December 27, 2010 - Putting the "Death Panel" Myth to Rest

A New York Times article published on Christmas Day reports the good news that sanity has finally prevailed in the halls of government, as further regulations connected with the landmark healthcare-reform legislation enable Medicare funding for advanced end-of-life planning.

This news comes - to my mind, anyway - with a particular sense of relief. Opponents of healthcare reform have cynically and cruelly exploited dying people for their own political gain, by raising up the myth of government "death panels." According to that improbable scenario, government bureaucrats would have played a role akin to that of the infamous Dr. Mengele at the Auschwitz concentration camp (he was the camp physician who decided, with a wave of his baton, which new prisoners would go to the barracks and which would be sent directly to the gas chambers).

What the original legislation, in fact, provided was money to pay for annual doctor's office visits - for those critically-ill patients who want them - at which the various options for end-of-life care would be explained. One significant option is hospice - the part of the medical community in which Claire works, providing bereavement counseling and support.

The recent news is that the Obama administration has quietly restored this funding - not through legislation this time, but through regulation-writing (it had been in the original bill, but was pulled out in reaction to the "death panel" kerfuffle).

I'm especially glad to see this funding restored because of situations I've seen arise time and again in my ministry (and which Claire sees much more often in hers). Far too often, patients avoid having the hospice discussion with their doctors and family members until death is imminent and it's too late for them to derive much benefit from hospice care. When patients' time on the program is measured in hours rather than days, there's not a lot the hospice team can do for them.

Hospice care is not intended to be delivered in such an accelerated time frame. Yes, it's designed for patients who are expected to live fewer than six months, but a lot can be accomplished in that period of time, improving significantly patients' comfort and quality of life.

Talking about hospice is NOT giving up on patients. Quite the contrary, it's about empowering seriously ill patients to live the remaining portion of their lives as they wish. If patients and their families decide to continue aggressive treatment, so be it. If they opt, instead, to go home to a hospital bed in the living room, with advanced pain control and unlimited visits from their grandchildren, then that's their decision and it ought to be respected.

Irrational fear of "death panels" has kept people off hospice care who should have been receiving it much sooner - and would very much have wanted it, had they understood the patient-centered philosophy behind it. This restored funding will allow doctors to plan significant time for consultations that will equip patients and family members to make their own, carefully considered decisions about backing off from aggressive treatment and focusing more on palliative care.

Time and again, I've heard bereaved family members say they wish their loved one had signed onto hospice earlier, but they just didn't have a sense of what hospice is all about until it was nearly too late.

Chalk this one up as a triumph for patients' rights: to make their own, well-informed healthcare choices.

December 7, 2010 – Remembering Elizabeth

Sad news, this evening, of the death of Elizabeth Edwards. Evidently, in the end it happened very quickly for her, which is a mercy.

The “late unpleasantness” of her husband’s irresponsible behavior has dominated the headlines in the past year or so, and many of us were very sorry to see that burden added to those Elizabeth was already carrying. It speaks to the strength of her character that, through faith and sheer determination, she somehow found the inner strength to be there for her family, to face the television cameras with her head held high and to continue to use her celebrity status to exercise compassion for others.

Her books, in which she candidly shared her life story, have been an inspiration.



Newsweek’s Jonathan Alter, himself a lymphoma survivor, shared a frank exchange he had with Elizabeth about her Christian faith, and the doubts she sometimes experienced, about both her cancer and the tragic, accidental death of her son, Wade:

“When I arrived, Elizabeth told me that cancer had essentially freed her to say whatever the hell she wanted. Then she proved it, by questioning the one thing all presidential candidates and their spouses must embrace - religious faith: ‘I’m not praying for God to save me from cancer. God will enlighten me when the time comes. And if I’ve done the right thing, I will be enlightened. And if I believe, I’ll be saved. And that’s all he promises me.’ But did she believe? Here she went further than any public figure this side of Christopher Hitchens.

‘I had to think about a God who would not save my son. Wade was – and I have lots of evidence; it's not just his mother saying it – a gentle and good boy. He reached out to people who were misfits and outcasts all the time. He could not stand for people to say nasty things about other people; he just didn’t want it. For a 16-year-old boy, he was really extraordinary in this regard. I wish I could take credit for it, but I can’t. You’d think that if God was going to protect somebody, he’d protect that boy. But not only did he not protect him, the wind blew him from the road. The hand of God blew him from the road. So I had to think, ‘What kind of God do I have that doesn’t intervene - in fact, may even participate - in the death of this good boy?”

That’s so like Elizabeth Edwards. She always told it like it is. Unlike so many people in public life who live elegantly fabricated lives, she was real.

Elizabeth will be well-remembered by those of us in the cancer community as a determined survivor, an encourager of others, an activist for change - and yes, a woman of faith. Let us offer prayers of thanksgiving for her life and witness.

October 5, 2010 - This Is the Day

This excerpt from a Presbyterian News Service release tells the story of the death several days ago of singer/songwriter David M. Bailey:

"David M. Bailey, a singer/songwriter who moved audiences as much with his story of personal courage in the face of terminal cancer as with his music, succumbed to Glioblastoma on Oct. 2 in hospice care near his home in Charlottesville, Va. He was 44.

The son of Presbyterian missionaries, Kenneth E. and Ethel Bailey, Bailey was raised in Beirut, Lebanon. He spent some of his youth in Germany — where he learned to play the guitar and began writing songs — before returning to the United States....

In July 1996, he was diagnosed with Glioblastoma, a particularly virulent form of brain cancer. He then quit his corporate job and turned to songwriting and performing full-time.

'They told me I had six months. They were wrong,' Bailey said. 'Despite what you might hear, hope is a very real thing, and with every passing day, there are more and more reasons to hope.'

For 14 years he defied that diagnosis, writing and performing virtually non-stop, covering 45 states and 21 countries. His concerts were deeply personal, brutally honest accounts — rendered in a musical style that has been compared to James Taylor and Cat Stevens — of his struggles with his illness and his determination to make the most of whatever time God gave him.

His signature tune was 'One More Day.' The chorus goes:

'One more day when you can hold your children
One more day you can hold your wife
One more day when you can watch the grass grow
One more day when you can live your life.'"

It calls to mind the familiar scripture verse: "This is the day that the Lord has made; let us rejoice and be glad in it." (Psalm 118:24)

It's a lesson David taught us: how to live in the now, praising God for all good gifts. His music - and that lesson - will live on, through his recordings.

Prayers and good wishes go out to his family.

August 3, 2010 - Clinging to the Tail of Possibility

On vacation in the Adirondacks, I read a remarkable article from the August 2 New Yorker magazine. I was tipped to the article by my brother, Jim – though I later learned from Claire that members of her hospice team have been passing it amongst themselves, causing lively discussion in their weekly staff meeting.

I think “Letting Go: What should medicine do when it can’t save your life,” by Atul Gawande, may set off at least as much debate as his June 1, 2009 article, “The Cost Conundrum: What a Texas town can teach us about health care.” (which I discussed in a July 20, 2009 blog entry, “Where Not to Get Sick.”)

Gawande is a general surgeon who practices at Boston’s Brigham and Women’s Hospital, and who teaches at Harvard Medical School. He’s operated on a lot of cancer patients. Some benefitted mightily from his expertise, and others’ last days would likely have been more tolerable without the invasive procedures. Yet, hindsight is always 20/02, and ahead of time it’s always a tough call.

It’s his physician’s perspective that leads Dr. Gawande to question the lack of agreed-upon procedures for end-of-life decision-making in America. For a country with some of the most advanced medical care in the world, our practices in this area are remarkably haphazard.

Gawande points out that the financial costs of successful cancer treatment can typically be graphed as a bell curve: there’s a steep climb from the time of diagnosis to a sort of plateau, as very expensive scans and treatments are deployed. Then, there’s a drop-off in costs as the patient recovers. In the case of patients whose treatment is unsuccessful, the frequent result is half a bell curve. We throw some very big money at solving problems that are – statistically speaking – unlikely to be solved, sending the line of the graph soaring upwards. Because it’s a human life at stake, doctors typically follow the lead of patients and their families, ordering such last-ditch treatments if that’s what they want. In many such cases, the patient dies anyway, often after many days, or even weeks, of intensive care. If the ICU stay is long, those days can end up costing as much as – sometimes even more than – the cancer treatment itself.

These are agonizingly difficult decisions, some of the toughest in medicine. When to pursue extraordinary, experimental treatment? When to throw in the towel and admit that maintaining a reasonable quality of life for the patient whose health is in a tailspin is more important than the increasingly quixotic search for a cure?

Gawande remarks that nearly all categories of dying patients and their families – with one exception – are ill-prepared to wrestle with such complex, emotionally fraught decisions. When, as too often happens, everyone’s energies are single-mindedly fixed on the search for a cure, doctors fail to raise the what-if question of death at all. It seems to them premature. Yet, when that likelihood suddenly looms large, and quick decisions have to be made about such interventions as feeding tubes and ventilators, patients and families scramble to wrap their minds around the new state of affairs. Unable to achieve unanimity, a great many families fall back to the default position, which is to press on relentlessly in search of a cure – even though the doctors may know, full well, that chances of extending such patients’ lives by more than a few weeks are slim.

Granted – as Claire reminds me, based on her hospice ministry experience – there are some cultural and ethnic traditions that inform this process. Orthodox Jews, for example, typically make decisions within a moral framework that nearly always opts for treatment, no matter what the chances of success. African-Americans and Hispanics, bearing cultural memories of parents and grandparents to whom the system too often denied advanced care, are more likely than others to press for it, even against medical advice.

Referring to science writer Stephen Jay Gould’s oft-quoted 1985 essay, “The Median Isn’t the Message” – in which Gould tells the story of how, upon learning he had mesothelioma, he decided to take his place among the tiny percentage of patients who survive, and did – Gawande speaks of the “tail” of the statistical curve. That’s the narrow portion that stretches a good distance into the future, and includes the fortunate few patients who manage to beat the odds and survive a deadly cancer. It’s good to remember, when faced with such stories, that the statistical median is just that – a median. Always, there are some who do better than clinical expectations, others worse. An awful lot of people, though, are trying to ride the tail of statistical probability – far more than will end up actually being on it. Gawande writes:

“I think of Gould and his essay every time I have a patient with a terminal illness. There is almost always a long tail of possibility, however thin. What’s wrong with looking for it? Nothing, it seems to me, unless it means we have failed to prepare for the outcome that’s vastly more probable. The problem is that we’ve built our medical system and our culture around the long tail. We’ve created a multimillion-dollar edifice for dispensing the medical equivalent of lottery tickets – and have only the rudiments of a system to prepare patients for the near-certainty that those tickets will not win. Hope is not a plan, but hope is our plan.”

I mentioned above that Gawande identifies one category of patients and their families who are better prepared for end-of-life decision-making. He’s talking about those who have received hospice services. Alone among the specialties of modern medicine, the hospice movement is not afraid to face death head-on and talk about it with patients – well before the anxious moment in the little family waiting room just off the ICU, when a doctor (or, just as likely, a critical-care nurse) sits down on the vinyl-covered furniture with the family and informs them a decision needs to be made about discontinuing life-support.

Patients who have signed on for hospice care have already decided they’re not going to cling to the slim tail of possibility any longer. They’re going to strive for the best quality of life they can construct in the here-and-now, placing their hope somewhere other than joining the tiny percentage who defy medical expectations.

I can’t begin to recall the number of grieving family members I’ve spoken with who told me they wished their loved one had gone on hospice earlier. Claire confirms for me, from her experience working with bereaved family members, that this is a nearly-universal comment. Curiously, the vast majority of hospice patients live no longer than a few days. That’s not because hospice care is somehow bad for them – quite the opposite. It’s because, by the time most patients make this decision, they’re already so far gone that hospice functions as little more than a transfer-station between the hospital and the funeral home.

It’s not meant to be that way. The hospice ideal is for weeks or even months of active, but mostly palliative, treatment. The hope is that the hospice experience will provide a gracious space for patients and their families to work through the full range of issues – medical, emotional, spiritual – they need to deal with at the end of life. Surprising as it may seem, there are even some patients who go on hospice for a time, then go off it – their improvement has been such that the “six months or less to live” criterion of hospice admission no longer applies to them.

So, signing up for hospice care is not giving up, as some fear. Far from it.

The key to a higher quality of life for the dying, Gawande points out, is communication. One of the things hospice team members do exceptionally well is to encourage patients and their families to share their thoughts and feelings about dying, then to listen attentively and respectfully to what they say. Next, they help them think through what goals they have for the rest of their lives, and do whatever they can to help them attain them. “You don’t ask, ‘What do you want when you are dying?’” explains one expert. “You ask, ‘If time becomes short, what is most important to you?’” Gawande observes:

“People die only once. They have no experience to draw upon. They need doctors and nurses who are willing to have the hard discussions and to say what they have seen, who will help people to prepare for what is to come – and to escape a warehoused oblivion that few really want.”

The asking of such questions was meant to be a central part of the new health-care legislation recently passed by Congress, but politics blocked it. The Tea Party mob ignorantly slapped the label “death panels”on the funding for these vital conversations, then pressured Congressional leaders to excise it from the bill – which they did, so as not to lose the bigger battle. This is a terrible miscarriage of justice for the dying: the sacrifice of a proven care approach that offered real promise for enhanced quality of life.

When the only goal worth talking about is to beat the disease, Gawande concludes – no matter what that may mean in terms of unproven, experimental treatments – the statistical outcome in nearly every case is going to be disastrous. Which general would you rather have leading the troops into battle? George Armstrong Custer or Robert E. Lee?

“Death is the enemy. But the enemy has superior forces. Eventually, it wins. And, in a war that you cannot win, you don’t want a general who fights to the point of total annihilation. You don’t want Custer. You want Robert E. Lee, someone who knew how to fight for territory when he could and how to surrender when you couldn’t, someone who understood that the damage is greatest if all you do is fight to the bitter end.”

This article is a good read, for anyone whose life has been touched by cancer – either their own or that of a loved one.

Necrology

This week I'm attending the Presbyterian Church's General Assembly in Minneapolis. I'm blogging about it on my Monnmouth Presbytery Clerks' Corner blog.

Yesterday was the opening worship service, with several thousand people in attendance at the Minneapolis Convention Center. At one point in the service, it was announced that the Necrology Report would be presented, in the form of a list of names projected on the large screens over our heads.

"Necrology" is an odd word, but to those who frequent Presbyterian official meetings above the local level, it means a report of recent deaths. The General Assembly's Necrology Report is a list of ministers who have died during the previous two years, since the Assembly last met.

Flashing the names up on the screen was a creative way of presenting this information, without having to go through the tedious exercise of reading the list aloud. As we listened to some wonderful music, I scanned the names as each page was put up there, to see if there were any I recognized - any honored members of the older generation.

Bam! There was a name I recognized, but not from the older generation. It was Karen, a seminary classmate with whom I had worked side-by-side for a couple of years after we graduated, when we were both associate pastors. She died in a freakish accident: a burst blood clot in her lung, while she was on a high-altitude hiking trip. By the time the mountain-rescue team got her back down the mountain, it was too late.

Then there was Carter's name. I had never met her in person, but she and I were on the writing team for The Immediate Word, an internet sermon resource for preachers. Every week, we would speak via conference call, as the team planned the next installment. She had died suddenly of a massive heart attack.

In my mid-50s, I'm at the stage of life when I can expect to hear about this sort of thing more frequently - members of my generation who are dying.

I was very much aware of the fact that, with my cancer experience, I could very well have been numbered in that company. What would others have thought as they saw my name flashed on the screen, I wondered?

We cancer survivors have to deal with ever-present reminders of our mortality. To us, they take on a meaning that I suspect is very different than those who have always enjoyed good health.

April 5, 2010 - An Idle Tale?

Preparing my Easter sermon based on Luke 24:1-12, I was struck by the reaction of the male disciples to Mary Magdalene and the other women who brought them news of the empty tomb and of the angel’s message: “Why do you seek the living among the dead? He is not here, but has risen.”

Their first response was to consider it “an idle tale.”

“Idle tale” translates an uncommon Greek word whose meaning is “nonsense” or “delusional.” If the women’s breathless announcement is in fact the first Christian proclamation, then it means we preachers started out with a score of 0 and 1 from the get-go.

Which is no big surprise – because the resurrection isn’t exactly an easy truth to absorb. In contradicts one of the most foundational of human experiences: that dead is dead, and there’s no coming back.

I thought about that sort of thing a lot when I was feeling ill from my chemo treatments. What if the treatments were unsuccessful and I was soon going to die, I asked myself? What if, someday soon, I was going to shut my eyes not only to this world, but to everything else? What if this life, this consciousness, that is me would suddenly blink out of existence? What would have been the point of it all?

My mind danced with that bleak idea from time to time, but didn’t invite it home. I kept returning to the truths of my faith, and especially this truth that is the resurrection.

I told the folks in our church yesterday that this whole “idle tale” response is actually a sort of backhanded testimony to the truth of the resurrection. If you were to set out to make up a story about a man being raised from the dead, would you be so quick to admit that some of the people who most wanted to believe it to be true rejected it, at first?

Similarly, if you were going to go out and make up a story about a man being raised from the dead, would you include details that made you, yourself look like a clueless doubter – as was the case with Peter? If you were interested in spreading a made-up story in the intensely male-dominated Roman world, would you make women the first witnesses of the resurrection – women, who were considered, back then, to be second-class citizens, whose testimony the male-dominated society considered unreliable?

Of course not. There are an embarrassing number of loose ends connected with the Easter narrative. Four different gospels tell the story, as well as certain passages from the letters of Paul – all of them differing from the others in one detail or another. If your purpose were to make the whole thing up, you would have managed your sources a little better.

The result is that it’s impossible to put the various Gospel accounts together in a single narrative – just as it would be if there had been multiple witnesses recording their impression of a single, dramatic incident, each from a different angle.

The resurrection is jarring and unexpected. The great Reformed theologian Karl Barth says somewhere that it’s “not a natural ‘therefore’ but a miraculous ‘nevertheless.’” Archbishop of Canterbury Rowan Williams – a distinguished theologian as well as senior leader of the worldwide Anglican Communion – likens it to the Big Bang. When we celebrate Easter, he writes, “we are really standing in the middle of a second ‘Big Bang,’ a tumultuous surge of divine energy as fiery and intense as the very beginning of the universe.” (Tokens of Trust, p. 95)

These are outrageous claims – but in their very confusion, contradiction and sheer outrageousness, they’re true to life, in an odd way. Such a mind-bending, paradigm-busting event could never be encapsulated in a tight, little spin-controlled story.

With all those lights of inquiry shining upon it from so many different angles, the resurrection is like a person moving across a room, lit up by a strobe light. You know how that looks: a person lit by a strobe seems to move in a series of jerky, disjointed snapshots, rather than the seamless, smooth motion of movie film. Under such lighting, you can get a general sense of what’s happening, what various events are taking place – but not how they flow from one to the next.

There are still significant gaps in our understanding of the resurrection – and always will be, this side of heaven. That doesn’t mean it’s not true. It means it’s a truth too big, too complex, too wonderful for us to fully comprehend.

September 16, 2009 - Leaving on a Jet Plane

Sad news today, about the death of Mary Travers (of Peter, Paul and Mary fame). A blood cancer was the culprit – in this case, leukemia, with which Mary had been living for some years now.

From an MSNBC.com news article:

“Travers had undergone a successful bone marrow transplant to treat her leukemia and was able to return to performing after that.

‘It was like a miracle,’ Travers told The Associated Press in 2006. ‘I’m just feeling fabulous. What's incredible is someone has given your life back. I’m out in the garden today. This time last year I was looking out a window at a hospital.’ She also said she told the marrow donor ‘how incredibly grateful I was.’

But by mid-2009, [Peter] Yarrow told WTOP radio in Washington that her condition had worsened again and he thought she would no longer be able to perform.”

The last time I saw the trio in concert was a couple years ago, at the Great Auditorium in Ocean Grove, here in New Jersey. I suppose it was not long after her transplant. Mary leaned heavily on a cane, but as she opened her mouth to sing, she was a force of nature.

She’s leaving. Not on a jet plane (would that it were so), but on a far longer journey.

Mary’s powerful voice for peace, justice, love, hope – and, yes, faith – will be missed.

Go with God, Troubadour.

Leaving on a jet plane
by Lancer_MX

June 25, 2009 - Farrah, Jane and "Let It Be"

News has just come through, today, of the death of actor and model Farrah Fawcett. I wrote about her cancer struggle in my May 16th blog entry. Her television documentary, Farrah’s Story, was a graphic account of the last months of her life.

While the film attracted some negative comments from critics, who branded it as reality-show exploitation, I saw it differently. It seemed to me a courageous (although rough-around-the-edges) statement from a dying woman whose deepest desire was to “not go gentle into that good night.”

Sure, Farrah’s story was hardly typical. She was an enormously wealthy woman with the means to jet all over the world seeking alternative cancer treatments. She was also more vocal than some about the problem of how cancer was affecting her physical beauty (hardly surprising in a woman who, in her prime, was a fashion icon). Yet, whose cancer story is ever typical, anyway? We’re all individuals, and in our respective responses to this disease we each display our own interior beauty.

This morning I walked across the street to St. Mary’s By-the-Sea Episcopal Church to attend the funeral of a neighbor, Jane, who died at mid-life after having been diagnosed about a year ago with a pretty-much untreatable form of cancer. She left behind two teenage daughters and a whole churchful of friends.

Jane designed the funeral service herself, down to every last detail. While it wove in and out of the Book of Common Prayer liturgy, the musical selections and personal testimonies were hardly typical funeral fare. We sang along with the choir to Pete Seeger’s “Turn, Turn, Turn” and listened to a talented guitarist sing the jaunty medley of “Somewhere Over the Rainbow” (as styled by the by the late Hawaiian singer Israel Kamakawiwo’ole) and “What a Wonderful World” that’s been making the rounds of indie singers.



We finished by singing the Beatles’ “Let It Be” – a baby boomer anthem if ever there was one. I’ve always heard the song’s mention of “mother Mary” was inspired by a dream Paul McCartney had of his own mother, whose name was Mary. After checking it out on Wikipedia, I learned his mother died when he was 14, of cancer. As she came to Paul in the dream, he was blessed with an overwhelming feeling of comfort and peace. According to Wikipedia, he later told an interviewer: “It was great to visit with her again. I felt very blessed to have that dream. So that got me writing ‘Let It Be’.” Speaking to another interviewer, he shared how in the dream his mother had comforted him: “It will be all right, just let it be.”

Some have assumed, I know, that “mother Mary” in the song must surely be Mary, the mother of Jesus, but of course that’s not the case. So, it doesn’t make sense, as some have done, to sing it in church as a celebration of that Mary. It turns out, though, in this context, “Let It Be” has a compelling personal (if not exactly liturgical) rightness.

From what I know of Jane – a deep-thinking, highly organized person – it’s likely she knew this story, and included it in the service for that reason. It’s the message she would have wanted her own daughters to take away from the experience of losing their mother:

“And when the night is cloudy,
there is still a light, that shines on me,
shine until tomorrow, let it be.
I wake up to the sound of music, mother Mary comes to me,
speaking words of wisdom, let it be.”

May 9, 2009 - A Most Useless Place?

Dr. Wendy Harpham sent me a link to the blog of Rabbi David Wolpe, who also has non-Hodgkin lymphoma. Several years before that, he had surgery for a brain tumor. Here, he writes about receiving his last Rituxan infusion, ending a two-year follow-up regime after chemotherapy for NHL:

“Recently I had the final infusion. But I was not at all sure that pulling away the safety net was a cause for celebration. My doctor poked his head into the curtained chamber to assure me that he expected a long remission. Kind of him, but what could he say?

Remission is cancer's suspended animation. The renegade cells are poised to return but no one knows when. It could be a month or a decade; for my type of lymphoma (one of the more than thirty varieties of Non-Hodgkin's lymphoma) there is no cure. So I am stuck in what Dr. Seuss – in a book I used to read to my daughter – calls “a most useless place. The Waiting place....’”

A most useless place. That phrase does sum up how it feels, sometimes. Unlike David, I’m out of remission – have been for a couple of years – but there are days when I, too, feel like I’m in suspended animation.

David’s experience is similar to mine, too, in that he is a member of the clergy, serving a congregation:

“I had the strange, surreal experience of hearing my congregants' shock that this could happen to the family of the Rabbi – as though professional piety was a shield against disease. As though God played favorites.

Right before my brain surgery I appeared in front of the congregation and asked them for their patience and their prayers. Three year later I was standing before them, bald. I witnessed the realization in their eyes that there are no guarantees, no protected people. No one is safe.”

No, no one is safe. Yet, that observation ought to be surprising only to those who believe God is some cosmic puppeteer, manipulating the lives and loves and illnesses of us poor, benighted souls who dwell below. Is cancer a thunderbolt, cast down in righteous anger from Olympian heights? I’ve never seen it that way – although I’ve met plenty of people, both inside and outside my church, who fear it may be.

Granted, there are strains within the biblical tradition that portray God that way. God punishes the ten spies who brought back an unfavorable report of the promised land by killing them with plague (Numbers 14:37). God gives the adulterous David and Bathsheba’s infant love-child a fatal illness (2 Samuel 12:15-17). Even worse, God famously afflicts Job with boils, not because he’s an unjust man but simply because God wants to win a debate with the devil.

Yet, before everything is said and done in the Hebrew scriptures, the Lord is portrayed as “merciful and gracious, abounding in steadfast love” (Psalm 103:8). That’s the majority witness. When it comes to the New Testament, of course, God not only sympathizes with human suffering, but personally undergoes it, becoming incarnate as Jesus Christ.

Yet, the ancient images of a capriciously angry God, that dread smiter of sinners, are maddeningly persistent. “What did I do to deserve this?" is the anguished cry we pastors hear again and again, whether spoken or unspoken, standing at the foot of many a hospital bed.

No one is safe. We’re all going to die. Some of us sooner than others. If we’re spared from some fatal catastrophe on the highways, we’re all going to hear some doctor admit to us, someday, “I’m sorry, but there’s nothing more medical science can do for you.” Is this God’s judgment?

The story of Adam and Eve in the Garden suggests it is. Death is, that story suggests, God’s judgment on the entire human race. That may be so, but, unless we toss out all the biblical witnesses to God as patient and merciful, it’s hard to make a case for God micro-managing the entries in our individual medical files. We belong to a race for whom that dark, old lullaby is all too true:

“Hush, little baby, don’t you cry,
for you know your mama is born to die...”

The divine decree of death is meted out to the human race en masse, not on a case-by-case basis.

The fact of death is perhaps the deepest mystery we children of Adam and Eve seek to plumb – as Rabbi David has himself come to realize:

“For now I am just waiting. I am trying to find my own way through this because, inevitably, I will be asked how I did it. Rabbis are supposed to be figures of authority and calm. It was hard enough to reassure my congregation that a fickle universe does not mean that God is absent. That belief does not indemnify me against adversity. That my faith through all this is unshaken. How does one live, Rabbi, is the question my congregants ask, of not so directly. Tell me, Rabbi – it is your job to know.

My answer, I now realize, is: Live as if you are fine, knowing that you are not. Death is the overriding truth of life but it need not be its constant companion. My safety net is gone. I feel, as all people in remission do, that each time I fly my hand may slip from the trapeze. But to live earthbound is to give the cancer more than it deserves.”

The place David and I find ourselves in may feel, at times, like “a most useless place.” On deeper examination – and, viewed through the eye of faith – it turns out to be anything but.

April 26, 2009 - Libation

Responding to my April 20th entry, a reader named Christine writes:

“My cancer has progressed to the point where I am on my last leg of this journey. I was wondering if you could direct me to what the Bible says about facing death. In essence, what are your thoughts on dealing with grief and sorrow? My journey has been four years and as I approach the end, surprisingly I find that my emotional and spiritual struggle have not diminished but intensified.”

Wow. I had to think about that one for several days, before attempting an answer. It’s not that I’ve never had to supply this sort of counsel before; it’s just that Christine poses her question so bluntly. Most people whom I visit in their final days raise the question obliquely, if at all. Whether they ask the question directly or not, I typically respond by sharing some of the great scripture passages that witness to God’s reliable presence.

For example, there’s Psalm 139, in which the psalmist imagines himself journeying to the very edges of the known world, only to find God still there beside him:

“If I take the wings of the morning and settle at the farthest limits of the sea,
even there your hand shall lead me, and your right hand shall hold me fast.” (Psalm 139:9-10)

For those who struggle with fatigue, cancer-related or otherwise, there’s always Isaiah 40:28-31, that promises:

“Those who wait for the Lord shall renew their strength, they shall mount up with wings like eagles, they shall run and not be weary, they shall walk and not faint.” (Isaiah 40:31)

Those of a philosophical bent may find some comfort in the timeless contemplations of “the Teacher” who wrote the book of Ecclesiastes. In these verses – immortalized for my generation by Pete Seeger’s folk anthem, “Turn, Turn, Turn” – he recalls how, in life, there is a time for everything, even a time to die:

“For everything there is a season, and a time for every matter under heaven:
a time to be born, and a time to die;
a time to plant, and a time to pluck up what is planted;
a time to kill, and a time to heal;
a time to break down, and a time to build up;
a time to weep, and a time to laugh;
a time to mourn, and a time to dance...” (Ecclesiastes 3:1-4)

THE BYRDS - Turn ! Turn ! Turn !
by danadi33

Certain psalms, like Psalm 69, pull no punches when it comes to voicing the honest cry of human anguish. Perhaps, Christine, you’ve felt like this in recent days:

“Save me, O God, for the waters have come up to my neck.
I sink in deep mire, where there is no foothold; I have come into deep waters, and the flood sweeps over me.
I am weary with my crying; my throat is parched. My eyes grow dim with waiting for my God.” (Psalm 69:1-3)

So, what does it mean to speak of God saving us, in a time of serious illness – perhaps even illness unto death? Some may be tempted to blithely drop a pollyanna catch-phrase, like “Expect a miracle!” Yet, this is unrealistic, maybe even deceptive. We all know miraculous reversals like this – the sort that cause doctors to scratch their heads and say, “I don’t know what happened, there’s no medical explanation for the way that tumor just disappeared” – are rare indeed. Besides, even in those fortunate cases where a terminal illness reverses itself, the patient is still going to die of something, eventually. No, that sort of miracle merely buys a little time, that’s all.

No, the only ultimate consolation comes from promises such as Jesus’ words in John 11:25-26:
“I am the resurrection and the life. Those who believe in me, even though they die, will live, and everyone who lives and believes in me will never die.”

Seeking to describe the life to come, Paul resorts to a variety of metaphors. In 2 Corinthians 4:16-5:1, he likens this present life of ours to a tent – a temporary dwelling, slated to be replaced by something more permanent:

“So we do not lose heart. Even though our outer nature is wasting away, our inner nature is being renewed day by day. For this slight momentary affliction is preparing us for an eternal weight of glory beyond all measure, because we look not at what can be seen but at what cannot be seen; for what can be seen is temporary, but what cannot be seen is eternal. For we know that if the earthly tent we live in is destroyed, we have a building from God, a house not made with hands, eternal in the heavens.”

In 1 Corinthians 15, Paul uses a different, organic metaphor, that of a seed planted in the ground – one I’ve cited just upstream, in my April 14th entry.

At the end of the day, though, all these are just metaphors. Such poetry, lofty as it may be, captures the emotion, but inevitably falls short on details – for, who can chart with certainty lands no human has visited, save on a one-way journey? (Jesus, of course, being the notable exception, and he wasn’t talking – not on that subject, anyway.)

In the course of my pastoral ministry, I’ve spoken with more than a few people who’ve had near-death experiences. There are more of these people around than you may think. Most are pretty quiet about it. They’re hesitant to speak of such experiences, for fear of being misunderstood – but, if you give them a chance, they’ll speak in hushed tones, eyes brimming with tears, of bright visions no words can capture. I feel incredibly privileged to have heard a few of these firsthand testimonies.

We can’t make too much of these subjective experiences, though. They’re elusive, dreamlike – merely the shadow of a suggestion of what the next life may be like. Still, I take some comfort, personally, in observing that, whatever these soul-travelers experienced, there was no terror in it: only a sense of comfort and welcome and peace.

Reflecting on his own impending death, the pseudonymous author of 2 Timothy speaks of his hopes and fears using the common coin of his own culture. He portrays his life as a “libation” – a sacred offering of wine, to be poured out onto the ground, as the Greeks and Roman were wont to do:

“As for me, I am already being poured out as a libation, and the time of my departure has come. I have fought the good fight, I have finished the race, I have kept the faith. From now on there is reserved for me the crown of righteousness, which the Lord, the righteous judge, will give to me on that day, and not only to me but also to all who have longed for his appearing.” (2 Timothy 4:6-8)

Back in my chemo days – when I was feeling sick as a dog and far from certain Dr. Lerner’s promises of a likely remission would ever come to pass – I wondered if my own life was turning out to be just such a libation.

It’s a powerful image, even though we have to work a bit to translate it into 21st Century terms. Then, as now, it defies reason to upend a perfectly good cup of wine and pour its contents out upon the ground: but sometimes that primitive calculus is the only response that makes sense in face of the absurdity we call “death.”

Surely, we protest, there’s got to be a better way. Surely, God – if the Bible’s descriptions of divine power are true – has the ability to arrange things in some other way for us.

The hard fact is, God chooses not to exercise that ability. Sooner or later, our life-force is bound to run out in rivulets, like that libation-offering, poured upon some unimaginably ancient block of stone.

A libation. That’s what we’ll be, one day.

Poured out. An offering to a God who (we can only hope) is, as the scriptures teach, “gracious and merciful, slow to anger and abounding in steadfast love” (Psalm 145:8).

If that is so, we will one day be able to affirm, with Paul, that:

“...in all these things we are more than conquerors through him who loved us. For I am convinced that neither death, nor life, nor angels, nor rulers, nor things present, nor things to come, nor powers, nor height, nor depth, nor anything else in all creation, will be able to separate us from the love of God in Christ Jesus our Lord.” (Romans 8:38-39)

That’s the sort of thing I’d be inclined to say to you, Christine, by way of summarizing the Christian witness about life and death.

On a more personal note, I’d also like to encourage you to try to step back and get some perspective on the faith-struggles you’re going through right now. A certain amount of angst is to be expected. Strong emotion is understandably part of the experience. Cancer stinks. So does an early death. There’s no way to sugar-coat such hard realities.

I wouldn’t be at all surprised if you’re feeling angry, as well. Just read through some of those biblical psalms of lament, and you’ll quickly realize you’re not alone in this.

Doubt can be part of the psychic landscape, as well. (Remember, even Jesus went through his own crisis of faith in the Garden of Gethsemane.) You may worry, at times, that you’re losing touch with all the beliefs you once held dear, but that’s simply what dying is like. It’s profoundly disturbing and disorienting (Hollywood cliches about falling gently back on the pillow notwithstanding).

There’s nothing more disturbing nor disorienting in all of life. If - as the Christian faith teaches - death is actually rebirth into a new way of living, then wouldn’t it be reasonable to expect a bit of birth trauma? Just try to keep your eyes upon Jesus, the one whom the letter to the Hebrews calls “the pioneer and perfecter of our faith” (Hebrews 12:2).

May God be with you.

March 22, 2009 - Waeger Still Wins

Another cancer survivor whose blog I’ve been following has succumbed to his disease. Dan Waeger, a young man with lung cancer, died last Monday, March 16. I’m a little behind on my blog reading, so I only just realized it.

(Prayers and good wishes go out to you, Meg. From your blog, it certainly does appear that you and Dan had a very special relationship indeed. No doubt you’ll miss him terribly.)

The blog Dan and his fiancee Meg have been writing is called, “Waeger Will Win.” Less than a week before Dan’s death, Meg wrote a little reflection on the meaning of winning, when it comes to cancer.

She was recalling something she’d heard Lance Armstrong say at a conference. Lance was relating a brief conversation he’d had with the chairperson of his foundation board. “This is fun,” said the executive to Lance, caught up in the enthusiasm of whatever project they were working on.

“It’s only fun if we win,” replied Lance.

Lance Armstrong is, of course, one of the most competitive people on the planet. It’s no wonder he’d view the work of curing cancer as the biggest, baddest bike race of all.

Meg offers a different perspective. She has some wise words to share about winning:

“But when Lance said that to the Livestrong audience, I remember thinking that judging victory in cancer solely by ‘winning’ is maybe worth another look. After all, many cancer survivors, like Dan, don't see the ultimate victory in being cured. There are 100s of cancers, and to ask for a cure sets a high bar, and one that may be unrealistic in our lifetime. This is not a ‘one-size-fits-all’ solution. Many cancer survivors would be ecstatic if their cancer could be managed as a chronic disease - like diabetes or AIDS. Or if genetic testing could even narrow down the treatment options so that they avoid toxic and crippling treatments as a cruel form of trial & error.

The day I heard Lance speak was about 3 weeks after we’d found out that Dan’s cancer had spread. I knew that even then, if Dan’s ‘win’ could only be fun if he was cured, than we were in trouble. If he passed on from cancer, we would surely say that he ‘lost his battle.’ But as many of you’ve pointed out, Dan’s story isn't a straight win/lose scenario. There are more ways to win than just judging the score.”

Indeed. In this life, there are winners and there are winners. Some win by conventional means, edging out a host of competitors by crossing the finish line first. Others start winning from the first moment they leave the starting line, regardless of the outcome.

We can be winners in the here and now, not just in the distant future. From everything I’ve read of Dan Waeger, he seems to have been one of those people who began winning from the first day of his diagnosis.

Faith helps create winners like Dan, of course. The Apostle Paul has something to say on that topic:

“But we have this treasure in clay jars, so that it may be made clear that this extraordinary power belongs to God and does not come from us. We are afflicted in every way, but not crushed; perplexed, but not driven to despair; persecuted, but not forsaken; struck down, but not destroyed; always carrying in the body the death of Jesus, so that the life of Jesus may also be made visible in our bodies. For while we live, we are always being given up to death for Jesus’ sake, so that the life of Jesus may be made visible in our mortal flesh. So death is at work in us, but life in you.” – 2 Corinthians 4:7-12

Clay jars. Amphorae, they called them – ordinary, everyday vessels used in the ancient world to carry water, wine and all manner of other liquids. To Paul’s readers, clay jars were about as exciting as Tupperware – and just as commonplace.

Yet, this is the image he chooses to describe the treasure of the Gospel – the very treasure that enables God’s people to be “afflicted... but not crushed... perplexed, but not driven to depair,” and so on.

In the world of cancer, the winners are not only those competitors who go charging across the finish line, pedaling furiously. Somewhere back on the racecourse a rider sits under a tree, dozing in the summer sun. He will not open his eyes again. He will not cross the finish line. He doesn’t need to. The finish line has come to him.

(To Meg and all of Dan’s circle of family and friends: blessings be upon you in these days of goodbyes. Remember what goodbye means: “God be with you.”)

March 2, 2009 - Power of Blog

One of the tough realities of following cancer blogs is that, from time to time, someone you’ve come to know and respect in this strangely intimate medium dies. This is what’s happened in the “Clusterfook” blog written by Lisa, a young wife and mother who’s been dealing with ovarian cancer for several years now.

One of the last topics Lisa blogged about was what she called “power of blog” – a concept similar to power of attorney, but having to do, instead, with who would take over her blog. As she entered hospice care, she had to find someone to whom she could entrust her username and password, so as to inform the blogosphere of her death.

Her husband is not evidently much of a computer person, so she turned to a fellow blogger. On Saturday, February 28, Lisa’s friend, Karl, posted news of her death.

Just over a month ago, Lisa mused about the reactions of some readers, who said they found her blog “too depressing.” I never had that reaction, myself, as I read her words. I found Lisa consistently blunt and down-to-earth as she described her decline in health, but she seasoned those grim facts with a quirky sense of humor and a passion for living her days to the fullest.

Here are a couple of excerpts from that post of January 26:

“As heart breaking as death is, I’m doing O.K. with everything that’s happening. Do you hear any ‘woe is me?’ in my writing? Do I sound like I feel sorry for myself? Am I crying out for pity?

No, no and no.

Every day I strive for inner peace and so far I’ve found it. I consider myself one lucky chick-o-dee, perhaps I should say I’m a blessed chick-o-dee to have such calm and inner peace.

That’s not to say that I don’t cry. Crying is a release of emotion for me but I’m not crying every day. Usually I cry when having deep, heartfelt discussions with family members and friends. Those moments when we are brutally honest about how we feel about each other and say to each other the things we should be saying but usually never have the courage to say. Then the day comes when it’s too late to say what we’ve always wanted to say.

If you ask me, it’s a gift to have those opportunities right now. My advice to you is don’t wait until you are facing death to tell those dear to you how you really feel about them. Whatever is holding you back…let it go.”

In a post just prior to that one, Lisa related what it had been like to tell her 8- and 11-year-old girls (whom she calls by the pseudonyms “Cam” and “Teeny”) that she was dying:

“Telling Cam and Teeny the truth, that I’m not going to get better, was one of the most heart breaking things I’ve ever had to do. It is NOT easy to tell your children that you are dying. Listening to them cry was one of the worst things I’ve ever heard. Not being able to fix it is the worst feeling in the world....

Dude [that’s her blogging nickname for her husband] and I decided to deliver the news to the girls last Saturday afternoon, a few hours before they had to go to church. Teeny has been consistently lighting a candle for me every week and she finds a lot of comfort in going to mass with Dude. Cam doesn’t complain about going nor does she get real excited. Dude and I thought they might find some extra comfort in going to church after talking to us earlier in the afternoon.

I’ve been too sick to go to mass for a while so Dude takes the girls by himself. He said that each girl was snuggled up as close and as tight to his side as they could be during mass. And of course, Teeny lit a candle as she always does. When she got home she told me that she still believes in the hope that I’m going to get better. God, how I wish that little ray of sunshine was right....

My kids are strong but they have been dealing with cancer in their lives for five years. I hope the lessons they’ve learned and continue to learn make them stronger and don’t scar them. Although how do you tell an 8 and 11 year old there’s a lesson to be learned when their mom dies?

Well, I’ve got them surrounded by great people and a good support system that I hope pulls through for them. That’s how you do it.”

Lisa’s blog has a subtitle: “It Is What It Is.” I can remember repeating that phrase on numerous occasions, myself, during the acute phase of my illness. I can remember taking an odd sort of comfort in it. There’s something strangely liberating about shedding all the myriad worries and distractions of everyday life in order to focus on one, true thing: living as well as you can.

One of the reasons “It is what it is” is comforting is that it reflects a fundamental truth: a cancer diagnosis is a lot scarier through the windshield than it is in the rear-view mirror. Eventually you adapt, your family adapts, your friends adapt, as together you learn to face the future, whatever it may hold. A few people around us are never able to do that, and withdraw – but most manage to make the transition eventually.

Yes, it is what it is. And, sometimes, it can even be beautiful – like Lisa’s indomitable spirit. Truly, that’s the “power of blog.” Prayers and good wishes go out to all who love Lisa and miss her.

November 23, 2008 - Brenden's Last Wish

This morning I have the TV news on while getting dressed, and I catch a CNN news item about the recent death of Brenden Foster, an 11-year-old boy with leukemia. It’s a sad story, to be sure, but there’s something very unusual – and powerful – about the way this young boy faces the reality of his own death. Brenden seems preternaturally calm, and incredibly accepting of the fact that his life is going to be far shorter than that of any of his peers.

Searching on YouTube later, I find this clip of an interview with him that aired a week before he died – a portion of which was included in the CNN story I saw:



Brenden exhibits what could be called the “It is what it is” approach to dealing with cancer. There’s a sort of wistfulness about him – not sadness, necessarily, but a detached, philosophical acceptance of what’s about to take place. Maybe there was a time when Brenden raged against the news of his own death, or denied it – but, if he ever was in such a place, he seems to have transcended it. He’s progressed far beyond those stages of the dying process.

I find Brendan’s demeanor calming, and beautiful. Would that we could all accept our own mortality with such equanimity.

November 8, 2008 - Unfinished Business?

I just picked up a new book that promises to help me make sense of my situation as a cancer survivor. Oddly enough, it was written by a man who’s dying.

Forrest Church has served more than 30 years as pastor of All Souls Unitarian Universalist Church in New York City. Love & Death: My Journey Through the Valley of the Shadow (Beacon, 2008) is the newly-published memoir of his journey through esophageal cancer.

What attracted me about this book, when I first heard it mentioned on NPR’s October 27th Fresh Air program, is that it was written by a preacher. Like me, Forrest Church has struggled to figure out how to be a cancer survivor while at the same time striving to bring a message of hope and peace to his congregation. A challenging task, that – finding the right balance between honesty and privacy.

As I page through this fine book – one of those little volumes that’s best read slowly – I expect I’ll find more than one insight to share here in my little corner of cyberspace.



One of the things Forrest marveled at, when he was first diagnosed, was how calmly he received the news:

“One of the first topics I tackled – still probing it to test any hint of denial at its core – was the way I cut straight to acceptance on first hearing what appeared at the time to be a death sentence. I came up with an explanation for my ease of mind.... The key is unfinished business....

Don’t get me wrong. I wasn’t happy about the prospect of dying. I had things left to do in my life and regretted the interruption of all my splendid plans.... My acceptance, however, abided in a deeper place. I was free to die, I realized, because, although I had much ongoing business, I had no unfinished business. I had made peace with myself, my fellows, and with God” (pp. 90-92).

I’m still pondering that distinction Forrest makes, between unfinished business and ongoing business. I think he’s onto something there.

I remember, in those days of December, 2005 and January, 2006, how life took on a peculiar intensity, in a way I’d never before experienced. After months of uncertainty, I had been diagnosed for sure. I didn’t fight that truth, in my mind. I, too, cut straight to acceptance. I girded my loins for the struggle ahead.

It’s not that I went through life preternaturally calm. I was plenty scared. But what scared me was more the prospect of suffering than the prospect of dying. If I am to die, I remember thinking to myself, it is what it is, and that’s all there is to it. I’ve been talking about God’s love, professionally, most of my adult life. Pretty soon, I’m going to find out firsthand how real that love is.

It was actually liberating, in an odd way. Suddenly, much of the oppressive weight of ongoing business in my life slipped away. I no longer needed to bother with that trivial stuff. My life had a singleness of purpose, as never before. That purpose was to get well, or die trying.

Now, several years later, I find myself in this odd limbo of being out of remission but no longer needing active treatment. I could be in this in-between place indefinitely.

Do you want know something strange? I miss the singleness of purpose of those post-diagnosis days. I don’t wish the fierce malignancy back, of course, and I’d be perfectly happy never to undergo chemotherapy again. But somehow, I wish I could recapture that low hum of purposefulness that was the music of my days.

I suppose it’s a sort of wisdom the contem- platives gain, after years of focused prayer. They gain it without having to face down a potentially life- threatening illness. I believe it’s possible to achieve that degree of focus in life, purely by seeking it, but it’s terribly difficult. Only a very few of us achieve it, without a life-threatening crisis to help us along.

As the chemo nurses opened my veins and poured in adriamycin, that harsh medicine they call “the red death,” I was receiving another sort of medication that aided my soul’s healing. It was that singleness of purpose, that purity of heart. The Danish theologian Søren Kierkegaard once wrote a book called Purity of Heart Is To Will One Thing. That’s what I was doing, in those days. I was willing one thing.

“Blessed are the pure in heart,” says Jesus, “for they will see God.” (Matthew 5:8)

November 2, 2008 - Talking to Children About Death

Today – the Sunday closest to All Saints Day – is our annual Service of Remembrance at the church. In our worship bulletin, we list the names of all the members and friends of our congregation who have died in the past 12 months, and pray for those who are mourning them.

This year, I do something I’ve never done before. I preach an entire sermon directed to the children of the church. There are plenty of adults here, as well, but I explain to them that their role today is to sit back and listen in to what I’m saying to the children.

My sermon is about death. Now, that subject may not top most people’s list of things to discuss with children, but in my experience it’s something kids do worry about sometimes – and parents, too, as they try to figure out what to say to their kids when there’s been a death in the family. With our Service of Remembrance theme today, the topic does seem to fit.

I’m used to doing brief two- or three-minute Children’s Sermons in the worship service, but I wasn’t sure I’d be able to pull off an extended version. Somehow it all does seem to come together.

Here’s an excerpt:

“You’ve probably noticed, when someone you know has died, that other people around you feel sad. Maybe even your mother or father felt that way. Maybe you even saw them cry – something you don’t see very often.

That can be one of the hardest things about somebody dying – how sad everybody around us feels. When somebody who’s close to us dies – someone in our family, or even an animal that’s a pet – we do feel sad.

Nobody wants to feel sad, but sometimes it’s a good thing to feel that way. Sad isn’t bad when someone we love has died. Sad is just the way we feel at a time like that. It feels good, then, to be around other people who are feeling the same thing. It’s good to get some extra hugs, or to give them. It’s good to crawl up into the lap of our mother or father – if you’re small enough to do that – and just feel safe and warm and loved....

The Bible tells us that, if we love Jesus, you and I go to live with God when we die. The place where God lives is called heaven. We have no idea what heaven looks like, or feels like, or sounds like, but we know it’s a very wonderful place. This world of ours is a wonderful place, too, and God wants us to stay here, with our families, as long as our lives last – but we know our lives don’t last forever. When we die and go to be with God, it’s something like climbing up into the lap of our mother or father, and feeling all warm and welcome and safe.”

There’s more to it than that, of course. You can check out the full version HERE, if you’d like.

I refer to a couple of Bible passages. One is the story of Elijah’s restoring to life the son of the widow of Zarephath (1 Kings 17:17-24).

I also draw upon a passage from 1 John:

“Beloved, we are God’s children now; what we will be has not yet been revealed. What we do know is this: when he is revealed, we will be like him, for we will see him as he is.” (1 John 3:2, Contemporary English Version)

What I do, this morning, is speak from the heart. There’s nothing sophisticated about today’s message: it’s just basic Christianity.

I don’t think this is a sermon I could have preached before I had cancer. Somehow, the experience of having had a life-threatening illness has freed me to speak with a certain degree of personal authority. Not that I mention my own health situation, of course. The effect is more subtle, and interior to me.

I get a lot of favorable comments from people at the church door afterwards. Some of the adults respond with emotion: there’s nothing like trying to see death through a child’s eyes to bring out strong feelings.

No matter how old we get, on some level we never stop being children.