We have thought on your steadfast love, O God.
– Psalm 48:9

Update: I am two weeks out from my second of six chemo infusions. My last echocardiogram (done, rather fittingly I thought, on Valentine’s Day) revealed an ejection fraction now within the normal range (unclear if that’s due to the two heart meds I’m on, a decreased dose for the second infusion, or testing error from the first echo, but good news regardless), leaving me cleared for my next chemo infusion in one week.

The physical side effects this second time around have been variable, some the same (nausea, mouth sores, GI issues), some better (fatigue), some worse (rhinorrhea), some new. The most interesting new one is an inability to produce saliva, which carries the charming medical moniker xerostomia and affects about fifteen percent of people on T-DM1. Turns out saliva is essential for talking or eating—whatever I put in my mouth turns to cotton. On the upside, I’ve never been better hydrated in my life, as I’m constantly sipping water to relieve the fuzzy, slimy feeling in my mouth. My kidneys must be doing great!

The mental side of things has been harder this time. I’m not sure why. Perhaps it’s the flush of novelty wearing off and realizing I’ve still a long way to go in what has become a new normal. Perhaps it’s the simple truth that when your body feels bad, it’s very hard not to have dark thoughts. Whatever the case, I find myself sinking into a fog of despondency, listlessness, anger, and frustration.

There is a Christian practice for this. It’s called lament, and I’m not that great at it. Lament in its simplest form consists of two things: complaining to God and choosing to trust in him. I’m much better at (1) pretending my feelings don’t exist (easy to do when having to function for kids who are constantly around), (2) rationalizing my feelings away (you still have your hair! you don’t have it nearly as bad as this or that person!), (3) escaping from my feelings (the constant search for that perfect show or novel), or (4) displacing my feelings (getting frustrated at small things).

None of these things is lament. Lament is feeling bad and not having to feel better. It is being in your feelings, but not allowing them to drag you into complete bitterness and despair because (and this is the main thing) you are telling your feelings to God. You are acting out a belief that there is still, especially now, a God who exists, sees, knows, and cares. And choosing to trust him has nothing to do with some cross-stitched platitude or even feeling anything at all—it just means finding some truth about him to hold on to. I imagine it like the difference between lying miserable in bed alone, spiraling into darker and darker thoughts, versus finding that my husband is sitting wordlessly next to me, and reaching out to hold his hand. The world is still as bad. I still feel as bad. But I’m holding onto his hand, which means he’s listening and I’m not alone.

I came in my reading today upon Psalm 48. That line, we have thought on your steadfast love, O God, is three words in the Hebrew: “we have thought” is a verb which means “to cause to compare,” something like “to imagine”—to bring something metaphorical, true but not literal in your current experience, to your imagination, to think upon it until its truth becomes real to you that moment. “O God” is a direct address; this is a prayer, a conversation. And “on your steadfast love” is that untranslatable word hesed: love and generosity and enduring commitment, all together at the same time. Loyalty, unchanging lovingkindness. There is no circumstance, no suffering that can change the hesed of God; that is precisely the point of the word.

If I had to write my own lament prayer, it would probably be something like: this sucks, but you’re there. I would tell myself, let your bad days be bad. But remember that God is steadfast: he is there, and that is all. You don’t have to feel better. But you also don’t have to despair. Stop your thoughts when they get too dark, and remember the ending of that most classic of lament psalms, Psalm 13: “but I have trusted in your steadfast love” (verse 5). The pronoun there is doubled in the Hebrew: but I, I have trusted. But I, I have made this choice. To allow myself to feel bad, and yet to believe that the reality I feel is not the whole picture. To believe that God’s intentions for me have not changed. What is trust, after all, but the hand you reach for in the dark? What is belief but what you’re willing to step out upon when you can’t see or feel much good at all?

Our oldest has sketched in graphite and charcoal a black-and-white image of me sitting in a hospital gown with my port hooked up to a chemo bag hanging beside me. It’s not a place or time I like thinking about, to be honest. But now she’s painting in flowers all around, a riot of color, the IV pole a bower of blooms. It’s as if her imagination has taken a truth—that T-DM1 was discovered from a plant—and filled it with a version of beauty and life that lies on a plane beyond what I can see. A pictorial lament, a demonstration that it is possible to be awake to what is terrible in the world and yet trust that there is a truth which lies in and beyond your experience of it.