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Preaching to People with Cancer:
The Eschatology of the Body
Douglas John Hall*
Montreal, Canada
The word “cancer” comes from the Latin for “crab,” that darting crustacean with four pairs of legs and one of pincers that fascinates and frightens little children playing at the edges of our waterways. According to the Oxford English Dictionary, this unlikely term was applied to this disease because “the swollen veins surrounding the parts affected [bore] a resemblance to a crab’s limbs”—this being the observation of the famous Greek physician and writer, Galen (12-200 A.D.). The word was adopted in Old English as early as 1100, and after about 1600 it received its more technical medical connotation. The image of a crab having a deadly hold on one’s body is a grim statement about the destiny of finite creatures. Nevertheless, for Christians the eschatology of the body is not a tragic story.
The Background Since I have been asked to write this small article out of my personal experience of cancer, it is probably best to begin with “the facts.” Last fall, as a result of a routine colonoscopy, it was discovered that my colon was host to an unwelcome guest, a cancerous tumor. An operation on January 14, 2005, “successfully” removed the growth along with a foot of the larger intestine. Subsequent analysis of thirteen lymph nodes revealed that three of them had had traffic with malignant cells; therefore, chemotherapy was recommended. I am almost through the twelve prescribed sessions of “chemo,” and I have been fortunate: no serious nausea, no great hair loss, only minor reactions like hiccups and periodic weariness oddly juxtaposed with bursts of unnatural energy. I am feeling fine, really. But of course—it’s cancer, and I am seventy-seven years old. “The Big C,” my general practitioner calls it. I read somewhere that 2 in every 3 males, and 1 in every 3 females in Canada contract cancer of some type during their lifetime. In the United States, according to the Centers for Disease Control and Prevention, “Cancer is the second leading cause of death among Americans. [It is] responsible for one of every four deaths….In 2005 more than 570,000 Americans—or more than 1,500 people a day—will die of cancer.”1 Many people are so frightened of contracting some form of this condition that they look for it in every skin blemish or body ache. Others are so debilitated by the very thought of cancer that they have enormous difficulty relating to people—often their close relatives—who suffer from it. A neighbor of mine, when I mentioned that I was “on chemo” simply gasped, touched me in a strange, fatalistic way, and never mentioned the subject again. In fact, he has stopped speaking to me. In some degree, what AIDS is to Africa, cancer has become to the West. There’s a certain stigma attached to it. It’s a synonym for mortality, death…the end.
* Emeritus Professor of Christian Theology, McGill University, Montreal.
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Ah!—but that word, “end,” signals for Christians thoughts that are not all negative. Sober thoughts, certainly, but not bleak ones only. What I intend to do in this short piece is simply probe that little word, and to do so as one who for the past seven or eight months has had to entertain very concrete reasons for thinking about the end. How, as a Christian, should I consider the reality that I, too, am now at the mercy of “the crab”? Although I shall concentrate, in this article, on the personal side of the subject, I have also been led to reflect on cancer as a vast, ubiquitous social fact, both a real and a symbolic “statement” of the human condition—the condition of creatures who move inescapably toward apparent oblivion. The environmental and lifestyle contributions to the causes of cancer make it necessary to consider this condition from the perspective of social ethics and not only as a question of personal health. I should like therefore to keep the social dimension in view in what follows, but I shall have to focus chiefly on the personal.
“Theology Helps” Let me first establish the point of view from which I wish to speak about my experience of living with cancer. Without discounting the marvelous support I have received from family, friends and well-wishers near and far, the greatest comfort I have found during these rather critical months has come from—theology. I am not, by nature, a patient person, but I have learned patience in coping with cancer because I was able to bring to that reality a perspective, a tradition combining both truth and hope, that I had imbibed over the years from the scriptures and traditions of the Hebraic-Christian faith. Nor am I, by nature, a calm person, easily able to accept the interruptions, psychic jolts, and major crises by which all human life is punctuated. But in the face of this great disruption I found myself turning in new and very practical ways to the theological background on which I had been reflecting and writing and speaking for decades. To my friends, I often wrote of this with some surprise: “Theology helpsl” I told them, almost as if it were an amazing and unanticipated discovery, late in time. Not just “belief or “faith,” which is of course the spiritual basis of any theological depth one might acquire, but theological reflection as such brings to the contemplation of one’s (let me call it) end-condition a certain calm that passes understanding, to be sure, but unlike a good deal of “religion” does not bypass it! The first thing I should like to say to my readers, therefore, is simply this: Do not despise theology! As you try, as preachers, pastors or friends, to help and comfort others who suffer from cancer or other end-conditions, don’t imagine that you have only your prayers and your presence and a few bits of practical wisdom to pass along to them (“Cultivate a positive attitude,” “try to live as normally as ever,” “get lots of really good food, and exercise,” etc., etc.). You have something better and more lasting to give. You have a vantage point of meaning and courage that you can, with a little discipline on your part, help to make accessible to others. You will have to translate your theology into the specifics of the individual lives you want to touch, and that is no easy matter; but it will always begin with your own revisitation of the best resources you can lay your hands on—the Bible of course, but also the great works of theology and biblical interpretation that have graced the past hundred years of Christendom; for, not accidentally, as Christendom itself has declined in the West, some of the best theology has emerged from the perceived ending of the “official” forms of this faith— probably beginning with Sören Kierkegaard. Like people, institutions often become
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interesting as they are caused to contemplate their ending.
The Two Senses of “End” The word “end” has two connotations. It “means both finish and aim; and as such it is an excellent tool for the expression of the two sides of the Kingdom of God, the transcendent and the inner-historical.”2 On the one hand, “end” refers to the termination of something. In “inner-historical” terms, all things under the sun—and the sun itself—bear within themselves the conditions that will lead, sooner or later, to their ending. On the other hand, however, “end” connotes goal, purpose, intention, aim— in Greek, telos. Hence that most famous of Protestant catechismal questions, “What is the chief end of man?” The teleological end of an acorn is to become an oak; and that “transcendent” purpose is also contained within the structure and substance of the acorn. In a real sense, therefore, disintegration and integration, destruction and fulfillment , death and life are present in every organism. Thinking about “the end” of life, when it is profound, is always a matter of reflection on both terminus and telos, both the winding-down and the intimation of purpose, both defeat in the frantic struggle to survive and the possibility of victory in the quest for life’s meaning.
The End as Terminus My encounter with the wily and versatile crab, cancer, has involved a good deal of meditation on both sides of this dialectic. The one side—termination—is obvious enough. In a society where cancer plays such a decisive role in ending human life, you cannot become its subject and victim without facing the prospect of your life’s termination. It may be that, in the future, cancer will be made to play a less prominent role in conducting human beings to the grave; for there will no doubt be many more breakthroughs in the treatment of its various manifestations—many such have already changed the treatment of and attitudes toward this dread disease. Yet we are mortal— how often during these months have I thought of the famous syllogism of classical texts on logic:
All men are mortal Socrates is a man Therefore Socrates is mortal
Overlooking for the moment the sexism of the syllogism (all women are mortal, too), just try substituting your own name for that of Socrates. If you have cancer, you won ‘ t have as much difficulty doing that. The sheer/aci of one’s finitude is now unavoidable. You’ve known it all along, of course. It has been haunting you for years, perhaps since the earliest glimmerings of self-awareness. But now it stares you in the face: I will die. Despite my knowledge of the fact that “all flesh is grass,” I’ve been acting, really, as if my life would go on and on—”world without end,” so to speak. I’ve based almost my whole lifestyle on that assumption, and every impulse of our consumer-culture has aided and abetted me in this self-deception. Well, naturally, I realized that I would die sometime. Everybody does. But in the Modern period the statistics of life-expectancy have created for me—for most of us, I think—the illusion of a kind of secular immortality. To the fifty-year old, seventy-eight (or whatever life-expectancy is at the
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moment) can still seem way off, and ninety a virtual eternity! But the actual presence of cancer turns all such statistical eschatology into dust and ashes. The general assumption of mortality becomes the sure and certain knowledge of one’s own perhaps imminent end. It cannot be repressed any longer. It flashes like an old-fashioned neon hotel sign on the inner screen of the mind. “Every morning I wake up thinking ‘I’ve got cancer,’ and it will soon kill me,” said a late friend of mine. To be sure, cancer may not always be the catalyst of our dread of non-being that it is now. One hopes for its reduction, and especially of those forms of cancer that affect the young. But the rhetoric of our “official optimism” can be very deceptive. The Republican administration of the U.S., which has a penchant for declaring “war” on nebulous and evasive enemies like drugs and terrorism, also, under Richard Nixon, declared war on cancer. War seems an inappropriate metaphor for dealing with all such elusive threats to human and societal well-being; but if the unsophisticated mind needs these dramatic categories to tackle such threats, I suppose one must bear with it. In the process of conducting such “wars,” however, a dangerous illusion is often courted: that the righteous warrior will bring about a state where these threats exist no longer—and that in the attempt to do so he will usher in a state worse than before. In the case of the “war on cancer,” it is all-too-easy to move from the assumption that cancer can be beaten to the assumption that death itself can be beaten. And that assumption really is dangerous, because it is blatantly illusory. So far as the body is concerned (and for Christians, unlike dualists, “body” connotes “self), termination is a given. We are (as Heidegger rather roughly stated the matter) “being-towards-death.” For the present at least, “cancer” is a prime factor in the eschatology of the body. Facing the fact of one’s own mortality is never a welcome experience, even for seventy-seven year olds; yet neither is it the worst thing that could ever happen to us. Much worse, surely, from both a human and a Christian perspective, would be never facing that reality. Individuals and whole societies devote enormous energy to the task of repressing the knowledge of mortality. Ernest Becker, in one of the best books of our era, argued that our own present culture in North America is a culture so dedicated to “the denial of death” that its life is vastly and deleteriously affected, its energies depleted, its enjoyment of existence blunted and artificial, its vaunted “pursuit of happiness” forced and pathetic.3 Could one ever apply the term “maturity,” or even “adulthood,” to an individual who by circumstance or design never gave a thought to death? The experience, which cancer inevitably brings, of having to consider death at close range, is thus seldom a purely negative one. It is at least potentially salutary in the degree to which it brings one a little closer to the fullness of humanity for which our Creator intends us. Endings of nearly every kind can produce in most human beings a surprising capacity for truth; and theologically as well as humanly speaking, becoming truthful is a condition greatly to be desired—even when the truth one has to confront is apparently a negating or humiliating one. If, as I suggested earlier, persons, like institutions, become especially interesting and often remarkable as they face their own terminus, it is at least partly because they are in some measure relieved, by death’s proximity, of the consuming illusions and untruths on whose basis they have conducted so much of their own lives. They find themselves being made real as they disburden themselves of so much of the superfluous unreality they have been carrying about on their shoulders. What is essential, like the love of those around them,
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or the true vocation that has beckoned them, or the sheer beauty of the world, shakes itself free of all the superficiality and sham—the accidens, the medievals would have said—that have nevertheless consumed so much of one’s time and energy. Even as terminus, then, “the end” has—or can have—a highly clarifying effect on those who are grasped by it.
The End as Telos But this positive function of the-end-as-terminus is never, I think, entirely separable from the other side of this same coin, the-end-as-te/as (aim, goal, purpose). Though they are theoretically different and distinguishable, I suspect that the two connotations of “end” are, in practice, never quite separable. Thanks to Johannes Brahms, whose wonderful work Ein Deutsches Requiem gives a decidedly Protestant slant to the Catholic practice of having masses for the dead, I have learned something that seems to me quite vital about the strange interconnectedness of these two meanings of the little word, “end.” In keeping with his determination to use only the Old and New Testament scriptures for all the words of the requiem, Brahms bases the third major section of his oratory on the first four verses of Psalm 39. But of course he uses Luther’s translation, which in this respect differs significantly from the King James and most of the later English versions of the text. The latter (which is virtually the same as the KJV in all the editions I examined) reads, “Lord, make me to know mine end, and the measure of my days, what it is; that I may know how frail I am (v. 4, KJV). The German text, however, introduces an important nuance,
Herr, lehre doch mich, Dass ein End emit mir haben muss, Und mein Leben ein Ziel hat Und ich davon muss.
(Roughly translated: “Lord, teach me, even me, that there must be an end [terminus] to what I call me, and that my life has an end [goal, purpose—Ziel] of which I must surely become conscious”). The point is, here we have both meanings of the concept, “end,” juxtaposed in one overarching thought: my life has its quite natural and necessary ending, but even including this ending it contains a purpose that it is my responsibility and privilege as a thinking animal to contemplate as deeply as I can. “…mein Leben ein Ziel haf Whether Luther got the Hebrew right, I will leave to others more qualified in that department. I know he got the theology right, and I wish the English translators had had his insight. For it is impossible, surely, to consider the termination of life (not only, but especially one’s own life) without being driven to ask, “And what purpose, if any, does this life that I have been living have? What’s the object? What’s the use of it? Is it, and all history, just ‘a tale told by an idiot,’ or does it have some perceivable goal?” During these past several months, I have found myself turning with ever greater interest to the past—the past as I have experienced it—my past. In fact, I have been drawn into retrospective meditation more than ever before in my life. I completed the final draft of a sort of theo-autobiography while under this influence4, and I have continued writing an extensive, more personal autobiography that I do not intend for publication—just for myself and those closest to me. Of course, I have the usual
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activist’s misgivings about spending so much time thinking about the past, and the usual “Christian” compunctions about concentrating so narrowly in the self. But it is the only self I shall ever have, and most of its journey through time has already taken place. Moreover, I am struck with this insistent, this (may I not say?) incarnationalbelief that if purpose is to be found it must be there—at least hiddenly, implicitly, partially— in the journey itself. In defiance of the kind of religion that reserves meaning for the journey ‘ s end—for “heaven”—I am convicted of the more frustrating belief that there must at least be intimations of purpose in the journey itself. I am certainly ready to wait for a final judgment about the course my life has taken, but I am not ready to give up on the capacity of reason, illumined by faith, to glimpse life’s goal already in medias res—in the middle of things. Just at the point where the future seems brief, and perhaps bleak, the past, revisited, becomes a new source of …possibility. I remember therefore I am. I remember therefore I hope. I remember in order to give my hope substance. There is a picture above my bed that I find myself contemplating very often now. It is an enlargement of a faded photograph showing a small family standing beside their stone house in old Ontario—father, mother, and two-year old son. It is the year 1930, and the clothing of the little group reflects that fact. Like most of their contemporaries, they have been hit hard by the Great Depression, and the young parents’ faces reveal something ofthat reality. Yet they stand together, leaning in toward one another. And if the parents are anxious about the future, the little boy doesn’t seem to be. His face is full of curiosity. Why should he be anxious? He is standing on a rock that is more dependable than the great granite stones of the house in the background: the rock of his parents’ love and delight in his being. I was that little boy. And as I try to trace, in memory, the course of my life from childhood on, I become conscious again and again of the secret that is already present in that photograph, for remembering reveals that it has been manifested many times over. And it is this: I have been accompanied, befriended, upheld, supported, in short—loved— all the way through. The persons who mediated that love—old ladies and gentlemen of my youth, friends, teachers, colleagues, students, strangers, my wife and children—were and are themselves needy souls; their love was not sufficient by itself to sustain me, any more than my love was sufficient to sustain them. But through this great admixture of actions and reactions, flawed motives and noble outcomes, imperfect loyalties and exceptional trust—through this great, continuing mixture of things that we call life, a love has been communicated to me that incorporates while it transcends all the relationships in which it has incarnated itself. I see this now (I have not always seen it) as I remember my past, as I relive in memory the great and small moments of my journey through time. And in that recall I recover something of the magnificence of the end, the telos, the Ziel, toward which I have been moving all this while. For that end is nothing more, nor less, than the full and no-longer-ambiguous and halfhearted acceptance and appropriation ofthat same divine love. How could I imagine that I will be left all alone and unfriended in death when from the earliest days I have been accompanied by a love that I neither fabricated nor ever wholly deserved? No, nothing will separate me from that love (Romans 8). That is the end toward which I have always been moved, even when I resisted it, and death cannot alter that trajectory any more than life has done.
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In Practical Terms Having indulged myself in such a grand affirmation, which I suppose many will think uncharacteristic of me, I feel the need to—no, not to qualify the affirmation, but to translate it, just a little, into practical terms. Not every life gives the extent and degree of evidence for transcendent love that I have been finding, lately, in my own. I know individuals, and I am aware of whole populations that seem to exist in an almost complete vacuum of care, or whose suffering so far exceeds anything by way of pain known to me that I am reduced to speechlessness as I think of them. The affirmation of divine love as the meaning and end of existence can never be made easily, even by those who, like me, have experienced wondrous intimations of that love in their personal journeys. The affirmation of divine love as life’s goal is always an affirmation of faith, not of pure sight. For life in its raw day-by-dayness always holds enough evidence of the antithesis of such an affirmation as to render the affirmation, whenever it is made, a leap of faith. Yet memory is strangely able, when prompted by a Spirit that transcends the here and now, to detect patterns and meanings and mysteries that elude the eyes of the flesh in their necessary confinement to the present and the visible. It is one thing to consider one’s life as it unfolds day after day, year after year; it is something else to meditate upon it, under the impact of a felt proximity to its ending, in its whole movement. Many lives, viewed in terms of their externalities, seem to those more fortunate devoid of meaning and hope. But I have known few persons well who, though surrounded by all the makings of despair, could not be helped to discern in the course of their lives intimations of something like transcendence. It was, after all, not some naive and shallow optimist or bourgeois devotee of “happiness” but the poet Job, humiliated and brought low by life, who, with the promptings of that same sharp Spirit, had to conclude:
For I know that my Redeemer lives, and that at the last he will stand upon the earth; and after my skin has been thus destroyed, then in my flesh I shall see God. (19:25-26, NRSV)
Job’s “friends” tried—and they still try—to quicken the stricken man’s conscience by prompting him to remember what ill he has done to deserve this apparent punishment. Real pastors also try to prompt the memory of their ill and dispirited friends; but they do not ask them to uncover and admit the wrong of their lives; rather, they encourage them to remember the good, the beautiful and the true that, in the actual living of their lives, they may well have missed or underestimated. I have been struck, lately, by the fact that not only I myself, but many of my friends and acquaintances, facing death in one or other of its many guises, have found themselves reflecting long and deeply on their past, to the point, in some cases, of actually writing autobiographies or memoirs. The pastoral conclusions that should be drawn from this (as I would call it) “tendency” are clear enough: in your counseling of those confronting their own end give them, first, the opportunity of speaking openly and freely about death and dying; do not think that you, along with all the others who surround them, must continue the fiction of living on and on! Our faith allows and enables us to become truthful, particularly just at this point.
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Second, encourage them to reflect—in whatever ways are natural to them—on their past. Draw them out, ask leading questions, repeat for them some of their own words as they tell their stories—for often we do not hear what we ourselves are saying. Let them talk! So much in their environment, especially now that they are singled out by the grim reaper, wants them to be quiet! Because when they are allowed to speak they inevitably speak as men and women who know they have come close to the end of their stories, and that threatens the living who live by the repression of just that thought. But they will only discover real hope, these who have fallen prey to “the crab,” if they are able to rehearse their lives with sufficient freedom to see, hear, and feel in memory what they could not experience fully in the happening. Be, for them, the occasion through which they may sense at last the steadfastness of the providence and love of God. Let them discover for themselves the faith that the destiny of our bodies— that is, of our very selves—rests in the amazing grace of the One who made us and who has never been very far from us.
Notes
1. “Cancer Facts & Figures 2005,” American Cancer Society, 2005. 2. Paul Tillich, Systematic Theology, vol. iii (Chicago: University of Chicago Press, 1963), 394. 3. The Denial of Death (New York: The Free Press, 1973). 4. Bound and Free: A Theologian’s Journey (Minneapolis: Fortress Press, 2005).
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