August 3, 2015 - Thief or Messenger?

Being diagnosed with cancer — especially if it happens earlier than the twilight of a full lifespan — can be a faith-shaking experience. I found it to be so with my diagnosis at age 49. Much of this blog has been a journal of my continuing efforts to understand the spiritual dimensions of this medical reality.

On this past weekend’s episode of PBS’ Religion and Ethics Newsweekly, I heard a fellow cancer survivor address this aspect of the cancer experience.

Father Cassian Folsom is abbot of the Benedictine monastery at Norcia, Italy.  Norcia (sometimes spelled Nursia) is the birthplace of Benedict, the founder of western monasticism in general and the Benedictine order in particular. In 1998, Father Cassian moved from St. Meinrad’s Abbey in Indiana to re-establish the Benedictine monastery at Norcia. That monastic community had been dissolved in 1810 under the rule of Napoleon.

Benedictine monasticism is now thriving again in the birthplace of its founder, but Father Cassian has been faced with a new, very personal challenge. Several years ago, he was diagnosed with multiple myeloma. He is now in his second remission.

You can view the interview here (the segment in which Father Cassian speaks about his medical situation is found at about 5:45):

The interviewer, Judy Valente, was asking Father Cassian whether he, as a monk, felt he somehow deserved a better deal from God than other people, when it came to his cancer diagnosis. Here’s what he said:

“It’s just a part of life, that’s all. I would say this: we can look at death as a thief or a messenger. A thief comes and steals what is most valuable to us, and so we’re afraid. A messenger who comes to tell us that our beloved is at the door, we respond much differently, don’t we?”

Those who are inclined to view cancer as a vehicle for divine justice may be perplexed when a person with a religious vocation is diagnosed. At times, I’ve gotten that reaction from others. Father Cassian gently deflects that line of questioning: “It’s just a part of life, that’s all.”

Cancer — even a cancer that goes into remission or is cured — is an abrupt reminder of the inevitability of death.

What the Abbot says next is, to me, what’s truly memorable. He says we can regard death as either a thief or a messenger. That decision on how to interpret the meaning of our cancer can make all the difference.

If we regard cancer as a thief, the only sensible response is to bolt the door — or, if our uninvited guest has already crossed the threshold — to energetically fight it off.  Fear and anger are the emotions associated with such a response (hence, military metaphors like a patient “battling with” cancer).

Yet, if we entertain the possibility that cancer could be a messenger, that it may have something valuable to teach us, then our response is different. We probably won’t open the door and invite it in for tea, but we’ll at least take some time to discern what message it’s bearing.

I’ve had a strong sense throughout this process — and have written about it upstream in this blog — that an early cancer diagnosis can cause a person to race through the normal stages of adult development and begin confronting issues others don’t begin to address until they’re in the retirement home. I think this may be what Father Cassian is getting at when he speaks of cancer as a messenger.

The spiritual question is: Do we have ears to hear?

May 22, 2015 — Dying and Unafraid

Anyone who’s read widely about religion in America knows the name of Phyllis Tickle. As the longtime religion editor for Publisher’s Weekly, she’s had a great influence on contemporary religious writing. In recent years, she’s garnered acclaim for several books of her own, most notably The Great Emergence. These have sought to make some sense of the rapidly-changing American religious landscape.

She hasn’t written much about her own faith journey, though — or, at least, nothing I’ve seen in print. She’s been diagnosed, now, with Stage 4 lung cancer and has been told that her condition is not curable.

Maybe that diagnosis has freed her to share more deeply about her inner life. In a Religion News Service interview published today (“Author Phyllis Tickle faces death just as she enjoyed life: ‘The dying is my next career’”), she shares the details of a near-death experience she had as a young woman of 21. She’d been given an experimental drug to prevent a miscarriage, and things went south after that:

In the middle of the night, she stopped breathing; her husband, a medical student at the time, was able to revive her long enough to get her to the hospital.

“Mine was a classic near-death. So, not much to say,” she begins. “I was dead.”

“I was like a gargoyle up in the corner of the hospital room,” she continues. “And I remember to this day looking down and watching Sam beat on me again and screaming for the nurses, and the nurses coming with the machines and the whole nine yards. And then the ceiling opened and I just went out the corner and into a tunnel, which was grass all the way around. Ceiling, sides, the whole thing.

“And I went to the end of the tunnel to this incredible — people call it ‘the light.’ I guess that’s as good a name as any. But an incredible peace, a reality, unity, whatever. The voice, which was fortunately speaking in English” — she laughs again — “said, ‘Do you want to come?’ And I heard myself saying, ‘No, I want to go back and have his baby,’ meaning Sam.”

She recalls that she turned around and went back down through the hole in the ceiling and into her body.

Her analysis, all these years later?

“You’re never afraid of death after that,” she told the interviewer. “I’m sorry. You could work at it but you’d just never be afraid of it. … You don’t invite that kind of thing. It’s a gift. It’s not like you can prepare for it or anything. It’s part of the working material you’re given.”

Such experiences are truly a gift — both for those who have them and for those who hear about them.

March 23, 2015 — God is Bigger

J. Todd Billings is a Reformed Church in America minister who’s on the faculty of Western Theological Seminary in Holland, Michigan. Like me, he’s dealing with an “incurable but treatable” blood cancer diagnosis: in his case, multiple myeloma. He’s written about his cancer experience in a new book, Rejoicing in Lament: Wrestling with Incurable Cancer and Life in Christ (Baker,  2015).

I intend to get the book and read it, but in the few teaser excerpts provided by the publisher, I’ve heard echoes of my own experiences of years past.

I was particularly impressed by an anecdote he tells in the opening pages, of receiving a card from a 15-year-old girl from his congregation with Down Syndrome. By way of encouragement, she wrote: “Get well soon! Jesus loves you! God is bigger than cancer!”

Billings identifies some pretty good theology in the girl’s words:

“While I had received many cards in the previous days, this one was different. ‘God is bigger than cancer!’ Yes. She did not say, ‘God will cure you of this cancer,’ or ‘God will suffer with you.’ God is bigger than cancer. The fog is thick, but God is bigger. My cancer story was already developing its own sense of drama. The sky was closing in, enveloping my whole world so that nothing else could creep in. But God’s story, the drama of God’s action in the world, was bigger. The girl in my church wasn’t denying the fog or the loss but testifying to a God who was greater, the God made known in Jesus Christ, who shows us that “the light shines in the darkness, and the darkness did not overcome it (John 1:5)….”

Billings also finds comfort in the famous first Question and Answer of the Heidelberg Catechism:

“‘What is your only comfort in life and in death? That I am not my own, but that I belong — in body and soul, in life and in death — to my faithful Savior Jesus Christ.’ Like the note from the fifteen-year-old girl in my church, it breaks through the fog of ‘terminal’ and ‘incurable’ and ‘cancer’ by pointing us to the bedrock of what matters: that I belong, in life and in death, to Jesus Christ. My life is not my own….”

I like this concept of the bigness of God, when it comes to living with cancer. The first tendency of many of us, as we learn of a cancer diagnosis, is to allow the cancer to grow in our minds until it crowds out everything else, even our faith. This amounts to making the cancer into an idol, an object of false worship. The god to whom that idol bears witness is a malevolent deity, indeed. But that doesn’t stop us — in horrified fascination — from ascribing to the cancer god all sorts of power over us.

A healthy understanding of the bigness of the one, true God is the way to overcome that false worship. As the teenager with the mighty heart bears witness, cancer’s big, but God is bigger.

Billings goes on to say:

“This place of not knowing is one that sometimes feels like a thick fog for me right now. I could have five years, ten years, or decades. Who knows? Not me. We belong to God — the Alpha and the Omega, who holds time In his hands — but we are not God. We are mortal, and we don’t know when we will die. There is a fog for all of us, whether we realize it or not, that as creatures we do not live in the world as individuals who own it but as temporary stewards of God’s good gifts.”

How easy it is to reduce God to the sum-total of our needs and desires! “Where are you, O God?” is so often our demand, when we learn that our expectations of a long and healthy life are threatened by a cancer diagnosis.

Yet, if God is indeed bigger than our dreams and desires — bigger, even, than our very lives — then isn’t it just a trifle audacious for us to shake our fists at the heavens, demanding an answer to that question?

It’s only human to voice such angry laments, from time to time. I don’t think God is particularly offended by that sort of thing. Because God is bigger. Yes, indeed.

(Quotations from J. Todd Billings,  Rejoicing in Lament: Wrestling with Incurable Cancer and Life in Christ [Baker, 2015], selections from pp. 1-7.)

January 9, 2014 — Who Am I?

Today I read an article by my friend and seminary classmate Kathleen Long Bostrom (“Identity Crisis,” Horizons, The Magazine for Presbyterian Women, January/February 2014). It speaks to where I am right now, in these days of recovery.

Kathy’s writing about what it feels like to take early retirement, for medical reasons. (She’s been dealing with a chronic obstructive lung disease for some years now.) Kathy had been serving as a co-pastor alongside her husband, Greg Bostrom. He continues in the pastoral role, in the same church. She’s now devoting her attention to her part-time writing career (she’s an acclaimed author of religious children’s books).

In my case, no one’s talking about retirement. The breathing difficulties caused by my matched pair of pulmonary emboli are expected to diminish in time. I fully expect to return to full-time pastoral work when that happens — but for now, I’m on temporary disability from my work at the church. With the three hospitalizations I’ve had this fall and winter (the most recent ending on December 28), I’ve had a few setbacks of the two-steps-forward-one-step-back variety.

Back in 2006, when I was receiving chemotherapy for non-Hodgkin lymphoma, I was also dealing with a kind of disability. But, that was different. With a once-every-3-weeks chemo cycle, I could anticipate one week of being out sick, a second week of moderate energy, and a third week of relatively normal functioning. I never did go on full-time disability.

It’s different this time. The blood clots in my lungs restrict my breathing, meaning I get winded very easily — even after the relatively minor effort of climbing a flight of stairs. I’m making progress with my outpatient physical therapy, but it’s slow (especially since each hospitalization has led to some deconditioning, setting me back a few spaces on the recovery gameboard each time).

The nature of pastoral ministry is such that it’s hard to step back from full-time to part-time. As far as the congregation is concerned, you’re either back or you’re not. I’ve received advice from numerous people not to attempt part-time ministry. It’s hard to set reasonable limits. It’s easy for a task-oriented person like me to overwork. Also, the congregation tends to think that, if they see you up in front, leading worship, many will assume that you’re back 100%, even if you’re not.

I asked my pulmonologist, Dr. Gustavo De La Luz, how long it will be before the emboli dissolve, and he said the average is 3 months. I’m coming up on that date at the end of this month, and I have noticed some modest improvement. The last scan I had at the hospital showed one embolism has gotten smaller.  But I’ve also had unusual complications: the big internal bleed I had during my first hospitalization, and two incidents of temporary kidney failure, caused by the CT-scan contrast dye (which my body can evidently no longer tolerate).

The result is that my disability is frustratingly open-ended. No one can predict with any accuracy when I’ll be ready to return to my pastoral duties. Recently, I’ve been advised to fill out the Presbyterian Board of Pensions’ disability paperwork, so that — if I’m still sidelined when I hit the 90-day anniversary of my diagnosis at the end of this month — I can begin collecting a temporary disability pension (which would save the church two-thirds of the salary they’ve graciously continued to pay me).

I learned years ago that, if there’s any advantage to receiving chemotherapy for lymphoma, it’s that the treatment’s progress is tightly regimented. With one treatment every three weeks, there was a predictable “chemo cycle” governing how sick I could be expected to feel.

Not so with this pulmonary embolism thing. The clots will dissolve when they dissolve. No one can predict how long that will take. Nor can anyone predict how fully the lungs will recover after the clots are gone. Some patients find that some of their lung tissue has become “necrotic,” after all that time deprived of oxygen from the bloodstream. That essentially dead lung tissue will never recover. No one can predict how much necrotic tissue there is, nor how it will affect my long-term recovery. The deep-vein thrombosis in my leg (for which I’m being treated with the anticoagulant, Coumadin) also bears careful watching. I’m wary of the possibility of another hematoma, even though I’m on just one anticoagulant rather than two, and I’m being carefully monitored by a hematologist (my oncologist, Dr. Lerner).

During my cancer treatments, I was able to make some modest plans around the ups and downs of the chemo cycle, that’s not possible in this case. I’m living day-to-day, pursuing a recovery of indeterminate speed and duration.

I can vividly remember the experience, on Easter Day, 2006, of looking across the street from my bedroom window, sick as a dog from my most recent chemo treatment, watching the congregation arrive for worship in all their Easter finery. It was a strangely disjointed feeling. It felt unnatural not to be there.

With my present pulmonary difficulties, that’s my experience every day.

Which brings me, at long last, to Kathy’s insightful article. She admits to feeling a certain kind of “identity crisis” as she transitions into early retirement — becoming no longer one of the church’s pastors, but merely the pastor’s wife.

“Who am I,” she writes, “now that I am no longer the pastor? Who are any of us, apart from the labels that define us, that can be cumbersome, even limiting, but that also give us a sense of identity and purpose?”

Musing on the experience of serious illness, she observes how we can “lose our intrinsic identities even further and become ‘a cancer patient,’ rather than ‘Joan, who happens to have cancer.’”

When I was in the hospital, I wore a plastic ID bracelet with my name, my birthdate and a bar code on it. Every time a nurse came in to give me medication, or a technician to draw blood or give me a breathing treatment, I would be asked to repeat my name and birthdate, so the hospital employee could check that information against my bracelet. Then, the person would scan my barcode with a little handheld device. This was for medical-records purposes, but I was also aware that it was related to the hospital’s billing process. It was the medical equivalent of waving a box of Cheerios over the bar-code scanner at the supermarket checkout. Every pill I swallowed, every new bag of IV saline solution, had its price.

In the hospital, the uniformity of my hospital gown and the ubiquitous presence of my ID bracelet proclaimed that my identity, as a patient, was pretty much limited to my medical condition. Pastor, husband, father, friend — all those roles diminished to secondary importance. Name, birthdate, barcode: those were my new identifiers.

Now that I’m home, and my main activity is getting better, it still doesn’t feel all that different. Many of those things I used to do, by which I defined myself, aren't part of my life at the moment. Even with family relationships, things have changed. I no longer do many of the things I’m used to doing as husband and father. Others must do some of those things for me.

Kathy quotes a little poem by theologian and martyr Dietrich Bonhoeffer, “Who Am I?”, which concludes with these words:

Who am I? They mock me, these lonely questions of mine.
Whoever I am, thou knowest, O God, I am thine.

Kathy then goes on to observe: “I am who I have been from the very beginning: I am a child of God. That has never changed. It is who I will always be, even though that identity has gotten lost in the shuffle of my labels. First and foremost, now and always, I am a child of God, which is what we all are, no matter the labels that have stuck to us over the years.”

Maybe that’s the lesson God is teaching me, through this protracted recovery. Ministering to the dying and their families, I've experienced the truth of the old cliché: “No one ever says, on their deathbed, ‘I wish I’d spent more time at the office.’” We're not defined by what we do, but by who God has created us to be.

Kathy’s right. At the end of the day, “child of God” is what we are. All of us.

April 6, 2013 — Newly Diagnosed? Tips from the Lymphoma Club

I found a great website today called the Lymphoma Club, which includes a helpful page containing tips for those newly diagnosed with lymphoma. This list is a bit long to absorb on one reading — 27 tips in all — but it’s well worth having a look at.

I’ve rearranged some of them into what I’d consider my Top 10. So, they’re renumbered, with the most important at the bottom. Where I thought a couple of the originals overlapped, I’ve combined them. I’ve added my own comments after each one.

10. Get organized.  Consider a binder. 
Or a series of computer files. Or whatever works for you. But you’ve got to have some kind of system for managing the tsunami of data you’re about to get hit with — some of it electronic, some of it paper (lab reports, prescription scripts, etc.), much of it stuff you’ve never heard of before. Start keeping an overall calendar of your treatment: you’ll be surprised how fast the weeks and months go by, and before you know it, you won’t be able to remember how many CT scans you’ve had, and when. Get in the habit of keeping a current medications list.  You’re going to be asked for that information more times than you could possibly imagine (mine lives in my smartphone).

9.  Find cancer support groups (ask your cancer center or search online).
For whatever reason — pride, idolatrous self-sufficiency, reluctance to deal with the weird reactions we ministers get from some people outside the church setting — I waited way too long to do this. The time to start going to a support group is BEFORE you think you need it. From the day of your diagnosis, you’re a cancer survivor. So, you can be sure there’s more than one group out there where you’ll be welcomed like you’re family, and (just like that old sitcom theme song) everybody knows your name.

8.  List ways family and friends can help you (chores, rides, cleaning, etc.).
This is a biggie. If you hear that little voice inside your head, saying “But I don’t want to impose on others,” speak sternly back to it, saying “GET BEHIND ME, SATAN!” (That’s a biblical allusion, for those unfamiliar with it.) You’ve got cancer. You need help. There’s absolutely no glory in trying to go it alone. Get used to it.

7.  Have a trusty advocate  join you during appointments to take notes and help  ask questions.
Remember that tsunami of information I mentioned above? This is one essential way of managing it. The necessity of bringing a friend or relative with you goes way beyond just sorting out a lot of medical jargon. You see, there’s a very common emotional reaction that’s especially strong at the time of diagnosis and just afterwards. You’ll be having a perfectly rational conversation with your doctor, and you’ll say to yourself, “No need to write that down, I’ll remember it,” then five minutes later as you’re walking out to the car, you’ll say, “Now did the doctor say my cancer is large-cell or small-cell, and which one is more treatable?” This has nothing to do with your intelligence, nor your memory power. It’s a species of denial. No matter how much you may imagine you’re cool, calm, collected and handling this pretty well, the reality is, you’ve just learned something that’s rocked your world, so your subconscious is saying, “That’s enough, I’m outta here!” You need that second set of ears, especially now.

6. Get educated. Know the details of your cancer diagnosis but don’t spent too much time online.
This is information-tsunami management, part two. To some extent, how you do this is an individual thing, but there are so many advantages to doing it — taking charge of the situation and becoming your own advocate — that this one makes my top-ten list, hands down. There’s a wealth of information out there, but the trick is separating the wheat from the chaff. Start with a good book on the details of your disease (I recommend Living With Lymphoma by Elizabeth M. Adler, a microbiologist and lymphoma survivor - Johns Hopkins, 2005). As for the internet, don’t be afraid to troll for useful information online — it’s not so much the amount of time you spend online, as where you go to find your information. Start with highly-reputable sites like the Leukemia and Lymphoma Society, or the National Cancer Institute, or the websites of world-renowned cancer hospitals. Then, move slowly outward from there (but always following links from these trusted sites). If you have any experience at all surfing the net, you already know it’s the Wild West out there when it comes to documentation and accuracy. It’s so very easy to wander down one of those electronic rabbit trails, and before you know it, you’re reading about how to cure lymphoma by wearing a crystal around your neck. Know, also, as you cancer-surf, that we all have a common defense mechanism that leads us always to jump to the worst-case scenario. All we need do, sometimes, is glance at a list of possible symptoms, and we’re quite sure we’ve got every one of ‘em. (The defense-mechanism angle is that our subconscious irrationally imagines we can protect ourselves from pain by inoculating ourselves with that same pain, even if there’s scant evidence for it; one of the reasons we have doctors is to protect us from such craziness).  Oh, and the other, similar tip about learning to read a lab report is absolutely correct. Learn what the most important of those little abbreviations on your CBC (complete blood count) mean, so when one of them shows up as elevated, you don’t flip out. Sometimes an elevated count is a big deal, but more often than not, it’s just normal variation.

5.  Feel free to seek a second opinion.
I agree with this as far as it goes, but I’d be much more emphatic. (Deploy megaphone.) GET A SECOND OPINION, STUPID! (Put away megaphone.) Sorry for the “stupid” moniker, but I had to get your attention. It doesn’t matter how much you like and trust the doctor you start with, cancer research is such a huge and complex universe that no single individual could ever be familiar with it all. If your oncologist is any good at all, he or she will have absolutely no problem with your seeking a second opinion, and will probably encourage it. On the other hand, if your oncologist bristles at the suggestion and starts bragging about his or her own medical credentials, then RUN, DON’T WALK to another doctor who better demonstrates the spiritual gift of humility. It’s exactly that sort of fall-in-love-with-yourself pride that leads doctors to overlook important details. Nowhere is this more crucial than in your all-important pathology report. And, do you know what? Your pathologist is by far your most important doctor you never meet. (The pathologist is the one who looks through the microscope at your biopsy slides and identifies your type of cancer cells, carefully counting how many of them there are, which determines the whole course of your treatment.) When you go from your local physician to an evaluation at a major cancer center (or, if you start with a major cancer center and go from one center to another) you get a new pathologist’s opinion along with it. You may well stick with your original doctor after getting the second opinion — or not, it’s up to you — but even if you stick with the original doc, he or she is going to be grateful that you presented the second opinion, which makes diagnosis and staging easier. (IF the doctor’s any good, that is — see “humility,” above.)

4. Pick an oncologist, one you feel comfortable with.  Preferably an expert in your type of cancer.
You DO have a choice. It’s your cancer, so you have a right to find a doctor you have confidence in. Whether it’s your first stop or a second-opinion consultation (see above), I HIGHLY, HIGHLY recommend checking out a National Cancer Institute (NCI) comprehensive cancer center. These are the cancer research hospitals that have access to the most up-to-date research findings and are able to point you to clinical trials, if that’s called for. If it’s a long journey between your home and a comprehensive cancer center, then consider working through a local oncologist who has strong ties with one of those centers (that’s what I do). And by the way — this is also real important — the mark of a good cancer hospital is not, I repeat, NOT how much money said hospital spends on TV advertising. The most prolific advertisers among cancer-treatment hospitals are certain for-profit institutions who garner impressive treatment results by cherry-picking the most treatable patients on the front end, discouraging those whose prognosis is less positive. (You won’t find these big advertisers on the NCI’s list, and there’s a reason for that.) This is ethically questionable behavior on the part of those who most stand to profit financially from that sort of approach. As with anything else that's driven by the profit motive, caveat emptor.

3. Continue to celebrate life in spite of cancer. You still have your identity. Don’t lose it. Participate in hobbies, live life and do the things you love to help keep you focused.
We’ve already established that a cancer diagnosis rocks your world. But that doesn’t mean you need to stand idly by and let it take over your world. Don’t let yourself become a cancer victim. Be a cancer SURVIVOR. There’s a huge difference, that has a lot to do with the degree to which you spit in cancer’s face and go on living your life, anyway.

2.  Find ways to relax and cope (yoga, guided imagery, music, hobbies, faith etc.). 
OK, I’ve elevated this to number 2, even though I have a major quibble with how it’s worded. Faith is not, I repeat, NOT in the same league as music, hobbies and the other items on that little list. There’s a common tendency in our non-sectarian society to label faith a “leisure activity” and lump it in with all sorts of more trivial  pursuits. A cancer diagnosis doesn’t just rock your world, it rocks your spiritual world. Whatever sort of faith you profess, this is the time when you most need to get serious about your faith-tradition and tap its resources. The benefit of doing that goes way beyond merely “relaxing and coping.” Your house of worship, if you have one — church, synagogue, meeting-house, temple, whatever — is the place to wrestle with the big questions, with help and advice from wise guides who have the life-experience and faith-experience to help you sort these issues out. (If you don’t have a house of worship, I advise you to find one.) Remember, houses of worship were in the healing business long before hospitals even existed. Nowadays, they perform their acts of healing alongside of, and in sync with, medical science, which means you get the best of both worlds. Your house of worship is also a great place to connect with friends who can, indeed, “help you” (see number 8, above).

And now, ladies and gentlemen, the number one tip for dealing with a new lymphoma diagnosis...

1. Take a deep breath and go easy on yourself.
Know that right now, today, is just about the worst time in the whole progression of your disease, whatever the ultimate outcome. Diagnosis is hard. (I’m not talking about it from the doctor’s standpoint, but from yours.) It’s hard because, in running the race for a deeper, more all-encompassing health, now is the time when you have to go from zero to a hundred in a matter of feet, not miles. So, treat yourself right, especially at this time. In the eyes of your Creator — not to mention those of your family and friends, and even yourself — you’re worth it. You really are.

Go ahead, now, if you’d like, and check out the other items on the original list. Most of them are pretty good, and very much worthy of mention. But these are my Top Ten, and I’m sticking with ‘em.

Finally, take a look at this short video, which comes from the same Lymphoma Club website. It’s guaranteed to lift your spirits and give you hope.

August 27, 2012 – The Downside of Up Life-Expectancy

Here’s a jaw-dropping statistic: “Since 1900, the life expectancy of Americans has jumped to just shy of 80 from 47 years.”

Among so many significant developments of the 20th Century, this may be one of the most far-reaching: and it gets so little press, compared to advances in transportation, communications, electrical power, data-processing and all the rest.

Walk through any older graveyard, and take note of the lifespans cut into the 19th century headstones. Stroll over into the newer section, and do the same for the stones from the last decade or so.  Then, do the math.

You’ll experience your own little “Wow!” moment.

We’ve been making huge progress, as a society, fighting cancer – which partly explains the increase in life expectancy, of course. Yet, those numbers also do their part to blunt the remarkable gains in cancer prevention and treatment.  They make them seem less impressive than they really are.

Here’s why. 

We all know cancer is an old person’s disease.  Not every cancer, of course. Small numbers of the young can be afflicted as well, and it’s especially heartbreaking when that happens.  Yet, the chances of getting most cancers go up with each decade of life: way up, once you pass 60 or so.

In 1900, when people were dying at the age of 47, on the average, most of them were succumbing to other maladies before they even made it into the prime cancer years. So many cancers are influenced by genetics: at a certain age, some mysterious, pre-programmed switch in the DNA gets thrown into the “on” position. Then, some of our cells start morphing into predators and lunching on those around them.

Sometimes, I hear people of my generation comment with alarm on how many of their friends are getting moles cut off, or undergoing mastectomies, or following the same chemotherapy path I and a few others of us have unintentionally pioneered. The cancer rate must surely be going up, they exclaim!

It’s not – at least, not if the effects of aging are controlled for.  What’s going up is their age, and the age of their contemporaries.  That, in itself, accounts for a whole lot of cancers.

Want to know what the leading cause of cancer really is?  It’s getting old.

What a paradox! With each new advance in cancer treatment, average life expectancy goes up.  Yet, for all those cancers that are prevented or successfully treated, the chances of getting other cancers increase, due to the demographics.

You’ve really got to feel for the cancer researchers.  They work so hard, and they announce their latest successes in triumph, but their numbers don’t look nearly so good as they would, were the average lifespan not also increasing.  They’re walking up the down escalator.

In the August 25th New York Times, David Ewing Duncan poses the very reasonable, but creepy, question of whether some of these medical advances are really worth it. He says he’s in the habit of polling his lecture audiences, asking for a show of hands as to how long they truly want to live. “I provided,” he says, “four possible answers: 80 years, currently the average life span in the West; 120 years, close to the maximum anyone has lived; 150 years, which would require a biotech breakthrough; and forever, which rejects the idea that life span has to have any limit at all.”

Before voting, he tells his audiences, they should assume that aging, as we know it, would continue. His question is simply about longevity that could be gained through eliminating life-threatening illnesses, not a matter of freezing the normal aging process. He’s not offering the opportunity, in his thought-experiment, for people to remain forever 30, or 40, or whatever ideal degree of physical maturity they’d care to name.

The majority — 60% — say they don’t want to live past 80. Another 30% declare they’re willing to power on through all the usual infirmities of aging, finally dying at 120. Nearly another 10% want to boldly go where no one has gone before, and live to 150. Only a tiny fraction put up their hands to say they want to live longer than that.

Duncan goes on to report that medical researchers are on the verge of a number of breakthroughs that could push the average life expectancy up even higher. Among these are medications to reduce inflammation of the coronary arteries, as well as various stem-cell therapies. The growing field of bionics — developing replacement hardware for the body, like cardiac pacemakers, brain implants for Parkinson’s sufferers, even artificial hearts — offers to add even more years to the average age at death.

“Curiously,” Duncan goes on, “after learning about these possibilities, few people wanted to change their votes. Even if I asked them to imagine that a pill had been invented to slow aging down by one-half, allowing a person who is, say, 60 years old to have the body of a 30-year-old, only about 10 percent of audiences switched to favoring a life span of 150 years.”

For many of those who don’t want to change their vote, it’s the various infirmities of aging that scare them off.  For others, it’s concern for younger generations, who would find the staircases to so many joys and achievements blocked by their elders, shuffling around on the landings above them. For still others, it’s about worry for the environment — whether the earth can truly sustain very many more people than are already here.

The tiny minority who do want to live longer speculate that we have no way of knowing what such super-centenarians could accomplish, with their added wisdom and life-experience. What new gizmo could a genius like Steve Jobs come out with, if he lived to 150?

We do know, Duncan concludes, that Albert Einstein was very clear about his own wishes, near the end of his life: “As he lay dying of an abdominal aortic aneurysm in 1955, he refused surgery, saying: ‘It is tasteless to prolong life artificially. I have done my share, it is time to go. I will do it elegantly.’”

Let’s hear it for everyone being given the opportunity to live long enough to still die elegantly!

April 6, 2012 - Godforsaken

Today’s Good Friday, and it fell to me to give the sermon at our local Community Good Friday service, sponsored by churches of the Point Pleasant/Bay Head area.

I’ve preached many a Good Friday sermon in my time, but today I was struck by the words of Jesus from the cross, “My God, my God, why have you forsaken me?”  Jesus is of course quoting Psalm 22:1, one of the gutsiest laments in the Hebrew scriptures.

Many Christians find it hard to stomach this awful scene depicting the Son of God in abject despair.  Some of them deal with their discomfort by staying away from Good Friday services altogether (or, at least, from worship services like ours that strive to regard the hard reality of the crucifixion without blinking). If relentlessly practicing positive thinking is your thing, and if – like some of my Baptist friends – you just can’t hold back from cheerily uttering that Pollyanna proclamation, “It’s Friday, but Sunday’s coming!”, you’re probably numbered among this group.

Other than boycotting Good Friday, the other way to manage such cognitive dissonance is to imagine Jesus wasn’t really so Godforsaken as all that.  Following the lead of the Gospel-writer John – who, unlike Matthew, Mark and Luke, is more inclined to portray Jesus as omniscient, and eerily aloof from even his own sufferings – they seek to to rationalize away his sense of abandonment.

That view of Jesus is actually heretical, as the church has traditionally viewed it.  The traditional doctrine of the Incarnation declares that, during the 33 years of his earthly life, Jesus was truly God and truly human. In a reversal of the state of affairs that’s prevailed through much of history, Christians in our highly-churched American culture are more likely to struggle to accept Jesus’ humanity than his divinity.

In the Garden of Gethsemane, as he wrestled with the decision he had made, he could only turn to God in prayer – just like any of us.  He could only ask God to “take this cup away from me.”  He didn’t say, “What do you think, God, hasn’t this show gone on long enough – isn’t it time, now, for me to overturn this cup?”

Throughout his earthly life, Jesus suffered and struggled, feared and doubted, bled and died – much like any of us.  The scriptures teach that he was unlike us in one respect – that he did not sin, and therefore went to the cross blameless – but in every other way he was human.  And that is why he was impelled to cry out: “My God, my God, why have you forsaken me?”

Do you think he didn’t really mean that?  Do you think it was just a line in a play, spoken for our benefit?  Do you think he knew all along that it would come out OK in the end, that this death – that was even then wrapping its cold, bony fingers around his neck and starting to squeeze – was not really death, as we know it from the experience of others (and will one day know it ourselves)?

No.  When Jesus cries out, “My God, my God, why have you forsaken me?” I take him at face value.  I believe he means what he’s saying.   I believe he truly feels Godforsaken.

That’s a colorful word, “Godforsaken.”  It hardly even sounds like an English word at all.  It’s more like one of those intricate, compound German words: schadenfreude or weltanschauung, or even the lowly pepper-cookie, the pfeffernusse.  The German language has that capability of combining shorter words together in a long string.  I’m glad that, in this instance, the English allows us to do so, because no other word captures the sense of abandonment and desolation, the fear and anxiety, the doubt and despair, that’s caught up in that word, “Godforsaken.”

Sometimes we speak of “a Godforsaken place.”  That expression is reserved for the driest of deserts, the most isolated of islands, the most barren of landscapes.  The geography of the human heart it describes is equally desolate.  That’s what Jesus was feeling, there on the cross.  The pain he felt in his body was only the half of it.  The sense of abandonment that tore at his heart was just as agonizing, maybe even more so.

Those of us who have had to cope with that unwanted guest, Cancer, gate-crashing our lives perhaps know something of what this means.  There may have been times when the word “Godforsaken” accurately described the way we felt.

Christian essayist G.K. Chesterton captures the sheer absurdity of God’s son crying out “Why have you forsaken me?” as he observes:

“When the world shook and the sun was wiped out of heaven, it was not at the crucifixion, but at the cry from the cross: the cry which confessed that God was forsaken of God.” [Orthodoxy (Moody, 2009), p. 20.]

We don’t like to think – no, not even imagine – that “God was forsaken of God.”  God’s supposed to stay in heaven, and all is supposed to remain right with the world.  The crucifixion was the one time in the history of the universe when that did not happen, when the fundamental balance of creation was thrown off, when chaos seemed briefly to reign, when the interrelationship of the three persons of the Trinity was severed, when darkness descended in mid-afternoon and the very earth beneath our feet rocked and reeled.

Speaking personally, I still don’t understand why it happened.  Yes, there are many competing theological theories of the Atonement, of why and how Jesus had to suffer and die so sins might be forgiven.  None of them, at the end of the day, answers every question.  I also don’t understand how it happened.  My mind is just too small to take in the mystery of the Incarnation, the complexity of the inner workings of the Trinity, the marvel of divine Grace.

Although I don’t understand why or how the crucifixion happened, I can say I’m awfully glad it did happen.  I’m glad because, when I look on from afar, from the perspective of twenty centuries, at the spectacle of “God forsaken of God,” as Chesterton says, I know that because of what Christ has done, I will never be Godforsaken in quite the same way.  Through every trial and tribulation, through every pain or struggle divine Providence may in the future place in my path, whether my lymphoma creeps back into my life again or whether it doesn’t, I’ll always be able to look to the cross of Jesus and know that I am not alone, that there is one in the heavenly places praying for me who knows what it means to be human.

To me, that’s what’s so good about “Good Friday.”  I would never be so bold as to ask one such as Jesus to go to the cross for me – I do not deserve it – but the good news is that he has done so, anyway, of his own accord.  For that, I am grateful beyond words.

March 12, 2012 – Job’s Comforters

One of the worries people often have when a friend is diagnosed with cancer, or experiences some other misfortune, centers around the question, “What do I say?”

Lots of energy is burned up fruitlessly trying to answer this question.  Even if an answer emerges, it can very easily turn out to be the wrong one.  Stories abound about unintentionally hurtful things well-meaning friends and family members have said to the newly diagnosed.

Yet, that’s no reason to stay away.  Friends need friends more than ever in times of trouble.

Here’s a little poem, “Comforters,” that gets to the heart of this matter.  It was written by a cancer survivor.  I can’t copy it here, because it’s under copyright, but you can easily read it by clicking on this link.

This calls to mind the ancient story of Job, the faithful man of God who’s suddenly afflicted by a perfect storm of suffering, including bad health.  Job receives a delegation of visitors, friends of his who are trying to comfort  him.  Each one presents an answer to the “Why?” question Job’s been asking himself ever since his troubles began.  Yet, each would-be helper fails miserably.

The first friend, Eliphaz the Temanite, comments philosophically on the inscrutable ways of God.  How hard it can be – he explains to his poverty-stricken friend, who has just lost his entire family and whose once-healthy body is covered with painful boils – for us to account for many of the things that happen, both good and bad!  There is no one who is without fault, so therefore it makes sense that no one is spared some measure of suffering in this life.  Besides, it could be that God – who’s noted for extending punishment for one person’s wrongdoings to the generations that follow – is simply collecting on some old debt.  The important thing is to keep returning to God, trusting in the Lord to bring healing and restoration in time:

“For misery does not come from the earth, nor does trouble sprout from the ground; but human beings are born to trouble just as sparks fly upward.   As for me, I would seek God, and to God I would commit my cause.  He does great things and unsearchable, marvelous things without number.... How happy is the one whom God reproves; therefore do not despise the discipline of the Almighty. For he wounds, but he binds up; he strikes, but his hands heal.”

[Job 3:6-9, 17-18]

The second visitor, Bildad the Shuhite, tells Job he’s just sure his afflictions must be his own fault, that he’s sinned against the Almighty in some way.  If he’s diligent about repentance, though, God just may have mercy and take away Job’s afflictions:

“Does God pervert justice? Or does the Almighty pervert the right? If your children sinned against him, he delivered them into the power of their transgression. If you will seek God and make supplication to the Almighty, if you are pure and upright, surely then he will rouse himself for you and restore to you your rightful place.”

[Job 8:3-6]

The third caller is Zophar the Naamathit.  He chides his friend Job for being so certain he’s blameless and undeserving of his terrible fate:

“Can you find out the deep things of God? Can you find out the limit of the Almighty? It is higher than heaven – what can you do? Deeper than Sheol – what can you know? Its measure is longer than the earth, and broader than the sea. If he passes through, and imprisons, and assembles for judgment, who can hinder him?”

[Job 11:7-10]

Yet, Zophar’s counsel is not without kindness.  He, too, urges Job to consider his burden of suffering as God’s correction, and repent:

“If you direct your heart rightly, you will stretch out your hands toward him. If iniquity is in your hand, put it far away, and do not let wickedness reside in your tents. Surely then you will lift up your face without blemish; you will be secure, and will not fear. You will forget your misery; you will remember it as waters that have passed away. And your life will be brighter than the noonday; its darkness will be like the morning. And you will have confidence, because there is hope; you will be protected and take your rest in safety. You will lie down, and no one will make you afraid; many will entreat your favor. But the eyes of the wicked will fail; all way of escape will be lost to them, and their hope is to breathe their last.” 

[13-20]

Commenting on the story of Job in his classic book, When Bad Things Happen to Good People, Rabbi Harold Kushner writes:

“Under the impact of his multiple tragedies, Job was trying desperately to hold on to his self-respect, his sense of himself as a good person. The last thing in the world he needed was to be told that what he was doing was wrong. Whether the criticisms were about the way he was grieving or about what he had done to deserve such a fate, their effect was that of rubbing salt into an open wound.


Job needed sympathy more than he needed advice, even good and correct advice. There would be a time and place for that later. He needed compassion, the sense that others felt this pain with him, more than he needed learned theological explanations about God's ways. He needed psychical comforting, people sharing their strength with him, holding him rather than scolding him.


He needed friends who would permit him to be angry, to cry and to scream, much more than he needed friends who would urge him to be an example of patience and piety to others. He needed people to say, ‘Yes, what happened to you is terrible and makes no sense,’ not people who would say, ‘Cheer up, Job, it's not all that bad.’ And that was where he friends let him down.”

[Harold Kushner, When Bad Things Happen to Good People

(Random House, 2001), pp. 120-121.]

Let us strive not to let one another down as well, when friends come upon hard times.  Just be there.  Listen.  Share the pain.  Offer to fill the water-glass or run some small errand.

You’re not there to fix it.  You’re just there.  And that’s what friends are for.

March 2, 2012 - A 12-Year Old Philosopher

Just a brief post today, to share something remarkable I just saw online.  National Public Radio’s “Morning Edition” show featured a story about a 12-year-old cancer survivor, Grant Coursey.  After multiple surgeries for neuroblastoma, a tumor wrapped around his spinal cord that was impeding his breathing, he’s considered cancer-free.

Grant was very young when he was receiving his treatment, but the experience has evidently made a big impression on him.  I’ve written upstream about how cancer monkeys with the stages of human development, often giving survivors perspectives on life that are more commonly held by much older people.  This certainly seems true of young Grant, as this exchange with his mother, Jennifer, demonstrates:

"I always kind of hoped that you didn't really remember much," Jennifer says, "but the scary stuff really stuck with you."

"Yeah. You know, I've got big scars all over my back from getting cut open," Grant says. "Whenever that kind of starts to twinge a little bit, like if I touch it wrong or something like that, it just kind of reminds me I'm lucky."

"Yeah," Jennifer says.

"You know, life is really good," Grant says. "And there's this saying that says if you've been close to death, you understand life more. And sometimes I think of that, and I think, you know, if this had never happened to me, I never would have understood how much life means, kinda. You know? What if I had died? I'd never have this amazing life."

"That's right," his mother says.

"That's crazy to think about," Grant says.

"It is crazy to think about," Jennifer says. "Well, Grant, I'm sure glad you got well."

"Yeah."

"I sure love you. And I hope you're picking up that I'm so proud of you," Jennifer says. "I'm so proud of you."

"I pick that up a lot, honestly," Grant says.

"Good."

Cancer’s a stern teacher, but an effective one.  Blessings to Grant, and to so many other kids like him who have had this tough but life-changing experience!

January 8, 2012 – Lessons from the Cancer Wilderness

Reading the Gospel of Mark in preparation for today’s Baptism of the Lord sermon, I come across a rather jarring transition.  It’s not actually in Mark 1:4-11 - today’s recommended passage from the Revised Common Lectionary - but it ought to be.  The Lectionary editors took the coward’s way out and chopped the last two verses off Mark’s account of Jesus’ baptism.

They end their scripture reading with the heavenly voice saying of Jesus, “You are my Son, the beloved, with you I am well pleased.” 

Now, isn’t that special?  A heavenly benediction.

But that’s not where Mark ends his story.  Two more verses come along, before he wraps it up:

“And the Spirit immediately drove him out into the wilderness. He was in the wilderness forty days, tempted by Satan; and he was with the wild beasts; and the angels waited on him.” [Mark 1:12-13]

Wow.  So much for the warm, fuzzy feelings.  So much for God’s benevolent benediction. Let the story spin out to its natural conclusion, and suddenly God doesn’t look like such a kind, benevolent deity.  No sooner does God bless Jesus, the son, then God gives him a good kick in the pants (or the robe, as the case may be).

I am not making this up.  It’s right there in the original Greek.  Well, maybe it doesn’t say “kick,” but Mark says the Spirit “drove him out into the wilderness.”  The Greek word means “to throw out, to drive out, to expel.”  It’s the same verb Mark uses in chapter 11, verse 15, as he tells how Jesus “entered the temple and began to drive out those who were selling.”

Seems God is a Tough-Love sort of parent.

So, what is this wilderness, into which God is so determined to push Jesus?  It is, in the Jewish imagination, the place where the deepest of spiritual encounters happen.  Moses’ epiphany by the bush that’s burning, yet is not consumed...  The giving of the 10 Commandments on Mount Horeb (or Mount Sinai, depending on which story you read)... Elijah hiding himself in a cleft of the rock, surviving earthquake, wind and fire to hear that “still, small voice” – or that “sound of sheer silence” – that tells him everything’s going to be all right...  John the Baptist’s favored abode, where he clothes himself in animal skins and scarfs down locusts and wild honey for breakfast.  All these take place in the wilderness.

At its very root, Jewish spirituality – and, therefore, Christian spirituality as well – is a desert spirituality.  The Hebrew refugees who walk away from the fleshpots of Egypt, straight through the Red Sea waters, aren’t exactly going on vacation.  God opens the way for them through the waters not so they can move to a gated community and take it easy, after all those years of hard labor building pyramids.  No, God casts them into a daily struggle for survival, where they’ve got to learn the skills they need to live, or die trying.

With all that background, it’s hardly a surprise that, when God gives Jesus a blessing and sends him on his way, God sends him first into the wilderness.   It’s Jesus’ experience of testing, of trial.  It’s Messiah boot camp.  The angels are there to serve him, but I expect their role is more like Marine Corps drill instructors than pillow-plumping flight attendants.

Cancer’s a wilderness experience.  Its diagnosis can bring on disorientation, grief, depression, anger, anxiety, and a whole host of other grim responses.

The poet T.S. Eliot is aware that there are all sorts of deserts in life, not all of them having to do with sandy wastes and scorching sun. In his poem, “Choruses from the Rock,” Eliot has this to say:

You neglect and belittle the desert.
The desert is not remote in southern tropics
The desert is not only around the corner,
The desert is squeezed in the tube-train next to you,
The desert is in the heart of your brother.
[T.S. Eliot, The Complete Poems and Plays, 1909-1950 (1952: Houghton Mifflin Harcourt), p. 98.]

Sometimes the desert is in the cancer survivor’s heart as well.

I find it significant that Jesus’ experience of being “driven out” into the wilderness takes place immediately after his baptism.  What appears to us a jarring transition actually makes perfect sense.

Think of what baptism really means.  We baptized a baby in church this morning.  Cutest little girl you ever did see.  The congregation loved the way she looked adoringly and trustingly up at my face as I washed her forehead with water carefully warmed so as to spare her any unnecessary discomfort.  But that’s not the essence of baptism. It’s not the heirloom gown passed down in the family for generations, the party afterwards with the sherbet punch and finger-sandwiches and potato salad.  No, baptism is made of sterner stuff.

As practiced by the first generation of Christians – before there was a second generation to grow up in the faith – baptism often took place standing waist-deep in a swift-flowing river, and the person performing the baptism pushed you down under the water and held you there, just long enough that you felt short of breath and feared you might drown.  Then, just as all seemed lost, you were lifted up into fresh, breathable air, gasping and sputtering, thoroughly relieved you were not going to die at all, that day.

When parents bring infants for baptism, they do it because they wish the very best for their children.  The very last thing on their minds is a life filled with pain and suffering.  As parents, their natural inclination is to shield and protect their children from anything so harsh and threatening as that.

But, do you know what?  Life is filled with pain and suffering.  Like cancer.  As it says in the book of Job, “human beings are born to trouble just as sparks fly upward” [5:7].  Baptism offers no guarantee whatsoever that the life ahead of this little child, or any other, is going to be more comfortable, or more protected, than the life of an unbaptized baby.

What we in the church offer children, in baptism – and in the years of Christian Education that follow – is not so much a soft, cuddly blanket as a wilderness survival kit.  For surely, this human life of ours can seem at times very much like a wilderness sojourn.  To get through it intact, we need to be trained in the ways of the woods, and know where to look to find food and shelter.

Henry David Thoreau, who retreated to his famous cabin beside Walden Pond because he “wished to live deliberately, to front only the essential facts of life,” speaks of something he calls “the tonic of wildness.”  A tonic, of course – in nineteenth-century parlance – is a medicine, or more like what we’d call today a nutritional supplement:

“We need the tonic of wildness, to wade sometimes in marshes where the bittern and the meadow-hen lurk, and hear the booming of the snipe; to smell the whispering sedge where only the wilder and more solitary fowl builds her nest, and the mink crawls with its belly close to the ground.  We can never have enough of nature.  We must be refreshed by the sight of inexhaustible vigor, vast and titanic features, the sea-coast with its wrecks, the wilderness with its living and its decaying trees, the thunder cloud, and the rain which lasts weeks and produces freshets. We need to witness our own limits transgressed, and some life pasturing freely where we never wander.” [Walden (Houghton Mifflin, 1854), p. 257.]

The poet Wendell Berry expresses a similar vision of wild places in these lovely lines, in a poem called “The Peace of Wild Things”:

When despair for the world grows in me
and I wake in the night at the least sound
in fear of what my life and my children’s lives may be,
I go and lie down where the wood drake
rests in his beauty on the water, and the great heron feeds.
I come into the peace of wild things
who do not tax their lives with forethought
of grief. I come into the presence of still water.
And I feel above me the day-blind stars
waiting with their light. For a time
I rest in the grace of the world, and am free.
[The Selected Poems of Wendell Berry (ReadHowYouWant.com, 2010), p. 36.]

I like to think that, when the Spirit drove Jesus into the wilderness, it was – at least in part – so he could have experiences such as these.  Yes, Jesus’ sojourn in the wilderness is traditionally depicted as a time of temptation, a struggle with Satan.  Yet, I also think it had to include its moments of peace and stillness, of contemplation and wonder, of living close to the earth and close to God.

I find it comforting, as I reflect on my cancer experience, to recall the therapeutic value of my baptism.  As with Jesus’ own trip to the river, it was followed eventually by an experience of being driven into the wilderness.  The wilderness is a fearsome place, to be sure.  But it can also be a fearsomely beautiful place.

And therein lies today’s lesson.

July 7, 2011 – Unbending Our Thoughts

Brian Stabler is a psychologist at the University of North Carolina, Chapel Hill, and a lymphoma survivor. In a helpful 2004 article, he speculates that a good deal of the trouble we go through in dealing with cancer is a result of unrealistic or “bent” thinking. The technical psychological term is “cognitive distortions.”

What are some of these bent thoughts? Stabler explains:

“For instance, when asked, many cancer patients report that they believe cancer is a foreign invader substance, such as a virus. This underlies the common misconception that you can actually ‘catch’ cancer from someone else. Obviously, this distorted belief could work against optimal outcomes, because it encourages the patient to rely on others – as if medicine, and a doctor or nurse is all that is needed to make things better. Not so: the patient is the most important part of the equation, and must learn to deal positively with cancer.”

Stabler encourages a technique of dealing with destructive thinking that requires immediately identifying the presenting thought that caused the negative emotional state, then “sweeping” it so it can do no more harm.

He suggests a learning exercise in which we keep a piece of paper close at hand, divided into three columns. The first is labeled “SITUATION,” the second, “REACTION” and the third, “THOUGHT.” When you find yourself reacting negatively, he explains, make a note of the situation that precipitated it, then try to capture the thought you were thinking just before you became aware of the depressive or anxious or angry emotion that ensued.

Stabler suggests several common categories of distorted thinking:

1. Black and white thinking – this is the all-or-nothing style where everything is simple and concrete, and there are no shades of grey.

2. Catastrophizing – where an individual interprets even the smallest problem as a potential disaster and reacts accordingly.

3. Fortune telling – the tendency to believe that we know what the future holds, and it generally is not pleasant.

4. Emotional reasoning – the belief that the feelings you experience represent reality, as in, "I feel bad all the time, so this must mean that things in my life are pretty bad."

If just one or two of these thinking styles is present, a cancer patient could have a poorer life quality, increased stress, and perhaps even negative changes in the course of [the] illness. Research has shown that if patients learn to journal their thoughts, and actively begin to challenge and adjust their ‘hot thoughts’ and distortions, they can anticipate improvements in their quality of life. I've come to firmly believe that keeping psychologically fit is every bit as important as keeping physically fit.”

Because cancer is generally not caused by some foreign-invader virus or bacterium, but is in fact an erroneous response of our own genes, our patterns of thought may well have a great deal of influence on how successfully we manage to live with this disease. We can’t think ourselves well by utilizing our minds alone, but our thought processes do have something significant to do with our well-being. It’s all part of the healing process. Every little bit helps.

June 27, 2011 – Hope Will Find You

Saw a real gem of an entry on Dr. Wendy Harpham’s On Healthy Survivorship blog (June 2). Exploring the subject of hope, Wendy quotes Rabbi Naomi Levy, whose book, Hope Will Find You: My Search for the Wisdom to Stop Waiting and Start Living, chronicles her journey towards a deeper spirituality after her 5-year-old daughter, Noa, was diagnosed with a rare, fatal and degenerative neurological disease.

In a magazine interview, Rabbi Levy shares an anecdote from the time when Noa was preparing for her bat mitzvah, that rite of passage for girls crossing into the teenage years. With Noa’s learning disabilities, her mother didn’t quite know what she was capable of absorbing, when it came to studying the scriptures.

The Rabbi asked her young daughter what a particular Bible passage meant to her, and she replied, “‘Mom, I think what it means to me is, if you don’t like your life and things are not going well, if you try very hard you can find hope.’ Then she stopped and corrected herself. She said, ‘No…hope will find you.’”

Her mother reflects: “Noa was saying…that hope would find me, that hope was searching for us and that goodness and mercy and all these lessons are actually seeking us, tracking us down, and too often we are running away from them. We’re thinking it’s a struggle, but in reality what we can do is relax a bit and let all these blessings in, because they are all around us.”

Relax a bit.

Relax? Are you serious? When the bad news is coming so fast and furious?

Yes. No one said it would be easy, but there’s simply no other way.

In the medieval spiritual classic, The Imitation of Christ, Thomas à Kempis teaches: “To sum up, dear friend of Mine, unclench your fists, and let everything fly out of your hands. Clean yourself up nicely and stay faithful to your Creator.”

So much of spirituality is about letting go. And the first and greatest thing our desperate fingers are clasping is the illusion that we are in control. For a few seasons of life, most of us can carry off that charade to some degree, but eventually reality catches up. With a bang. Some hard piece of news may first turn our minds in that direction. Perhaps it’s a cancer diagnosis – or, in Rabbi Levy’s case, the unspeakably sad realizaton that she will one day bury her daughter. Even the most fortunate of strivers can’t keep the illusion going indefinitely. Eventually, even those titans who sprint relentlessly into the final lap must one day lean into retirement. Then, soon enough, come the gasping infirmities of age, and finally the awareness that Death will soon come calling.

The drunken Welsh poet Dylan Thomas counseled,

“Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.”

Noble words, these, and not without a certain desperate bravery. Yet, in the end, the brash author of those lines succumbed to pneumonia, after imbibing huge amounts of whiskey on a bender lasting several days. It was by no means his first. Thomas was a tortured soul, who wore himself out in his frenzied pursuit of hope. Rage, however poetic, is hardly conducive to the discovery of inner peace.

We simply don’t have it in us to manufacture the variety or the quantity of hope we need. It can only be gathered in, and then only by those who have ceased to pursue it.

Young Noa Levy was wise beyond her years. Would that we all could be so perceptive.

June 5, 2011 – An AIDS Survivor’s Testimony

There’s a thought-provoking op-ed essay in today’s New York Times, written by a man who’s been living with AIDS since the early days of that epidemic (Mark Trautwein, “The Death Sentence That Defined My Life”). While there are many dissimilarities between HIV-AIDS survivors and cancer survivors – most notably the horrible stigma and irrational fears that still lurk around HIV-AIDS, and which were especially intense in the early days – there are also some notable similarities.

At one point, Mark Trautwein and his partner, both infected with AIDS, actually packed up and moved to a new home closer to Mark’s family, because they were convinced both were not long for this world and they would need someone to care for them in their last days. Then, the protease inhibitor class of AIDS drugs came out, and everything changed. Suddenly, their looming deaths were pushed back from “soon” to “sometime.”

With the medications that are now available, AIDS – while still a dread disease – has become transformed from a sentence of certain death to something more akin to the “incurable but treatable” NHL that I have.

I’d be very cautious, myself, in drawing any parallels between my story and that of someone struggling to stay healthy with AIDS – especially someone like Mark, who lived through those dark years when no one even knew what this new “plague” was, nor what could be done about it, short of quarantining everyone who had it – but I did have to nod with recognition at what he says he’s learned from looking death in the eye:

“For 15 years, death had been ever present. I'd thought about it daily, got familiar with it and planned around it. It had amazed me that people could walk around every day as if they were immune to it. Now I had to adjust to a life I'd been schooled to believe I'd never have. It was one of the hardest and most welcome things I've ever had to do.”

Even though, at the time of my diagnosis, my objective chances of survival with NHL were far, far better than those of the early AIDS patients, I still went through a major phase of asking all sorts of “what if” questions about my own death – some of them weighty and philosophical, others trivial and even silly. What if this is my last year on earth? What does it mean to “get your affairs in order”? How does one know when it’s time to do that? Is it worthwhile springing for that new crown the dentist says I need?

At mid-life, I’d scarcely begun to absorb the fact that I’m going to die someday – not so much an intellectual realization as an existentially, gut-level one. Suddenly, the thought was with me constantly. I felt like I’d been sleepwalking for years – and, like Mark, I looked around at all the healthy people and wondered how they could be so oblivious to it all. “Why waste your time watching reality shows, people?” I wanted to shout. “Don’t you know your own reality is precious, and of limited duration?” (Thankfully, I kept my mouth shut. I could have been a real downer at dinner parties.)

Aware of my own “incurable but treatable” NHL diagnosis, I was curious to read of Mark’s perspective after 30 years of living with his own:

“My relationship with AIDS is one of my most enduring ones, and has both enriched and beggared my life. It robbed me of friends and loved ones, and with them memories we would have had and repositories of my own history. It ended a career I loved. It cost me a marriage. My intimacy with health care in America has been costly and exhausting. I know these are small prices to pay for life.

What I've gained is precious. Above all, the constant companionship of plague has taught me that life is about living, not cheating death. Fighting disease is required and struggling with life inevitable. But I accept the outcomes now, whatever they are. My disease does not make me special, nor does my survival make me courageous.

On that day I walked from the hospital knowing I had "it," I was given a great gift: the realization that we all dangle from that most delicate of threads and that the only way to live a life is to love it.

I haven't died on schedule, and I've been learning not to live life on one either.”

I don’t swallow 25 pills a day for my immune-system disorder, as Mark does for his. Nor do I have to worry about lingering social stigma. My daily road is still far easier than his. After more than 5 years of watch-and-wait monitoring – and even a recent PET scan that showed no potential lymphoma “hot spots” at all, though it’s surely still there – I’m even beginning to wonder if I’m losing the keenly introspective, philosophical edge I had back in my chemo days. Back then I felt lousy, physically, but in terms of spiritual discernment I felt like I was near the top of my game.

I hope I still love this God-given life as much as I did then. Yet, I’m also realizing how easy it could be to fall back into the poppyfields and go back to my blissful, pre-cancer slumber.

Cancer’s lessons are hard-earned. I hope I don’t lose them.