Esophageal Cancer Then and Now

ESOPHAGEAL CANCER  THEN AND NOW                                                                                                              

  • THEN THE YEAR 2000 
    Only basic information available
    Hard to find meanings of staging
    Scarce esophageal cancer awareness
    Difficult to treat
    Survival Statistics dismal
    Generally advanced stage at diagnosis
    Few support groups available –  2 Wonderful sites – EC Café/ EC Support                                                                            
  • How I Learned About Esophageal Cancer
  • My chance encounter with a woman I had not seen in twenty years was instrumental in my introduction to esophageal cancer.
  • When she finished telling me the story about her husband’s death from cancer, I felt compelled ask her what kind of cancer he had and what motivated him to seek medical help. She said he had esophageal cancer and sought medical help because of swallowing difficulties. Her answer triggered the  images of my husband’s multiple episodes of swallowing difficulties. It was the catalyst to convince him to seek medical attention.
  • THEN _SWALLOWING DIFFICULTIES SEEMED TO BE THE PREVALENT INDICATOR TO SEEK MEDICAL ATTENTION – OUR EXPERIENCE

  • In November 2000 my husband’s diagnosis from the endoscopy procedure was advanced esophageal cancer. 
  • Next the staging determined whether the purpose of his treatment was curative or palliative.
  • A palliative classification meant no surgery, maintain the symptoms and no cure.
  • His cancer, Stage III T3 which meant,
  • Tumor invaded adventitia, probable N1, which meant, regional lymph node metastasis, adenocarcinoma of the distal esophagus with extension to gastric cardia.
  • He became a candidate for surgery because of no metastasizes to the liver.
  • Recommendations were: chemo-radiotherapy prior to surgical resection.
  • Surgical resection in April 2001, Transthoracic partial esophagectomy, Ivor Lewis Pull-up.
  • Important to us 
  • Treatments and surgery were done at a major medical center and teaching hospital.
  • In 2004,
  • 14,000 new cases of esophageal cancer were diagnosed and more than half of these cases were adenocarcinoma affecting the glands in the lower third of the esophagus.
  • In 2005
  • Researchers reported adenocarcinoma of the esophagus was the fastest rising cancer in the U.S. 
  • The rise of this cancer the researchers suggested might have been attributed to awareness and earlier screening.
  • NOW 2016 – WHAT’S NEW                                                              
  • More Research Online sites ripe with Esophageal Cancer information Awareness
  • Advertisements for Barrett’s Syndrome, and Acid Reflux
  •  Earlier screening means esophageal cancer is treated earlier bettering survival.
  • New Therapeutic drug treatments Online Support Groups
  • Esophageal Cancer Awareness Association excellent for help and support from patient and caregiver warriors.  
  • WHAT HAS NOT CHANGED
    The prevalence of Stage III OR IV AT diagnosis
  • Is listed in the top ten most lethal cancers
  • Still difficult to treat
  • Still waiting for a cure  

April Is Esophageal Cancer Awareness Month – If You Experience Difficulty Swallowing, Run Don’t Walk to Your Doctor, Please!

 

APRIL IS ESOPHAGEAL CANCER AWARENESS MONTH

Since 2000 treatment and longer survival from esophageal cancer has improved significantly. Squamous cell and adenocarcinoma are the two groups of esophageal cancer.

In 2000, when my husband received his diagnosis (from acid re-flux disease) of Stage III adenocarcinoma at stomach junction (GE Junction), which included cancer visible inches into his stomach (called cardia), also known as distal junction, information about this cancer was minimal and optimistic survival time was not very optimistic.

By 2004, studies showed some advancement in epidemiology, etiology,diagnosis, staging, prevention and treatment, and possibilities for surgery. A stage IV in 2000 pretty much meant surgery not an option. Still in 2004 long-term prognosis remained somewhat poor.

In 2013, an article in the World Journal of Gastroenterology esophageal cancer was one of the least studied and deadliest cancers around the world.

Adenocarcinoma esophageal cancer sadly has earned a ranking of six in mortality among all the cancers. and its incidences have risen sharply. However, the good news is that  research into the causes and risks of this lethal cancer are also on the rise.

In 2015, The American Cancer Society, estimates about 16,980 new esophageal cancer cases will be diagnosed.( Men, 13,570 – Women, 3,410)

Now the survival is 20% of patients at diagnosis surviving five years and beyond. While in 2000, a whooping 5% of patients survived at least 5 years after diagnosis.

Of course, catch it early and the survival rate and perhaps even remission rise sharply.

Risk factors for esophageal adenocarcinoma are: Acid Re-flux, (GERD)  Barrett’s Esophagus, smoking, and obesity.

Although in an article, The Epidemiology of Esophageal Cancer, written in The World Journal of Gastroenterology, said, “no particular risk factor is responsible for the rising incidence of esophageal adenocarcinoma.”

In our family, my husband’s uncle died from esophageal cancer.  Our youngest son, born with an acid re-flux issue, now in his thirties, he schedules medical monitoring, and watches his diet.

What preventive daily home measures can you take?

  • Quit Smoking
  • Eat Vegetables, raw vegetables are more protective than cooked vegetables.
  • Eat fruit
  • In both fruits and raw vegetables, vitamin E, C and Carotene are protective.
  • All that to say this… research to understand what foods, smoke and other ingested materials, affect the health or deteriorate the lining of the esophagus.

Again, hear me yelling, if you are having trouble swallowing get help immediately. Difficulty swallowing is what sent us running to the doctor for help.

Perhaps if we realized the swallowing issue was not just indigestion, my husband and I may have had a chance for more years together.

Discussing Mortality- It Matters

My Case for Palliative Care 

Forced to face mortality is to walked through the fires of sorrow. It is not the stage on which anyone of us chooses to play. So joy in life is, so sorrow is too.

When the vigil begins, is the being mortal conversation open to include family and the patient facing imminent death?

How important is it for the patient’s medical team to visit daily and continue their involvement?

How important is it to not isolate the dying patient?

What becomes important when being mortal is one’s last reality?

Is there hope beyond hopelessness?

Is there anything in the natural world that possesses the power to reverse the last breath, or is the natural world indifferent to one’s finite being?

Wendy Karasin, who blogs, Musings of a Boomer, read a book written by a doctor, titled, Being Mortal. After she read the book, she asked this question. 

“Where do you stand on this issue?” I agree with Karasin’s observation that death is a tough subject to discuss, and many might think it too depressing to discuss. In my opinion, however painful or frightening, the discussion matters a great deal.

I posted her article, Being Mortal, here on my blog. I wonder what others think about, “Is death too upsetting to consider?”

Today, there are new programs available to open the discussion and address this issue of “being mortal”. In the last ten years, doctors who felt the need and importance to care for patients and address end of life matters, now have the opportunity to pursue a specialty in palliative care.Their dedication,compassion, and comprehensive care for patients who have come to the end of the medical-help road, has contributed enormous support for their terminal patients.

Equally important, palliative care programs offer guidance to those families who choose to become physically and emotionally involved in their loved one’s end care.

From my experience this creates a natural and comforting environment where all involved can talk together about end of life concerns, express emotions, and deal with spiritual matters, if faith has been a part of their lives.

Because I believe each person and their families must navigate mortality on their own terms, I only speak from my experience and belief.

 

Being Mortal

My Case for Palliative Care

Discussing Mortality – Does it Matter?

To answer the question posed in Discussing Mortality


“Does anybody matter enough to you to open the door and find out?”



For me, Yes, and many times, yes. My late husband and I walked that end of life road where the gift of life was as precious as our last walk together.


Wendy Karasin - Musings of a Boomer

I just picked up a book titled Being Mortal, in which the author, a doctor, considers the experience of mortality. He explains that he was taught in medical school how to keep people alive, but not how to let them die, or even have that discussion, if there was no longer anything he could do to make them better.

He  says “our ideas about how to deal with finitude” (his word, not mine) are inadequate, if not lacking totally. He talks about doctors having conversations about the risks of operations—which can include severe complications such as paralysis and death—with greater ease than they can discuss why not having the surgery is the preferable decision. Even when they agree.

Death is a tough one. No matter our belief system. So is getting older and frailer, and losing pieces of our dignity. One would think, I would think, there is no better…

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Who I Am and Why I Write

  Who Am I

Artist, Pianist, Teacher, Writer, Child of God

Why I Write

I write because esophageal cancer forced my family on a journey we did not choose.

I write because the suffering esophageal cancer delivers on families and their loved ones leaves me breathless.

I write because of the Helper I turned to when facing terminal cancer with my husband, Werner. It broke my heart, and tested my courage and faith.

I write because I was his wife, lover, friend, and support during the three years we journeyed the esophageal cancer road together.

I write because of who protected me from despair.

I write to testify to one man’s never quit courage, perseverance, and faith when esophageal cancer assaulted his physical strength, emotional well-being, and his will to live.

I write because I must.

I write because it was his story, my story, our story!

Today I Remember A Beautiful Man

 

 

Eleven years ago, cancer stole my husband. Sometimes it seems like yesterday when I look at is handsome face. However, of this I am certain, I was blessed to have this beautiful man in my life for almost 33 years.

After navigating through the dark waves of grief, I entered the next lesson, transitions. This phase of rebuilding my life stretched my learning curve, blessed me, made me cry, occasionally annoyed me and made me laugh. Following  is the annoyance to laughter transition.

I remember Werner with the story of our hike to a remote pond campsite and the transition that now makes me smile. It all began after I bought a two person tent for Werner.

I bought the tent because my Swiss husband, and life-long mountain climber, expressed an interest to hike to and camp-out at remote mountain ponds. However, when just the two of us hiked to these nether reaches of the wilderness, my comfort level never quite hit the one hundred percent, I am fine with this, button. Cell phones did not exist. Bears did.

On this camping trip, Jurg our youngest son and home from college joined us. While they packed their individual rucksack with the overnight gear, I had spread out on the kitchen table, anticipation laced their conversation. They filled the inside of their backpacks with food, water, a bottle of French red wine, sweaters, my pencils, and sketchbook. Once they decided who would carry  3 sleeping bags, 2 sleeping pads, Jurg’s camping hammock,  fishing gear, and the tent, they strapped the gear to the outside of their backpacks. I carried nothing. Packing done, we were off.

We couldn’t understand this phenomenon because the end of the trail opened to East Pond, a crystal clear pond nestled in the mountains. Knowing this, we nurtured our hopes that we would be the only party to enjoy the pond’s quiet beauty, swim in the cold water and enjoy dinner at the water’s edge.

Our favorite East Pond camping spot offered an open large sandy beach  and a prime view of the pond. While we hiked I remembered our other dinners shared around a campfire and watching the sun dip behind the mountains. The thoughts lightened my steps. As day transitioned to early evening, Werner pampered me. He boiled tea water for me on his small propane burner. Warmed inside by his care, I gathered and handed him dry sticks to start a campfire. I loved sitting encircled in his arms and watching the sun say a fiery

As day transitioned to early evening, Werner  used his small propane stove to boiled hot water  for tea. We gathered dry sticks to start a fire in a rock pit. The sun made a last fiery goodnight, before it disappeared behind the mountain ridge. Blackness descended on us until the full moon appeared behind the mountains. In front of us the water’s surface reflected the yellow face. Behind us, the forest disappeared in the night. Frogs presented a free symphony  surrounded by the sound of water caressing the shore and slapping against rocks.

The  ink-black shade pulled down over the forest, gave light to my darker imaginings.  Of course, unseen critters must be watching us from the void. Whatever my childish imaginings, I loved to see Werner relax. He was at home in the mountain wilderness, in his element and happy.

On this particular hike, transitional turmoil played havoc with our chosen destination. We arrived at East Pond, immediately disappointed to see our favorite campsite  occupied. “Not to worry, my positive thinking Werner exclaimed. “We will take the campsite over there. It’s even better than our usual one.” He pointed across the pond.

“Not to worry, my positive thinking Werner exclaimed. “We will take the campsite over there. It’s even better than our usual one.” He pointed across the pond.

I looked across the pond at the open campsite. “Yes,” I agreed. “It’s beautiful, but it’s across the pond and inaccessible.” Water covered the normal sandy and rock trail around the pond  and extended into the brush on the far side of the path. I thought my logical observation closed the subject.

Water covered the normal sandy and rock trail around the pond  and extended into the brush on the far side of the path.

I thought my logical observation closed the subject.

Not to be deterred, Werner told us that he knew another route around the pond.

“Really,” I said, “how do you propose we find that route, as all normal routes to the campsite are underwater?”

Without hesitation, he said, “we will bush-whack.” I probably rolled my eyes at this point, but not to spoil his fun, I followed behind Jurg and him. We continued to walk along the normal unobstructed path, arrived at our favorite campsite, greeted the occupiers and trod on for a few moments.

“Wait a minute, stop,” I said. The normal trail ended. I felt my boots squish in the muck under my feet. “With all that gear you carry, you mean to tell me that we are going to bush-whack through that dense jungle and over fallen trees underfoot?”  I carried nothing.

“We’ll be fine,” Werner assured me. Bush-whacking transitioned us from the fine familiar unobstructed path to the jungle. We squeezed through saplings packed tight together. and gingerly stepped up and over downed trees. The forest floor was a booby trap of holes made by rotting  trees crisscrossing each other. Step wrong and the overgrown brush covering these holes became a leg-breaker.

With every step I mumbled,” of course, we’ll be fine,” as my foot dropped into another hole. Humidity levels in the forest added to my misery. I climbed over tree trunks, stumbled into hidden holes, and caught the toes of my boots in the tangled mass of rotting limbs and sticks. My shirt stuck to me skin.

I chuckled when my two adventurer’s progress halted mid-step their backpacks stuck fast between two trees. I’m sure I mumbled some less than encouraging word, as I  helped set them  free. Several times I repeated the task. Being trapped between trees did not deterred the high spirits of my two men. They laughed, sometimes they cursed, but they trudged on like two boys on a great mission of discovery.

Whatever shine I had at the onset of this bushwhacking adventure, I lost somewhere between stumbling over twigs and trees, slapped in the face by twigs  I didn’t see, and bitten by mosquitoes buzzing around my ears. I swiped at the sweat dripping down my face and c worried. “What happens if one of us breaks a bone?” No response from my leaders.  I nurtured my annoyance. They tolerated my pain in the neck grumbling. Realizing my grumblings did nothing to advance my progress, I surrendered and slogged on through the jungle just to get it over with.

When suddenly,  one of my fearless men told me to look up. I did. The tops of the trees thinned out to allow light to penetrate into the jungle. I saw the tops of trees instead of toppled trees.

My look at the bright side, son and husband encouraged me. Look ahead, they told me. More light and fewer trees tells us there is a clearing  up ahead.

A few moments and stumbles later, we entered a worn path and sunshine. We walked onto flat clearing at the water’s edge. Maybe they said to me, now this is beautiful don’t you think. I had to admit to its beauty. I looked at crystal clear water and surveyed the surrounding mountains cupping the pond in its embrace. I smiled, and maybe I said, wow. Inside, I felt ashamed for complaining throughout the twists and turns of transitioning from the easy

Maybe they said to me, now this is beautiful don’t you think. I had to admit, yes, it was the loveliest campsite on the pond. I smiled. Inside, I felt a bit sorry for not trusting my two leaders throughout the twists and turns of transitioning from the easy path to no path.

Throughout the bushwhacking experience, my husband and son treated me with undeserved grace. Werner’s  smile said it all.

Once they set-up the campsite, I listened to their laughter as  their fly fishing lines cast an arc through the air. I sketched  the scene. The jungle was forgotten. Today, the memory of our hike to East Pond makes me smile. Most of all I remember the beautiful man I shared it with.

Today, the memory of our hike to East Pond makes me smile. Most of all I remember the beautiful man I shared it with.

 

What I learned bush-wacking around East Pond.  Werner never shied away from traversing difficult  and unfamiliar territory.  I often grumbled to myself when he led me on challenging terrain or up steep trails. When we reached our destination or mountain summit, my grumbling turned to joy and the satisfaction that I did it. He always let me choose the pace. From the day we began our path of our life together, I walked secure beside him, because he had my well-being at heart.  He challenged me to work through my fears, and too often my anxious nature.

When we reached the goal together, his smile said it all.

 

http://dailypost.wordpress.com/dp-writing-challenge/memoir-madness

Diagnosis Terminal Cancer-Part I

DSCN3871“I look to the mountains, where will my strength come from?

January 2003 – Who can save my husband – this mountaineer, a dad, a man of integrity, courage and faith, this man known as a “great guy.” Who can save him from terminal cancer? Can his doctors, can God, can I? When all the answers are no and the agony of terminal cancer trumps coping, how can I sustain my courage to face what is coming?

By Christmas, Werner said to a friend who said, “How are you doing?”  “When I wake, I don’t have any energy. I feel wiped – out. I’m just hanging on.” It set my alarm bells ringing.

On January 28, 2003, the sun rose pale and cold and the cancer wheels ground forward. As usual, we walked in silence from the parking lot and into the hospital for the appointment to hear the CAT SCAN results. Holding hands, we walked our beaten path along the oncology corridor. As usual, we stopped to look at the artwork displayed doing its job to distract. In crowded Oncology, we found an empty love seat along the wall. We sat. We waited. Having had lots of practice, we waited well. He read. I wondered.

The nurse called our name. I said, “Okay, love, here we go.”

Always upbeat, he slipped his arm around my waist. “We’ll be fine.”

We entered the back rooms where test results might mean a matter of life or death.

In our tiny windowless exam room, we sat in our usual worn waiting chairs. But nothing about this day turned out usual. Werner’s nurse stayed. She usually left after she entered Werner’s vitals and weight loss in his health chart.

Werner’s oncologist arrived, and pleasantries followed. “Hi, Carla and Werner. How are you?  Nice to see you. How’s the skiing Werner?” All the while Werner lived with cancer’s assaults on his body, his extraordinary energy and continued active involvement always amazed his medical team.  His oncologist said, “How are you doing?”  “Great,” was Werner’s reply.

And then the silence hung heavy and lingered too long before the hammer came down shattering our world like the breaking of a crystal glass.

“The CAT Scans are back, and I am afraid the news is not good. We are sorry to tell you that your cancer has returned.”

“Bummer,” said my beautiful husband.

I dared not look at him.  My fragile emotional hold retreated to a hiding place for protection.  I reached for his hand and held on tight to hear cancer invaded Werner’s lymph nodes, pancreas, and liver. It spider-webbed around vital organs prohibiting surgical removal. Cancer acted like a parasite. It ate his food first sucking out the nutrients and left him the trash. And then came the worst, “There is no cure. Perhaps six months.”

Everyone’s eyes fastened on us. Tense. Silent. Waiting. How will we respond? Anger, hysterics, blame?  No, we sat. We did not move. The atmosphere in the room felt oddly calm.

The oncologist broke the silence and offered the palliative program chemotherapy and without hesitation, Werner said, “I will fight. When do we start?”

As if on cue, a palliative care doctor arrived followed by his nurse and Werner’s nutritionist. After we had accepted all the palliative help offered, we stood to leave, amid hugs and good wishes. Werner walked half-way through the door, turned and said, “I am going skiing tomorrow.”

 

Part II: Beyond coping when facing a loved one’s terminal cancer. Who Will Help?

“My strength comes from God who made the mountains.”

The Sixth Gate – Living Normal the Abnormal

    December 2000, January 2001, February 2001 

   Werner began the aggressive chemotherapy protocol against Stage III  esophageal cancer. He received the standard chemotherapy drug, Docetaxel.  When his medical team asked  if he would like to volunteer to become a research patient for an experimental  cancer drug, Werner responded without hesitation, “Let’s just do it.”

How did he manage the time his protocol demanded? How did he carry on with his responsibilities as Alpine Director of Loon Race Team and Holderness School Alpine Ski team coach while ongoing treatments?  One way –  Werner’s way. To his protocol team, he said, ” If you can’t schedule my treatments first thing in the morning, I am not going through with this, because I need to be on the mountain by noon every day.”

Werner’s treatment protocol included chemotherapy twice a week for two months, followed by five days a week for six weeks of radiation mixed with chemotherapy. When the time for the radiation treatments to begin, Werner faced driving an hour one way over mountain roads to arrive at Dartmouth-Hitchcock Medical Center. When family members, friends, and colleagues heard about this schedule, they not only wanted to help preserve Werner’s energy, they wanted to spend time with him. So they joined to become a team of chauffeurs. Once we knew the schedule for Werner’s treatment protocol, a friend or family chose and signed on a particular calendar day to be the driver.

During the six-week daily radiation therapy, a friend or family member walked into our kitchen at 7 o’clock in the morning. They always arrived with a smile. After coffee, hugs, and few laughs, the two travelers left the house for the hour drive to the medical center.

These faithful family members, friends, and colleagues showered us with the love of giving. Their time with Werner preserved my energy for later. Werner did not miss a day on the mountain.

                                      

         

Top Photo: The Big Sky Gate photograph taken by Stefan Zwahlen

You Must Be Brave – A Choice

You Must Be Brave, by Carla M Zwahlen, Published by Guideposts  Books, 2007

“You must be brave,” said my beautiful husband. You must be brave? He must be

kidding. The peril we faced suffocated me. Being brave was about as far

removed from me as the life we knew and the future that fast slipped from our grasp.

Where would I find brave in the midst of this nightmare?

 

Werner’s oncologist appointment ended and staggered us with the diagnosis, stage III

esophageal cancer at the stomach junction, with a few lymph nodes adjacent to the tumor

affected. The treatment protocol included months of chemo and radiation therapy,

followed by a massive radical esophagectomy, the likes of which I can’t begin to

comprehend. Brave, I wasn’t brave, I was numb.

 

Eighteen years ago, there were other hospital stays and hours Werner, and I spent sitting

In the grip of nerve-wracking waiting room chairs. Then, our eight-year-old son, Stefan,

Underwent neurosurgery to remove a brain tumor. Three years later, Stefan’s

neurosurgeon removed another brain tumor. Here we were again, hospital bound, for

more waiting and wondering. This time for Werner’s fight.

 

The long day of doctors’ consults and tests finally ended. Exhausted, we headed for the

exit doors through the busy hospital rotunda. Although I didn’t see exit doors, I

saw flashbacks of Stefan’s fight merge with Werner’s battle, and my

emotions, like the worn seats on those waiting room chairs, slid down. I lagged

behind Werner hoping to harness my crumbling mood before I faced him.

I thought my external expression masked my inward turmoil. It didn’t.

Werner saw through my mask.

 

I looked ahead among the steady stream of people exiting the huge glass doors and watched Werner walk out onto the noisy portico sidewalk. The hum of car engines idling while

people helped patients get in and out of their vehicles, created quite an echo din under the high

ceiling portico.

I caught up with Werner and followed behind for only a few paces away

from the big doors, when Werner stopped abruptly in the middle of the people traffic.

 

When my private husband, not known for courting public attention, turned to face me, the

sheer determination expressed in his eyes jolted me. I didn’t know his intent, but his

action was surprisingly uncharacteristic. He had my utmost attention. He placed his

hands on my shoulders and said, “You must be brave.” His brown eyes along with his

four words pierced my heart.

Time can stop for seconds. People moved past us in slow motion. Noise

muffled and ground down like the sound of an old phonograph record played at the wrong

speed. No one passing us on the sidewalk under the portico noticed time stop, except Werner and

me. Captured in that time-frozen moment, he met the first challenge of the fight for his life,

me. He needed to rescue an avalanche of fear crushing me before it buried him.

I felt the soul of our wedding vows spoken thirty years ago, through sickness and in

health, and to love and to cherish until death parts us, come alive. Did it mean and be brave too?

 

I felt his eyes plead with me. Promise me you will be brave. I am forced to

attempt the most threatening and difficult climb of my life. We are roped

together to climb this mountain. If you let go of the rope, I cannot fight. I will suffer

enough, but my suffering will be unendurable if I must watch you suffer too. Just as

sudden as he stopped me under the portico, he dropped his hands from my shoulders,

turned away from me, and walked toward the parking lot.

 

Did I respond to his request? I must have said yes, I will be brave. Of course, I said yes. I

don’t know if I said yes. I don’t know what I said or if I said anything at all.

His sudden and unexpected public show of emotion to face me and its abrupt end nailed me to the spot. Yet at that moment, I had absolute clarity that courage defined the way in which he wanted to deal with his cancer. Knowing this would be pivotal for my choices in the time to come.

I shook myself out from the daze. As I followed after him

down the sidewalk, I wondered how I would honor his request. When I caught up with

him, we did not speak. I just felt his fingers wrap themselves around mine.

 

I drove towards home along the narrow winding mountain road. Darkness covered the road

and my thoughts. Werner slept. At least driving prevented the tears, but nothing could erase Werner’s

plea, “You must be brave,” repeating in my ears. When I didn’t hear his plea, ominous visions and

questions took root in me like the uninvited weeds that grow in my garden.

Who will help me to be brave in the face of esophageal cancer’s death threat that

assaults Werner’s strong athletic body?

After Werner endures months of aggressive chemotherapy and radiation that will kill

his healthy and diseased cells, who will hold my hands on the rope with him?

Where is the hope against the odds of Werner surviving this Beast? Brave, what brave?

Brave means I must be fearless and bold. It’s more my character to worry. Where is bold

in that?

 

As the miles flew by, panic waves built around me. I held my breath against the

black sea of suffering this cancer portends for Werner. I feared I’d soon drown in those

thoughts until somewhere in that angry sea, I heard a quiet voice, Look at Jesus.

 

Tired and battered, I was desperate for a lifeline, so I looked at Jesus.

The quiet voice spoke again. Your terror, like Peter’s, is keeping your eyes on Jesus

moment.

What lesson did the Lord use to teach Peter to trust Him, when Peter and the other

terrified disciples were at the mercy of a midnight storm on the Sea of Galilee? When

Jesus appeared out of the mist like an apparition and said to Peter, come and walk on the water

with me, did Peter say, I don’t trust you to keep me from drowning. What did Peter do?

I remember, I said. Peter fixed his eyes firmly on Jesus, stepped over the boat rails, and

against all the laws of physics, stood firm upon the waves.

The quiet voice spoke, Trust Jesus! Nothing else will work. Keep your eyes on Him. He

will keep you from drowning in your own maelstrom. He will show you how to be

brave.

Yes, of course, I told myself, God will supply the brave I need. I will trust God.

Really? A voice mocked. You are going to ask God to be your

brave? Why?

Now the mocking voice had my attention.

Isn’t God the one who allowed this cancer’s threat upon Werner’s life? You should be

angry with God. Remember, your son’s brain tumors. You thought after the first brain

tumor it wouldn’t get worse. Who allowed the second brain tumor to grow?

Yes, God allowed those awful circumstances, but he also

said do not be afraid or surprised when life hands me trials. It’s you, with your mocking voice,

who manipulates misery in the world. You try to make me doubt my trust in God.

I can’t choose my circumstances, but I can choose whose voice I will listen to and whose

directions I follow.

I heard a quiet voice. Nothing can separate you from God’s love.

That’s true, God promised never to leave me no matter what my circumstance.

Again, the quiet voice spoke, Keep your eyes on me, like Peter did when he trusted me

to stand him on the storm waters.

The mocking voice was silent.

 

I asked myself, would my anger against God help Werner’s fight? The answer was clear.

Not likely, if I chose to handle Werner’s illness with bitterness and despair, he’d see my

discouragement, and then, he’d be forced to expend more energy to fight under my dark

cloud. Certainly, my anger would add to his misery.

 

Yes, I was sad and weary when I turned the car into our driveway, but the despair was

gone. God had replaced the fear with the promise of Himself. He chose to tell Peter’s story.

However difficult the climb Werner and I are forced to attempt, I can

trust God for the courage I needed to honor my husband’s request, “You must be brave.”

Keeping my eyes on the Lord, I was ready to begin.

***

Little did I know the mocking voice was not finished with me.

 

 

THE SECOND GATE – DENIAL

We walked towards the hospital exit doors. We left behind the patient beds, normal days, and life, as we knew it. We pushed open the hospital door, exited and entered the second gate of Werner’s Run, denial.

“Why did you tell her that I have cancer?” Werner sat at the long kitchen table looking at me as if I told a lie.

I had just said good-bye to my mother who telephoned to ask the results of the endoscope. I told her that the endoscope results were malignant.

Incredulous that he asked me such a question, I stood at the end of the kitchen table with my mouth hanging open…angry, stunned, speechless.

He wasn’t finished… “I don’t want my staff, the kids or the club members to know. I can handle this by myself. No need to make a fuss over it.”

Classic Werner, a stoic Swiss. He expects us to go on as usual and pretend that cancer has not entered our home. Am I to keep this a secret? I realize we are both in shock, but he can’t ask me to deny that we are walking down an unknown and frightening path. I am all too aware of his need to keep all things private, emotions, and what he accomplishes, but this confrontational question and request for secrecy is unacceptable.

Holding back tears, I said, “My love, you are going to lose your hair. How will you explain that to your staff and family?”

Without looking up, he sipped his tea. I sat down next to him. We didn’t touch or speak. In that long tortuous silence, I began to realize, when cancer strode across our home’s threshold, it brought with it other baggage containing its own set of psychological, emotional and spiritual rules. I knew if Werner left the table now and walked out the door enclosed in his usual silence, a wedge would develop between us. Shocked, stunned, sad, whatever I felt or he felt, we had to communicate right then or an unhealthy stoic silence would set the standard throughout this fight. I prayed, please don’t leave the table. Cancer without physical treatment will multiply, fester, and finally kill. Denial has the same possibility to kill us.

Smothered in the silence, I waited. Finally, Werner said without looking up, “OK, you can tell your family, but no one else, not yet anyway. Give me some time. I will figure out how and when I tell my staff.”

“I respect that. One thing we cannot do is to hide.”

Relieved, I still tread softly, because, not only is he an emotionally private man, he carries on with whatever he does, without the need to talk about it.

“We need to put everything about this cancer on the table, so that Stefan, Jurg, family or friends won’t be afraid to ask a question, or talk about it with us. I need to talk about it. I can’t bottle it up. You know that people will want to offer help and encouragement. Helping will also be a comfort for family, friends, your staff, and your racers, because they care about you. What happens to you will emotionally affect others. Forcing my silence will build a barrier between you and me, our children, family and friends. How can we handle this challenge if we can’t speak about it?”

He took my hand in his and finally looked at me. “Just give me some time. I know this is hard for you. We’ll be ok.”

He kissed my cheek smudging my tears. I stood up, picked up his cup and put it in the dishwasher. He got up from the table, folded me in his arms, and said, “I love you. We’ll be Ok. I am going out for a bit.”

Tasting my tears, I smiled at him and whispered, “Ok.”

Together, we made it through the cancer’s second gate – denial.

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