Three and a half years on

In other news, it's been about three and a half years since I finished treatment and there has been no sign of any relapse, for which I praise God! I saw my oncologist a few days ago and am now only going to have appointments every six months, which will cease if I make it to five years.

Jessica and I were reflecting again with some Australian friends who visited recently that coming to Scotland was a very effective way of "moving on" from my period with cancer. We arrived to a situation in which I was no longer being asked about my health every day and where people didn't look at me and immediately think of cancer, loved ones they'd lost, their anxieties for those still ill, and their own mortality. Although these connotations often opened up some deep conversations, it also closed down other ones. It has been nice to no longer be a walking reminder of our mortality and to be a mere mortal again.

(Now people look at me and think of birth instead of death!)

Still Not Dead

Today I finally saw an oncologist weeks after having my latest scan and he said that there were no problems to report. Next scan is likely to be another year or so away, though I will continue to have physical check-ups every three months. It helps if you are not ticklish for these!

I've now been clear for over two years and I no longer regularly think of myself as a cancer patient (even when I was very ill I tried to not let this become the primary description of who I was). For life and ongoing good health, I remain very thankful. Indeed, Jessica and I still begin each day (more or less) with the call and response from Psalm 118.24: This is the day that the LORD has made. Let us rejoice and be glad in it/him! Sometimes it is said a little grumpily or with a yawn, but the repetition is good for our hearts.

Even though I have been feeling much better (or perhaps, have been taking my good health for granted again), I have recently been thinking some more about what it means to die well. Here are some thoughts on the common phrase "dying with dignity".
This picture was obviously from a couple of months ago, since the temperature for the last few weeks has sat around a balmy 10-14ºC.

Thanksgiving reflection

Saturday morning was a service of thanksgiving. It was a wonderful time, with around 150 friends and family members joining together at All Souls to thank God for all his goodness. I'll write more about the service at some stage, but for now, I thought I would post the text from my reflection. A number of people asked for a copy and so I thought I'd make it generally available. Many of the ideas were taken from posts on my main blog over the last few months.
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It’s great to be here today.
It’s great to still be here today!

Death sucks
Our church signboard just out here on the corner recently caused a stir with a message of just two words. Tim and I were called up by the local paper, The Glebe, which ran a short article on the sign. Numerous parishioners were asked about it, or overheard animated conversations as people walked past. It made it into column 8 of the Sydney Morning Herald. It even attracted the attention of a local graffiti artist, who wanted to express disagreement. The two-word message was simply this: Death sucks.

When I first received the diagnosis of cancer back in December, this was precisely how I felt. Life is a good gift from God, and so death, which ends that gift, sucks. I had no desire to die. And as my situation developed and my symptoms got worse, it was not just death, but all that led up to it and anticipated it, that also sucked. The loss of good things in life, the loss of easy breathing, the reduction of strength, the decline of my voice, the coughing, the compromise of physical comfort, the loss of a full night’s sleep - these too were all causes of grief. And even once treatment began and progress was being made in reducing the tumour, I still regretted the side-effects of treatment: the constant needles, the lessening of mental concentration, the confusion of memory, the swollen feet, the suppressed immune system, the burned and itchy skin, the painful swallowing, the perpetual tiredness. And this is before I mention the social effects: telling people that you have cancer means that for some people you become a walking symbol of their fears and regrets, a constant reminder of their mortality.

Psalm 116
All these things have been part of my experience over the last few months. And now that they’re gone, and the possibility of imminent death has retreated somewhat, I am very thankful to God. Just like the psalmist in the passage Celia read (Psalm 116), I called on the name of the LORD: “O LORD, I pray, save my life!” and the LORD dealt bountifully with me. For he delivered my soul from death, my eyes from tears, my feet from stumbling. I still walk before the LORD in the land of the living.

Why?
God healed me. Through the doctors, through the chemotherapy, through the radiotherapy, through the prayers and love of many here, through his design of a good human body, through his life-giving Spirit, God healed me. Why? Like the psalmist, all I can say is our God is merciful.

Why me and not others? It would be tempting to give all kinds of answers to that question. But the truth is, I don’t know and don’t think anyone does. I know this, however: it wasn’t because I had more faith, or because I deserved it. Life is an unmerited gift. We can only accept it, and give thanks.

And so I thank God. I also thank God for all those through whom he has loved me over recent months: Jessica, my brothers and sisters here at All Souls and also at Barneys, all my relatives by blood and marriage, our friends, and even many whom I don’t know well directly, but who have been praying for us and generously giving love and support in all kinds of ways. Jessica and I thank God for all of you. I thank God that I’m alive to enjoy knowing you and being known by you.

It is a good thing this is not a funeral today. Death sucks. Life is a gift and for that we thank God.

But wait, there's more
But there is more to be said that this. It would be a shame to leave our reflections there and not dig deeper into this experience I’ve had and which so many of you have shared. Because what might we say if this was a funeral? What might we say if I go for my next scan in another month, or six months or six years, and the tumour is back, worse than ever?

The great taboo
Our culture doesn’t seem to know what to do with death. People seem to oscillate between denial and obsession. On the one hand, for most of the time, we live as though we won’t die: we arrange things so that the dead and dying are kept out of sight, out of mind; we stay busy and avoid silence in order to minimise reflection; we politely change the topic after an awkward silence if death does come up - as though we were trying to fool ourselves that it just might be possible to get out of this life alive. Yet, on the other hand, we’re obsessed with death: we spend billions of dollars each year on crisis healthcare, we demand doctors do everything in their power to keep us alive. To my mind, both denial and obsession seem to indicate that deep down, we’re terrified of death.

We pursue riches partially so we can try to insure ourselves against dying. We try to chase away terrorists with ever-tougher laws because we’re happy to pay any price to avoid the possibility of being killed. And when we do think about dying, we want our death to be quick and painless, we want a sudden death, to not know that it is coming so that we need not live in fear. Sometimes, it feels like this is almost the only thing left uniting our fractured society: we all share a fear of death.

Worse than death
But there are things that are worse than death. There are things more important than simply staying alive. And so while I have always wanted to do things that help me survive, I don’t want that effort to dominate my life and thought.

Why do I think there are things worse than death, things better than life? Because Jesus seems to have thought so too. He loved life as God’s good gift, but for Jesus, trusting and obeying the giver came before preserving the gift. When faced with the choice of obedience or survival, he prayed ‘not my will but yours be done’. He could have run. He could have kept his head down. He didn’t have a death-wish – he knew that death sucks. But he also knew there was something worse than death: a life that failed to trust God.

Death is bad, but untrusting anxiety, apathetic lethargy, bitter regret, faithless betrayal: these are the real enemies of God and humanity. These will blunt and bleed the soul, poison the spirit, and stop the heart more surely and grievously than the cessation of brainwaves and breath.

Bitterness, fear, apathy
For me, this was brought home sharply a day or two after getting the results of my first scan back in December. I clearly remember travelling home and realising that the more sinister danger facing me was not the wayward growth of cells in my chest, but the potential growth of bitterness or fear or apathy in my heart.

I could see myself becoming so fixated on my problems that my grief might sour into resentment, blinding me to all the good things with which life is filled, many of whom are sitting here in front of me. I could be so scared of what might happen, of pain that might come, of losing more abilities, so scared of missing out on the rest of my life that I could fail to live that life. Poisoned by bitterness, paralysed by fear, I might then give up and sink into apathy, losing the will to care about anything beyond my immediate physical needs.

These were the real dangers. To shrink into bitterness, fear and apathy would have been to lose part of my self.

Thankfulness, hope, love
But there was another option. Instead of bitterness, I could give thanks for all of God’s gifts. Instead of fear, I could place my hope in the God who raises the dead. Instead of losing myself in apathetic self-centredness, I could discover who I really am by loving and serving those around me.

Thankfulness
God has given me so much: not only life and breath, but new life by his Spirit; not only a loving family and wonderful in-laws, but brothers and sisters who share the same Father in heaven; not only the best wife I’ve ever had but a saviour who gave his life for mine. I am blessed and double blessed. How can I not be thankful?

Of course, all these good gifts and many others don’t mean I don’t grieve. I do. One of the saddest moments for me was back at Christmas, when my two and a half year old nephew asked me to sing with him ‘Jesus loves me this I know’. I tried and nothing came out. I’m sad that my voice isn’t able to sing as I’d like to. I’m sad that plans and dreams have been put on hold. I’m sad that many others - including many of you here - have suffered far worse for far longer than I ever have. Yet avoiding bitterness doesn’t mean minimising or ignoring the darkness. The thanks and the grieving go together. This is because giving thanks is already an act of hope. I can give thanks even in the midst of disappointment and heartache, not because I think the pain is good, but because I know something of God’s future.

Hope
God raised Jesus bodily from the dead, as we heard in our second reading (Luke 23.50-24.9). Jesus overcame death. To speak of this resurrection doesn’t mean Jesus or his spirit went to some afterlife with God. This would simply be as though death were being redefined – you think he’s dead, but really he’s in a better place. No, the tomb was empty – why seek among the dead for one who is living once more? God didn’t rescue Jesus from death; he rescued him from out of death. He was given life again after the grave. Bodily life. Life in every sense of the word that we mean – and more.

Jesus’ resurrection shows that God hates death, and his solution is not transferring us to another world, but to renew this world, to resurrect dead bodies to new life beyond even the possibility of death. God’s promise is that those who find their lives turned upside down by Christ will also experience a resurrection like his. In fact, God will renew his entire world.

And because of this – why fear? God is thoroughly committed to his world. He has demonstrated his love for us in that Jesus died to reconcile us. He has demonstrated his power in raising him from the dead. He given us a taste of this in pouring out his Spirit upon those who belong to Christ. His project of renewing creation has begun. So I live in hope, not fear. Not hope that God will rescue me from death, but hope that he will rescue me – and all his good creation – from out of death. Hope that he will finish the job he began in Jesus’ resurrection. Hope that death will not have the last word. Hope that I will not be overcome by evil, but that evil will be overcome by our good God, who raises the dead.

And not only does this hope make sense of being thankful, despite all that is wrong with the world, it also highlights just how wrong the world is. If death was the end, we mightn’t like it, but we’d just have to get used to it.

Instead, being hopeful makes me less content with how things are now. Paul talks about groaning and yearning for the day when God raises the dead. Jesus himself said blessed are those who mourn, who hunger and thirst for things to be right. During the most painful parts of treatment, I would repeat to myself these beatitudes. Blessed are the poor in spirit, for they belong to God’s rule; blessed are those who mourn, for they will be comforted; blessed are the meek, for they will inherit the earth; blessed are those who hunger and thirst for things to be right, for they will be filled. Jesus is basically saying that if you don’t like how things are now, and so join God’s protest and renewal movement, then you are blessed, because renewal is indeed coming. The dead will live again.

Love
And this is why love makes more sense to me than apathy. If God’s project of life wins over death, then every life really counts, every person is of inestimable value, every act of service is divine. I can pour myself out for others, enjoying them without needing to protect myself.

Thanksgiving, hope, love: none of these are about cutting myself off from the world or ‘being philosophical’. None of them are about just trying to be positive. They all rely on what God has done in Jesus and on his promised future.

Theology and experience
When I was thinking about what to say today, a good friend suggested I talk more about my experience and my feelings than theology. The more I think about it, the more I find the two can’t be separated. How we feel, how we experience adversity and prosperity, how we react, are all inseparable from who we think we are, and ultimately, who we think God is.

And so every day each of us faces this question: Will I look back on the past with bitterness or thankfulness? Will I face the future fearfully or with hope? Will this moment be one for uncaring self-indulgence or joyful loving service?

[Let’s pray:]
Thank you Lord for you are good, your steadfast love endures forever. This is the day that you have made; let us rejoice and be glad in it! Amen.

Prognosis

Is it terminal? How long do they expect you to live?
Again, no idea. Because of the rarity of this kind of growth in a person my age, there are very few statistics to give a guide as to average life expectancy or likely progression of the cancer and its responsiveness to treatment. Even if there were a larger body of statistics, all they can tell you are averages and likelihoods based on those somewhat similar to you. Every cancer is different and so is every individual response. Many doctors do not think that speaking in terms of so many years or months to live is particularly helpful in any case as it can become a self-fulfilling prophecy. Indeed, having a hopeful outlook can improve your chances. I am hopeful not because I think Christians are impervious to sickness, but because I hope in the God who raises the dead. Each day, each breath is a gift from the one who made everything and is able to sustain me as long as he desires.

Why do we need a doctor's permission to live or die? I will depart when my Lord calls me, not before. I pray and hope that is later, rather than sooner. I have no desire to die, no secret deathwish. Death is a bad thing, though it is not the worst of all possible things and in Christ, I need have no fear - not because he promises to keep me alive, but because he will accept what I entrust to him and raise me up into his new world one day.

Having said all that, initial indications seem to be that treatment is being effective. My breathing has improved significantly after just the first few weeks of chemotherapy. My oncologist's response when I asked if the chemo could be working so soon: "Chemo or prayer - I don't really care, as long as it works!". He seems quite upbeat about my chances and speaks in terms of "going for broke" and "curative doses" of radiotherapy. I take them as good signs for the moment - and keep praying!
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Blog Title

What does it mean?
My title is borrowed from a phrase by the Apostle Paul in 2 Corinthians 4.8. Here it is in context:

   For we do not proclaim ourselves; we proclaim Jesus Christ as Lord and ourselves as your slaves for Jesus’ sake. For it is the God who said, “Let light shine out of darkness,” who has shone in our hearts to give the light of the knowledge of the glory of God in the face of Jesus Christ. But we have this treasure in clay jars, so that it may be made clear that this extraordinary power belongs to God and does not come from us.
   We are afflicted in every way, but not crushed; perplexed, but not driven to despair; persecuted, but not forsaken; struck down, but not destroyed; always carrying in the body the death of Jesus, so that the life of Jesus may also be made visible in our bodies. For while we live, we are always being given up to death for Jesus’ sake, so that the life of Jesus may be made visible in our mortal flesh. So death is at work in us, but life in you. But just as we have the same spirit of faith that is in accordance with scripture--“I believed, and so I spoke”--we also believe, and so we speak, because we know that the one who raised the Lord Jesus will raise us also with Jesus, and will bring us with you into his presence. Yes, everything is for your sake, so that grace, as it extends to more and more people, may increase thanksgiving, to the glory of God. So we do not lose heart. Even though our outer nature is wasting away, our inner nature is being renewed day by day. For this slight momentary affliction is preparing us for an eternal weight of glory beyond all measure, because we look not at what can be seen but at what cannot be seen; for what can be seen is temporary, but what cannot be seen is eternal.

- 2 Corinthians 4.5-18 (NRSV)

Paul is speaking of his own ambiguous experience in life. He lives the reality of following a crucified and resurrected Lord and his experience embraces both realities: suffering in this present age in the midst of a groaning world, yet filled with the same Spirit who raised Christ from the dead. And this is the experience of all Christians: neither a triumphalistic walk in the park through wealth and health, but nor a bleak and hopeless spiral into pain and despair. Nor simply a mix of light and dark. But a rich yearning in a cracked world, where experiences of failure and suffering become occasions for the revelation of God's mysterious resurrection power: his power is "made perfect in our weakness", Paul claims later in this same letter, because it is at these points that the nexus between human effort and success is broken, and it becomes apparent that our frail existence owes everything to God. We have the treasure of life and new life in Christ hidden in the clay jar (the ancient equivalent of a throw-away styrofoam cup) of a bodily life constantly thwarted by illness, sin and ultimately death. The goal is not a Platonic escape from the body into a 'spiritual' extra-bodily existence, but is nothing less than our own future resurrection from the dead in a renewed universe.

But while we wait, my experience of the Christian life is often well summed up by a phrase that has been something of a personal motto since it struck me powerfully back in 1998: perplexed, but not in despair.

And to wax a little indulgent, here is a piece of angst poetry from my 20-year old self when I adopted the motto.

perplexity without despair

Wandering slowly up the garden path,
      trapped between conceit and metaphor:
      an adult playing at adult games.
Uncertainty, aimlessness, ignorance.

Wondering slowly between vague mistakes,
      undefined ideas far from ideal,
      far too bored to misspend a minute.
Introspection, paradox, transience.

Pondering when, what and whether to think,
      looking at a world of perceptions,
      but not out for other perceivers.
Fragmentation, finitude, selfishness.

Pandering to wind, wave, whether and whim;
      often vanquished at the death struggle,
      yet stalwart with this treasure within.
Vacillation, tragedy, assurance.

(31/10/98)
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