We enjoyed our first full day on the content of Africa. The sights sounds smells and magic of this place simultaneously startle and sooth our senses.
Cancer has taught all of us that life does not always conform to a predetermined schedule or itinerary. Seven of the 40 members of our group spent an unexpected 10-hour layover in Amsterdam due to a flight delay. One cancer survivor has been subject to two canceled flights and is still making his way across the globe to join us. We know that these unscheduled interruptions in our itinerary are not truly interruptions in life but are actually part of life and amazing encounters that never would have happened are now part of our group’s collective memory. As we assemble to begin our first meal together in Africa, we shared a blessing. We thanked all those forces both human and divine that brought us together. We thanked all those loved ones, family, friends, and caregivers that made the day possible. And we prayed for those back home who are praying for us. We acknowledged the irony that we would not be here in Africa preparing to climb the continents highest peak if it weren’t for life’s interruption that we call cancer.
I shared with our group a blessing from John O’Donohugh’s book To Bless the Space Between Us. The blessing was entitled, “For a New Beginning.” The final stanza reads
Awaken your spirit to adventure;
Hold nothing back, learn to find ease in risk;
Soon you will be back in a new rhythm,
For your soul senses the world that awaits you.
We are all excited and ready for our new beginning. We look forward to all the interruptions that Africa has to share with us. We welcome the transformation that these life-interruptions will bring us as we journey together in Africa.
Today we immersed ourselves into the local Kilimanjaro culture. There are more than 70 tribes in northern Tanzania and southern Kenya that surround this massive snowcapped peak. Today we toured a local Chagga village with our guide victor.
Victor is 29 years old and grew up on the slopes of Kilimanjaro. As we were seated next to each other on the shuttle bus taking us up the dirt road to the village, victor commented on the faded scuffed and mileage-warned backpack at my feet. I shared with him that it had indeed traveled many miles with me and seen many continents, but it and I were now in Africa for the first time. He then noticed the roll of multi colored prayer flags that I had strapped to the side of my pack. I took them off my pack and unrolled them on my lap. Life after life opened before us as the unfurling of each prayer flag revealed a picture of a patient of mine who had lost their lives to cancer along with a written tribute lovely composed by families. Our group is carrying over 700 such prayer flags with us on the journey to the summit of Kilimanjaro. Each flag remembers someone who has lost his/her life to cancer or honors a cancer survivor who can’t make the journey in person but wants to join us in spirit. When we reach the summit of Mt Kilimanjaro we will fly these flags as part of our Relay for Life ceremony.
Victor was surprised by the number of lives that these flags represented. I shared with him the magnitude of the cancer problem in the United States. More that a half million people each year lose their lives to this disease in our country. I then unfurled the flag that represents the life of my mom, Odetta Deming. Mom was a wonderful, compassionate, dedicated, fun and lively woman who gave her love and laughter freely. She was also a long-time cigarette smoker. She was diagnosed with lung cancer when I was in high school. She lost a 7-year battle with her cigarette-induced disease two and a half years before I graduated from medical school. Although her 7-year survivorship was an amazing gift, her death at the age of 52 remains a tragedy of a life left partially un-lived.
I asked Victor about cigarette smoking in Africa. He told me that over 70% of young men in Africa smoke. He began smoking at age 20. Cigarette smoking has become endemic in Tanzania. A pack of cigarette costs less than a six-pack of soda. He is largely unaware of all of the health consequences of smoking. He looked down at the flags representing lives lost of cancer and said, clearly moved by the image of my mom, “I am going to stop smoking”
We all know this will difficult, but every difficult journey begins with a spark of inspiration. Perhaps this moment-in-time, this spark-in-creation is one of the many reasons for our group’s journey to Africa.
Victor and I and 18 cancer survivors continued our day of cultural immersion. We learned from Victor about the Chagga and the Masaii. He told us stories of their ancestors and their beliefs. As stories of the past engaged our imagination, we shared hope for a future with less cancer and more birthdays. I silently acknowledged my mom and the role that she played in creating this moment of clarity.
Today we actually begin to climb the mountain. The energy and the fear are palpable. The day begins with suburban sounds we have heard for the past two mornings, the Muslim call to prayer broadcast from a nearby mosque, the crow of a rooster and the sound of a bugler playing reveille from an adjacent police academy.
We start our day with yoga at sunrise as the preeminent presence of Mount Kilimanjaro beckons to us in the near-distance. Tomoko, our yoga instructor, donates her time weekly at my cancer survivor program in Des Moines. She has joined our journey as a caregiver and leads us in morning yoga each day. We enjoy the warming sun, the gentle kindness of her voice, the stretch of our muscles, and the opening of our minds and hearts that flow from this ancient tradition.
Breakfast begins with a blessing before the meal by Dave, a 73-year-old prostate cancer survivor. He reminds us of the many blessings that have been bestowed upon us and he asks God to provide us strength to make it up the mountain.
The breakfast conversation is laden with both excitement and fear. Nina, a 47-year-old survivor of multiple surgeries, numerous rounds of chemotherapy and radiation therapy for salivary gland cancer shares her fears with me. She’s been through an amazingly difficult cancer journey that has provided her with tremendous courage and confidence, yet still, this challenge that she has willingly placed in front in herself, seems overwhelming to her at this moment. I tell her that all she has to do is take one more step, a million more times, and she will have it made. She nods her head and smiles.
I also share with Nina a secret weapon that I witnessed on our journey to Everest Base Camp last year. In Nepal, Theresa, a 47-year-old breast cancer survivor, found hiking up that mountain incredibly difficult especially because of prior hip surgery. She found great strength, courage, and inspiration in assisting the only survivor who was having more difficulty than she was. This act of kindness simultaneously raised the spirits and strengths of each of them. Nina clearly has the grit, determination, and compassion to face our Kilimanjaro challenge. Kilimanjaro is a mere molehill compared to the mountain of cancer that she has already climbed.
I ended our morning together in the hotel dining room with a reading from John O’Donohue’s book, To Bless the Space Between Us. Aptly, this morning’s reading is entitled, “For Courage”. It includes the lines,
Invoke the learning
Of every suffering
You have suffered.
Gather all the kindling
About your heart
To create one spark.
That is all you need
To nourish the flame.
A new confidence will come alive
To urge you toward higher ground
Where your imagination
Will learn to engage difficulty
As it’s most rewarding threshold.
This afternoon we will begin our climb toward higher ground. None of us know if we will reach the summit of Kilimanjaro, but we will tackle this challenge together, fueled, in-part, by the courage that our survivors have gained in their cancer journeys. We are ready for the challenge.
It’s 1 a.m. and I am wide-awake. I am laying in my sleeping bag in a tent in the rainforest jungle of Tanzania writing in my journal by the light of my headlamp. I pretend to be Ernest Hemmingway writing “The Snows of Kilimanjaro”, sans the whiskey. The jungle is alive with sounds: monkeys, birds, babbling stream, and snoring tent mates. We are on the mountain and we are headed UP. It is the first night in tents and I can hear, amidst the snores, sounds of other restless campers as zippers unzip and folks wander out to find the “restroom”. It will take awhile for us to get used to the rhythm of camping on the slopes of this African mountain.
Cindy, a 43-year-old breast cancer survivor and mother of 3 provided a moving reflection for us before dinner last night. We were all assembled in the “mess tent” for dinner. Included in our group was her husband, Jim. She told us of the near meltdown that she suffered the previous night. She was missing her children and she wasn’t sure she even wanted to begin climbing this damn mountain. She then reflected on the reason that she had decided to join this journey in the first place. She isn’t here to prove to herself that she is a mountain climber. She said that she is here for “Them”. She went on to explain who the “Them” are in her life. Her children, first and foremost, are her inspiration. She wants them to know that her cancer diagnosis does not define or limit their mother. “Them” also includes her own mother who is surviving stage 4 ovarian cancer. “Them” includes Jim’s father who lost his life to cancer. “Them” includes all of those whose lives have been cut unnecessarily short by this disease. She vowed to climb for those who can’t climb and we vowed to support her every step. Tears fell and hugs were exchanged. Bring on that mountain!
Journeys into nature and, in particular, journeys up to the tops of mountains, invoke an awakening to spirituality. In the faces and cultures of Africa we are becoming aware that many people in the world do things differently and have beliefs that are different than our own. This journey has the potential teach us to see that manifestations of the divine may come to us in ways, shapes, and forms unlike those we have previously witnessed.
We also bring an interfaith spirituality to this journey. Father Frank is a 71-year-old Catholic priest and prostate cancer survivor. He is one of the 18 survivors with us tonight. His niece, Annie, is a thyroid cancer survivor, a nurse and an Army officer. She is accompanying her Uncle Frank on this quest. Tomorrow morning Father Frank will celebrate Mass with us in an interfaith service that will welcomingly include our porters and guides, some of whom are Muslim.
Beverly is a 59-year-old breast cancer survivor. She is Jewish. This week she will honor and celebrate the anniversary of her father’s death in the Jewish tradition of Yahrzite. She shared with us the meaning and the rituals of that ceremony. She will say a prayer as she lights a candle at sundown on the evening before the anniversary of her father’s death. The candle will burn for 24 hours. We are not quite sure how we will do it, but our group is committed to making it happened. I’m sure that as we help her commemorate the anniversary of her father’s death, we will also reflect back on the lives of parents that we, too, have lost. I think again of my mom and dad, each having lost their lives at age 52. We all find meaning and comfort in sharing spiritual traditions with others.
The manifestations of religious traditions that we will celebrate together beneath the African sky will bind us together in ways similar to the bond that cancer has brought to our group. The often unspoken possibility of death’s nearness not only inspires us to live each day to the fullest, it also leads us to seek wisdom and encourages us to look for the presence of the divine in the world around us. As St. Thomas of Aquinas reminds us, we can see the footprints of God in the wonders of nature.
Tomorrow our climb gets steep and we pursue higher ground. Tonight, I lay back down on a pillow of prayer flags that support my head and fill my dreams with memories of departed patients and family members who are making this journey with me in spirit to the top of Mount Kilimanjaro.