Arsenic and its Happy Half Life

Friends:
I know it’s been several weeks since my last update, and I’ve been hearing from a bunch of you wondering if I’d fallen off the planet. Uh, no, but it’s felt like it some days--but let’s not get ahead of ourselves.

When I last wrote, I’d recently been told that, surprisingly and distressingly and despite the fact that I’d been feeling pretty well, my protein (UPEP) counts were up again to just more than 13, up from 8ish in March (which was well down from the pre-transplant and very dangerous high 30’s). While the transplant had given some serious relief, it was clearly temporary, and hadn’t “taken” as we’d hoped. Clearly, remission would be elusive.

Arsenic
Dr. Luger responded to this news with a characteristic mix of detached medical curiosity and empathetic bedside compassion, and so we sat together with my medical file, now four-plus years old and about that many inches thick, and immediately began to tear through my history to figure out what we should do next. After a careful survey, we realized that there was one (just one… sigh) non-invasive chemotherapy treatment we hadn’t tried in one way or another, either alone or as part of a cocktail: Arsenic. Yep, arsenic!--as in “… and Old Lace” and rat poison. Dr. Luger ran over over the protocols and side-effects, talked about its history and how it works.

(Wanna know how? Well, basically, the arsenic stops the Myeloma cells from trying to make my bone marrow immortal. Seriously. One of the things that this kind of cancer does is switch of the trigger in our cells that let them die and make new cells; with that trigger off the new cells gain what can best be described as an unnatural dominance of the other cells, and that means that the good things those cells produce (certain proteins) overwhelm the proteins that the other cells produce, which means that the initial good of those initial proteins becomes a bad, an evil, which overwhelms the system, keeps bones from developing (and ultimately eats away at them) and produces too many things for the system to handle, stressing and eventually shutting down the kidneys. Kinda cool, huh, how the “will to power” or the desire for immortality in isolation from a larger system kills rather than builds? If only I was learning this in a book…. Sigh.)

Anyway, after explaining all of that to me (and enduring my curious, ah shucks theological/metaphorical quizzeries) she looked at me, I looked at her and we nodded. It was a done deal, and so, on April 25th, one week after my last updates, I began yet another Chemotherapy regimen—Arsenic--in the form of a drug called “Trisinex”, given over four hours in cocktail with very high doses of Vitamin C for five consecutive days the first week, followed by twice-weekly two hour infusions after that, in 12 week cycles.

Coincidentally (& perhaps unfortunately) April 25th was also the date I’d given myself to begin the “home stretch” for what was, at the time, not only a big surprise but also in effect my full-time job for the next two weeks--completing the plans for my parents’ 50th Anniversary Party!

Yep, when I wasn’t ‘front loading’ the Trisinex (the first week required five straight days of 4-5 hour infusions—2 & ½ hours of Arsenic preceded by lots of IV fluids and a big dose of Vitamin C) I was also working on the final plans for a surprise party my sister Susan, Sheri and I were throwing in Burlington, ON (Canada) for my parents on May 7th, their actual anniversary. Not that we hadn’t been working and planning and emailing invites to long lost friends and colleagues and trying to figure out how to best pull off a surprise party that was being organized (mostly) from 400 miles away (with a hefty dose of good ideas and help from my sister Susan in Hong Kong).

Dwight Ozard, Party Planner
So as you might imagine then, those first two weeks of my arsenic infusions and last two weeks of party planning were crazy busy, to say the least. First thing in the morning I would head to the hospital for blood work, then back to the famous “chemo room” at Dr. Hoessly’s office ‘til just past 1 pm (for a bit of insight into the carefree goings-on into that glorious, grace-laden environment, check out Just Like Cheers, But… which I wrote during Xmas of ’03). When that infusion was passed and the nurses were sure my blood pressure was ok (the Arsenic makes it drop sometimes) I’d then run to the printers or back home to take care of the last few details and arrangements taken care of for the party, all while on a crash course to gain as much weight as possible, since I’d lost almost 10 lbs in mid-April during my bout of Shingles.

Fortunately, Trisinex’s initial side effects are fairly limited early on in the regimen, so during those first few weeks I was neither terribly fatigued nor significantly slowed by the infusions, and when we moved to the regular schedule of two infusions/week the next week (the first week of May & the week of the party) I was both on top of the party details and felt quite good, (tho’ I was a bit tired, wired as I was from all the adrenaline). By the time I got in the car on the 4th of May to drive to Canada, I was fairly confident that we’d done almost all that we could do--and when I met with my team on the ground in Canada (including the amazing and energetic Rev. Scott Doggart, pastor of Glad Tidings Church where we were planning the party, and Carol Brown, a woman who once worked for my dad and who had offered to help us guide the party and organize the food along with the equally splendoriphic Doreen Farough, Edith Whitelaw and Barb and Kim Brunton, all of who went, collectively and individually, far and beyond any call or any duty), I was certain that if we could keep up our lying, the party would be a success.

Lies, Lies, Lies
And it was a success. While I was in Ontario those last few days before the party making lists and checking my them twice (no one was naughty, btw), I was also able to spend a day and change catching up with two long lost college friends (“Hi Dawn and Kim!”) as well as enjoying a small gathering of some of my best friends--some I say… Chris, where were you????--over dessert and drinks at a lovely old haunt of an English pub called “Chaucers” in London, spending the night (as per normal) at my glorious friends Mark and Bill’s perfect Victorian just around the corner--and light years--from where I used to live there) and then heading to Woodstock to see the theatre performance of Brent Holmes, the son of my best man--who was born 13 years ago on my 30th birthday.

All this time my parents thought that Sheri and I were taking a short driving holiday up to NY State’s “finger lakes” and Ontario’s “Thousand Islands” and then would come to their place for the weekend--just one of many lies told in preparation for the party. (They’d also been told that I had come up to Canada, while they were in Florida, for meetings with World Vision--a lie I had their complicity in--while I was slaving in their basement with their prehistoric computer scanning scads of old photos for the party decorations.) Finally, on Friday morning Sheri flew into the Toronto airport for a happy reunion, and together we headed back to Burlington to meet with the Rev. Scott along with Carol (& the equally servant-like husband Reg) to finish the final details of party and map out our table, chair and “special stations” for the room. At suppertime we called my folks and informed them that we’d “made better time than expected” and were already in town, so we headed over to their home, where they’d been expecting us for what was supposed to be a quiet weekend of family celebration, starting a lunch on Saturday with my nephew CJ and his wife, and then a fancy dinner that night with just Mom & Dad and Sheri and me.

All this was made possible by an intricate web of lies I’d been weaving since the very first doozey I told them back in February when I had, after the death of Jim, Sue’s husband, told them the entirety of the initial plans my sister Susan and I had made for their celebration before that tragedy--plans including a pig roast, a sit-down dinner, a feature film (ok, not that). I then told them that because of the circumstances--Jim’s passing, Sue’s limited ability/capacity to come back to Canada just a month after returning to Hong Kong, my illness and recovery schedule, all that--we could no longer do anything; we’d have to just settle for a small dinner. Yes, Sue was no longer able to come back to Canada, adjusting to her new life alone in Hong Kong, and sure, I haven’t had the smoothest post-transplant months, and obviously both Sue and Sheri & I had seen a significant falling away of our income; of course we couldn’t achieve the same scale we’d hoped for last summer when we first started planning and had contacted our friends (and former parishioners of my fathers) who ride the summer competitive barbeque circuit to cater the party. All I told them was true.

Sort of.

It was truth in the tradition (and service) of the best comedy and illusionists--misdirection.

We even got my mom’s sister (Aunt Miriam & Uncle Chuck) and some of my parents’ best friends in on the lies, letting them know what we’d said and what we were now plotting instead. Dad or mom would talk to someone, they’d ask if there were any plans in the works for their 50th and Dad would give the little speech back I’d given him about how a big party would be in some way inappropriate this year.

Tee hee.

We had no intention, of any kind, of not making the most of this exceptional celebration, and so as soon as I began to feel even remotely decent (early March) I set out to make sure that happened. Lots of emails, a special secret section of my website, lots of phone calls and planning, a trip to Burlington to make copies of photographs, lots of time at printers making huge posters and a couple dozen 11X17 laminated “placemats” of old photographs, plans for toasts and food and a second evening dinner with about 30 of our family, the wedding party and closest friends, and lies, lies, lies.

Two months of lies past and just before lunch on Saturday, May 7th, after an alleged “breakfast” with Scott Doggart (we were setting up the final arrangements at the church hall) followed by a (quite delightful) morning back at Mom & Dad’s looking at old wedding albums and photos we’d never seen before (even after three days in March rummaging through every archive and album I could find), I told my final whopper to get them to the church to meet my nephew (and their grandson) CJ & his new bride Ali for lunch.

CJ, we told them, was there “practicing with his band” and we’d pick have to go in and get him. (My apologies to CJ for using his youth and inexperience and making like he was irresponsibly double shifting a band practice as a way to get my father impatient enough to get out of the car and into the church.) Of course, everyone was there, quietly jammed into the hall, and we had to come up with yet another lie to explain the endless cars in the lot.

Oh yeah, I said, CJ said there was some kind of meeting going on, so when we went to get him we’d have to use the back door and be quiet.

They were biting on every one.

Once there (and having just barely negotiated a thick-headed guy who was helping with the parking who announced to dad that he was there to help with some “anniversary thing”--Arrrrggghhh) we finally got them to the room filled with 350 of their friends waiting to shout their “Surprise!”

Silence.

Dad walked into the darkness of the room and then stepped back.

We can’t go in here, it’s somebody’s party. Well duh.

The loud Happy Anniversary! needed to be coaxed from the crowd. (These were good folk, all, but most seemed to need permission to party. How very, very odd.)

But when it finally was loosed, the exultation was both loud, full of passion and overflowing with genuine, obvious affection. It was the first of many moments that made me swell with pride.

Unfortunately, it filled Dad with trembling. Actual, full-on, jack-hammer trembling. I honestly worried for a second that we might lose him.

Mom, meanwhile, was frighteningly breathless. Images of her January ’89 heart attack and subsequent mini-strokes overcame me.

Had I killed them? Oh my GOD, had I killed them?!?

The Party, The Celebrations, The Honors
Only then did Mom and Dad notice the huge poster of our family in 1969 facing back at them, then, look beyond it through the barrage of 350 familiar faces (350!!--sensory overload already, I’m sure) to scads of unbelievable food around the hall, then around the room to more poster-sized blow-ups of the young lovers 50 years ago and just last year in the Mountains, surrounded by 50 long stemmed roses that Susan had sent from Hong Kong, then more familiar faces--the members of their wedding party, mom’s sister, dad’s brother’s widow, their best friends, a gang of guys who worked for Dad over the years, all there waiting for the party to begin.

It did, quietly and perfectly, with a short movie that my nephew had pieced together, tracing Mom & Dad’s life together. After that, we sat their trembling bones down on a couple of make-shift thrones for the guests of honor under a banner announcing our congratulations, where we pointed out the four special stations around the room.

First was a huge “pantry shower” of label-liberated canned goods (an echo of their first pantry shower in Windsor--we gave the cans, labeled with a pen on their bottoms, to the Salvation Army Soup Kitchen afterwards). Second there was a table for the guests (350 of them!) to sign, instead of a guest book, portraits of our family through the decades of their marriage, one each for the 50s through present. Third, the guests could visit the Memories and Artifacts table, bringing old photos and scrap book pages to commemorate the day. Best of all, there was a table for the guests to place their cards and gifts into a series of offering plates. This last thing was an overwhelming joy for us all--in total, they received more than $5000 toward their yet undetermined but now perfectly decadent, summertime anniversary trip! Indeed, from the first ‘surprise!’ to the dinner with just family and closest friends later that night, every moment of the day was a series of unmitigated, un-ambivalent delights, marred only by Susan, Curtis and Christy-Rose’s inability to attend.

Dry Wit, Warm Hearts, Dry Toast
And then there were the toasts. Dad’s best man, Bill Brady, who had left Windsor in the late 50s to become a broadcaster, newspaper guy, writer, a talk-show host with integrity and wit and curiosity and a generosity of opinion that made him one of the most beloved characters in London and, eventually, a real-live, honest-to-gosh media mogul--chair of the local daily’s Board and President of the oldest radio station in town. (He also is a first-class philanthropist--which means very few ever knew about his philanthropy). Through all of his growth to notoriety, he remained (and never wavered as) a good and loyal friend to my father, and his toasts that day both celebrated and roasted that friendship, rejoiced in and skewered their shared Pentecostal heritage (“sinning is easy when everything is wrong”--Bill, like me, had joined the big, bad United Church of Canada) and set the tone for a day designed, deliberately, to less celebrate Mom & Dad’s ministry together as their love affair--a no less insignificant event in human history.

Richard Chung, our glorious British New Guinean friend from Toronto, reminded us of my parents hospitality and generosity at a time when Toronto (and Toronto churches) were still a long way from the cosmopolitan tapestry it is today. I swelled with pride at his words--and the memory they evoked of a couple who modeled the welcoming arms of Christ in how they treated the front door of our home. Kim Christink and Leonard Van Dyke, who both served as assistants to Dad in London (the second time) and Elora-Fergus respectively, talked of Mom & Dad’s example as a couple as well as mentors, and again, I was full. Jim Lawton and Jim Farough from Essex both near wept with affection as they spoke, as did the notorious Maury Blair. My own offerings seemed to pale in the light of these testimonies, but they did bring it all back to the core of things: I raised my glass, said a few words, gave them a knife to cut their (massive and delicious) cake and then Jack and Dorothy embraced in a good, long, delightful kiss.

(I must add, briefly, that the day was a success for another reason: my parents have been good friends to my friends, and this occasion gave me a chance to see many I love and miss dearly, like Kevin Rogers, my oldest friend in the world, who finally got to meet the “alleged” Sheri, or Mark Griffin, an old Bible College friend who dropped in between marrying a couple and their reception. Perhaps best of all we got to see the good Reverend Dr. John Stephenson, my former professor, mentor and now Rector to a wealthy parish in northern Toronto, a man who was easily the most important and formative teacher among the very many great teachers I have been blessed to have, as well as a friend and co-conspirator in all things good, and finally the man I want to bury me one day. (See "20 Years of Greener Pastures", a music review that is, in fact, a tribute to John). We shared only a short conversation, one not worthy his challenge and intellect, but it was something, and it made me glad for days and days….)

Mothers’ Day
The next day was Mothers’ Day, so we went to church in Oakville where my dad is serving as interim pastor and celebrated that day in worship and then, as all good church goers in Canada, with brunch together. A few more moments of fellowship later and Sheri and I were off to Niagara Falls where we settled into a delightful Falls-view room, walked down from the Rainbow Bridge to the Horseshoe Falls and back, had some dinner and then pretty much crashed directly into bed, near exhaustion. The next day we filled our stomachs with a huge carboverload breakfast then drove home, ordered pizza and again, crashed, comatose.

Recovery, Sort of…
I spent the next week pretty much in a fog, either getting Arsenic, sleeping, trying to write (nope) or rubbing my eyes and waiting anxiously for Friday the 13th, when Sheri & I would celebrate our own 10th anniversary.

The truth is that while we’d been well-prepared for the party, and while the first two weeks of treatments hadn’t left me too worse for wear, and while I’d gained a good amount of weight back (after my early April dose of Shingles), I was still at the end of my line by the time the weekend was over. I was tired enough that even trying to sleep made me exhausted--y’know?

And while on the surface I continued to feel relatively good that week (as I had since the Shingles had passed), I could feel my energy waning, spurred on by my Arsenic-induced lowered blood counts (my white, red, hemoglobin and platelet counts plummeted during my third week of treatments, a fairly typical side effect of Trisinex, and one I’m not too thrilled about--more to come). By the beginning of the following week my fatigue had merged with my seasonal allergies and I developed a nasty, unrelenting, cough-orama infection in my nether regions that ultimately settled into my chest, which eventually devolved into a messy, mucous-lined cauldron.

This sucked for many obvious reasons--not writing, not working on my friend’s new special event business, not going to the dentist (ok, some upsides), not doing much but lying on the couch watching TV, coughing up mucous the size of small rodents, and certainly not going out for a fancy birthday dinner.

Self-Pitying Sorry-*ssed Fool
It also sucked, however, for less obvious reasons, like missing cool events. For example, the weekend of the 20th my good friend and old colleague and boss Tony Campolo was celebrating his 70th Birthday and 35 years of EAPE, the organization we moved back to Philly in 2000 to lead. We were to be part of a dinner with friends and colleagues in paying tribute to Tony, including music types like Mark Lowry and Bill Gaither, politicos like Hillary Clinton and fellow-Kingdom muckrakers like Jim Wallis. That event was to be followed by a "survivors walk" as part of a local Cancer Society "Relay For Life" in which a bunch of patients were to join Dr. Hoessly’s staff (“The Chemo-sabies”) in some symbolic laps around a local high school track, while a few hundred others walked for nearly 24 hours. We missed both events, as both of us were pretty much numb with snot. (We did drag ourselves to the Philly Art Gallery to see the quite spectacular--but over-sold--Salvador Dali exhibit.)

What’s Next?
The next Monday (5/23) I met with Dr. Luger for my monthly check-up and we talked about what we should do next in the light of my still rising counts. Remember that in April the UPEP Protein markers had risen dramatically from 8-point-something to 13ish (this rise led to beginning the Trisenex treatments). In May, they went up again; however, the increase was less than two points to just more than 15.

Now, we weren’t expecting an immediate turn-around after only four weeks on the Trisinex; rather, we were hoping that the increases would be arrested or at least not spike--and that’s just what happened. Still, without a complete arresting of the increase, Selina (Dr. Luger) suggested it was prudent to start to again ask the tough questions about my prognosis, and begin to examine what options I have if the arsenic isn’t doing the trick and produced some kind of lowering of my counts by the first of July. And so, we pulled out the file (all four years and just as many inches thick) and went through my history, month by month, treatment by treatment, result by result, looking for hints and clues along the way, examining what has worked and what hasn’t and for how long, wondering if there were any more “big” non-invasive options I’ve missed, any new cocktails of drugs tested since I’ve used them last, anything. Anything at all….

I want her to exhaust every single non-invasive (i.e.: transplant) option.

And I intend to do the same.

At the end of the appointment, we came up with two things.

First and worst, the hard realization that it’s possible that by the Fall I’ll be in queue to have a full-on bone marrow transplant.

Sigh. ‘Scuse my language, but shit.

The second is, sort of at least, not so bad: adding high dose steroids (my old friend Decadron) to the Trisinex regimen.

And all this crap has forced me to think hard and long about the nature of my faith, and the nature of faithfulness. I’ve had to ask if I honestly believe that God can and does intervene (see "Have You Been Healed") and then commit to becoming the belligerent old woman in Jesus’ parable about the Judge and the, well, belligerent old woman. I’ve had to wonder what is the proper mix of responsibility (in light of my medical situation) and faithful hope (we started writing down all our “arrangements” and making sure that my pall bearers and my old professor are ready and willing to lead my services and wakes in Canada, here in Philly and in Nashville, and I wrote down my “do not make me into Terri Schiavo Living Will).

These are tough times, forcing us to do stuff that we hate doing, and to be reminded again and again (and without blinking) of my frailty. Thankfully, the chest infection thingy is finally subsiding a bit--after a big old blood transfusion last Saturday and a week of hazy, steroid-induced blahs--and since Memorial Day my appetite has returned (I’d managed to re-lose all the weight I’d gained again, taking me down under 170 lbs again--way, way too skinny for someone still over 6’2”!). The last few days I’ve been able to actually get a bit of work done (well, not counting yesterday which was spent at the ER trying to stop yet another nasal hemorrhage (another result of my depressed blood counts, in this case my platelets are waaaay low, which makes clotting a problem, especially in my nose where a couple of old broken noses from my street hockey days have left me with a blood vessel prone to blow like a careless birthday party balloon), and hope that next week I’ll be back to something that reminds me of normal.

And Yet Grace Abounds
Indeed, through all the ups and downs, good and bad health, fearful glimpses into the future and waves of optimism there is grace. Everywhere there is grace.

And opportunity. For example, all things being equal we’ll travel back to Canada, where on July 10 I’ll be the summer guest preacher at Metropolitan United Church, the country’s largest “mainline” church and where I worked back from 1989 to 1992. Back in the Eighties the “Summer Preachers” at Met were a huge deal, the pulpit filled with the best preachers in Canada. With my invitation that tradition has clearly passed, but it’s still a treat to go back “home” and to be part of the trajectory of great preachers who have shared the Word from that pulpit.

There’s grace too, in the hope that sometime, soon we hope, we’ll go on some kind of vacation, tho’ being broke makes our options narrowed. Sheri is just plain spent, and needs to get out of here and her office soon, and, assuming I’m well, so do I, perhaps just as badly. Plus, we want to figure out a way to celebrate our own 10th anniversary. Our dear friend Jon Paul is helping us brainstorm a bit on this hopeful vacation (he made the NYC trip last summer possible), but I’m not sure when that can work out. Prayers here please.

One of the side effects of feeling like crap and not being able to work is that you think about what matters most to you, what you don’t want to lose, what you want to honor and give your time and energy to. Obviously, one of the most important things (perhaps the most important thing) is my life with Sheri, and on May 13th --just one week after my folks’ party--we were able to celebrate our 10th anniversary at an exceptional local restaurant. We were also able to pick up an amazing, if I do say so myself black mother of pearl on white gold anniversary ring for Sheri in a moment of either foolish decadence or good faith. My love for Sheri has grown so much in the past four years of illness, and is now more intense, more private than I can articulate, even if I wanted to. The past four years have been hard on us, to be certain, but I’ve learned the goodness, the grace, the depth of soul that comes from enduring and sharing our bumpy little road. I’m the luckiest guy in the world, and I have no idea how to say so.

An Example
But one thing I can say is how pleased I am to have my parents’ example of how to love. Sure, we’re very, very different in a lot of ways, and I’ve made choices they’ve never considered and they’ve done things I could never do, but in all they’ve taught me more than I can say. And when I first became ill, one of the things that grieved me the most was this odd little thought: that I might not be able to eulogize them, to properly honor their love and service to me and so many others. Seriously, I know it’s odd, but this made me ache so deeply I can’t even begin to say, so the opportunity to honor them on their Golden Anniversary probably meant more to me than it might have normally. I wanted to at least tell them, as I eventually did, how proud I am of them, how blessed I am to have been taught and led by them, and how much I’ve learned about what it means to love by watching them.

I remember back to that night in January ’89 when Mom had her heart bi-pass surgery. After being up close to 24 hours waiting on her (she was a study in complications) and despite her very “touch and go” condition, I finally got Dad to agree to lie down in a quiet waiting room and sleep for a few hours. As I covered him with his jacket and hugged him, his controlled, ordered demeanor broke and one huge tear ripped itself from his eye and he looked at me and said: “What will I do, Dwight? How will I live without her?”

I couldn’t speak, but not because Dad made me sad. I realized that however much I’d loved to that point--and I’d had more than my share of girlfriends--I had never loved like that; I had had passion and lust and dreams and hopes and promises, but I’d never known what it was like to be truly “one” with someone, to need beyond my own needs and wants and desires, and under that realization, I couldn’t speak because I envied him.

About an hour later I moved quietly into ICU and was with Mom as she awoke, curling her fingers around mine like a child and asking in a hush that took all her energy: “where’s Daddy?”

There, in those two moments, I knew that I knew dick about love, and I began to pray that one day I might be able to know even a glimmer of that thing they shared.

And so, this May 7th, just one week short of 10 years into my own marriage & four years and two months into this stupid disease, what I know of love, what I’ve shared of the divine with Sheri, has it’s roots in those moments, & on that day I got to say a few small thanks, and I couldn’t be more proud, or more fortunate.
*****

And to Come?
As for the mundane, here’s the situation: I’m going to continue my arsenic treatments for at least one more cycle, and the doctors will evaluate what to do next based on how my Protein counts are responding. Assuming we have a positive response (and my Protein counts come down), I guess we’ll stick with the arsenic (and get regular blood and platelet transfusions to fight the side effects of low blood counts).

If the results are not positive, well, we’ll have to face the tough choices that are next. Last year they’d identified a marrow donor for me, but they hold those donors for just a year--we’ll have to look for a new donor this fall should that be the course we take, and if we do, I’ll be sure to make sure you all know how to get tested for this.

Fear and Trembling
Not that I want this option. The kind of transplant that Myeloma patients receive has about a 25% mortality rate (from the procedure or from Graft-Host disease, not from the disease itself), and I just hate those odds. There’s a part of me that wants to go elsewhere for other options should we get to this road, but I don’t know. I’m learning to trust.

And I’m learning to listen, to pray more deeply, to hear the voice--no, to feel the heart--of God in the day to day.

Small things like the pain of stares I get since I’ve losing so much weight. At under 170 lbs, I’ve got a classic AIDS body, and especially when I’ve got on good, stylish (tho’ baggy) clothes I notice a kind of oh, he’s got that disease look that betrays a kind of contempt, a kind of genuine hatred. Not everyone, of course, but I’ve seen it enough to be reminded of why I started ending these notes with reminders to remember the voiceless and the nameless and the marginalized in the first place.

Can I be honest? It’s hard to want to love God, to want to know God more, because as you do you begin to understand the weight of true love, you begin to understand how much it hurts to see your own suffering. My own suffering has been a an infinitesimally small glimpse into God’s kindness, and sometimes I’ve wanted to turn away, to stop praying, to tell God enough.

I mean, my God!--TEN MILLION ORPHANS from a preventable disease, a disease we have the resources to address, to challenge, to stop.

Millions of women at risk simply because they are married, monogamous, and Christian--told that if they don’t “submit” they’ll be ostracized from church and family--and then they die.

Dear God. It’s too much to bear.

But it’s not too late to do something.

Go to www.one.org for starters, or get involved in the LIVE8 movement.

Do something.

And remember those whose names are not spoken for reasons worse than they are unknown--unspoken out of contempt and hatred and prejudice and ignorance. Repent for those feelings. Drop to your knees and beg God for mercy. No one can bear such enmity--and God will not.

And please pray for us. We need you.

And we love you.

Thanks.

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