November 4: Living by Grace

I've been talking to my wife and to friends about bravery a bit, though my talking to friends has been by email and text mostly. My neutrophil count is zero, so I'm limiting human contact. In fact, I'm limiting contact, period. I touch as little as possible with my hands, and if I notice that I've touched something that someone else could have touched, then I wash my hands.

Hillside at the Grande View apartments

Back when I was going straight to transplant, before I had the third round of chemotherapy, Nurse Works told me, "If the first round kicked your butt, this transplant round will really kick your butt!"

Well, the first round didn't really kick my butt. Except the hemorrhoids, it was remarkably easy, even with a couple fevers from an infection from the PICC line. Thus, while her warning got me prepared, it didn't frighten me much.

The third round, however ... Now that kicked my butt. It's not the horrible cramps and muscle pains, though those were the worst actual pain. I barely remember those. It was whatever the Cytarabine did to my brain. It was miserable, unpleasant. When the other nurse, Meghan, saw me on Monday, she almost looked relieved versus the Friday before. "You seem yourself," she said.

Yeah, no doubt. The Cytarabine didn't really kick my butt; it kicked my brain.

So now, the thought of another round of chemotherapy, with the almost certainty of bad hemorrhoids, which I had again this time, and the potential of facing Cytarabine again, plus probably three more spinal taps ahead, is frightening. On top of that, the chances are good that I will get six total body irradiations. Picture a sunburn in your esophagus. Have you ever had heartburn? Picture heartburn, then getting a sunburn in your esophagus, and then going back the next day to get a new sunburn!

"Pain medication will be your friend," Nurse Works said.

Note: I really like "Nurse Works," and in person I call her by her first name, Esta. She is very nice, inspires confidence, and nothing negative is implied by "Nurse Works." I just like the name.

So I started to get a little bit frightened.

Now, I wasn't too worried about being brave. The most certain source of bravery is necessity. Based on my research, which is considerably less than that of the doctors here at Vanderbilt, I agree with their assessment that my likelihood of relapse, apart from the marrow transplant, is 99.9%. I have no choice. Now, I could ask for a reduced intensity transplant. Then I would get a little bit less chemo, enough not to frighten me, and only one dose of radiation rather than six. That would not frighten me. Walk in the park.

If I did the reduced intensity, the "non-myeloablative" transplant, no one knows the odds that I would relapse. I'm pretty sure that the doctors would advise against it but that they would agree to it.

It doesn't seem wise to me. My leukemia wandered all over my body out of my blood. It went to my spinal fluid, my lymph nodes, and my spleen. Our best shot at getting all of it before we install a new blood system seems wise to me, and before God, I'm comfortable with that. (It's still amazing to me how the whole process works!) If you know me, please pray that's a wise decision. I'd be open to you telling me you've got something from God thinking I should do otherwise.

Anyway, the point is, I was getting nervous about the pain in my future, though I knew I had no choice but to simply face it, even if I was a whimpering coward, though I was somewhat confident that I wouldn't whimper. It's not that I'm particularly brave, but I know that whimpering and timidity just makes everything worse. At some point, I would have to pluck up my courage, announce "I'm going to do this and do it well," and get on with it.

Until then, there was a lingering nervousness in my gut, if not in my Spirit.

My wife's been assuring me that I didn't need grace last week, I would only need it when the time came. She wasn't worried about me. God would come through.

I'm really not used to living nervously, and I don't like it. So yesterday, when I got a text from a friend asking how it was with my soul, I told him I could use some prayer for bravery and faith.

Now this is not any friend. This is a pastor from Uganda who's traveling in the U.S. for a while. I've spent a lot of hours with him, and I once drove him from Tennessee down to Florida. We picked up a hitchhiker together who had just gotten out of prison for a double homicide. We have a certain connection!

Anyway, later that day, I was walking. I got a phone call from a Memphis number I didn't recognize. I answered it, but the person just hung up. Wrong number, I assume. Then I looked up, and I saw the fall foliage on the hillside by our apartment, and there was something inspiring about it. "Thank you, Father, for this grand adventure," I prayed.

The most amazing thing happened. Every bit of nervousness just melted away. This joy came down on my heart, and I immediately sent a text to Wilberforce, the Ugandan pastor. "You been praying for me?" I asked. He answered, "Of course. Praise God."

I mention the phone call from Memphis because it gives me, on my phone, the exact time that happened, which was 5:13 pm yesterday. So if you were praying for me just before supper yesterday, you can take credit for really effective prayer.

So today, even after typing out everything I typed out above, I feel great.

It really is a grand adventure.