Hubert

Content notes: cancer, medical diagnosis, battling insurance

Despite my jokes, I really did think cancer would make me wiser. 

I mean, we’ve all seen it happen, right? Someone with cancer takes to their keyboard and reflects on their journey, sharing the heart-wrenching stories that framed their sickness from diagnosis onward, and we all learn so much from their reflections, their musings, their wisdom. Cancer is a best-seller, a fame-maker, an attention-getter, especially if you get it before you’re forty. Thirty-four with a five-centimeter mass in your colon? Instant power up. 

This nagging thought, this idea that somehow cancer would make me a better person, is probably the clearest sign that the reality of my diagnosis hasn’t set in yet. And in truth, I don’t have a full diagnosis to grapple with yet. I don’t have a stage or a long-term prognosis. They need to remove the mass from my colon in order to see how deep it’s penetrated into the wall of my colon and if it’s spread to the nearby lymph nodes. The good news is that the most recent CT scan of my abdomen didn’t show any evidence of metastasis to my lymph nodes or liver, the two locations colon cancer likes to spread before spreading to the lungs (which we’ll be looking at in another CT this week). Most likely, given the givens, I’ll be cancer-free by Christmas, but there’s not a 100% guarantee. 

But still, if I was taking my cancer seriously, I would dismiss as childish or cynical any idea that cancer on its own would give me a better perspective, or wisdom, or respect. And really, looking at my cancerous mass (which we’ve named Hubert) in the color pictures from the colonoscopy did bring me down to reality for a time. Tumors are ugly, or at least mine is. Admittedly, the picture is post-biopsy, so Hubert is bleeding pretty profusely, spewing my blood into my colon via his wounds, but he’s also a genuinely disgusting mushroom-like mess. I was gobsmacked to see that something this gross is in me, that my body has spent the past five months growing a monster the size of a fun-size candy bar in my gut and I didn’t know. There’s no wisdom in cancer, or at least in my cancer as it is right now. There’s just pain and nausea and a lingering loss of control. 

But pain and nausea I can deal with, actually. I’ve been living with them constantly for months, and off and on for more than a year. I went to urgent care late last summer with what I was sure was appendicitis, only to be sent home with an order for the earliest available ultrasound appointment, which was three months later, at an imaging center in a hospital an hour away in West Virginia. This stabbing pain in the lower right quadrant of my abdomen would leave me doubled over time and again, while the scans all came back clean. COVID, and later Epstein-Barr Virus, threw a wrench into the search for the source of my abdominal pain because everything hurt from January to June of this year. But when that abdominal pain sent me to the ER in April, the CT scan, ultrasounds, and bloodwork all came back normal. And since diarrhea was a side effect of the medication I was on, I assumed, for a while, anyway, that I was simply dealing with the on-going effects of what I now took to be a chronic illness. 

So I put up with it, until my stool started changing colors. After a check-in with my doctor, I was able to get a GI appointment in September, which led to orders for a stool sample (immediate) and a colonoscopy (scheduled for December). I waited as patiently as I could for the colonoscopy, until mid-October rolled around. The pain, which had been hit or miss, was now constant. It hurt to sit, it hurt to lay down, and it hurt to stand. I had been planning a trip to North Carolina the first week in November, but I found myself calling around on Halloween, cancelling plans. I just couldn’t imagine sitting in a car by myself, driving for hours, trying to avoid bumps and the jolts of pain they would inevitably cause. One friend who I was bailing on told me to go to the ER. I wavered. She insisted. 

“You’ve been in pain for so long already. What will it hurt to go?” 

After some back and forth (mostly about whether it was too late in the afternoon to go, given the shenanigans that might send others to the ER on Halloween), I went. I sat in the waiting room, got my blood drawn, sat in the waiting room some more, was shown to a room, showed a nurse a picture of the aggressive amount of blood in my stool, turned down a particular type of pain medication in case it would irritate the hypothetical ulcers I had, endured the most painful ultrasound of my life, told the technician to ask the nurse if I could have those pain meds now, had a CT scan, and muted Jaime Lee Curtis’ screams in whichever Halloween sequel was on the TV so the doctor could tell me that they found an area of concern on the CT scan, which could be cancer. 

That doctor went to bat for me, getting my colonoscopy moved up to election day. I went and voted in the morning, on the emptiest of empty stomachs. Ian and I tossed around ideas for dinner after the scopes in the waiting room and found the Continuous Ambient Relaxation Environment channel in the recovery room, making jokes about the shapes of mountains while we waited for them to take me back. I also joked about racing the beds on wheels around the halls with the nurse who took me to the colonoscopy room, and when the doctor came in after I woke up from the anesthesia and told me that they’d found a mass in my colon, I said, “Great!” 

And I honestly meant it. Here was an answer, after months of non-answers. There’s a mass. It’s causing my problems. There’s a solution. 

The doctor, who was presumably bummed to be telling someone the age of his hypothetical daughter that she likely had cancer, said, “No! Not great!” I guess it was a new experience for both of us. 

We expected to wait at least a week and a half for the biopsy results, but the pathologist released them to MyChart that Friday around 4pm, and at that point, we were off to the races. Phone calls, texts, google searches, more phone calls, explanations, texts, searches, phone calls. My GI doctor was able to move up my consultation with surgical oncology but not my CT scan. My insurance company hadn’t received the order for my CT scan. The hospital said they sent over the order as soon as it was scheduled. I can move up my CT scan if I get approval from my insurance. Calls. Texts. MyChart. MyChart. MyChart. Google. 

It’s all so much. 

It’s all so much and it’s all so new. It’s all so new, and I’m tired all the time. It’s all so new and I still hurt all the time. It’s all so new and my brain has been having trouble finding words. (I spent a solid thirty seconds with the surgical oncology nurse trying to find the word for electrodes as I made circles on my upper chest, trying to explain the type of adhesive I was allergic to.) It’s all so new and there’s still unknowns. A month ago, I thought my colon was a couple of inches at the end of my digestive tract, and now I know that I have so much colon that they can cut out twenty centimeters, staple it back together, and call it good. There’s so much more to know. 

So, no wisdom yet. No profound reflections. As of right now, it doesn’t appear as if I’ll have to look Death too closely in the face, though a diagnosis like this does have a tendency to push you to get the paperwork in order, just in case. But in one sense, at least, I’m glad cancer hasn’t transformed me into a sage.  The fact that I thought it would tells me that I still have a long way to go towards accepting things as they are, rather than jumping to what they might be. As it is right now, I am a deeply loved, worthy person who also has a moderately differentiated invasive adenocarcinoma named Hubert at the top of my descending colon. That is what I know. And that is enough. 

If you’d like to follow my journey towards wisdom (or not), I’ll be posting updates here on my website. These updates will be mixed in with the rest of my writing, so I’ll be sure to title them with “Cancer Update” at the front, so if you’re just here for the cancer, it’ll be easy to sort out. If you’d like to receive an email every time I post, you can subscribe using the button at the bottom of this post.

If you’d like to help me continue doing work I love doing while I wait for, undergo, and recover from surgery, you can go to patreon.com/wthiap and sign up for a monthly subscription to the podcast that I do with my cohost, Ethan. We typically interview pastors and other church leaders, current and former, about their jobs and what they think, but we also did a thoughtful, very joke-heavy episode working through my diagnosis and our initial reflections on how we think about cancer. You can listen to that in the embed below or by clicking here and listening on the podcasting app of your choice.

Whether you subscribe or listen or both or neither, I’m glad you’re here, reading this, alongside me. Thanks for being here. And if you’re Ian, thanks for being Ian. I’m so glad you’re my partner and my person and I love you a lot.

For the non-Ians out there, talk to your family members, if you can, and see if there’s a history of colon cancer in your family. If there is, start talking to your doctor about getting a colonoscopy. Sure, you might be too young, but so was I. If your digestive process isn’t comfortable or you’re otherwise in abdominal pain, go to the doctor. I’m so, so serious. It’s easier for them to snip out some polyps during a colonoscopy than it is to remove a little guy like Hubert. They have to use a robot and everything on me.

And if you’re traveling for this holiday week, or if you’re not, be thoughtful. Wear a mask in public to help stop the spread of germs so that people like me and everyone else who’s body isn’t going to bounce back from a cold or the flu or COVID can stay healthier. Test for COVID if you’ve got any symptoms. You can get at-home tests for free from CVS if you’ve got insurance. You don’t have to have cancer to start treating your body kindly.

Okay, I think that’s it. Love yourself and one another, friends, as best as you can.

Except for Hubert. I think it’s okay to hate him right now.