On January 30th, Nancy drove me to Fred Hutch Cancer Center (formerly Seattle Cancer Care Alliance) for my three-month appointment and blood draw. My nurse practitioner, Michael Lai, gave us the excellent report that my PSA was once again undetectable—for thirty-three months. For the first time since receiving the reports, I had difficulty finding joy in the news. Since November 22nd, 2022, I have been having daily migraines, brought on by the 0.1 milligrams per hour nitro patch I’ve been wearing daily. In one-hundred and ten days, I’ve been migraine free for only about ten days. Sometimes the headaches haven’t been very severe; other days mind-numbing. Yet, I have had little to no angina for the most part! On our way home from Fred Hutch, I was grateful for the excellent news.

In the Autumn, I signed up for palliative care through Catholic Health Initiatives. They assigned me a palliative care social worker who has been helping me through these challenging times. In one of our sessions, she reminded me to find joy in each day—which came as a good reminder. Sometimes, in the moment, amid the thunder of a severe migraine, finding joy has been seemingly impossible. Yet, the still, small voice of the Holy Spirit has reminded me of Jesus’ promise, “I will never leave you, nor forsake you.” When the lightning of a nine out of ten migraine strikes, all I have is His presence with me.

On Friday, February 19th, Nancy drove me to the St. Michael’s Emergency Room for what I would later learn is gross hematuria—which, beyond its medical name, isn’t worth going into any further description. After working on me for several hours, the doctor discharged me home. By noon the next day, Nancy was driving me back to the emergency room again for round two. My doctor released me home again, but within several hours the spasming pain arising from the condition necessitated Nancy calling 911. When the medics arrived, they quickly lifted me onto a gurney and took me back to St. Michael’s. Without a specialist doctor on staff who could address my disorder, they contacted one of my doctor’s partners at the University of Washington Medical Center for advice on treating the condition. He recommended having me transported by ambulance to the University of Washington Hospital.

I was admitted to St. Michael’s and given a bed on the seventh floor—which is the oncology floor. When the hospitalist came to see me, he informed me that it usually takes about a week to get the transfer made because of lining up an ambulance while finding a room. Nancy sent out a prayer request. Six hours later, the medics loaded me into the back of an ambulance for transfer to the University of Washington Hospital!

As I lay strapped to the gurney, I still felt much pain. I turned on Google Maps on my phone to distract me from the bumpy ride while giving reports to my wife and daughters where we were passing. I didn’t know that riding in the back of an ambulance/medic van is like riding in the back of a U-Haul truck. When we arrived at the University of Washington’s main campus emergency room, they wheeled me into the hospital. As the driver spoke with the triage nurse, it dawned on me that the last time I was in this E. R. was on the day friends brought me in after a night of heavy binge drinking in which I sustained a severe head injury, leaving me unable to speak. And at that moment, I was overwhelmed with gratitude for the thirty-nine years of life God has given me since, finding a moment of profound joy!

The driver returned and sheepishly said, “We’ve brought you to the wrong hospital. We were supposed to take you to the Northwest Campus on 115th Street, so we still have fifteen to twenty more minutes of drive time. I’m sorry!” Yet, in their mistake, I knew this was no coincidence. God was reminding me of how much I have to be thankful at the same time as giving a glimpse that I was not alone. He was with me! He is always with me!

Upon arrival at U. W. Northwest Emergency Room, after a nurse, followed by a specialist, worked on me to clear the condition, they diagnosed me with hemorrhagic radiation cystitis, a late occurring side effect of radiation I received in the spring and summer of 2019. Again, any further description would be inappropriate beyond giving you the technical medical name for the diagnosis. They kept me in the hospital for three days and discharged me on Wednesday, February 22nd. I received extraordinary care while at the hospital in Seattle, for which Nancy and I are deeply grateful.

Two days later, Nancy drove me back to Seattle to see my University of Washington Medical Center specialist. She conducted a test that confirmed the diagnosis: hemorrhagic radiation cystitis. She informed me that one of the best treatments for the condition was hyperbaric oxygen treatments, saying she would begin looking for a center with an opening.

The following day, as Nancy drove me home from my cardiac rehab appointment at St. Michael’s, she asked me, “Do you want to find some joy with me in driving down to Bachman Park to see the ferries pass by?” I wearily consented. She parked just off the beach, looking out at the north end of Sinclair Inlet. I looked up the ferry schedule in my WS-DOT app to see when the next ferry would pass by the park. Soon the fast ferry came by from Seattle on its way to the Bremerton ferry dock. Again, we peered through the heavy rain falling on the dismal, grey water. In a few minutes, the Walla Walla trudged through the waves on its way to Seattle. In another ten minutes, the Bremerton Fast Ferry returned to Seattle.

Then we saw them! Several rafts of sea lions began swimming north just off the beach. First, their heads would appear out of the water as they snatched their breath, then their long bodies glided like miniature Loch Ness monsters. We counted over sixteen of the creatures on their way north, likely coming from the Puget Sound Navel Shipyard docks. Just then, two Canada geese flew by heading south, honking their farewell as they passed by overhead. A seagull flew just in front of us out over the water, hanging motionless while peering down into the water, then diving, coming up with a small fish that it quickly swallowed. All along, cormorants flew by in twos and threes, skimming just above the waves, some heading south and others heading north. I thought to myself, “I wonder where they are going.”

Nancy and I had found joy; better put, joy had found us! Then, the Holy Spirit whispered a verse into my thoughts, “Look at the birds of the air: they neither sow nor reap nor gather into barns, and yet your heavenly Father feeds them. Are you not of more value than they?” Those last words were just what I needed to hear! Our true joy comes not from ourselves but from how much God values us! Nancy and I returned home marveling at this creator God who had once again revealed His love and care for us through a parade of animals and birds—revealers of His glory—sent by just for us!

A week later, on Saturday, March 4th, I experienced another bout of hemorrhagic radiation cystitis. Nancy drove me back to the U. W. Medical Center Northwest campus through the rain in the dark. The same specialist admitted me for a four-day stay, the time it took for them to resolve the condition. While Dr. Kirk was working on me in the emergency room, he said, “Coming into the E.R. like this isn’t sustainable!”

I wasn’t finding any joy amid eight out of ten pains during my two visits to the Northwest campus. Nancy brought me home on Tuesday, March 7th. I was profoundly exhausted! On Friday, I drove myself to cardiac rehab, intending to take it very easy during the hour-long exercise. Fifteen minutes into my gentle exercise, I started having chest pain in the upper-left quadrant of my chest, followed by the feeling that I had cobwebs clinging to the inside of my left arm. Eric, the R.N., came by to check my oxygen. He asked, “How are you doing today?” I described to him the spider webs in my left arm and the chest pain. Immediately, he ordered me to stop exercising. Another R.N. watching the feed from our heart monitors, said, “Those symptoms are on our list to call 911.” I thought, “I am already at St. Michael’s Hospital! Are they going to take me by ambulance across the parking lot and around the back side of the main hospital?” The two nurses strongly encouraged me to let them call 911. I finally consented.

The ambulance took a little while to arrive. When the medics came into the exercise room, they had me lie on the gurney. On the way around the building, the paramedic tried to get an I.V. in my right wrist. Later I found out that it was an unsuccessful attempt. I was again admitted to the hospital for the third time in just three weeks. After the hospitalist consulted with my cardiologist, they agreed to double my metoprolol and nitro patch from 0.1 to 0.2 milligrams per hour. They observed me for two nights and three days, discharging me this past Wednesday.

While in the hospital, I received a message from my specialist in Seattle, who informed me that she had referred me to the Wound Care and Hyperbaric Clinic at the U. W. Medical Center – Northwest. She said they would contact me soon. Just before leaving the hospital, I received a phone call from the clinic. Unfortunately, they had a cancellation the next day at 1:30 PM. Would I be able to make the appointment? I readily consented! God again let me see his presence in the quick succession of events: referral given on Tuesday, call received on Wednesday, appointment made for Thursday.

Hyperbaric oxygen therapy is an approved, effective treatment for hemorrhagic radiation cystitis. On Thursday, the doctor told me that I would have to have twenty to forty two-hour sessions in the hyperbaric chamber every Monday through Friday. I expect to hear from the clinic following my insurance’s approval next week, and then I will start the treatments soon.

I was in severe pain during my first two hospital visits for cystitis. Finding any joy amid such pain was unattainable. Yet maybe that’s where I’ve got it wrong! We look to ourselves and our circumstances for that elusive joy. Circumstantial, serendipitous joy is no joy at all. All joy has its source in Jesus and in the Father of lights, from whom comes every perfect gift. I often forget it’s the “Joy of the Lord”—not mine! When I have Him, His joy is always with me because He is always with me! Even in the most painful moments I’ve recently lived through, His presence has never left me!

Today, I bore through a severe migraine that ramped up to a nine out of ten pain. I thought, at one point, Nancy would have to take me for another trip to the E. R. My head felt like it would explode. How does one find joy while experiencing such intense pain? Yet, tonight, I found joy in the leftover salmon Nancy had heated up for my dinner, a small portion of Japanese sticky rice, and a cup of steamed, fresh asparagus. Each of these gifts, my best friend Nancy, the wonderfully spiced salmon, the sticky rice, and the fresh asparagus, have come down to me from the Father of lights. Jesus, the one through whom all things were created, had knitted Nancy together while she was yet in her mother’s womb, she for me and I for her! He had designed the salmon, giving it its rich, oily flavor. Jesus gave us green plants for food and the grains they bear. He made the asparagus with its unique flavor while giving us just the right taste buds to enjoy it! Every perfect gift!

Often, finding joy is beyond my reach. I can neither manufacture it nor find it amid such painful circumstances. Yet, joy has found me! So much of what I’ve lived through in the last month between hemorrhagic cystitis, severe migraine, and repeated chest pain has been far more than I can handle; however, none of these have been more than He can handle. In those times when I only want to escape the pain—but it isn’t diminishing—Jesus remains, the quiet joy of His presence always with me. Maybe we don’t so much find joy as joy finds us! Have you let the Joy of the Lord Jesus find you today? He is always about looking for you because you are of great worth to Him—worth spilling His blood even to death that He might find you!.