Troubles and Worries

The “troubles” that one patient experienced was not a “worry” to the staff at the Department of Corrections until the inmate showed up late for meals and roll call.  Months later, he wended his way through the medical system and got a neurosurgery referral to Jacksonville.

As this white-haired, stoop-shouldered African-American shuffled along in leg irons, his shuffle looked little different from other men in leg irons.  But when the guard removed the shackles, the inmate clearly had the spastic gait of a man with spinal cord compression.  Further testing confirmed a narrowed spinal canal and degenerative disk disease in his neck as the cause.

This patient, whom I will call Daniel, needed a decompressive cervical laminectomy.  But in truth, few operations worry me more.  The operation is necessary–without surgery he would be wheelchair confined within several weeks, and lose hand function shortly thereafter.  And though the results of surgery are usually good–90% of patients improve, and another 9% will stabilize–another 1% will be paralyzed as a complication of the surgery.

It’s that remaining 1% that worries me.  If Daniel gets worse, the fact that ninety-nine strangers got better after the same operation will give him, and me, little comfort.

We talked for a long time about the costs of surgery–not the financial costs, but the costs in terms of pain, suffering, recovery time and, especially, risk.  Daniel had vague fears about why he couldn’t walk easily anymore and what the future held.  I needed to share my medically-based fear about his future without surgery.  Then I needed to share the hope that surgery would make him better, and my fear that it could make him worse.  This is a melding of purpose: his hopes become my hopes, his fears become my fears.  His troubles become my worries.

I scheduled the surgery.

Then we waited.  The Department of Corrections, due to security concerns, budgetary constraints, and logistics, decides when the surgery will take place.  Literally months passed. Calls to the D.O.C. went unheeded.  I became increasingly worried that by the time the surgery was done, it would be too late; the spinal cord would already have been permanently damaged.

Finally, the surgery was scheduled and Daniel showed up at the hospital with barely enough time to complete his pre-op checklist.  He looked inexplicably content, shackled to a stretcher, a complacent guard at his side.  It had been so long since we talked that I wasn’t sure he remembered anything about his condition or the surgery.

I wanted to give him the whole pre-op talk again with time for questions and answers, give him a day to think about it, and return for more questions if necessary; it was that serious.

But I didn’t really have that option.  If I cancelled this operation, I didn’t know if the surgery could be re-scheduled before he was wheelchair bound.  I had only a few minutes.

“The operation could kill you or paralyze you,” I said.  “But it’s your only chance to walk normal again.”  I skipped all the information about expected recovery times, percentage chances, pain, or even where the incision was going to be.

Daniel smiled.  He still did not appear to be nearly as concerned as I thought he should, and it worried me.  I wondered if he was intellectually impaired.

I started again. “You understand the risks–”

“I heard you, Doctor,” he interrupted, still with that inexplicable smile.  “And I remember what you tol’ me before.”

I must have looked unconvinced because then he reached out with a shackled arm and patted my hand.  “I got troubles,” he said.  He reached over and touched the crucifix tattoo on his forearm.  “But I ain’t got no worries.”

Worries filled me, but by comparison to Daniel, I had no troubles.  I didn’t have decades to serve a prison sentence, a crippling illness, nor did I face a painful and life-threatening operation.  At the end of the day I was going home to a comfortable house and a loving family; if things went well, he would go back to prison.

The operation did go well, and Daniel walked again, normally now, able to get to meals and roll call on time.  He still had troubles, of course.  But spinal cord damage wasn’t one of them.

Days of trouble have come to me before, and they will come again.  But when they come again, I remind myself:  like, Daniel, I ain’t got no worries.

God in our Fear


Having cancer is fear: like having a gun put to one’s head. The day before the diagnosis, one could go where he or she wanted. When the diagnosis comes down, the patient’s autonomy boils down to a single question. Will I accept or refuse treatment?

As they were prepping me for surgery they screwed metal bolts into my skull. It was like something out of a horror movie, and I just lay there acting like it was normal while they tightened the metal halo, and my head felt like a grape being squeezed. A few minutes later they had me lie down on the gurney. I was encased in a metal cubic framework screwed into my skull.

Then, a month later I could actually smell my skin burning during radiation therapy.

During cancer treatment there dozens of atrocities visited upon a patient’s body. I had to have my blood drawn every week. My veins weren’t so good so it took a lot of sticks. I can remember telling myself that if I got better I would never let anyone stick me again.

Then there was morning when I came in for a CT scan. They gave me a “Big Gulp” sized cup of contrast. I drank a little less than half and couldn’t get any more down. My mom urged me to keep drinking; I did my best. Then I started throwing up.

I feared not only dying or discomfort. I also feared of my utter lack of autonomy. They could have told me that they were going to have to cut off my leg or my nose or blind me and I would have had to say yes. In this way being a cancer patient is like being in a concentration camp, except that a concentration camp seeks to kill while cancer treatment seeks to give a long, arduous road to life.

Where is God in the midst of this journey? He carried me when I wasn’t strong enough or brave enough to walk. I wasn’t particularly pious or spiritual. I just had a feeling, a spiritual feeling, that I was going to be ok.

During my cancer treatment I suppressed my fears and thoughts of trauma. Later, when God put me down I had to deal with them. God carried me through a horrific wasteland, like a battlefield inundated with explosions, shrapnel, barbed wire and terror. When he put me down I had to look back over that wasteland and examine the scars on my body, my spirit and my soul.


“As the sun was setting, Abram fell into a deep sleep, and a thick and dreadful darkness came over him. Then the Lord said to him, “Know for certain that your descendants will be strangers in a country not their own, and they will be enslaved and mistreated four hundred years. But I will punish the nations they serve as slaves, and afterward they will come out with great possessions”(Gen 15: 12-14).


The Israelites did not come out of Egypt without scars. There were the literal scars from the whips of the Egyptians and the overseers. There were the memories of the babies killed by the soldiers or eaten by crocodiles in the Nile. Bodies were broken by decades of slave labor. More than all of these, they lived with constant anxiety. They had lived for four hundred years in a setting where one simple change, like not gathering enough straw, could bring utter ruin.

My biggest anxiety was the MRI machine. To me, going into an MRI was like being buried alive. Less than six inches separated my eyes from the top of the tunnel. The sides of the tunnel pressed my arms to my side, and it was always cold, around sixty degrees. The mechanical voice on the intercom told me time after time not to move. Even swallowing my saliva worried me. A typical MRI takes about 50 minutes. Of course, in the machine I had no way of sensing of time. All I had was my thin, cotton gown. About halfway through the scan they would move me partially out of the tunnel, stick me, and add contrast to my veins.

Above all the unpleasantness hovered the fact that one MRI in August of 1991 had changed my life forever. One bad MRI took me into the wasteland of cancer. Any MRI after that could return me to the same wasteland.

It was the summer of 1992. I was going for my first annual MRI scan. By that time I’d started to rebuild my life. I was driving again, taking tennis lessons. I had enough hair to brush, and I looked forward to my senior year of high school. I walked into the imaging center determined to put on an optimistic face.

In reality, I was absolutely terrified.

God must have laughed at my phoniness.

When I registered, a new Christian manned the desk. We talked about the cancer and my fear that it would come back, and I received the gift of peace. God knows and ministers to our fears, even the ones we are afraid to admit to ourselves.