The Paradox of Suffering
“To live is to suffer, to survive is to find meaning in the suffering” ~ Friedrich Nietzsche
There I was, lying on the tray that would soon begin to slowly move me through the giant magnetic oracle that would reveal the question on every cancer survivor’s mind: is there any sign of metastatic disease? As I waited for the MRI techs to finish their prep work, I stared up at the floral faux-stained-glass panels covering the fluorescent lights on the ceiling above and felt a rush of pure gratitude overwhelm me almost to tears. I was a changed person in ways I don’t think I realized was possible. Two decades describing the same anxieties and frustrations in journal after journal and suddenly it was like I had found the answer. Something in me was transfigured and the realization was an unexpected feeling of joy. My problems weren’t gone, my hardships from stage IV cancer remained the same. But I wasn’t. The same, that is.
I write a lot about how I’ve struggled as a cancer survivor. My mom asked me once why I couldn’t write more about hope (I wrote an entire essay on the topic, mom). She thought I could better help people that way. But I think honesty helps people more. And if she’d read my essay about hope, she might realize that you can have both honesty and hope at the same time. You can be sad and have hope. You can be in pain and have hope. That is what’s so great about hope. That it’s a choice (unlike the side effects we suffer from cancer and it’s treatment).
“Suffer from.” A while back, when I uploaded an essay to a cancer support platform, their editors changed my wording to remove “suffers” because it’s their habit to avoid the phrase “suffers from…” After a conversation with them, I had a better understanding of why they did this — mainly because their site originated for the purpose of mental health support and cancer support was a new area for them. I think it’s okay to talk about “suffering from” something, but I get it. When people talk about suffering, it’s innately negative. Pain. Agony. Grief. Misery. Put upon. It’s something we should be sad about, pity someone over, hope to avoid. But alas, this last thing we cannot. Because if there is anything we can count on with suffering is that it’s inevitable.
So, if suffering is inevitable in life, how do we not despair? How do we have both suffering and hope, both suffering and joy. “Weeping may endure the night, but joy comes in the morning.” I’ve heard this part of Psalm 30:5 my entire life. I grew up churched like many of my fellow Americans in the land of western Christianity dominance. Maybe you’ve seen it on a color-blocked background posted on social media. Or as many of my fellow cancer survivors have experienced: one of the well-meaning, but trite sayings that we find written in get-well cards and our social media comments sections.Things suck now, but eventually it won’t. I have a friend who lost two of his four sons to cancer. I don’t know if there will ever be a time that his loss doesn’t suck. That he won’t feel the familiar pangs of grief.
But I’m certain that he will experience joy again. Because despite how unhelpful hearing quotes like that can feel in the worst moments of suffering, I do think there is truth in that Psalm. We hear it expressed in other ways: “It’s always darkest before the dawn,” “There is light at the end of the tunnel.” The darkness we feel in suffering doesn’t last. Unless we decide to dwell in it. To stay in the tunnel. Unless we choose to despair.
“We must accept finite disappointment, but never lose infinite hope” ~ Martin Luther King Jr.
There is a hymn titled “It is Well with My Soul” penned by Horatio Spafford, a deeply pious late 19th century lawyer living in Chicago. Spafford could be considered a (relatively) modern-day Job (the oft-referenced sufferer from the Bible). Horatio lost nearly all of his real-estate holdings in the Great Chicago Fire. As he was picking up the pieces of his misfortune, he sent his wife and daughters ahead of him on a trip to Europe, where he would join them for a much needed respite. It was on that trip that his family’s ship was wrecked in the night, splitting it in two. Less than 100 were saved by a passing ship, Spafford’s four daughters (all under the age of eleven) were not counted among them. His wife sent him what has now become a somewhat famous telegram, just two words, “SAVED ALONE.”
Horatio set off immediately to meet his grieving wife, and it was as he passed the very place his daughters were lost to the sea that he wrote these words:
“When peace like a river, attendeth my way,
When sorrows like sea billows roll;
Whatever my lot, Thou hast taught me to know
It is well, it is well, with my soul.”
There are more verses where he goes on to profess assurance of hope through his faith, but it’s this first verse that I prefer to focus on for now. Spafford had lost nearly everything. All but his wife with whom he’d share his grief: “sorrows life sea billows roll.” But he still hoped for peace while declaring (though I’d guess…not yet feeling), “it is well with my soul.” I’ve been familiar with this story since I first sang the hymn in a church service. I knew this song was written by someone who had lost their daughters at sea. It was usually mentioned before we’d stand and sing the hymn. But that was always the whole of the story. The preacher’s message from the pulpit probably discussing the book of Job: steadfast faithfulness in times of sorrow or suffering.
But that’s not what I’m writing about here. Not that it isn’t inspiring. It is. And unwavering faith in suffering can be a part of the discussion, but it isn’t where I’m headed with this. I’m using examples that reference religious faithfulness because (A) they’re easy to come by — suffering is a major theme in the Bible and (B) I grew up churched and studied theology in graduate school. It’s my wheelhouse. But my religious examples are just that, examples. Not about religion, but human suffering (which just happens to include, but is not limited to, religious people). I’m over-clarifying because religion can be controversial and I’m sure I’m not the only one who started reading an essay and got tricked into being proselytized to.
Which brings us back to Horatio Spafford and the rest of the story. After the Chicago fire, Spafford had one remaining estate, which he used to house people displaced by the fire. His whole fortune was taken from him and the one thing he had left, he surrendered to help others. He lost his four daughters at sea and later a son to illness but his life did not end there. He and his wife formed a community in Jerusalem that aided, housed, fed, educated and provided health care for those in need — regardless of their nationality or religion and without proselytizing. Their community became know as a safe haven where those fighting all around could reside in the same place with an agreement of peace.
The Spaffords lost so much, but their story didn’t end with their grief. There is a scripture that says, “we count those blessed who have endured” (suffered). I don’t think I fully understood this until I was diagnosed with cancer. And I wonder if the Spaffords experienced this paradox of blessing and suffering similarly. I wonder if they felt joy in helping those in need knowing that it was suffering that made it possible when it would be, I think, much easier to resent or despair over the trauma they had endured. And that’s where I think choice enters the equation.
I compared Horatio Spafford to a modern-day Job; someone who basically had two lives — the one he lost to fire and tragedy and the one he lived afterward. If you are unfamiliar with the tale of Job from the Old Testament of the Bible, it is a story where God and the devil basically make a bet on Job’s faithfulness. God puts his money on Job and the devil tries to swing the win his way by challenging God to allow Job to suffer. Like “lose everything you have and love, boils on your skin, excruciating pain and grief” suffering. God accepts and everything terrible you can imagine happens to Job, but he remains faithful. God wins the bet. And afterward, Job ends up with more than he ever had before. It’s like Cinderella. She has a nice life, everything goes to shit, but then she ends up a queen. The tale of Job is often criticized as representing a cruel God who would use Job as a plaything to prove a point. To that I say, “it’s a story, man. The God-Devil bet is a framework.”
Job’s story usually begins and ends with his faithfulness despite suffering. But I think the real takeaway is that despite his unwavering faithfulness, he suffered. It’s an example of the inevitability of suffering. It doesn’t matter how “good” or “bad” you are, you’re going to go through some shit at some point. Job’s faithfulness was a decision he made while experiencing hardships. In other words, Job could have despaired, grown bitter, given up, turned to the bottle and I don’t think anyone would have judged him for it (except his closest friends, who judged him even when he was faithful). But he would have missed out on the life that came after his suffering. One that didn’t replace his former life — those losses would still be felt — but rather a second chance at joy, peace, health, love and so on.
We all suffer. There is no choice in that. Suffering changes us. Our choice lies in how: Hope or Despair. Silver lining or bitterness. New life or living death. Help others and be helped by others or wallow in alienation and self-pity. These are chosen states of being, not passing emotions that you might feel when you are struggling with pain. There is a difference. No one should feel ashamed of the natural emotions that one goes through in troubled times. Which brings us back to the paradox — you can choose to hope and help others while simultaneously experiencing resentment or bitterness towards what has happened to you.
I’ve been in remission for a few years now, but any cancer survivor could tell you, that is not where the story ends. Managing my health is still almost a full-time job. My body has had a lot of trauma from cancer and its treatment and my life is very different from what it was before. Doctor’s appointments fill my calendar like business meetings. Oncologist, Ophthalmologist, Dermatologist, Onco-Gynocologist, Otolaryngologist, Colposcopy, Cardiologist, Allergist, Therapist, Physical Therapist. It never ends. And some days…it’s simply exhausting and I get sad or angry that I have to deal with one more thing.
This past fall I was having some vision issues. I get a lot of ocular migraines, but I was also struggling with my general eyesight. Vision problems are one of the side effects of an immunotherapy drug I currently take, so I tend to get things checked out when something feels off. After inspecting my eyes, my ophthalmologist noted that my ocular nerves were faded and that she’d like to do tests to determine if it was from a single trauma occurrence or if it was a progressive issue. In short, she wanted to find out if I was going blind. So, for two weeks while waiting for appointments and results, I wrestled with the possibility of going blind. BLIND. I already have major hearing loss from radiation. I can’t afford to keep losing senses. I had a few panic attacks and ended up with a heart monitor for two weeks as a result.
It turned out that the trauma to my ocular nerves was most-likely due to radiation and gamma knife brain surgeries. It was not progressing and my eyes should only get worse from natural aging. Phew. But that’s what every ordinary health concern feels like. It can be overwhelming, stressful and frustrating. But there is a flip side I experience, like what I felt that day during my MRI, of gratitude, joy and acceptance. Two sides of the same coin flipped in the air, me wondering which side it’ll land on. Both are me. When the one side is face up, I’m still aware of the other. And surprisingly, it’s the existence of the the “other side” that gives me hope when I’m down and appreciation when I feel joy.
I can’t count the times I’ve wished that the permanent affects of cancer on my body would change. That my hair would grow back from radiation baldness, that my hearing would return, that my eyesight would be normal, my ovaries would produce healthy eggs, that my brain would stop dropping words when I need them. My bones, my nerves, my skin, my muscles. But before I get to the end, I begin to wonder if what I went through would be pointless if suddenly my body went back to the way it was when I was healthy. If my scars healed over and there were no more reminders of what I suffered. Would that sacrifice my empathy? My ability to share in the community of sufferers? I have helped and been helped by other cancer survivors. Those moments have been some of the most fulfilling and emotionally rewarding of my life; and the times I remember most are when I’ve connected with someone feeling and experiencing what I have felt and experienced (as much as one can). There’s a place there for me. It’s not my only place. There’s more to survivors than their cancer. But it will always be a part of who we are (like those who have grieved the loss of a loved one or been through trauma). And we have the choice to be stronger for it. Like a broken bone that heals stronger than it was…if it is set right.
After five years as co-president of an adolescent and young adult cancer patient advocacy board at Northwestern Medicine, I have been overwhelmed by how many cancer patients ask how they can give back. How they can help others going through what they’ve gone through. They want to find meaning in their suffering. They want beauty for ashes. It’s what I felt, too, and why I got involved with the program in the first place.
“It is an illusion to think that a person can be led out of the desert by someone who has never been there.” ~Henri Nouwen, The Wounded Healer
The difficult things we have gone through or will go through can remain trauma that we harbor within ourselves, or we can recognize that what happened to us gives us a unique opportunity to help others like us. It is an opportunity to take the power back from the trauma and flip the script.
Cancer was the best and the worst thing that happened to me. I grieve while being grateful. I find joy hidden in pain. I remember with fondness the person I was before, but I am proud of and excited for who I have become. I live within the paradox of suffering and it is well, it is well with my soul.
“I began to understand that suffering and disappointments and melancholy are there not to vex us or cheapen us or deprive us of our dignity but to mature and transfigure us.”
~ Hermann Hesse, Peter Camenzind
