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CHAPTER 1
I was alone when I learned I was going to die.
The doctor who told me was a stranger. Until that moment, I had not been to a primary care doctor in more than twenty years.
But abdominal cramps had been plaguing me. They had come suddenly in the night three months earlier while my daughter Stefanie and I were in India. Through our local Episcopal church we learned of a Swedish woman who'd started teaching poor and orphaned children in her apartment outside Chennai, India. After a dozen years, the school had grown to two hundred children. She relied on volunteers to help and needed someone to teach English. Stefanie had taken a gap year to travel and work before starting college. So she ordered Hooked on Phonics and bought a small portable CD player, and we both volunteered for two months.
I thought the cramping and diarrhea were bowel issues relating to diet in a remote country, or possibly a parasite, and didn't think much more about it. And yet, on the long flight home, as we struggled to get comfortable in the cramped tourist-class seats, Stefanie asked to lay her head in my lap. The pressure of her head against my lower pelvis was so painful I had to ask her to sit up.
Once home, the cramping and diarrhea continued, but I considered it more of a nuisance than a serious problem. I was fifty-five years old; I had always been robustly healthy with boundless energy, and I was careful to eat nutritious, organic food. I exercised daily, doing yoga, lifting weights at the gym, or walking along the beaches and in the canyons around San Diego where we lived.
I was healthy. I was sure of it.
A few weeks after returning from India, my younger sister Juanita came to visit. We were planning to take a road trip to visit an elderly and ailing uncle, our mother's last living brother. On the six-hundred-mile road trip, my pain became unbearable. After the first day, I could hardly sit still, constantly adjusting my position while driving, trying to lengthen and expand my body for temporary relief from cramping and back pain. At night, I soaked in a hot bath and slept with legs elevated and knees bent to relieve the pressure in my lower pelvis.
Juanita looked at me in the morning and said, "Edie, this isn't normal. There is something seriously wrong."
I promised to visit a doctor as soon as we got back to San Diego.
I looked online and found one who took new patients, though his first appointment was three months away. I booked the first appointment available and gave the receptionist my symptoms.
His physician assistant, Jane Davidson, called me within an hour. I must have said something to alarm her, I thought when I heard her on the other end of the phone.
She asked me to come into the office. As I stood on the scale, I stared at the number in shock. I weighed 20 percent less than my normal weight. I had always been tall and slender, but now I was skinny and bone thin. We did blood tests and urine analysis. I went home hoping for more news. Jane called me in again the next day, this time for an abdominal ultrasound.
It seemed this investigation was far from over.
The ultrasound technician was interested in yoga and, as she moved the ultrasound wand over my abdomen, was talkative and curious, asking me about beginner classes and teachers. Suddenly, she stopped talking and became quiet and serious. After a few minutes of continued probing, she stopped the ultrasound without any explanation and left the room.
It seemed like a long time before she came back into the darkened room with the radiologist. They both sat down beside me and together continued probing my abdomen. They spoke in hushed whispers: "See that?" "Look closer at this." They finished about an hour later.
Before he left the room, the radiologist squeezed my shoulder. I asked the technician if everything was okay. She would say no more than, "There are a few things we would like your doctor to take a look at."
That night, Jane called me at home and asked if I could come to the clinic the next morning for a pelvic ultrasound. She had also scheduled a CT scan right after lunch.
We were going on day three of what I had thought would be a simple checkup.
I didn't sleep well that night, tossing and turning and going over everything I could remember about the abdominal ultrasound, and not liking where my fears were taking me. The house was quiet, with children off at college and working, and my husband, Dale, across the ocean in Ukraine, on a business trip for the company we had recently founded together. I was grateful my family wasn't here for this long waiting game. Much easier to laugh about the scare I had after this was all over.
The pelvic ultrasound was quick, a much more pleasant procedure than the CT scan that followed. I had to sit outside in the cold basement lobby and drink two large containers of contrast solution. It was two hours before the scan, and it took the entire time to drink the awful-tasting fluid. I almost gagged on each small sip. My bladder was bursting full, and I was not allowed to go to the restroom.
The next morning, my life changed forever.
Dr. Murad walked in and shook my hand. He looked confused to see me sitting there alone.
"Where is your family?" he asked gently.
"Two children are away at college, another has taken a year off before starting college and is working. My husband is in Ukraine with a software development team putting together a new business," I replied, searching his face, fearful of what might be behind his question. "Why?"
"You need to call them immediately and have them come home," he said, dodging my direct gaze and question.
I clenched my fists, unsure of what that meant.
"Why?" I asked again, my voice not so strong.
He closed the folder he held in his hands and leaned forward over his desk. His eyes met mine.
"I'm sorry, Edie, but you have cancer."
It felt as if my heart skipped a beat, but then picked up again as usual, my trusting source of life. I took a deep breath as I tried to let its steady beat calm my anxious spirit.
I asked the only question I knew to ask next.
"Where?"
He didn't answer and seemed to be pondering the question, searching for the right way to answer.
I pressed on. "How much?"
He pursed his lips and looked at me with professional, yet soft, directness. "It is hard to determine exactly how much cancer there is and where it is, but the ultrasound and CT scan suggest it is your gallbladder."
I knew hardly anything about cancer, just enough to ask the most important question. "Has it spread?"
"Yes."
I took another deep breath. Just three days before, I had been arrogantly healthy and joyously happy. Now, here I was, in an unfamiliar room with a stranger, my new doctor, looking through images and test results in a fat file folder with my name on it. How could this be happening? I felt strangely removed from the conversation, as if watching from afar.
Dr. Murad's initial reluctance vanished, and he began to speak candidly, evidently resigned to having to help me face this news alone.
"You have cancer, lots of it," he said, no longer mincing words. "It appears the source may be your gallbladder, but there are multiple tumors in your liver and several other organs. You have a very large seventeen-centimeter solid mass within the peritoneum."
I wasn't exactly sure where the peritoneum was, nor did I care. I asked, "How big is seventeen centimeters?"
"Almost seven inches." He looked straight at me. "Edie, this is serious. You need to call your family home immediately."
He continued speaking, but I didn't hear anything further. I had spread my hands seven inches apart, and realized the tumor was as long as my abdomen. I couldn't take my eyes off the distance between my hands or connect with what he was saying.
I did hear him say that I should hear back from an oncologist that afternoon about getting scheduled for a liver biopsy. My gallbladder was black with cancer; there was no doubt there. But the gallbladder is tucked underneath the liver and is hard to biopsy. So having the biopsy from the liver would answer some essential questions about where the cancer started and what stage it was.
I somehow got from the office to my car and got in to drive home. But I soon found myself pulling over to the side of the road under a shade tree, next to an old tarnished mission bell hanging from a rusted pole curved at the top. I rolled down the window. I felt dazed, as if someone had just punched me in the face. I needed to connect with reality, to feel the wind on my face, and hear the quiet, comforting sounds of nature.
I breathed in. I breathed out. God was always in the stillness between breaths. I needed to find him now.
"Lord, have mercy on me," I prayed, and felt my breath slowly deepen as my heart stopped its frantic pounding. The morning was sunny with a gentle breeze. It was peaceful under the tree, quiet, with the soft rustle of wind moving the leaves. A narrow beam of sunlight flickered through the branches above the mission bell and into the open car window, and its warmth relaxed my clenched jaw. How could I die and leave this? This morning, I had been looking forward to a long life, eventual retirement, travel, grandchildren, and more, and then in a span of an hour, it all seemed to be ripped away. I looked around me at the stunning creation. I tried to absorb its beauty into every sick cell in my being.
I knew this news was devastating, but I'd been a fighter my whole life. It was not time to lie down and die. It was time to gather forces. Surrender was not an option. I was not going out without a fight.
CHAPTER 2
I was home from the appointment not ten minutes before I quickly dove into the rabbit hole of the Internet to learn exactly what I was faced with. I knew I needed to call Dale, my husband, but wanted to understand more, knowing the questions he would ask. I soon learned the gallbladder is a puny organ tucked under the liver and nestled close to the stomach, pancreas, colon, the hepatic artery, and the portal vein. Gallbladder cancer is a deadly and demonic form of the disease, spreading silently and viciously to other organs with few symptoms until cancer has taken control.
Gallbladder cancer preys on women; we are 75 percent of its victims, and 80 percent of us are diagnosed after cancer has spread beyond the gallbladder. My cancer was stage 4. There is no stage 5. My odds of surviving five years were less than 2 percent.
The diagnosis was a death sentence.
I was in for the fight of my life, for my life. It would take a miracle to make it through this, an enormous amount of luck, and help from a battalion of angels — family, friends, doctors, strangers, and departed loved ones.
I had no time to waste. There would be no second chances.
*
Dale was groggy with sleep when I finally reached him in Ukraine, and the telephone connection was weak. He couldn't hear me. I wasn't surprised. I could barely speak above a whisper. "You need to come home," was all I could say. I didn't want to say the word cancer. It was evil and repugnant. I wanted to keep it buried and not give it shape or power by uttering its name.
Dale was wide-awake now, and his voice was loud and fearful. "Has there been an accident? The girls ..." His voice cracked, and he was unable to complete the sentence.
"I have cancer."
There was silence on the other end, and then Dale's faint, whispered voice. "How bad is it?"
"Bad. Really bad," I replied, and I could say no more.
Dale started gearing up for the fight the minute he hung up the phone. It took him fifty hours to travel home to San Diego from Ukraine. Every minute he could get connected online he was researching gallbladder cancer and reading every published research article. I was too. We e-mailed back and forth almost the entire fifty hours. We decided to wait until he got home to call our children. We both needed time to digest what this meant and to determine what to do.
Alone for two long days waiting for Dale to get home, I found myself on my knees, praying for God's help to live with dignity and tranquility however short my life, for wisdom to face cancer factually and honestly, and for strength to deal with what was to come.
I took Mama's Bible down from the bookshelf and dusted it off. I grew up on a farm in Oklahoma, born in a decade when nature turned its fury on itself. The first years of my life were during some of the worst droughts in Oklahoma history. Though we were utterly, completely dependent on nature for our livelihood, Mama and Daddy knew better than to lose their faith or trust in God, or become bitter, or turn to drink. Daddy worked a little harder, and Mama used a little less. As a family, we accepted and adjusted. We prayed and patiently waited for a good year with spring rain and a bountiful harvest.
In both good times and bad, Daddy and Mama relied on God to provide. They showed me how to trust in God, to be flexible, and to moderate expectations. They taught me to be happy with what I have, to guard against blame, and to refrain from feeling sorry for myself. Now, facing cancer, I would remember the strength of my mother and father, and go forth with faith in God, but do my part to make the miracle happen.
Mama's Bible was one that she had given to James, my brother Edmond's son, when he was ten. Mama had raised James and his older brother, John, since they were babies, and she had ordered a large-print Bible for each of them so they could read them when they were old men with failing eyesight. Tragically, they died in a motorcycle accident on the way to school when James was fourteen and John was fifteen.
Mama died of a broken heart less than five years later. She was holding James's Bible when she passed. Edmond died of a broken spirit five years after Mama.
Now I held the Bible in my hands, closed my eyes, and tried to breathe in Mama's presence. She had been such a guiding force in my life, a woman who had come from nothing, but dared to dream, and instilled in her seven children that passion as well. She was a woman of faith and courage, and I knew I needed her strength as I faced this journey.
I slowly and prayerfully read Ecclesiastes, absorbing its ageless wisdom that there is a purpose and a season for everything under heaven. Life is but a short season to be lived joyously, whether one breath or many.
On the same bookshelf as Mama's Bible was a worn and dog-eared book saved from my college days, the classic Manual of Epictetus, compiled from Stoic teachings in the second century. I took it down from the shelf and smiled at his persistent reminders that few things are within our control. Death is not one of them. How we choose to live life is.
As I read Ecclesiastes and Epictetus, I felt spiritually strong and mentally ready to deal with whatever was to come. Acceptance of death and cancer did not mean I intended to give up, just the opposite. I was prepared to fight cancer not out of fear of dying, but out of joy of living.
*
By the time Dale walked in the front door, we knew the top oncologists and research hospitals in the country. We also recognized that we had made two decisions years earlier that made our battle plan easier.
Two years before, we had purchased a catastrophic health insurance policy providing PPO coverage for our family. This meant I could go to any doctor in any state for treatment, and the policy paid for unlimited treatment regardless of cost after we paid the annual deductible. The PPO meant freedom to choose. In catastrophic illness, freedom or lack of it predetermines destiny.
Ten years earlier, I had purchased a life insurance policy with an accelerated death benefit that paid 50 percent of the policy if I were diagnosed with a terminal illness with a high probability of death in fewer than six months. Within three weeks of my diagnosis, I received a check from the insurance company. The money meant freedom to seek out the best medical treatment and fly across the country to see doctors. It also allowed me to consider options outside the United States, if needed, in places where cancer researchers, unencumbered by the FDA, were pushing the envelope on cancer treatment and surgery.
While the cancer diagnosis was mine alone, Dale and I would share the battle. We had been married thirty-two years, and we had been true comrades from the start, meeting in an IBM marketing class in Endicott, New York, and fighting for first place in class. I had been elected president of the class, but Dale edged me out for first place. That playful competitiveness developed into a fun, jovial friendship. We also discovered we had much in common. He'd spent the first five years of his life in rural North Dakota, his father a farmer and his mother a homemaker. His parents emphasized honesty, respect, hard work, and Christian values. We loved being together from the moment we met and were married three months later. Dale's beloved forty-six-year-old mother was dying of breast cancer, and his Lutheran minister married us in the hospital chapel so his mother could attend. She died a few weeks later.
As soon as Dale was home, I felt a sense of peace. While we wished this wasn't a battle we had to face, we were stronger because we had each other.
(Continues…)
Excerpted from "The Mission Walker"
by .
Copyright © 2017 Edie Littlefield Sundby.
Excerpted by permission of Thomas Nelson.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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