Resurrender

Our real journey in life is interior; it is a matter of growth, deepening, and of an ever greater surrender.
– Thomas Merton

Update: my third chemo dose was deferred yesterday because my liver enzymes are too elevated. The upper limit of normal for one of them (ALT, or alanine aminotransferase) is 61—before chemo, I was 24; after the first dose, 63; yesterday, I clocked in at 211. I imagine this is my liver saying I’m super pissed off having to clear this poison out of your bloodstream (highly scientific, I know, and all I have to show for myself after four years of medical school). For non-metastatic cancer, T-DM1 is held if ALT levels are above three times normal, so the decision was made to give my liver time to recover and try again next week.

I hadn’t known my lab results in advance of heading in for the infusion, because infusion days consist of three same-day appointments that get you a full tour of the cancer center: you start off on the lab floor, where specialists use sterile technique to access your port with a Huber needle that pokes through your skin into the port (and looks exactly like a flat-headed electrical plug). They draw blood through the port and send it off stat, then leave the needle and tubing taped into place for the day. Next stop is your oncologist, who reviews lab results, sees how you’re tolerating things, and live-orders the chemo for the day. Finally, you head to the infusion floor, where they wait for the drug to arrive, run it in, de-access the port (they never say “deport,” haha) and let you go.

Yesterday, I was walking towards the infusion floor when they called me with the liver test results, and I did a literal one-eighty back to the lab to get the port de-accessed and head home. It felt disorienting—logistically, of course, all the medical visits I had planned for the next four months had to be changed, not to mention my work schedule.

But it wasn’t just that. The analogy my husband has come up with for these chemo infusions is that it’s like watching me step into a boxing ring. We might not know exactly where or how hard the hit will land, but we know it’s coming and will put me down for the count. It does weird things to your psyche to know you’re going to have to step back into that rink, just when you’re picking yourself off the floor after the last round. You end up doing things to cope with going back, to work yourself up to it—cry, pep talk, retail therapy, baking, chores, exercise, tossing and turning the night before—and finding the timing’s all changed feels like having the rug pulled out from under your feet.

This, it feels like, is the one consistent thing about having cancer: you never know how something is going to go. You are perpetually one scan or imaging test, one biopsy or pathology result, one lab draw away from everything changing. You are faced with scenarios that are emotionally and/or physically challenging, yet asked to pivot from one to another at a moment’s notice. And all of it escapes your logic, your ability to predict anything: why should someone with no preexisting heart conditions have an abnormal echocardiogram? Or no preexisting liver disease have such a spike in enzymes, and that after the second dose was decreased? Why should I have cancer at all? Why should mine have been caught early while so many are not?

There is no logic, only a choice: to go crazy trying to control things, or to surrender, and surrender again. Surrender is not resignation—it doesn’t mean I stop doing and preparing for what I can. But it does mean that, at the deepest level, I yield the right to control how things will go.

In his book Discernment, Henri Nouwen writes, “In retrospect, many of the good and important things that have happened to me in life were completely unexpected. And many things that I thought would happen to me did not occur. As I reflect on this reality, it is clear that God is present in the events in my life, yet I act and speak as if I am in control. But if the future is not in my hands, then I have all the more reason to stay in the present and give honor and glory to God from where I am… To start seeing that the many events of our day, week or year are not in the way of our search for a full life but rather the way to it is a real experience of conversion.”

Every unforeseen turn in this journey has interrogated what I believe: do I really trust that what is ultimately “good” or “bad” extends beyond what I can see or know? What am I willing to give up, and what does that show about what I am living for? Can I accept my present reality, even if it’s not what I expected? Nouwen is right: the most good and important things that have happened to me in my life have not been planned—meeting my husband, seeing my kids become their own unique persons, encounters with the divine, friends who have come into my life. Maybe I prepared in some ways for these things, but never could I say that I maneuvered them into being. Why should this be any different?

During spiritual retreats, I used to walk the labyrinth, a circular maze that winds its way towards a center and out again. I always walked it as a walk of surrender, each step less concerned with where I was heading then letting go of what I was holding. I took a walk with the dog today in like manner, noticing as I let her lead how uncommon it was for her to walk a straight line, how much less interested she was in the quickest route to our destination than in sniffing every little thing along the way. As we walked, I tried to let go of my own straight shot to the end, and see instead this bonus week I’ve been given—not enough time to achieve anything grand, just enough to enjoy whatever is in my present a bit more. The next hit will come, and when, I do not know. I will instead take this meandering walk in the sun, wherever it may lead.