Returning to the Valley

The news is not good and my mind is both a-whirr and awash with thoughts, feelings and emotions. I’m writing this in the wee, small hours of 9th September in our darkened bedroom.

Yesterday afternoon, Clare – one of the very supportive specialist nurses at the hospital – rang and asked if I could come into the Oncology Department at 4.15pm. My MRI head scan results were back. I sensed it wasn’t great.

So, taking our long-standing friends and former neighbours at college in Auckland, Tim and Kathryn Handley, currently staying with us, off I went.

Dr Goodman asked how I was. “Generally OK, but aware of fresh small lesions/tumours appearing under my skin on my upper body.”

“Well”, he replied, “I’m afraid I’ve not got good news”. He then went on to describe that my head scan late last week showed multiple tumours in the brain, and whilst generally in the left hand side, were somewhat spread out. It seems that the pembrolizumab (aka Keytruda) is having little or no effect chasing melanoma secondaries in the brain. He’s also concerned that the drug is showing signs of increased ineffectiveness in my body generally. It’s either holding things, or the melanoma is now advancing again.

He asked if I’d seen any signs of effects on the brain. No headaches or dizzy spells, but I guess I’d been aware of an instance a couple of weeks ago, talking with Catherine, of a strange speech episode where, mid sentence, I’d started making an elongated “uuuummmmmmm” and couldn’t produce any words. Then some ongoing, occasional inability to string a sentence together.

They’re all possible symptoms of something going on.

My clarifiying questions were many.

Apparently the brain is a very good gate-keeper and works hard to keep out infections, so good that it can also keep out the drugs like pembro that can help get rid of tumours like this.   

As we talked, Dr Goodman was clear that we’ve now reached a particularly serious stage from which it is difficult to return. Medically, some small hope is offered by five short doses of radiotherapy to shrink the tumours.But because the tumours are relatively spread out, they can’t be targeted by a specific beam and so it’ll have to be general radiotherapy to the brain. This can have its own consequences in the form of possible memory loss and an increased inability to concentrate, something which could then further deteriorate with time. I’ll also lose my hair.The positive effect of the therapy is that it may “bump start” the brain into accepting the pembroblizumab/keytruda in. But, he emphasised, it’s only a slim chance this will happen.

I start the week after next, and for the next few days, I’m on a course of steroids as part of the procedure. He also told me that the presence of the tumours means I’m prevented from driving from this point on.

We’re left as a family, once again, rocked. Whilst news like this has always been a possibility, it’s news that we hoped nonetheless we wouldn’t hear. As Catherine and I gathered the children around the table when I got home (ironically 23 months to the day since my original diagnosis) and I walked everyone through the scenario, there were plenty of questions, but plenty of tears. “I hoped you all wouldn’t be facing this so soon after losing Ben”, I struggled to say. Together, we considered many things, both practical arrangements and then who is getting what support from where, at least for the next few days and weeks.

There’s no idea of time. I could suddenly deteriorate. The fact I haven’t had a seizure with the number of tumours present is a good sign, showing they’re currently in more low risk areas. But the fact that I’m now barred from driving shows the risk of further development is nonetheless high. But God. And His praying people.

Where do I go with all this and what do I feel? Internally for me, fresh anxieties and fears have surfaced – I’ve always felt particularly bothered about any of this ever affecting my brain. But once again, where countless others might currently want to say to me, “Where is your God?”, I find myself drawn back to the One who walked on the waters as Lord of all creation – and the One who now comes and walks on the waters of my troubles and fears. The One who alone has the words of eternal life. The One who returned from beyond death. And the One who is Life, even in the face of death. And so already, in the hours after this news, whilst I’m conscious of a big emotional tsunami rolling in, I can sense His promised peace. None of this I say glibly because “Well, he’s bound to…he’s a vicar-type”…no, I say it based on years of seeing the promises and power of His Word ring true through all the circumstances of life and then seeing Him at work in the most profound and life-changing ways in both my and others lives. 

And so as I sit here writing this in our darkened bedroom, I’m encouraged as I read these words of Jesus spoken to His disciples who were about to face the most brutal persecutions and difficulties –

“I have told you these things, so that in me you may have peace. In this world you will have trouble. But take heart! I have overcome the world.” (John 16)

That encourages me as I face today. We’re going to face this a day at a time.

We sense we’ve got a dark valley ahead of us, but as Catherine and I lay on our bed together last evening, we joined in a brief prayer, “May we know you near us, Lord”