Monday, October 27, 2008

October 27, 2008 - George Herbert on Prayer

In my study-leave reading, I ran across a remarkable poem by George Herbert. I’ve long admired the poetry of this seventeenth-century Welsh divine. Herbert, a sickly man from a noble family, was ordained a priest at mid-life and labored in an obscure country parish. He died soon after, and would have quickly been forgotten were it not for his poetry, stunning in its imagery and use of the English language.

Reading a George Herbert poem is not easy. Like the scribblings of Shakespeare, his writing is studded with archaic vocabulary. To the persistent, though, what seems dense and incomprehensible at first slowly reveals hidden treasures.

Here’s the poem:

Prayer (I)

Prayer the Churches banquet, Angels age,
Gods breath in man returning to his birth,
The soul in paraphrase, heart in pilgrimage,
The Christian plummet sounding heav’n and earth;

Engine against th’Almightie, sinner’s towre,
Reversed thunder, Christ-side-piercing spear,
The six daies world-transposing in an houre,
A kinde of tune, which all things heare and fear;

Softnesse, and peace, and joy, and love, and blisse,
Exalted Manna, gladnesse of the best,
Heaven in ordinarie, man well drest,
The milkie way, the bird of Paradise,

Church-bels beyond the stars heard, the souls bloud,
The land of spices, something understood.

So, what is prayer, anyway? Herbert’s answer comes in the form of metaphors, slung at us readers rapid-fire. Their meaning is so rich, you have to spend a little time with each one, turning it over and over in your hands...

“the Churches banquet”
– a biblical allusion, to any one of a number of passages that see the life to come as a rich feast. Isaiah sings of “a feast of rich food, a feast of well-aged wines,
of rich food filled with marrow, of well-aged wines strained clear”
(25:6). Jesus tells a parable about a host so determined to fill every seat at his banqueting-table that he throws the doors open to street people (Luke 14:15-24). “You that have no money, come, buy and eat!” (Isaiah 55:1). Prayer is a feast, to which all are invited.

“Angels age” – Since Herbert doesn’t use apostrophes to indicate possession, this could mean “angels growing older,” or it could be – with an apostrophe – “the era of the angels.” I think it’s the latter. There’s something timeless about prayer.

“Gods breath in man returning to his birth”
– The poet of Genesis sees life as breath: the Creator God breathing life into nostrils of inanimate clay. To Herbert, prayer is a sort of exhalation, an exchange of respiration.

“The soul in paraphrase”
– To paraphrase dense prose is to render it understandable. In prayer, the human soul gives voice to its subtlest heartbeat, its deepest longing.

“heart in pilgrimage” – This one’s self-evident. Prayer is a long and deliberate Godward journey. It also suggests that prayer is best engaged as a long-term discipline.

“The Christian plummet sounding heav’n and earth”
– To us, “plummet” means to drop or fall, but it’s related to an old word for “lead.” The plumb is a lead weight a builder hangs from a line, in order to build a perpendicular wall. Ancient mariners would fling a lead weight overboard, attached to a line, in order to gauge the ocean’s depth. This technique was called “sounding.” Prayer, then, helps us test the depth of dark and incomprehensible mysteries.

“Engine against th’Almightie, sinner’s towre”
– The next few lines are about prayers of lament or imprecation: angry prayers that give honest voice to human pain and frustration. The “engine” is probably a siege engine, the ponderous wooden contraption an attacking army would wheel up against a city wall. Some of these siege engines were so tall, they could be called towers. A woman in my lymphoma support group was speaking recently of how her cancer has led her to ask the “Why me?” question. Cast in the form of prayer, such a question is an “engine against th’Almightie.”

“Reversed thunder” – If God sends thunder and lightning upon the earth, then prayer is our means of sending it rumbling right back. “The crash of your thunder was in the whirlwind; your lightnings lit up the world; the earth trembled and shook” (Psalm 77:18).

“Christ-side-piercing spear”
– Here, the poet considers the full implication of prayers of lament or imprecation. Such prayers, while honestly voicing human pain, are as the spear that pierced Christ’s side.

“The six daies world-transposing in an houre” – Prayer actually compresses time, wrapping the six days of Creation up as in a single hour.

“A kinde of tune, which all things heare and fear”
– There’s an old tradition of singing our way through suffering. Think of African-American spirituals, or the rhythmic chanting of chain gangs. As long as Christians can still sing, as long as they can still pray, oppressors hear and tremble.

“Softnesse, and peace, and joy, and love, and blisse, exalted Manna, gladnesse of the best” – Prayer is power, but also it gives voice to feelings of deep and perfect peace.

“Heaven in ordinarie, man well drest” – Herbert returns to his earlier image of reversal, of dynamic exchange. Earlier, he described an exchange of breath (“Gods breath in man returning to his birth”). Now, he gives us an exchange of wardrobe. In prayer, heaven takes on the garb of an ordinary peasant, while humanity is attired as a grandee. In Herbert’s time, clothing instantly revealed what level of society its wearer belonged to. Laborers who habitually wore “ordinarie” homespun could never aspire to the silk doublets and hose of the nobility, let alone the fine cloth and lace collars of the rising merchant class. Prayer, however, is equally accessible to all. It flattens the most pronounced social division of all, that between earth and heaven.

“The milkie way, the bird of Paradise”
– Exotic images, these. Prayer allows us to reach out and touch the unattainably beautiful.

“Church-bels beyond the stars heard” – One of my most enduring memories of my year at Oxford in 1976-77 is the weekly, Sunday-evening rehearsal of the change-bell ringers. For an hour or so each Sunday, the skies above that town of many spires echoed the glorious cacophony of the bell-carillons, their ringers all practicing at once. It seemed like those melodies could reach even to the stars.

“the souls bloud” – Someone once observed that, if writing is the act of transforming blood into ink, then the dramatic act of speaking it aloud is the transforming of ink into blood. As the poet pours out the blood of human experience upon the page, so too does the poet transform “the soul’s blood” into the words, or even the silent communion, of prayer.

“The land of spices” – Another exotic image. To people of Herbert’s time, the far-off Indies, the spice islands, exerted an exotic and compelling pull on the imagination.

“something understood” – Herbert’s final metaphor for prayer is his simplest and most compelling, in an understated way. When we pray, often and with regularity, we gradually come to understand.

Friday, October 24, 2008

October 24, 2008 - Communitarians, Arise

I’m on study leave for a few days, at our Adirondacks place. I’ve got quite a pile of accumulated books and journals to plow through.

The first thing I pick up to read is the September 9th issue of The Christian Century, whose news briefs section cites some political commentary from a column by E.J. Dionne. U.S. history, Dionne observes, is a back-and-forth tug of war between individualistic and communitarian impulses. The Century summarizes Dionne’s argument: “Dionne thinks there is a communitarian correction after a period of time when the individualistic metaphor of free markets reigned supreme. McCain’s notion of honor associated with the military is more communitarian than individualistic, and Obama’s slogan ‘Yes we can’ reflects deep communitarian commitments.”

My generation, the Baby Boomers, advanced communitarian ideals through the social upheavals of the 1960s, then settled in for a long period of individual striving. Many of us traded George McGovern for Ronald Reagan, backpacks and sandals for briefcases and wing-tips. We trekked from Woodstock to Wall Street.

Our parents’ generation, the “Greatest Generation,” traversed similar territory in their time. They cheerfully pitched in with Victory Gardens and rationing coupons during the World War II years, then traded in their communitarian values to raise nuclear families in the up-and-coming suburbs.

Ronald Reagan’s political revolution was an emphatic, angry resurgence of individualism. The recent near-collapse of the financial markets – brought on by the absence of government regulation – is the natural conclusion of the Great Communicator’s program. These developments have exposed the central economic dogma of Reaganism – that unfettered individual striving will result in “trickle-down” communal benefits – as a fraud. Greed has done what greed always does, left to itself. It has nearly wrecked our society. Now, as Dionne astutely observes, both presidential candidates are speaking communitarian language again. The one who is most adept at it – Obama – seems poised to win the election.

The other night, I attended the monthly blood cancer support group sponsored by the Leukemia and Lymphoma Society. What could be more communitarian than a bunch of people sitting around in a circle, sharing their stories and seeking to uphold one another? It would seem the way to health – for us as well as for our nation – lies in facing the beast together, rather than alone.

Wednesday, October 22, 2008

October 22, 2008 - Keeping Faith in Anxious Times

I’ve just finished a 3-part sermon series on living with anxiety. What I had in mind, as I preached these sermons, was the current economic situation. After enduring the one-two punch of collapsing real-estate values and the Wall Street meltdown, the American public has been living with high levels of anxiety.

Here’s a short excerpt from the first of these sermons, “KEEPING FAITH IN ANXIOUS TIMES, I: REPAIRING THE CISTERN”:

“Some psychologists – borrowing language from medical science – draw a distinction between acute anxiety and chronic anxiety. Acute anxiety, they say, is related to some immediate threat. If you step out of your front door, for instance, and come face to face with a grizzly bear, that’s acute anxiety you’re feeling. No surprise, there. Yet, if you wake up each morning with a sense of free-floating dread – but have little idea where these dark feelings are coming from, nor any idea when or how you’ll break free from them – then, chances are, you’re a victim of chronic anxiety.”

Acute anxiety, anyone can understand. A newly-diagnosed cancer patient, getting ready to scoot over onto the operating table or receive that first chemo treatment, will quite naturally feel anxious. It’s the patient in remission, or maybe – like myself – out of remission but in a long-term watchful waiting regime, who feels chronic anxiety.

Here’s another excerpt, from the same sermon:

“The word “anxious” is historically related to a Latin word, angere, which literally means “to choke or strangle.” If anxiety gets its bony fingers around your neck for any length of time, you’ll soon be gasping for breath. There’s another English word that races its lineage to the same Latin root. The word is angina – which, as you surely know, describes the sharp, piercing pain that precedes a heart attack. Angina arises when one of the coronary arteries is choked off by arterial plaque, blocking oxygen from reaching the heart muscle. Anxiety, in other words, can kill you.

Another English word that grows out of this Latin root, angere, is “anger.” Anxious people, as it so happens, are often angry people. They sense the breath of life being choked off from their soul – and so they lash out, flailing wildly in an effort to remove the threat, whatever they imagine it to be.”

I borrowed some of this stuff from Peter Steinke's book, Congregational Leadership in Anxious Times (Alban Institute, 2006).

I was preaching, that day, on a passage from the book of Jeremiah. The prophet blasts certain faithless people: who – in his eyes – “have forsaken [God], the fountain of living water, and dug out cisterns for themselves, cracked cisterns that can hold no water.” (Jeremiah 2:13)

I think that cistern image has a lot to teach us. If the spiritual sustenance God provides for us is like a spring of water, then religious practice is a method of gathering that water into cisterns. It’s a beautiful thing when God provides us with what we need, spiritually, right on the spot, but it doesn’t always happen that way. Sometimes we need to rely on water stored in the cistern. If we neglect the regular practice of our faith, we can end up with “cracked cisterns that can hold no water.”

Many of us cancer survivors live with chronic anxiety every day. A significant step in the journey towards healthy survivorship is learning to recognize it for what it is, and name it – but not letting it master us.

I don’t think we ever solve our anxiety, or cure it. We’ve got to learn to live with it.

Much as we learn to live with our cancer.

Thursday, October 16, 2008

October 16, 2008 - Got Dem Watchful Waitin' Blues

Today I run across a couple new 3-minute web videos on the Lymphoma Research Foundation website. Several of them seem more or less made-to-order for my situation.

One focuses on twenty- and thirty-somethings with indolent lymphoma. I don’t fit that age category, of course, but I’m still younger than the average lymphoma patient. It’s a pretty good discussion on indolent disease, and how different it is, conceptually, from other cancers:

Click HERE.

Another describes the Watchful Waiting approach to treatment:

Click HERE.

“That’s one of the differences about indolent lymphoma that’s difficult for people to get past,” says one indolent lymphoma survivor on the Watchful Waiting video. “It’s always a present tense.”

Indeed it is. Other cancer survivors are either in treatment, or in remission, or they’re cured. They get some sort of resolution eventually. We indolent lymphoma survivors live in an eternal present.

The trick, I suppose, is to find some way to get our future back again, to escape that eternal present.

Wednesday, October 08, 2008

October 8, 2008 - Better Living Through Web Crawling

There have been lots of technological developments in recent years that have revolutionized cancer treatment. One of the most revolutionary of all, though, is a change whose impact is indirect, even as it is massive.

You’re participating in it right now, as you read these words. It’s the Internet.

A September 29th article
in the New York Times highlights the many different ways patients deal with this vast ocean of medical information at their fingertips:

“Information gives some people a sense of control. For others, it’s overwhelming. An acquaintance of this reporter, a New York father coping with his infant son’s heart problem, knew he would be paralyzed with indecision if his research led to too many choices. So he focused on finding the area’s best pediatric cardiologist and left the decisions to the experts.

Others, like Amy Haberland, 50, a breast cancer patient in Arlington, Mass., pore through medical journals, looking not just for answers but also for better questions to ask their doctors.

‘Knowledge is power,’ Ms. Haberland said. ‘I think knowing the reality of the risks of my cancer makes me more comfortable undergoing my treatment.’”
(Tara Parker-Pope, “You’re Sick. Now What? Knowledge Is Power,” New York Times, September 29, 2008)

My personality type is obviously closer to the second of these two patients than to the first. One of the first things I did, even before my diagnosis was definite, was to high-tail it to library. What I couldn’t find on the library shelves, I began searching for – voraciously – on the internet. Before long, I had a basic knowledge of lymphoma and the underlying biological systems that are affected by it. My doctors know vastly more than I, of course – I never pretend otherwise – but at least we’re able to converse together with some degree of mutual understanding.

Not everyone’s like this. I know some fellow patients who put themselves, wholly and completely into their doctor’s hands, saying, “Please don’t overwhelm me with details, Doc. I trust you, and I trust you to tell me what I need to know about my condition.”

There’s no right or wrong here. It’s a matter of style.

Vive la difference.

Monday, October 06, 2008

October 6, 2008 - Got Cancer? Better Keep Your Job.

This excerpt from a recent news article tells a story that’s – sadly – all too common today, in the dysfunctional world of American medical insurance:

“Most experts acknowledge that people who have cancer or have recently beat it have a tough time finding individual coverage – a fact Angela Clay of Atlanta discovered the hard way.

Clay, 33, was diagnosed with non-Hodgkin's lymphoma eight years ago, while she was living in South Carolina. She survived, thanks to a regimen of chemotherapy, radiation and stem cell treatment, for which she was covered through her job at the time. After she moved to Atlanta in 2001, she had coverage through her job as a teacher in a day care center.

Then another center offered her an assistant manager position in 2004 – a step up with better pay but no benefits. Clay figured she'd simply buy insurance. ‘I'd go online once a month and fill out applications,’ she says. The numerous insurers she has tried turned her down, she says, and one told her she had to be in remission for 10 years to receive health insurance. ‘I've got more than two years to go,’ Clay says.

Clay still has no coverage and so must put off nonemergency medical care, including the follow-up she needs to be sure the cancer hasn't returned. ‘I'm very worried,’ she says. ‘I know I need checkups for my health. It makes me feel vulnerable.’ She sees a doctor only for emergencies, such as a severe boil she developed in January. (She's still paying off the $800 it cost to have the doctor drain it, at $20 a month.) Clay fears the stress of living without insurance will further harm her health. ‘It's hard for me to focus because I have this on my mind,’ she says.”
(Jonathan Cohn, “When you are denied health insurance,”, October 6, 2008)

This is a difficult position for cancer survivors to be in. You’ve gone through treatment, you’ve been declared to be in remission, you’re feeling fine – but, you’d better think twice about taking that new job, because it means switching medical-insurance carriers. You do that at your own risk – maybe even at risk of your life. Once your new employer’s insurance carrier gets wind of your medical history, they’ll drop you like a hot potato (or, they’ll accept you only if you agree to a hefty pre-existing condition exclusion – which amounts to pretty much the same thing).

Cancer survivors in remission yearn for nothing more than to get on with their lives. But, if they are in an occupation in which advancement typically happens by switching to a new employer, getting on with their work lives may be an impossible dream. Because of the pre-existing condition shell game, their cancer history has effectively doomed them to give up all hope of advancing in their profession.

It’s just one more example of the numerous cruel “gotchas” that are lying in wait for cancer survivors, in the dark recesses of our broken healthcare-funding system.

I’d love to hear the Presidential candidates respond to a case-study like Angela Clay’s story, explaining how their respective health-care plans will prevent this sort of abuse from happening.

Friday, October 03, 2008

October 3, 2008 - Register to Vote (public service announcement)

OK, it's off-topic for this blog, but what could be more important?

(Warning: Gratuitious profane language ahead. But, hey, the cause is important, and these are comics and actors, so what do you expect?)

Now, back to our regularly-scheduled blogging...

October 3, 2008 - Onion Article: "Man Succumbs..."

Check out this article from the satirical e-zine, The Onion. It’s good for a smile or two...

Man Succumbs To 7-Year Battle With Health Insurance

September 22, 2008 | Issue 44•39

DENVER—After years of battling crippling premiums and agonizing deductibles, local resident Michael Haige finally succumbed this week to the health insurance policy that had ravaged his adult life.

Haige, who had suffered from limited medical coverage for nearly a decade, passed away early Monday morning. According to sources, the 46-year-old was laid to rest at Fairplains cemetery, surrounded by friends, family members, and more than $300,000 of mounting debt....

For the rest of the article, click HERE.

Thursday, October 02, 2008

October 1, 2008 - Stable Is Good

“Everything looks pretty stable.” That’s Dr. Lerner’s assessment of my recent PET and CT scan results, as we meet together for an examination this afternoon. He delivers the news in his best physician deadpan style, one I’ve grown used to over the course of our many consultations.

The doctor goes on to explain that the areas that were lighting up near my neck on my earlier PET scan are no longer lighting up on this recent one, and that there’s a small, new area lighting up on my lower back. “The problem with PET scans,” he quickly adds, “is that there are a lot of false positives – these areas are pretty small, so they could be nothing.”

They all look fine on the CT scan, he continues.

I ask about my residual abdominal mass that had measured 17% larger on my last CT scan – a measurement Dr. Lerner figured at the time could still be within the statistical margin of error (it seems the radiologists don’t start getting alarmed until such a mass shows 25% enlargement). It doesn’t look any bigger at all, on this most recent scan.

Round about this time the phone rings. Dr. Lerner apologizes for the interruption, then takes the call. It’s evidently from another doctor who wants to confer about a patient. The receptionist brings in a thick file, and Dr. Lerner spends 3 or 4 minutes sharing details similar to my own case – something about the growth rate of certain tumors, I can’t follow it all. After hanging up, he comments, “It’s nice to be able to tell someone good news for a change.”

“I guess my test results are good news, right?”

“Yes, they are,” he replies, “for your situation.”

It’s not exactly a ringing endorsement – and it’s delivered in that same deadpan style, friendly but not overly cheerful – but I’ll take it. What I think the doctor means by that last qualifier – “for your situation” – is that, with an indolent lymphoma no one looks for cure, only stability.

Stable is good. Guess I’ll watch and wait some more.