preface of walking through the valley of the shadow of death

8/14/2019 Preface of Walking through the Valley of the Shadow of Death

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Preface:Why I Am Writing about Death

To everything there is a season, and a time to every purpose

under the heaven: A time to be born, and a time to die (Ecc.

3:1-2a, KJV).

Skin cancer; it was skin cancer that killed my dad. And no, he

was not always beet red or golden brown from working outdoors.

In fact, he was a white-collar engineer who did a little outdoor

maintenance on our home through the year. We did live in one ofthe worst states for skin cancer incidentsArizona. With no

beaches like Florida, its rival state for worst effects of skin cancer,

people in Arizona get skin cancer from being out in their swim-

ming pools, in tanning booths (although safer, you can still develop

skin cancer from their tanning rays), golf and other outdoor activi-

ties. Wearing sunscreen is no guarantee against the disease al-

though it helps. He had no family history, no physical exams

showing a propensity for developing the disease and no darkgolden brown skin from excessive sun exposure. Instead; one day

we simply noticed a small mole on his arm that looked like it had

changed color.


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Kimberly Rose Carolan

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He went to his dermatologists office and a biopsy showed that

it was melanoma. Of the three types of skin cancer, melanoma is

the most deadly. This is typically the type of skin cancer a personhas when a mole changes color or shape. But he was not worried.

After all, it was just skin cancer. His dermatologist removed a

twelve-inch patch of skin a few inches deep in his arm. His derma-

tologist and oncologist (cancer specialist) agreed that they got it

all and that dad was cancer free. He was forty-five years old at

the time. All he needed to do was have routine exams to check for

new cancerous moles. They did not check for the primary tumors

movement or metastasis.Four-and-a-half years later he developed a knot under his arm-

pit. While putting our Christmas tree up that year, he had trouble

reaching because of this odd knot under his right arm. He went to

the doctor to have it examined. They removed the lump and dis-

covered cancer. It took a little time to figure out what type of can-

cer it was, but there were two possibilities: melanoma or

something else (like lymphoma or another migrating cancer). The

report from the pathologists, the doctor who analyses cells, wasthat the cancer in his lymph node was melanoma.

Cancer is a disease where the DNA of a cell is altered from its

normal formation. At any given moment, most people have altered

DNA. However, special enzymes go up and down our DNA check-

ing the pattern and fixing altered DNA. Problems arise when the

enzymes are delayed in getting to the altered portion of the DNA

and the cell reproduces itself. This creates cancerous daughter

cells.

Cells routinely reproduce themselves, but cancer cells can re-

produce faster than normal, healthy cells. Once reproduced, the

enzymes allow the daughter cell (the new reproduced cell) to keep

its altered DNA structure. These altered or mutated cells reproduce

and create a cluster of abnormal cells, cancer cells, called a tumor.

Sometimes cells in a tumor break off and find a new place to re-

produce. When the cells break off from the first tumor, called theprimary tumor, it is called metastasis. This means that a small por-

tion of the tumor moves to another part of the body, usually

through blood or lymphatic fluids. In this new region, the cells


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continue to reproduce. Cancer becomes incredibly dangerous when

the cells migrate to an area of the body where a growing tumor im-

pedes other bodily functions. Another danger is that tumors takefood from other cells. This causes healthy surrounding cells to

die while the tumor thrives. If the healthy cells are blocked from

doing their normal function or die, significant damage can start to

happen to the body. This often results in death. The path of metas-

tasis determines where these migrating tumors take root and con-

tinue to cause damage.

Most types of cancer have a particular path that they follow.

When primary tumors metastasize, they are carried through thebody a particular way. For melanoma, the cancer starts in the pri-

mary tumor then to the nearest lymph nodes. In my dads case, his

arm then small glands in the armpits, neck, groin and scattered

parts of the body; then to his brain or spinal cord. We found that

the tumors had broken off of the original tumor on his arm. The

surgery had not removed all of the melanoma. That led to about a

billion cancer cells in the lymph nodes under his armpit.

Lymphatic fluid travels throughout a persons body. The lym-phatic system helps the immune system remove toxins and old cel-

lular waste from the body. It is ironic that a system that usually

helps ward off disease was the conduit for cancer in my dads

body. He took Interferon, a drug they dripped into his body

through an IV three times a week for an hour at a time. This was

supposed to increase his likelihood of fighting off the disease by

33%. That is, as long as the tumors did not reach his brain as the

drug does not cross the blood-brain barrier.

Nine days before my wedding to Joseph we found out that my

dads most recent MRI showed that my dads cancer had spread to

his brain. There were four tumors, all about a centimeter in diame-

ter. In the brain, these were large enough to cause damage that

warranted a prognosis of four to six weeks to live! Can you imag-

ine? Not four to six years or months but mere weeksbefore saying

goodbye forever to this world. The doctors started aggressivetreatment of these inoperable tumors. They used radiation and an

experimental chemotherapy. Their goal was for my dad to be able

to walk me down the isle without the aid of a wheelchair.


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Through the help of his oncologist and radiation oncologist, he

succeeded in walking me down the isle without a wheelchair. In

fact, he did not lean on my arm. He walked me down the isle asproudly and confidently as he could considering the little strength

he had in his body.

I saw my father cry three times in my life and they were all

centered on my wedding. He cried at the rehearsal the day before,

the day he walked me down the isle and when he danced with me

at our wedding reception to the music of Bob Carlyles Butterfly

Kisses. It threw me off guard to see him cry but I thought that it

was tender. Who really knew if he would ever see me again if heonly had so little time to live?

The room was silent as he danced with me. Of the two hundred

people attending the wedding, everyone knew my dads prognosis

and knew how precious it was that he was alive. Most people in

attendance were relatives or friends from our church. It was a

sweet time in our life as I married my dearest friend and spent

those precious memories with my dad.

Four weeks turned into six and went far past his given progno-sis. We were especially happy about that. We spent lots of time

together until the end nearly a year later. But that last year of my

dads life went by quicklytoo quickly. It seemed as though we

went from watching the Today Show and cooking shows together

in the afternoon to the hospice room too fast. His illness seemed

like it lasted forever. But it took him so quickly once it did take

him. We even thought that he was in remission for a time but his

cancer spread once againthis time to his spinal cord.

The doctors tried to blast away the new tumors with aggressive

radiation treatments but were unsuccessful. My dad feared being

paralyzed once the tumors spread to his spinal cord, but he would

not have time to worry about that. Within a month, his doctor

turned him over to hospice care where nurses visited in my par-

ents home almost daily. At one point, we put the television in my

parents bedroom because he could not walk to the living room andwatch programs during the day.

While hospice nurses were in my parents room, my brother

and I would whisper in the other room about what we would say at


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his funeral. I thought I would play the piano and maybe say some-

thing. My brother, Kevin, thought that he might talk a little and

have me accompany him in singing a hymn or play his guitar.One day they came with a medical transport vehicle and took

him to the hospice facility for a few days to monitor his bowel

movements. That was Wednesday and he died on Saturday.

Joseph and I were going to try to celebrate our first wedding

anniversary Saturday; our anniversary was on Sunday. When we

found out that my dad would probably die on Saturday, we nixed

our plans for the time. Instead, Joseph brought my flowers to dads

hospice room. About 40 friends and relatives came through hisroom at different times that day. My mom had a half-hour alone to

share her heart with my dad but he could no longer communicate

with us.

The last time we heard from him was the day before he died.

When I saw him earlier that day he said he would rather be at the

Grand Tetons. The last thing he said to any of us was to my mom

that night at 2am before she went home to sleep. He said his typi-

cal, Love you. And the last words we said to him as we watchedhim die were the same, We love you; well miss you.

Our good-bye with him was the beginning of a new and fright-

ening life without him. Out of that experience I was inspired to re-

search death and grieving, to talk to many others who had these

experiences and to write down what I learned. Many common

similarities exist in the experience of losing a loved one to death

that transcend the grief period. Irrevocable damage happens with a

death. I hope to open up and make a difference for those who have

lost. In addition, I hope to open the eyes of Christians to another

means by which we can serve others by caring for survivors of

death.

preface of walking through the valley of the shadow of death

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