I woke up at 2:30 am after a solid 6 hours of sleep. I went outside to see the Himalayan sky. There are no street lights for miles, thus the stars are extra bright here in the mountains. What a beautiful sky! The Milky Way is a swath of crystal dust across the sky.
Our lodge in the village of Phakding is on the banks of the river called Dud Cosi. Dud Cosi means “Milk River” – a name that refers to the hazy whitish color it possesses as a result of the pulverized stone that is suspended in the river. The stone “flour” is a result of the glaciers that scrape the stone from the mountainside as they move over the face of the mountain. The river is huge and powerful as it winds its way through the valley.
Milky Way and Milk River form a protective border around the space we inhabit on this journey.
Today we hike from Phakding to Namche Bazar. It’s a difficult hike that will ascend 2,000 feet up into the mountains. Today is also Dina’s birthday. Dina is a 52 year-old nurse who is on this journey as a caregiver. Her mom was recently diagnosed with leukemia and Dina is caring a prayer flag in honor of her mom. Dina is also a yoga instructor and provides our group with a stretching routine each morning under the Himalayan sky. One of Dina’s unique features is a left hand with only 4 fingers – the result of a lawn mower accident as a child. She loves giving out “high 4’s” to members of our group.
Ruth is a 64 year-old sarcoma survivor. In order for the tumor to be resected, she had to have her left hand amputated at the mid forearm. She calls her foreshortened left arm “Stumper” as a sign of affection. Before undergoing the amputation she held a contest for family and friends to come up with a name for her 4-inch tumor. The winning entry was “Golaith.” She thought that the name aptly described her tumor because Golaith was “a seemingly invincible foe that was defeated by a neophyte who trusted in God.”
Ruth has a great sense of humor and puts all of us at ease with her many “one hand” jokes. (“Can I give you a hand?”) Her grace, grit and determination humble all of us as she hikes the uneven terrain with a full pack and a single hiking pole. She is very independent, but she does allow me to put sunscreen on her right arm since it’s pretty much impossible for someone to apply sunscreen to your right arm with your right hand!
Dina and Ruth develop an immediate bond. Two strong women made even stronger by their missing appendages. What they lack in fingers, they make up for in courage and determination.
Our hike today is also a bit of a Golaith. It is up and up and up. We cross some insanely high suspension bridges today and then climb a 1000-foot high winding “staircase.” Several members of the group were forced to dig deep today to get ‘er done.
Although I often describe our Above + Beyond Cancer group as “19 cancer survivors and 17 caregivers,” the truth is, we are truly a team of 36. On the mountain the labels fall away. The world is not a dichotomy of survivors and caregivers. It’s not a dichotomy of staff or client. We are one team. None of us is as good as all of us.
Marilyn is a 56 year-old woman from Ames, Iowa. She’s officially a “caregiver”, having come to Nepal in support of her friend, Kim, a 47 year-old survivor of both brain cancer and breast cancer. Marilyn has beautiful red hair and a friendly laugh. She’s a bit overweight, but she’s worked out diligently to get fit enough to be able to support her friend on this journey. Today was a challenge of epic proportion for her. The steep uphill climb into Namche was seemingly more than she could handle. Tears flowed as she tried to muster enough strength to continue.
The rest of us became a band of cheerleaders loud enough to support the Dallas Cowboys. We cheered, sang, hugged, pleaded, cajoled, pushed, pulled, lifted, tugged, and danced Marilyn up the mountain. Suzanne, a 48 year-old breast cancer survivor from Alabama walked a few feet ahead of Marilyn gently coaxing her forward with a syrup-sweet Southern drawl, “Come on, Baby Girl, if Suzanne from Alabama can do it, so can you.” That brought on a chorus of “Ol’ Suzanna,” from the cheerleading choir.
I walked beside Marilyn, grasping her rear belt loop and gently tugging her up with each step. “It’s just one more step, Marilyn. One more step, a million more times. Can you do one more step?”
“Yes,” she says. And she does. The Sherpas and I begin to chant, “One-More-Step,” as Marilyn continues her slow ascent.
I ask Marilyn who she’s climbing this mountain for. We have all brought along prayer flags that have been decorated in honor of loved ones who have died of cancer. “Whose prayer flag do you have with you today?” I ask.
“My mother’s,” she says. “She died of breast cancer when my children were young. I wish they could have gotten to know her. She was a wonderful woman.”
“Let’s climb the mountain in honor of your mom,” I say. “Can you take one more step for her?”
“Yes,” she says. And she does. As we reach the high point of the hike, the cheering squad is waiting for us with imaginary pom-poms pumping in support. A spontaneous dance party of celebration erupts.
After a few minutes of dancing, I quietly remove myself from the celebrants and observe the celebration from a comfortable distance. I stand next to our Sherpa team as they look on in amazement. Marilyn is smiling and dancing. Hugs are as bountiful as blossoms in spring. My heart swells and my eyes well as I struggle to fight back tears. I loose the struggle and soon I’m tasting the sweet salty flavor of emotion.
In truth, Marilyn wasn’t the only one suffering today. Others were suffering, too, but they were doing so much more quietly and less dramatically. Judith, a 59 year-old breast cancer survivor was slowly and quietly making her way up the mountain. Waves of nausea overtook her and she stopped to vomit at the side of the trail. She apologizes to those helping her and continues her quiet meditative journey up the mountain.
When I was told that Judith was having difficulty, I descended the trail to see if I could help. I found her quietly walking with Mary G on ones side of her and Mary L on the other. Both Marys are on this journey as caregivers and they are doing so with loving kindness. Judith stops her slow ascent, apologizes once more, and bends forward to vomit once more. Mary L takes off her bandana and gives it to Judith to wipe her mouth. Mary G offers Judith her water bottle. Judith quietly continues her journey and finally arrives at the lodge. She is enveloped in hugs. With tears in her eyes, she apologizes for being so slow and she thanks the two Marys.
“This has been a wonderful day,” Judith says. Her gentle smile says it is true.
At dinner this evening I ask Marilyn to say a blessing before we dine. Marilyn is Jewish. Yom Kippur has just ended and Marilyn reads to us from a book by Harold Kushner that focuses on the meaning of suffering. She says that after today, she has a new perspective on suffering. She reads, “Pain is the price we pay for being alive. We may not ever understand why we suffer or be able to control the forces that cause our suffering, but we can have a lot to say about what suffering does to us, and what sort of people we become because of it. Suffering can make us sensitive and compassionate.”
Judith is unable to join us at dinner. She’s in bed under heaps of blankets trying to will her body to rest. A makeshift “emesis basin” is on the floor beside the head of her bed. Dr. Charlie, Dr. Laurie, Dr. Leah and I all take turns checking on Judith, providing her nausea medicine, sips of electrolyte fluids and hugs. Her roommate, Yasmina, a caregiver from Des Moines, is a gentle and compassionate presence. Judith is concerned that that she will keep Yasmina awake tonight. Yasmina assures Judith that she cherishes her role as roommate and caregiver and there is nothing right now she would rather do than provide comfort to her friend.
I make “rounds” on all my “patients” before I turn in for the evening. All are resting quietly. I give Judith a tender hug and then I head off to find my bedroom. I pray that a night of rest will heal, strengthen and nurture us.