Mt. Kilimanjaro allowed us to climb her earlier this week. A part of us is still on top of the mountain and always will be. Slowly, we’re incorporating the meaning of the climb into our new selves and our transformed identities.
We have descended Kilimanjaro and returned to our hotel in Moshi. We’ve luxuriated in the splendor of our first shower in 10 days and we stare in disbelief at the dirt and grime that reluctantly releases itself onto the once white bath towel after a lengthy shower. It will take more then one shower to get rid of the mountain that remains embedded in our pores. I must admit, we are as reluctant to totally let go of the mountain, as she is to totally release herself from us.
Today we begin a 2-day immersion into the real world of Moshi, Tanzania. We’ve hooked up with Dr. Greg Higgins, a retired American doctor from Northern California. Along with the young and dynamic Tanzanian teacher, Lazaro Edward, Greg started the Kilimanjaro Orphanage Center in Moshi. AIDS has caused the death of many young adults in Tanzania and has left thousands of children without parents. Through the generosity of Lazaro, Greg and many benefactors, they’ve created a loving home for 39 orphans, aged 2 to 17, including boys and girls. It’s the only interfaith orphanage in Moshi, serving Muslim and Christian children.
We spent the day with Greg, Lazaro and the children. We were welcomed to the orphanage by the children as they sang a song of greetings to us and entertained us with a lighthearted skit. They introduced themselves to us one by one. We, in turn, introduced ourselves to them. We had brought crayons, pencils, paper, toothbrushes and soccer balls with us from the U.S. Playtime turned into a free-for-all of hugs, laughter, ring-around-the-rosie, swinging and teeter-totter. The nurturing hugs that were exchanged between the children and the cancer survivors were truly therapeutic. I noticed that Kerri, a 32-year old breast cancer survivor who had struggled with homesickness early in our journey, chose a 3-year old girl, the same size and age as her daughter, Lily, who awaits her mom’s return to Iowa. I dare say that Kerri likely received more therapeutic benefit from the hugs than her little Tanzanian friend. The hugs were strong and generous.
Our visit left a lasting impression on all of us. Tanzania is a country of wild beauty alongside abject poverty. Our journey up the mountain, together with our experience in Moshi, has opened our hearts and left us feeling more generous and compassionate toward those less fortunate than us. We know that we will find a way to further help Greg and Lazaro in their mission of compassion to the children of Moshi.
On Friday night we enjoyed our formal celebration dinner, although in all honesty, we’ve been celebrating ever since we summited. We know that our accomplishment and our impending departure from Tanzania require a distinct ceremonious ritual to mark this important threshold in our lives.
We are welcomed to dinner by a group of Massai warriors who perform a traditional dance for us beneath the splendor of another cloudless African night. Our great good fortune of having experienced nothing but clear skies for 10 straight days is not lost on us. It’s one of the many blessings we count as we begin our evening of celebration.
We gather beneath the roof-covered, but open-walled dining room. As we’ve done on each of the previous 10 evenings, one of the survivors gives a heart-felt prayer of thanksgiving before the meal begins. This time it’s Dave, the 73-year old prostate cancer survivor who was not able to make it to the summit due to illness, dehydration, and exhaustion. We had reunited with him and Nina, the other survivor who had had to turn around due to exhaustion earlier in the week. Both Dave and Nina had recuperated completely and fully re-engaged with the team. Dave’s blessing this night gave thanksgiving for the safe return of the climbers and gave thanks to our kind African hosts who had provided us comfort, food and shelter during our stay.
As we shared food and drink, the joy and laughter of our group filled the African night with the satisfied sounds of companionship, compassion and the pride of a shared accomplishment.
I took the opportunity to thank all the wonderful and dedicated staff that had made our journey a success. First and foremost, I acknowledged Charlie Wittmack, executive director of Above & Beyond Cancer for his leadership and dedication. This trip would not have happened without his tireless planning and oversight. The relationship that I’ve developed with Charlie is just one of the many blessings that I have received from Above & Beyond Cancer.
We then thanked all of our African guides and porters who took care of us while we were on the mountain. Their professional skills and compassionate concern for our well-being were key factors in our success.
I also thanked the American Cancer Society for their tremendous support. Dave Benson and Gail Richman, wonderful, kind and caring ACS staff, accompanied us on our journey and provided caregiver support for the survivors on the climb. They also helped us remain connected to our ACS readership and provided valuable leadership in successfully completing the highest ever Relay for Life.
It still seems impossible that 17 cancer survivors and 20 caregivers actually reached the summit of Mt. Kilimanjaro. The survivors, aged 29 to 71, were not athletes or mountain climbers. They accepted the challenge of this journey because of the confidence and courage they had gained on their cancer journey. To be able to journey with them to the top of Kilimanjaro is an experience that will forever change my life. Through diarrhea, headaches, nausea, vomiting, blisters, and exhaustion, they pushed on. It was only through their own personal strength and the assistance of the 20 caregivers that success was achieved. None of us could have done it alone. And isn’t that the way of the world?
We then acknowledged, once again, the higher purpose of our journey. Nearly 600,000 Americans will die of cancer this year. Many of them will be our family and our friends. We acknowledged the heart-wrenching, unnecessary loss of life that these statistics represent. We vowed that the deaths of those who had lost their life to cancer and the inspiration of the cancer survivors on this journey would motivate all of us to Fight Back.
Single file, we walked out onto the lawn near the dining room. A million stars shined down on us from the African sky and a waning gibbous moon illuminated our team. We formed a circle around a cluster of luminaria that glowed warmly on the grass at our feet. One by one we personally accepted the challenge to save at least one life during the coming year by addressing the issues of prevention, early detection, access to quality treatment and increased funding for research. We vowed to speak out with volume and passion. Who knows, the life we save could be our own.
One by one, we planted an American Cancer Society flag in the ground at the center of the circle made by the ring of luminaria. This positive action was done as a manifestation of our personal commitment to reducing the burden of cancer in the world.
Our group has been transformed over the preceding 10 days. We know that we are all incredibly blessed to have had this experience. We also know that we have a responsibility to use our newfound passion, compassion and commitment to its greatest potential. We can’t wait to return home and renew our commitment to a world with less cancer and more birthdays.
Our evening ended like every other evening has ended throughout this entire journey. Hugs and tears and compassion filled the African night.
Celebrate, Remember and Fight Back
17 cancer survivors and 20 caregivers reached the top of Mount Kilimanjaro, the highest point on the African continent, late in the afternoon on January 10th. The team had spent the previous 10 hours ascending the steep mountain face with coughs, headaches, intestinal disorders and enough courage to fill up the dormant volcanic crater that would be our home for the night. Our expedition chose a non-traditional route up Kilimanjaro. Most climbing groups ascend the face of Kilimanjaro in the dark of night in order to reach the summit at dawn and then, after a brief celebration at the top, descend quickly to a safer (lower) altitude. We wanted to spend the night at the top of the mountain, camped in the crater of this extinct volcano. This gives us the mountaintop to ourselves for 12 hours of magnificent beauty and afforded us the opportunity to conduct the world’s highest Relay for Life.
The fastest of our group reached Stella Point (19,000 feet) mid afternoon on the 10th and then descended a few hundred feet down into the large base of the crater to prepare the campsite and the Relay track. They arranged the luminaria to spell out HOPE in the snow near our tents which were located at the base of a huge wall of ice, the leading edge of the glacier that calls Mount Kilimanjaro its home.
I have travelled all over the world. I had seen pictures of Mount Kilimanjaro in preparation for this trip. I was not prepared for the stunning beauty that presented itself to us. The “peaks” of Mount Kilimanjaro are actually the high points on the rim of the crater that circle us as we settle into the crater center. The peaks ringed our campsite, along with glaciers with their sheer walls of ice and deep blue skies. The sun and blue skies quickly transformed into a cloudless night filled with the stars of the southern hemisphere. The full moon rose over the rim of the crater and illuminated our campsite.
Our team had been waiting for this moment for weeks. We knew that we were not here to climb a mountain for mere bragging rights; we were here to demonstrate to the world that cancer does not have to limit one’s life. It also is a journey that is intended to celebrate survivors, remember those who had died of cancer and motivate us to fight back against this disease. And so we began our Relay for Life. We were prepared to Celebrate, Remember and Fight Back!
As the sun set, we lit luminaria in memory of those who had died of cancer and in honor of those surviving the disease. We paid tribute to all the family, friends and patients of ours who had shown us courage, grace, grit and determination in their fight. We circled HOPE as the stars came out. We then huddled in our tents on top of Africa and struggled to find warmth and sleep at 19,000 feet.
The African sky began to brighten at 6:30 am on January 11th.. The sun finally showed its face above the rim of the crater at 7 am. The sun brought light and warmth and courage to all of us. We opened our backpacks and 800 prayer flags poured out onto the crater floor. We had brought them with us from the U.S. Each one was decorated with photographs, drawings, and phrases commemorating the lives of individuals who had died of cancer or survivors who weren’t able to make the journey but wanted to be with us in spirit. We all joined in and strung the prayer flags onto three strands of rope. We carried one end of each strand to the top of the 150-foot high glacier wall of vertical ice that stood adjacent to our campsite. The other end of the strands stretched out over the HOPE luminaria forming 2 arcs of multicolored flags. I spotted the face of my mom on one of the flags as it danced in the African breeze. She died of lung cancer when I was in medical school. I saw the faces of Chris, Marjean, Jill, Suzanne, Connie, Sid and countless other patients of mine who had inspired me over the course of my career. I also saw the names and faces of patients who are still fighting the fight. Every one of the 37 team members gazed knowingly at the flags. We all gained inspiration and motivation from the lives they represented.
Seventeen cancer survivors circled our track around the word HOPE. They had survived cancer. They had also survived a grueling climb to the top of Africa’s highest mountain and had inspired those of us who were blessed to accompany them. The next lap was for the caregivers. We all joyously joined the survivors on that lap. Not just the 20 of us who had come from the U.S., but also our African porters and guides who had been caregivers to all of us during the preceding week. We then paid tribute to those who were no longer with us. The faces of family members, patients and friends looked down on us from the prayer flags that fluttered in the wind above our heads. We silently circled our track and reflected on how our lives had been enriched by the intersection of theirs with ours. Finally, we vowed to Fight Back. Those who have died will not have died in vain. They and the cancer survivors who have climbed this mountain will motivate and inspire us to do everything we can to reduce the burden of cancer and create a world with more birthdays.
As we completed the final lap of our Relay, we came together in a huddle beside HOPE. In the midst of our huddle were 17 cancer survivors and 20 caregivers. The cancer survivors included men and women ages 29 to 71. They were here, not in spite of their cancer, but because of their cancer. They were here because of the courage and confidence they gained during their cancer journey that inspired them to take on this challenge. They showed us once again what they are made of. Father Frank, a 71-year old Catholic priest and cancer survivor, said a spontaneous prayer of thanksgiving, remembrance and celebration from the midst of that huddle. Then, the song, “Amazing Grace” suddenly sprang forth from the huddle and filled the African sky with music fit for a cathedral. I’m not sure who started the singing, but we all contributed our voices to the amazing choir. None of us wanted the moment to end. We embraced with the love of companionship, camaraderie, and respect that is hard to describe.
We took down the flags, packed up the luminaria, broke down our campsite and headed back up the rim of the volcano. We ascended to the highest of the 3 peaks that form the rim of Mount Kilimanjaro. Uhuru is at 19,342 feet. We arrived at noon. We had the summit to ourselves. The skies were clear and we could see forever. We were sure, from where we stood, that we could see the future where there is a place with more birthdays.
The Mountain is Our Friend
“The mountain allows itself to be climbed.” It really is true. There are lots of slogans thrown around about “conquering the mountain,” “beating the mountain,” “attacking the mountain,” etc., but they are all incorrect. The mountain is not our enemy. It is our friend, our partner, and our collaborator in a journey toward personal growth. The mountain allows us to ascend it. Sometimes the weather is bad, the winds are fierce, the snow is impassible and we realize that she is not in the mood for our advances. When everything is right, she sheds her armor and invites us to the top.
As we accept her invitation, we also accept the invitation to come together as a team and be transformed. Today I witnessed some amazing displays of grace, grit, determination and teamwork as we ascended from 12,000 feet to 15,500 feet on our way up to the 19,340 feet summit.
Corey, a 32-year old lymphoma survivor is deathly afraid of heights. Early on today we had to scramble up a steep face of a canyon wall that was quite intimidating even for someone who isn’t afraid of heights. With assistance from his teammates, he was able to make it. I don’t think he’s ready to join a high-wire act in the circus just yet, but he’s faced his fears and learned that challenges can be overcome with the support and comfort of a team.
Steve, a 69-year old prostate cancer survivor and the “owner” of two artificial knees and an artificial hip, learned that his body parts might have some mileage limitations. It was a long day today – 10 hours of hiking up and down, mostly up. By the time we reached our destination for the day, it was dark. We were at our 15,500-foot camp and Steve was exhausted, but still moving. If it hadn’t been for the assistance of his son, Jed, and his fellow survivors, Michael and Brandon, Steve probably would still be sitting on a rock back on the trail singing to himself. He responded to gentle encouragement mixed with large doses of tough love (suck it up!). His strength, fortitude and sheer determination were an inspiration. I can’t imagine that there is another 69-year-old cancer-surviving, triple joint replacement person on this planet that could do what Steve has done. He rocks!
I witnessed similar stories at least a dozen times today. It was a tough day, but the support, whether in the form of music, dancing, singing, Power Bars, or therapeutic hugs, kept everyone going.
Connie, a 63-year old breast cancer survivor and farmer’s wife ended the journey today with strength to spare. Three days ago she didn’t have the strength to walk to the dining tent for dinner. Today she was supporting others on the trail. Such is the karma of life on the mountain. We’re all eagerly anticipating Kilimanjaro’s permission for us to ascend to the summit in two days. Whether we all make it to the top or not, we’ve learned a lot about our untapped strengths and the value of teamwork along the way.
Eye on the Prize
Ever since the massive hunk of a mountain known as Mt. Kilimanjaro popped into view on Day 3 of our hike, we’ve had our “eye on the prize.” Mt. Kilimanjaro is an extinct volcano that rises up from the Serengeti plains of eastern Africa. Unlike Everest, which is part of a huge mountain range, Kili is a solitary mountain that cannot be mistaken for anything else. It has an identity that is distinct and uncomplicated.
We’ve come here, 19 cancer survivors and 21 caregivers, to blend our distinct and complicated identities into a team. It really hasn’t taken all that long for us to gel. Our common bond is a mighty powerful glue.
Over the past 3 days of hiking we’ve witnessed a transformation in climate and topography. We began our hike in the Tanzanian rain forest with thick foliage and a large canopy of trees. It was hot and humid as we made our way through mud and moisture, monkeys and birds, flowers and thorny brush. We then ascended out of the rainforest and into the subalpine region of scrawny brush and rock-strewn dry ground. We started to see evidence of previous eruptions of the now dormant volcano.
Lava “bombs” dotted the landscape. These are large boulders of solidified lava weighing up to 20 ton that were blasted out of the volcano crater many hundreds of centuries ago. We also found congealed lave “flows” representing solidified lava that had flowed down the mountainside.
As we ascend up and around the mountain in search of the pathway that will lead us up and over the lip of the crater and down into the dormant caldron, we witness canyons filled with unusual cactus-like trees and exotic succulent plants that form green cones with purple highlights. In our search for analogies, we move from the Mojave Desert to the Grand Canyon to the surface of the moon and back again. All the while, we keep the snow-capped peak of the mountain in our view. Tomorrow we end our counterclockwise approach and begin the ascent in earnest.
As we’ve journeyed part way around the mountain in preparation for our ascent, we left part of ourselves along the way and we’ve gained and assimilated parts of our new selves.
Two of our cancer survivors have had to leave the mountain to return to Moshi to wait for the rest of us to return in 4 days. Dave, a 73-year old prostate cancer survivor, became so dehydrated and unsteady due to severe diarrhea that he could not continue. Nina, a 47-year old salivary gland cancer survivor from Philadelphia reached the limit of her physical stamina and returned to Moshi with Dave. Dee Wittmack, mother of Above & Beyond Cancer’s executive director, Charlie Wittmack, and mom to all of us, agreed to accompany them to Moshi to help “mother” them back to health and await our return.
The departure of Dave and Nina was difficult for all of us, but we knew from the outset that it was unlikely that every member of our group would reach the summit. If this were an easy endeavor we wouldn’t be doing it. The 17 cancer survivors and 20 caregivers that continue up the mountain do so with the sober realization that there is a lot of ground remaining between the summit and us. We all have our eye on the prize, but we all know that reaching the summit is optional, while returning home, safe and sound, is mandatory. This journey has never been about the destination. Dave and Nina have not “failed.” Their journey has been rich and memorable. They continue to inspire each of us as we continue our journey up the mountain.
Fellowship of the Journey
Rhinos, lions, water buffalo, elephants, cheetahs and zebras are everywhere in sight. It’s our second day of our climb to the summit of Mt. Kilimanjaro and we are at 7,500 feet on our climb to 19,340 feet. To be clear, we have not actually seen any of the aforementioned animals. They represent the names we have given to the six teams in which we have divided ourselves so that our walking groups will remain manageable in size.
Before we even begin the day’s hike, the cheetahs decide to change their name to hyenas. Steve, a 69-year-old prostate cancer survivor (who also happens to be the proud recipient of two artificial knees and one artificial hip) is the playful joker/trickster who keeps us all on our toes with his banter and his song.
He insisted on his group being known as the hyenas. He knows that humor and sincere connections with others are essential glues that bind us together. His 39-year-old, Jed, is along with him on this journey. It’s fun for all of us to witness their relationship.
The day started off a little uncertain. Several of the cancer survivors and caregivers are affected with diarrhea. Dr. Brad Hiatt, a gentle, caring oncologist from Des Moines, and I are making pre-dawn “tent calls” to assess the condition of those affected. In addition to gastrointestinal woes, homesickness has also become apparent. Kerri, a 32-year-old breast cancer survivor, has left behind her 3-year-old daughter, Lily, in the capable loving hands of her husband, Travis. Kerri needs some diarrhea medicine and she needs some hugs. Dr. Hiatt provided her with the former and our entire Above + Beyond team provided her with the latter. One cannot overestimate the therapeutic value of a good hug.
Sunrise arrives, breakfast begins, tents come down, water bottles are filled and we continue our ascent of Mt. Kilimanjaro. Kerri is feeling better in the daylight than she did in the darkness of her tent. Sheryl, an insurance executive, caregiver, and tent-mate of Kerri’s, tended to her needs with genuine compassion and helped nurse Kerri to her ready state.
Today’s climb takes us from 7,500 feet to 8,600 feet as we intentionally choose a slow pace to allow for better acclimatization. We journey through dense rainforest on a winding dirt and mud pathway through lush greenery, peppered with brilliant flashes of colorful flowers. We’re disappointed we don’t see many animals, but we are rewarded with occasional sightings of monkeys as they dart through the trees.
In addition to the sights and sounds and smells of Africa, our walk also provides the opportunity for lots of fellowship. It’s the fellowship that really makes these journeys unique. One can overhear conversation on everything: Aristotelian philosophy, the religious interpretation of suffering, and the art of making the best birthday cake for a 5-year-old grandchild. That advice would come from Connie, a 63-year-old farmer’s wife and breast cancer survivor from Iowa. She’s never been on a hiking trip before, she came by herself, and she looks as comfortable climbing up Kilimanjaro as she looks doing chores on the family farm. She inspires me with her determined perseverance and her kind and gentle aura.
Julie, a 43-year-old breast cancer survivor and professional viola player from New York City, shares with me an insider’s view of a string player in symphony orchestras and Broadway pits. We also have a lengthy discussion of the health benefits of vigorous exercise in reducing the side effects of cancer treatments, lowering the risk of cancer recurrence, and preventing cancer. Approximately 85 % of breast cancer patients gain 20 pounds or more while going through their cancer treatment. Yet, Julie observes, the medical professional is reticent to recommend exercise to cancer patients. She knows the important role that exercise played in her recovery and is a crusader for making everyone aware of its important. This is just one of the many issues that she and I agree on.
The four-hour walk is over in the blink of an elephant’s eye (no we did not actually see an elephant’s eye today or any other part of him for that matter). We arrive at our Big Tree campsite and all of the hiking groups reunite. Hugs are exchanged, stories are told, bonds are strengthened.
After a hot lunch of noodles and vegetables under the shade of a large tree, we are treated to a beautiful serenade by our head guide, Chombo, and his team of assistants. We all delight in their smiles, voices and spirit. We look forward to more music as the week progresses.
In the late afternoon, after we’ve all had a chance to rest, reflect and journal, the campsite becomes a swarm of excitement. We just learned that Michael, a 38-year-old lymphoma survivor, who was stranded en route due to several flight cancellations, is on his way up the trail, with Brandon, a 29-year-old leukemia survivor, who stayed back in Moshi to walk with Michael. Two beaming faces attached to two very sweaty men appear in camp and are instantly surrounded by the rest of the 38 of us that have been eagerly anticipating this moment for days. Hugs, tears, and high-fives welcome the men to camp. Our group is whole for the first time. Above + Beyond Cancer: Kilimanjaro is now 19 cancer survivors and 21 caregivers, a team of 40 ready to continue our ascent together as one.
It feels like the entire extended family has finally made it home for Thanksgiving dinner. There is wholeness and we feel complete.
An Awakening to Spirituality
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 “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.
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.
The Spark of Inspiration
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-worn backpack at my feet. I shared with him that it had indeed traveled many miles with me and had seen many continents, but it and I were 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 his/her life to cancer along with a written tribute lovingly composed by their 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 to our family, 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.
For a New Beginning
We enjoyed our first full day on the continent 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 share our first meal together in Africa, we also 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.
Above & Beyond Cancer
As a cancer doctor, I am inspired each and every day by the grace, grit and compassion of my patients. During the next two weeks, I am taking time away from the hospital to embark on a journey that I hope will transform and inspire me. I arrived yesterday in Tanzania with 18 cancer survivors to begin a journey to the top of Mount Kilimanjaro. I am with seven men and 11 women, ages 29 to 73, who are survivors of breast cancer, prostate cancer, thyroid cancer, salivary gland cancer, lymphoma, and leukemia. Some have been survivors for over a decade; some are still actively undergoing cancer treatment. The survivors come from every walk of life and include a priest, viola player, army officer, cage fighter, and an insurance executive. We have trained together as a team and we are ready to learn what Africa and the mountain have to teach us.
Climbing a mountain is a metaphor that many cancer survivors use to describe their cancer experience. Only cancer survivors, themselves, can articulate the overwhelming sense of accomplishment they feel when they succeed in reaching the “summit” of their cancer journey. But what every survivor will tell you is that during the ascent, his or her perspective on life is forever changed.
Through the adversity along the way, survivors have to apply personal strengths, often illusive before their trek. On the other hand, they’ve also had to acquire an appreciation for the talents of others, those who are there for their support. At the end of the journey, they are transformed. In straightforward terms: adversity often leads to personal growth.
Most cancer survivors come through their cancer journey with a better sense of who they are, what their priorities should be, and gratitude for having been given a second chance at life. Most come through their experience with a greater appreciation for their fellow human beings, with an enhanced sense of gratitude and generosity. They feel more connected to the world.
This experience resonates with climbers and explorers as well. The journey is difficult, but when one succeeds, there is a rush of excitement and that same sense of accomplishment. And both journeys ultimately become less about getting to the top, and more about the self-knowledge and wisdom one learns along the way. When all is said and done, when the backpacks and hiking boots put away, life goes forward, with a dramatically altered perspective. Priorities are re-ordered. Life is a gift and not a single minute should be “un-lived”.
In April of last year, I led 14 cancer survivors to the Mount Everest Base Camp. It was an incredible journey of inspiration, motivation, and self-discovery not just for the survivors, but for all of us who travelled with them. I had been to Everest in 2000 on a climbing trip with a group of other mountaineers. I knew from that experience that a trip into the Himalayan Mountains could be transformative. That trip for me was all about going further, farther, and higher, yet, along the way I was rewarded by moments of spiritual clarity and a sense of compassion that developed from my relationship with the Sherpa guides and with nature. It was a trip that fulfilled my dreams. My journey to Nepal earlier this year with the cancer survivors was about giving birth to dreams. Even with 30 years of experience caring for cancer patients, I was not prepared for how meaningful and inspirational the Everest journey was going to be.
On our journey to Everest Base Camp, we experienced some physical hardships along the way. The adversity we encountered led us to new heights of personal growth. We met people who lived simple mountain lives. We learned their culture and their religion. We felt gratitude for their hospitality and we learned that we are all connected to each other on this earth. We gained an appreciation for the magnificent beauty of our planet as we travelled into the mountains. We explored our relationship with our environment and we developed humility and gratitude for its splendor.
The adventure on Mount Kilimanjaro will mirror and reinforce the journey already completed by cancer survivors. Laughter and tears along the way will deepen our understanding of how adversity can enhance our lives and the lives of those around us forever. We will return home with an even greater appreciation for life, our planet, and our fellow human beings. Our gratitude and generosity will help change the world we live in for the better. I look forward to sharing our journey with you over the next two weeks.