difficult decisions

"All flesh is as grass, and all its loveliness is like the flower of the field.

The grass withers, the flower fades, when the breath of the Lord blows upon it;

Surely the people are grass.

The grass withers, the flower fades, but the Word of our God stands forever."

--Isaiah 40:6-8

"I will give full vent to my complaint; I will speak in the bitterness of my soul.

I will say to God, "Do not condemn me; let me know why You contend with me!"

--Job 10:1-2

Karla & I met with Dr. Iqbal 2 weeks ago to decide upon our future course of action. It appears that I am no longer responding to my current chemo regimen. Plan B would involve numerous horrendous side effects in exchange for, according to medical data, 2 or 3 extra months. We have decided, for the time being, to stop chemo altogether and remain in the loop for promising clinical trials. We can always change our minds and go back onto chemotherapy.

The most difficult aspect of this is not that, from a scientific perspective, the 4-5 years I had hoped for now looks like something much shorter. Science does not always account for the possibilities of divine power through the prayers of one's faith community, not to mention the unique capabilities of each human body. Moreover, new breakthroughs in cancer research appear all the time, so who knows what could happen? The diificult part, rather, is that I have now begun to feel the physical effects of the tumors growing in my body.

In particular, I have developed ascites, a condition in which the liver produces and retains excess fluids. This makes it difficult to breath and places tremendous strain on my back muscles. (More than one mother has told me that I look and sound as if I were pregnant.) Every 4 or 5 days, I go to the hospital for a paracentesis, a procedure that usually draws 2-4 liters of fluid off my gut. I suppose one major consideration that would cause me to go back onto chemotherapy would be to learn that it could probably reverse this condition. We'll meet with Dr. Iqbal again next week to discuss this further.

I've also begun to come to terms with something that I've managed to hide from myself for a while: that I am struggling with some degee of depression. It's not that I sit around feeling depressed, but I do experience many of the symptoms normally associated with depression. I don't sleep well at night. The dark humor that I used to enjoy so much in the past now bothers me on a deep level. It's more difficult than before to read reports on Iraq, global warming, or political and economic oppression. Even in fiction, depictions of physical or emotional harm to human beings have become very painful to read or watch.

Here again, I find Job, the Psalms, and the Prophets so comforting. In addition to their cries for justice, words of praise and thanksgiving, theological reflections, and visions of a better future, the authors often express their fears and even despondency over the fates of their own bodies. God honors their most intimate emotions and embraces them into the divine breast.

What can I say? The question "how are you doing" is simply more complex than it sounds.