A chair with a view

WindowI lucked out the other day at the Infusion Center.

Jeannette found me a chair in a quiet corner, with no loud TV viewers in close proximity, and on an end with a window. To make things even better, it was in the realm of Barb, one of the compassionate veteran oncology nurses who always get the needle in the vein on the first try. Jeannette, the nurse in charge of the center, remembers me from the original cancer, and is unaccountably fond of me.

The first time I saw the center, it was after hours. Deserted in the late afternoon, unlit in the slanting sunlight, it was a little eerie. I walked in, looked around, and shuddered, the kind of shudder old-timers explain as the result of someone walking over your grave. The first time I had a treatment there, I entered feeling fine, but had to be helped out of my chair, thanks to the cherry-Kool-Aid-colored drug cocktail the nurses call “the Red Devil.” Inflammatory Breast Carcinoma is a particularly nasty and aggressive cancer, and requires a treatment to match.

This one is, in comparison, a piece of cake with extra frosting. The cancer is Stage 4 – the IBC decided on a return engagement in my sacrum – but the treatment is relatively easy. I take a pill every morning with my breakfast; once a week I take a Mystery Pill, part of a clinical study. Is it the real deal, or a placebo? I suspect the former, but even my oncologist doesn’t know. Once a quarter, I have scans to be sure that the cancer is behaving itself. Once a month, I get an infusion, a bone-building drug, delivered via IV. It leaves me feeling a little flu-ish for a couple of days.

I would doubtless have bitched and moaned at length about something like this Before Cancer; now, a veteran of much harsher treatments, I shrug it off. It’s not chemo; I’m not sick; I have hair; my brain is unfogged. How can I complain?

Now I focus on gratitude: gratitude for the researchers who have made it possible for me to survive this long with such a good quality of life, gratitude for my caring doctors, gratitude for the best phlebotomist I have ever had the pleasure to encounter, gratitude for the careful, caring nurses who even laugh at my jokes. I’m grateful for the friendly volunteer, a retired EEOC lawyer, who passed around the Girl Scout cookies (Thin Mints!) she discovered in a cabinet, and for all those who smile back when I smile at them. I’m grateful for a window to see a blooming garden on a sunny day in May. I’m grateful for the boss who gives me the time I need for my treatments. I’m grateful to God for giving me more time, however long that turns out to be.

The cancer has changed me, in more than physical ways, in good and caring ways. In that sense, even a deadly cancer can contain a blessing. I savor the view through the window, and say a prayer of thanks.

– Sarah Bryan Miller

‘It’s déjà vu all over again’

I don’t dwell on it.

I don’t care to be defined by the disease. I do not claim it as my own. I declined to put a pink ribbon magnet on my car. I wear my screaming pink “Survivor” T-shirt from the Komen walk only when everything else is in the wash.

Still, I can’t forget that I had breast cancer. The reminders are as close as the scars I bear, and the tiny tattoo on my sternum that helped  the radiation techs calibrate precisely where to blast me. They are as close as the pill bottle on my nightstand that contains the unpleasant maintenance meds I have to take when I awake each morning.

And now it’s back.  As the late Yogi Berra famously misspoke, “It’s déjà vu all over again.”

Actually, that cancer is not back, which is a blessing; the oncologist tells me that if it shows up again, the end will be in sight. No, it’s a new and different breast cancer: ductal, not lobular; early stages, not late. The refrain has changed, but the song remains the same.

Frankly, I’m annoyed. It’s too soon: almost exactly two years after my first diagnosis. I haven’t had a chance to recover fully. My friends, a wonderful, generous, giving group who provided a life-saving support system, haven’t had a chance to recover fully.  I have work to do. But life is indifferent to our schedules.

This time is easier, in that I know what to expect, like an ex-con returning to the pen. My medical team, one of the best in the world, is already in place. The treatment should be simpler and less debilitating. If the cancer has not spread, I can avoid chemo; if it has spread, the chemo won’t be as bad as last time. If I undergo the surgery – a “simple bilateral mastectomy” – radiation treatment will not be necessary.

More importantly, I have already been on the knife’s edge between life and death. I have felt the reassuring presence of Christ as I hovered on the verge of unconsciousness. I know that there is more than this world, that there is nothing to fear.

That doesn’t mean I’m going to go without a fight. I have promises to keep. I have things I need to do, and plans I intend to see through.

And so I try to maintain a balance between the tug of this world and the promise of the next, doing what I can in the here and now, but aware that my life here may end at any time. It’s a useful reminder: isn’t that how Christians are supposed to live every day?

– Sarah Bryan Miller

I have always loved this hymn. The words are from the 5th century, by Synesius of Cyrene; the translation was made by Allen William Chatfield in 1875. The tune, “Southwell”, is number 641 in The Hymnal 1982; Benjamin Britten made memorable use of it in his church opera “Noyes Fludde.”

Lord Jesus, think on me,
and purge away my sin;
from harmful passions set me free,
and make me pure within.

Lord Jesus, think on me,
with care and woe oppressed;
let me thy loving servant be,
and taste thy promised rest.

Lord Jesus, think on me,
nor let me go astray;
through darkness and perplexity
point thou the heavenly way.

Lord Jesus, think on me,
that, when the flood is passed,
I may the eternal brightness see,
and share thy joy at last.

Lord Jesus, think on me,
that I may sing above
to Father, Holy Ghost and thee
the songs of praise and love.



Sermon notes: From the mountaintop

Sermon notes, Last Epiphany, Year B (Preached at St. Peter’s Episcopal Church, 2/19/12)

There’s something about a mountaintop.

There’s something about the achievement of the climbing in itself, of making your way upward over steep, difficult ground. And there’s something fulfilling about being at the top: the sense of accomplishment, the views, the sensation of being closer to heaven.

It’s no wonder that mountains have such an important place in ancient religions. The Greek gods, you will recall, had their headquarters on Mount Olympus. The Tibetans believed that gods lived on every one of the mountains in that very mountainous region. And, of course, mountains figure heavily in both the Hebrew Bible and the New Testament.

Noah’s ark came to rest on Mount Ararat. God spoke to Moses on the heights of Mount Sinai, and showed him the Promised Land from the heights. The Devil tempted Jesus by taking him to the top of a high mountain, showing him the kingdoms of the world, and offering it all to him – if only Jesus would worship Satan.

In today’s Gospel reading from Mark, Jesus and three of his disciples have the ultimate mountaintop experience. After a long, tiring uphill slog, Peter, James, and John see Jesus transfigured, his clothes turned a dazzling white. They see Jesus talking with two great prophets, Moses and Elijah, whom, it was believed, God had spared from a normal death. They hear a voice from a cloud above them saying, “This is my Son, the Beloved; listen to him!”

It’s an incredible moment. It provides proof to the apostles of Jesus’s relationship to God, of the nature of that relationship. Everything becomes clear to them.

But they can’t stay on the mountaintop. They cannot remain in that moment of transcendence. They have to come back down again.

The Transfiguration is not only about the struggle to climb the mountain, and what was encountered at the peak. The moment is also about returning from the mountain, and what is brought along. A treacherously steep path can sometimes be harder to descend than it was to ascend. In the exertion of getting back down safely, and the worry about what will be encountered along the way, the wonder of the mountaintop moment can sometimes be pushed to the back of the mind.

The disciples have to return to all the troubles of the ordinary world, where the sick and needy push and clamor for Jesus’s touch, where the hopeful are looking for a different sort of messiah, where religious leaders regard them with anger and suspicion, and where the Roman authorities and their collaborators would just as soon beat them as look at them.

They have to return in the knowledge that Jesus will soon suffer and die on the cross. His assurances that he will rise again from the dead are probably not much comfort. But they have that transcendent experience, that mountaintop moment, to cling to.

We have mountaintop moments, too. What’s more, we don’t need to go to an actual mountaintop in order to experience one. A mountaintop moment brings a sudden clarity, a new and deeper understanding. It’s an epiphany that casts a fresh and brilliant light on life, a  “Eureka!” when the pieces of the puzzle fall into place.

Episcopalians aren’t much for talking about these things, but I have been blessed with several moments of that peculiar clarity. Two stand out.

One of them occurred when I was a teenager. My family had just pulled up stakes and made a difficult move to another part of the country where we knew no one. I wasn’t happy about anything in my life. I had recently decided that I was an atheist.

But there I was in our new church’s choirloft on Christmas Eve, gazing at the altar just before the consecration, when suddenly the very air seemed golden, and I knew, with absolute certainty, that God exists and that God cares for me and for all of us. I don’t know how long the moment lasted – I know I didn’t miss the choir’s next entrance – but I have carried it with me ever since.  (That was also, incidentally, the end of the atheistic phase.)

I had another moment almost a year ago, during what seemed like an endless course of chemotherapy. I was terribly sick and getting sicker, and my doctors were running out of ideas. I realized that I might well die soon, and I prayed for peace and grace, and for acceptance.

At that moment I felt Jesus’s presence. At that moment of crystalline certainty, I knew that, whatever happened, it would be all right – that whatever happened, it was not the end.

Those moments of true understanding aren’t that frequent. God seems to hand them out sparingly. Once we’ve experienced the purity of vision we find in the mountaintop experience, it can be very hard to return to sea level, to the struggles and pain of everyday life.

But we can’t stay on the mountaintop. The air is too thin; the sun is too harsh. This is where we live, in the clamor of daily life.

Jesus and the disciples came down from the mountain and started making their way to Calvary and the cross. When we follow Jesus, we may join him on the mountaintop, but like the disciples, we will also experience low points along the way. That discipleship comes at a cost, but it brings with it the greatest of rewards. Thanks be to God.

– Sarah Bryan Miller


I’m nearly through the third and final stage of my cancer treatment. Five mornings each week I leave the house at a little past 7, drive to the hospital, and get nuked.

Radiation oncology is just down the hall from the chemotherapy infusion center, but the two are very different; instead of sitting for hours with an IV drip, I’m in and out in less than 20 minutes.

The machine that zaps me is the medical equivalent of a combination fax-phone-printer: It takes X-rays, sends the images to the technicians, and then delivers a dose of carefully calibrated, carefully aimed radiation to my breast.

I receive it while lying on a hard narrow board, my head on a sort of padded doughnut, my arms above my head in special frames. My job is to lie very still, something that’s easier if I don’t think about it.

The radiation burns my skin and makes me tired. If I’d had it first I’d have groused about the side effects, but my attitudes about what’s difficult have changed considerably since chemo.

In a matter of days it will all be over. Meanwhile, thin fine hair like an infant’s is sprouting atop my head, giving me hope that I’ll soon have enough to comb ; the beginnings of eyebrows have appeared, and my eyelashes are almost back to normal.

“This time next year, it will just be a bad memory,” say well-meaning acquaintances. Perhaps, but the cancer has changed me forever,  physically,  spiritually, and emotionally. I will never take my life and abilities for granted again, nor the lives of those around me. This life is a great gift from God. I intend to use it wisely.

– Sarah Bryan Miller

The pathology report

The phone rang just after noon on Sunday. It was my surgeon, a man as kind as he is skillful: “Your pathology report found its way to my office over the weekend,” he said, “and I didn’t want to make you wait any longer for the results.”

I suspect he also wanted the pleasure of personally delivering the unalloyed good news that the cancer was dead and gone, so thoroughly departed that only microscopic traces of the tumor remained in tissues that once harbored five deadly centimeters of pure ugly aggressive malignancy. The tissue margins were clear. The lymph nodes were clear. The chemo worked, and all of the struggles of the last six months were worthwhile.

My oncologist has used words like “astounding” and “amazing” to describe the tumor’s response to treatment right from the start. The chemo worked, but I believe there’s more to it than that.

The other thing working on the tumor from the beginning was prayer: the prayers of family, friends, and colleagues, the prayers of my own parish and my father’s, prayers offered by other churches, synagogues, and religious communities, the prayers of online friends and people I don’t know.

My mother used to say that she could feel it when people prayed for her. I feel it too, a kind of lightening and buoying up, a reassurance of the love, faith, and concern of others.

Attempts by researchers to study the effects of prayer on the sick have, unsurprisingly, yielded mixed results, and I do not pretend to know why some prayers are answered and others don’t seem to be. For now, I am simply grateful for the knowledge and skill of my doctors and nurses, and for the mercy of God in this miraculous gift of healing.

– Sarah Bryan Miller