Thanksgiving reflection – learning to be thankful for cancer

Summary

In my last blog post I was surprised to recall my Dad’s constant reminder, “Nie daj się!” (Never surrender yourself!) I sought to discover what he really meant. Today, on the distinctly American holiday of Thanksgiving, I wondered if I could approach the Thanksgiving table ready to express thanksgiving, even for my cancer! It has, perforce, captured my, and my family’s, worried attention. But maybe there are ways in which it can be a catalyst for some understandings I might otherwise never have sufficient motivation to explore.

Detail

Step into any Catholic Church anywhere in the world. Look around and you will soon find (usually arranged around the perimeter of the nave) a series of 14 illustrated or carved images representing the last hours of Jesus’ passion and crucifixion. These images are used year-round for private meditation, the goal of which is to deepen one’s awareness of the unutterable suffering and agony of Jesus’ passion and death, and—simultaneously—to raise consciousness of one’s own personal sinfulness and subsequent participation in Jesus’ passion. (Sin, in this context, might be defined as an unthinking separation from God and my community. In place of these essential relationships, sin adopts the illusory centrality of my self, what most pleases me, and what most closely conforms to the idea of “on my terms.”)

During the last days of Lent—during what is called “Holy Week”—the “Stations of the Cross”, as they are called, become part of the Church’s public liturgy.

Clearly, this is serious spiritual fare. Yet meditations of this kind lead to, and are components of the central run-up to the great feast of Easter, the most important feastday of the Church calendar. Even for those who disdain spiritual or religious belief, the effort to come to terms with suffering is certainly beneficial. It can result in a deeper understanding of the role of suffering in our person, in nature, and in the world. Suffering, after all, is something with which each of us has intimate experience.

Contemporary Western society finds little value in suffering. In fact, avoiding suffering has become a cultural priority. I might be out-of-bounds to assert that everyone can and should welcome suffering. But it is not impertinent to suggest that for those who may be ready to confront their suffering head-on in spiritual meditation, doing so could prove valuable. The Stations of the Cross can act as a good catalyst… so can be something like a chronic life-threatening disease. Seen in this manner, I could be grateful for anything—even my illness—if it helped me understand who I am and how I want to live.


There’s a virtue to which we are taught to aspire. It is empathy. True empathy is hard to attain. It is too easy to slip into pity or disinterested observation, as if simply observing someone in distress and recognizing their pain is empathy. It is not.

Throughout my experience of cancer, I have been forced to come to terms with my vulnerability, dependence and embarrassment. For me, these have been serious obstacles to reconciling myself to the presence of cancer in my body. (This entirely self-centered reaction is precisely a manifestation of the sinfulness to which I earlier alluded.)

If—with an opposite outward-directed perspective—I observe the attentiveness of Monica and my children to me, in my “fallen condition”, I begin to see why empathy is a virtuous goal.

Let me use a couple of uncomfortable but decidedly real examples.

I don’t know if there is any connection at all with chemo and my olfactory sense. Both in Round One, several halcyon years ago, or this Round Two, that I’ve just begun, my sense of smell seems to have been aroused and heightened. Mainly, what I smell, I don’t like. The predominant offensive smell is, alas, me. I’m embarrassed by it. It is strange that I—who, after all, am intimately acquainted with my own familiar (and, to me, comfortingly pleasant) odors—no longer recognize myself in my normal odors. No doubt this is caused by my body as it naturally metabolizes my chemotherapeutic agents and rids itself of the toxic chemicals pumped into me over a length of hours and even days. Even my excretions contain their chemical smell. My breath and exhalations are different and unpleasant to me. Even my sweat smells odd. I hope no one else notices, but I can’t help believing that they, too, are offended.

I am also experiencing what Monica and I have come to call “Sporadic Wonkiness”. The worst of it is, Sporadic Wonkiness assails me from an unknown etiology. I cannot tell what it is, much less what is causing it. In practical terms, out of the blue, I feel myself being out of breath… but not really, because I am breathing in deeply and exhaling normally. Yet I feel an overall physical weakness, as if my breath is providing its essential oxygenation exclusively to my lungs and no further. The experience is often accompanied by a slight dizziness, even a distortion of my sight. I feel as if I might faint.

So far, the wonkiness has always passed, and I’ve returned to “normal”. But it doesn’t help, psychologically at least, that—just weeks ago—a dear friend/priest/art historian/professor in our parish had just begun his own protocol of chemotherapy. A couple months ago, he was driven home from his Clinic. While walking towards his room, he reportedly turned to his friend who had driven him from his hospital appointment, and said, “Gosh. I can’t seem to catch my breath.” Immediately thereafter, he quietly collapsed and died on the spot. I can’t help wondering if—just as unexpectedly—I, too, might leave this life in the same sudden manner.

“Sporadic Wonkiness” is undeniably frightening. It also frightens those, especially Monica, who observe me when I’m under the thrall of “wonkiness”.

I am dutifully reporting these symptoms both to my oncologist and my cardiologist in the hope they can discern a treatable condition of some kind that can be understood and amoeliorated. My reports are not enough for my wife and daughter.

Throughout this journey, Monica has steadfastly and generously tolerated and cheerfully accommodated herself to my odd culinary preferences, weird schedule, strangely unfamiliar—even to her—smells, and my occasional odd mood swings. But she has also actively participated in applying all her skills and ministrations—physical, psychological and spiritual—to assist me. Importantly, as she has added my special care to her activities, Monica has not allowed my care to displace her own social and professional commitments. This—particularly the latter, I think—is comforting to me.

Similarly, Krysia is not satisfied with what she sometimes considers my over-subtle reports to my doctors. Krysia confidently barges right in—as the capable advocate she is—writing or calling my doctors to say things like “You know those symptoms my Dad discussed with you? Don’t be fooled by his demeanor. They are not merely ‘occasional nuisances’. From my perspective, they are dangerously detrimental. Here’s what I know that he may not have communicated strongly enough. What should we be watching for? What else can we do to help you aggressively care for him?”

Such active involvement signals, to me, the expression of empathy. Empathy is not merely sympathetic observation, but a “living together with” someone in trouble or in pain, contributing when possible whatever may be truly helpful. A critical component of empathy is to avoid crossing the line by which the empathizer “loses themselves” in solving another’s difficulty. Such self-destructiveness is another by-product of sinfulness, one by which we proudly believe exclusively in personal power and claim we can alone accomplish more than is ever possible. Such self-aggrandizement is destined for failure. Scripture records that Jesus, himself, was tempted to believe in his complete and sufficient independence from his Father.

Having someone simply share a burden of illness is more than enough. It provides dignity to both the giver and receiver of empathetic ministrations.

Achieving true empathy is definitely a difficult balance. Being surrounded by empathetic caregivers is something for which I can be truly thankful on this Thanksgiving holiday… and every day.


Can I, in my turn and condition, develop empathy, myself? Here’s a difficult case.

At the very moment of this writing, innocent individuals and families in the cities of Mosul and Aleppo are suffering grievous murderous hostilities over which they have no control. They are victims of their condition in some real way not dissimilar to mine in relation to my cancer. Can my cancer help me empathize with those individuals?

I think the answer is “Yes”. But it takes some reflection to tease out “How?” And it will take humility if I cannot discern any empathetic physical action I can contribute.

The news media gives us sensational sound bytes. The reports of what alone is happening (much less attempting to explain why they are happening) are clearly disconcerting but altogether momentary, squeezed in, as news stories are, between advertising commercials for the newest car and the most attractive Black Friday sale items. Not a bit of empathy, understanding or helpful interpretation is to be found on TV or radio in such reports.

Instead, I can focus my attention on a nameless but personalized individual in his situation in an Aleppo neighborhood. I recognize that the man is exhausted with worry and fear just like I am… Really?…

My worry and fear is shared with my medical caregivers, family and friends. He has lost most of his family to bombardment in the past week and has not even been able to accord them the dignity of a burial. He is surrounded by people, all of whom are traumatized, as is he. There are abundant causes of his distress.

I have the luxury of distracting myself from my fears by contemplating and articulating my observations for myself and for those others who may be interested. He has no place for contemplation. Half his house has been ripped apart. His precious personal and family belongings are scattered in the rubble of what used to be the street where he lived.

If my “Sporadic Wonkiness” ultimately disables me, I am confident someone will call for an ambulance to take me to the closest ER where competent attention will be administered. He can be certain that no such attention will be available to him. Even were he to painfully strain his back or suffer a broken limb, there is no hospital or urgent care center in his neighborhood, much less pain-relieving medications; nothing more potent than the few aspirin tablets he discovers, unaccountably, in his pocket.

Worse still, my, by now, friend, hovers helplessly over his wife, who is wracked in pain from a deep gash in her ankle. He looks toward his granddaughter, trembling in the doorway; a horror-stricken look in her blankly-staring eyes. No mirth. No playfulness. No innocent childhood is being imprinted in her dear memory. He, who has been their reliable protector and provider, realizes he is helpless to offer any assistance whatsoever to either of his most beloved.

The realities of this one man’s life bring tears to my eyes. I am crying not only for the pain of his situation, but for my selfishness in ever thinking my own worries and fears were so vainly important to me.

I cannot do anything to physically help my fellow human in need. Like Job, I cannot even comprehend any rationale or fathom any explanation to account for why he is being tormented so. But there exists a real, though ephemeral, link between the man in Aleppo and myself.

Scientists are discovering similar linkages all around us, in nature. In the midwest there exists a massive mycological network in which individual fungi operate so collaboratively that scientists prefer to call the hugely extensive assembly a single organism. There is evidence of a kind of altruism that can take place among individual trees in a forest where the healthiest trees contribute some of their energy, through their root systems, to weaker trees. Whales participate in their community through audible signals that, reportedly, travel across the widths and breadths of oceans in order to keep the community in touch with one another.

The Dominican Sisters at my grammar school knew what to teach their young charges on this subject. They suggested it was possible—since we were all members of one spiritual body—to consciously “offer up” our (puny) discomforts. It was lasting advice. I can offer my discomforts as expiation for my shortcoming, and pray that—however valuable it may be to offer up my sufferings for this man—I do so gladly and intentionally to alleviate his burden. I hope and trust that he will be sustained in his grief and will experience a glimmer of hopefulness from the energy I send his way. Even such an insignificant glimmer of hope may mean his survival. A glimmer may be equivalent to the minutest measurable bit of energy. But it can travel across the globe to reach my friend in Aleppo. That can serve both me and him.

For this man, I can do no more. But neither can I do anything less. He and I are related in the mystery of our creation. I am thankful, today, that it is possible to transform my discomforts into something so precious.


I am receiving an infusion, among others, of a drug called Irinotecan. Irinotecan is unabashedly described in the Fact Sheet given me at the hospital as an “irritant”. It begins its caustic irritation to the inside of my veins the moment it comes in contact with them. Medical staff handle this drug with extreme care. Even though I realize that medical descriptions carefully list and describe each and every potential side effect of a compound being tested for medical implementation (and even if only one person among hundreds of clinical trial patients experience a particular single negative reaction), the list makes daunting reading. It reminds me of some of the darker of Edgar Allen Poe’s literary oeuvre.

What caught my attention was the fact that Irinotecan is a compound comprised exclusively of botanical molecules. Here’s a single paragraph from several pages of description I was given.

Irinotecan belongs to a class of chemotherapy drugs called plant alkaloids. Plant alkaloids are made from plants. The vinca alkaloids are made from the periwinkle plant (catharantus rosea). The taxanes are made from the bark of the Pacific Yew Tree (taxus). The vinca alkaloids and taxanes are also known as antimicrobule agents. The podophyllotoxins are derived from the May apple plant. Camptothecan analogs are derived from the Asian “Happy Tree” (Camptotheca acuminata). Podophyllotoxins and camptothecan analogs are also known as topoisomerase inhibitors. The plant alkaloids are cell-cycle specific. This means they attack the cells during various phases of division [in the process of which, they also raise havoc with (i.e., kill) a lot of my otherwise innocent and mainly-beneficial fast-growing cells].

I’m grateful that someone at Kaiser believed patients should not be “talked down to” and believed that some might be sufficiently interested in reading this decidedly Latinate and professional scientific description.

Reading this paragraph brought to my mind the Brother Cadfael-like horticulturalists and investigators like Gregor Mendel, Carl Linnaeus, countless relied-upon but persecuted “witches” over the ages [especially them], apothecaries, and botanical scientists of various stripes and specialization whose names are unknown to me, but who have advanced the earlier “primitive” work of their forebears. It recalled for me adventurers like Charles Darwin, Joseph Banks, Alexander von Humboldt and so many other intrepid explorers whose precise and carefully-documented and carefully pressed and dried botanical samples populate our great horticultural herbaria across the globe. The early investigations and hypotheses have blossomed [sorry] into current enthusiasm for agricultural diversity, efforts to preserve heirloom plant varieties and the worldwide effort to establish seed banks. It will come as no surprise that, second only to books of prayer, the meticulously and beautifully illustrated horticultural albums are the most treasured of “rare books”. They are still consulted today.

I sometimes wonder if the Angel Gabriel didn’t show considerable mercy when banishing Adam and Eve from the Garden of Eden. Yes, the angel knew the errant couple and their offspring would be condemned to toil and labor, but Gabriel made certain that all the cures, devices and sensitivities Adam and Eve’s progeny would need for survival and prosperity were to be found scattered around them in plain sight. Thenceforward humankind needed only to look, study and discover the answers to their needs. Doing so, of course, depends upon humankind’s (and my own) attitude of respect, careful preservation, and responsible attention to the natural habitat in which we live. Gabriel was highly respectful of human capabilities. That optimistic opinion forms a challenge to which we continue to aspire.

On this Thanksgiving day I can be—and am—grateful for the mysterious operation of plants in my life, both in their contribution to my nourishment and in their particular contribution to combatting my cancer-cells-gone-amok. Added to my appreciation for plants, specifically, I can add thanks for the individual contribution of dedicated and persistent individuals across time who have pursued their insights and experience. They intuited that plants possessed secrets that could eventually defeat debilitating diseases like mine. Finally, I am grateful for the pharmacists, nurses, and medical practitioners who dare risk exposure to these toxic compounds to corral them for my individual needs.


Can I be thankful for my cancer as I approach the Thanksgiving table today?  At this point in my journey with cancer, I can profess a hopeful “Yes”.  I can’t be certain that I will be able so to claim as time (and my cancer) progresses. I admit to worrying about how I will manage to deal with the ultimate debilitating effects of the disease. But I hope that contemplating it, now; learning about it (to the extent I am able); and discovering and training my own reactions to conform to an ideal about which I’m learning, will serve me to maintain balance into the future. I pray for the grace to incorporate into my interior life what I’m learning about suffering.

I realize I am graced in countless ways. I realize I am not a victim. I know that suffering has much to teach me. I am not alone and am immensely grateful for family, caregivers, friends and to all those who pray for me because they know and care for me.

 

All these make me feel unreservedly thankful. Happy Thanksgiving!

 

Chet