In addition to bring 17 cancer survivors on this journey, we also have 14 caregivers in our team of 31. What’s a caregiver? It’s someone who has never had cancer who has chosen to be on this journey in support of the cancer survivors. Some of the cancer survivors are doctors, some are nurses, some are spouses of individuals with cancer and some are individuals who have lost someone to cancer and are on this journey as a way of remembering their loved one and keeping their spirit alive.

We have incorporated the prayer flag project into all of our Above + Beyond Cancer journeys. We carry with us prayer flags in the tradition of the Himalayan mountain tradition. Each flag is on a brightly colored square of material: green, red, white, blue and yellow. Unlike the traditional Tibetan flags that have prayers written on them, the flags that we carry have been decorated by families back home in honor or in memory of someone whose life was touched by cancer. We have over 1,000 prayer flags with us in our backpacks as we ascend the mountain. We will fly them at the high point of our trek today when we go over the Salkantay pass at 15, 253 ft elevation.

Last night as I prepared to sleep, I took the 100 prayer flags that I’m carrying with me out of my back pack and put them into a light weight pillow case to provide comfort for my nights sleep. I have many family members, friends, and patients who have lost their life to cancer and are now remembered by lovingly decorated prayer flags that I carry with me. My mom died of lung cancer when I was in medical school and is part of the reason for me choosing oncology as a career.

I also have many flags in my backpack that honor individuals who are still embarked on their cancer journey. Last night my mom’s flag along with flags of many other individuals, some departed, some still on their journey, provided comfort for my head and inspiration for my dreams. As I placed the flags into my pillowcase I paused to reflect on the lives they represent.

Each morning at breakfast, one of our teammates says a blessing before we begin to eat. This morning, Joni asked if she could give the blessing. Joni is a 54 year-old melanoma survivor and elementary school teacher. In yesterday’s blog I described her difficulty and success on that days journey. This morning she was confident, optimistic and grateful.   She described yesterday’s hike as a blessing. She thanked everyone that had helped her make it up the mountain. She also discussed the distinction between cancer survivor and caregiver on this journey. We often describe our group as 17 cancer survivors and 14 caregivers, but in reality, we are one team. The distinction of the title falls away quickly as each and everyone helps each other up the mountain.

After breakfast, Mary, our fitness instructor and yoga teacher, leads us in a yoga session that brings us together beneath the clear Peruvian ski surrounded by snow-capped Andes peaks. It’s a great way to stretch out our muscles and become present to the day before us. Following yoga, I share a reflection for day. It’s entitled “A Mirror of Questions”. It asks us to think about the reason we have been provided the opportunity to experience another day and what we will do with the blessing of this gift.

“What dreams did I create last night?

What did I learn today?

What new thoughts visited me?

What did I begin today that might endure?

What did I do today for the poor and the excluded?

Did I remember the dead today?

Where could I have exposed myself to the risk of something different?

Where did I allow myself to receive love?

With whom today did I feel most myself?

What reached me today? How deeply did it imprint?

What did I avoid today?

From the evidence – why was I given this day?”

The sun is shining. The mountains are beautiful. We are anxious to begin what will be our longest day of hiking. We will be ascending to the highest point on our trek, the 15,263 ft mountain pass that will then take down into a different valley as we traverse the Andes on our journey to Machu Picchu. The trail up to the pass is steep and we soon fall into our step-rest-step technique of ascent. Although the day begins is cold, our bodies warm quickly and we begin to shed layers. We are delighted by the sight of a wild chinchilla that unexpectedly scurries in front of us on the trail. As we ascend the mountain pass, we encounter another group of trekkers. They notice our Above + Beyond Cancer shirts and enquire about our group. We share the story of Above + Beyond Cancer with them. Not surprisingly, their lives have also been touched with cancer. One of their group, Michael, shares with us his wife’s story. She is an ovarian cancer survivor. We stop along the trail long enough to provide him with a blank flag and some colored markers so that he can make a prayer flag to honor his wife. It joins the contents of my backpack as we continue our ascent.

By mid-morning we have arrived at the Salkantay pass. It has begin to snow lightly. Weather can change quickly in the mountains. Sunshine can become rain and rain can become snow in the matter of minutes. It reminds us of the impermanent nature of life and the changes that we each face moment to moment and day to day. As we arrive at the top of the pass, the sun shows it’s glorious face and we all share hugs and high fives. We decide to fly our prayer flags at this high point of beauty as a tribute and honor to those we are carrying in our backpacks. We take the flags from our backpacks and string them onto strings which we then fly in the Andean breeze amid snow-capped peaks. The green, red, white, blue and yellow flags add color to sky. The faces of those whose lives continue to inspire us bring us hope. We feel a connection to those whose lives have been lost and we feel strength in the faces of those still undergoing their journey. We take time to remember those who have died and reflect on the impact that they have had on our lives. Greg, a VP of marketing for Delta Dental, lost his wife, Jill, to cancer 7 years ago. Her 12-year journey with stage IV breast cancer was a journey of courage and love. Throughout her life she taught us how to live our lives with compassion and loving kindness regardless of the twists and turns that our journey takes. Jill’s flag flew with the same grace and beauty that she lived her life.

Kyle, an orthopedic surgeon from Iowa Ortho is on this journey as a caregiver along with his wife Laurie. Kyle’s sister, Heidi died of metastatic sarcoma several years ago. Ironically, the last big trip that she and her husband took together before cancer became a focal point of their lives was a journey to Machu Picchu. Kyle showed me the beautiful photo of his sister and her husband in front of Machu Picchu. That picture adorned her flag as Heidi’s spirit found its way back to Peru.

There must be at least 20 flags flying in support of 24 year-old Charlie. He’s on a journey with lymphoma. If love and support from family and friends were all that were necessary to cure cancer, Charlie would have been cured long ago. He continues his cancer journey for now and I pause to send him a prayer as his flags brighten the Peruvian sky amid mountains that I have no doubt he will someday climb.

Susan, a 58 year-old breast cancer survivor and nurse at Mercy Des Moines is carrying several flags that her colleagues have made in her honor. She is grateful for all the support that she has received during her recent cancer journey. She also carries flags in support of friends who are on their cancer journey.

We all gather beneath the flags to reflect on the lives that they represent. We celebrate the success stories of the 17 cancer survivors that are with us today. We remember the friends and family members who have lost their lives to cancer and we vow that their lives will not have been lived in vain. They inspire us to live our lives with purpose and passion.

We take down the flags and put them back in our packs. We will be flying them again later on this trek when we participate in an American Cancer Society Relay for Life™ at our last campsite as we get closer to Machu Picchu. For now, the provide us with inspiration as we continue our trek.

We have a long afternoon and evening of hiking down hill as we descend all the way to the Urubamba River that cuts through the bottom of the valley. It’s this river that flows to Machu Picchu. The downhill hiking is a relief at first, but after several hours, it begins to take its toll on the knees. David is a 64 year-old prostate cancer survivor. His first wife died of cancer several years ago. His wife Kathy’s first husband also died of cancer. They are finding strength, comfort and inspiration in doing this journey together. David has been strong on the uphill, but this continuous downhill is causing a lot of knee pain. Roger and Diane, a couple from Des Moines who are on this journey as caregivers, have been walking with David all day, providing comfort and support along the way. They alert me to David’s increasing pain and difficulty. I happen to be walking with Kyle at the time. Kyle and I retrace our steps to assess the situation. Kyle performs a mountainside orthopedic consultation complete with full knee exam. Diagnosis: chondromalacia patella. Diane has an extra knee brace in her backpack. Kyle provides David with a good anti-inflammatory medication and applies the brace. I’m not sure what was most effective: the kindness and support of Roger and Dianne, the reassurance that comes from a trusting doctor-patient interaction, the medicine, the knee brace, or the power of the hugs that David received from the team. It really doesn’t matter. David proclaimed a miracle and picked up his pace as he headed down the mountain.

David wasn’t the only one suffering that day. The 8-hour high altitude, steep ascent and steep descent affected many.   Diane, a 49 year old breast cancer survivor, was having difficulty that day as well. Cyndi, a 55 year-old breast cancer survivor and Sue, a 46 year old breast cancer survivor provided Cyndi with support and sisterhood that comes from a common experience.   Many times during the day I saw Cyndi and Sue encouraging and supporting Diane on the journey.

We didn’t make our goal of arriving at campsite before dark. Darkness descends quickly in the mountains. The trail became muddier and steeper as we approached the river. The power of the river became more and more apparent from the sounds we could here as we descended even though darkness prevent us from seeing the wildly cascading river. We crossed the river on small bridges in the dark. The power of the river became even more apparent as the sound of the water and the feel of spray heightened our excitement.

Eventually we all made it to camp safe and sound in the dark of night. The emotions of the prayer flag ceremony earlier in the day, the physical exhaustion of 8 hours of hiking and the apprehension of hiking a slippery muddy trail at the edge of powerful river in darkness made for memorable day. This day ended like yesterday – hugs from everyone. Hugs are wonderful inventions. They work in both directions.

Before dinner this evening, David asked if he could say the blessing.   He recited a portion of the 29th psalm and spoke of the loving kindness of a shepherd. He thanked all those that had helped to shepherd him through the day by providing support, medical care and compassion to him. He knows that he could not have done it on his own. He also knows that, with the shepherding support of others, he is capable of even more.

After dinner we enjoy each other’s company and the warmth of a campfire. Justin, a 30 year-old brain cancer survivor brought his guitar along. He lives in the Clear Lake, Iowa area and works as a volunteer providing support for concerts at the Surf Ballroom. He provides stories of his interactions with famous musicians that have played at the Surf and then he delights us with his music. Justin is like a puppy dog on steroids when you put a guitar in his hands. His energy, joy, and enthusiasm is infectious. He shares with us an original song that he wrote as a reflection on his own cancer journey. It’s a poignant tune that describes the emotions he felt when he had to tell his father and mother about his diagnosis.   It was a scary time. In the song he comforts his parents and assures them that he will fight this disease with all his might. Don’t you worry, Mom and Dad. “If I die, I’ll go down fighting.”

Joseph, a 23 year-old cancer survivor from Minneapolis and Brian, our Above + Beyond Cancer journalist, also entertain us around the campfire. Brian has been on previous journeys with Above + Beyond Cancer and I’m not surprised by his wonderful musicianship. Everyone loves his singing and he uses his music to express himself. Joseph, however, surprises all of us. Who would have suspected that inside this 23 year-old is a beautiful voice and an expressive emotional sensitivity. It reminds us that we all have parts of ourselves that others may not have the opportunity to witness. As the embers of the fire die out, we trickle off to bed. It’s been another great day and I feel blessed to be journeying with these amazing people.

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