Chapter 1
Diagnosis
I had lost almost thirty pounds by the time I was referred to a gastrointestinal surgeon at Duke University Hospital. Every few hours I doubled over from a stabbing pain in my stomach. This had happened so often over the last three months that I had developed a little ritual for it: reach for the nearest wall with the right hand, clutch my stomach with the left hand, close my eyes, keep perfectly silent. When the pain subsided, I would reach into my purse, take a swig from a giant bottle of antacid, stand up straight, and resume whatever I was doing without comment. It was a little creepy to watch, I’m sure, but it was the best I could do at pretending for so long. Now I was tired of pretending. I eyed the surgeon warily as he came into the small examining room where my husband, Toban, and I waited. He sat down heavily on his stool, sighing as if already annoyed.
Then he said, “Well, I looked at your latest tests and they don’t tell us anything conclusive.”
“I don’t understand,” I protested. “I thought the last test suggested that it was probably my gallbladder.”
“It’s not entirely clear,” he said in a hard voice.
“So you’re not prepared to operate,”
“Look, there is nothing to suggest that we are going after the right thing. I can take out your gallbladder and you might be in the same pain you’re in today. Plus the pain and inconvenience of a surgery.”
I sighed. “I don’t know how to get you, or anyone, to pay attention. I’ve been to all your specialists, but I have been in a crazy amount of pain for three months now, and I can’t keep doing this.”
“Look,” he said, as if having to start all over again. “We’re at the squishy end of an already squishy diagnosis.” He throws it back at me, nonchalant. “Again, I can take it out, but I don’t know what you want me to say.”
“I want you to say that you’re not going to rule out the gallbladder surgery and just send me back out there with everyone else! No one is trying to help me solve this, and I can’t take it anymore!” I could hear the desperation leaking out.
“I’m sorry you feel that way,” he said. We sat there glaring at each other.
“I’m not leaving,” I said loudly. “I am not leaving until you send me for another test.”
“Okay. Fine,” he said, and he rolled his eyes.
“Okay.”
He wrote a note to authorize a CT scan, and I felt only relieved annoyance. They would find something simple and that would be the end of it. I’d just have to schedule my life around a surgery, nothing major.
I am at the office, pacing at my treadmill desk and flipping through my latest research, when my phone rings.
“Hello, this is Kate.”
It’s Jan from the doctor’s office. She has a little speech prepared, but my mind is zeroing in and out. I can hear that she is talking, but I can’t make out the words. It is not my gallbladder, I catch that much. But now it is everywhere.
“What’s everywhere now?” I ask.
“Cancer.”
I listen to the buzz of the phone.
“Ms. Bowler.” I absentmindedly put it back up to my ear.
“Yes?”
“We’re going to need you to come in to the hospital right away.”
“Sure, sure.”
I need to call Toban.
“Ma’am?”
“No, sure. I get it. I’ll be right there.”
“I’ll send someone down to the lobby to get you.
“Ma’am?”
“Sure, sure,” I say, almost inaudibly. “I have a son. It’s just that I have a son.”
There is a long silence.
“Yes,” she says, “I’m sorry.” She pauses. I picture her, standing near an office phone riffling through charts. Likely there are more people to call. “But we’re going to need you to come in.”
“Is God good? Is God fair?”
A hulking Norwegian asked me this once in the line at my college cafeteria.
“I think so,” I said. “But it’s seven a.m. and I’m starving.” But now I wonder. Does God even care?
One of my favorite stories told by prosperity preachers comes from one of the original televangelism duos, Gloria Copeland and her husband, Kenneth. Gloria, who, even at seventy-something, looks like a glamour-puss real estate agent, and her husband, a true Texan, who always looks like he has strolled in after a leisurely day at the ranch. For decades, they have saturated prime-time television and the Christian bookstore shelves with teachings on living the abundant life. They don’t expect God simply to be fair—they expect God to rain down blessings. So when a tornado threatened to destroy their home, said Gloria, they crept in the night to their porch to face down the storm. They prayed loud and long that God would protect their property and, for good measure, commanded God to protect their neighbors’ houses, too. And so, they said, the storm turned and went another way.
It is an image I cannot forget: two of the world’s wealthiest Christians shaking their fists at the sky, protesting to the God of Fair.
After all, what father, when his child asks for bread, would give him a stone?
Fairness is one of the most compelling claims of the American Dream, a vision of success propelled by hard work, determination, and maybe the occasional pair of bootstraps. Wherever I have lived in North America, I have been sold a story about an unlimited horizon and the personal characteristics that are required to waltz toward it. It is the language of entitlements. It is the careful math of deserving, meted out as painstakingly as my sister and I used to inventory and trade our Halloween candy. In this world, I deserve what I get. I earn my keep and keep my share. In a world of fair, nothing clung to can ever slip away.
I got married at twenty-two, when I was especially dumb. I wasn’t dumb to marry Toban, exactly, because that ended up being one of the most sensible things I’ve ever done. But I was probably pretty dumb because I didn’t yet realize that Toban was one of those great investment pieces that increase in value but seem like overkill. He was like beachfront property when I probably could have settled for a suburban condo. At the time, however, I mostly thought about how beautiful he was, how great he was at explaining the finer points of skateboarding, and how he would never lose his hair.
Now he rushes into my office and throws his arms around my neck, and all my words are pouring out.
“I have loved you forever. I have loved you forever. Please take care of our son.”
“I will! I will!” he cries, and I know it is true. But the truth is not going to help us anymore.
I call my parents on the walk to the hospital, but I have to stop and lean against a high stone wall for a minute. Toban puts his hand on my back to steady me. We are both gone, gone, gone somewhere else, flitting back and forth between now and where we used to be.
I tell my parents they need to find a place to be together and sit down, that I have been told that I have cancer and that it doesn’t look good for me.
“You need to give Zach to us! You have to change your will!” my mom blurts out, her voice shaking. I have been, coincidentally, drawing up a living will for my life insurance policy, a policy I will be denied because they will find out that I have cancer and reject the claim, a bet they no longer want to take. But right now my mother is confused. Her child is dying and suddenly, so is the whole world. She is desperate to salvage what is left of my life: my son.
Copyright © 2018 by Kate Bowler. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
