A beautiful season

Isaiah 43:2

"When you pass through the waters, I will be with you; and when you pass through the rivers, they will not sweep over you. When you walk through the fire, you will not be burned; the flames will not set you ablaze."

This has been a beautiful Christmas season in so many ways. I was blessed to have been able to spend time with my family. We are fortunate to have each other and our health. But there has been a lot of recent sadness, not just with my routine work, but in our community. My heart has been heavy this week for those of us left behind to mourn losses. And to try to make sense of it all, I have struggled.

Perhaps we have no greater fear in life than that of death. Although, I do not think it is really death that we fear as much as the process of dying, or dying too soon, or dying before we have had a chance to live the life we dream of. We don't want to leave our children behind to grow up without us. We don't want our children to go before they are grown. We fight with every ounce of our beings to prevent death, and illness, and pain. Paradoxically, we go through misery and pain to prevent misery and pain. Cancer seems like the worst form of suffering. The treatment can be worse than the disease. Chemotherapy itself is pain. But every day, I meet people who willingly let me give them drugs which they know will cause many adverse effects, all in the name of healing.

I have real trouble with this. I know with the simple stroke of my pen that I can order a treatment that can save a life....not that I take credit for a life saved on any level. I know very plainly that the only lives that are saved are through the miracles of God's great healing power. I do believe His great works are done with modern medicine in many cases...indeed I believe our discoveries of medicines ranging from penicillin to morphine to paclitaxel chemotherapy were all orchestrated by His guidance. But in the same way these medicines can heal, they can harm also. So there is the paradox. I have given drugs to heal cancer, and I have seen people die from the side effects of their treatment, even after the cancer has been cured.

How can I reconcile what is happening in these events? I treat a patient's life threatening cancer, giving chemotherapy drugs that certainly work, and then watch another problem develop that has potential to take a life. Robin Roberts, now not only famous as the host on Good Morning America, but also for her battle with breast cancer, was treated with chemotherapy in an effort to permanently cure an early stage breast cancer in 2007. Only 5 years after that she developed a rare condition known as MDS (Myelodysplastic syndrome), a likely direct result of the damaging effects of her initial chemotherapy on her bone marrow. The prognosis for MDS is very poor, many patients only surviving a few years. Cures from MDS are quite rare.  Surely, the odds of developing MDS are only 1-2% of all patients receiving chemotherapy for breast cancer.  The bottom line is, when I look at the odds of curing the breast cancer that my patient already has, compared to the risk of MDS or some other devastating outcome (there are many), there seems to be a clear answer: give the chemo and save a life, and take your chances with the possible bad outcomes too.

But then I see a patient who is the "1%." Statistics mean nothing when you are the 1%. And this is where I struggle the most. Why would God let me get so far along in a decision and treatment plan, only to come out on the other side to face yet another deadly sentence? I feel betrayed at times like this! I get angry at God, and at myself. Could I have done something different to have prevented this from happening? Should I have somehow known that this one patient would be the one to have a bad outcome from her treatment? Could have somehow predicted it? Will she survive this?? In much the same way, I question him even in other circumstances...like why does He 'let' a young mother get a horrifying cancer and lose her life before she has really had the chance to live - to raise her children or grow old with her husband? Or why does God 'let' a child suffer with cancer and then 'lose' the battle?

It is a crazy thing even as I sit here writing this, to have such an accusatory tone with God, my creator, who is so all knowing. How can I ask Him, "Why did you let that happen? Why was that life lost?" In fact, He knows that no life is lost. Our bodies are just earthly shells of the beautiful souls created in His perfect image. He knew us and loved us before creation and when we depart this place, He has a perfect heaven waiting for us. Psalm 139 tells us: "For you created my inmost being; you knit me together in my mother’s womb. I praise you because I am fearfully and wonderfully made; your works are wonderful, I know that full well." God tells Jeremiah "Before I formed you in the womb I knew you, before you were born I set you apart." (Jer 1:5). God in fact tells us many times in the Bible that He knows us, knows the plans He has for us, He knows our journeys. He has great plans for us. (Psalm 121:3, Zephaniah 3:17, Psalm 62:1, 2 Thessalonians 3:16, Matthew11:28, to name a few...). But He never promises an easy journey. In fact we have all experienced that through our suffering is the greatest opportunity to grow closer in our relationship with Him. 

Although we are left behind here to mourn those souls who move on before we are ready for them to go, they are blessed and free of all sadness, sickness and pain. I truly know God was with them on their journey and continues to be with them. They are no longer suffering to prevent more suffering. There is no need for chemotherapy to heal, no need for morphine to ease pain. God has cured everything by allowing their souls to leave this place and move on to a more perfect place next to Him in His kingdom.

I have been directly and poignantly asked many times, "How do you know this is true? What if there is no heaven? Isn't this belief just a comfort to help us feel better about the loved ones we have lost?" I certainly have asked that of myself many times, and as an old friend once said best, "you never really know God exists until you start asking questions." Maybe that is a bit of a simplistic way of stating it, but I do know there is a lot of truth there. I have been with many people as they make their journey to heaven. I have been in many hospital rooms and have felt the presence of the Holy Spirit in a way that words cannot describe. I was at my father's bedside when he died. I saw my father leave his body and go to heaven and without a doubt it was the most precious moment in my life to be able to witness that miracle.

But how I know for sure is somewhat of a complicated and convoluted explanation, and I have many examples I can share. I look back on experiences and see much more clearly how God has been present. Often in times of stress God is hard to see so vividly...we are wrapped up in our own grief and panic and we lose sight of the big picture. But take a moment and look back at one of the most stressful periods in your own life. Then look back beyond that in the days or months leading up to that time, and remember how a series of otherwise seemingly unconnected events came together in a way that clearly impacted the crisis you were going through. God was carrying you through the storm when you did not even realize a storm was brewing.

My father, about a year before he died

My father passed away when he was only 61 years old. He had always been organized, thoughtful and compassionate towards his family, and to his friends. He was giving always to others, giving of his money, his time, his prayers. He was devoted to his family, and he adored his only grandson, my son Ethan. My father was a small business owner, a contractor in eastern North Carolina. When he began having health problems, his business suffered for 2 years before his death. He had been ill - more than we even knew - and was unable to tend to matters of his company. He ultimately had to declare bankruptcy. He was inattentive to bills, and creditors were calling. He let life insurance policies expire. He even let his health insurance policy expire. All of this, I know now, was the result of his illness taking its toll on his mental clarity. But when he died, somehow, every bill was paid just before benefits ran out. The bankruptcy cleared just before his death, unknown to him. My mother was strong through everything, her strength no doubt a miracle from God. My father's funeral costs were significant. Shortly after he died and not long after the funeral, when we were trying to figure out how to pay the bills, my mother was again miraculously taken care of...my father had a single remaining life insurance policy that paid exactly enough to cover his remaining expenses for the funeral.


No one will ever convince me that God did not know the journey we were taking. Even before we realized what was happening - that his death was imminent, God was there, carrying us and making provisions that we would all be ok. And we have been. More importantly, so is my father. He is there in heaven waiting for us to one day be with him again. And I know we will be.

So to reconcile why does God let these things happen? I cannot exactly explain why we get sick, or why we hurt, or why young mothers have to go to heaven far before their time here seems to be done. But I do know that we never make the journey alone, nor are we left behind without the help of God getting us through those difficult times. That is our comfort. And that is His message to me daily. We are never without His presence, even when we do not ask for Him to be with us, He carries us. And even when you do not realize the storm is coming, He is preparing the way to bless you even then. 

"Even though I walk through the valley of the shadow of death, I will fear no evil, for you are with me; your rod and your staff, they comfort me." Psalm 23:4