Wednesday, August 26, 2009

August 26, 2009 - The Passion of His Life

The death of Senator Edward Kennedy is a milestone for our nation. He was, and remains, a controversial figure – flawed like all of us, but undeniably larger than life. Not even his opponents can dispute the impact he has had in advancing a variety of populist causes.

Among Ted Kennedy’s most enduring legacies is his struggle for affordable health care for all Americans. In this video clip, he calls it “the passion of my life,” then explains some of the personal reasons why:

I can relate to many of the stories he tells. Even though I’m fortunate enough to have good medical insurance, my own experience as a cancer survivor has acquainted me with neighbors for whom illness threatens not only physical infirmity and death, but also financial ruin. This is deeply wrong. It is even more deeply wrong that wealthy corporations continue to squeeze vast profits out of this broken system. Medical and insurance lobbyists exercise such power on Capitol Hill that even the voice of the overwhelming majority of the American public may not ultimately be heeded.

The dream of universal health care is not yet achieved. Strident voices are disrupting public meetings, in ways that intimidate fair-minded people and undermine democracy.

I resonate deeply with these words of Jim Wallis, in a tribute to the Senator published today:

“On the occasion of his death, I pray that God may now move us as a nation to address the greatest commitment of Sen. Kennedy's life - the need for a comprehensive reform of the health-care system in America - as a deeply moral issue and one that calls forth the very best that is within us. May we honor the life and death of Sen. Edward Kennedy by laying aside the rancor, lies, fear, and even hate that has come to dominate the health-care debate in America this summer, and regain our moral compass by recovering the moral core of this debate: that too many Americans are hurting and suffering in a broken and highly inequitable health-care system, and that it is our moral obligation to repair and reform it – now.”

This cause was the passion of Ted’s life. May it become the passion of ours as well

Tuesday, August 25, 2009

August 25, 2009 - Be Your Own Advocate

Here’s a rather shocking statistic from a recent study: 25% of abnormal medical test results never get reported to the patient.

Part of this is due to the negligence of certain doctors and their staffs – although, in some cases, it has to do with the national shortage of primary-care physicians. Often, it’s the primary-care physician who wrangles the test results and reports them to the patient. If someone’s getting their basic care from a doc-in-the-box or an emergency room, the lab or specialist may not have a clear idea of the chain of command. (In case you don’t know, a “doc-in-the-box” is a nickname for a walk-in clinic, at least here in New Jersey.)

Whatever the reason, this number is way too high.

Actually, something like that happened to me with my colonoscopy several years ago (results were normal in that case). I didn’t hear from the gastroenterologist, and I simply told myself, "I guess no news is good news." On a subsequent visit to Dr. Cheli (my primary-care doc) a few months later, I asked him if he’d heard the results of my 50th-birthday colonoscopy. He hadn’t, and had one of his nurses call back, then and there, to the office of the gastro guy. Then, I overheard him talking on the phone to one of that doctor’s office staff, chewing them out for not sending the results to either of us. Good thing there was no abnormality – although his office evidently didn’t have a fail-safe procedure in place for checking back in the event of results that never came.

All of this just goes to show us patient types: in this crazy, dysfunctional medical system, we’ve got to be our own advocates. If we don’t look out for our own interests, it’s very possible no one else will.

A word to the wise...

So, what about the rest of you? Have any of you had difficulties with test results not getting reported to either you or your primary-care doc? Sound off in a comment, below...

Sunday, August 23, 2009

August 23, 2009 - That's a Lot of "I Dos"

This afternoon, I officiated at a wedding. As I was recording the details afterwards in my pastoral record book, I happened to notice that this wedding was the 250th I’ve performed, since my ordination in 1983.

That’s a lot of “I dos.” It’s hard to believe I’ve been through the premarital counseling process with so many couples.

Maybe I should have offered the couple a prize. You know, something like: "Congratulations! As the one millionth customer to walk through the doors of this department store, you’re the lucky recipient of a shopping spree!" Don’t know what I’d offer a newly married couple, though... Somehow, I don’t think a coupon for a complimentary marriage counseling session would be much appreciated (and would be no bargain, anyway, since I don’t charge for marriage counseling).

I like doing weddings. They’re such joyous occasions. Every couple is so different, yet also so similar in their hopes and aspirations. As I scan down the list of names in my record book, I can still picture a great many of them. Some I haven’t seen since their wedding day (often because they were in typical young-adult transition, and moved elsewhere). Others are still right here in this congregation. For some of those couples, I’ve already had their kids in confirmation class (no weddings, yet, of any of their kids – I haven’t been here quite long enough for that).

Some of them, I’m aware, have divorced. A sad, but true reflection of national trends.

Personal anniversaries like this are great milestones. They remind me there’s much more to who I am than my cancerversary.

Thank God.

Saturday, August 22, 2009

August 22, 2009 - Laughter Yoga

This little video is endearing – and not just because it features the always-amusing John Cleese as narrator. I’ve heard of India’s “laughter yoga,” but have never actually seen it before, in action.

I figure this stuff has got to be therapeutic – but, if nothing else, it looks like great fun:

I’m especially intrigued by the observation that it doesn’t seem to matter whether the laughter is forced or natural: the therapeutic benefit is the same.

Of course, as the doctor points out in the video, even if participants are forcing their laughter at first, after a few moments of looking at all those goofy faces, only a rock could keep from laughing in response.

Maybe laughter really is the best medicine.

Wednesday, August 19, 2009

August 19, 2009 - Resilience

A New York Times article speaks of a new sort of training the U.S. Army is implementing for more than a million of its soldiers: training meant to encourage emotional resilience.

The goal is to reduce the incidences of post-traumatic stress disorder in soldiers returning home from combat. The Army’s going ahead with the training program, even though some have expressed doubt that the service’s macho, just-suck-it-up culture is compatible with such a touchy-feely approach.

Behind the training is Dr. Martin Seligman of the University of Pennsylvania, a proponent of “positive psychology” – an approach that focuses more on wellness and prevention than on treating pathology.

“Psychology,” he explains, “has given us this whole language of pathology, so that a soldier in tears after seeing someone killed thinks, ‘Something's wrong with me; I have post-traumatic stress.’ The idea here is to give people a new vocabulary, to speak in terms of resilience. Most people who experience trauma don’t end up with P.T.S.D.; many experience post-traumatic growth.”

I find that remark of Dr. Seligman’s interesting with respect to cancer survivorship. For many people, the effect of cancer treatment seems similar to that of a soldier in combat. The key is to slow the logical progression from thinking of one’s life as normal to seeing it as utterly devastated. In reality, there’s a whole spectrum of possibilities between those two extremes. Cancer need not be a life-shattering experience, no more than a tour of duty in a war zone needs to be. Both experiences are difficult, even life-changing. Yet, both are survivable, psychologically speaking.

Many of us cancer patients, at the time of diagnosis, operate from a stereotypical, worst-case understanding of the disease. Our minds leap to the assumption that it’s a death sentence. We imagine the next words out of the doctor’s mouth, after “You have cancer,” will be “I advise you to get your affairs in order.” It’s not that way, of course, and is becoming less and less so as time goes by, as new treatment protocols emerge from the laboratories.

Cancer survivorship is no picnic. But, it’s not death row either.

Elizabeth Edwards’ latest book is titled, Resilience: Reflections on the Burdens and Gifts of Facing Life's Adversities. I haven’t read it yet, although I did read her autobiography, Saving Graces: Finding Solace and Strength from Friends and Strangers. I find it interesting that Elizabeth has latched onto this word “resilience,” in light of all the trials she’s been through: losing a son, getting cancer, responding to her husband’s marital infidelity in the glare of national publicity.

I found an excerpt from the book online, in which Elizabeth tells of meeting a fellow cancer survivor named Mark Gorman. He carries around with him a slip of paper from a fortune cookie that says, “You cannot change the wind, but you can adjust the sails.”

So true.

Resilience. It’s a good word.

Tuesday, August 18, 2009

August 18, 2009 - The Breadth of God

Rabbi David Wolpe recalls how, when he was laid low by chemotherapy, a verse from the Psalms kept coming to his mind:

“From out of the depths I called unto God;
He answered me and set me free.”
(Psalm 118:5)

“Out of the depths” is a classic expression of lament. Wolpe brings added perspective as a scholar of the original Hebrew:

“But ‘the depths’ can be translated as ‘narrowness’ and ‘free’ as ‘expansively.’ A literal translation is – ‘from my narrowness I called to God and I was answered by breadth, O God.’ My world grew through pain and the increasing recognition of the ways in which it both opened my heart and helped me draw closer to others in pain. A single verse opened a world and a way of seeing that gave me strength and the breadth promised by the verse itself.

My spirit opened to an infinitely larger Spirit. When in pain, we tighten up like a fist. It is easy to push others away – after all, they are not feeling the pain – and to turn increasingly inward. Only I matter; only my pain is real. The Psalm urged me to expand, allowing me to embrace others, to understand that pain need not always be private, unshared. Open up, the Psalmist taught; both in heaven and on earth you are not alone.”

- Why Faith Matters (HarperOne, 2008), pp. 159-160.

Paradoxically, the experience of serious illness can deepen the life of the spirit. That was Rabbi Wolpe’s experience, and in the long run, it's been mine as well.

There were no epiphanies – no memorable, soul-stirring moments of encounter with God. Just a broadening of life, at a time when all the wisdom of the world could predict nothing but a narrowing.

I’m not sure how often this is true of people who approach an experience like cancer without the resources of faith to draw upon. I’d be curious to hear some personal testimony from atheists or agnostics on that subject. It seems to me that, without faith, cancer therapy can only be a narrowing experience. So many limitations, so many life-changes, arise in the form of side-effects. Fatigue alone – probably the most common and pervasive of side-effects – is a significant narrowing experience.

The gift many people of faith are fortunate enough to receive, out of cancer treatment, is an unexpected experience of spiritual breadth.

It’s the breadth of God.

Tuesday, August 11, 2009

August 11, 2009 - Bring On Those Nanobees

There’s a widespread news story in the past couple days about “nanobees” – a technique of cancer treatment involving nanoparticles that head right for tumor cells. Researchers at Washington University in St. Louis have armed these tiny particles with melittin, a protein that’s the active ingredient in bee venom.

It’s a colorful image: swarms of nanoparticles racing through the body, locating cancer cells and stinging them to death. The fact that these particles are armed with a chemical found in actual bee venom verges on the poetic.

Here’s Paul Schlesinger, one of the researchers, commenting on why melittin shows such promise as an anti-cancer agent:

“Melittin has been of interest to researchers because in high enough concentration it can destroy any cell it comes into contact with, making it an effective antibacterial and antifungal agent and potentially an anticancer agent. Cancer cells can adapt and develop resistance to many anticancer agents that alter gene function or target a cell’s DNA, but it’s hard for cells to find a way around the mechanism that melittin uses to kill.”

So far, the researchers have had success in killing human tumor cells that have been implanted in mice. The nanobees have done their job on the tumors, delivering the melittin without causing ill effects in the mice.

This is important because, if melittin were injected directly into the bloodstream, it would attack hemoglobin cells. Somehow, when this protein hitches a ride on a nanoparticle, it holds off on its venomous attack until the nanoparticle delivers it to a cancer cell.

Yes, there’s a lot of lab work involved in developing a treatment like this. I find it interesting, though, that the new therapy’s essential ingredient is something found in nature – in the humble honeybee.

Whatever actual treatments may emerge from this new approach, it’s comforting to think that the answer was out there in nature, all along.

Wednesday, August 05, 2009

August 5, 2009 - Pulling the Boat to Shore

More from Rabbi David J. Wolpe’s Why Faith Matters...

Wolpe retells a centuries-old rabbinic parable, about a man in a boat pulling on a rope, in order to bring his boat to shore. From the illusory perspective of a passenger on the boat, it may seem as though the boatman is pulling the shore to him. In reality, of course, it is the boat that is moving. The land is solid, substantial, immovable.

Prayer is like that, says Wolpe:

“People have much the same confusion about spiritual weight and motion: In prayer, some believe that you are pulling God closer to you. But in fact the heartfelt prayer pulls you closer to God.

I have prayed in fear and in joy, in crisis and in calm. Each time I understood that what I was asking for was not the object of my prayer. My prayer that I would be healed was a prayer, stripped of all its topmost layers, to be assured that whatever happened would be all right. Every prayer in this way is a prayer for peace; it is peace in the world and in one’s soul, the certainty that the pain is not empty, the world not a void, the soul is not alone.”

- Why Faith Matters (HarperOne, 2008), p. 142.

No wonder so many scripture passages describe God as a rock that cannot be moved.

So much about the way we live our lives is egocentric. We really do believe – as the ancients believed about their home, the earth – that the universe revolves around us. One of our deep, spiritual tasks, as we mature through life, is to dispossess ourselves of this mistaken notion.

Cancer has a way of bringing that truth home all the sooner.

Tuesday, August 04, 2009

August 1, 2009 - In the Now

I’m sitting on the screened-in porch of our little house in the big woods – what they call, here in the Adirondacks, our camp. These are the waning days of my vacation.

I’m joined here today by our college-age daughter, Ania. She’ll be with me through the weekend, before we make the long drive home on Monday.

I picked Ania up at the train station in Fort Edward, near Glens Falls, late Friday night. The train was nearly 3 hours late – good ol’ Amtrak – so by the time we drove the couple hours back up to our camp, we didn’t get to turn in till 3 a.m. Needless to say, we both slept through the morning.

Ania’s working on a jigsaw puzzle, one she remembers from when she was much smaller. Of all the things we could be doing, this is what she wants to do right now, and that’s fine with me. This is her time, and I’m happy to simply enjoy it with her.

Turns out the puzzle is missing a couple of pieces. That doesn’t faze her. To Ania, it’s all about the process, not the product.

I’ve had a week and a half to ease myself into relaxation mode, but Ania has the gift of being able to jump right into it. She’s much better at living in the now than I am. I take a lot longer to shed all the to-do list items I typically carry around in my head.

Living in the now is a survivorship skill. Some of us are just slow learners.