Acts 1:18 recounts Judas’ death as follows: he bought a field, and “there he fell headlong, his body burst open, and all his intestines spilled out. Everyone in Jerusalem heard about this, so they called that field in their language Akeldama, the Field of Blood.” From the ground contaminated with Abel’s murdered blood to the perils and promises of blood transfusion and today’s fascination with personalized blood tests, the liquid that suffuses us continues to dredge an ever-deepening river in our collective imaginations.
However, my question when reading this passage was, Why mention his guts? Although most of us are no longer familiar with the details of hunting and butchery, one of most essential aspects of field-dressing an animal is the prompt removal of the viscera to avoid spoiling the rest of the carcass. Past death and outside a living creature, intestines have little use except as fermentation chambers for sickening rot. However, the importance of Judas’ entrails became clearer to me when I looked up the context behind the Greek word used, transliterated as splagchnon. The verb form splagchnizomai appears in passages like Matthew 20:34, where Jesus is “moved with compassion” to heal the blind. He is, to paraphrase, moved at the level of his very bowels to act: at the level so often smothered with shame and secrecy and euphemism that we forget the fact of their being. While the physiological connections between our guts and brainstems continue to be explored by contemporary science, most of us no longer consider our gut feelings to be so remarkable. Hearts and minds have been sculpted over the millennia as noble organs, worthy of wonder and veneration, while our guts sit in the darkened sub-basement of our awareness – unacknowledged – until they no longer work.
Kate Bowler knew something was wrong with hers, but not what – even after a parade of visits to various doctors. By the time of her referral to a gastrointestinal specialist at Duke University Hospital, she’d lost 30 pounds and spent countless lonely moments leaning in hallways, swigging grimly from a bottle of ER-prescribed antacids. A few months before that, she’d “felt breathless with the possibilities . . . [with the] certainty that God had a worthy plan for my life . . . I wanted God to make me good and make me faithful, with just a few shining accolades along the way.” All of that collapsed in a smothered roar as the last doctor informed her that they were reaching the “squishy end of a squishy diagnosis,” a squishiness that suffused her with something heretofore unimaginable: cancer.
The quote I selected above might tempt the prospective reader to think that Bowler is a sweetly unquestioning adherent of bootstrap-pulling, wealth-achieving, hearty American prosperity gospel: far from it. She wrote one of the first in-depth histories of the subject, first for her PhD and then in book-length with the appropriate title Blessed. She was more familiar than most with the perils of theology that promises God’s grace is distributed like a meritocratic credit rewards program, with the most faithful lives stretching into unblemished old age and preserved memories of the power to drive off tornadoes. Even so, she – like many of us – swam in its diluted milieu, the dregs of which dampened even the soil of her childhood Mennonite community that “prided’ itself on its legacies of martyrdom and material simplicity [in the eyes of televangelists, poverty]. She remained convinced that her life could burble along on a mostly beneficent current and that each apparent stretch of dead water would later be revealed as proving ground for greater spiritual renewal. God had a plan for her life, in which she was the “center that would hold,” connecting the strands of her husband and baby in a solid rope that did double duty as an anchor and a saviour from threats of drowning.
Her cancer takes this conviction and drowns it. She wakes up every day facing the impossibly, blindly cruel near-certainty that she will die young and leave the people she swore she cannot be without, one of them too young himself to yet remember her. Despite the overwhelming sobriety of these circumstances, Bowler does not wallow in self-pity; she cauterizes it, brilliantly, with sharp doses of humour, including asides about how she has the second-least-sexy cancer – thank God it’s not rectal! She includes vignettes on the stalwart support of her friends and family: how one drives screaming through a thunderstorm to be at her side after surgery, how another burns a dress so loaded with now-toxic false hope that she can’t bear to even see it, and how they all, in one way or another, avoid the sickening platitudes on the cover.
Even the metaphors that surround “sexier” versions of cancer memoirs and treatment themselves, with their sagas of battles and wars and survival, obscure the uncertainties Bowler navigates with every next breath. Her type of colon cancer, as it turns out, is the “magic” variety found in a scant three percent of patients that allows for her experimental treatment at Emory University: a treatment that, in her case so far, is successful. To her own former study subjects, this would be evidence that (1) God let her have cancer but ensured she wouldn’t die from it so that (2) she could live to write this very book and demonstrate how faith pays. These gospel adherents, in their wish to construe her story in its shiniest optimal light, neglect the shadows cast by outsize statistical inflation. Everything does not happen for a reason. God does not – either intentionally or through some mystifying divine negligence – afflict people with cancer. Cancer is a multitudinous, networked, cavernous disease that proves to us, again and again, that the same processes that sustain us – cell growth and division – exist on a biological knife edge: it is not outside of us, but an inward part, a part that sometimes survives better than we can. In the words of Siddhartha Mukherjee, a cancer physician, researcher, and author of a “biography” of cancer, “its existence is a pathological mirror of our own.”
Life is not a river that always empties in God’s waterfall of wealth, but neither is it nihilistic randomness. God is with Bowler, with all of us, in all those spaces in between, in the gut-emptying and the gut-wrenching and the not-knowing: that whatever else, Love is here; love is your baby and your husband and the crumbs of joy that you choose; love is this even when the route that never was evaporates.