Advent.  Week 1.

(please note: in accordance with privacy laws, patient names have been changed)

“The people walking in darkness have seen a great light; on those living in the land of deep darkness a light has dawned.”

Isaiah 9:2

Mary Gardner. That name looks so familiar.  It stares back at me on the computer screen, telling me that this woman is second in the morning of palliative care appointments.  She is new to palliative care, but, I swear, not new to me.  I cannot put a face to this name, but sometimes as a nurse in a clinic, you just see a name and think to yourself, “I like that person,” even when other details have escaped your mind.

I am waiting for the coffee to kick in as I follow the doctor to the exam room. I’ll take notes from the visit, put orders in the computer, whatever is needed.  I am usually running chemo upstairs, and am glad for the chance to be “on the other side.”

He opens the door, and I see her there, tiny, not filling but half of the exam chair. I see her wrinkled, expressive, smiling face, obscured by the bill of a baseball cap.  And I know instantly who she is, this Mary Gardner.

It’s been a while since I’ve given her chemotherapy- several months, maybe a year.   She came in with a big floppy hat and curled herself up under a mountain of blankets, so that if you didn’t know better, you wouldn’t know there was a person there under the pile of material.  She had been incredibly sassy with me, had rolled her eyes in exaggerated fashion several times, made wise cracks- as she will in the exam room this morning.

The doctor knows her story but asks her to tell it- how she was diagnosed with a chronic, slow-growing cancer that has very recently become more aggressive.  Mary has refused further chemotherapy because it makes her feel miserable.  The doctor nods in agreement, looks at recent lab work, and keeps asking questions.  How are you feeling? Are you having any pain?  What’s your worst symptom?  Are you very fatigued? He becomes concerned as her daughter tells about her recent weight loss.

After this, he gently brings up hospice.  Mary was expecting this; I’d heard her mutter at one point, “we were never guaranteed to live forever—not here anyway”.   She reminds me of the stalwart character Reepicheep in The Voyage of the Dawn Treader, with her brusque assessment of the truth. After hearing about how hospice will essentially allow Mary to receive her healthcare at home, Mary and her daughter both breathe a sigh of relief: that would be lovely.  Her daughter tears up at this conversation; I hand her the last tissue out of the Kleenex box.

The visit continues.  After having considered Mary fully- her disease, her functioning, her current weight loss, the doctor quietly tells her, “I think we’re looking at months, and especially given how you’re doing, maybe six months or less.”  Mary nods, again unfazed.  Her daughter begins to cry.  I slip out to get another box of tissues.

When I return, Mary and her daughter are still taking it in, and it is here that I tear up.

“You know, I’ve been talking to Jesus a lot throughout this whole thing,” Mary says.  “Especially here lately.” She goes on. “Every afternoon, I feel the cancer, just all over my body.  And I go lay down for an hour, every afternoon, and talk to Jesus.”  Her words are even, matter-of-fact.  She is not worried about what’s coming.

The doctor offers to pray with her, like he always does.  Simple and quiet, and by the end both the daughter and I are teary-eyed.  There’s additional paperwork to be filled and signed before hospice, and as we finish up, the room is all joy.  Mary is making jokes, her daughter is wiping her tears.  It is a good hospice referral.

Sometimes I feel as if death is a person and he works in my clinic.  It sucks.  I hate death with all my might and often dream of writing some spit-fire piece called “Giving Death the Bird.”  But that’s a story for another day.  This story is about hope, about what Mary exemplified to me.  We didn’t talk about the gospel; she didn’t spell it out for me, why she was so unruffled about dying—she didn’t need to.  She exemplified that hope that we’re supposed to have, that people are supposed to ask us about (1 Peter 3:15).  I suspect if I had asked her about it, she would have said, “I trust in Jesus.  I’m not worried.”

And it is now, at Christmastime, that we celebrate Immanuel, God with us. Christ, Jesus Christ, entered our world so we could enter his, both in this life and in the life to come.  He entered this broken old world not just so we could have hope in the hereafter, but hope in the here and now.  It is interesting that when he came, he did not reverse all death and suffering—indeed, he healed and forgave many, but when he left this world it was just as lousy as before.  Death still happened; death still happens.  But he’s Immanuel; he changes the death and suffering because now, he’s with us.

He came, he lived, he died for you and me so that in him we could have hope.  So by his righteousness we can approach a holy God and talk to him when we’re dying (or feel like we are).  He will be with us as we suffer.  When you feel the world’s brokenness like cancer in every bone of your body, you can sit and talk and cry to Jesus because he’s taken away every reason for you not to.  The condemnation, the shame- he took it, so you can talk to God.  So God can be with you– both as you laugh and as you weep.

And in the end, because of his work on the cross, we can know, like Reepicheep, that Aslan’s country is not far off, and that that’s where the ultimate reality is.  The cancer, the death, the brokenness- it’s all shadows, shadows indeed, to be chased away by the coming light.

There is hope.