Amy Durfee West’s Blog
“Throw your heart over the bars and your body will follow.”

Last May I took three psychological tests, and on December 21 I met with a psychologist in Denver to complete the evaluation process. She had the results from the three tests, plus reference letters from three people I had chosen.

Last Friday the psychologist read me her report over the phone, and gave me an opportunity to comment or offer corrections. She had paid close attention to what I told her in the two-hour session in her office, and she accurately reported feedback I had given her at the time. I took notes while she read me the report, and I offered one point of clarification and one (perhaps slightly defensive) comment.

She told me the tests were “valid,” meaning, I suppose, that I didn’t appear to be hiding anything or trying to outsmart the test. However, she said my answers showed me to be “somewhat defensive and reluctant to admit to common problems.” I have a “tendency to minimize negative affect.” She also said I am too naive and trusting. She did say that these results might relate to my style of test taking, but she didn’t elaborate on what she meant by that.

In the report she said I “glossed over” my early history but answered her questions about it. That’s true and, at the risk of sounding defensive, I think that shows that I am not naive or excessively trusting. This woman held my future career in her hands, but she was a complete stranger. I had no intention of telling her any more than she needed to know, and my strategy was to demonstrate by the way I talked about myself that I am honest, emotionally mature, solidly grounded, and realistic. She found me to be “guarded,” while the tests seem to indicate the exact opposite.

I had talked about how the challenges of parenting helped me learn and grow, but the five children I raised only rated one sentence in the report, and she didn’t ask me about my relationships with them, or about how they are doing. They are mature, responsible, stable people. They meet challenges with a sense of calm and inner strength (something she said about me), and they are appropriately close to one another and to their parents. They have empathy and compassion. They are ethical, honest, hard working and well socialized. They love each other.

I want to comment on my supposed reluctance to admit to common problems. Last summer I read Erich Fromm’s book The Sane Society. In it he challenges the idea that we can always assess someone’s psychological health by how well he or she adapts to the dominant culture and exhibits traits common in it. Society as a whole may be sick. It may be founded on invalid assumptions. It may value the wrong things. I don’t know which “common problems” I am “reluctant” to admit that I have, but another explanation is that I simply don’t have them.

I used to. I used to be a bundle of resentments, anger, self-absorption and anxiety. I used to worry all the time. I was perfectionistic and controlling. Despite my best efforts to hold onto everything I have lost jobs, husbands, friends. I have tried to do the right thing and ended up making messes. I have been misunderstood. I have misjudged people. I have “over-shared” in the naive belief that by being honest about myself others could also learn to examine their own dark sides and find their own ways into the light. I have tried to rescue people. I have done too much of the work in personal relationships, and have been bitterly disappointed in the results. I have spent countless hours analyzing others’ faults and shortcomings, and agonizing about why they are the way they are. I have manipulated people. I have failed countless times at countless fool’s errands and hopeless quests, and each failure was devastating.

I came through all of that, by the grace of God, to a place of acceptance and contentment. It’s not that I don’t become worried, angry, scared, lonely, bored, or depressed. I do. I just don’t let those feelings rob me of the joy of living. As a matter of fact I feel those feelings far more intensely than before. I let them come up, I recognize them for what they are, and I let them go, the way we’re taught to handle wandering thoughts that come up while we meditate.

I’ve learned that feelings are not dangerous or bad. Danger and damage come from poor choices about how to handle feelings. People aren’t bad either, but some are trustworthy and others are not. I give everyone the benefit of the doubt, and I am open minded and forgiving. Nobody’s perfect. But I am also quite vigilant, though in a quiet, unobtrusive way. If I find someone to be lacking in integrity I choose to steer clear from then on. I do it quietly and with dignity. There’s no need to make a scene. There’s nothing to be gained from that and, besides, it’s disrespectful. But I do whatever I need to do to protect myself and my loved ones.

I have had numerous psychological assessments since I entered seminary in 2008. I haven’t really learned anything new about myself from them, but they are an interesting exercise in relating to psychologists. Like pastors they are in a helping profession. (The first assessment exercise was with a pastor who is also a psychologist.)We share some of the same personality traits and styles of relating to people. We also have similar insecurities and shortcomings.

The Denver doctor’s assignment was to determine whether I have any emotional or personal issues that might affect my work as an ordained minister, and to make recommendations for further personal growth. I have every intention of continuing to grow as a person and as a spiritual being. That is what I feel called to do, to strengthen my relationship with God and to trust God to guide me and provide for me. Her recommendations came down to doing the things I had told her I wanted to do–strengthen personal relationships, work on ministerial skills, and learn to be an effective pastor. I think I “passed.” I’m not happy to have personal details about my life and my past being reported to the church, but there’s no way to avoid that. At least it’s over now.

The title summarizes how I formulated my eating and exercise plan. The touchstone is optimal diet. For me, there’s extra urgency because of the immune system and hormone problems exemplified by my cancer. But before the diagnosis my cholesterol was much higher than it used to be, and my blood sugar as measured over time (Hemoglobin A-1C) was also creeping up. I’ve been interested in diet, fitness and health all my life. Cancer is the immediate issue, but far more women die of heart disease than cancer, and we’re facing an epidemic of diabetes and of a kind of abdominal-fat-focused weight gain and insulin resistance called “Syndrome X.” That may be linked to too much added sugar and simple starches (white flour, white sugar, white rice, white potatoes) and to an unhealthy balance of Omega 3 to Omega 6 fats.

I have concluded that it all comes down to (a) energy management, (b) antioxidants, (c) avoiding inflammation and, possibly, (d) consuming foods and beverages that have anti-cancer properties. Whether (d) is true or not, the advantages of adopting a diet-based “complementary therapy” for cancer are that it’s tasty and it is highly unlikely to be harmful.

For the basic structure I’ve gone back to the food guide in the first part of The New Laurel’s Kitchen, which is based on the best nutrition research available at the time (1986). It says that every day we should eat four servings of whole grain foods and three servings of vegetables, including one “super-vegetable.” To that add one serving of either super-vegetable, legumes, or dairy foods. Round out calorie needs with other whole foods like fruit, eggs, nuts and seeds. A super-vegetable serving is 3/4 cup cooked dark leafy greens, or one cup of edible-pod peas, brussels sprouts, broccoli, asparagus, okra, or bok choy.

Garlic, onion, and celery have anti-cancer properties. Red and orange vegetables are high in antioxidants. Vegetables have several kinds of dietary fiber that aid digestion and elimination while they fill us up and help us feel satisfied. The Mayo Clinic eating plan allows unlimited non-starchy vegetables. Starchy ones like squash, sweet potato and potato count as carbohydrates.

Since I’m not a vegetarian and I’m convinced that we need Omega-3 and vitamin D, I also have fish oil supplements, vitamin D-3 supplements, and fish. I occasionally eat grass fed beef. The serving sizes and the nutrient mix are compatible with the exchanges in the Mayo Clinic “healthy food pyramid.” I made little cards that will fit in my wallet with room to write down what I eat and tally the exchanges. Supposedly it takes three weeks to establish a new habit, and I haven’t been doing it that long yet, but so far, so good.

Fruits, vegetables and whole grains have lots of antioxidants and fiber. Legumes (beans like lentils, split peas, garbanzos, etc.) are also good sources of antioxidants. Antioxidants may help protect against (or fight) cancer. Fibrous foods, even if they are relatively high in carbohydrates, are less likely to cause blood sugar peaks and the attendant insulin spikes and inflammation that may be caused by eating simple sugars and refined starchy foods. And of course the main thing is not to eat more calories than I burn. Since I want to lose weight, I have to eat fewer calories than I burn.

When I became a vegetarian in the early 70′s everyone’s big concern about that was whether I could get enough protein. Then came Diet for a Small Planet, which was based on research into combining plant proteins in ways that would balance amino acid profiles and make complete, usable protein. Individual plant foods do not have all the essential amino acids (amino acids that human bodies can’t make on their own.) Combining rice and beans, corn and beans, wheat and sesame seeds, etc. remedies this deficiency.

Back then they thought you had to consume the right protein combinations together in the same meal. It turns out that if you have a small intestine, and if you’re getting all the essential amino acids over time, your body can do the rest. Amino acids are cut apart and remixed in the small intestine. One glass of milk or a serving of yogurt every day is enough to fill out the missing pieces. So is a small amount of meat or fish. This is true for people who are getting enough calories so that their bodies aren’t burning protein for energy. For people who are restricting calories, it may be wise to get extra protein.

I think probiotics help promote health. I make my own yogurt, and I have some just about every day. Usually that’s in the form of a smoothie made with yogurt, whey protein, egg white and fruit. Probiotics feed on “prebiotics” in the intestine. Prebiotics are fiber, which is abundantly present in the foods I’m eating. Some think that the intestinal environment plays a significant role in the immune system.

The advice on yogurt making in Laurel’s Kitchen is very good, but I’ve modified it a bit. I boil the jars and lids instead of sterilizing them with chlorine. And with every batch I make two quarts of yogurt to eat plus a 6 oz. jar of starter. I keep the starter jar sealed in the refrigerator until it’s time to make the next batch. That reduces exposure to wild yeast, other molds, and wild bacteria. (The starter sat in the fridge unused for four weeks while I was away, and it worked fine the next time I made yogurt.) I also use a little agar (1 tablespoon per batch) and some extra non-instant milk powder (1/2 c. per batch) to help firm it up. The agar has to be softened by simmering it, which I do while I scald the rest of the milk. To keep it warm while it’s culturing, I put the jars in a small ice chest and fill it to the top with warm (just under 120 degrees F.) water. Home made yogurt costs about half as much as store-bought yogurt, and it’s sure to have plenty of live and active yogurt bacteria.

To make “Greek yogurt,” all you have to do is line a colander with clean muslin, dump in the yogurt, and let it drain until what’s left behind is thick enough for you. However I don’t know if the probiotics I want are in the thick part or the watery part, so I don’t do that.

I try to do an hour of walking or some other exercise, such as yoga, every day. A recent New York Times article discusses the drop in metabolism and permanent food cravings that people who lose weight often experience. (There’s a link to the article here.) The article talks about a registry of people who’ve lost at least 30 pounds and kept it off for at least a year. They exercise a lot, and they constantly monitor their weight and food intake. Weight management for them is a lifelong commitment. There are only about 10,00 people in the registry. Millions of Americans are overweight, and most, if not all, of them have tried more than once to change that.

I got back to Boston from Denver early Tuesday morning. I had an appointment to get my Herceptin infusion that afternoon, and the rest of the day was taken up with two family crises, a trip to the grocery store, and cooking. Yesterday I worked out and cooked. I cooked steel cut oats, brown rice and red beans, made some “Better Butter” from the Laurel’s Kitchen recipe, and made yogurt. I ordered the books I need for the new semester. I also spent a lot of time on facebook. Today I plan to finish a PhD application, the third of three.

Classes start next Tuesday. It will be my last semester as a masters student at BU. The last class will be on my birthday, and graduation will be in mid-May. It feels strange to have a second day in a row with no deadlines or appointments. I could go to The Crossing tonight, and I’d like to do that, but at the moment the weather is wet, windy and cold, so I might not go. These “in between” times are good for self assessment and reflection.

I lost four pounds in the three weeks I was in Denver. I’m pleased, of course, but it’s a little puzzling. I ate sweets and treats. I had a lot of restaurant meals. I walked a lot, but I usually walk a lot. If I could figure it out I’d do more of the same.

The last time I lost a lot of weight it was involuntary. I had a broken heart, and I simply could not eat. I lost about 25 pounds in a short time, and when my appetite came back I quickly gained that back and more. It proved conclusively that crash diets backfire.

Losing weight really is a simple matter of “eat less, exercise more,” but it is not so simple in practice. I have no obvious bad habits, but I’m overweight, so there’s an energy balance issue. I have some ideas about what’s causing the imbalance and how to rectify it. The changes have to be realistic, healthy, and feasible, and I have to keep it up. I didn’t put on all these extra pounds overnight. Over time, my habits changed so that my “new normal” weight was higher than before. (Getting older and having different hormones also happened–but I don’t think that’s the whole story.) I need to make permanent lifestyle changes that will help me keep the weight off once I lose it.

Two years ago I was trying to lower my cholesterol with diet. I set daily targets for calories, protein, carbohydrates, cholesterol, total fat, saturated fat, fiber and soluble fiber. I tracked everything I ate, and tabulated it. That took too long to be sustainable.

To avoid the pitfalls of excess complexity I’m going to use an exchange system. The Mayo Clinic has an online guide to weight management based on exchanges. (Click here if you want to see it.) I can learn to tabulate exchanges in my head, and get in the habit of tracking them. I’ve also ordered a set of scales and a hot air popcorn popper.

I need a full-length mirror. I had that where I was staying in Denver, and it was quite revelatory. I simply can’t kid myself about how I look when I see it all at once–my tiny head, my Michelin-Man middle, my thighs. I don’t hate myself, but I can do better.

When I was in Denver I had a two-hour psychological evaluation. It’s required of everyone seeking ordination in the United Methodist Church. I’m happy they screen people. It would be irresponsible not to do that. But it was not fun. I had taken three written tests in May (MMPI-2, Cattell’s 16 Factor Personality Test, and a sentence completion test). The psychologist had those results, plus three letters of reference from people I had asked to write about me. She asked some follow-up questions from those tests and letters, but she didn’t ask them until I first talked about myself for over an hour. She took notes, and asked clarifying questions about my narrative. Then she gave me feedback.

I wish I could remember exactly how she phrased this, but here’s what I inferred from one of the comments she made: my answers about my level of anxiety and fear seem dishonest because I report abnormally low levels of those feelings. She also said I’m “too naive and trusting.” I found both of those assessments puzzling. I used to be quite anxious, fearful and resentful, and my current relatively calm state is the result of diligent effort, over many years, to heal and become more whole. Also I agree that I am open-minded and willing to give people the benefit of the doubt, but I am actually quite vigilant. I assess people all the time, and I have learned to avoid people who are not trustworthy. She also said I’m “defensive,” which made it difficult to respond to things that seemed incorrect, at the risk of seeming defensive.

I know I’m not perfect. But I also know I’m honest, empathetic and emotionally stable. Let’s hope the church thinks so too.

I’m wondering about the spam that I get. The posts that get the most hits are “Bertha,” “Knitting Dishcloths,” and “Saving Jesus from the Church.” I have no idea why. I just go through and mark them as spam, so it’s no big deal. But today there was a real comment to approve. That was much more fun.

So it’s the new year. Let me just say I am especially happy to have made it to 2012. It might have been otherwise.

But of course there are the resolutions. The obvious one is to lose weight and keep it off, though not just weight but fat. I honestly don’t care how much I weigh as long as I’m happy with my body fat percentage, and right now I’m not. The two best things to do to prevent cancer and/or keep it at bay are to be lean and fit. I’m actually pretty fit for someone my age who’s 30 lbs. overweight. That’s good–a good start. There’s a free program at the hospital to help people with weight management and fitness after cancer treatment. I’ll be signing up.

My daughter Lily is getting married in September, and I don’t want to be the fat lady in the wedding pictures. Between vanity and health concerns there should be sufficient motivation for making lasting changes. Or so I hope.

I also want to start having more fun. I think I should do one thing a week just for the fun of it. I’ve been doing fun things every day since I got to Denver on December 20, and it’s great. A related resolution is to spend more time in face-to-face relationships. I have a lot of virtual friends, but no regular practice of visiting with people or playing with them. I know some wonderful people in Boston. I’m going to do more dinner parties and brunches. Or maybe it should be walks and bike rides. The other night a friend of mine and I worked out together at her gym. She says she likes to combine socializing and exercising. It makes sense.

I have completed two doctoral applications, and there’s one to go. All my recommenders did their part. I think I have all the transcripts and test scores in. After uploading one last personal statement all that will be left to do is wait. And work on the last three classes for my M.Div.

I get it. People don’t really know what to say about cancer, or what to do if someone they know has it. But on Christmas Day I asked those present never to say I lost my battle with cancer if I end up dying from it. If I were run over by a truck you wouldn’t say I lost my battle with the truck. I’m no warrior. I’m not brave. I take my pills and show up for appointments on time and lie still in scanners and let them put needles in my veins for various reasons, but that’s not courageous. I feel fine, and I’m pretty sure the cancer treatments are the reason. If I hadn’t cooperated with the treatment plan I might well be dead by now. What’s brave about that?

Maybe I’ll get to the point where, either because remission has lasted a long time or none of the treatments are doing any good anymore, I stop treatment. That might be considered brave. Maybe. Or maybe that will still be a simple calculation about benefits and costs, quality of life vs. the potential to extend it.

It’s not really a battle, either. As I said in an earlier blog post, cancer is us. It’s our life processes gone awry. Genes that are supposed to turn off fail to do so, or genes that are supposed to switch on don’t, but it’s really just a horrible biological mistake, not a war. Thinking of it as a war can lead to rash decisions or misunderstandings.

The question of surgery might be in that category. Back in the days of the radical mastectomy, surgeons got better and better at doing more and more disfiguring excision of  breast, lymph nodes, chest muscles–anything on the same side as the tumor. It turns out that was never the right surgery. Either the cancer had already spread to other parts of the body, and mutilating the poor woman had no effect on that, or it hadn’t spread and it was unnecessary to cut out so much. Statistically, women who get lumpectomies and have clear margins, especially if they also have radiation treatment, have the same overall survival rate as women who get mastectomies. So most of the time mastectomies are not necessary. The old style “radical” mastectomy (with radical referring to “root”) is always wrong.

For people who are Stage IV at diagnosis, it’s not clear that surgery has any effect on overall survival. There are not yet any controlled, prospective studies on that question, only retrospective analyses of various data sets. Those studies attempt to screen out confounding variables, but without having matched experimental and control groups you just can’t be sure. For example, women who didn’t have surgery might have been too sick to have it, and they’d have died either way, so they should be excluded entirely, but most of the time you don’t know enough to tell who to screen out. Surgery might actually be harmful. The original tumor might suppress the growth of the metastases, and if it’s removed they might flare up. It’s also possible that general anesthesia can suppress the immune system enough to exacerbate cancer.

I feel fine, mentally and physically. I am adjusting to this “new normal.” I don’t know what’s going to happen next, but at least I have been through eight months of things heading in a good direction, and that makes a big difference. When I was diagnosed I had no clue. I didn’t know how treatment would affect me physically and cognitively. (One of my aunts assured me I’d have chemo brain and assumed that my medical people didn’t tell me that. They did warn me that it might occur, but it didn’t.) I didn’t know if treatment would be effective. Now I have reason to hope I’ll achieve and maintain complete remission. There’s no way to be sure I can, but there’s also no reason to think I can’t.

You never know how much time you have. People die, sometimes suddenly. Cherish the loved ones in your life. Love your life. Be grateful for every breath. Be gentle with yourself and others. I am really too busy doing those things to do any brave battling. I’m just doing the best I can with what I have.

This is the last six days of the semester. I have final projects due next Thursday, a take-home final consisting of three essays of five pages each, and a research paper of around twenty-five pages. It is also the deadline for applying for the ThD program at BU for the fall, and I have to write a 2,000 word personal statement for that.

So what am I doing blogging?

First I wanted to expand on what I said last Saturday about childhood Christmases. Although the invitation to reflect on those days was a lot like a bomb going off in my psyche, derailing my plans for the day and disturbing my equilibrium, it started me sifting through memories for something positive, and I was successful.

My family lived in Germany from the time I was one year old until I was almost four, and we picked up the custom of celebrating “Wise Men Day,” otherwise known as Epiphany. I have great memories of Epiphany. We’d put our shoes out the night before, and the Wise Men would come and leave us gifts. We’d always get a new toothbrush, and something else. Quite possibly, the “Wise Men” took advantage of after-Christmas sales. One year I got a microscope. Another year I got a chemistry set. I loved them both, and I am thankful my family had high academic expectations for both boys and girls.

In 1968 we celebrated our first Christmas back in Denver. My parents had just bought a house on South High Street, but our stuff, including Christmas decorations, was still in storage. My mom borrowed a sewing machine from a neighbor and bought a bunch of felt, which I turned into customized Christmas stockings for myself and my brothers and sister. Each one had a distinctive decoration, and the name embroidered on it. As husbands and babies came along I kept making stockings. The most recent one was for my daughter-in-law early this year. So, at 14, I started a family tradition that is still going on.

When I started this post I hadn’t heard yet about my PET scan, but then the Nurse Practitioner called me from home to tell me the news. The liver lesions are gone. The lung nodules are less than 5mm, which puts them below the threshold of what a PET can evaluate. The tumor in the breast has not grown and is not active. It might be just inflammation, or necrosis.

I was mentally prepared to “keep on keepin’ on” no matter what the scan showed. But this is, of course, the best possible news. I am so very happy. I am healing and I will continue to heal.

In the last post I said I was going to have a thyroid biopsy. The doctor took four samples from each of two nodules, one on each side of my trachea, using a small needle, and guided by ultrasound. The larger of the two nodules was most concerning for cancer, and it tested benign. (Yay!) There were not enough cells harvested from the other one to know what it is, so I’ll have to have another biopsy in January.

I’m scheduled to have a PET scan on December 5 to assess how my cancer treatment is working. I’m optimistic that it will show more progress toward the goal of “permanent remission, normal lifespan.” I feel and look healthy. I have plenty of energy. A doctor friend of mine told me this illness is just an immune system/hormone problem and there’s no reason to think it can’t be corrected. I agree.

I went to Philadelphia for the Thanksgiving break. I took a bus that left Boston at about 1:30 Thursday morning, and I got to my friends’ house at about 8. My host and his daughter were off running the Turkey Trot five mile race. His mom, who was visiting from New York, let me in, which is how I got to meet her. His wife, who was my first friend at Arch Street United Methodist Church, greeted me warmly when she got up.

I helped cook Thanksgiving dinner. That was a delight. My host printed out the recipes and taped them to cupboard doors around the kitchen. I did the sweet potatoes, and they were excellent. They had fresh ginger and cayenne pepper in them, which gave them a nice little kick. And they weren’t too cloyingly sweet. I love cooking, and it was fun to cook in a group. The other great thing was having leftovers to eat for the rest of the weekend.

I had a wonderful weekend, even though I also had to write a paper. I decided to write just a “good enough” paper and not let it take up all the time I was there. It was due Monday morning. I finished the first draft by dinner time Sunday night, and I left it alone until early Monday morning, when I edited it and emailed it in. But while I was editing it I kept thinking, “the argument is weak here,” or, “I need a citation for this.” But of course it was too late, so I just turned it in as it was. I took an afternoon bus back to Boston Monday, and arrived home at about 11:30 p.m.

Today I’m at a “reading retreat” at school. Reading retreats are a chance to combine spirituality and community with scholarly pursuits. The school provides food, and Robin Olson, the director of the Spiritual Life Office, plans three short worship services throughout the day. It is a joy to be part of a community of worshiping learners. The retreats reinforce the feeling that God brought us together for a reason and is working within and among us to bring about healing, reconciliation and wholeness. I love taking part in these gatherings.

This morning Robin guided us to reflect on a specific Christmas memory from our childhoods. That was tough for me. My mother loved celebrations and had a great sense of joy and fun, but over the years she became  increasingly incapacitated by mental illness. She was less and less able to keep everything together, and my father was no help, being lost in his own personal hell. So, sadly, the increasing weight of ever more stressful, dysfunctional Christmases has dragged all my childhood Christmas memories into a dark, twisted jumble of images and scenes that I would rather not remember. I was able to recall feeling a sense of hope and wonder anyway, as if God was bathing me in light and love and protecting me from my parents’ demons, but it was a struggle to find that one bright jewel among the ruins.

I tried to build warm memories and healthy traditions of Advent and Christmas for my own children. I think I succeeded.  Maybe I’ll write a separate post about that. Right now I need to get to work on end-of-semester projects.

On Mondays I go to a support group for people with Stage IV breast cancer. Today one of our members told us she has quit being treated and has arranged for hospice care in her home. She was calm and dignified. Someone asked her how she was feeling and she said she was fine. Several of us told her we’re sad for her, but it also makes us sad for ourselves. Barring a miracle, or some other really bad luck, we will all be following in her footsteps eventually.

Support groups specifically for people with Stage IV cancer are few and far between, and I feel blessed and lucky to have this group, even though it can be pretty intense, as it was today.  We don’t always talk about death, but we don’t ever have to pretend it’s not sitting in the room with us. The group is self selecting for people who would rather get things out in the open than try to run and hide. We are kind and supportive and good to each other. We can talk about whatever we want to talk about. We laugh a lot and we cry sometimes. It is a sacred space.

Stage IV cancer is a zigzag path for most people. They have times that the disease progresses, and they have to try some new treatment and deal with the side effects. There are periodic scans and anxiety about the results. Then maybe they get some relief–a little break from treatment, a little time that it’s stable or even retreating. Some people are “NED” (no evidence of disease) for long periods. One member of our support group has been getting Taxol and Herceptin for eleven years. She still has cancer, but it’s stable. On the other hand, in the office where we meet there’s a group picture from years ago, and the only two people in the picture who are still alive are our group facilitator and that one eleven-year survivor.

At some point in the dance with cancer the whole routine gets to be too much. There’s too much pain, too many side effects, not enough benefit from the drugs, and the person decides she’s had enough and stops. And then the cancer finishes its work. Last year Elizabeth Edwards announced that she had discontinued treatment, and the next day she was gone. I’m pretty sure she must have stopped some months before she announced it, to give herself time to prepare her family for the end, to say goodbye to her loved ones, and prepare herself. I hope so, anyway. She was a public figure, so I believe she delayed announcing the decision to the last minute just so she could die in peace, and not have to talk to anyone she didn’t love.

I don’t want to die, but I’m not afraid of it. I think the world passes away and that’s all. It’s not scary and it’s not even sad for the person who dies. I don’t want to leave my kids or my friends or my studies, but we all have to take our last breath at some point. The process starts with the first breath we take. It’s inevitable.

I like realizing I’m in good company. My parents and grandparents, some of my friends, and some famous people who’ve been important to me are no longer alive, but they live on in my heart. I have had many, many happy days. I have made beautiful memories with the people I cherish. I hope I have touched other lives in good ways. I will live on in them and in their futures. And it’s quite possible that the membrane between the living and the dead is more transparent and permeable than the living realize. My mother died in 1976, but I still feel her presence, especially when her grandchildren do things that I know would please her.

When I was 16 I had a job as a nurse’s aide in a nursing home. In the space of about a week, two patients died while I was feeding them breakfast. If I had known they were dying I think I would have held their hands and stroked their heads or something, but it was completely unexpected. Both of them were nonverbal, and they were both cooperating with the feeding, so I guess they also didn’t know they were about to die.  It was kind of freaky that the two events were so similar, and happened so close together, but it really wasn’t bad. I think that was about the time I decided that the best plan for life is to live as fully as possible with as few regrets as possible. For the most part I think I’ve done that.

I’m not planning to exit any time soon. I feel fine, and things seem to be going well with my treatment. I will do all I can to stick around. I am making plans for what to do after I graduate, and I have some exciting ideas.  If I get to live 30 or 40 more years, I’ll make the most of every single day. And if it’s less than that, then that’s all the more reason to make the most of it.

I just made it through three and a half intense weeks in which I wrote a paper, wrote the hardest take-home midterm exam I ever took, and then did a presentation in my narrative sermon seminar that counted for 50% of my grade. For that, I had to do a 50 minute lecture on a sermon method, then deliver a sermon demonstrating the method. Each project would have been better if I had not had to do the other two, but I’m taking three classes, so that’s the way it goes. I’m glad they’re done. It’s also great that the due dates were spread apart.

The paper was for my History of Western Philosophy and Social Ethics class, and it was called “Dissecting Aristotle’s Political Animal.” The presentation was on a book called Confessing Jesus Christ. I preached on Amos 5:18-24, which is one of the lectionary texts for next Sunday. Three of the five classmates who heard it said they didn’t hear the gospel because they don’t like politics, or political sermons.

The passage (which is really two separate sections) is a warning that when the Day of the Lord comes, it will be a bad day for the Israelites, contrary to what they expect. They think YHWH is going to come and defeat their enemies. (As Anne Lamott says, you can be pretty sure you’re making God in your own image when you think God hates the same people you hate.) According to the prophet Amos, they are God’s enemies, because of the way they treat the poor. The passage ends “let justice roll down like water, and righteousness like an ever-flowing stream.”  I talked about how being God’s chosen people means both trusting and obeying God, both worshiping God and obeying God. The Sinai covenant makes specific demands about loving
God and neighbor, including debt forgiveness and distributive (really redistributive) justice. If that’s political, then so are parts of the Bible.

One of the people who gave me a thumbs down is a preacher who is auditing the class. He says he decided in seminary not to preach political sermons. He says people would leave if he did. I would certainly never tell people how to vote, or favor one political party over another. I agree that one should not preach political sermons.

I don’t think my sermon was political. I think it was prophetic. I took a couple of shots at Congress as a whole, but I didn’t take sides. (They made it too easy for me. On Tuesday they voted 396 to 9 to confirm that the 55-year old official motto of the United States is “In God We Trust.” At last! Bipartisanship!)  A recent survey showed that the more people read the Bible, the more liberal they become. I don’t see how they could avoid it. There are something like 2,000 verses in the Bible that deal with money, greed, social justice, and oppressing the poor. If  members left because they didn’t like hearing biblical sermons with prophetic truths about social sin, I would be glad to see them go.

On the health front I’ve had a bit of a setback. Despite the fact that I think there should be a one-cancer-at-a-time rule, I’ll be going in November 23 for a biopsy of my thyroid, which has some suspicious-looking nodules on it. It might not be a new cancer. It might be metastatic breast cancer. Or it might be benign, as most thyroid nodules on older women are. I should know by November 30. I would not have known about the thyroid nodules, because I have normal thyroid function and no symptoms, but both of the reports of the CT scans recommended an ultrasound of the thyroid, and I finally got a referral to an endocrinologist and started down this path. All I can say is I wish I hadn’t let all my life insurance expire.

Right after I got the biopsy appointment Tuesday I felt sad, tired, and defeated. I’m worried about losing my voice. As a singer and preacher, my voice is important. I play the cards I’m dealt, but that would be a tough hand.

It’s interesting how something like this exposes feelings and attitudes. In 2002 I had a detached retina in my right eye, and the retina in my left eye was torn. For a few terrifying weeks I confronted the possibility of going blind, and I wondered how I would manage. One of my favorite hymns is “Be Thou My Vision.” It took on much more significance during that time. I became convinced that God would take care of me, and that whatever happened I would be alright. And I’m alright now.

I’ll see my oncologist next Monday. I feel fine. My feet and ankles were swollen all summer, but they’re close to normal now. I still have a little neuropathy in my toes, but it’s not too bad. I can walk unimpaired and it doesn’t affect my balance. I was having some side effects from Arimidex, but that’s greatly improved too.

The best news is I don’t have brain metastases. I got a brain MRI a couple of weeks ago, and it’s all clear. Breast cancer can get into the brain, and most cancer treatments don’t cross the blood-brain barrier. Brain metastases can be treated in other ways, but both the tumors and the treatments can cause cognitive impairment. I am extremely grateful that my brain is OK.

Instead of blogging I’ve been working on school work, mostly. I’ve also been posting on a forum for people who have HER-2 positive breast cancer. Today there was a thread responding to a magazine article about breast cancer survival statistics. One woman whose recovery does indeed appear to be miraculous wrote about positive thinking. Another wrote eloquently about living in the now. Several others talked about loving life, being spontaneous, and being grateful. I wrote the following contribution to the conversation (plus some editing and embellishing).

I do think there’s a mind/body connection, but I don’t think we either give ourselves cancer or cure ourselves solely with prayer/meditation/positive thinking or the like. However, I do think it’s quite possible to kill myself with negative thinking, with giving up, with saying “what’s the use?” And it certainly can’t hurt to harness the power of the mind in service of a physical outcome that we prefer.

Except for one thing. I would hate for anyone who “fails” at that to think she did something wrong or she just didn’t want it enough. That is just cruel. And it’s horribly unfair.

On top of all the miseries of cancer diagnosis and treatment, cancer patients are supposed to be cheerful and positive. I think the subtle (and sometimes not-so-subtle) pressure to do that comes from society’s uneasiness about death and dying. It’s almost like I have to pretend I don’t have an incurable illness so other people can go on pretending they aren’t going to die. I have decided I can do them (and myself) more good by learning how to live as fully as possible.

I try to live in the Now  (thank you, Eckhart Tolle and Jon Kabat-Zinn) and to cultivate an attitude of gratitude, wonder and joy. I realize the latter is helped a great deal by the fact that I don’t feel sick. The days I do get gloomy or grumpy are usually correlated with some physical complaint. So there’s another mind/body connection.

For me it’s a matter of submitting to and accepting my own mortality and being happy, grateful, joyful and fully human not just in spite of that fact but because of it. It is my creatureliness that makes me who I am. It is this body, this mind, this spirit, this history, this unique expression of creation that is me, myself. Inevitably, mortality is part of it.

The author of the article is concerned about seeing her daughter graduate from high school. I sympathize, but nobody ever gets “done.” My “do” list, my “bucket list,” my hopes for the future, will be interrupted at some point, even though I will always want more. But I realize I can’t let my wanting more blind me to the life I have now. I used to be very driven and goal-oriented. Then I noticed that every time I hit a goal I felt let down. That’s because I kept thinking that realizing the goal would make me happy, and it never did. Happiness is not getting what you want, it’s wanting what you’ve got. “I would be happy if ______ [fill in the blank]” is never true.

The Psalms often talk about the “sacrifice of thanksgiving.” Being thankful for whatever happens is easy when it’s smooth sailing, excruciating when you just got your heart ripped out. I have had to force myself to say “Thank you, God” in situations that I could see absolutely no upside to, and that I had, moments before, been begging God to change. When I submit, when I quit fighting, when I say “thank you,” it really is a sacrifice. I lay my ego on the altar. I lay my certainty down. I lay down my righteous indignation. And I crawl into God’s lap and cry. Then comes the peace that passes understanding. There’s no earthly reason to be thankful for misery, and I’m not, but I’m thankful that nothing can come between me and God’s love, and I’m thankful that God will never abandon me.

The key to happiness and wholeness is to Be Here Now and be thankful–to radically accept my situation and quit wishing it weren’t so or imagining that if I were in charge of my fate I’d design a better one. My ultimate destiny was set the day I took my first breath. It is certain that someday I’ll take my last breath. OK, so now what?

I listen to guided imagery for healing. (As I said, I figure it couldn’t hurt.) When I first heard one of the affirmations, when I was newly diagnosed and still freaked out, it was quite off-putting. But now I love it. It says something like, “More and more, I know that I can heal myself and live or I can heal myself and die. My wholeness is not determined by my physical condition.”

I am whole, healed, accepted, loved and perfect in my imperfection, in my finitude, in my fragility, in my humanity. There’s really nothing to be afraid of, and there’s everything to gain from seizing the moment and loving it as completely as I can.