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April 8, 2011



by Rev. A. J. Iovine

In the back of my mind since that fateful day of March 7 when I found out that I had cancer has been the possibility of dying. While my oncologist has been positive about the outcome of my treatment since the cancer was found in an early stage, the idea of my death has continued to bounce around in my head.

Dying is not something that is on my mind a lot, but it sits there in the back of my brain and makes itself known when I try to put my head down to sleep. During the day as I go about my treatment and my pastoral work, the thought of dying doesn't even cross my mind. In fact, I stay abnoxiously positive about beating this crap whereby I virtually ignore talking about the cancer in my body. Everyone I know tells me that I things are going to be OK, including my doctors, and I readily and publicly agree.

But then there are the times when I am in bed, trying to go to sleep, when the dormant death thoughts pop up and say, "What will happen if you don't wake up?"

And this has caused me to toss and turn at night, sometimes spending hours fighting these terrible dying thoughts before sheer exhaustion overtakes me and I get a couple of hours of rest. The lack of sleep has been building since March 7. Even though I have taken naps during the day, they are not very restful — I find myself more tired after waking up than I did when I plopped my head down on the pillow.

This morning, my oncologist paid me a visit when I arrived at the center. I was kind of surprised that she was there so early. We went over the major event that was going to happen to me today – a PICC line was going to be placed in my arm following my treatment. I had visions of a larger piece of plastic sticking out of my arm, similar to the one that my father had in his upper chest/neck area when he was going for chemotherapy during his colon cancer fight. The one I am going to get is smaller, more stable with a less "flapping around" look. She said I could cover it with a bandage, if I want.

She asked me how I was doing, how my body was reacting to the chemo. It told her the aches, the fatigue, and the nausea were what was expected, and as of right now, they weren't preventing me from doing my pastor job, news that made her happy. I did tell her that I have this annoying rash on the top of my left foot that tickles at the most inopportune time — when I am driving. She laughed and said that was normal. Of course, she didn't give me any hint as to how to fight it.

The doc then asked me about my resting pattern since the bags under my eyes this morning were a little "baggier" than normal. I then told her that that I was having difficulty sleeping at night. She told me that she could prescribe some kind of sleeping pill to at least give myself a better chance of sleeping.

I've never been a big sleeper since my days in college. Ever since, I've been getting around 4 to 5, and on the very, very outside maybe 6 hours a night. With the thrice-weekly chemo treatments, my body does get worn out, and since I am locked into that painful pattern of 4 to 5 hours of sleep at night, I readily admit my body is not resting as much as the chemo-induced fatigue needs.

After my doctor left me hooked up to the IV, I starting thinking about dying, the nightly topic in my head. Many times during the past month I have found myself thinking about what happens when I die. Maybe because I am a pastor, I start thinking about the topics we discussed in seminary, especially the idea of "soul sleep." Essentially, that is the belief that when we die, our soul sleeps with God, and then on Judgment Day, our souls wake up and we stand before our Lord in our resurrected bodies. This, of course, goes against the popular cultural idea of "being awake in heaven" where after we die, our souls rise to heaven and we're greeted at the Pearly Gates by Saint Peter and we go into heaven and spend it with God for all eternity. 

OK, maybe we don't meet Saint Peter at the gates. There may not even be gates.

This culture of ours says that when we die, we go to heaven where there are pretty flowers, green trees, and flowing rivers – essentially a place of peace and tranquility since God is up there somewhere.

Playing off the "going to heaven and hanging out by the river" thought, I always think of seeing my mother and other relatives I've known who've died. I wonder if my maternal grandfather is playing the bagpipes. Sometimes I dream of going off to visit others who have died and I always wanted to meet, like Ronald Reagan, Pontius Pilate, and the guy who created the egg cream ( I favor the Brooklyn egg cream with chocolate syrup, seltzer, and milk). And then I want to go off and see my friends who have been called home. I wonder how heaven is truly laid out — does it look like the world we're used to, or is it more like the time in the Garden with Adam and Eve? Will there be snow for people who like snow or beaches for those who loved to frolick in the ocean? Do Adam and Eve wear clothes now instead of loinclothes? And will I ever get the answers to all those questions I say I want to ask God when I get to see Him?

And when I start going down this path, I get scared. 

Honestly, I don't want to know if heaven is tranquil like an undisturbed beach. I don't care to know if when I die my soul sleeps until the day of resurrection. I don't care if I never understand why snakes are just so nasty looking.

I just don't want to die.

Yes, even pastors who know that the faithful in Christ die and go to Him for all eternity, we still don't want to die.

I'm 39 years old with an aggressive cancer in my neck. There is still the possiblity that after all this treatment I am undergoing, the cancer could spread. Goodness, the idea of dying should be the furthest from my mind. But at night, these thoughts in my head plague me. They remind me that my mother died of lung cancer at 47 and that my friend of cancer at 36. There have been a lot more worldly and important people who died of this disease much younger than my 39 years, so what makes me so special that I can beat this?

These damned thoughts pain me! And so I toss and turn in bed. I get up, go downstairs for something to drink. I sit in the chair and death's reflection continues to swim through my head.

Last night was no different. After the painful Rangers' game, I turned off the television and turned on my iPad to read a book. I could not have been a page in when my mind starting wandering. I thought of my brother, who is in the hospital in Yonkers and is still battling a form of Crohn's Disease, and I wonder who would be there for him if I up and died. Not the nicest thought, I know. But for about an hour, this is all I could think about.

Around 10:45pm, I got out of bed, turned on Sirius XM and turned to the Highway, a country music station. I turned the volume down low, and started to listen. Focusing on the lighthearted songs that populate the country landscape today, my mind cleared and I got tired. Sometime after 10:45pm, I fell asleep until 4:03am. I got up, with the Highway playing in the background, got ready for the day and head out the door to the city and the treatment center, where I am as I type this.

I think I need someone to talk to — not a friend or a congregation member. I need someone professional to sit down with and talk over my anxiety about having cancer. 

This is not something easy for me to write about. I try my best to hold my personal feelings inside; but today, I was encouraged by my doctor to write about it. Writing and talking with someone could be something that helps me deal with the fact that I have disease that kills millions of people a year.

5 Comments Post a comment
  1. Marianne Herrmann
    Apr 8 2011

    You know, this sounds so familiar to me. After the heart attack and the medications that I have to take to control the arrhythmia, I started getting what I call “panic attacks” at night. I think it is my body reacting to the medication which also can give me awful nightmares…really frightening ones…and that old “fight or flight” response. I have long wanted to go to a therapist…I think they have biofeedback therapists that can help you deal with pain and then there are psychiatrists who can help you talk about fears, etc. You are probably having some things happen that you also are not mentioning here…maybe some dreams or thoughts you don’t even want to mention. Just hang in there and pray constantly when it happens and look into a therapist. I am still trying to find one, just tried calling around one day ago but the bad thing is alot of them do not take my insurance anymore. They take no insurance at all around here. So I have to find someone that will take insurance because I certainly cannot afford a therapist otherwise. I am thinking of going to Valley Hospital and looking into their services there. But I bet you that what you are going through is very normal for someone who’s body is fighting this awful disease and struggling with the chemo treatments and fatigue. God bless you, Pastor Iovine.

  2. Marianne Herrmann
    Apr 8 2011

    P.S. I will tell you what happened to me once or twice…I felt a presence of something bad trying to strangle me…it was super scary and obviously I was asleep but thought it was a waking thing…I got so scared but the more I took the medication and the more people I talked to let me know that I was not alone with these feelings and dreams. Luckily, in my cardiologists office there were a couple of people on the medications and they told me they had the same experiences one day when we were all waiting to see the doctor. I talked to the doctor about how to take the medications and I now take them farther away from bedtime and with my largest meal of the day which is supper time with my family and that helped me. I did not get those more horrible dreams and manifestations again. I have also weaned myself (with the doctor’s encouragement) off 800 milligrams of multaq down to 200 which helped me alot. I had looked up the side effects and it explained exactly what I was feeling…like a crushing in my chest…basically some of these meds can save me or kill me. I think that is the same with the chemo. Again, God bless.

  3. Laura
    Apr 9 2011

    I was fortunate enough to have a psychologist at the cancer center. I consider that she saved my life as much as the treatments. She helped me navigate this trip to the underworld. She was a light in a very dark place. Also, I take .5 mg of Ativan before I go to bed. It’s the only thing I found that gives me a good night’s sleep and quells the anxiety. Just a few thoughts for you from someone who has been there and back again…good luck!

  4. Rev. Iovine
    Apr 9 2011

    The nervousness that I feel at times is “unnerving,” and very much not like me. I have always been a little stone-cold, to use a phrase. I don’t fly off the handle much or react without thinking. But since I’ve been diagnosed, I have exploded more often – just ask the members of my church’s Voters Body…I was ugly. The anxiety, fear, and the not-knowing does get to me a times.
    I will definitely reach out for someone at the center to talk with.
    My doctor also gave me a prescription for Ativan, but like the stubborn Italian I can be, I haven’t filled it yet…

  5. Bob Kuppler
    Apr 18 2011

    Anthony, I’m thinking about dying all the time now. Though myasthenia gravis is not supposed to be fatal, I know it can eventually cause death. I’ve already overcome the cancer thing. minor case really – bladder cancer stage 1. not even chemo, though some treatment was necessary after surgery. one of my doctors said they don’t even think of it as cancer anymore. May this be what they say of yours! but back to my dying…
    i’ve had m.g. since the end of feb and it’s much more aggressive than other cases. I see double; my speech slurs; i have difficulty swallowing. I’m losing weight cause I can’t get food down without getting tired from chewing. and as we get closer to holy week, all of our liturgical things and hymns move us to the theme of death. And yes, though i can’t work much – what good is a preacher who can’t drive to make visits cause he sees double, and can’t talk more than 2 or three minutes without his speech slurring into incoherence…i’m not feeling too good about myself and wondering if this will spread to my limbs and the muscles that help me breathe. And of course we had FOUR deaths this week, and two memorial services on saturday and one burial last thursday. One of the family members comforted me after an almost incoherent committal that what’s happening to me is a spiritual battle…Satan attacking me so that the work of Christ in our congregation wouldn’t go on and therefore bear no fruit for the kingdom. Yes, I believe that, but I don’t want to die. And at the memorial service, they played taps for the deceased vet and I wondered if my family will do that for me. And his son, a navy captain, gave one final salute to his dad after the committal and I wondered with tears in my eyes if my own captain son will salute me. Oh yeah, I’m thinking about death alright. And then in worship, I can no longer sing like I used to, because the muscles in the neck get tired after about a half verse, and I love to sing…it’s how I, as the worship leader, worship my Lord and , and how i lead the saints in worship, and even in the midst of my communing community, I think about my dying. I can do nothing about this, other than take a bazillion pills a day to try to control these symptoms, but when the pills wear off, the symptoms come right back. So, this sucks. but you know this all too well, too. But something else is happening: the Lord is providing – hey, at least there are pills to control the symptoms; there are many people stepping up to assist and lead and do what I’ve been doing, and are experiencing the joy and the blessings, and I know that the Lord has taken care of it all. and hey, i think i’ve preached this a time or two, so it might be good if i live it – the Lord is with me so that I can experience him through it all. So, maybe I’ll not be able to eat a pastrami sandwich again cause it’s too hard to chew or swallow – as tender as they are in the right delis – but I still can drink a brooklyn egg cream. So maybe it ain’t so bad. Thanks for sharing, brother. You made my day. Bob


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