is, indeed, the dreaded word for people like me. My next PET and CT scans are scheduled for a week from now. It’s not that I’m spending a lot of time actively thinking about those scans – but, the awareness is always there, in the background, a sort of low-level emotional noise. When I was initially diagnosed, I was not aware of any symptoms. The disease crept up silently, and ambushed me from behind. I suppose that, should I ever have a recurrence, it could very well happen again in just that way: with no warning.

I’m feeling pretty good these days, physically. I’ve been working out at a local health club, the Atlantic Club, and find that it’s helping my energy level and general sense of well-being. Every once in a while, I reach up to the spot on my upper chest, just below the right shoulder, and feel the little knot under the skin. It’s my implanted port, the only physical reminder I still have of my cancer treatment.

Yet, the disease is still with me, and will continue to be with me, even if the scans come out clean. It’s the nature of cancer, and the reason why facilities like The Wellness Community, and the Cancer Concern Center here in Point Pleasant Beach, are necessary.

“The challenge,” says the write-up on The Wellness Community website, “is learning to live in the moment.” Oh, yeah. That about sums it up. We cancer survivors all too easily live in the past, remembering our past struggles, or in the future, dreading that which could (but may not, in fact) be. In the Sermon on the Mount, Jesus has a little something to say about that:

“So do not worry about tomorrow, for tomorrow will bring worries of its own. Today’s trouble is enough for today.” (Matthew 6:34)

The novelist, Anne Lamott, has that same sort of thought on her mind, as she recalls:

“Some mornings I wake up and I instantly feel discouraged by the world and my government and by my own worried mind. It's like my brain has already been up for awhile, sitting on the bed waiting for me to wake up. It’s already had coffee, and has some serious concerns about how far behind we are already. So I always pray, first thing upon awakening, very simple prayers like the one [my son] Sam prayed years ago when his head got caught in the slats of a chair: ‘I need help with me,’ he whispered…. I know that most of the time, for me, the only real problem is, that left to my own devices, I am on my own mind almost all the time.” ("Every Sandwich," Salon.com)

Let’s hear it for getting ourselves off our own minds! Today’s trouble is surely enough, without borrowing some from tomorrow.

February 12, 2007 - More Than Conquerors

Today, I read an e-mail from my friend, Bill, who sends me a link to some stuff Walter Wangerin has been publishing online. I’ve admired Walt’s work for some time, now. He’s a Lutheran college professor, novelist and preacher, who’s got a wonderful way with words.

What I learn, after visiting his website, is that Walt and I have something in common: cancer. His, too, is lodged in his lymph nodes, though it didn’t start out there. It’s lung cancer, that’s metastasized to several other parts of his body. He started treatments about the same time I did – both chemo and radiation – and his road has been harder than mine.

Walt’s written a series of letters to friends and family members, describing his ordeal. They’re posted online. This isn’t highly polished prose. He wrote some of them in the chemo suite, while hooked up to the I.V.

In his most recent installment (December 13, 2006), Walt reflects on the violent imagery many people use to describe cancer treatment. For a variety of reasons, that imagery makes him uneasy:

“I have never construed my cancer as my enemy. No, I do not judge others who do (thoughtfully) choose it, for whom ‘fighting’ may be a helpful stance and attitude. On the other hand I am critical of the media when, without genuine thought or analysis, it routinely declares in its death notices, that so-and-so died ‘after a long battle with cancer.’ Why does it have to be a ‘battle’? What: are folks with cancer good fighters if they win? Bad fighters, failing knights, if they lose? Can they be heroic only in triumph? It really isn't an issue of defeat or victory. We are all going to die: what a terrible, terribly total annihilation such language must make of our slaughters individual and wholesale, of our universal losses to sickness, disease and death.”

Walt’s musings put me in mind of some words I frequently use in my ministry, from chapter 8 of Romans. It’s one of the most beloved of all scripture passages, in which Paul triumphantly proclaims: “...neither death, nor life, nor angels, nor rulers, nor things present, nor things to come, nor powers, nor height, nor depth, nor anything else in all creation, will be able to separate us from the love of God in Christ Jesus our Lord” (Romans 8:38b-39). I read those words at nearly every funeral I conduct. I figure it’s a good thing to remind grieving people that, in the providence of God, love goes on.

Yet, just a few verses earlier, as Paul’s cranking up to deliver his soul-stirring theological riff, he blurts out a jarring verse, one that seems to contradict his otherwise triumphant language:

“As it is written,
‘For your sake we are being killed all day long;
we are accounted as sheep to be slaughtered’” (v. 36.)

Coming, as it does, between “If God is for us, who is against us?” and “Nothing can separate us from the love of God,” the image of sheep waddling up the ramp into the slaughterhouse seems just a wee bit incongruous. Where’s the comfort in that?

Much as I hate to cut-and-paste the scriptures, for many years I used to skip over that verse at funerals. “Why inflict such graphic imagery on grieving people?” I used to reason.

I don’t skip over it anymore. The bereaved don’t need the easy certainties of feelgood religion. They already know the feeling of a sharpened knife to the neck. Paul didn’t intend those thrilling words about God’s invincible love for those whose lives are placid and calm, who are winning life’s battles. It’s for those who fear they’re losing, and worry that the time of slaughter is drawing near.

Walt Wangerin suggests that, rather than focusing on winning “battles with cancer,” we ought to talk, instead, about how cancer survivors find the courage to hold their heads high as they endure the disease, and even face death:

“Why not use the imagery that acknowledges how one experiences dying? – how one behaves in the face of death? – what one has to offer those who stand by in love and relationship?... Before sciences and the medical profession began (indirectly) to persuade us that cures could be possible for every disease we might diagnose, describe, explain and name; before commercials began to establish it as a principle that each affliction identified also had an antidote; before our society made ‘feeling good’ an individual human right (setting at enmity anything that made us feel bad) we did not have so self-centered, so childish, so simplistic, so unavailing and purposeless a frame of reference for the experience of sickness-unto-death.... Sickness is not an enemy. It is a rooster's crow, calling me to the truth of myself and to the precise condition of my relationships – God, society, nature.”

We live with cancer. After a while, it becomes like a member of our family (a meddlesome interloper, to be sure, but a member of the family nonetheless):

“For my own part, I recognize cancer cells as parts of me (of Walt, the body-soul continuum), tissue which is part of all my tissue – even as my children are a parts of our family (without whom the family itself would be something else). They (whether cells or kids) become selfish, demanding more of the resources of the family (of the body) than other members can receive. My children are not my enemy. And my diseases, far from acting the foe, are profound initiators of spiritual clarity, devout meditation, a faithful (a peaceful!) seeking after God, praying, shaping thanksgivings for Jesus’s re-building of the relationship between God the Father and me.”

Walt’s right – and so is Paul. Whether we win the cancer battle, or whether we lose, we are so very much more than conquerors.

February 11, 2007 - Small

I’ve been thinking about the vastness of the universe. Today, I preached about it. It’s Evolution Sunday, a day when some of us preachers are trying to help our people understand that religion and modern science are not adversaries, but rather two different ways of describing truth. Here’s some of what I said:

“I remember, when our kids were in grade school, helping them with the obligatory model-of-the-solar-system science project. I can vividly remember helping our son Ben make his model of the solar system. We took a cardboard box, and cut out one of its sides. Then, we covered the inside with black construction paper. Styrofoam balls came next, in various sizes. We hung them from the top of our universe-box with black thread. In the end, what we had was the nine planets (we still had nine, back then), which Ben colored with magic markers, to approximate the colors he saw in his science book.

The only problem is, our model was not to scale. It couldn't possibly be to scale: because we'd have needed a box so big, we couldn't have gotten it into the car, let alone carried it into the school building.

Science writer Bill Bryson describes it this way. Imagine the earth as a pea. Jupiter would be a thousand feet away. Pluto (that planet that, as of last year, is no longer a planet) would be a mile and a half – but Pluto is so small, compared to the size of the pea-sized earth, you'd never even see it. At that distance, it would be like the size of a bacterium. [Bill Bryson, A Short History of Nearly Everything (New York: Broadway Books, 2003), p. 24.]

And that's just the solar system. Venture out beyond Pluto, into the realm of the stars, and the distances become unimaginably vast. One writer has described it this way.

Imagine that each star in the known universe is represented by a grain of sand. How many stars are there in the Milky Way, the galaxy in which we live? Enough to fill a large wheelbarrow. That's 100 billion grains - 100 billion stars are out there, each one potentially capable of having planets circling it.

Now, imagine that you took a thimble, and dipped into that pile of sand in the wheelbarrow. Your thimble would scoop out at least 10,000 grains of sand. That's more than enough to account for all the stars you and I can see from the earth, if we stand outside on a clear, dark summer night and gaze up at the heavens.

OK, so the wheelbarrowful is the Milky Way, and the thimbleful is the stars we can actually see with the naked eye. How many stars are there in the entire universe?

To answer that question, we have to think of a freight train, pulling great, big hopper cars full of sand. Now, if a wheelbarrow represents the Milky Way, then each hopper car holds enough sand to represent hundreds of galaxies like our own. Imagine that the train cars begin to pass us, one by one, at the usual speed of a freight train. We're sitting in a car at the railroad crossing, waiting for the train to pass before we can drive across. How long will be sit there, counting railway cars, before we finally see the caboose?

Three years. Three years of sitting and counting hopper cars – each one of those cars containing hundreds of Milky Way galaxies!” [Based on Terence Dickenson and Jack Newton, Splendors of the Universe, Firefly books, 1997; cited by Ralph Milton in the Rumors e-newsletter, June1999.]

My journey with cancer has been a journey of faith, all along. I can’t claim to have had any blinding revelations, any burning-bush moments. Yet, from the day of my diagnosis until now, I’ve quietly sensed that God has been present, through it all.

I haven’t asked for, nor expected, any special favors from the Almighty. I’ve prayed for healing, and welcomed the healing prayers of others, but I’ve never felt entitled to it – not more than any other person, anyway (no, ordination doesn’t have its privileges, not in that way).

Yet, through it all, I’ve felt the silent nearness of God. And that’s been enough.

I suppose I should feel lucky. I haven’t had the experience of feeling abandoned, nor have I become fixated on the “why” question: on the unfairness of getting lymphoma at age 49.

Given the vastness of the universe, the psalmist’s wondering words make sense. I’ve cited them before, in an earlier journal entry:

“When I look at your heavens, the work of your fingers,
the moon and the stars that you have established;
what are human beings that you are mindful of them,
mortals that you care for them?”
- Psalm 8:3-4

What are we, indeed?

February 7, 2007 - A Glimpse of the Grail

Today I read a news article about a breakthrough in the field of cancer research. It seems researchers at the University of Michigan have, for the first time, identified stem cells that lead to the growth of pancreatic cancer tumors. This is very good news, because it gives pharmaceutical-company researchers a target to aim for, as they seek new medicines to block the advance of this deadly disease.

I remember Dr. Lerner telling me, as he first diagnosed my cancer, that if – hypothetically speaking – I could choose which form of cancer to have, Non-Hodgkin Lymphoma would be one of the leading choices. That’s because modern medical science offers several effective treatment options. Research breakthroughs in the past ten or twenty years are largely responsible for this remarkable progress.

If that’s true, then pancreatic cancer is one of the worst forms of the disease to have. When medical tests reveal malignant pancreatic cells, doctors have little recourse other than to dispense the ominous advice, “It’s time to get your affairs in order.” Often, these patients’ lives will be measured in weeks, not months. The article about the University of Michigan breakthrough provides these grim statistics:

“About 33,700 people will be diagnosed with pancreatic cancer this year, and about 32,300 will die from it. Five year survival rates are a dismal 3 percent. The disease is difficult to detect early and is often diagnosed at advanced stages. Only 10 percent to 15 percent of patients can benefit from surgery.”

A pancreatic cancer diagnosis is a virtual death sentence, with no appeal. Yet, now, for the first time, there’s some hope on the horizon. An effective drug is still years off – sadly, not soon enough for those being diagnosed today – but it surely will come, eventually.

I know a person who was diagnosed with pancreatic cancer. He’s still alive today – not because his disease was cured, but because he was misdiagnosed. In the space of a week or two, he went on the emotional roller-coaster ride to end all emotional roller-coaster rides, as subsequent tests revealed the doctors’ mistake.

We live in remarkable times. “Finding a cure for cancer” remains the holy grail of medical research – and, like the holy grail of ancient legend, it may be just as elusive. Yet, as today’s medical knights-errant ride off in search of their shining prize, they’re discovering all sorts of lesser cures along the way. It’s even possible – as some researchers have speculated – that there may be no single disease called, simply, “cancer.” The word may refer to a large, loose-knit family of disorders that display some common characteristics, but which won't all respond to a single treatment. If that’s true, then victory will ultimately be achieved through the cumulative weight of many small breakthroughs, rather than a single, paradigm-busting discovery.

Either way, the University of Michigan report is good news. For patients with every form of cancer, this sort of thing gives us hope.