But because of his great love for us, God, who is rich in mercy, made us alive with Christ even when we were dead in transgressions--it is by grace you have been saved. And God raised us up with Christ and seated us with him in the heavenly realms in Christ Jesus, in order that in the coming ages he might show the incomparable riches of his grace, expressed in his kindness to us in Christ Jesus.
Ephesians 2:4-7

I’ve been told that many of you have been tapping your fingers impatiently on your desks waiting for an update on Karen. I am sorry to have waited so long but a lot happened this week and so I wanted to wait until we got to the end of it to let you all know what is going on.

On Wednesday we went to the initial consult with the radiation oncologist in Walnut Creek (John Muir Medical Center) where Karen will be getting her radiation treatments. This location is much closer to us than UCSF and was highly recommended by the team in San Francisco. Our radiation oncologist there has been in the business for decades and is very experienced and self described as “pedantic.” He said this is a good trait in a radiation oncologist considering he’s going to be pointing radiation at Karen’s head and spine and could paralyze her if he doesn’t pedantically plan the dosage and angles.

This appointment, as most are, was punctuated by many periods of waiting. As I’d forgotten to bring some reading material I was entertained as we moved from room to room by the different reading material that was made available in the form of thousands of magazines. As we entered another waiting area I reached over and started rummaging through one of the stacks. I quickly passed over “Vogue” and “Bay Area Mother” and picked up “The Economist.”

On of the articles that caught my eye (to no one’s surprise) was a feature on a very successful executive who had been diagnosed with terminal cancer and who, together with his wife, co-authored a book about his experiences over the next 6 months until his death. I’ll admit that I didn’t have the opportunity to read the whole article, but what I did read got me to thinking. This admittedly successful man handled his cancer and his imminent death with what anyone would call a kind of calm and purpose. However, I was primarily interested in how this man turned to meditation as a means of calming himself and remaining focused as he entered his last days of life.

This interested me because it got me to thinking about how Karen has viewed her “spirituality” in the context of her cancer. Meditation, as I understand it is practiced by most westerners today, is primarily about clearing ones mind and focusing one’s attention on a specific thought. I asked myself, “what was this man focusing his attention on? Did the object of his meditation really matter? Was all that mattered that he found it helpful? How does his experience in turning to meditation compare and contrast with how Karen is dealing with her own cancer?”

These series of questions reminded me of something I wrote early on in the blog as I wrote about faith. I talked about how the most vital part of faith is what you are placing your faith in. As I read about how this very successful, driven, thoughtful executive turned to meditation the fundamental question remained the same. What was he meditating ON? What was the object of his meditation?

John Calvin talks about something similar in his Institutes. In chapter 4 he is discussing how the natural and inescapable nature of man is to smother and corrupt their knowledge of God. Unless God reaches down, interferes in our lives, and changes our hearts, no one would want to seek after God to discover who he is as he has revealed HIMSELF. In this context he writes:

“Indeed, vanity joined with pride can be detected in the fact that, in seeking God, miserable men do not rise above themselves as they should, but measure him by the yardstick of their own carnal stupidity, and neglect sound investigation; thus out of curiosity they fly off into empty speculation.

They do not apprehend God as he offers HIMSELF, but imagine him as they have fashioned him in their own presumption.

When this gulf opens, whatever direction they move their feet they cannot but plunge headlong into ruin. Indeed, whatever afterwards they attempt by way of worship or service of God, they cannot bring as tribute to HIM, for they are worshiping not God but a figment and dream of their own heart.”

As I think about the many things God has done for our family I am utterly speechless. By his grace he has showered his mercy on our family and opened our eyes that we might see him as he has revealed himself. Karen and I thank him that he is continuing to wash away the residue of our own presumption, speculation and stupidity. We know that he is using this time of struggle as a means of refining us so that as we meditate on his word, THE Word, our meditation has the express purpose of bringing into more vivid focus the awesome character of our saving God.

When the doctor finally met us in the conference room, most of the information he gave us was basically the same as what the radiation oncologist in SF gave us. It was interesting, though, to see the nuances of difference in the way he presented the info and what bits he gave us that the other specialist didn’t. I also cracked a smile when toward the end of the meeting he asked us if his plan was different in any way than what would have been prescribed at UCSF. I guess I shouldn’t be surprised at this friendly professional comparison. All in all the meeting went well and Karen was in good spirits.Thursday we drove to San Francisco (UCSF) to have a CaT scan done of Karen's chest, abdomen and pelvis. Our Neuro Oncologist ordered up this CaT scan as a conservative precaution to make sure that the cancer had not spread to the rest of Karen’s body. The CaT scan was a totally different experience than the MRI. It was extremely fast and she didn’t even have to disrobe. I don’t think she was in the machine more than 10 minutes from start to finish. The good news is that we got a call from the doctor yesterday and after reviewing the CaT scans there does not appear to be any cancer in her body except for her brain and spine. No surprises there.

Though Wednesday and Thursday were filled with lot’s of doctors and nurses they were both pretty easy days. Friday’s appointment was of quite a different character. We went back to John Muir for the radiation "planning session." This became another one of those moments that drives reality home regarding how hard the next 6 weeks are going to be.

The purpose of this appointment was to get her body oriented in the machine. They had her lay face down on the bed of the radiation machine with her face pressed against an apparatus used to hold her head still. A plastic mold was form fitted to the back of her head to additionally secure her body from moving. Her head, was thus, squeezed in a kind of vice grip.

Unfortunately this important and necessary apparatus used to prevent her from moving, squeezed her face so hard that it was almost unbearable. It was all she could do to keep from breaking down into tears because of the pain. The physical pain was only made worse by the mental strain of trying desperately not to cry for fear that if she did she’d move and mess the process up and she’d have to stay trapped in this device longer. So Karen fought back the tears and tried her best to bear up under the pain.

I had no idea this was going on in the room next door. I was content to have my attention bounce back and forth between my book on President Andrew Jackson, the “Today show” that was playing on the TV above me, and the small sea of seemingly happy cancer patients that surrounded me. I was not all that concerned that Karen would be in discomfort because every indication we’d been given up to this point was that the process would be painless.

Apparently the pain that Karen experienced is unusual. The technicians explained that it was due to the fact that she has so little “padding” on her body. The technicians tried to encourage her by praising her for how easy it was for them to “find her spine.” I guess the obesity epidemic in the U.S. has real implications on the ability of radiation technicians to efficiently do their job. So as the moments elapsed Karen tried desperately to control her emotions. As the process came to an end Karen finally broke down into tears as the technicians informed her that though the future sessions would be shorter, that if the first session was painful they would all be just as painful.

As I looked up from my book and saw her walking toward me the first thing I noticed as she entered the waiting room was how pink and puffy her face looked. I furrowed my brows quizzically trying to process what that actually indicated. Had she simply fallen asleep or had she been crying? Then I noticed her eyes. It wasn’t really the fact that they too were pink and puffy that clued me in. Honestly, they acted for a moment like the proverbial “windows into the soul” I could just tell as I looked into them that something was really not right.

The pain had triggered the weight of reality to further press down on her and this produced more tears, I think, than the pain did. Waves of emotion passed over her throughout the rest of the appointment but the storm did calm as the day progressed. Mike and Michelle flew in that morning to spend the weekend with us and their arrival provided the perfect distraction to help Karen put the morning behind her.

Before we left the appointment, our doctor informed us that next Wednesday will be the follow-up planning session. This will entail Karen laying on that same contraption while they take Xrays of the exact locations on her brain and spine that will be radiated. This is a dry run that will allow the doctor to see the precise location where the radiation will go. He’ll be able to further refine the radiation plan including dosage and angles to make sure the plan is perfect before they actually start the radiation treatments the next day. Please pray that this goes quickly because it could drag on and every moment in that contraption is truly agonizing.

Also, as I mentioned in a previous blog entry, our oncologist is having the pathology of the tumor reviewed again. He wants a second opinion to confirm tanacytic ependymoma. Thus he has sent the sample away to Mayo Clinic to be reviewed by a totally new set of pathologists. We won’t hear back on this for about another two weeks.

In the mean time, as Karen begins radiation next week, we ask that you continue to pray for Karen. Please pray for the pain she experienced while being strapped down, for effectiveness of the treatments and for no long term side effects.