Surprise! Surprise!

God loves a surprise. He has a penchant for the unpredictable. Tracing His activity is a study in sacred spontaneity. I don’t think you will find this stated anywhere in Scripture, at least not explicitly, but just observe a few examples:

Surprise, Sarah! Though you haven’t had a period in 40+ years, you’re pregnant! (Gen 17:17, 21:2) Surprise, Job! All your livestock have been stolen or destroyed in the same day, your servants have been killed, and tragedy upon tragedy, all your children were lost in a house collapse! (Job 1:13-19) Surprise, Peter! Notwithstanding your protestations to the contrary, caught off guard, you denied me three times. (Matt 26:69-75) Surprise, Paul! Suddenly blind, you will soon see all I have in store for you. (Acts 9:3-16)

There are many more such instances of the unexpected in Scripture. This is not to say that God is caught unawares, nor that His actions are arbitrary or capricious – quite the contrary. It is often that an event that appears quite unexpectedly to an individual was foretold long before it occurred (e.g., Sarah, Peter). Further, not every sudden turn of events is a result of divine intervention, but rather the result of our own fallen and imperfect state and the presence of evil in this world. (Deut 30:17-19, Prov 6:14-15, Luke 13:4) We are even warned to be prepared for the unpredictable. (Mark 13:35-37, 1Cor 10:12)

And with every unexpected alteration in the fabric of our lives, God weaves a pattern that leads us to a greater understanding of His unstoppable love, mercy and grace. (Prov 16:9, Jer 29:11, Rom 8:28) Tony Snow, who was recently promoted to the life hereafter, said it best: “God relishes surprise. We want lives of simple, predictable ease—smooth, even trails as far as the eye can see—but God likes to go off-road. He provokes us with twists and turns. He places us in predicaments that seem to defy our endurance and comprehension—and yet don't. By his love and grace, we persevere. The challenges that make our hearts leap and stomachs churn invariably strengthen our faith and grant measures of wisdom and joy we would not experience otherwise.”

When I look back on the last six months of my own life, it is rife with surprise…

• Jan 23, 2008 – Without warning, a “routine” CT scan performed for a prostate problem demonstrates disseminated cancer
• Jan 31, 2008 – A liver biopsy report returns, demonstrating that the cancer is a particularly aggressive form of malignant melanoma. I am referred to UVA for consideration of Interleukin-2 therapy.
• Feb 7, 2008 – Extensive test results reveal the cancer has spread to the brain, lungs, liver, spleen, spine, ribs and long bones. No primary source is found. Because of the brain tumors, I do not technically qualify for Interleukin-2 therapy, but Dr Grosh is willing to consider it if the tumors can be treated successfully with gamma knife surgery.
• Feb 8, 2008 – Severe pleurisy-like pain raises the question of a blood clot to the lung. None is found.
• Feb 11, 2008 – It is discovered there are actually five small tumors of the brain. All are treated with gamma knife surgery.
• March 4, 2008 – After numerous imaging studies, several trips to the emergency room to rule out complications, IL-2 therapy is again postponed due to questions about possible pneumonia. Meanwhile I am losing weight (~20 lbs), in nightly pain, and getting weaker by the day.
• March 10, 2008 – Having ruled out active infection, we finally begin high-dose IL-2 therapy (one week in hospital, one week recovering at home, then back for second week of therapy).
• April 21, 2008 – Imaging studies show a remarkable response to the IL-2 therapy, unusual for someone with such extensive disease.
• May 28, 2008 – The Port-a-cath device has to be removed due to breakdown of the overlying skin. Fortunately, no infection is found.
• June 9, 2008 – Repeat imaging studies show persistent regression of the tumors elsewhere, but there are eight NEW brain tumors, again suggesting a fairly aggressive cancer. Repeat gamma knife surgery is arranged. This development again calls into question whether future IL-2 therapy will be tolerated. The decision is made to proceed.
• June 14, 2008 – Unexpectedly, I develop recurrent pain in my left arm suggesting a nerve impingement in the neck. An MRI shows no nerve compression and the pain “spontaneously” subsides.
• June 16, 2008 – We begin the second cycle of high-dose IL-2 therapy, suffer significant toxicities during each week of treatment, but avoid serious or permanent damage.

Then this past week we were hit with yet another surprise – one that threatened to shake our faith to the core.

Three days after discharge from the hospital I discovered a firm, tender nodule in my left arm pit. It was rounded, fixed, and rapidly enlarging without associated signs of infection. The clinical assessment was that this could very well represent resistant melanoma – particularly bad news having just completed the “final” course of IL-2 therapy. I alerted the oncologist and managed to arrange an open biopsy with a surgical colleague and friend, Dr Randy Gould.

Having experienced God’s faithfulness through a series of surprise developments, Linda and I determined that our trust in God would not be moved. His character (His unchanging love, mercy, and grace) are not determined by our circumstances. Even if this “surprise” meant my life here may be shortened, we affirmed that His goodness and lovingkindness are unwavering.

July 16, 2008 – Dr Gould examines me and is also concerned. He promises to get tissue at least to establish a diagnosis. During the procedure he spies a black hard mass, still highly suspicious for melanoma. But on further examination he discovers that the mass is simply a clot which had mounded up inside the vein where my previous central catheter had been placed. Pathologic examination of the vessel wall reveals no cancer and there are no surrounding lymph nodes. Subsequent venous ultrasound studies show the extent of the clot. No immediate treatment is necessary and I am reassured that this will resolve on its own with time. It is not the sort of clot that travels to heart or lung.

The God who loves surprises never stops loving us. His love for Job, Peter and Paul were never diminished, despite their circumstances. He is God, the sovereign One, and there is no more secure place than in the palm of His hands. We now look forward to whatever awaits us around the next bend: repeat total-body imaging to be performed on August 4 at UVA.

Continually surprised by His love,
Dan