John W. Cowart
It’s all good news, but after today I intend to stop writing about medical stuff for a while; nobody needs to know about my every ache, pain and complaint.
However, I wonder if it might be helpful for me to go though the process of how I came to my decision about how to handle my prostrate cancer yesterday.
Batten down for a long posting
I’ve been going through this process for over five months now.
Bottom line is that after asking the oncologist two final questions yesterday, one about the meaning of some numbers in the biopsy report and one about insurance coverage, I chose not to treat the cancer at all, to adopt the Watchful Waiting stance as the disease runs its course.
Medically this means going in for more testing every few months to spot when the cancer becomes more aggressive Then revaluating what, if anything, to do next.
So this blog post will trace how I looked for God’s will and arrived at my decision to engage in watchful waiting instead of one of the many other treatments available to me.
But first let me announce that the tremors that trouble me disappeared within hours of my taking 5,000 mg of vitamin B12!
That amazes me.
(Dr. Trout — I give my doctors fictitious names related to literarily characters the physicians remind me of. Thus Dr. Trout is named for the character in Kurt Vonnegut’s novels; Dr. Woody, my primary care doctor, relates to Woody Woodpecker in the cartoon; Dr. Bay, the dermatologist, reminds me of a lifeguard on Bay Watch; Dr. Oz, the oncologist, is the mighty Wizard of Oz; and, of course, you can guess that Dr. P. is my urologist.)
Anyhow, Dr. Trout, the neurologist, had not wanted me to take this vitamin before in case the B12 might mask some other cause of the tremors, but once he prescribed the stuff, it acted immediately. I hope it lasts.
Now, all the typos I make, I can’t blame on my shaking hands.
They are all mine.
Deciding how to deal with my cancer is a more complicated story:
Years ago a mainstream religious publisher asked me to write a book for college students about How To Find The Will Of God. I chose a clever working title: If God Leads Me Then Why Do I Run In Circles?
I studied Scripture and biographies. I interviewed politicians and policemen and preachers. I reviewed my own diaries from 20 years past. I made a couple of hundred pages of extensive notes…
Then I gave up.
I have no idea how God leads us today.
Yes. Yes. I know the standard answer to the question: that you should pray and read Scripture and consult godly advisors and follow your heart and arrive at a sense of peace, etc. etc. etc.
Yet, personally I found the glib Four-Easy-Steps process usually presented for learning God’s will in a specific situation, such as buying a car, or choosing a college roommate, or deciding whether to marry Mary, Betty or Fefe La Boom — This process just did not satisfy me.
Yet, in deciding how to deal with my cancer, I found that I considered many of these same steps I found unsatisfying.
So, having confessed that I have no idea of how to find God’s will, then let me go through how I’m going about seeking Him in my own particular situation concerning my cancer.
This process may help you in your own decision making, but remember that this is just an outline of what one lone confused Christian tried. It may help you, or it may not.
When Dr. P, the urologist, first told me I have cancer, he acted more upset than Ginny or I did. We tend to regard this as just another damn nuisance. He presented us with five or six options to chose from and we had to learn an entirely new vocabulary. For instance, I’d never heard the word brachytherapy before in my life.
Maybe it was a mental block related to denial, but I could never remember the right words the medical people used. I just labeled the radiation pellets they proposed to stick up my ass as kryptonite and let it go at that.
I did learn the term DRE (Digital Rectal Exam). Boy, did I ever learn that one!
Anyhow, Ginny and I first considered several factors:
My cultural background. Being of North Florida Cracker heritage, I tend to think you only go to a doctor as an absolute last resort when you are in a terminal condition and that a hospital is a place people go to die, a place where you get septic flesh-eating bacteria if you have to go in there to get a simple chainsaw wound bandaged. Never go to a hospital because you’re not likely to walk out alive.
Intellectually, I know this view is only partially true, but my gut feeling is that the only way you should ever see a doctor is if the ambulance carries you to the hospital while you’re unconscious and can’t escape.
My Cringing At Being Touched. I’ve written about this several times before in the past couple of months (for instance see “Skin Flick” on March 1st).
Our Sex Life. Ginny and I have only been rehearsing sex for 39 years and we’re really getting the hang of it. With that much foreplay leading up to our next encounter we feel we’re getting good at it. We do not want to gamble on anything messing that up for us and every prostate cancer treatment carries that possibility.
Ginny’s Health. She controls her diabetes very well — so far. But the day is almost sure to come when it turns bad nasty on us and I want to be around to give her the hands on care she might need.
My Macular Degeneration. Dr. Lamb, the ophthalmologist, tells me that if I live long enough, I’m almost sure to go blind. That does not give me much incentive to stretch things out; it’s sort of like choosing between the Lady or the Tiger.
My Hardheaded Resistance To Change. I lead a very happy life. I love my work. I enjoy my grown kids. I adore my wife. I own a Lotto ticket that may make me a millionaire. I don’t want anything to change. And here God drops this prostate cancer thing on my head… actually on the other end of me, but you get what I mean. I do not want anything to change. I am a happy man. But being hardheaded and resisting the change God sends is dumb. I know better than that.
My fear Of Death. Am I a Christian believing in eternal life?
Am I scared of dying?
Shouldn’t a Christian exercise faith in Christ and approach death without fear?
Maybe so. But I’m scared anyhow.
As I see it we are souls God has grafted into physical bodies. He engineered things to give us a fear of death for a perfectly good reason — to keep us from doing stupid things, like say hang gliding or motorcycle riding or fooling with Don Vito Corleone’s wife.
One amusing passage of Scripture portrays the Apostle Paul aboard a ship in a wicked bad storm. As apostles were wont to do Paul stood up and gave a speech:
“Sirs, be of good cheer: for there shall be no loss of any man’s life among you, but of the ship. For there stood by me this night the angel of God, whose I am and whom I serve, saying, ‘Fear not, Paul…” Wherefore, Sirs, be of good cheer: for I believe God…”
Quite a declaration of faith in God.
But then the ship sank.
And they that could swim cast themselves into the sea and paddled for land, And the rest, some on boards, and some on broken pieces of the ship, some hugging barrels or hatch covers or whatever struggled and treaded water and thrashed and splashed and struggled to get to land — and there was the fearless Paul, a Christian par excellent, dog paddling holding onto a board just like the pagan sailors.
In the face of death, our physical bodies react by clinging to life tooth and claw, clinging to any board, barrel or broken mast we can cling to. That’s the way God made us. So, yes I believe in Jesus, and no, I don’t want to die anymore than He did.
Anyhow, those are some of the factors bounding around in my brain as I began to seek God’s will about how to handle this cancer.
First, I said, “Damn, what a nuisance”.
I had other plans.
Then, of course, I prayed.
I prayed two prayers:
I prayed, “Lord, what will You have me to do”?
In essence, that is the only question worth bothering with. Anything else is froth and through all this believe me, I’ve churned up a lot of froth.
Then I prayed like the old lady in the Stephen King movie, The Stand. In her crisis, she prayed, “Lord, if it be possible, please let this cup pass from me. That’s the same thing Your own Son asked in the garden; but, I ‘spect I’ll get the same answer He did”!
Then, I investigated whether or not this cancer has spread beyond my prostate already. That’s why I steeled my self to be examined by Dr. Trout, Dr. Lamb, Dr. Oz, Dr. Woody, Dr. Bay, and Dr. P.
The other biopsies of suspicious areas turned out benign.
So I began eliminating options.
Dr. P indicated that surgery would be most likely to permanently cancel our sex life. Cross that one off the list.
Then there was chemical castration (sounds nicer when they call it hormone therapy). Here in Florida prisons do that to rapists and child molesters. Besides, this treatment not only kills the cancer cells, it would also cause my breasts to grow so large that with a blond wig, I could pass for Anna Nicole Smith.
I’m not a handsome man, but I’d make one hell of an ugly woman.
Cross that one off.
And Dr. Oz discovered that because of scar tissue inside me from surgery years ago, I am not a candidate for one of the most promising cancer treatments, the kryptonite thing of radiation implant pellets (I forgot what they really call it).
Possible treatment options began to narrow down.
The Scripture says that “For by wise counsel thou shalt make thy war: and in a multitude of counselors there is safety.”
Naturally I sought out wise counselors.
I talked with my family; they gave me their unwavering support whatever treatment I would chose.
I talked with my father-in-law, who died last week. He said, “Cut it out! Cut the damn thing out. Don’t wait a minute, not another day. Cut it out”.
Jack was always so shy and retiring about offering advice.
I talked with my eldest daughter, a registered nurse; she assured me that she would undertake my care should I become bedridden or anything like that.
I talked with a friend, a nurse at the world-famous Mayo Clinic, who actually gives hands on care to terminal prostate cancer patients in an intensive care unit. There I got a vivid description of how this cancer metastasizes to seek out bone marrow especially in the pelvis and spine where the cancer cells creates an agonizing amount of pain that is very difficult to control.
And I talked with a friend who urged me to drink green tea with red clover, a sure-fire cure for cancer.
I also read Dr. Peter Scardino’s Prostate Book. Dr. Scardino (his real name) is chairman of the urology department at Memorial Sloan-Kettering Cancer Center. His book thoroughly explains the pros and cons, history and projected future or each possible treatment. I highly recommend it.
Speaking of reading, as a Christian, I naturally turned to the Scripture to see what the Bible says about my prostate cancer predicament.
Not a word.
The closest thing I found was in Deuteronomy 23 where any man who is “wounded in the stones or hath his privy member cut off” is excluded from being a priest.
Isn’t that helpful?
However, I found a great deal of general comfort in God’s promises such as:
Trust in the LORD with all thine heart;
and lean not unto thine own understanding.
In all thy ways acknowledge Him,
And He shall direct thy paths.
And I learned that the word comfort is derived from two Latin words: cum forte which mean “with strength”. God does not make things easy for me, He helps me meet them with strength.
But, as I floundered around in all these factors, worries, words of counsel, hopes, fears, aggravations and frustrations, as I tried to decide which option to choose, as I felt scared of making a fatal error, a wrong choice — one thought from God’s Word helps me more than any other.
It’s found in Psalm 37:
The steps of a good man are ordered by the Lord
And He delighteth in his way.
Though he fall, he shall not be utterly cast down:
For the Lord upholdeth him with His hand.
The same idea is found in Isaiah:
Even when I screw up and make a dumb choice, even then, the prophet Isaiah said, “Thine ears shall hear a word behind thee, saying, ‘This is the way, walk ye in it,’ when ye turn to the right hand, and when ye turn to the left”.
My role in all this is to try to be a good man and be open to God’s correction.
For me that’s trickier than it sounds.
Remember the old proverb: “In his own eyes, no man is an asshole”.
Er, in case you’re wondering, that’s not from the Bible but I think it true nonetheless.
Can I say dogmatically that I have found the will of God?
I’m suspicious of such dogmatic declarations.
Can I say with cautious confidence that God is leading me?
Yes, I can. I am at His disposal whichever way this cancer thing goes. He deserves nothing less.
Instead of going through all these mental gymnastics, would I have made just as good a decision by simply flipping a coin?
I don’t doubt it for a moment.
Even a flipped coin lands in the Hand of God:
As the Scripture says: “The lot is cast into the lap; but the whole disposing thereof is of the Lord”.
Ginny finds decision making much easier than I do. She is much more confident of the Lord’s mercy and grace. She’s an intensely practical Christian. In such a matter she simply asks, “What’s best for us, for now?” and goes with that.
Anyhow, I have chosen to not treat the cancer at all for now, to engage in the watchful waiting technique subject to close observation and periodic tests.
And after having thought all this through for months, I feel relieved to have made a decision, any decision.
I feel joy.
I feel peace.
I feel like a bowl of ice cream.
Now, do I want chocolate or vanilla or strawberry?
What were those decision-making steps again?
(The above is an entry in my blog (www.cowart.info/blog ) for Friday, March 30, 2007.)