One day at a time

“The Lord your God is with you, the Mighty Warrior who saves. He will take great delight in you, in his love he will no longer rebuke you, but will rejoice over you with singing” Zephaniah 3:17

I have relished my return to work....(I never imagined I would say that but...)...Returning after surgery has been enlightening to me. (If you have not been following my prior posts, I am returning to work after a brief medical leave while I recovered from surgery).

I feel like a layer of badness was shed from my outer self while I was away. The surgery itself was really life changing, but what happened to my spirit seems wholly different. Before I had the surgery, I had layers and layers of burden and stress covering me. I felt heavy and tired. I had trouble taking deep renewing breaths. I was weary and felt I had reached the infamous “burn out.” 

As it were, I planned to be out on medical leave for three weeks, and as I described in my last post, my surgery was more than a physical success. My whole self seemed to be rebuilt. While out, I spent hours reflecting and sinking into scripture, and realizing what God had worked in my life just through that operation. My strength was suddenly renewed and my eyes again opened to my purpose. After two weeks, I had no pain, and since I was up and about, I did not want to sit at home another week while my office staff and partners took care of my patients in my absence, on top of their already overbooked schedules. So after two weeks out, I returned to work on a “light” schedule of half-days. 

Although I was physically tired, my emotional state was entirely different. I felt as though my heart would truly melt with contentment when I returned. Seeing my patients and hearing their voices, and listening to what was happening with them, gave me a deeper sense of purpose than I had ever noticed before. I am having a difficult time putting these thoughts into words, but suffice it to say, I was happy to be back. Really deeply happy. 

The sadness of death was still ever present, and my heart is heavy for the family of a very special patient who went to heaven last week. Her family is still racked with grief and I am praying for them constantly. 

This week I was asked a very poignant and challenging question by one of my patients and I have thought of little else since our conversation. As a background, this patient has been suffering, with not one but two different cancers, both of which are tragically aggressive and both of which have been unrelenting in her case. She has always been healthy and always active, with no risk factors for the cancer she has (not that anyone ever deserves cancer regardless of their lifestyle choices or habits). As a result of the cancer’s ravaging effects on her body, she has trouble breathing most days now, and she has no stamina to enjoy anything in life that used to bring her great pleasure. She cannot travel, which was a way of life with her husband for more than 40 years. She has pain and anxiety, the severity of which are entirely new to her.  She cannot sleep. She is losing weight. Cancer is not discriminating and has sympathy for no one. It destroys the physical self and in the process can destroy the will to fight. Cancer can break oneself to a heap of tragedy that could never be fathomed.

“For I am convinced that neither death nor life, neither angels nor demons, neither the present nor the future, nor any powers, neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord” Romans 8:38

“Cast all your anxiety on him because he cares for you” 1 Peter 5:7

“For God has not given us a spirit of fear and timidity, but of power, love and self-discipline” 2 Timothy 1:7

Shortly after my return to work, she came in for her scheduled follow up visit. I thought of her a lot while I was out on medical leave, knowing how sick she had been, and I was relieved to see that she was coming back in for a follow up and that nothing too terrible had happened while I was away. When I saw her name on the schedule that morning, I wondered what shape she would be in when she got to the office. As it turned out, she was in terrible shape. 

She was breathless and weak, tearful, and particularly despondent. I admitted her to the hospital that day, since there was no way she could continue struggling at home in the shape she was in. She had fluid filling the right side of her chest, completely compressing her lung, so that she was effectively using only one portion of her left lung to breathe. She gave me no argument at all when I suggested hospitalization (always a very clear indicator of how sick someone is, how they respond to the idea of being admitted to the hospital...)

“Search me, O God, and know my heart; test me and know my anxious thoughts. See if there is any offensive way in me, and lead me in the way everlasting” Psalm 139: 23-24

She was placed on oxygen, and medications were administered to ease her discomfort that first night. But she had a very bad night regardless. She was restless and had panic attacks through the night. Her oxygen level was hovering just barely at a safe range. The nurses were wonderful in their efforts, but with a chest full of fluid, you can imagine the anxiety that can create - very hard to overcome the feeling of not being able to breathe. Anxiety medications that night seemed to make no difference whatsoever. She was miserable.

When I made rounds the next morning, she let me know how miserable she was. Through tears, she explained all of her symptoms. She told me that she just could not see things getting better and she could not understand what was going on with her body.  As we were speaking in her hospital room, she was desperately trying to reconcile what was happening to her. 

Of course, I cannot offer the explanation as to why this has happened. Why does someone get cancer and suffer?? I do not know why? There, in her hospital room, with machines beeping, alarms ringing from her low oxygen level and high heart rate, I try to offer words of support and encouragement and tell her I will do my very best for her to get her through this journey as comfortably as I possibly can. I explain the medical side of what is happening to her body, in hopes that with some practical understanding of why she is having the symptoms she is experiencing, she will be better able to emotionally deal with them. I explain the procedure we will do to try to remove the fluid. I explain the medications we will give to relieve symptoms. I believe, in my mind, that if I just tell her that her shortness of breath is because of fluid in her lungs, she will be able to calm her breathing and relax, just in the understanding of what is happening physically. Of course, this is wishful thinking on my part. Nothing had worked so far to this effect.

Through very tearful eyes, she asks so many questions for which I do not have answers. Finally she looks at me and says, “I have never been sick, I have always been okay, and now I am suffering like this and my life is over...I have been praying but nothing gets better. I believe in God, and I have prayed all along, but where is God in all of this?” 

Although I know people wonder this often, this I am rarely ever asked so bluntly. In fact, she and I had never really had a conversation about God and His role in her life, up to this point. We had prayed before, and I have prayed a lot for her, but we had not gone deeper than that. When she asks this question, I am at first speechless and we are alone in silence. In my mind, I question the same thing....Lord, this is a good question...where are you in all of this? Why is this happening? 

I considered saying prayer for her (and for us, and for her family), but for once, I did not feel that was what I was supposed to do at that very moment. She had just told me that she had been praying, but she did not think He was answering her prayers. Reflecting now, I do not think she could hear His response through her own anxiety and fear.  I thought of several scriptures all at once, and I suddenly knew. I pulled out my portable Bible (my smartphone, always well equipped for any emergency...) and I read to her. My devotion that very morning was directly from Philippians 4:6...

“Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God” Philippians 4:6. 

The fearful and anxious thoughts that were consuming her were not emotions placed on her by God. He gives us scripture telling us that He is with us through everything, and not to be fearful, not to carry anxiety over anything. The burden of fear and anxiety is not from Him, and we can be free of this heaviness, even in times of severe physical illness and peril. We suffer, yes, but in suffering we are drawn close to Him. I know that God does not want us to be sick, but illness is upon and among us and our bodies are frail. In this life, in our times of peace, prosperity and health, we rarely turn to God to ask for more, and I dare say we rarely turn to Him to give the thanks we should, to have so much in times of plenty. But of course when we are struck with illness or hardship, we desperately seek God. Even the nonbeliever will seek “the higher power” for answers to desperate prayers. Even when people consciously choose to deny God, He still yearns for our return to Him. And when we turn to Him in those desperate times, He is a gracious God! He does not grow angry with us because we finally turned back to Him. On the contrary, He rejoices when we come back to Him, regardless of the circumstance that brings us to Him! God rejoices over us, just as scripture tells us in Zephaniah. We draw close to him in hard times. Perhaps therein lies the blessing of cancer. What irony that there could be such a thing. 

After pouring out these thoughts, and scripture to this patient, I looked at her face and she was very still. Tears had stopped and she seemed to be deeply studying what was said. I prayed that God was giving her heart peace and rest and that she would carry no more fear. Regardless of whatever path this journey carries us on, I am desperate for her peace and comfort. I plead with God constantly that He will work this miracle for her. I pray for her total healing. I pray for her cure. I know what statistics say, and I know what experience tells me, and I have seen miracles. I do not rule anything out any more when it comes to trying to predict what can happen in this world, and in this occupation. 

I will tell you, on the weekend in a hospital, invasive procedures (such as what she needed) are only on an emergency basis, and she was stable enough that we decided to wait until the next morning to have the fluid removed from her chest. She had  been through that procedure before, and things had not gone well in terms of her pain during procedure (known as a thoracentesis), and so she would only agree to have the procedure done if she could be sedated. Again, difficult to arrange on a Sunday. I left her that day after our visit seemed to have calmed her somewhat. I had no nursing calls about her for the rest of the day or through that night. 

So on Monday I made rounds, and when I arrived in her room, I was completely amazed. She was breathing better. She slept through the night, soundly - stating it was the best night sleep she had in as long as she could remember. She had no pain. She was able to lie flat in her bed...again, an almost impossible feat with half her chest full of fluid. She said she had no anxiety or fear. She felt “great.” She was not the same person as 24 hours before. The fluid had not even yet been removed from her chest, and yet she appeared to be ready to be discharged from the hospital. She looked and felt well. 

‘When anxiety was great within me, your consolation brought joy to my soul” Psalm 94:19

I reviewed her CT scan from the night before. No improvement from the last scan, and in fact, things were looking worse on the x-rays. How did she look this good? 

We proceeded with the thoracentesis and she did remarkably well. No complications. She went home the next afternoon. I saw her in the office the next day. She again looks amazing. She looks like a picture of total peace. No fear, no anxiety. Even as I write this, I can honestly tell you, I have never seen her look so calm since I have known her. 

So I have no idea what tomorrow holds. As I have explained to her, there is nothing more that I can do for her cancer, as she has had all treatment she can tolerate, and if the last treatment does not work, there are no others. But as I tell her this, she calmly listens and then says, “I will just take this one day at a time.” I asked her if I could share her story here, and she graciously agreed, and even allowed her sweet picture to be enjoyed. She is grace and happiness before my eyes. 

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We will plan for many scenarios, but we will live this day that He gave us, and be joyful in it. If I let anxiety and fear take control of my day, then I have taken my eyes off of God and the life that He has for me. Even in the darkest hours, and most perilous times, He is there and He will carry us all if we only ask Him to. I have witnessed a change in this patient that I truthfully never could have expected if not for the miracle of prayer and His promise to us. I have seen in her the change that is possible in every one of us if we pray deliberately and believe He will hear our prayer and respond. He is so mighty and so powerful and so capable of more than we can even imagine. Truly, through Him all things are possible. 

“I am leaving you with a gift -- peace of mind and heart. And the peace I give is a gift the world cannot give. Do not let your hearts be troubled and do not be afraid” John 14:27