Brenda could not recall any action that would have caused a broken rib; however, it was pointed out that even a loving hug from one of her strong sons could do that. So the X-ray was done immediately at radiology. When Dr. Fagan got the report, there was no broken rib. However, in the background behind the rib cage, they noticed there was something else. It was a growth about the size of a golf ball in her lung, which had to be investigated.
“Mitchell could not look me in the eyes. He looked down at the floor.” She teared up as she described our beloved doctor. I could see she was shaken, and amidst my own shock all I could do was respond by holding her quietly for minutes, until she handed me the phone and told me our doctor would talk to me about any questions I had.
I called right away and spoke to Dr. Fagan on speakerphone so Brenda could hear. He began to lay out the course of what would be taking place over the next two weeks. Tests, a biopsy and scans that would lead to a diagnosis of the growth being either cancer or non-cancerous. He spoke of how fortuitous it was that Brenda came in with a pulled muscle, for it led to the X-ray and hence the discovery of the growth. Without that, it may have remained there growing or spreading for a much longer period of time.
Inwardly, I felt better after talking with the doctor. It did not change the news in any positive way, but I felt his personal care, concern and love, as we have over many years. He is an incredibly intelligent and experienced physician, always sharing what he is learning from the latest medical research journals. He has always led our family well in medical matters, and we trust him.
Brenda was never a smoker, so I couldn’t help but wonder how this could possibly be lung cancer. You begin to cling to anything that offers hope. One thing that was being explored was the possibility of a certain type of fungus that presents itself much like lung cancer in scans. Just in the past few years Brenda had visited parts of the world where this particular fungus exists, and any traveller there could pick this up in their lungs. The tests ahead would determine what was actually going on, but you can appreciate how we reached for hope and would take a fungus over cancer any day. O Lord, let it be a fungus!
The next ten days are a whirl in my memory, although my journal is filled with notes of all the appointments, scans, and specialists we experienced. Brenda quickly accumulated 12 doctors treating her, and every day there were more tests. This was exhausting, both physically and emotionally. We tried very hard not to run ahead in our thinking. We just wanted to get the facts in front of us.
On Day 11, Brenda’s lung specialist, Dr. Whitman, asked to meet with us, as she had the test results. It was a Saturday, and that morning Brenda was the guest speaker at a fellowship breakfast at our church. Our three daughters (by marriage) joined us that morning, and we listened as Brenda/Mom, the gifted communicator, was once again remarkable in sharing spiritual wisdom—especially considering that no one there realized we were leaving right afterwards to receive her diagnosis.
The entire family came except for our little ones. We arrived and crammed into the small office. Brenda sat in a chair across the desk from the doctor, with her three sons standing behind her, creating what looked like an arc of protection over their mom. Looks of concern among our children were mixed with hope and stirred by disbelief that we were even in this setting. They all wanted to be there. In our family, we do things together and we face things together. They wanted to hear first-hand from the doctor and be able to ask questions.
Dr. Whitman began running us through all the test results by telling Brenda that she was a model patient. First was the bronchoscopy, and it went very well. She then continued, “I couldn’t see anything abnormal on the inside, but I did get an answer, and it is cancer.”
Can you imagine having her job? I can’t. But she was very good in writing out notes for us to take home, knowing that things might get a little blurry for us from that point on. Her first note said that Brenda had non-small cell cancer, and she explained that there are many subtypes, but it was confirmed as being cancer. The doctor told us that samples were being sent to the lab to check for the fungus, but she didn’t expect that the test would show anything.
Dr. Whitman continued, “When we talk about cancer we also talk about the stage of cancer, and this pertains to how advanced it is and where it has gone to. You at this point are stage four.”
Brenda was shocked by this, knowing that stage four is the highest stage. This news had the impact of someone rolling a small scale nuclear device into the room. We may have all feared it being cancer, but we had not anticipated an advanced stage.
Dr. Whitman then reviewed the bone scan and the CT scan, both of which showed the spread of cancer to her lower back and also that cancer was present in her brain. She hinted that the bone image might be a little questionable and we would have to monitor it carefully. The brain scan, however, was conclusive and showed that the cancer was metastatic.
“If cancer starts in the lung and then goes somewhere outside the localized region, it is considered metastatic. Where lung cancer likes to spread to is bone, brain and adrenal glands.”
The doctor continued sharing while she changed the images on the computer so we could see the images of the cancer in the brain. She continued to show the CT scan, showing a nodule where the cancer in her lung was growing into her chest wall. “Now what this means to you is that…[long pause] this is unlikely to be curable.”
Boom!
This was the first of many occasions when we would hear the phrase “unlikely to be curable” over the days and weeks that followed.
The treatment Dr. Whitman would be offering depended on the particular subtype of cancer that Brenda had. Dr. Fagan had already anticipated this and ordered an MRI and referred Brenda to the cancer agency for special genetic testing of the cancer to determine the subtype, to see if she might have a mutation of cancer that they could target with a new medication.
“Brenda, what this also means to you is you are no longer able to drive.”
Boom!
This was such a shock to Brenda. It’s one thing to be told you have cancer, but the severity was driven home (pardon the pun) when she lost her license. Her life was now being dictated by others, and the implications began to flood her mind. What about my work with leaders? How will I get to party days at preschool? Can I fly? Can we go to Kauai as we had planned and do each January?
How long do we have? Anyone in this kind of situation cannot help but ask the question of how long they will live, and our entire family wanted an answer.
I feel deeply for doctors who are put in the position of having this question asked, but they must get it all the time. I could not help but think that, when asked, doctors have a miniature lawyer from the hospital on their shoulder guiding their next words legally, as they cannot really give a precise answer, and there might always be a possibility of litigation from making a promise they cannot keep. Doctors work off of their experience and reams of data when answering. So the answer is always an average. It could be longer; it could be shorter.
Dr. Whitman responded with a range, saying that probably Brenda would be dead by June, but then she added, “You definitely will probably not see another Christmas.”
Boom!
Another shock wave went through the room, and all of us were stunned. Brenda then calmly and kindly responded, “You don’t number our days.” The doctor acknowledged this with admiration for Brenda’s response.
Brenda was referencing the story of Job in the Bible where he acknowledged that his days were determined, and the number was with God. God has appointed limits that we cannot pass (Job 14:5).
Brenda knew her Bible well, having read through it every year for as long as I can remember. So I cannot help but think that Brenda was already reflecting on