Tuesday, September 30, 2008

Father Knows Best

But He knows the way I take; When He has tried me, I shall come forth as gold. Job 23:10

This is not going to be anything close to a perfect analogy, but for those of you old enough to remember the classic TV sitcom from the 1950s and 1960s starring Robert Young, you will get my point.

Imagine you are able to select from a number of alternate endings to this most recent episode in the series on the life of Dr Dan, who has just returned from UVA and another round of extensive imaging studies to assess the progress of his response to Interleukin-2. Which would you choose?

A – No trace of cancer is found

B – Imaging studies are unchanged (architectural changes persist, but no new tumors)

C – There is evidence of a limited number of new metastases

D – Extensive recurrent metastases are discovered

Well, you can guess which ending I would have chosen… but (fortunately) I am not the author of this drama. The writer of this episode has chosen option “C”: The MRI of the brain shows a tiny new tumor of the left frontal lobe and the PET scan shows an area of faint but suspicious activity persisting in the left hip region. Lab studies remain normal, there is no associated pain and the patient’s clinical condition is stable.

The next scene, therefore, will take us back to UVA medical center on Thursday, October 2, where I will undergo another gamma knife procedure to eradicate the brain tumor, then an MRI of the left hip and possibly radiation therapy to that region as well. This is akin to extinguishing a few "hot spots" where once there was a raging forest fire.

Although I would have chosen (and honestly was fully expecting) version “A” with a “happy-ever-after” ending to this episode, I am grateful not to be playing the lead role in version “D”. And after some contemplation, I am truly looking forward to the page-turning adventure of a script that only the Master Author can create. I must admit that I would not have written any of this story. But then I would not have known the depth of intimacy with my Creator, nor the wonder of His provision… the power of prayer… the peace of His palpable presence.

Linda and I agree, there is no going back to a “routine” life, one that runs on automatic pilot. We are forever changed, living by the moment, fully dependent and surrendered to a loving, wise, and awesome God. Indeed, Father knows best!

The LORD is good, A stronghold in the day of trouble, And He knows those who take refuge in Him. Nahum 1:7

Stay tuned for the next episode...

Saturday, September 20, 2008

For Goodness' Sake!

God saw all that He had made, and behold, it was very good.
(Gen 1:31)

I remember the first day of my college ethics class… the professor asked us to define “good”. Go ahead, give it a shot. You will quickly find yourself either chasing your tail in some circular reasoning or appealing to some other moral determinant that supercedes the essence of good. You will also quickly learn whether you are a moral relativist (i.e., that perceptions and circumstances define what is good) or subscribe to absolutism (i.e., that objective good exists, regardless of my perceptions and/or circumstances). It is not my intent to solve that debate here.

We all get comfortable, however, with our suppositions about what “good” looks like – “You made a good choice… It’s been a good day… The fundamentals of our economy are good…” In normal discourse we rely on a common understanding of what good is and often assume that our audience shares that understanding. Of course the opposite also applies: We make judgments every day about what is “bad” – “That was a bad decision… It was one of my bad hair days… The bailout is a bad idea…”

Now we don’t always agree on what constitutes good and bad, and at these times, we appeal to some standard, characteristic, or outcome that would convince our listener of the merits of our position. When we do this, we reveal to ourselves and others the basis upon which we determine the true nature of what we consider good.

If you were to ask me six months ago about my situation, it would have been disingenuous of me to say “It is good.” I had rapidly shed 20 pounds; I had frequent waves of nausea and no appetite; nearly all my strength was gone; there were nightly episodes of bed-soaking sweats, fever and chills; bone-wracking pain in my ribs and spine was a daily experience; and cancer was continuing to spread to brain, lungs, liver, spleen, lymph nodes and throughout my skeleton. Surely that cannot be considered “good”.

But in retrospect, it was good. More precisely, it resulted in many good and wonderful things.

If you have been following this blog since the beginning, you have seen the good – I have a faith in God that is stronger and more pervasive in my life, having passed the test of adversity; I have a relationship with my Creator that is more intimate, real and consequential than ever before; I have a greater appreciation for the steadfastness and power of His love, mercy and grace; armed with the certainty of eternal life, the prospect of death holds no dread nor fear; I have been humbled by the outpouring of genuine concern by so many and awed by the power of prayer; like never before I have learned to value the relationships I have with family and friends; indeed every human encounter now carries a weight of eternal significance in the light of this new perspective.*

Against incredible odds, I have experienced an extraordinary response to the high-dose Interleukin-2 therapy. As of my last check-up, my cancer is declared to be in remission. I am no longer in any pain; my strength and stamina have improved; I have recovered most of the weight I lost (and don’t need those extra pounds I was carrying anyway!) In one more week we will return to UVA for another series of imaging studies and examination to determine the trajectory of this remarkable healing.

But what if the outcome of my treatment were different? What if, like 94% of stage IV melanoma patients, I did not respond to Interleukin-2? What if ...? You can fill in the blank. You can probably write your own story. None of us is guaranteed a happy ending to every story. Ultimately, we are all terminal.

Among all the blessings of this difficult journey, the one that stands out the most is that I have learned that God’s character is not determined by my circumstances. When it comes to proving His character, He nailed that one forever when He sent His only Son to suffer and die for me on a cross. (Romans 5:8) Whether my situation is deemed good or bad, His goodness is unchanged. (Hebrews 12:5-6, James 1:2-3)

There is a popular song of praise that repeatedly answers the question “What is good?” The chorus rings “God is good all the time! All the time God is good!” I am one who now sings that phrase with greater confidence and joy than I have ever known before. And I will continue to sing it until time is no more.


*If you want a good read on how the prospect of imminent death might change your perspective, consider the book One Month to Live, by Kerry and Chris Shook.