Saturday, March 14, 2009

Joy, and light, and life

There’s an opportunity that I have no idea whether I’ll get—but that I really, really want. It would mean a year on the opposite coast, doing work that is completely up my alley, in a living situation that feeds me. All I’ve done is write to inquire about it, and I haven’t heard back. I can’t even say that I’ve properly applied. But I know that if they gave it to me, I’d go. My heart wants this.

The catch: I don’t know what it means for my healthcare. And I know exactly what I’m risking, if I let my coverage lapse.

I had an appointment with my oncologist yesterday; the usual check-up, every two months. He knows I’m graduating (eek!), and asked about my future plans.

“Well. That’s what I wanted to talk to you about.”
“Really? Why?”

I told him. And I asked him, “How scared do you get for me, hearing that?”

He was completely clear with me about how serious my history is, how uninsurable I am on the private market, and how my greatest medical need is access to surveillance. He told me where I am statistically (40/60 in my favor, against recurrence), and reminded me that the cancer could come back within five years, or out of nowhere fifteen years from now, or never—but that if I need care, I've got to have it. We talked a little bit about county safety nets. He knows there's no actual prosperity in urban ministry.

I’m going to ask on Monday, how expensive COBRA is. I doubt I could pay for it—so staying in California, in the name of stability, does not make me safe.

There is no safety, after cancer. My skin grew something, out of its own tissues, that could have killed me. I feared an invasion inside my own body. The illusion of safety is gone. There is love, and faith, and hope, and truth, and community, and joy. More freedom than I could have imagined. Safety no longer exists—and I don’t know, whether I miss it. It’s hard for me even to remember that innocence.

It's not replaced by a sense of danger, but by knowing that I don't know. And by a deep, cellular hunger for what is real, and bright, and vibrant, and connected, and alive.

The first place I went, when I was diagnosed, was my best friend’s couch. She loves me more than I know. She kept her own fear from me, for weeks. And I knew even then, that she could not protect me. God cannot protect me. I cannot protect me.

Because cancer had not invaded me yet, my surgeon could protect me. But almost a year later, I’m still in treatment, because we can’t be absolutely sure.

I could be free and clear forever. I could have recurrences that mean periodic cutting things out of my skin, and going through the whole panic again about what is or might be in me. I could have a fatal recurrence, not discovered until I’m physically sick, sore, or confused. I will not forget, ever, my first oncologist’s words to me, explaining the order, and likelihood, of possible metastasis: “Lungs, liver, bones, brain.”

Margaret knows: “As a cancer survivor, sister death is always as close as my shadow.”

And I also know, and my doctor repeated, that we never know what's in front of us. I know that I could never listen well enough, or be faithful enough, or be good enough, to keep me safe from cancer. I can follow God and my heart perfectly, and still get sick. This is the world we live in. What I know, is that I am healthy right now.

There is more than freedom in that. There is joy, and light, and life.

He came back again to his bottom line:

"Make choices that protect yourself, when you can. And do what makes you happy in your life."

It's the best advice I ever could have gotten.

What sparked this conversation—the opportunity I would jump at—may or may not actually happen. But this is the way I make choices. The same argument led me to seminary (which ultimately, because health insurance came with it, could have saved my life). My head knows that caution is a losing battle, when my heart says, "Go." And I really wanted to see, what I'm risking when I trust it. And to know whether I would do it, when the cost is more than student debt.

The answer is yes.

I know that fear. I shuddered again, when he gave me the stats that I asked for. And I know, as well as I've ever known anything, that choosing from that toxic, paralyzed place leads to entombment while you are alive.

I understand now, what I only wished for when I was well. I love this life, enough to truly live it.

I had to go through cancer, to get that. And now, this life is mine.

I'll see the doctor again in late June, after I'm done with interferon.


Joan Calvin said...

I pray for the day no one has to worry about health care; when no one has to make difficult choices based on whether one has or can get health insurance.

The possibility of death is very real with cancer and without health insurance.

Kirstin said...

Yes, I know. And I'm not done with the thinking and praying.

But I do know that I would risk being really alive.

Thank you.