John W. Cowart
It’s all good
news, but after today I intend to stop writing about medical stuff for a while;
nobody needs to know about my every ache, pain and complaint.
wonder if it might be helpful for me to go though the process of how I came to
my decision about how to handle my prostrate cancer yesterday.
Batten down for
a long posting
I’ve been going
through this process for over five months now.
Bottom line is
that after asking the oncologist two final questions yesterday, one about the
meaning of some numbers in the biopsy report and one about insurance coverage,
I chose not to treat the cancer at all, to adopt the Watchful Waiting stance as
the disease runs its course.
means going in for more testing every few months to spot when the cancer
becomes more aggressive Then revaluating what, if anything, to do next.
So this blog
post will trace how I looked for God’s will and arrived at my decision to
engage in watchful waiting instead of one of the many other treatments
available to me.
But first let
me announce that the tremors that trouble me disappeared within hours of my
taking 5,000 mg of vitamin B12!
That amazes me.
(Dr. Trout — I give my doctors fictitious names related to
literarily characters the physicians remind me of. Thus Dr. Trout is named for
the character in Kurt Vonnegut’s novels; Dr. Woody, my primary care doctor,
relates to Woody Woodpecker in the cartoon; Dr. Bay, the dermatologist, reminds
me of a lifeguard on Bay Watch; Dr. Oz, the oncologist, is the mighty Wizard of
Oz; and, of course, you can guess that Dr. P. is my urologist.)
Trout, the neurologist, had not wanted me to take this vitamin before in case
the B12 might mask some other cause of the tremors, but once he prescribed the
stuff, it acted immediately. I hope it lasts.
Now, all the
typos I make, I can’t blame on my shaking hands.
They are all
Deciding how to
deal with my cancer is a more complicated story:
Years ago a
mainstream religious publisher asked me to write a book for college students
about How To Find The Will Of God. I chose a clever working title: If God Leads Me Then Why Do I Run In Circles?
Scripture and biographies. I interviewed politicians and policemen and
preachers. I reviewed my own diaries from 20 years past. I made a couple of
hundred pages of extensive notes…
Then I gave up.
I have no idea
how God leads us today.
Yes. Yes. I
know the standard answer to the question: that you should pray and read
Scripture and consult godly advisors and follow your heart and arrive at a
sense of peace, etc. etc. etc.
I found the glib Four-Easy-Steps process usually presented for learning God’s
will in a specific situation, such as buying a car, or choosing a college
roommate, or deciding whether to marry Mary, Betty or Fefe La Boom — This
process just did not satisfy me.
deciding how to deal with my cancer, I found that I considered many of these
same steps I found unsatisfying.
confessed that I have no idea of how to find God’s will, then let me go through
how I’m going about seeking Him in my own particular situation concerning my
may help you in your own decision making, but remember that this is just an
outline of what one lone confused Christian tried. It may help you, or it may
When Dr. P, the
urologist, first told me I have cancer, he acted more upset than Ginny or I
did. We tend to regard this as just another damn nuisance. He presented us with
five or six options to chose from and we had to learn an entirely new
vocabulary. For instance, I’d never heard the word brachytherapy before in my
Maybe it was a
mental block related to denial, but I could never remember the right words the
medical people used. I just labeled the radiation pellets they proposed to
stick up my ass as kryptonite and
let it go at that.
I did learn the
term DRE (Digital Rectal Exam). Boy, did I ever learn that one!
and I first considered several factors:
My cultural background. Being of North Florida Cracker heritage, I
tend to think you only go to a doctor as an absolute last resort when you are
in a terminal condition and that a hospital is a place people go to die, a
place where you get septic flesh-eating bacteria if you have to go in there to
get a simple chainsaw wound bandaged. Never go to a hospital because you’re not
likely to walk out alive.
I know this view is only partially true, but my gut feeling is that the only
way you should ever see a doctor is if the ambulance carries you to the
hospital while you’re unconscious and can’t escape.
My Cringing At Being Touched. I’ve written about this several times before
in the past couple of months (for instance see “Skin Flick” on March 1st).
Our Sex Life. Ginny and I have only been rehearsing sex for
39 years and we’re really getting the hang of it. With that much foreplay
leading up to our next encounter we feel we’re getting good at it. We do not
want to gamble on anything messing that up for us and every prostate cancer
treatment carries that possibility.
Ginny’s Health. She controls her diabetes very well — so far.
But the day is almost sure to come when it turns bad nasty on us and I want to
be around to give her the hands on care she might need.
My Macular Degeneration. Dr. Lamb, the ophthalmologist, tells me that
if I live long enough, I’m almost sure to go blind. That does not give me much
incentive to stretch things out; it’s sort of like choosing between the Lady or
My Hardheaded Resistance To Change. I lead a very happy life. I love my
work. I enjoy my grown kids. I adore my wife. I own a Lotto ticket that may
make me a millionaire. I don’t want anything to change. And here God drops this
prostate cancer thing on my head… actually on the other end of me, but you get
what I mean. I do not want anything to change. I am a happy man. But being
hardheaded and resisting the change God sends is dumb. I know better than that.
My fear Of Death. Am I a Christian believing in eternal life?
Am I scared of
Christian exercise faith in Christ and approach death without fear?
Maybe so. But
I’m scared anyhow.
As I see it we
are souls God has grafted into physical bodies. He engineered things to give us
a fear of death for a perfectly good reason — to keep us from doing stupid
things, like say hang gliding or motorcycle riding or fooling with Don Vito
passage of Scripture portrays the Apostle Paul aboard a ship in a wicked bad
storm. As apostles were wont to do Paul stood up and gave a speech:
“Sirs, be of
good cheer: for there shall be no loss of any man’s life among you, but of the
ship. For there stood by me this night the angel of God, whose I am and whom I
serve, saying, ‘Fear not, Paul…” Wherefore, Sirs, be of good cheer: for I
declaration of faith in God.
But then the
And they that
could swim cast themselves into the sea and paddled for land, And the rest, some
on boards, and some on broken pieces of the ship, some hugging barrels or hatch
covers or whatever struggled and treaded water and thrashed and splashed and
struggled to get to land — and there was the fearless Paul, a Christian par
excellent, dog paddling holding onto a board just like the pagan sailors.
In the face of
death, our physical bodies react by clinging to life tooth and claw, clinging
to any board, barrel or broken mast we can cling to. That’s the way God made
us. So, yes I believe in Jesus, and no, I don’t want to die anymore than He did.
are some of the factors bounding around in my brain as I began to seek God’s
will about how to handle this cancer.
First, I said,
“Damn, what a nuisance”.
I had other
course, I prayed.
I prayed two
“Lord, what will You have me to do”?
that is the only question worth bothering with. Anything else is froth and
through all this believe me, I’ve churned up a lot of froth.
Then I prayed
like the old lady in the Stephen King movie, The
Stand. In her crisis, she prayed, “Lord, if it be possible, please
let this cup pass from me. That’s the same thing Your own Son asked in the
garden; but, I ‘spect I’ll get the same answer He did”!
investigated whether or not this cancer has spread beyond my prostate already.
That’s why I steeled my self to be examined by Dr. Trout, Dr. Lamb, Dr. Oz, Dr.
Woody, Dr. Bay, and Dr. P.
biopsies of suspicious areas turned out benign.
So I began
Dr. P indicated
that surgery would be most likely to permanently cancel our sex life. Cross
that one off the list.
Then there was
chemical castration (sounds nicer when they call it hormone therapy). Here in
Florida prisons do that to rapists and child molesters. Besides, this treatment
not only kills the cancer cells, it would also cause my breasts to grow so
large that with a blond wig, I could pass for Anna Nicole Smith.
I’m not a
handsome man, but I’d make one hell of an ugly woman.
Cross that one
And Dr. Oz
discovered that because of scar tissue inside me from surgery years ago, I am
not a candidate for one of the most promising cancer treatments, the kryptonite
thing of radiation implant pellets (I forgot what they really call it).
treatment options began to narrow down.
says that “For by wise counsel thou shalt make thy war: and in a multitude of
counselors there is safety.”
sought out wise counselors.
I talked with
my family; they gave me their unwavering support whatever treatment I would
I talked with
my father-in-law, who died last week. He said, “Cut it out! Cut the damn thing
out. Don’t wait a minute, not another day. Cut it out”.
Jack was always
so shy and retiring about offering advice.
I talked with
my eldest daughter, a registered nurse; she assured me that she would undertake
my care should I become bedridden or anything like that.
I talked with a
friend, a nurse at the world-famous Mayo Clinic, who actually gives hands on
care to terminal prostate cancer patients in an intensive care unit. There I
got a vivid description of how this cancer metastasizes to seek out bone marrow
especially in the pelvis and spine where the cancer cells creates an agonizing
amount of pain that is very difficult to control.
And I talked
with a friend who urged me to drink green tea with red clover, a sure-fire cure
I also read Dr. Peter Scardino’s Prostate Book. Dr.
Scardino (his real name) is chairman of the urology department at Memorial
Sloan-Kettering Cancer Center. His book thoroughly explains the pros and cons,
history and projected future or each possible treatment. I highly recommend it.
reading, as a Christian, I naturally turned to the Scripture to see what the
Bible says about my prostate cancer predicament.
Not a word.
thing I found was in Deuteronomy 23 where any man who is “wounded in the stones
or hath his privy member cut off” is excluded from being a priest.
Isn’t that helpful?
found a great deal of general comfort in God’s promises such as:
Trust in the LORD with all thine heart;
and lean not unto thine own understanding.
In all thy ways acknowledge Him,
And He shall direct thy paths.
And I learned
that the word comfort is derived
from two Latin words: cum forte which mean “with strength”. God does not make
things easy for me, He helps me meet them with strength.
But, as I
floundered around in all these factors, worries, words of counsel, hopes,
fears, aggravations and frustrations, as I tried to decide which option to
choose, as I felt scared of making a fatal error, a wrong choice — one thought
from God’s Word helps me more than any other.
It’s found in
The steps of a good man are ordered by the Lord
And He delighteth in his way.
Though he fall, he shall not be utterly cast down:
For the Lord upholdeth him with His hand.
The same idea
is found in Isaiah:
Even when I
screw up and make a dumb choice, even then, the prophet Isaiah said, “Thine
ears shall hear a word behind thee, saying, ‘This is the way, walk ye in it,’
when ye turn to the right hand, and when ye turn to the left”.
My role in all
this is to try to be a good man and be open to God’s correction.
For me that’s
trickier than it sounds.
old proverb: “In his own eyes, no man is an asshole”.
Er, in case
you’re wondering, that’s not from the Bible but I think it true nonetheless.
Can I say
dogmatically that I have found the will of God?
of such dogmatic declarations.
Can I say with
cautious confidence that God is leading me?
Yes, I can. I
am at His disposal whichever way this cancer thing goes. He deserves nothing
going through all these mental gymnastics, would I have made just as good a
decision by simply flipping a coin?
I don’t doubt
it for a moment.
Even a flipped
coin lands in the Hand of God:
Scripture says: “The lot is cast into the lap; but the whole disposing thereof
is of the Lord”.
decision making much easier than I do. She is much more confident of the Lord’s
mercy and grace. She’s an intensely practical Christian. In such a matter she
simply asks, “What’s best for us, for now?” and goes with that.
Anyhow, I have
chosen to not treat the cancer at all for now, to engage in the watchful
waiting technique subject to close observation and periodic tests.
having thought all this through for months, I feel relieved to have made a
decision, any decision.
I feel joy.
I feel peace.
I feel like a
bowl of ice cream.
Now, do I want
chocolate or vanilla or strawberry?
What were those
decision-making steps again?
(The above is an entry in my blog (www.cowart.info/blog ) for Friday, March