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Essay

The Need

EVERY COUPLE OF MONTHS,  you go to the doctor looking for a new word—a name that is different from the one you have now: hypo, hyper, metastasized, malignant, benign. The hope is always for an upgrade, though it’s hard to say which names are better than others in this game. Take benign, for example: it sounds better than malignant, but what if malignant is the word you’re looking for, because the words in the last blood test results were traceable thyroglobulin, which you understand in the terms that your doctor has given you: tumor marker, but the word in the mouths of all the ultrasound and PET scan technicians is undetectable. Suddenly every lump you find in your neck, armpits, and breasts is something you want to call malignant, but they’re all benign, and you begin to think you’ll never find it—the trail of terms leading to located, leading to removed, leading to remission.

 

Waiting

 

“The blood test last time still showed some thyroglobulin, no?” the doctor asks me. I’m lying in the leather recliner next to the ultrasound machine, paper towels tucked into the neck of my shirt.

“Yes,” I say.

“You are a very interesting case,” he tells me. “Turn your head to the left, please.”

I look over toward the counter at the little plastic model of a throat used to show patients where the thyroid gland is located. Attached to the plastic trachea is a violet-gray, dimpled piece of plastic shaped like a butterfly, with wing-like lobes that flare out and wrap around either side.

He pushes the sensor down on my throat like a fist, digs it into my collarbone again and again. “I’m sorry,” he says, “that I have to press so hard, but it’s very deep, I think, beneath the carotid artery.” He can almost see it clearly—the bed where my thyroid used to sit, where he suspects the problem is. His hands loom, huge below my face. They move in a steady and determined way, forward and backward and forward, as if carving and smoothing a chunk of clay.

“The other lymph nodes are the same,” he says after a few minutes. “But I wish I could get to that spot under the carotid, or into the thyroid bed—because no surgeon will operate without a tissue sample, you know. And that’s where the bad ones are, behind the carotid and in the thyroid bed.”

“Hmm.” The lymph node biopsies I’ve had over the last two years have both come back negative, and I’ve begun to suspect that this is more frustrating for my doctor than for me.

“It’s very unlikely that it has spread to the lungs or the brain—still possible,” he says, “but unlikely. And the scan showed nothing, so.”

I listen to his jaw popping as he chews his gum and runs the gooey sensor over my neck—left, press, pause, right, pause, press, then left again.

 

Limbo

 

Limbus: Latin for hem, border or edge (Think: your fate is yet to be determined.)

Thanks to Dante, we know that hell has nine floors. The first one is limbo: a place for good people who just can’t be saved. That’s where the poets go. In The Divine Comedy, Dante describes limbo this way:

Here, for as much as hearing could discover,

there was no outcry louder than the sighs

that caused the everlasting air to tremble….

In aspect, they were neither sad nor joyous.

Limbo is not to be confused with purgatory, where the souls of those who have been saved are cleansed before they enter paradise. No one is leaving limbo.

Cancer limbo is not quite purgatory, but it’s not a place you’d want to stay for long. It’s like living on top of a volcano that’s been inactive for a while. If you peer and squint into that great hole in your front yard, you can see a hint of lava, red and orange, quietly swirling around down there in the dark, waiting for you to turn the other way. Except that this volcano is your body. The catastrophe is you.

 

Faith

 

After overgrowth—the invasion of stable cells by cancerous cells—the conquest leaves everything hard and thick as marble. Once my thyroid gland was removed in the first surgery, calcified was the term used to describe the cancerous lymph nodes found like little pebbles in my neck. Metastasized was not used at first. This is how cancer works: growth brings death. Overzealous cells, in their frenzied movement, still what is alive and turn it to stone.

Trying to gather these paradoxes into metaphors, aphorisms, and life lessons is an awkward hobby, much like prayer. In prayer, people fumble with their personal crises like slippery balloons, too large—large as their own bodies. They try to turn one crisis around and shape it with their tiny hands until it looks like hope, until it looks like something God-given, until it feels like a blessing. It takes a level of willful blindness—or faith—of which I am incapable. It takes a kind of turning away that I have not yet been able to do, because in the acceptance of prayer and stillness, the other side of that slippery crisis is still in my arms; I’ve only turned it around to look like design or blessing, to hide the worst of it.

I’m not a believer in the religious sense of the term, but I have put a lot of faith in medicine, because I’ve had to. Patients don’t have much of a choice about that. When a doctor tells you the tissue sample looks suspicious, you ask him, as you would a priest, what to do. He tells you: “Surgery,” like a penance, and you do it, trusting that it will help you. When it does, a little, your faith in medicine is strengthened, so you’re happy to have another assignment, and another. You’re happy to have radiation this time, too, like throwing an Our Father into the endless string of Hail Marys. How many surgeries and doses of radiation will you take, there on your knees, mumbling all the words you’ve learned, counting them in your hands like rosary beads, before you begin to question your faith?

If medicine is my god, I’ve put in four years of devotion, and my faith is beginning to wane. Medicine takes so much faith that I’ve got nothing left for any other god, and certainly no room for a savior. Salvation in the medical world means being cured, but cured is not a word typically used for cancer patients.

 

The Gospel of Statistics

 

The words fall like stones from my stepfather’s mouth: “Maybe you should pray more.” I don’t know how to answer what sounds like half request, half accusation. I feel as though I’ve just been sunk. I’m lying on a riverbed in the passenger seat of his car, my pride like flotsam in pieces around me.

“I think I need more medical treatment,” I say.

“Both—you need both,” he says.

“So what about all the people with cancer who pray and die anyway?” I ask.

It’s not a sincere question. I have my answer already, and I don’t care what his answer is. I turn my head and watch car dealerships roll past, unwilling to offend him, and perhaps unable to defend myself, a rationalist, a nonbeliever—worse, a disbeliever—to a man who relies on nothing if not his faith in God.

Maybe God is as good as anything, in terms of reliance. Statistics offer no comfort, and certainly no reliability. Before the first biopsy on my thyroid gland, I was given good news: ninety-five percent of all thyroid nodules are completely benign. After the biopsy results turned up “suspicious,” instead of benign, I was given more good news: “If there’s a best kind of cancer to get, this is it.” I was also given a few more factors to work into my prognosis—more numbers, more charts, more statistics. There are four types of thyroid cancer, I learned, each with its own set of statistics attached, and the good news was, I had the least deadly kind. Also, as a female, age twenty-two, with a papillary cancerous thyroid nodule that was less than half a centimeter, I had a ninety-five percent chance of being alive and healthy ten years after my nodule was removed. After my entire thyroid gland was removed, I was given the statistic that had slipped past me (and the surgeon) before the first surgery: in all cases of thyroid cancer, there is a fifty percent chance of metastasis to the surrounding lymph nodes. Four months after my surgery, that’s what happened. But again there was good news: this wouldn’t change my prognosis. In ten years, when I was thirty-two, I’d probably be alive—unless I wasn’t.

After you’ve been in the other percentage so many times, statistics begin to lose their charm. The gleam of that number that was once on your side begins to tarnish like an old coin, but you hold onto it anyway. Nights in bed, you squeeze it in your hand, trace its ridges with your nail, press its edge against your fingertip, turn it over, squeeze it again. It dulls and warms in your palm, but you hold it and hold it and hold it, because your other hand is empty.

 

In kindergarten, I learned that there are ten commandments. Later, I learned that there are seven sacraments of the Catholic faith, and also seven deadly sins; these two should not be confused. Even later, I learned that there are three people in the Holy Family (plus God), and later still, I learned that three can sometimes equal one, as in the case of the Holy Trinity. I’m sure that Catholicism resembles medical practice in more ways than I, as a patient, am aware, but what’s most striking to me is their shared reliance on specific labels and terms, on naming and numbering. In both, this seems to come partly from an emphasis on tradition—call it the scientific process, call it ritual. There are steps, and for each step there are categories, words, names, labels that one must learn, and they are often quite confusing.

Despite the challenges of spiritual math, the tidy sacrament of confession offered me comfort as a child. In the second grade, I prepared piously for my first confession, which had to be completed before I was to receive the real prize—first communion. The two events would happen in succession on one very big day. I memorized the Hail Mary and the Our Father, as I would need them to say the penance that Father would give me after I confessed my sins, which I also memorized. On the big day, breathing wafts of Pine-Sol inside the wooden confessional, I counted them off: I’d recently lied to my mother, fought with my sister, and talked during Mass. (I was too embarrassed to admit that I’d been gluttonous with the Zebra Cakes, so I made a note to list lying to a priest in my next confession.)

After confessing in the open air of the church, rather than inside one of the booths tucked into the walls (a setup that the church recognized as significantly less frightening to an eight-year-old), I did my penance, silently reciting three Hail Marys and one Our Father at the tabernacle, and maintaining my focus even through the loud whispers of the girl next to me, who did not recite her prayers silently, as instructed. As I walked back to my pew, I felt good. The white cotton of the dress my mother had made for the occasion was still pressed and cool in the sticky heat of the church, and I knew that I’d accomplished something important.

In a confessional booth, one sheds one’s spiritual burdens. In return for each sin, a spiritually ill person is given instructions for recuperation. There are clear rules to follow, a path set for every pilgrim. You are forgiven, she is told by her priest or healer, and she leaves with a renewed sense of certainty: I will be okay. Even at eight, I sensed the power of ritual. I’d gained these new words—confession, penance, communion—and with them, the power to undo whatever terrible things had already been done.

 

Word Made Flesh

 

The faithful are often comforted by the idea of an omniscient, omnipotent, and omnipresent God. When circumstances become difficult to comprehend, they are told that God is in control—though they cannot hear him, he understands their pain; though they cannot comprehend it, he has a plan; though they cannot see him, he is always with them. Even for the faithful, it seems, this can be difficult to accept. Despite our best efforts to transcend the world of material concerns, we long for the tangible, the physically evident. In Christians, this desire for a tangible God is fulfilled by Christ, the Word made flesh, and the sacrament of the Eucharist allows believers access to him, a physical incarnation of the divine. “The body of Christ,” the priest tells them, and as they place it on their tongues, it is. God becomes real through them, through their bodily processes. “The blood of Christ,” the priest says, and as they drink it, it is.

 

After my second surgery, I undergo radiation therapy in the form of drinkable radioactive iodine. At the hospital, the iodine is brought to me in a tiny lead-shielded canister by a man in a hazmat suit. “Try to drink it all at once,” he says, and I do. When I get home and prepare for a week of isolation, I wait to feel nauseated or crampy, as the doctor told me I might, but I never feel any side effects, and I wonder how I am supposed to know whether or not it’s working, killing every thyroid cell left inside me. I simply have to rely on faith until measurements of thyroglobulin and other thyroid hormones in my blood can be taken six months later.

Ultimately, those measurements show that the radiation has worked, but not enough. There are still traces of thyroid tissue somewhere in my body, and the hormones it produces will continue to be the only proof of that tissue’s existence for years. The cancerous cells will evade every scan and probe my doctors can order—the invisible tumor, only putting out small signs of its omnipresence to be interpreted as little words and numbers printed on a sheet of paper year after year, a constant never fleshed out.

 

Westminster Abbey

 

In the spring of 2009, I went to London. During the course of my twelve-day trip, I visited five churches. While my interests in the churches were either architectural or historical, these visits began to shake loose some bits of memory long pressed to the bottom of my mind: the scent of oak and varnish, my mother’s veined knuckles, the sharp point of the diamond on her engagement ring. When I was a child, a fifty-minute Mass felt like an eternity. It was excruciating to sit, stand, kneel, and sit again, all in one spot. As we only went to church on holidays, and were usually late, we were lucky if we got seats. I could never see anything over the heads of the hundreds of people in front of us, so I occupied myself with my mother’s hands. I remember almost nothing else about church. I would pick her hand up, turn it over in my lap, trace the creases in her palm, tap her nails with the edge of my own, bend her fingers at each knuckle, slide off her rings, put them on my own fingers, put them back again. All the while, my mother continued to sing and mouth the prayers. I must have run my fingers over her hands hundreds of times in church—over her tiny bones, her papery skin, her one piece of gold, the voice of the priest a world away from me, singing, amen, amen.

 

Westminster Abbey, as I discovered during my audio tour, is a maze of chapels within chapels, with bodies tucked into every wall and beneath every floor tile, each marked by a plaque or shrine. The tiny chapel containing the shrine of Saint Edward the Confessor, now partly dismantled and closed to tourists, is a space of stone and wood large enough for only a few people. From the outside, it looks like a couple of antique trolley cars stacked one on top of the other. It was difficult to see anything through the tiny arches and windows, but a plaque told me that the step at the shrine’s base shows slight dips where centuries of knees have worn away the stone. Ages ago, the faithful and desperate would come here asking to be cured of various diseases, and some would even leave their sick loved ones at the shrine overnight in hope that they would be cured by morning.

Saint Edward is said to have healed several people just by touching them. He is dubbed “the Confessor” not because of any compulsion to confess his sins, but because of the church’s system of classifying saints. Every canonized saint is either a martyr or a confessor. A martyr bears witness to the faith through his death, a confessor through his life.

I imagine myself left inside the chapel beside the shrine of Saint Edward: the only light comes from a few candles left to burn overnight. They illuminate bits of faces and hands in the wall—the hundreds of carved statuettes of saints above me. They seem to lean in, their arms outstretched, fingers crooked and pointing, looming over me. Their hands are nothing like my mother’s in Mass; they are cold, clenched, unreachable, unmoving. I lie on the floor, the marble cool on my back and shoulders. It feels good at first, but when the cold begins to creep into the spaces between my bones, I feel lonelier than ever. I spin the little glass ovals of my rosary between my thumb and forefinger. I mouth what words I remember from prayers memorized in school, but they come to me broken and hollow: mother, father, son, sins, bread, fruit, forgive, amen, amen, amen.

 

The nave was the final stop of the abbey tour. Pulling my headphones down around my neck, I stepped through the entrance, moved past the priest opening and closing the glass door for tourists, looked up, and stopped. The air inside was different, the shuffle of coats and hushed chatter more urgent. This space was full of people praying and mourning in the pews, at the altar, at the votive stands. This room felt full of a fresher pain than the rest of the abbey—pain not yet relinquished to history. It seemed at that moment, under the vaulted ceiling, that something tight in my chest unfolded.

As soon as I saw the rows of tiny votive flames melding into a box of fire—fire made modest by the size and splendor of the place, the ceiling lost somewhere in the sky, the echoes from mouths in crevices and corners of the room that I couldn’t even see—I wanted to light one. I walked to the votive box, then stepped away again, afraid of this sudden flicker of superstition. I scolded myself for the lapse in rationality, wondering for whom my votive, had I lit one, would have been—I had no terminally ill family or friends, none soon-to-be nor recently dead, none struggling with recent misfortune. I walked carefully, my boots echoing across the checkered tile, reading the engraved names of clergy and kings, doling out quiet tsks at all the predictable -isms buried beneath, feeling suddenly like a tourist, and quite detached.

As I rounded one of the endless white stone pillars on the opposite side of the nave, I met another glittering shelf of votives, a tin bucket of new white tea lights beside it, begging for fingers. Despite my stubborn disbelief, my refusal of irrational comforts, despite my defense against hope, despite my not-yet-admitted anger at the simplicity of good and bad, of wrong and right, of just and unjust, and despite my anger at, for lack of a better term, God, I wanted to light one. I reached into the bucket, feeling the rush that comes to tiny hands when plunged into an oversized cookie jar, touching wax and tin, tacky and sharp in my hand. I pulled one out and lit it, holding the tiny wick up to the flame of someone else’s—a low votive, almost done. Once it was lit, I placed mine in the left corner of the top row. And then I took another. I felt that taking a second votive was almost certainly frowned upon, but I couldn’t help myself. Once I let reason go, it was gone. If one candle could solve a problem, anything could happen. But questions followed: What if I lit it the wrong way? What if I placed it in the wrong spot? This was no small problem. What if one wasn’t enough? I placed the second votive in the other corner, on the right end of the top row. There they stood then, their flames like two little flags, flanking a whole row of fears and hopes strung like beads, desperation burning small and quiet in this giant marble cave.

I watched them for a minute, and imagined a momentary stillness inside my body—not prayer, or even meditation, but just a momentary emptiness. Emptiness was what I had been longing for over the past two years—the opposite of cellular chaos, overgrowth, tumors, intrusion. I wanted to feel nothing, and the only recognizable sensation I could think of that came close to nothing was stillness. Oddly, the frantic jumping of the flames cultivated that feeling, for everything in that giant room—stone, stone, weary faces and legs, more stone—looked incredibly still behind the frantically trembling orange mass of the votive box. I dropped a fifty pence coin through the slot in the black metal donation tin, picked up a prayer card, and read the suggestions: for someone known to you who needs your prayers, for the many unknown who also need your prayers, for your home, city, town, parish or church, for Westminster Abbey and the ministry here. I felt a quick flush of embarrassment. The single recipient of my two greedy votives was not on this card, because you are not supposed to light votives for yourself.

 

Meaning-Making

 

metastasis: Greek for displacement (Think: replacement, after-placement.)

meta: Greek root meaning on, about, after, post, next, aside, with, among, beyond (Think: beyond; think: after; think: movement from one place to the next; think: metamorphosis; think: change.)

stasis: Greek root meaning standing, placement, stability, or when the flow of bodily fluids stops (Think: stillness, stability, a stand against movement or change; think: anti-transformation; think: when blood stops. Think: I am rushing toward stillness.)

 

Incurable

 

After my tumor has succeeded in hiding its location from my doctors for two years, I am told that I might simply be in the category of patients who never reach full remission—trace amounts of cancerous tissue remain in their bodies, perhaps evident in blood tests, but not perceptibly growing. I am essentially incurable, because my cancer refuses to reveal itself. When the doctor tells me this, I recall being told about original sin in the first grade. I remember falling into despair when my teacher explained that, despite my best efforts to be a good girl, despite the devastation I felt with every misguided or accidental transgression (usually working myself into a tearful apology before the broken vase or stained rug was even discovered), I would always be sullied by sin.

For Christians, this despair is alleviated by the knowledge that God has already forgiven us. For me, in the doctor’s office, there is no sense of forgiveness, because my shot at salvation through medicine has been taken away. Medicine, my god, has failed to cure me, and though I will never be allowed to see it or touch it, my sickness will always be with me. On my way home from the clinic, I recall lines from a favorite Anne Sexton poem, “With Mercy for the Greedy”:

True. There is

a beautiful Jesus….

How desperately I touch his vertical and horizontal axes!

But I can’t. Need is not quite belief.

 

A Gift

 

A few months ago, I found a term for my cancer. Complete remission, according to Chemotherapy.com, occurs “when a physician can no longer observe the tumor cells by simple examination, chest X-rays, and/or blood tests.” This as opposed to partial remission, “when some tumor cells are still detected by the tests.” Bingo: partial remission. It sounded so official, so stable, so hopeful—for if part of something is in remission, the other parts are sure to follow. A term like partial remission implies that there is an organized event taking place within my body—a remission boarding school for unruly cancer cells; not just some state school’s cancerous freshman dorm on a Friday night, cells dividing like mad whenever and wherever they please.

Why hadn’t any of my doctors given me this glorious word to hold, to pack into my purse like a tiny gem, to pass around like a new baby among family and friends when they ask how I’m doing, or to pull out and admire when I’m alone? Partial remission. I’d needed this word.

The need to name things is basic. After food, water, shelter, and toilet paper comes the need to name. People have always felt the need to name what they see, what they discover—countries, rivers, flowers, beetles, children. Much of this is practical, but there is a pleasure in the naming of things that reaches beyond the satisfaction of determining which mushroom is poisonous and which mushroom is dinner. Once you can point to something and say, There—I know what that is. It’s the Thames, you’ve conquered it. You’ve conquered the Thames. It’s yours, every time you call it, every time you put your fingertip over it on a map and move your lips. Every time you utter its name, it’s yours—or at least, the name is yours, the word like a souvenir to stuff in your pocket and carry home.

 

Words, Trinkets

 

While in London, I also visited the British Museum’s Living and Dying exhibit, which featured, among a plethora of dolls, masks, herbs, spells, and pottery from tribal communities all over the world, an almost perfunctory section on Catholic traditions. There, hanging like keys inside a glass case, were tiny silver arms and feet, a silver tooth, a heart, a hand, a leg: handmade miracles, milagros.

A milagro is usually made of silver or other common metal, and is meant as a prayer offering, like a votive candle, but more specific. The milagro physically represents the very thing that is thought to be the source of woe—a heart for heart disease (or conceivably a broken relationship), a lung for emphysema or lung cancer, a tooth for a root canal, and so on. It’s a charm against ill health and bad fortune. When I saw milagros hanging in their case at the museum, I decided that these were better charms than the generic white votives of Westminster Abbey. There is a lot to be said for specificity. Making one’s pain physical—through something as solid and squeezable as a tiny metal replica of a body part—functions not just as a type of prayer, but also as a kind of naming. In addition to the comfort of prayer, of believing that someone is listening to your problems, there is the comfort of knowing, of defining, of saying, of more completely owning those problems. Most importantly, ownership allows for agency—or the illusion of it, at the very least. Below the milagros in the British Museum is an image of Christ comforting the ill, and the words: Your faith has saved you. Be healed.

It occurred to me, as I looked over the milagros, that I couldn’t have made one if I’d wanted to. What would it look like? A thyroid gland? That’s gone. A collection of lymph nodes, strung together like pearls? Those are gone too—the bad ones, anyway. Their places in my neck are empty, scraped and nuked clean. But something still ails me, some invisible thing—my blood knows it. It has no shape, and the organ that hosts it has no name. So there in the British Museum, I made a phantom milagro in my mind. It has the butterfly shape and wings of a thyroid gland, and the tiny pebble body of a lymph node, but it’s made of mercury, so it keeps losing its form in my hand. I try to mold it, to contain it, to hold it, but it just leaks through my fingers like sand.

 

Luminous

 

I sit in the examination chair, its plastic covering squeaking against the leather seat as I shift my weight and the chair eases into a reclining position. In the ultrasound room with me are the doctor and three people I haven’t seen before: a perky middle-aged radiologist wearing two sets of gold hoop earrings, a middle-aged saleswoman in a turtleneck, and a silent young man in a suit, whom I take to be another sales representative, here to promote a new ultrasound machine.

The doctor and the radiologist speak to each other about the mechanics and workings of the machine. She sits in the chair next to mine, in front of the machine, and shows him a new function, pressing the sensor gently over my neck. Then she gets up, and he sits down and tries the new move, pressing the sensor more firmly under my jaw, searching. Then they switch again.

After a few minutes of this, my doctor takes over the chair and the sensor, and the radiologist steps aside, next to the machine, to discuss the clarity of the images on the screen with the turtlenecked saleswoman. By now, I have stopped expecting to see anything on the ultrasound screen that I can understand, and I have stopped expecting the doctor to find any new meaning there.

Suddenly the radiologist looks down at me, as if only just noticing me. “You scan real pretty,” she says. I can hear her earrings clinking as she nods her head.

“Mm,” I say, my eyes straight ahead, on the ceiling. The young man in the suit, who hasn’t moved from his spot at the door, stays silent.

“There. Look at that,” the doctor says, pointing to the screen. “There it is, behind the carotid artery.” He looks up at the radiologist.

She bends down and squints at the screen. “Oh, yeah,” she coos, drawing out her affirmation.

“Oh,” says the saleswoman, moving closer to the screen. The man in the suit stays silent, doesn’t move.

“It’s a beautiful image—clear,” the doctor says. “I can send this to a surgeon for biopsy; it’s much more visible here.”

I shift my eyes over to try and get a look at the lymph node on the screen. I can barely see something glowing there—something white and round in the static, almost tangible. It is a tiny calcified part of me, the words in my neck made flesh. The little node is impossibly deep beneath arteries and veins, but luminous as a flame on the screen, mercifully visible against the grainy striations of black and gray.

 

The Language of Faith

 

In school, I was taught that the difference between belief and faith is that faith does not require proof, nor does it rely on reason or measurable outcomes; faith defines its own worth. It is a semantic distinction that has always puzzled me. How does one put faith in something that has not proven itself? But if I have gained anything from my illness, it is the knowledge that apparent proof is not infallible. The node found by the new ultrasound machine was too deep in my neck to be sampled for biopsy; thus, it is inoperable. It has simply been added to the list of unknowns in my body. An image that I took as evidence of disease ultimately failed to lead me to an answer.

I would like to say that while medicine has been unable to offer me a cure, I have found a way to turn to God for spiritual healing. In truth, there is no resolution to this story, perhaps because I have allowed myself to become comfortable in the limbo between good news and bad news, in the same way that I have found comfort in the limbo between proof of God and proof of nothing. If I never go in search of the divine, I will never encounter the disappointment of finding nothing. I have come to understand faith as a willingness to confront the unknown with sincerity and conviction. Sometimes I am afraid that I don’t have the fortitude this takes.

Yet I call myself a writer, a poet. What is poetry if not the language of faith? To utter words with the belief that they can penetrate the barrier between the physical world of sound and the ephemeral world of emotion—surely, this is a leap of faith akin to religious ceremony. To the faithful, the prayer and its power are indistinguishable, and so language becomes both agent and object of faith. In the same spirit, I repeat the words I’ve learned from my doctors like prayers, assuring myself that if I can name my illness, it will materialize in a kind of linguistic transubstantiation. In these moments, I have to wonder: is my faith in the medicine, or in the words? Paradoxically, for me the blurring of this line has clarified the difference between evidence-based belief and simple faith. Perhaps by looking for some piece of proof (of God, of effective medicine, of the world’s goodness) in which I can put my faith, I have been searching in the wrong order; perhaps proof must be found in faith itself.

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