Living in the Twilight

 Kate Bowler, Everything Happens For a Reason And Other Lies I’ve Loved, 2018

Having cancer isn’t funny, but that doesn’t mean we have to stop telling jokes.

What makes Bowler’s book significant in the world of books about cancer is that she is dying and she’s not. She has Stage 4 colon cancer that is being held at bay by experimental chemotherapy and immunotherapy, and lives two months at a time, from one checkup to the next. If the checkup is good, then she knows she has two more months of life. If it’s not, then she knows to start saying goodbye. 

What’s different is her timeline. When you’re diagnosed with cancer, you generally have a number of years as doctors diagnose and treat you. If you are Stage 4, there are drugs that can keep you alive for five years or more. Bowler was given a 30% chance of lasting just two years. She says there’s a cost to living with this kind of stress, which intensifies as she gets closer to the time for her next scan.

Colon cancer is the fourth leading cause of death among American women. Among the causes is a diet high in processed red meats, and having the Lynch syndrome, an inherited genetic disorder. After I developed prostate cancer, I took up my cancer center’s offer to be genetically tested to see if I had inherited a gene for prostate cancer as well as any of the other seventy know cancer-causing genes. I asked my geneticist to look specifically for the Lynch gene because my grandmother had colon cancer, along with breast cancer, as did two of my aunts. When I found out I didn’t, I breathed a deep sigh of relief.

Bowler is a professor of religious history at Duke Divinity School and has studied the Christian prosperity gospel. This theology says that if you are right with God, the proof will be that you are healthy, have money, a great family, and will prosper in your work. The flip side is that if you get sick, are poor, or stuck in a job you hate, then you are an unrepentant sinner and aren’t trusting God enough, even if you happen to be one of the pastors who preached this theology and was in his 40s when he died. It’s cause-and-effect. I don’t know how they explain a child getting cancer without their feet getting tangled up.

Prosperity Christians like to say that getting cancer is part of God’s plan, and many of them have said to Bowler that there is logic and meaning to her getting cancer and possibly dying — either it’s to inspire others with her noble struggle, or there is a divine lesson that she needs to learn. I’m not going to get into the particulars of this, other than to say that I don’t think God cares about material possessions. I don’t believe that God gives us cancer as a punishment. I think God values community, compassion, and helping one another, including those with cancer.

Bowler’s long-term maybe-dying, maybe-not-today, cancer has freed her from her shoulds so that she can just be herself, including laughing in public at inappropriate times (There’s a lot of humor in the book. For example, she took up swearing for Lent.) I’m drawn in when she says she’s living in a time suspended between life and death. This is what people with cancer discover. Our focus shifts from always planning for the future to living fully in this moment. We realize that the only thing we can be sure of is that we have today to take care of those we love, because tomorrow one of us may not be here. 

Facing the possibility of dying is hard, at any age and for whatever reason, because we are facing the stark reality of ceasing to exist. It’s also hard on our support crew to suspend their dread of what might happen and not screw up their faces as they try to smile while being deathly concerned.

What is needed when someone is living with cancer, Bowler says, are not words but touch — the power of a hand holding ours, a hand on the back, the warmth of a long hug, the comfort of someone’s presence as we sit together and share coffee. This makes a big difference because it means that we’re not traveling though this wilderness without caffeine.