Here I am: How shall I live my cancer?

August 3, 2010

It’s Thursday morning, November 9, 2006. It’s ten after nine. I’m at my desk, working through Ecclesiastes for a book I am to write. The verse I’m working on goes like this: “Better a handful with quietness than two fistfuls with toil and a chasing after wind.”

In the middle of this verse the phone rings. This is Dr. S. Your biopsy has turned out positive, and it’s bizarre. It’s a rare, aggressive cancer of the prostate. I’m to come in for a CT scan.

Suddenly everything has changed. In a split second I have become one of “them”—a cancer patient. Suddenly I find myself encapsulated in the present moment. Suddenly I find that my past—last year, last week, yesterday, an hour ago—is a country I used to live in. And I am unable to imagine the future. There is just the present moment.

It continues like that for several days. No panic. No anxiety. Just a sense of utter, settled clarity. So . . . the chips are down. Now we see whether what I’ve believed, what I’ve worked in the name of all these years, is true or just a house of cards.

My wife and I had planned to attend the annual meeting of the Society of Biblical Literature. We go ahead with our trip. Driving east along I-70, I discover that, if all there is in this world is the present moment, it is good; it is precious. I think it may be the patience of the trees and the fields along the road, the unassuming familiarity of farmhouses and side roads. I feel a deep, quiet sense of the goodness of life, a keen gratitude for everything.

We arrive in Washington and register for the meeting. I spend most of my time in the book exhibit, where sooner or later I should run into most of my academic acquaintances. Again, the strange experience of being inside a bubble. Outside of it, people are living out of their past and into their future—inter acting with others, who likewise are living out of their past and into their future. Someone buys a book for a course planned for next year. What is it like to do that? To plan so matter-of-factly for next year? I used to know, but now I can’t recapture that feeling.

My eyes fall on an interesting book. Normally I would buy it. But will buying it now be an act of denial—as if I were trying to assume a future I can’t even imagine? Will not buying it be an act of fatalistic giving up? Choosing a third option that I don’t have a name for, I buy the book. I continue walking around, among people who still inhabit the four-dimensional space-time country I used to live in. People two feet away from me are in a different world.

Then I run into Jenny, who asks me, warmly, genuinely, innocently, how I am. Not to tell her would insult our friendship. So I tell her. And now a strange, wonderful thing happens. She, still there in that other country, and I, still inside my bubble, find ourselves in the same space. And this happens again with Pat. And then with Walt. And then Jack, and Michael, and Peter, and Kent. Amazing!

But hadn’t I experienced this with my own family? Well, not quite. When my wife, Eileen, underwent treatment for cancer five years earlier, I had felt myself in a similar sort of bubble with her; and now she is with me, has been all along, in this bubble.

We return home, and on November 22 I undergo a CT scan. We wait for half an hour while the radiologist reads the plates and then hands them to me to carry back to Dr. S. As we walk along the corridor, I feel like the master of ceremonies on Oscar night, my future sealed in the large envelope under my arm. In Dr. S’s office we wait for 15 minutes while he scans the plates. He calls us into his office, guides us over to the wall where several plates hang in a row, backlighted for easier reading. He escorts us through each frame in each plate—over 80 frames in all. At each point he notes with satisfaction that there is no sign of cancer outside the prostate. So in a month, surgery: a simple, routine prostatectomy. My bubble dissolves.

As we leave the clinic, the streets look—no, they feel—wider, and I find myself once again inhabiting this wider world. The question now is how do I approach the surgery and whatever may follow?

I remember an interview on National Public Radio with an Arab storyteller who runs a school for the revival of oral folklore. He described a young Arab woman in his class who told her story under the title “How I Lived the War.” My first reaction had been to smile at how this Arab hadn’t got the English idiom quite right; it should be “How I Endured the War,” or “How I Survived the War.” Then I realized—no! That’s it! How she lived the war. Not war as some extraneous event impinging on her life, but war as now shaping the life she was given to live. How I lived the war.

Remembering this, I think, yes, that’s how I want to ap proach this. Not “My Battle with Cancer”—though that way of approaching it is helpful to many people. Perhaps because of my Mennonite ancestry, that idiom, that attitude, is not available to me, doesn’t ring true for me. A better question is how shall I live my cancer, and its treatment?

Well then, how shall I live it? I take down a book that I had read many years earlier and that is heavily underlined and annotated. It is Pierre Teilhard de Chardin’s The Divine Milieu, which is divided into two main sections. In the first section, “The Divinisation of our Activities,” he sets forth a vision of the Christian life as a robust participation in the evolutionary history of this world under God and toward the destiny God intends for it. Here, we are to bend every effort to help eliminate disease and poverty, rectify injustice and so on. But then, he observes, there remain those evils that will ever elude our most strenuous efforts to ameliorate them. What then?

In the second section, “The Divinisation of our Passivities,” he sets forth a vision of a universe that Paul in Romans describes as creation groaning in travail and pain. Teilhard calls upon us to approach not only our activities but also our sufferings, as our participation in this vast cosmic, evolutionary drama, by God’s grace and toward God’s future for it.

In my case, what might such participation mean? How shall I live my participation in this ongoing drama, as one who has cancer? I recall some words of Teilhard that Bob Shaw offered to Ed Wheeler on his installation as president of Christian Theological Seminary. The words have a backstory: in the early 1970s I was for a while director of chapel worship, and one day my student assistant, Tom Jewell, came to me with a request from a group of students. Could we have a short service including the Lord’s Supper once a week at noon?

For two or three years a small group met each Wednesday at noon in a little prayer room. I had drawn up a simple form of service in which the prayers for the bread and the cup ended with words that Teilhard had written on an occasion when he found himself in an Asian desert without bread and wine and had simply invoked all the parts and all the happenings of creation as that day’s eucharistic elements.

Bob had often participated in this noonday service, and he reminded me the other day that I had concluded my sermon at his ordination by offering him Teilhard’s eucharistic words as a context for his own ministry. When Bob came to the end of his part in Ed Wheeler’s installation, he pulled out his wallet and drew from it a small, worn card onto which he had copied those eucharistic words. And he offered them to Ed as I had offered them to him, as a context for ministry.

Do you now therefore, speaking through my lips, pronounce over this earthly travail your twofold efficacious word: the word without which all that our wisdom and our experience have built up must totter and crumble—the word through which all our most far-reaching speculations and our encounter with the universe are come together into a unity:

• Over every living thing which is to spring up, to grow, to flower, to ripen during this day say again the words: This is my Body.

• And over every death force which waits in readiness to corrode, to wither, to cut down, speak again your commanding words which express the supreme mystery of faith: This is my blood.

This, I say to myself, is how I want to live my cancer and its treatment.

The day before my surgery, I realize that I want to approach the operating room like a golfer. As golfers know, it is fatal to swing at a ball with too many thoughts in one’s head. Those thoughts are OK for the practice range, but on the golf course one should have in one’s head only a single swing thought. What swing thought might I take into surgery?

Of course: Job 38, that wonderful vision of creation coming alive again under the fall rains that water the parched earth; and in the midst of this scene of nature coming alive is the single word hinnenu. Out of the rain and thunder and lightning, Job hears God say to him, “Can you lift up your voice to the clouds, that a flood of waters may cover you? Can you send forth lightnings, that they may go and say to you, hinnenu!—‘here we are’?”

On Mount Moriah, Abraham responds to God’s call with hinneni, “here I am!” At the burning bush, Moses responds to God’s call with hinneni; in the temple at night, the child Samuel responds to God, hinneni; in the temple, Isaiah responds, hinneni—all these, in Greek, idou ego. And so also Mary, to the angelic annunciation—idou (here I am)—the handmaiden of the Lord. Just so, in Job 38 each element in God’s creation, in the very act of existing, of standing forth in response to God’s call, says or simply enacts, hinneni.

The next morning they wheel me to the doors of the operating room and tell me that I am to get off the trolley and walk in. Walking in, I see a bunch of young kids standing around the table in green-blue scrubs. I can’t very well say to them, hinneni, or even, “Here I am.” But noticing that they are young enough to have recently paid their bills by waiting table in a restaurant, I walk up to them, spread out my arms and say, “Hi! My name is Gerry, and I’ll be your patient this morning.” The next thing I know, I’m in recovery.

It turns out that the CT scan has failed to pick up a diseased, golf-ball-sized lymph node. It was hidden under a dense mass of what my imagination pictures as TV cables and storm sewers. So they’ve removed that node and its companion nodes and sewn me up, leaving the prostate in place so that I can heal faster and get on with chemotherapy.

I cannot speak highly enough of the dedication, skill and humanity of every person on the respective medical teams. I have often suspected that I am genetically defective in that I don’t seem to have a “why-me?” gene. Given the kind of world we live in and given what happens to others, why not me? But through this experience I have discovered my “why-me?” gene. When so many in this country, let alone other parts of the world, are not able to have access to the treatment that my Medicare and pension fund supplemental coverage have made possible, I find myself asking, “Why me?”

I try to approach each infusion of chemotherapy by simply, as St. Paul might put it, “presenting my body.” Not cringing; not flinching; just being present. (When Paul says, “Present your bodies as a living sacrifice,” I appropriate his words to myself as meaning, “Participate in the life and the travail of God’s world in a manner that is faithful to God’s intent and that stands in solidarity with God’s world, whether in living or in dying.”)

So, too, with radiation treatment. Each day, as I lie on the machine, with that beam of deadly radiation going through me, I repeat Psalm 23 silently, not just for myself but for all the people I know who are also undergoing cancer treatment. I hasten to say that I do not take this approach in order to increase my chances of a good recovery! That is a trap I want to avoid like the plague. Rather, I want simply to present myself to the process as my participation in the travail of the world on its way to redemption.

In the summer of 2006, months before all this began to happen, I read a sermon by Austin Farrer in which he takes John 1:5 in a sense I had not heard before. Many of us are familiar with the difference between the KJV and the NRSV here. Drawing on one meaning of the Greek verb katalambano, the KJV reads, “The light shines in the darkness, and the darkness has not comprehended it”—hasn’t “grasped” it, in that sense. But the NRSV reads, “The darkness has not overcome it”— hasn’t “grasped” it in that sense.

Farrer employs the verb in yet another of its possible meanings: “The darkness has not overtaken it.” In chapter 12 Jesus uses this same verb in saying, “Walk while you have the light, lest the darkness overtake you.” He says that he himself has come to do the will of his father and to finish his work. And in one aspect, his ministry is a race against time. Will he get it done before time runs out on him, as his opponents, in their incomprehension, overtake him and overcome him? Well, in the very moment in which they think they have overcome him, he cries out, in this Gospel, tetelestai—“It is finished!”

In a way that message dovetails with Teilhard’s emphasis on “the divinisation of our activities.” John’s Gospel has a robust doctrine of the work that Jesus’ followers are called to. “Greater works than these shall you do, because I go to the Father.” If Jesus was able to finish his work before time ran out on him—before the darkness overtook him—what about his followers? What about us? Isn’t there all too much evidence of lives cut short before they have fulfilled their potential? And if so, how does this aspect of the story of Jesus help us with our own story, in our own work?

What about all those essays I have drafted that need final revision? What about that contract for a book on Ecclesiastes? Not to speak of the delightful joys and responsibilities of being a grandparent. Where in John’s Gospel might I find something to help me with these issues and illuminate my own situation?

On Easter, after the service and a noonday lunch, I was cleaning up some branches that had broken off in a high wind. They were not weak or sickly but thriving, covered with green needles and still oozing sap. As I worked on them, for some reason the various Easter pericopes in John’s Gospel played around in my thoughts. Suddenly my thoughts went to the last scene, where Jesus is reinstating Peter after Peter’s earlier denial of him.

Simon, son of John, do you love me? Yes, Lord; you know I love you. Feed my lambs. This is repeated three times, so that Peter will not later think he was wishfully dreaming it up. Feed my lambs. Tend my sheep. Feed my sheep.

Two days earlier, Peter had been overtaken for a time by the darkness of incomprehension or fear that had moved him to deny Jesus. Now, beyond hope, he is reinstated, with a wonderful work ahead of him. But then Jesus speaks a further word. We know it is the most important word in this passage, because Jesus underlines it by saying, Amen, amentruly, truly. “When you were young, you girded yourself and walked where you willed; but when you are old you will stretch out your hands, and another will gird you and carry you where you do not will.” (This Jesus says to show Peter by what death he is to glorify God.)

Then Jesus says, simply, “Follow me.”

Peter sees the beloved disciple following them, and he asks Jesus, “Lord, what about this man?”

Jesus answers, “If I will that he remain until I come, what is that to you? Follow me.”

What is his case to you? What is her case to you? Follow me.

With cancer or any other physical affliction—or any of those innumerable vicissitudes that can threaten to overtake us before we live out our lives—comparisons with other persons are not helpful. One size does not fit all. Nor does the specific circumstance, the specific profile, of one person’s vocation fit another’s.

In John 10, Jesus says that the Good Shepherd calls his own sheep by name to follow him. At one level, we may say, each one is called individually, by name, to a specific calling. Now, at the end of this Gospel, Jesus in another way addresses the individuality of our calling: “If I will that he remain until I come, what is that to you?” One calling does not fit all. Yet at the very deepest level, there is only the one vocation that all of us are called—in any and every circumstance—to follow.

When Peter can no longer feed God’s sheep because he is imprisoned, and even when he is taken to be executed for his faith, there is still something he can do—he can continue to follow a Lord who lived and worked and then completed his work in his dying on the cross and now lives as Lord of the dead and of the living.

This means that Peter can live his dying as he has lived his living, as a follower. Deeper than any specific task, deeper than the work that is dearest to our heart, the work that is dearest to the heart of God is for us simply to follow.

In the light of the gospel of a crucified and risen Lord, there is no conceivable situation in which that deepest work can be thwarted or aborted: simply to follow. To say, hinneni, Here am I, to live my living and sooner or later to live my dying, as part of your creation, groaning in travail and in hope.

That, it seems to me, is also what Paul means when he says in Romans, “If we live, we live to the Lord, and if we die, we die to the Lord. So then, whether we live or whether we die, we are the Lord’s. For to this end, Christ died and lived again, that he might be Lord both of the dead and of the living.”

This article is adapted from an essay that appeared in J. G. Janzen's book At the Scent of Water: The Ground of Hope in the Book of Job, published last year by Eerdmans.


Herding the Wind

is there still a publication date for Janzen's Ecclesiastes? Or any commentary he has done on it? Any direction is appreciated .