Updates from David Powlison
You may have heard about David Powlison’s recent diagnosis. This landing page will be the place where we provide updates as we receive them. Please continue to keep David, Nan, and the Powlison family in your prayers.
March 21, 2019
It is a pleasure to catch up with all that has been happening.
First a medical update. We got the results of my CT scan on March 6, and it is good news: the January and March scans side by side look identical. The tumors are "stable" (my doctor's word) both in number and size, so the chemotherapy is accomplishing what we hope it will do. Given the unpleasantness of the chemotherapy experience, however, this raises the conundrum of what to do going forward. My medical team is attuned to that dilemma, and I much appreciate their commitment to do what works for the patient. Three possible adjustments:  insert a port, to eliminate the discomfort from using veins in the forearm;  do chemotherapy every other week, rather than three weeks on, one off;  lessen the dose.
We will be making those decisions when we return from... Hawaii! After getting the CT results, we flew back to my family and family homes here on windward Oahu. We are in the middle of a much-anticipated two weeks visit. It has been a rich ten days. We spent the first week with my cousin Cosette, whose home overlooks the ocean, and is next door both to my brother Dan's and to my sister Diane's homes. Lots of visiting back and forth; many shared meals; beach walks daily; rainbows over the ocean; humpback whales spouting and breaching offshore; body surfing; the delight of spotting tropical fish while snorkeling; reminiscing over dinner with a group of high school friends from the class of 1967.
In other words, we've been much more active socially and physically than we imagined we'd be. I made a significant observation while Nan and I were traveling here on March 8. During our layover in Los Angeles, we were walking around the airport. At one point I suddenly realized, "I feel like myself. I feel better than I've felt in 6 months!" After the unpleasantness of jaundice in September, a whirl of diagnostic medical events in October, major surgery and slow recovery through November and December, and then chemotherapy in January and February, I now feel almost normal. We had been hoping that this time out from chemo would give us a sense for my current baseline level of energy, mental acuity, and overall subjective sense of health. It has done that, and the baseline is very encouraging—though of course what is happening objectively remains serious. Such days are a gift of God for this season, and I say, "O my Father, thank you!"
Nan and I recently read a finely worded comment about gratitude: "Grace and gratitude belong together like heaven and earth. Grace evokes gratitude like the voice evokes an echo. Gratitude follows grace as thunder follows lightning." It's a wonderful gift to not only feel grateful, but to be able to express it in words to the Giver of every good gift.
March 3, 2019
How did a month pass so quickly—with no updates? It has been eventful on many fronts.
Medically, it was a relief to have that week off from chemotherapy in early February. But the next two infusions (February 14 and 21) were increasingly unpleasant. The infusion process caused increasing “discomfort.” (My nurse commented, “This particular chemo is rough on veins.”). And though the steroid worked well to short-circuit any fever spike like what happened in January, the after-effects were increasingly unsettling. I’d have a two day steroidal buzz, followed by a hard crash into fatigue for a couple of days. Not how we want this to go. I canceled the third infusion last week after very good conversations with the treatment team. My nurse practitioner, Karon, is a gem—knowledgeable, a straight-shooter, very committed to understanding the patient’s experience and to working with this patient.
I will be having the follow-up CT scan tomorrow (March 4). This is what we’ve been aiming for in our two month experiment with chemotherapy. It will give a point of comparison with the early January CT scan, so we’ll get a bead on what is going on inside. We can assess what the therapy is doing (or not doing). I should be receiving a more specific prognosis. Having these facts will help us in deciding what to do (or not do) going forward.
Personally, this month brought grief in a way I did not expect—though it makes perfect sense on reflection. For three or four days in early February I felt as if I were behind a veil, standing at a distance from where life was unfolding just beyond arm’s reach. When I stopped and thought about it, I realized, “I’m grieving.” Future events and plans are the topic of so many conversations with family, friends and colleagues. I find myself in discussions that involve futures I may not be part of. The most poignant moment came when our daughter Hannah announced that she is expecting a child in October. Will I see this new baby? Will I go to CCEF’s national conference in October? Will I celebrate my 70th birthday in December. Will I sing “O come, all ye faithful” and “Joy to the world.” I don’t know, but I do hope so.
Interpersonally, Nan and I have been having rich conversations. Yesterday morning we spent two hours immersed in memories. Our reverie was prompted by Lilias Trotter’s description of a fortnight on the Cornwell coast in southern England:
Cornwall has the most wonderful attrait [French: attraction, highly desirable appeal] of any place I know on earth—except perhaps the desert. And there is a likeness, too, in all their unlikeness—the huge illimitableness of everything—ones whole being can expand…. I nearly cried for joy when I got out among the heather on the cliff. Oh such places there are—far more wonderful than I remember even. Today I sat for hours among the boulders on the slope of the cliff of a little bay….. The sea below every shade of emerald and sapphire and lapis lazuli, with deep purple shadow where the seaweed-covered rocks showed through. And above the till of moor, tawny turf and amethyst heather. (A Blossom in the Desert, p. 185)
Nan and I walked that very coast in 2006 with our daughter Hannah. We similarly delighted in every gem-like shade of green and blue in that same vast ocean below those cliffs. That memory then evoked memories of other vistas with a similar quality of “huge illimitableness”: in Wales overlooking the Irish Sea, along sea cliffs in the Orkneys, hiking in the Anza Borrego desert east of San Diego, and, repeatedly, right at home in the ocean off Lanikai where I spent so much of my childhood.
We’re expecting snow tonight here in Philadelphia. Snowstorms awaken something similar to huge illimitableness—the stillness, the complete alteration of every familiar thing we see outside our windows, a certain quiet thrill. (In fact, it’s just starting to snow right now.) I suspect that because of growing up in green, fragrant Hawaii, winter storms have never lost their magic even after 50 years on the mainland. By the way, there will be no repeat of that barefoot sprint around the house in the snow. It won’t be cold enough! Instead, Nan and I will take a walk through the neighborhood before bed.
How about my work at CCEF? I feel deep satisfaction as I witness my fellow workers thriving and fruitful during these months when I’ve had to significantly step back. I have continued to be active in meetings with our board, with fellow faculty members, and in all-staff gatherings. And I’ve also been working on editing projects and a book. But it’s not the same. We are all at least subliminally aware of what I am facing.
Psalms 141, 142 and 143 have been invigorating companions in recent weeks. The psalm writer is so fully awake to what it means to be human! He is so alert to good and evil, danger and safety, life and death, weakness and strength. And he is so honest about the immediate way God connects to these most significant aspects of our daily lives. Psalms have been a first-person tutorial in what it means to be a sentient human being.
Finally, thank you for the concern, care, and encouragement that so many people have expressed to Nan and me during a hard season.
February 1, 2019
You will laugh at one story. One of our longstanding family traditions has been that when there is snow on the ground and the thermometer gets down into single digits, we put on our bathing suits and run around the house barefoot. Well, last night it went down to 3°, and a beautiful snow squall in the afternoon had powdered us with an inch of fresh snow. So…, yes, even without any children or grandchildren around to participate and chortle their delight, I did run around the house in my swim suit. It’s very invigorating! You ought to try it, though I must admit that Nan sincerely declined an invitation to join me. 😉
A word about those fundamental perspectives. One characteristic of these past months has been that the relevance of Scripture has been electrifying. The more precarious life is, the more pertinent all that Christ is, does, and says. One particular significant encouragement came from Psalm 138:3: “On the day I called you answered me, and you made me bold in my soul with strength.” That clarity, focus, purposefulness, and inner strength has been a sweet gift of God, and a reality for which I am very grateful.
January 18, 2019
During the first ten days of January we said goodbyes to our children and grandchildren after a rich two weeks here in Glenside and up in Vermont. The weather was perfect for sledding and ice-skating, a rare pleasure for the Hawaii and Florida contingents. (Our Croatia contingent experiences weather similar to Philadelphia, with the Alps only a moderate drive away.)
Here’s the health update. On Monday (1/14) I had a CT scan to establish a baseline of the cancer, and then on Tuesday I received my first chemotherapy infusion. It was straightforward and went reasonably well, though I felt a bit out of sorts Tuesday and Wednesday. I’ve started to feel better and clearer the past couple of days. As you can well imagine, this process is creating many moving pieces physically, relationally, emotionally, and spiritually. What’s next? I’ll have weekly chemotherapy three times, and then one week off, when we’ll assess how my body is responding and decide how to proceed.
Here’s where things stand with my participation at CCEF. It is a joy to begin taking small steps back into the work that I love. I’m starting to come into the office for morning prayer and for faculty andJournal of Biblical Counseling meetings. I’m looking forward to working with mentoring, with JBC, with donors, with our board, and with some writing projects. But with health and treatment uncertainties, I’ll be quite part time. Until further notice, Jayne Clark will continue to serve as CCEF’s Acting Executive Director. She and I will consult (as we have all along) about major decisions.
Psalm 139:10 has been very meaningful. No matter where we are and what we are facing (and verses 7-12 cover every circumstance), “Your hand shall lead me, and your right hand shall hold me.” Pray that Nan and I would know God’s personal touch. We are planning to take this weekend as a retreat to read, think, talk, pray, worship, and plan. As you’ve probably experienced, such plans and good intentions can shipwreck in a thousand ways. A major snow, ice, and rain storm is predicted, which is a big encouragement for us to sit by the fire, drink tea—and fulfill this plan!
December 13, 2018
A Conversation Between Friends
David and Ed conversation (short)
David and Ed conversation (full)
November 21, 2018
Thank you for your concern for me and for Nan as we have faced a life-changing swirl of medical events. Let me briefly summarize.
What has happened medically? In early October I was diagnosed with an early stage pancreatic cancer. Various scans showed no evidence that it had spread. My doctors were hopeful that surgery would be the cure. However, during surgery on November 5, they discovered small tumors on the liver as well. In that moment, the diagnosis shifted from “stage 1 operable” to “stage 4 inoperable.” Though that is an unexpected whiplash, the front and center issue has simply been to heal from major surgery. Recovery from an 8 inch belly incision is no small thing. But I am sleeping well. Pain and tenderness are gradually lessening. I’m able to walk more each day.
How are we doing personally? As I shared before, Jesus’ words in Matthew 6:32–34 have been living and active. Each day’s particular trouble is sufficient for this day, because your Father cares for you. He knows what you need. We have been able to live in terms of what faces us today, each day. It has been a grace to focus now on healing, and let the larger questions be tomorrow’s trouble.
What is next? On December 6 I will have several appointments, first for post-op clearance, and then for discussion (and perhaps decision) regarding future treatment. We’ve met informally with the surgeon and with the oncologist for question-asking and information-gathering. We have really appreciated the attitude and ethos of all my doctors. They’ve put no pressure to opt for one treatment or another, and have presented fair-minded information, with a sense for the patient’s dignity and choice.
What is happening with my work at CCEF? Jayne Clark has stepped smoothly into the role of Acting Executive Director. It was a fine providence that Joe Novenson spoke in my place at our national conference, and that various staff members covered for me. It was another fine providence that our next issue of the Journal of Biblical Counseling was completed before I went into surgery.
Here are two prayer requests. For Nan, “It’s easy to get into a daze of practical operations, and not be in touch with the poetry of our lives together and with the Lord.” I like the way she put it. There’s no formula for facing a hard thing well and with honest feeling. For me, it’s easy to get into the haze of feeling very unpoetic queasiness and not absorbing nutrition. My innards still need to “get sorted,” as the Brits say. So amid all these medical practicalities, pray that we will never lose sight of the reality that life is not—is never—a medical drama.
May the peace of God keep you,
November 8, 2018
I am deeply thankful for your continuing prayers, expressions of support, and encouragement. I am now recuperating at home from a delicate, major surgery.
The outcome proved to be very different from what my doctors hoped and expected. We all went into this surgery thinking it was a stage 1 operable tumor; mid-way through, the surgeon discovered that it is stage 4 pancreatic cancer. Needless to say, this is hard news. We are just beginning to process it.
Nan and I have been very heartened by Jesus’ words in Matthew 6, that the day’s own trouble is sufficient for that day. So for now, we are simply focusing on managing pain and on healing from the operation. Next week’s days will bring a different focus as we meet with our oncologist to begin discussing options and scenarios going forward.
We are comforted by the liveliness of God’s words to us. He is with us, as so many wise people have reminded us. We appreciate your prayers for our entire family, and the care and concern you have expressed for the staff at CCEF, and your prayers on their behalf as they continue our work in my absence.
May God bless and keep you,
November 2, 2018
Dear friends of CCEF,
I have been deeply encouraged by the care, encouragement, and intercession that Nan and I have received from so many people.
As you may know from the video and note we sent out several weeks ago, I will be having surgery for a tumor in the pancreas, and we now have a surgery date: Monday, November 5, first thing in the morning. Because it was discovered so early, at this point the plan is for surgery to be the treatment. The anticipation is that I will be in-patient for about a week, and will be recovering at home for about a month after that. While I am out of circulation, my Chief-of-Staff, Jayne Clark, will be CCEF’s acting executive director.
As I mentioned earlier, my doctor’s words to me were: “It’s a bad diagnosis, but with a real silver lining because we found it early.” I sincerely hope that the “silver lining” is what proves true. At the same time, I desire with all my heart that Psalm 112:6-7 will be formed at the very center of who Nan and I are individually and together. The sense of weakness and need is a gift from God. It makes us realize we need Him, we need all of His mercy to us, and we need people who love us. I’m grateful for your care, for CCEF and for me.
If you would like to continue to receive updates on how I’m doing, they will be posted here with a notice sent out through our eNews.
October 17, 2018
I have sobering news to share with you, our faithful friends.
After several weeks of illness in September, I went to my doctor. A series of tests led to a definitive explanation of what is going on. The diagnosis is that I have an operable tumor in the pancreas. My doctor said, “It’s a bad diagnosis, but with a real silver lining because we found it early.” This is hard news to receive. But I am encouraged that the tumor is small and contained. Again, from my doctor, “Surgery offers a real possibility of being the treatment, and of being successful.”
The surgery, of course, will be complex, and medical hopes are only possibilities, not guarantees. How fragile we are! Yet, God knows us. Psalm 121 has been a frequent voice in my heart. The Lord truly helps. He is wakeful and protective. He is watching over me and Nan and CCEF. I’ve been heartened by Psalm 112:6-7. I want to be a person who is unafraid of bad news, who responds with a firm and steady heart, who trusts in the Lord, and again, who is not afraid.
I ask for your prayers, for myself and for Nan, for all of us at CCEF. May God’s nearness be tangible to us all.
I hope that through whatever unfolds we will trust our God, and ask his help, and express our thanks, and care for each other.
Thank you for caring,