WHEN DEATH
ANNOUNCES ITS NEARNESS

Evelyn King Mumaw

Something new and unexpected happens when death sends a message on ahead that he will be coming for you before long.

Your focus changes. You have been planning earth-based activities for the future. Now you focus on setting your house in order as you prepare to leave it.

You experience a whole new gamut of feelings, thoughts, and questions. Things you hadn’t felt or thought before run persistently through your mind.

Your perspective changes. Many elements of life and living that have been important to you lose their importance. Many things that had been only minimally important now take on major significance.

Such is turning out to be my experience.

As I have shared with friends about these changes I have been encouraged to express in writing what has been happening in my mind and spirit.

With the Lord’s help I have tried to do that. Perhaps my shared journey can help to break the loneliness of the way for others needing to take a similar journey.

Oh, No!

You have cancer. It’s ampullary cancer—a rare kind—cancer of the bile duct. It does not respond well to chemo or radiation treatments. There is only one possible cure: whipple surgery. That is radical surgery that takes some of a number of organs around the tumor. It would be harder on you than your open-heart surgery was. The recovery period would be lengthy. The quality of life following this surgery is often very poor. Forty percent of the persons who undergo it live five more years.

The other surgical possibility is a bypass from the stomach to the small intestine. This will not limit the growth of the tumor or the spread of the cancer. It will simply bypass blockages.

Bit by bit, from many doctors, all of this information and more came searing its way into my mind and consciousness. Gradually, in the days that followed, I worked at processing it.

Help!

After discussing possible surgeries with me one doctor said, "You must decide. No one can decide for you. Think about it and pray about it and then decide."

But having seen three family physicians, two gastroenterologists, two oncologists, one cardiologist and three surgeons, and having had an ERCP with stint placement, an echocardiogram, an upper GI check, a blood transfusion and various other intravenous treatments and much lab work done, I was utterly confused. I was too weak to think clearly and find my way through this mountain of foreign information that had been given to me.

And I had prayed and prayed and so had lots of other people.

All I could say was "Help me Lord!" And he did. My spirit became quiet and after some hours I began to think more clearly again.

83 and Vacillating

I’m almost 83. I can’t live forever. Perhaps this is my time to call it quits and go on home. Why should I try so hard to stay here when the end of life, sooner or later, is inevitable? But I do want to stay; God made me that way. I do want to be involved in the life of my church, to see the development of the Brethren-Mennonite Cultural Center, to take the beginner’s class about computers, to be a support to my sister, to complete my writing projects, to interact in stimulating conversation with friends and family members, to share my faith freely wherever I have the opportunity, to revel in the changing seasons. . . .

It’s early fall—just hinting at the glory soon to be. The geraniums, nasturtiums, roses, begonias, trumpet plant, spreading mint, hostas, and three tomato stalks in my northeast bed are an array of delight.

The hummingbirds, goldfinches, rosy finches, mockingbirds, cardinals, mourning doves, blue jays, Carolina wrens, robins, and song sparrows bring life and cheer as they come to visit and feed at my feeders. The bunnies and the squirrels come too.

The harvest moon was big, bright and full a couple nights ago.

The night creatures join the pre-frost chorus—or is it a symphony they perform? When late night quiet falls about us, their sounds stand out clear and full.

I remember the title of a poem written by the late M. T. Brackbill: Lord, I Like It Here. I guess I do, too! And I’d like to stay awhile longer.

More About Being 83

Of course this thing of being 83 influences my decisions, my goals, my plans, my dreams, my outlook on life.

All my life I’ve been a planner. I’ve made my lists of things I’d like to do, places I’d like to travel to, goals I’d like to reach, improvements I’d like to make, projects I’d like to complete . . . But at 83, with heart disease and cancer, most of those lists are no longer reasonable or realistic. Goals must be revised, projects adjusted, dreams changed, and travel done by videos or local trips.

There are still many ways in which my life can be worthwhile and full of joy.

At present I am reading the Bible through—one more time.

I have time to pray for many people and situations.

I want to review and sharpen my accuracy on passages I’ve memorized over the years—of course in the King James Version.

As long as I can I’ll keep on writing letters to friends and extended family members.

I am blessed with good vision so I can read and read.

I love visiting with friends when I am strong enough.

I want to keep on stretching my mind and exploring new areas of thought and insight.

Addendum: Being 83 had much to do with my decision not to have major whipple surgery. If only 40 percent of the persons undergoing that surgery live five years following the surgery, that means 60 percent live less than five years after surgery. And if quality of life is very poor during those several years, why bother!

One Foot Here—
One Foot There

The struggle for balance in perspective when you are my age and have heart disease and cancer is not easy. If my time here is nearly spent, I should be finishing my projects, disposing of my possessions, writing some farewell letters, canceling that clothing order, relinquishing responsibilities. . . .

But I don’t really know if I’m leaving soon. The Lord may shrink that tumor and give me more good years. I find myself planning ahead for Christmas, for next spring’s plantings and social activities, for church involvement . . . and then I remind myself, If I’m still here.

It’s sort of like having one foot in heaven and eternity and the other one on earth in fleeting time; the walking gets a little awkward and disjointed sometimes. But it shouldn’t. I need to learn how to live graciously in both worlds without losing my balance.

Terminally Ill

Terminally ill. What an ominous phrase! We don’t use those words in the presence of the ill one. We say it quietly, in hushed tones, outside of the ill one’s hearing.

I am terminally ill. Have been a long time. Just didn’t know or realize it until recently.

And, hey! You are too. You just aren’t as aware of it as I am.

During the past week at least three people whose lives have touched mine in some way, and who were much younger than I, have died. They did not know they were terminally ill. Nor did their families know it.

Face it. We are all terminally ill. Death is stalking us. We’d best come to terms with him now.

I’m curious.

I guess that’s just another way of saying, "I wonder why. . . ?"

Three years ago I almost died from heart disease. I had open-heart surgery with three bypasses and a valve replacement. Six months later the main bypass closed. Currently the replaced valve is calcifying. So I thought I’d had my waterloo. Enough for one small elderly woman.

Now cancer—dreaded disease. And not the ordinary kind, if such there be. A rare kind, practically untreatable.

So I’m curious. I’m wondering why I should need to experience both of these dreadful illnesses. I’m not blaming God for them, I’m not mad at him. He didn’t send them. But he permitted them, and I wonder why. Does God have a special reason or purpose for allowing them? Does it take extra suffering to teach me the lessons I need to learn because I learn so slowly? Or is it difficult to mold me into the vessel God wants me to be?

What does he want to accomplish through all of this?

I’m curious. I wish I knew. But then, perhaps it’s best this way.

Don’t Waken Me!

It seems like I’ve had a bad dream—of hospitals, tests, doctors and more doctors, many "sticks," weakness, red, orange and yellow jello . . . and cancer.

I’m at home, comfortable, eating well, using my exercise bike, taking my vitamins, going places, enjoying life. Nothing the matter with me!

Please don’t waken me. I’m having this good dream now.

One Day at a Time

How now shall I live? Taking life one day at a time, I’m trying to make the most of each day. That sounds so trite. There is even a song that says "One day at a time, dear Lord. That’s all I’m asking from you."

But the idea becomes a new reality when life’s uncertainties demand recognition. No one knows for sure what will be in the next day, but many people say that with an underlying expectation that tomorrow will be very much like today. Yet some of us know that tomorrow is very uncertain.

There is another approach to living in uncertainty that appeals to me. I have adopted it as my slogan to live by. "I will live each day as normally as I can as long as I can." That is what I’m trying to do.

I’m bringing in fresh flowers. I’m feeding and giving water to the birds. I’m writing notes and visiting with my guests. I’m doing lots of reading. I’m preparing my own simple meals and going for my groceries.

Sometimes I press the boundaries of normal living a little much, such as when I went to Village Coffee. And when I went to the worship service even though I left before dismissal.

But I’m trying!

My Pact with God

After several weeks of facing the reality of this illness, and thinking of what it could mean for me, I made this commitment to the Lord.

Dear Lord,

You know better than anyone else does how ill I am with what appears to be terminal cancer. After thinking about the implications of all this, there are several things I need to say about where I have arrived.

I know that you are the healing God. I have experienced healing again and again through these many years. You work miracles; sometimes instantly, other times over longer periods of time.

I’d like to be healed, and I know without doubt you can heal me. I’m not demanding or insisting that you heal me. But I’m letting you know that I am very open to your doing repair work to this temple of yours.

If you do not see fit to heal me, I will love you and trust you just the same. I will trust you to walk with me through whatever comes. I will trust you to supply the grace I need for each day. If I am tempted to demur, I will remember the submission of Jesus as he faced suffering and told his Father "Not my will but thine be done."

My desire is that out of these two possibilities you will choose the path for me through which you will receive the most glory. I know that will be best.

I look forward to the time when and place where I will be completely healed with a new body like that of my risen Lord.

—Your unworthy but devoted child.

I Count My Many Blessings

How blessed I am! If I were a refugee woman or developing-world resident with this illness, I shudder to think what I would endure. But I am here, and I am immersed in blessings. So in the morning, in the day, and at night I remember God’s goodness expressed in innumerable ways— and I give thanks.

Sometimes during wakeful night hours I think of my simple but pleasant and comfortable home, of the deliciousness of night quiet interrupted only by the singing of little night creatures. I slip out on to my back deck and feel the refreshingly cool night air. I look up at the stars and marvel at their constancy. I give thanks to their creator, theirs and mine.

In the morning I give thanks that the Lord has kept me through the night, has provided warm water for my morning bath, clean clothing to encourage me to greet the day, nourishing food to renew my strength. Then there’s the song and message from the Christian radio station that stirs my hope for the day.

I am so grateful for a daily quiet, undisturbed time with the Lord; I mean that time when I give my full attention to his speaking through his word and my responding to him in prayer. If I’m wakeful in the night, that’s my time. If not then, I take an hour or more upon waking in the early morning. I give thanks for God’s presence then and throughout all of my day.

In the evening I review my day. In it I have answered the phone again and again; gone through my mail; welcomed and enjoyed visitors; relished a neighbor’s fresh bread, applesauce or potato soup; laughed at a loved one’s bit of humor; sung over and over a song fixed in my mind by the Spirit; ridden my exercise cycle; given water to my plants and the birds; and brought in fresh flowers. These are a sample of experiences in which I have joy and give thanks.

Today I am nearly free of pain. Oh how grateful and blessed I am!

Fear

I have been asked what place fear holds in my present experience. My greatest fear is the fear of pain. My threshold for enduring pain is not very high. And of course I’ve heard the horror stories of cancer pain and suffering. So yes, I am afraid of the pain that may await me.

I am afraid of my reactions to pain. Will they be a reproach to my Lord? Can I give a clear testimony that his grace is enough for me? Can I claim his grace?

What about fear of dying? I’m basically shy and hesitant about going new places and trying new experiences by myself—a little fearful. I wish I knew more about heaven—the afterlife—and eternity. I know with my mind it will be wondrous and glorious but I can’t seem to get that into my feelings.

My trust in Christ’s work to provide my salvation removes the greatest fear. I deserve nothing but rejection; I have failed the Lord in so many ways so there is no reason why he should favor me with eternal life in heaven. But, thank God, someone told me that Jesus died to save me and have me with him in heaven. So my faith is in him and his work on my behalf.

As to the actual dying; some years ago in intense pain I passed out and slumped to the ground. Somehow in that experience I sensed the ease with which I could have died. The dying itself would not have been a dreadful experience—just a passing from one state of being to another.

So the thought of death—while I do not anticipate it with pleasure—neither do I dread or fear it greatly.

Tempered Grief

The thought of leaving the familiar, the pleasing, the enjoyable, the comfortable . . . brings a sort of grief to my spirit.

And my things, my possessions. Oh I know people often say of a loss, "They are just material things, they don’t really matter."

But many of my things do matter to me. The desk my grandmother sent from Ohio to Pennsylvania to help furnish our home after the fire, the lovely wooden bowls and candleholders John made for me on his lathe, the cedar chest my parents gave me for my twenty-first birthday, the tall chest of drawers my Virginia grandfather gave my grandmother whom I never knew, memorabilia I saved from early childhood until now, my books. . . . Just things? No. They are symbols of the many ways God has blessed my life. They remind me of his grace and goodness and all the people and experiences through which he has enriched my life.

I confess that I grieve a bit at the thought of leaving all these simple but significant items that have been so much a part of my life.

There are the experiences I have treasured that have blessed my life so richly. Now I find myself wondering repeatedly if this is the last time that I will be able to take communion, plant my spring flowers, sing with a special group, travel to Pennsylvania, attend Park Village activities, experience the change of seasons, prepare a meal for friends. . . .

And of course leaving the people I love who bless me in so many ways brings a measure of sadness. No more reunions with siblings or daughters or nephews and nieces and grandchildren. No more letters from members of my large extended families. No more discussions with friends about the really important things of time and eternity. No more times of rich fellowship with prayer partners. No more thrilling at the development of young people in the church. No more enjoying my good neighbors.

Yes, there is grief that accompanies the realization that I have a terminal illness. But it is tempered by the certainty, though vague at times, that there will be joys with the Lord that are beyond comparing with the joys I leave behind. Then, too, I am aware that so many family members and friends I’ve loved are already over there. And many I love here now will soon join us over there.

Grief? Yes. But a tempered grief.

Anger

I think of myself as not being a very angry person. But for a time one day I felt angry at this ampullary cancer. I was angry at it for stealthily invading my body, devastating it, and changing my entire life. I wanted to tell it in no uncertain terms to be gone. I wished for the power to cast it out!

I also struggle with anger at the seeming complacency in our society about cancer. It is all around me taking one life after another, disrupting other lives, devastating families. People of all ages are its victims.

And yet there seems to be an almost quiet acceptance of what is happening. Oh I know research is being done and cancer societies are hard at work. But I’m thinking about the mood and response of society in general.

I compare the public’s reaction to cancer with the outcry about AIDS. Great sums of money are being demanded and designated for finding its cure. Worldwide conferences deal with it. One reads about it in many publications. It seems to be on everyone’s mind.

Understand, I do care about the people who are suffering from this horrible disease. Especially my heart goes out to the women and children who have been infected because of the profligate behaviors of spouses or of parents.

But at least AIDS is a preventable disease. How it is transmitted from one person to another is known. How to prevent cancer and what causes it are still largely unknowns.

I listen and ask, "Where is the outcry about cancer?" I feel puzzled and dismayed about the disparity of concern and action between these two killer diseases.

Sometimes my feelings border on anger—until I deal with them.

Refreshments for the Journey

The Lord has ways of providing encouragement and assurance for difficult days. Soon after I was hospitalized I spent time reading in the Psalms. I was assured of God’s amazing sufficiency through Psalm 18:2. "The Lord is my rock, and my fortress, and my deliverer, my God, my strength in whom I will trust: my buckler and the horn of my salvation, and my high tower."

I can’t say that I know the meaning of all those strong, powerful words. But they give me the clear impression that individually and all together they provide whatever I need for the journey.

"You are in the Lord’s hands," friends remind me when they hear my story.

"I am in the Lord’s hands," I say when I finish informing others of the doctors’ evaluation of my condition.

The Lord’s hands? What does it mean to be in the Lord’s hands?

I recall Bible references about God’s great and wonderful hands. I think of the ways the Lord Jesus used his hands in the years of his ministry. Then I know that I can count on the Lord’s hands to minister to me.

In this period of my life, when I have been told by a number of doctors that they cannot cure my illness, I find myself wanting to curl up in the hollow of God’s hand and trust him to be all I need. What better place to be than in the Lord’s hands.

Crisis

While I was still in the hospital, I was told that the usual treatment for cancer would not cure this ampullary cancer. The doctors did inform me, however, that radiation and chemo could shrink the tumor and keep the disease from spreading.

The stent, which was placed in the bile duct, has made life fairly comfortable this past month and a half. But the stent is expected to function for only four to six months. So it seemed reasonable to consider radiation with xeloda, an oral chemo, to enhance it.

We have now talked to both the radiologist and the chemotherapist. The combined information received made it clear that this treatment could have major side effects. I could become quite nauseated and weak.

So what do I do?

Do I try to prolong life at great cost? Or settle for a brief time here, hopefully with less physical distress?

"If any man lack wisdom let him ask of God."

Please Lord—I need clarity of direction.

—Evelyn King Mumaw, Harrisonburg, Virginia, has long been a retreat leader as well as author of many articles and books, including Journey Through Grief (Masthof Press, 1997) and The Merging: A Story of Two Families and Their Child (DreamSeeker Books, 2000). This article stops where it does not because her journey has ended but because DSM had to go to press. She plans to continue to write as long as she is able about what happens "when death announces it nearness."