The meaning of illness

Dear Friends,


I’m embarrassed to be delinquent in posting my weekly blogs. The reasons are manifold: tiredness, nothing novel to say, brain-freeze, postponitis, etc. I’ve been humbled to have received a number of “dunning notices” from readers of these random essays. Forgive me for the former. A sincere “thank you” for the latter.

I’ve been surprised to have become discombobulated about what I considered an insignificant side-effect. It surprised me by its impact on me; greater than I’d anticipated. Some weeks ago, the cumulative effect of the chemotherapies I’ve been undergoing started manifesting themselves through a gradual loss of taste and smell. Now, just as Thanksgiving and the Christmas holidays are upon us, everything I eat seems to taste like unseasoned mashed potatoes. It shouldn’t be a big deal. The effect of the deterioration of my taste cells should simply validate that the chemo is working. Its evidence, after all, that the chemo is likely to be doing the same thing to any fast-growing cancer cells that remain in my body. But the timing of the loss of taste seems particularly inconvenient with the arrival of the holidays. It is during the holidays that the particular culinary smells of the house and kitchen typically evoke so many fond memories. Missing the fullness of those sensory recollections disappoints me more than I expected it would. To make matters worse, my nurses tell me to expect that this condition will persist through to the end of my chemo, 3 months hence.

As I’ve been traveling through my process of confronting cancer, it is difficult not to wonder “What is the meaning of this illness?” It may be the right time for me to gather a couple of my personal perspectives. Though there are many, I’m only going to examine the meaning of my illness through two.


From a purely medical perspective, my illness can be understood as emerging from only a handful of sources:

Natural Internal Processes. The body ages in ways we don’t completely understand. Some cells apparently have some sort of time switch that, when activated, causes them to begin losing their ongoing “liveliness.” Or the switch simply lets the cells die. Some cells, such as those that constitute our hair follicles might lose their capacity to create or pass on coloration with the result that our hair turns white. Some degradation of other cells may affect our resilience, strength, vision, taste or hearing. Since our bodies are comprised of bacterial organisms by the millions, a change in the balance of those organisms internal to us can be a cause of illness.

External Causes. Another source of illness might be external. Some of our cells may mutate due to cosmic rays from the sun. Whenever we go through the security scanners at airports we receive bursts of energy that can harm our cells. When we board a plane, the flight path brings us closer to danger by our altitude. Even on terra firma, our cells can be damaged when we stand too close to a poorly sealed microwave oven. There are many things in our civilized urban environment that expose us to etherial energy waves. Other toxins to which we are exposed are preservative chemicals in our food or ingredients in the plastics in which our food is increasingly packaged. Contaminants in our air and water can damage our body through external sources.

Psychological Causes. There is increasing evidence that our state of mind has an influence on our health. Stress manifests itself, physically, in headaches or backaches. Stress can also change our moods. These effects are being increasingly studied (not least by our daughter, Krysia, who has taken a particular interest in this arena). Emotions and mood appear to have a strong correlation to health; especially on the rate of recovery from illness.

Social Causes. Moods are affected by realities beyond individual control: by not having a job, by living in a relationship that is harmful. The list is long. There are things we can do but we must be willing to actively confront the source of our problems. Even if individuals are willing to go through such a process, they may find it difficult (or even impossible) to change their situation to eliminate the conditions that damage them. The process can be rocky and painful for many.

To answer the question of the meaning of illness, the medical profession examines these alternative sources of illness and attempts to understand disease better. This has proven to be no small endeavor. Equipped with today’s sophisticated capabilities and tools, scientists and researchers drill down to ultimate structures in microbiology. As they do so, they seem to constantly uncover deeper underlying levels and incredibly complex micro-relationships. These hidden relationships seem to be at the heart of life. Yet what, at the molecular (or even finer) level can be defined as the source of life continues to be elusive to the scientific researcher.

At the other end of the spectrum, science also explores the organism that is our body and mind within a macro-context. There, science examine personality and social structures, hoping to identify what makes us individuals. All our relationships, family, society, culture, have an influence on us as individuals. Scientists are discovering that the macro-dynamics are equally as complex as the deconstructionist micro-examinations.

In the end, defining the meaning of illness in our lives—within an exclusively biological context—seems confoundingly elusive.


Religious persons might explore the question of the meaning of illness from a different perspective.

The vulnerability of the created being. Religious believers often conclude that the source of life is embodied in individual beings. For some, the source of life derives from a Life Spirit. The nature of the Life Spirit is not easily identified, but is concluded to exist from the logic of Faith. For others the source of life is personified in—and discerned through—the form of various deities. Animists believe in the inherent liveliness of the world in which we participate. They ascribe various levels of “life” to all the objects we discern in the world around us. Monotheists define the source of life simply as “God”. God cannot be completely understood by mere mortal mental capacity, but spiritual scholars have enlarged our understanding of a Creator God who is, at once, intimate and present in each of our lives.

What seems to be common to all religious believers is an awareness, not merely of the animating influence of life, but of the essential personal and social imperatives that derive from living. They also recognize a sense of life’s vulnerability. It is that vulnerability that gives rise to patterns of behavior (and mis-behavior). Abstract considerations distill to the practical questions of how one individual, me, lives my life. Religion encourages me to confront the question of how my life (or my sins) impact me or the world around me, if at all. How do my individual choices and actions relate to illness?

One way religion invites us to view illness is through our human capacity to choose. Health requires us to become aware of the effects of our choices on ourselves and on others. Religious insight seeks to help individuals learn to make positive choices. Religion asks us to master our ability to choose, and exhorts us to choose wisely. Every day, we make choices along a wide panoply of spectra. We may be counseled to examine these decisions by religious advisors.

The relation of illness to the freedom of choice. There is considerable literature about the human freedom to chose. It is a challenging behavior to understand. Some contemporary studies question the very notion of whether or not we even possess freedom of choice. The question has been examined for millennia. Ancient Sufi wisdom-seekers took up a study that focused on the traps that lay in the path of choosing wisely. A contemporary form of that practice of the Sufi meditations has come down to us, today, as the enneagram mandala. Working one’s way, consciously and without anxiety, through the structure of an enneagram, an individual begins to recognize patterns of his or her own existing behavior. The goal of the study is greater awareness of self. A further goal is to become more aware of how one can become enthralled (to be a thrall of, or a slave to) to patterns of behavior that somehow contradict or inhibit our becoming free and fully human.

What the Sufis attempted to understand is akin to that to which the Buddha eventually aspired. Buddha came to practice abstinence and abnegation of the self for similar reasons the Sufis sought to rid themselves of barriers to fullness. Buddha sought to become un-enthralled to those aspects of the world (inhibitions and attractions, both) that surround us and falsely tempt us away from our true nature.

Christian writers have concluded the same. Saint Ignatius counsels his students to adopt a radical detachment: “We should not fix our desires on health or sickness, wealth or poverty, success or failure, a long life or a short one.”  The model for Christians is the life of Christ. His life is grounded in trust in God the Father, living a coherent life inspired by the Spirit, and conveying justice, mercy and charity to all who deserved it without claiming anything in return. The living of such a life is sufficient, unto death.

Perhaps because they preceded the rise of science, religious widom-seekers have enriched us across the millennia by uncovering how we are to relate to the world around us, to our fellow human beings in this life, and to our communities and societies. Men and women across the ages have passed on insights on how we form ethical and moral lives. They sought, over and over, to comprehend human life as derivative of the ultimate source of life. They have consistently been guided by the “how?”  we can fully participate in creation. In such a cosmic context, illnesses (spiritual or physical) are understood in a different way, not exclusively biological. What, then, is the meaning of illness in such a broad context?

Through my blogs, I’ve explored a growing awareness of various fears I possessed about which I was previously only dimly aware. Composing these blogs have heightened my attention to the physical (and perhaps psychological) effects of my chemotherapy. I’m drawn by scientific, medical perspectives to concentrate, analyze, and attend to myself in ways in which I was not altogether accustomed. They are ways that are clearly informative and important. They all contribute to my participating in managing my health so that I can more properly assist the specialists and care-givers that have studied and researched the biological illness it is their job to cure.

To look at my illness, alternatively, from a religious perspective is instructive. I’m immediately confronted by the reality that I do not possess my life. I did not cause it. I did not ask for it. I was never in a position to chose to accept life or not. I cannot deny it. My life is a gift. As such, I can glory in it. I can celebrate it. I can live it with passion and joy. I, myself, can share it with others as my own gift. What is startling is that life defiantly resists being rejected. Life, by its very nature, appears to be indestructable, buoyant, optimistic, and forward-evolving. In such a context, my illness is a part of my life.

Perhaps I am well advised, under these circumstances, to learn to ignore my illness. If it is a part of life, it is not appropriate to respond to illness with self-pity. I am capable of letting it becoming a source of detrimental over-concern; too dominant in my thoughts and actions. I don’t want that to happen. In another way, my illness presents an opportunity. Experiencing its effects lets me understand more clearly my own fallibility. Illness can challenge me to think more deeply about time. It may encourage me to reflect upon (to use a phrase from a confessional prayer) “what I have done and what I have failed to do”. Illness may encourage me to live in the now. Thinking of the ultimate effect of a life-threatening illness may direct me to recognize how fleeting is the time I inhabit this body and this world. Meditations of these kinds can help me become more empathetic with those who really suffer in this world. I can exercise ways in how my discomforts can be put to better use to ameliorate or lighten the load that others bear. I can gain practice in being more sensitive to those around me: those who are my care-givers, and mainly those who are my lovers (for it seems altogether too easy to take my lovers for granted and to expect that they share my personal perspective [which they can’t, for they have their own]): my family, my spouse, my offspring, my extended family.

If the meaning of illness is linked to the fact that it can assist me to deepen virtues that are already a nascent part of my life… If my illness can sharpen my detachment, hearkening to the advice of mystics, buddhas, Sufis, native American shamans, and all those who have been passing their wisdom from generation to generation to me… then my illness is not as fearful as it is instructive; perhaps even welcome in such a context.


I’m not certain I can integrate such disparate approaches as quickly as I wish. I only recognize that it is helpful to spend some time within the framework of religious teaching, allowing spiritual insights to mix with physical insights to which I am exposed through the field of medical theory and practice. Mixing both perspectives exposes me to exhilarating lessons that either, alone, might not convey. Together they enrich my chances to live a more attentive human created life from this point on, until the transition of my life through death. Understood through these broader reflections, my death, after all, is inevitable. It will be something I will experience, irrespective of whether the transition is caused by my cancer or by my being accidentally run over by a streetcar, or by the cessation of my breathing at night, or by my being trampled to death by a startled stampeding elephant. Any one of those real possibilities will occasion my death. More likely, some other cause will inaugurate the transition of my life into wherever or however it will manifest itself in the life that persists and may follow this one.

Reflecting on both the medical and the religious dimensions of my cancer allows me to experience it in richer and broader context than would be possible if I possessed only one perspective from which to think about it. In this state of mind, I apologize, anew, for not keeping up with my weekly postings, especially for those who have been interested in them, and who may have employed these missives as a means of identifying that I’m still well and proceeding with personal awareness through this surprisingly rich process.


What I learned by sorting screws

Dear Friends,


I am tethered close to home by my chemo fanny pack and by my still disconcertingly frequent visits to the hospital, blood lab or Infusion Clinic. To be entirely candid, the tethering is due, more, to one of the side effects of my chemo that requires my being fairly close to a bathroom at critical times. Some readers don’t want to hear about such practical details, but they become important. Being confined to location gives me an opportunity to catch up on some domestic “housekeeping”; the kind that is altogether too easy, in real life, to let slide. This week I gathered together all the assorted boxes and jars of spare screws in my garage and began sorting and organizing them. Its remarkable how my brain is able to quickly slip into an unconscious active mode of its own, while I am engrossed in a mind-numbing and repetitive (but altogether satisfying) task. What can be extrapolated from screw sorting about my feelings about cancer knowledge?


Sorting screws is a bit like working in an archeological trench. Much is revealed but not quite everything one might want to know. For example, examining a series of different screws assembled in order of observed age might reveal how screw design responded, over time, to deficiencies experienced in their use. The series might tell of the arrival of new manufacturing technologies. Nothing observed in an archeological “excavation” provides clarity about the personalities of the inventors of screws, nothing of the patents for which they may have applied or the business realities associated with screw manufacturing and distribution. What’s missing is often that which stimulates the greatest curiosity. With respect to sorting, itself, the screw sorter faces the always-intriguing challenge that librarians face in common with them: how to sort and classify the countless variables. Variations are always encountered when one begins to look for and recognize differences and unique characteristics associated with individual specimens. It is useless to have a jar full of miscellany at one’s disposal when working on something that requires “the proper” or “just the right” screw fastener. Organizing the collection in a way that access is facilitated to “just the right” specimen or item is intellectually and practically challenging. This is true whether dealing with a jar full of hundreds of screws or a cyberspace “cloud” filled with thousands of links, images, documents and notes.

Random assortment of screws from one of my containers.

When it comes to screws, there’s a longer list of pertinent attributes to identify and sort than one might, at first, expect:

Type (Machine screw or wood screw? I’m restricting myself only to sorting the hundreds of wood screws in my containers; segregating machine screws will come later.)
Length (Often the first consideration I have when looking for a useful one to use is “how long is it?”.)
Guage (The thickness or diameter of the shank of the screw is measured in increments from 1-24. The diameter can be measured as a root diameter [the shank less the height of the threads] or, more commonly, as a shank diameter [which is measured across the top of the threads]).
Material (Is the screw made of brass, tool steel, stainless steel, galvanized, etc.?)
Head design (Does it have a flat head, a round head or a pan head; will the head be recessed or left surface proud?)
Thread pitch and thread count (This influences how easily a screw can be set. Is the screw self-starting? Has it been designed for rapid insertion? How many threads are there per inch? How many spirals of thread?)
Purpose (Is this screw designed for use with wood?  for masonry?  for chipboard?  for electrical?  for sheetrock?  for something else?)
Driving Surface (Does the screw have a slotted head for use with a standard screwdriver, or a customized head for one of the several newer type of driving bits such as Phillips, hex, Allen, Torx, etc.? The design of the head essentially describes what kind of tool must be used to drive the screw, but it also has a relation to how easily the screw can be driven, and—its corollary—how difficult it might be to remove.)
Standard (Conforming or not? …to which standards body?)
Condition (Is it a “keeper” to be re-used or shall I toss it out as “damaged beyond re-use”. Screws are durable. Perversely, there are not too many to toss; they’ll have to be put away for future use.)
I’m going to have to pick up a few more plastic gadget boxes with flexible dividers to separate all these variables into some useful configuration!

Observation can deduce information about the screws themselves, but the study of so common an item can, in addition, reveal a lot about the evolution of carpentry after the Industrial Revolution. A new direction emerged at that historical point that led to the mechanization of cabinet making. It eventually evolved into the mass production of furnishing components. Along the way, the trend facilitated the ushering in of a modernist style of interior decoration. Those changes even influenced architectural design. An astute screw sorter could conceivably write up such observations. In the doing, he/she might realize an unexpected association: that at its inception, the new carpentry was—to a significant extent—based on re-use of durable and valuable components, and at the same time, perhaps, witnessed the general demise of re-usability.[1]

It would take a couple years of agreeable study, followed by a few more of concentrated writing, to worthily describe the history of the lowly screw (and its wider context of social mercantile evolution). It might be an undertaking that would appeal to Henry Petroski, whose The Pencil: A History of Design and Circumstance, published by Knopf in 1993, has become the definitive work about lead pencils and their development. Petroski describes the evolution of the pencil from its humble origins to its grander status of a once-ubiquitous implement everyone owned: the iconic yellow hexagonal Dixon Ticonderoga #2 graphite pencil. In telling the story of the pencil, Petroski relates a lot of social history, peppered with insights about art, communication, business, competition, writing and even poetry.  The same dramatic and literary elements that were combined to make The Pencil satisfying to read, exist in the history of the screw. Archimedes depicted the first screw: a spiral device with which to elevate water. Leonardo Da Vinci imagined the screw as potentially enabling flight. Today’s corrosive resistant stainless steel screw fasteners (and others made from rarer metals and alloys) circumnavigate the earth, reliably holding together space stations.

In contrast to the likelihood that it might (only) take a dozen or fewer years to complete a worthy history of the screw, its startling to consider how many skilled professionals and researchers; how many worldwide institutions and laboratories; how may decades; how many millions of dollars; and how many patients and sufferers have dedicated their careers (and lives) to assembling all that we know about cancer… and to confront just how much is yet unknown after such a massive global effort. I admit to possessing an ignorant frustration about the state of our knowledge despite the amazing progress that has been made in treatment protocols. I should know better; yet can’t shake off the dismay. I do not, in the slightest, wish to denigrate the practical progress of treatments. (I wouldn’t dare, being fully confident that my own treatment will lead to my complete remission and cure.) Nevertheless, it seems perverse that we should collectively expend such effort and still fundamentally know so little about triggers or causes, environmental or nutritional influences, or the mechanisms of infection of cancers.

If I stop to notice my subconscious mind, clues to the complexity of the task of cancer researchers are revealed to me in the mundane task of sorting screws. Other clues come to me from seemingly casual conversations.

I mentioned to a nurse at my Infusion Clinic that I’ve been gratefully surprised (enormously so) by the milder-than-expected side-effects I was, thus far, experiencing from my treatment. She explained that colon cancer patients frequently endured milder side-effects than most. Colon cancer has been well-described and is generally “well-behaved” as far as cancers go. Certain medications have proven effective in mitigating unwanted side-effects. I’m given a dose of such medications, in pill form, before each of my infusions. “The same cannot be said”, she continued, “of patients with breast cancer.” Clinicians and researchers have discovered that not all breast cancers are alike. They have identified several distinct kinds of breast cancer. [This will require a few new sorting categories.] Each responds with various success [Allowance will be needed in the databases for annotations.] to different treatment protocols [A few additional criteria about protocols will need to be included and appropriately linked to individual cancers. Privacy protections will have to be accommodated to provide statistically useful information, but not individual names or identifications.] and each responds (or not), to a mixture of different combinations of drugs [We’ll need to add footnotes, qualifiers and descriptions of source documentation. We’ll also want to provide external links to data sets by which future researchers will be able to replicate and confirm hypothetical results, etc.] “Added to which” she tossed over her shoulder as she hurried to attend to another patient, “different personalities, or even their bodies, react very differently to the same treatment. We don’t yet know if it is physical, psychological, racial, or some combination of those… or of something else, entirely. But we’ll find out.”

The challenge of sorting medical information[2] is magnified by the absence of needed data; indeed, the absence of data whose very absence may not yet be even suspected.

I, myself, have been left with a handful of un-sortable screws that turned up in my collection. They are oddly shaped screws. I can’t recall ever having seen their like. I don’t know what they were made for… what is their particular function. I have yet to (but will) find out what kind of screws these are. Curiosity, alone, will drive me. My annoyance at finding unidentifiable screw fasteners is hardly comparable with the highly important challenge of discovering life-critical evidence within worldwide specialized data repositories. How does one satisfy the goal of answering why it might be that two individuals suffering, apparently, from the same cancer respond differently to identical treatment protocols? The query is made worse by not knowing if the answer is, in truth, lurking somewhere in cyberspace; or if the answer is to be found in an observation that has yet to be made and recorded.

What’s to be concluded from this screwy rumination?[3]

It is surely nothing less than to prompt me to send a conscious and heartfelt salute to the men and women who participate in the search for knowledge about our bodies, our diseases, our corporeal nature. Theirs is a meticulous, painstaking and indescribably complex task. Whereas I was struggling (while, in truth, relaxing) by undertaking a simple task that proved itself more complex than might have been anticipated, cancer researchers struggle with a complex task that has proven immense. Yet they persevere. Both tasks—mine and theirs—show signs of progress being made in sorting and classification. I expect that both sets of information will submit to useful organizational solutions. Learning about and managing information (irrespective of its subject matter or format), making it available for future analysis, retrieval and useful application is a new discipline of our own information age… changed as much as the screw changed artisanal carpentry. One can only hope that the challenges of the new discipline attracts genius intellects. Such individuals will have important and satisfying life careers.



[1] The following age—the one in which we now live—no longer values reusability in the same way. Our age depends, economically at least, on replacement. We purchase millions of smart phones, for example. Two years, hence, we will discard them in order to purchase other millions of the most up-to-date versions. I’m not certain whether this is inherently wrong-headed, or, on balance, beneficial. The observation simply reveals a continuum along which we can define how we conserve or consume materials in order to create more comfortable environments for ourselves. Some would claim that replacing old with improved communication capabilities makes us more efficient. Others would disagree. I believe it is generally wiser to observe and consider the implications of changes in our lives, rather than suffer their effects having entirely overlooked the causes.

[2] It is worth noting that the designation “medical information” is not sufficiently encompassing. Today’s cancer research deals with disciplines as diverse as chemistry, biology, immunology, crystallography, physics, molecular biology… the list is seemingly endless. Yet insights from each, if they can be combined into a concentrated understanding of interaction related to cancers, might eventually answer core questions that cancer researchers are prompted to ask from the grounding of their own specialized experience and observation.

[3] One sometimes hears an admonition that individuals should not exaggerate their efforts to satisfy (mere) bodily concerns; …that some variety of detachment from the physical body is beneficial to the spirit …that our goal is an afterlife where all will be rosy and well (if that’s where we end up). But, for this existence at least, the Creator has endowed us with both spirit and body. One might reasonably conclude that the second is at least equal to the first (else why would a corporeal nature have been given us?). To participate in the fullness of Creation (as is our goal and privilege), demands respect for and attention to both. Under such circumstances, it would be unthinkable that the eradication of such an incidious disease as cancer would remain beyond our grasp. It is consoling to recognize that the path, itself, has been, and will continue to be, replete with learning.