Planetary Pilgrims get Philosophical Sometimes

Pastoral Care for Someone Living With Cancer
I am still thinking about some of the things I heard at a workshop on living with cancer, which I attended some years ago. The more I think about it, the more implications I see for pastoral care. Cancer (together with AIDS, which often renders the patient susceptible to cancer) is the new "leprosy". 

There are many aspects to this condition that isolate patient and family, even at the very moment that the community wants to offer support. 


Shock and horror - together with the inevitable sense of relief that "Gee, I hope I don't get it", with the attendant feeling of guilt and pity, all conspire to make for a huge power differential between the patient and others in the immediate and extended community.


Loss of self - patient, family and the entire circle of friends become saturated with the crisis, and the patient, even though at the centre, can experience a loss of selfhood. One knows that people are talking about one's condition and about how one is feeling. There are huge expectations to "fight a good fight", a "courageous battle". To what extent does a person feel like wearing a mask to keep people from constantly wondering how one is doing?

"How are you doing?"  - I wonder how many times patients would like to answer: "Well, I feel crappy, and am scared shitless that I'll die from this, I am damned bitter about having my hopes shattered, my family life threatened, my kids having to do all this work on my behalf when they should be launching their career. I am pissed, and sometime I feel sorry for myself, and utterly alone. I lie there next to my husband, and am afraid to touch him, I could not stand his rejection. So, he lies there afraid to touch me, lest he hurt me! A fine pair we are..." 


Crazy making language - you are fighting a battle with cancer, hating the tumour means hating a part of yourself. We tend to demonize a tumour, yet at a certain level it is a part of your body. Radical procedures such as a mastectomy mean rending, tearing, cutting off a part of your body, which you mourn. And the worst cut of all: a cancer cell is one that has been “favoured”, somehow, it is a cell that is growing and doing much too well (in the illogical logic of Cancer!). 


Living with a death sentence – there is a sudden awareness of this, a sense that one is "condemned". People begin to see you as tarnished, it becomes the chief part of your identity. People struggle with what to say. To make it better, patient ends up comforting the care givers!


The human body is a time-limited offer - yet Cancer seems to be an intruder, much more than other conditions. We are not always logical about living and dying, yet there is a “cancer logic” that seems to insist that Cancer is a curse. Some groups do not even like to utter the word Cancer. It is as if, by magic, one could bring it on oneself by speaking the word. There is a sense of “blame” associated with Cancer that is not present in, say, Parkinson’s, or Multiple Sclerosis. Why is that? When Cancer is detected early, the medications sometimes make you sick, very sick, long before the symptoms of Cancer make you sick. Another example of the craziness of living with Cancer. Do I have to feel guilty because I cannot see that pain really has to come before gain? What if I don’t gain?

Role of alternative methods – While we encourage people to take initiative and a proactive stance toward one’s health, the moment a cancer patient seeks alternative methods we seem to assume that the patient is in denial, or desperate. Why is that? If extracurricular activity is what makes you really feel that you are alive in high school, how can we ensure that we do extracurricular activities when a person has cancer? We have not yet begun to explore fully the role of intentional stress relief activities and lifestyles.


Where is God in all this? -  Where do we begin to give the message that life is short, always too short, but ever so precious? When do we begin to acknowledge that quality (not length) of life is a patient’s right, not a luxury? When do we begin to acknowledge that education about how to relate to a friend or loved one who has cancer is a huge part of the healing process? What does “teach us to number our days so that we may grow in wisdom (Ps. 90:12)” mean in this context?


And when do we stop telling a person that they must stay positive? - My friend says: "If someone tells me one more time to stay positive, I will scream!". What does that mean, exactly? How do you stay positive? What if you are not feeling well? Does that mean that you are not fighting the good fight and staying positive? Hmm...
 
I am feeling good today. Really good. I vacuumed, cooked a pot roast, and made a really delicious spaghetti sauce, with lots of garlic. I am going out shopping with David soon. 


This felt like a good day to jot down these thoughts. I have been wondering how my experience with cancer will affect the quality of my work as a chaplain. So, I thought I would jot these thoughts down. They are not original, and some I have written before.
 
On the way to Santiago, there is a field where people have created stone cairns, hundreds of them, one stone at a time. Today, with you, on the way to Santiago, I am placing one little stone on one of the cairns, to symbolize my thoughts as a chaplain who will return to work someday. And we will see you around, one pebble at a time, on the way to Santiago!