By Ian Smith
This is the article I did not want to write. From my current situation, having been in remission for over a year, it re-opens the door to a phase of my life that is strangely painful yet rewarding. The days are starting to fade when every conversation began with a discussion of my health – and an article like this might start that unwelcome cycle of conversations all over again. Yet having met so many people who have walked the path of the medical and emotional intrusion that cancer forces upon us, I write this in the hope that it may be of some use to others.
The insidious thing about cancer is that it can be growing within you and you do not know it. I did not experience any sickness – just a pain in my left pectoral muscle, just below the collarbone. A lump had developed in the muscle, but I thought nothing of it. I know there are parts of my anatomy that should be checked for lumps, and my pectoral muscle is certainly not one of them. Eventually, however, as this lump was growing, I did the sensible thing and saw my GP who asked me to have an ultrasound.
The ultrasound led to a CT scan. The CT scan led to a visit to a surgeon and before any surgical procedure was performed the surgeon said to me the unforgettable words, “There is no need to do a fine needle biopsy, we know this is malignant… this is serious, this is very serious.” The hopes that this was a benign growth, a bad dream or a curable infection were all dashed in a startling dose of reality.
Although this surgeon was very direct, in a strange way I appreciated his candour. You don’t hear much in a conversation with a doctor after he has mentioned the “c” word – but we went on chatting. He told me that it was either lymphoma or a muscular sarcoma and a biopsy would give us the answer. I asked his opinion, and he told me that the presence of the largest of the tumours in the pectoral muscle was relatively conclusive that it was a muscular sarcoma. I used that “prognosis” word (which everyone uses as a euphemism for “will this kill you?”). He told me that if it were a muscular sarcoma, he would give me a maximum of six months; if lymphoma, my prognosis was better. He is a surgeon, and surgeons like to cut, so I asked about surgical removal. He told me that it was so extensive that it was inoperable. He then proceeded to organise an immediate biopsy under local anaesthetic.
As I left the hospital so many thoughts raced through my mind. There was nothing new in being told I had a terminal illness – after all – such is life. The thought of my own death did not worry me, but not being there for my family was an immediate concern. I tried to pray, but I did not know what to pray. I had spent my life praying for people who had walked through such difficult times, but I was not experienced at praying for myself. There is a certain “otherness” about praying; we do not wish to focus upon ourselves in our prayers. There is a point when we must depend upon the prayers of others.
Questions raced through my mind. How do I tell my wife? My children? My parents? We long to protect our loved-ones from pain, not to inflict it. All I could hear were the words “muscular sarcoma” and “six months”. Should I pray for a miracle cure? After all, surely God was capable of such things.
It was a strange and unforgettable time as I paused on the hospital steps. The reality of God’s presence in the midst of this was undeniable. I was convinced that I was dying, and yet it was not the hope of some miraculous cure that sustained me. The great confidence came from the doctrine of providence. I was reminded that God was not just the creator of every cell in my body, but he sustained each one, the malignant and the benign. God had not lost control and nor should I. His providential care meant that nothing could separate me from his love. His providential care meant that he was the God of my wife and my children and my parents. My prayer was simple, “Lord, let me die well.” My mind went to others I had seen die of cancer, how they had died in the Lord and died well. I was reminded of what a strong testimony this is to the grace of God and prayed that should my ministry be in death rather than in life, that it might still resound to God’s glory. I reminded myself of the importance of rejoicing in God’s sovereignty.
When I arrived home, my wife, Jenni, was cooking dinner and the kids were busy in preparation for Friday night activities. The inevitable “how was your day?” question arose. What answer do I give? Much harder than being told you have cancer is the need to tell others. So on that Friday night I sat and told Jenni that I had cancer, and the doctor expected I would live for a maximum of six months. That was not easy. Many doctors told me many things, and as I sat and listened I was emotionally numb. But telling was a different story. The only times that tears came to my eyes was when sharing the news with those I loved.
Jenni and I decided that we would not tell anyone else until we had all the details from the biopsy. So began the long wait.
That Sunday morning I went to church. My understanding of the dynamic of worship became very real. I knew that church was a heavenly activity of God’s people gathering around the glorified Jesus, but that morning the truth of this dawned upon me in fresh vigour. Surrounded by the people I saw every Sunday, none of whom knew of my current predicament, it was a rare privilege to be led into God’s presence through prayer and singing. The God whom we worship is faithful and that Sunday morning was a reminder of the certainty of heaven, in a world that was full of uncertainty.
The wait for the results was over and Jenni and I returned to the hospital. Why is it that on such occasions the doctor is always running late – delayed in surgery then delayed in traffic? Imagine our frustration when he told us that the results of the biopsy were inconclusive! Yet there was good news – although the results were inconclusive, they were highly suggestive of lymphoma – a result that was confirmed a few days later by a subsequent biopsy.
I could not believe it. I know that lymphoma is serious, but for the first time in a week the reality dawned on me that I might be around for a bit longer. At this stage we were happy to share the good news with our family and friends – who did not necessarily share in our joy.
People’s responses to the news were as varied as their personalities. Many did not know how to deal with it and so withdrew. Everyone seemed to have a story about their great-aunt Sally who had survived cancer and gone on to become an Olympic triathlon champion. Those stories really do not help. I didn’t need any more pressure to perform. There is something deeply personal about illness that makes comparison with others unwelcome. Others treated me as someone who was emotionally fragile, and yet the presence of God in the midst of all this made me feel more emotionally resilient than ever. At times I longed for normal conversations with people – if my days were numbered, I certainly did not want to spend them talking about cancer! But amidst all this, what was so encouraging was that people tried to help. They didn’t all get it right, but that didn’t matter. Some prayed with me. Others wrote. Some helped in practical ways – and it was all appreciated. The ones who avoided me seemed cowardly by comparison.
The six months of chemotherapy began. What a great opportunity exists in a chemo ward for witnessing to the power of the Gospel. The every day life for the medical staff, the patients and their carers is one of life and death. For the first time I really understood the whole concept of power in weakness. It was in such a situation of weakness, in a place of public crucifixion, that Jesus showed his ultimate power. I met terminally ill Christians whose preaching was more powerful than the most eloquent sermons I had ever heard. People pity those who have terminal illnesses, but some people in this situation want to rejoice in every day that the Lord gives them. It is good to rejoice with them.
As I look back on that time, it is a bit of a dream and a nightmare. God in his providence decided to heal me – but through it all he has taught me so many things. I have learnt afresh what it means to walk with him. For the 6 months I was on chemo, I was also taking large doses of steroids, which meant I slept for less than 2 hours a day – normally between 3 am and 5 am. I would sit awake at night and read large portions of the Old Testament. It was such an encouragement to see how from generation to generation, through death as in life, God was working out his purposes. To think that my current predicament, whether in death or life, could be part of the purposes of God was both comforting and encouraging. As time went on, I did not have the energy to do much, but the one excursion I really looked forward to was attending church on Sunday morning. I wanted this little piece of heaven – and still do. My perspective has changed. Instead of being a person who is “constantly becoming” – thinking of what I will do next – I have learnt what it means to “Be still and know that I am God.” Christian ministry has become far more about relationships and much less about performance. I do not see myself as the centre of God’s universe and I certainly do not see myself as offering anything irreplaceable to his church. My life is in his hands and his faithfulness is sure, whether in sickness or in health – and amazingly whether in life or in death.
Now I am learning what it means to be a “cancer survivor”. In many ways surviving survival has been one of the hardest battles. It is not easy to just slot back in where things left off. But one thing I know for sure: God’s grace is sufficient for me. The Christian has great joy and confidence in facing death and disease. I do not wish the suffering of cancer on anyone, including myself, but I thank God for his sustaining power and for his healing which extends beyond the physical.