In the morning when I apply mascara to my lifeless eyelashes I wonder, “Is this necessary?”

I don’t mean whether or not it’ll make me look better but whether or not it’ll be cried off at some point before nightfall. Daily weeping over missing Nate has stopped, although I can “lose it” at any time. My widow warriors tell me that may go on for years, but the spaces between break-downs will get longer and longer. Their counsel is true.

Today my mascara would have been better left in the tube. As I sat down with my cholesterol-lowering bowl of oatmeal, I decided to reread a few of the many emails my girls printed out for me long ago, at my request. I had asked them to print out messages “from the beginning” when we’d just received Nate’s pancreatic diagnosis.

Although he and I had spent time during those early days of adjustment last September reading the emails together, that time period is only a blur. I’ve been wanting to re-absorb the words of our precious friends in those messages for quite awhile. I set the thick stack of 8½ x 11 pages on the table, intending to look at one or two whenever I got the chance. There were hundreds of them, a treasure trove of love and a war chest of pertinent Scriptures.

The very first message was from our daughter Linnea expressing shock, sadness, disappointment, confusion, and by the end, total abandon to whatever God decided to do with her father and his family. It was hard to get through her words, but I managed. The second was from our son Nelson, simply one Bible verse: “Now to Him who is able to do immeasurably more than all we ask or imagine, according to His power that is at work within us, be glory in the church and in Christ Jesus throughout all generations for ever and ever! Amen!” (Ephesians 3:20-21) At that point, I was dabbing at my eyes.

The third email was from our son Hans’ parents-in-law in faraway England, sent two days after the diagnosis. Sarah wrote, “Hans and Katy are clinging to each other and have the comfort and closeness of Baby Nicholas, who smiles lovingly at them and cheers the sad moments. We’ll do our very best to support Hans, but he understandably wants to be with you. We will all be praying for a successful application to the Home Office.” This resurrected the tale of how God dramatically moved a mountain of snarled red tape to get Hans and his family to us in record time. [10/5/09 blog post: “Then God stepped in.”]

Hans’ father-in-law wrote, “There are lots of tears here, lots of questions, but still the knowledge that Somebody knows how this all fits together, even if in our moments of weakness we each lose the plot for a while.” And my sniffing began in earnest.

When I came to the fourth message from Pastor Lutzer and Rebecca, I had to get the Kleenex box. There on top of their two page email was Nate’s loopy handwriting of words written two days after his terminal diagnosis: “Bless them!” I must have printed the email for him to read privately, and as he sometimes did, he pulled out his pen and responded. His comment was written next to this statement from Rebecca: “As I read your email, I burst into tears…”

…as did I.  And that was enough reading (and mascara) for today.

“There is no one like the God of Israel. He rides across the heavens to help you, across the skies in majestic splendor. The eternal God is your refuge, and his everlasting arms are under you.” (Deuteronomy 33:26-27a)

Dear Mrs. Nyman,

Thank you for allowing me the privilege to share some thoughts for your blog. Your posted messages are intensely personal, very conversational, and spiritually grounded. I will try to follow your lead, as best I can.

Some introduction:

Over my 37 years as a physician, I have mostly done academic clinical oncology. Sometimes this was medical oncology and hematology, either clinical, clinically focused lab based research, or a combination of both. Later, this was radiation oncology and clinical research related to my patient care and that of my colleagues. The decision to specialize in oncology was driven by observing my mentors when I was a medical student and early resident, by the challenges and opportunities posed by trying to help manage patients with malignant disease, by the excitement of new advances as I was finishing medical school and beginning training, by my mother undergoing surgery for breast cancer and receiving chemotherapy in an early trial of adjuvant chemotherapy shortly after I graduated from medical school, and by the training opportunities available.

However, at the core of all of this, what consistently kept me centered was the human connection. My internal definition of “being a doctor” required being regularly involved in caring for other human beings. When I didn’t have this, there were times when it was “ok.” Particularly in the beginning, when I was immersed intensely in my lab work – trying to get started, develop techniques, prove myself, and get results. However, over time, it became clear that being exclusively in the lab was not my calling. Later, I felt I had to choose between one or the other, as doing both at the level of excellence I expected was, for me, too demanding. I chose patient care and left the lab behind.

In the early 1990’s, my clinical practice became focused on the nonsurgical care of pancreatic cancer. This assignment found me – almost accidentally, from my perspective. It was a function of the institution where I worked, programmatic needs, and no one else to do the task. This was a hard assignment for lots of reasons, and I had to grow into it. I would say it took me about five or six years before I began to feel truly comfortable in this new role.

When I met you, your husband, and other members of your family at the end of September 2009, it quickly became clear that none of you, as of yet, quite understood what was likely happening. There was a huge disconnect between how “bad” Mr. Nyman’s images appeared and how well Mr. Nyman was feeling and looked that day. As a physician I never presume that I really know what will happen to any of my patients. However, I do know what is likely. That doesn’t mean it will necessarily happen, but it does mean that, to the extent possible, I try to avoid letting my patients and their families be “blind sided” by what I think might be coming, especially if it looks like it might be very bad and distressing. Since I don’t really know what will happen, I can’t and don’t say too much, but I try to provide sufficient “just in case” interventions to be prudent and helpful. My fear was that your husband, and therefore all of you to some extent, were about to fall off the edge of a clinical cliff called “dying from metastatic, pancreatic cancer.” I couldn’t stop the fall, although I wished that the means to do that was available, but I could do some things to try to cushion the fall a little, just in case. So, I did. Unfortunately, it was only a few days later when my fears for your husband and family began to be confirmed all too clearly.

Your husband’s brief period of radiotherapy was a time of medically necessary intervention and also provided “safe haven” during which you and he could learn what was happening, process this most unwelcome reality, and decide how to proceed. These are among the most challenging of times for any person and family. For some patients and families these challenges lead to a place of coming together, intensified love, and spiritual enrichment, in addition to severe emotional pain and wrenching loss.

From talking with you since your husband’s death, it seems this growth has happened in your family. You and they came to this unwelcome time and task with intellectual strength, love for each other, psychological determination, and spiritual preparation. It wasn’t easy; it’s still not easy. But, you all gained and grew. As much as you lost? Who am I to say? I think that’s the wrong question, really. You lost husband and father; companion, teacher, and guide. How does one even measure that loss, much less replace it? I think the concept is that even given what you lost and lost so irreplaceably, the experience was not exclusively about loss and pain. In fact, I think this is the underlying message of what you write and post. Life can go on: painfully, differently, and with adjustment; but, also with increased spiritual connection, strengthened family love, and a desire to both grow one’s humanity and share the power of that growth. This is a powerful message for all of us. It’s a message we want and need. It’s not guaranteed, only possible.

My thanks to you, your family, and your departed husband for providing, and modeling, this important message and lesson.

Ross A.