Archive for category: People

I Think I’m Special, But How Is My Cancer?

04 Aug
August 4, 2014


“My Mom said, ‘The policeman may not catch you. I may not see you, but God will always see you.’ You cannot outsmart God,” Ionna said in a strong Ukranian accent. “Because if I tried to do some crap or anything, I felt like somebody was kicking my ass.” She laughed and smiled at me.

“The God who kicks ass,” I laughed. This was our first meeting and I was enjoying Ionna’s spirit and self-expression.

She told me more about growing up as the youngest child of five in the Ukraine, where her mother took them to the Russian Orthodox Church, kept her children in line, but prayed nonjudgementally for people everywhere. Ionna thought the fear of the God who kicks ass helped her to be a decent person and to have a moral compass during her twenty years in the corporate world.  When she became tired of that and had the means to quit, she followed her heart into the Peace Corps in Bosnia to help others. It was not long before she was shocked to learn that she had a stage IV gynecological cancer. It seemed like only days to her until she grew as bloated as a Telletubby, she said. Operated upon in Bangkok, the Peace Corps flew her back to the United States.

She’d had the choice between chemo with a 10% chance to live and no chemo with about 2 months to live in a lot of pain. “I’m like, Oh Bummer,” she told me. What a choice. Hearing it made my heart drop. (Yes, of course, she was seeing me because she was dying.) She wanted to live. “I want to be happy while I’m here. I want to enjoy every sunrise.” Yet, the choice to have chemotherapy had led her down a difficult path with a lot of pain. She had not asked any of her friends to take care of her and was therefore reticent to take enough medicine to truly cover the pain for fear of being “out of it” alone. “What are your biggest fears?” I asked. She said she had enough spirituality to not be afraid of dying, but not enough to deal with the pain of dying and being dependent.  We talked about these things, hoping for the best and preparing for the worst.

She wrestled with the 10% odds of survival versus death. Ionna was a vivacious forty-year-old and dressed colorfully with a
realistic-looking, fashionable wig. She had a heart-shaped face, a cheerful disposition and a trim figure. It was hard to believe that she was so sick, just looking at her. I only saw her on her energetic days, just before her chemotherapy treatments. She was totally exhausted and debilitated by the infusions. Her attitude was hopeful and realistic at the same time. “I think I’m special, but how is my cancer?”

These meetings became a space where Ionna could “Live the questions now.” As Rainer Maria Rilke wrote, “Perhaps you will then gradually…live along some distant day into the answer.” I planned to embody a guide to her to clarify the questions, the choices, and lift up any leanings this way or that, hoping she might find her way, before her choices narrowed very much. One decision Ionna faced was where to die: in a hospice in the city where we were or in her Ukranian family home with her mother and sister. She didn’t want her family to see her suffer or remember her “that way.” Plus, her mother didn’t want her to be cremated and that was her clear wish. She also feared poor medical care (i.e. pain). The hospice seemed to offer only dependence upon strangers, which was more acceptable, and better medical care. While she referred to other people telling her what to do, I called out what she wanted and emphasized her preferences.

“I feel like I’ve been carried through it all, you know, like the whole thing. I don’t think I’ve done much,” Ionna claimed.
“Well, if you’ve been carried, who’s been carrying you?” I was curious.
“You know, like God or angels or whoever had the time. I’m not sure.”
I remarked that it was a comforting image to feel like you’d been carried. Then, I asked, “Have you been talking to God at all?” And she replied that when she was in bed, she prayed, “Okay, God. Make me better or let me die.” She asked me if that was bad.
“I don’t think any heartfelt prayer is bad. Whatever you want to say to God I think is perfectly acceptable,” I spoke from all my experience and the depth of my heart and belief.

Then she unfolded a piece of paper with a lengthy paragraph filling the page. It was a prayer she had written! She claimed she had not really written it since it came from the Bible and other stuff. However, it was composed of thoughts which she found meaningful about rising from the ashes, awakening and hearing the liberty bell ringing, being afraid and remembering God’s presence with her, and living God’s plans to prosper and have hope and a future. She said this prayer helped her now when she began an infusion of chemotherapy. She sat in the chair. She felt cold. She began to cry. She would read this prayer. It would give her peace. She would stop crying. I told her it was beautiful.

In our last meeting, she said, “Remember, I told you that I would bring you something?” She unwrapped an object from tissue paper. It was a beautiful Ukranian pysanky, a traditional Easter Egg made by drawing an intricate pattern with layered waxes and colored dyes. She told me that it was made by her ninety-nine-year-old aunt, who had had a steady hand until the end. The pattern had grains of wheat and crosses, red for blood and yellow and white for the resurrection. She could not remember all the symbolism or meanings. She wanted me to have it. All I could say was, “It is so beautiful! Thank you,” over and over. Tears came to my eyes. She was giving away some of her possessions, knowing that she was going to die, although she wanted to live. And she wanted me to have this. My tears told me that we’d made a heartfelt connection.

I really liked Ionna’s honesty and quirky expressions. She said she was glad we had talked about death, because no one else wanted to talk about it. “Therapy is not my cupcake!” she declared. I think she meant “it was not my piece of cake”  or “cup of tea” because the therapist wanted her to be optimistic. Her cancer support group didn’t want to talk about dying in their first meeting, which I actually did not find all that surprising. Even the other members of the Palliative Care Team, she judged as not open to discussing death. She also felt reconnected to her sense of spirituality. Her image of God seemed to change from the One who kicks ass to the One who journeys with her and brings her peace. I don’t know what she ultimately decided about where she would go in her time left, but I do hope she found relief from pain, freedom about being dependent, and her heart’s desire in the life to come. I thought she was special.

Rita was my age

04 Aug
August 4, 2014

Rita was my age and she was dying from late stage lung cancer. She was tall, maybe six feet tall and big-boned. She said she’d lost a lot of weight, but now seemed at a good weight, not too thin. She had short gray hair, which had grown back after the last round of chemo. Shortness of breath and fatigue were her biggest symptoms. She was my patient; I was her chaplain. “I’m a lapsed Catholic,” she said somewhat apologetically. And she recited several things about the Catholic Church with which she took exception. I nodded. I asked her if she had ever tried any other Christian denominations? At first, she didn’t understand what I meant. Then, “oh, you mean like Baptists and Presbyterians and all that? No. I just always felt Catholic, even if I don’t go anymore. I went so much as a kid.”

During the time we spent together, Rita told me about several broken relationships she had with her alcoholic sister and her drug-addicted niece. They were huge enmeshed, conflicted situations and I referred her to AlAnon. She had been there before and seemed ready to go back. I felt relieved because I knew she needed the ongoing help of a sponsor.

“What concerns you most, Rita? When you awake in the middle of the night all alone, what comes up?” I asked. “I am afraid of dying. I don’t know if there’s anything after this life. Either there is a heaven, like the Catholics think, or there is another place.” She rolled her eyes, “a place I don’t want to go, you know what I mean, Michele. Or maybe there’s nothing at all. I have a hard time believing that. What do you think?”

“Well, I get that you’re afraid. No one really knows for sure, right? And at the same time, I think it would be good to decide what you believe. In my experience, people who have it worked out for themselves have an easier time facing their death.”

“Yeah, well, how do I decide?”

“Tell me about a time when you felt most deeply loved.” Rita told me about her deceased father. Growing up, she identified with him, rather than her mother. He took her everywhere in her hometown NYC with him: the meat packing district, walking around the burroughs, and to the Mass every Sunday. He was a devout Catholic. They were very close. She idolized him. Yet, as she became an adult she began to see his flaws and to judge him. She saw how generous he was with others but judged him as only trying to get people to like him. She began to think he was manipulative, tremendously weak and insecure. And she began to resent him.

Previously, she had told me a story where she had brought homemade cookies to the chemotherapy nurses, who were treating her in the outpatient cancer clinic. And she had judged herself for trying to get them to like her. I recalled this to her, challenging her. “You acted with generosity. It didn’t matter about your motives at all. It was your gift out of love that mattered. I wondered at the time you told me why you were judging yourself so harshly for that,” I told her quite emphatically.”do you think the nurses cared about your motives. No, they only cared about your act of generosity -the cookies!” “Really?” she said quite hopefully. I continued, “And your Dad was a generous man, generous with you and generous with others. Do you really think his motives mattered?” She began to cry and she pulled a wrinkled photo of him out of her wallet to show me. “The love he showed you was God’s love for you,” I commented softly. She told me more stories about him.

She began again to speak of her father taking her to church. “I notice that you use masculine language for God. It makes sense to me because you were so close to your Dad. Some say we get our earliest image of God from our parents.” She thought about that. And came back to our next session having prayed on her own and visited Catholic Charities for some help in getting financial assistance and a lead on a part time job she could do at home. She called it a God-send. She was feeling much more optimistic about living fully the time she had left. And she did decide to take “a leap of faith” to believe mostly in an afterlife, about 90%. I thought that sounded just fine.

I learned from Rita that it does not have to take a long time to let go of a resentment and find new life, even at the end of life.