2018 was such a year for me. Three days into the new year, I had colon cancer surgery, which involved the removal of half my stomach. The month after that, I celebrated Valentine’s Day with a partial right mastectomy for breast cancer. The two separate cancers were connected only by times of onset. All three surgeons were confident that the cancers had been removed, but in March, a CT scan revealed that the colon cancer had recurred.
It took several weeks to meet with the oncologist who my primary physician assured me was worth waiting for (it turned out that she was right about that!). I was clear from the beginning that I was not willing to undergo chemotherapy. At my advanced age, almost 88 years old, I was not about to endure a treatment that would allow me to live longer but sicker. At that point it looked likely that the recurrent colon cancer would be fatal. Thus my assumption was that this was the eschatological period of my life, the “end time,” my mortal destiny.
Having been a hospice chaplain for the past 25 years and living in a retirement community for 15 years, where we frequently witness the deaths of our friends and acquaintances, I have long since made my peace with the inevitability of my own death. Our whole Foulkeways senior living community read Atul Gawande’s Being Mortal a few years ago. This was a great help to many of us in overcoming the prevailing culture of denial and recognizing that death is an acceptable part of being mortal. Additionally, I had experienced the deaths of many loved ones, including my parents, a sibling, beloved aunts and uncles, and close friends. I found, much to my surprise and delight, that all those relationships survived the physical deaths of those individuals. Those whom I’ve loved continue to reside in my heart, and I still feel very connected to them, even though I can no longer be in their physical presence. Since I no longer travel much, I am no longer in the physical presence of many faraway, cherished friends and relatives. Yet I still feel very connected to them as well.
So, as I contemplated my death as imminent, I found that I wasn’t all that upset. I realized anew the imperative of “getting my affairs in order.” I wanted my daughter to be able to grieve my death in as uncomplicated a manner as possible, rather than cursing the day I was born if I were to leave too big a mess. I set about to address the particularities of those tasks, including beginning to clear out scores of books and decorative memorabilia accrued over a long, well‐lived life.
Many of the individuals who I see dispensing wisdom, compassion, thoughtfulness, and care claim no belief in a relationship to any faith system. Yet they do the work. This somehow validates my conviction that we are all connected; there isn’t any them, it’s all us.
At this still‐early phase of my assumed “eschaton,” I was experiencing a wave of love, concern, and hope for my full recovery from scores of my friends, both local and far‐flung. In the early days following my surgeries, my daughter sent out frequent email reports of my progress. I felt blanketed with “Belovedness”! Many years ago, I had an epiphany, a powerful experience of God’s love for me and for everyone else. I have concluded that all the love we give and receive to and from one another is of divine origin and that we are mere conduits of that love. I was (and still am!) astounded by the number of people who are channels of God’s love and concern for me and for one another. I have come up with a name for this phenomenon: I call it the “Divine Delivery System” (DDS). Observing the daily workings of DDS keeps me from falling into despair over the crumbling of our planetary infrastructure. I am so heartened by observing the many daily episodes of compassionate, caring, and wise actions on the part of so many people. Many of these folks are people of faith who are aware that they are agents of divine love and care. But many of the individuals who I see dispensing wisdom, compassion, thoughtfulness, and care claim no belief in a relationship to any faith system. Yet they do the work. This somehow validates my conviction that we are all connected; there isn’t any them, it’s all us. We all have a stake in our mutual well‐being.
All of this was going on while I still assumed that I would succumb to the recurrent cancer. It was sort of a relief to expect not to have to live long enough to see how much worse our climate deterioration would get. Then I finally met with the oncologist in March, and new possibilities opened up. On our first appointment, he spent over an hour and a half outlining all the treatment possibilities with their likely results. When I categorically rejected any chemotherapy, he informed me about a newly licensed immunotherapy that was a good match for my particular recurrent cancer, which has a mismatch repair gene that disables its ability to repair damage done to it by a therapeutic attack.
Immunotherapy boosts the healing abilities of the body’s inbuilt healing mechanism as opposed to chemo which introduces a poison attacker. Generally, it does not cause debilitating side effects. He applauded my agreement to try that route, and I began immunotherapy in May. I have been getting half‐hour‐long IV infusions of Keytruda every three weeks since then, without side effects. Regular CT scans have shown a steady diminishment of recurrent cancer cells, the most recent one revealing that over 90 percent has been eliminated.
In the meantime, I was presiding over a continuing crumbling of my infrastructure. In May, at a routine eye checkup, I was diagnosed with wet macular degeneration in my left eye. This resulted in regular shots in that eye. During the summer months an upper jaw dental bridge broke (wore out!); I had several molars pulled; and in August, I started wearing a partial upper denture. This has resulted in a presumably permanent alteration in my diet. Plastic molars do not work as well as homegrown ones do. No more red meats, popcorn, or any kind of nuts. Inevitable culinary grief ensues! I’ve worn hearing aids for almost three years now and was treated for squamous cell cancer on my left lower leg in August. In September, I had lithotripsy for kidney stones. Infrastructure crumbles! Atul Gawande explains in Being Mortal that medical science is allowing us to outlive our bodies that “didn’t evolve with the ability to live this long.” I am living proof (so far) of that statement.
Even with all that “crumbling” happening, the immunotherapy treatments enabled me to feel stronger and healthier. I continued my long‐term thrice‐weekly resistance training, stretches, and free‐weights routine at the fitness center, and daily 30‐minute walks. My appetite was good; physically I was doing well. I received lots of positive encouragement about how well I looked and gratitude from loved ones that it seemed like I would be around for a long time. But I found, to my surprise, that I was experiencing a return of the depression that I had experienced before my cancer diagnosis. This helped me to return to working with the psychologist I had seen back then. He presented me with yet a new diagnosis: whiplash! The psychic kind, not the physical. I had done such a good job of preparing to die that the mounting evidence that this wasn’t going to happen as soon as I had been counting on brought back the depression.
So apparently my task now is to continue to heal in all ways available to me, whiplash included, and to come to terms with continuing the messy, untidy, joyful, pleasant, and unpleasant day‐to‐day of living in community.
Part of my success in welcoming the likelihood of probable death within the next year or so was a reflection of my discouragement with the way things are going in the world. I watched the nationalistic anti‐immigration attitudes here and abroad, the brick‐by‐brick disassembling of our social networks, the crumbling of our rural and urban infrastructures, the rising disparities in income and gender equality, the distrust of science, and the refusal to address climate change at a governmental level. I hated to face the apparent fact that I was going to live long enough to watch it get even worse. So the “good news” that immunotherapy was working provided the seedbed of the realization that I would probably live to be old enough to get increasingly disabled alongside this beloved planet! I’ve got some good news and some bad news. It’s the same news!
Getting ready to die was easier than getting ready to live a lot longer. It had been thrilling, in a way, to prepare for a great adventure: the last frontier! I’d long since given up the belief in the afterlife that I’d been taught as a child. Learning about the cosmos showed me that “there is no there there” for heaven and hell. Understanding that we humans are organic beings and return to the dust from which we came makes perfect sense to me and holds no terror.
Soon after my January surgery, a new friend gifted me with a poem that gave me a new context within which to consider my new situation. I won’t quote the whole poem but a part of it:
When it’s your time to give back
the life you were lent …
bow to your body,
it knows when it is time.
You are about to begin
the long effortless journey
to become subatomic particles,
joining the universe as it sweeps
these invisible seeds into its birth canals
for new stars and planets,
tosses them into the dark soil of matter,
grows them into fuels of energy,
stirs them into cocktails
that may again pour out life.
You’re going to be big.
This poem spoke to me in a powerful way. My daughter and I agreed that it should be read at my memorial service and the poet magnanimously assented. The idea of being released to participate in the continuing creation of the universe was and is so inspiring; it permanently robs death of its sting for me. I have no need for eternal life as a differentiated, Western, female, twenty‐first‐century human being. That doesn’t appeal to me at all. But transforming my organic matter into subatomic particles to create new stars and planets … what’s not to like?
So, apparently my task now is to continue to heal in all ways available to me, whiplash included, and to come to terms with continuing the messy, untidy, joyful, pleasant, and unpleasant day‐to‐day of living in community: loving one another the best we can and forgiving ourselves and one another for being flawed and broken human beings as well as beloved children of God.