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Never Sure to Preach Again: Cancer and Easter Hope
Mars Hill University, Mars Hill, North Carolina
Seventeenth-century Puritan pastor Richard Baxter, persecuted and sometimes imprisoned for his nonconformist convictions, said: “I preached as never sure to preach again and as a dying man to dying men.” Not because of persecution, but because of serious illness, I feel an urgency similar to Baxter’s. I have become unavoidably aware of my mortality, and while my health is relatively stable for now, I have a palpable sense of uncertainty about the future. When will I no longer be able to bear witness to the good news about God made known through the history of Israel and through Jesus? When will be the last time I invite people to lift up their hearts in response to the audacious hope which Easter makes possible? I preach as never sure to preach again, as one who is dying to those who are dying.
Just over two years ago, I was diagnosed with Multiple Myeloma (MM), a cancer of the bone marrow and blood. It is an incurable disease, but there are life-extending treatments, a variety of which I’ve been receiving since early 2014. I was 57 years old when I learned that I have cancer. Before then, I had rarely, and never seriously, been ill. A couple of racquetball injuries had kept me out of work for a few days, and a few bouts with a cold or the flu had briefly sidelined me. I’d not been a hospital patient since I was sixteen and had undergone orthopedic surgery to repair an ankle which had been shattered in a high school football game. I had worked hard to be as healthy as I could be, exercising regularly and watching my diet. I was fortunate not to have to take any medications other than over-the-counter pain relievers for mildly arthritic joints. So to say that I was shocked by the hard news is an understatement. It unsettled barely-conscious but powerful assumptions I had made about my physical strength, my ability to provide for my family, and my remaining time for the challenges and opportunities I wanted to pursue.
As surprising as the diagnosis was, for about a year before diagnosis, however, I had sometimes complained: “I feel more tired than I think I ought to feel.” It was taking more time for me to recover from long work days. Extended concentration had become more difficult, especially when, as increasingly happened, sleep ambushed me when I tried to read or to write. I was concerned, but I chalked up these annoying symptoms to my being in my mid-fifties and working more hours each week than was wise. I assumed that my near-exhaustion was the result of the way I carried the demanding responsibilities of the role I had as pastor of the First Baptist Church of Asheville, North Carolina, a congregation which I was grateful to serve and which always challenged me to grow. I soon learned, however, that extreme fatigue is one of MM’s main symptoms, along with possible bone and kidney damage.
In late December of 2013, I had my annual physical, and lab results prompted my primary care doctor to refer me to a hematologist-oncologist. Further tests showed that I had cancer. I was in an evening Finance Committee meeting at the church when my oncologist called. I stepped out of the meeting, went to a nearby room, looked out the window at the rain-soaked street shining in the glow of street lights, and listened as the doctor briefly and straightforwardly told me that I had MM. He said he needed to see me as soon as possible so that we could plan treatment which, he indicated, would likely involve several rounds of chemotherapy and an eventual stem cell transplant.
The call lasted less than five minutes, but the news it bore moved my primary residence from what Susan Sontag called “the kingdom of the well” to the “kingdom of the sick.” She wrote: “Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.”1 Multiple Myeloma has forced me to acknowledge my citizenship in “that other place,” a place of struggle and suffering.
In the kingdom of the sick, I have sustained many losses. I’ve had to surrender my illusions of invulnerability and independence, to come to terms with diminished physical energy and capacity, and to relinquish the role of pastor, a role which had been central to my vocation for more than three decades. When treatment was most intense, I experienced “chemo-brain” which, in my case, caused me to be occasionally disoriented and confused, to have difficulty remembering the names of people whom I know well, and to put dirty socks in the recycle bin instead of the clothes hamper. From time to time, I have experienced searing pain, endured fearful and sleepless nights, been unable to keep food or medicine in my system, had a severely compromised immune system, and twice come to edge of death.
Of course, the kingdoms of the sick and the well overlap. Both kingdoms operate by the values of market capitalism. In the kingdom of the sick, large healthcare corporations, insurance companies, and drug manufacturers largely govern the treatment of the ill.
Both kingdoms venerate autonomy. Medical ethics and practice have so elevated the principle of autonomy that patients and their families are often left without the expert guidance and prudential counsel which they need to make wise decisions. It is one thing—and a good thing—to guard against paternalism; it is quite another to put the ill in a position to make choices which they feel both inadequate and fearful to make.
Both kingdoms deny death until denial is no longer possible. Euphemisms for death abound in the kingdom of the sick as they do in the kingdom of the well. Even with an incurable illness like MM, the terms most often used (except in the fine print of consent forms) are “negative outcome,” “exhaustion of treatment options,” and “irreversible disease progression.”
These days, I shuttle back and forth between the two kingdoms, essentially living simultaneously in both of them. I take an oral chemotherapy drug each day, the ongoing side effects of which are diminished immunity, nausea, and bone pain. The cancer is present, but at low levels, and I’ve been able to take up new work as a college professor and as a guest preacher in various congregations. I am learning about how to honor, rather than to resent, my limits.
My challenge as a follower of Jesus and as a preacher is to remember that my primary identity is not as subject or slave in either the kingdom of the sick or the kingdom of the well. I am, instead, a participant in the rule and reign of God in which faith, hope, and love endure even when the well become sick and the sick die. When I remember who I am and, even more crucially, recall that God’s gracious order of shalom is the true and transcendent one, I have been able to face the givenness of my death and to trust the gift of resurrection hope.
In the month or so before Holy Week last year, I was at risk of forgetting. I had severely adverse reactions to one of the chemotherapy drugs: a rash which turned to whelps which broke open and bled, unremitting itching, fever, and flu-like symptoms. Then, just as steroids and antibiotics were clearing those problems, I came down with the actual flu. There were a few days when I was so out of it that my memories of them are cloudy at best. As I had in times of weakness and pain across the preceding year, I felt viscerally the presence of death. I desperately needed to find a faithful way to live realistically in the kingdom of the sick and, at the same time, mindfully in the kingdom of God.
As Holy Week of 2015 approached, I heard the whispers of an insistent invitation: “Face as fully as you can the fact of your death and embrace joyfully the gift of your life.” I knew that these two tasks were intricately intertwined, because we only begin to live, truly live, when we come to terms with the stark reality that our lives will end. Psychiatrist Irvin Yalom said, “Though the fact, the physicality, of death destroys us, the idea of death saves us.”2 Yalom’s words call to mind the prayer of Psalm 90: “So teach us to count our days that we may gain a wise heart” (90:12). I wanted to learn to hold death in my mind and heart but also to let Joy hold me.
While this Holy Week invitation felt difficult to answer, it also registered with me as a calling which tenderly and clearly demanded a response. Thankfully, the Easter which was approaching was the first in 37 years on which I would not preach. I was relieved because I needed to hear the good news far more than to announce it. Not having the responsibility to preach meant I could spend all of Holy Week simply listening without wondering what I would soon have to say.
Since my tenure at First Baptist Church of Asheville had ended in January, my wife and I had been worshipping at All Souls Episcopal Cathedral. The welcome of that congregation, the beauty of the language of The Book of Common Prayer, the fine music and preaching, and especially the centrality and regularity of the Eucharist were sources of rest and renewal for me. I decided to lean in to the liturgies of Holy Week at All Souls and look to them for the guidance and support I needed for the soul-work to which I felt summoned.
Maundy Thursday worship was starkly beautiful; it included foot-washing, Eucharist, and “the stripping of the church,” a rich symbol of the poverty and shadows into which the world descended as Jesus moved ever deeply into suffering and death. The choir sang an arrangement of George Herbert’s “Love Bade Me Welcome”; the words and music touched with healing hands the ache of my tired body for mercy, of my weary heart for grace, and
Love bade me welcome. Yet my soul drew back
Guilty of dust and sin.
But quick-eyed Love, observing me grow slack
From my first entrance in,
Drew nearer to me, sweetly questioning,
If I lacked any thing.
A guest, I answered, worthy to be here:
Love said, You shall be he. . . .
Canon Thomas Murphy’s homily spoke directly to the challenge I was attempting to meet; he talked about how preparing to die is a way to make room in oneself for new life. As I reflected on what Thomas said, I connected his words with Ernest Becker’s claim that “the human animal is characterized by two great fears that other animals are protected from: the fear of life and the fear of death.”3 I’m convinced that we fear life because we fear death and that the greater our sense of un-lived life, the greater our anxiety about our impending deaths. We will regret the end of our lives all the more if we come to our deaths with a sense that we have never pursued our dreams, used our gifts, spoken our truths, told our stories, and sung our songs. It’s the ultimate vicious cycle: fear of death begets fear of life which increases our fear of death which heightens our fear of life. Maundy Thursday added clarity and urgency to the work I was doing.
On Good Friday night, I experienced the solace of long stretches of shared silence, hauntingly lovely music, and guided prayers of petition and intercession. After the service, I sat for a while in the darkened church, and this prayer took shape in me: “O God, give me the love which embraces my death and transforms the fears it generates. Cause me to trust anew that all shall be well. Show me how to die, and, by so doing, show me how to live.”
For me to be able to trust, as Julian of Norwich did, that all shall be well, I had to reckon with what I believe about life after death. I have been, for most of my adult life, uncertain and agnostic about what, if anything, lies beyond our deaths. There have been times when I have been fairly sure that the Ash Wednesday liturgy, echoing Genesis, speaks the last word: “From dust you were made and to dust you shall return.” At other times, times when I most needed resurrection faith, it has risen in me. It certainly did when life was ebbing away from me during the stem cell transplant process at Duke University in the summer of 2014. One late-night and early morning, I was on the thin border which marks the passage from life to death. Chemotherapy had torn me down, and weariness had brought me close to surrender. I was drifting away. Suddenly, I was startled to alertness by the loud sound of iron slamming into iron, like the shutting of a massive gate or the clanging closed of a prison door. Though the light had not disappeared, the shadows were darker than the light was bright. I could easily have gone more deeply into the valley of the shadow. To turn back toward life would, I knew, take more determination and effort than would dying. To live would take more will and strength than I had.
Then, to my surprise, anger overtook me. I got, as my West Virginia kin would put it, “good and mad.” If I had had energy to do it, I would have “cleared off a place and pitched a fit.” I wasn’t mad at God or myself or the doctors or even the medicines that had to nearly kill me in order to cure me. I’m still not sure who or what exactly I was mad at, except that I was furious at the thought that I would go that far down, endure so much, and then let the treatment itself kill me. Unbidden, except perhaps by the wordless prayer of the Spirit in my spirit, I felt Jesus nearby, joining me in my anger and my tears. Though I heard no words, his presence seemed to say, “If you want to live, let’s do this together.” Together, we prayed for the strength and courage to live; then he responded gently but tenaciously to the prayer we prayed. We clawed our way back from the borderline.
Three days later, as I lay in Duke Hospital with a high fever, I went back to the threshold. I again felt Jesus’ presence, but I heard nothing new. I was aware that I could live if I chose. It will not always be that way, of course; there will come a time when my choice will simply be whether to welcome or to resist the end which will come no matter how I respond to its approach. That night, though, quiet but palpable Love gave me the freedom and the will to live rather than to die. I decided to live. On Good Friday night, then, as I reflected on what I believe about life after death, these powerful experiences of Jesus’ presence on the verge of death tempered and questioned my agnosticism. I came to a conclusion which I think Pascal would recognize: I would either die into nothingness and, because I would not be conscious of this oblivion, all would be well; or, I would die into the arms of God, and all would be well. I felt a bracing release from constricting anxiety about what comes after death; and since that night, my trust that we die into God’s embrace has become stronger. I have been to the edge and to the bottom, and God has met me in those hard places; it makes sense to my heart that God will meet in and beyond death.
At Saturday night’s Great Easter Vigil, reaffirmation of baptism was the pivot on which worship turned from Lent to Easter, from shadows to light, and from death to life. We read from Romans 6, which included a phrase I heard differently than I have heard it before: “You must consider yourselves dead to sin and alive to God in Christ Jesus” (6:11). I was struck by that word consider—deliberately think of—yourself as both dead and alive. I saw what had always hidden in plain sight: to view life with baptismal imagination, with Easter discernment, is to perceive that we are dying to the powers that distort, demean, and diminish us, even while we live, and that we are living by the energies of creation and resurrection which flow into us, fill us with joy, and inspire us with hope, even while death is at work in us. Baptism is our Easter.
Multiple Myeloma has certainly affected my preaching. I keenly feel the urgency which Richard Baxter described: I preach as never sure to preach again, as one who is dying to those who are dying. It’s not just that I no longer take it for granted, as I sometimes did in the week-to-week and year-to-year routine of the pastorate, that I will “always” have the opportunity to preach. It is that my sojourn in suffering has made the good news we preach more tangibly and immediately a matter of life and death.
The themes which flow from baptism keep demanding that I give voice to them. Over and over, I feel gladly compelled to remind people that because we are immersed in grace, submerged in mercy, and flooded with love, we are who baptism says we are, beloved children of God in whom God takes great delight. God sees us and responds to us as God sees and responds to Jesus. Because that is true, there is, as Paul affirmed, “no condemnation for those who are in Christ Jesus” (Romans 8:1). We face both life and death with the assurance that God has freed us from the guilt, shame, and fear which cause us to disengage from the present and dread the future. I keep coming back as well to the companion promise at the end of Romans 8: “I am convinced that neither death, nor life, nor angels, nor rulers, nor things present, nor things to come, nor powers, nor height, nor depth, nor anything else in all creation, will be able to separate us from the love of God in Christ Jesus our Lord” (Romans 8:38-39). For the children of God, there is no separation and no condemnation. Nothing separates us from God’s love—neither death which constantly threatens life nor life which fails to be more than struggle. No matter what happens, God is for us, not against us, and with us, not distant from us. Sometimes, these baptismal promises are all I know; and always, they are enough.
I began chemotherapy on Ash Wednesday of 2014. The week before, I had spent a few days at Valle Crucis, a retreat center operated by the Episcopal Diocese of Western North Carolina. I wanted to prepare for, and especially to learn how to pray about, whatever I would face. I walked in the mountains, sat near a waterfall, and stayed up late in my room, listening for words which might become prayers. I wrote page after page in my journal. Eventually, these sentences found me:
O God, remind me always that my life is your gift, that I live under, and rest in, your Mercy.
I offer you what I have: a broken but grateful heart, a wounded but wonder filled spirit, an unknowing but searching mind, and a sick but yielded body.
Break what is broken in me, O God, then fashion me anew from the pieces. Break the grip which brokenness has on me, and let me know freedom and joy.
Fill my heart with trust in your love, my mind with thoughts of your goodness, my spirit with hope, and my soul with joy.
Give me courage to face pain, strength to carry weakness, and help, from you and others whom you send, to bear what I cannot bear alone. Show me how to cooperate with your Holy Spirit and my truest spirit and with doctors, nurses, and other caregivers.
Use the drugs I take as agents of curing.
In all things, reduce and increase me to Love. Amen.
As I continue to pray these words, it is the healing of brokenness even more than the curing of cancer which I seek.
Brokenness, whether we experience it primarily physically or psychically, affects the whole person. Because body, mind, soul, and spirit are all connected, it is impossible to keep the varieties of our brokenness apart from each other. When sick- ness diminishes our bodies, it also threatens how we feel, think, and believe. When loneliness wounds our souls, the pain registers in our bodies. We can’t corral our hurts behind gates which keep them from running through every dimension of who we are. Across these two years, I have had to come to terms with a disease I did not cause, but I have also had to face pain to which my own failures contributed. Cancer has gathered up and brought other wounds to consciousness. I have been shattered, and it is such a gift, a hard and holy gift.
Anne Lamott wrote that “the three most terrible truths of our existence [are]: that we are so ruined, and so loved, and in charge of so little.”4 The Easter good news is that we are so loved that God, in and with Jesus, has taken our pain, even our forsakenness, into God’s own great heart. From God’s now wounded but healed heart and hands, we receive hope amid the ruins, light in the shadows, and joy within and beyond suffering.
1 Susan Sontag, Illness as a Metaphor (New York: Farrar, Strauss, Giroux, 1977), 3.
2 Irvin Yalom, Staring at the Sun (San Francisco: Jossey-Bass, 2008), 7.
3 Ernest Becker, The Denial of Death (New York: The Free Press, 1973), 53.
4 Anne Lamott, Help.Thanks. Wow. The Three Essential Prayers (NY: Riverhead Books, 2012), 27.