And don't come back

This is the day that the LORD has made;
    Let us rejoice and be glad in it!

- Psalm 118.24.

This time five years ago, I was receiving weekly doses of poison and daily radiation burns to my chest after being diagnosed with a rapidly growing malignant tumour just above my heart and invading my left bronchial tube. Today, I went into an oncologist's office and was told not to return, as five years of follow up is enough.

Although it is still possible for me to experience relapse, the chances are that any cancer now found in my body is more likely to be a new growth than a renewal of the one that was well on its way to killing me in 2006/07. I am obviously delighted to reach this milestone and continue to receive each day as a gift. I did not deserve to live, did not earn my reprieve, did not qualify for healing through the quality of my faith. Faced with a very rare form of cancer (numerous specialists have given me the impression that I'm one in a million), medical science took its best (highly educated) guess as to treatment and it worked beyond all expectations.

And so praise God for life, for health, for wonderful support from family, friends and even strangers, for medical specialists and all the care I have received over five years from dozens of healthcare professionals both in Oz and the UK and for public healthcare that has meant my total out of pocket expenses have been AUD $0 + GBP £0 for treatments that probably cost tens of thousands (thanks fellow tax-payers!).

Yet the experience continues to have its shadows. Given that the first side-effect mentioned on the consent forms I signed for both chemotherapy and radiotherapy is that those treatments are themselves carcinogenic, cancer is still quite likely to be part of my future, as is reduced life-expectancy. I am also aware of the costs the illness and treatment have brought to my health in other ways; being poisoned and burned are not generally conducive to good health (I've always thought that Nietzsche's boast that whatever did not kill him could only make him stronger was one of his sillier ones).

And I am not the same man I was. Being gravely sick has reconfigured my emotional and spiritual life, not to mention shaping my academic interests. For much of this I am grateful (and this is undoubtedly the true referent of Nietzsche's comment), especially for the reminder of my own frail mortality and the liberating realisation that survival is not our highest priority. These are important lessons that I hope always to keep close to hand. Has the experience also made me more pessimistic about our future prospects? Given that being ill significantly overlapped with the period during which I began investigating ecological and resources predicaments in greater depth, it is hard to tell whether the chicken or the egg came first.

The significance of my reaching this milestone was brought home powerfully to me a day or two ago when I came across the story of Kristian Anderson, a Sydney Christian man in his 30s with a wife and young kids, and who died from cancer two days ago. Kristian recorded more than two years of his physical, emotional and spiritual journey since diagnosis on a blog called How the Light Gets In (H/t Andrew Paterson). I ran out of tissues while reading it. I never met him, but I thank God for his life and witness, even amidst great darkness, and I pray for his widow and little boys.

Life is a precious gift. Let us rejoice in each day we receive.

Hauerwas on illness, dying and medical idolatry

Quite some time ago, I included a small link to a talk by Stanley Hauerwas where he addressed themes of illness, dying and western society's often idolatrous attitudes towards the medical industry. The title of the talk was "Theology, Medicine and the Christian Community" and it was delivered on 19th August 2006. This fifty minute talk helped to shape my thinking during the period of my own illness and treatment, and I have recommended it to countless people since then. It was one of the inspirations for my series on things worse than death.

Since I found this talk so illuminating, and since the original no longer seems to be where it once was, I thought I'd link to it again in a new location (approx size: 20MB).

Nicholas Stern: facing the future

On Thursday night I went to hear Nicholas Stern at the Edinburgh Book Festival. Lord Stern is the author of the Stern Review on the Economics of Climate Change, a 2006 publication of the Government Economic Service of the UK, which famously laid out an economic argument for a strong global response to climate change. The Review claimed that an annual investment of around 1% of global GDP is required to avoid the worst effects of climate change, which, if left unattended, could have a long term consequence of reducing global GDP by 20%.

Lord Stern has recently published another book, A Blueprint for a Safer Planet, in which he defends the necessity and content of a comprehensive global agreement that must be achieved at the Copenhagen conference on climate change later this year, an event which he calls "the most important gathering since WWII".

His talk at the Book Festival the other night consisted of readings from his new book as part of a summary of its argument. In it, he claims that poverty and climate change are inextricably linked in our context and one cannot be addressed without reference to the other, that these are the two great challenges of the present time. In order to minimise the risk of runaway climate change, he argues for a 50% reduction in carbon emissions (from the usual 1990 baseline) by 2050, with developed nations (who have been responsible for the vast majority of carbon already emitted) leading the way to demonstrate that low-carbon growth is possible and developing nations following according to a timetable he lays out in more detail in the book. But for developed nations, this involves a 20-40% reduction by 2020 and an 80-90% reduction by 2050 (the numbers vary for different nations, depending on their current and historical emissions). This timetable would see emissions peak around 2030 and reach a steady level by 2050 at around 2 tonnes per person per annum (currently, the UK average is about 10 tonnes per person, the US and Australian average is almost 20 tonnes).

In passing, he acknowledged that the numbers used in 2006 to estimate the extraordinary costs of continuing business as usual were hopelessly out of date. When more recent data is included, he now believes the real cost would be far higher than 20% and probably closer to 50% of global GDP.

Nonetheless, he was upbeat and positive and confidently assumed that a solution is possible that includes continued economic growth (low carbon growth). Noticely absent was any mention of peak oil or any references to other reminders of the impossibility of infinite growth in a finite system. As a member of the UK House of Lords, he was also unsurprisingly positive about the role of national governments and international agreements (despite admitting that no precedent exists for an agreement of the scope and nature that he is advocating). He also seemed to be at least partially banking on technologies that remain as yet unsuccessful, making reference to carbon sequestration and nuclear fusion.

However, what I found of most interest for my own research were a couple of telling points during the question time with audience members after his talk. First, he was asked what would happen if no agreement is reached in Copenhagen, or the conference is inconclusive. His answer was over five minutes long but he never answered the question. He merely repeated how important it was that the conference not fail and pointed to various indications that might give hope of success. Second, the final question of the evening came from the lady chairing the session. She pointed out that he had spoken of some terrifying possibilities and that he had told us we ought to be scared, but that he had still come across as a cheerful person. She asked how he managed this. After first joking that it was due to his chemistry (natural, not illegal!), he went on to say that if we believed that it was impossible we would never even try. Optimism by itself may not be sufficient (since it may be deluded), but it is necessary. Amongst his final words were ones something like this:

"If we don't think we can do it, we may as well buy a hat [presumably due to the hotter climate?] and write a letter of apology to our grandchildren."

In these two responses I felt there was something missing (and granted that Lord Stern is a very smart man and the format was brief and fairly popular). There seemed to be nothing between success and total failure, no possibility that we might fail to solve climate change (or that some of these problems might lack solutions) and yet still respond well. I am not talking about mitigation or adaption, though these will be elements of any scenario since much damage has already been done. I am talking instead about the possibility of faithful "failure". This is not to say that action on climate change is unimportant, nor to foster any kind of defeatism. However, I do feel sceptical that we can (in the words of his new book's subtitle) manage climate change and create a new era of progress and prosperity. What if despite our best efforts at responding to climate change (and the host of other issues) we end up poorer and more fractured as a result of the damage already done? What if cushioning social decline is all we can legitimately hope for?

To put it in more personal terms, imagine someone dying of a terminal illness for which there is no known cure. The doctors may say that optimism is necessary but not sufficient, they may wish to try new things and seek breakthroughs, and these may all be good things. But the fact remains that it appears likely the patient will die. Faced with such a situation, it is tempting to think that there are only two options: success (a miracle cure) or failure (death). And it is tempting to think that the highest calling is to devote every resource to avoiding death. But might there be a way of dying, of facing one's own imminent end, that is faithful and "successful" in some deeper sense than spending every scrap of remaining energy on seeking to escape death a little longer?

Of course, the parallel is far from perfect, since a society is not a single organism with a lifespan that faces biological death. Such terms are metaphorical when used of societies, which transition from one level of complexity to another, rather than suddenly dying. But the point is similar: that perhaps there are situations where the desperate search for a solution that gambles everything on maintaining the status quo is a worse path than grieving loss, accepting change, caring for others and preparating for a very different future. I am not necessarily saying that we have reached that point, but if we had, how would we know? And if we had, would we be willing to admit it? Can our social identity survive the realisation that the foreseeable future might be all downhill?