1장
When Life Defies Our Carefully Crafted Plans
Kate Bowler was living her dream-a tenured professor at Duke University, a published author, wife to Toban, and mother to toddler Zach. Then came the 4 AM hospital wake-up, fluorescent lights flickering on, and a young doctor delivering the news that would shatter her carefully constructed life: Stage IV colon cancer with a 14% survival rate. "You'd better be holding my hand if you're going to say stuff like that," she told him as he reluctantly explained that "survival" in this context meant just two years. In those early morning hours, Kate began calculating what remained: 730 days, two Christmases, two summers, 104 Thursdays. Not enough time for anything that matters.
Before her diagnosis, Kate had spent a decade studying the prosperity gospel-the belief that faith, positive thinking, and righteous living guarantee health and wealth. Now, facing her own mortality, these promises rang hollow. The "best life now" philosophy that permeates American culture through wellness industries and self-help suddenly seemed like cruel fiction. As a historian who understood that nothing in life is inevitable, Kate was forced to confront the ultimate human limitation: we cannot outwork, outpray, or outthink our mortality. There is, quite simply, no cure for being human.
2장
The Brutal Mathematics of Limited Time
My house became a hive of activity after my diagnosis, with my Mennonite relatives buzzing around purposefully-my mother doing laundry, my father-in-law fixing the fence, my sister-in-law managing medications. In this flurry of activity, I recognized the urgent efficiency of collective despair, rooms cleaned and meals prepared with military precision. My father, a fellow historian, understood when I asked if this felt like a siege-cancer was the patient enemy waiting outside while we took inventory inside.
Time, once experienced as productivity, transformed into a precious commodity I couldn't afford to waste. Before cancer, I was a human bulldozer streamlining processes and refining habits-once sobbing over accidentally taking nighttime cold medicine because it would force me to rest. Now, a well-spent day became a feat of accounting. I woke at 6 AM to change dressings and give myself injections before Zach stirred-he was the wonderful exception to my ruthless timekeeping, where minutes felt loose and elastic.
Every Wednesday, I left at 3:45 AM for treatments in Atlanta, returning at midnight with new chemotherapy packs and medical reports showing shrinking but stubborn tumors. I faced harsh realities: my family taking out loans to cover what insurance denied; the clinical trial's requirement that I could never have another child; wearing toxic chemotherapy drugs that kept my toddler from being held. I bought a do-it-yourself will, arranged family portraits, and met with HR to discuss benefits my family might receive after my death.
The most heartbreaking moments came in the quiet hours with my son. Reading his favorite story about a mother bunny who searches for her baby wherever he goes, I stumbled over the reassuring line "Wherever you go, I will find you," realizing I was speeding toward a future where I couldn't find him. I cataloged every detail of his growing body-his feet straining against his sleeper, his attempts to climb out of his crib-knowing I might not witness him learning to swim or trying to flatten his cowlick. For me, he would always be a toddler in a crib I had inherited from a friend who asked if I was borrowing it or keeping it. "You'll never get this back," I had laughed. "I've got plans."
3장
Living in the Eternal Present
At my friend Chelsea's birthday party, I briefly escaped my cancer identity until a casual acquaintance reminded me I was dying and should "go out with a bang." This painful interaction sent me crying in the bathroom, lamenting that "the world is not safe for people in pain," though for a moment I had felt like myself again. The popular wisdom to "live in the moment" took on a cruel irony-my moments were filled with brutal treatment cycles that left me increasingly weak, with doctors who sometimes spoke of me as a "little lab rat" rather than a person with hopes beyond survival.
Despite trying to stay present, the future kept interrupting with its possibilities and uncertainties. My Christian understanding of eternity felt useless against my immediate reality, and my friend Warren's reminder that "Christians must live into the future" confused me when all I could see was a cliff ahead. Meanwhile, my eternal present consisted of medical appointments where life-altering decisions were made with clinical detachment.
When my oncologist casually mentioned he could have arranged for me to receive immunotherapy at Duke instead of traveling to Atlanta for months, I was initially thrilled until I realized he had withheld this option while I struggled with travel and finances. The doctor mentioned reducing my chemotherapy and switching to pill form, which left me stunned that I had endured unnecessary hardship. Despite my gratitude, I was shaken by the realization that my treatment was prolonged "out of respect for the trial" while another patient received local care.
Yet the terrible gift of illness taught me to truly appreciate the present, where "the mundane began to sparkle." I treasured holding my son, dancing wildly with friends, and savoring fleeting moments that felt eternal. Still, I was haunted by the knowledge that my son might not remember me, leading me to obsessively research childhood memory formation. My psychologist gently reminded me that I was building his foundation, even if "I might not get to see what he builds on top of it." On a zip-lining adventure, despite my paralyzing fear of heights, a guide with her own health struggles helped me understand that "not all risks are equal" and that living itself requires courage-because "in the end, the hero dies."
4장
The Illusion of Bucket Lists
For six months, my weekly routine became a mechanical rhythm of medical interventions: flying to Atlanta for alternating chemotherapy and immunotherapy infusions. Each visit was a meticulous data-gathering exercise, with doctors methodically documenting my pain levels on a scale of one to ten, tracking side effects from mild nausea to debilitating fatigue, and calculating how close my organs were to reaching toxic thresholds. Every sixty days brought the tension of CT scans - my bimonthly "report card" measuring whether the constellation of tumors in my liver were growing, shrinking, or remaining stable. If they held steady, I could continue treatment - a commitment that stretched indefinitely into whatever future remained for me.
The cancer clinic counselors, well-meaning in their approach, suggested I create a "Bucket List" as a way to find meaning in this new reality. Intrigued, I dove into researching the concept's rich historical roots, from ancient travelers who sought out the Seven Wonders of the Ancient World to medieval pilgrims who traversed continents to visit sacred sites. Today's bucket lists, I discovered, have morphed into something different - a manifestation of experiential capitalism where we collect moments like souvenirs, ticking off skydiving adventures and exotic locations rather than truly confronting our mortality. With unlimited resources and perfect health, we could theoretically do anything, but this abundance of choice often obscures the deeper question of what truly matters.
I found myself caught in an existential tug-of-war, desperately wanting more life while wrestling with whether I should simply accept my fate. My father's experience resonated with me - after fulfilling his lifelong dream of visiting the ancient ruins of Troy, he had joked that "everything was over" because he had achieved his goal and raised his children. Meanwhile, I immersed myself in medical terminology, learning the precise, neutral language of oncology. I studied research papers and clinical trials to ask more informed questions, but often felt lost in the cold abstractions of blood counts, tumor measurements, and survival statistics. It reminded me of the French Revolution's attempt to rationalize everything with the metric system - in seeking precision, we sometimes lose sight of what makes life meaningful in favor of what's merely measurable.
The truth is that mortality forces us to confront not just one final death, but the continuous deaths of countless possible futures throughout our lives. As illness narrows life's once-wide road to a distant point on the horizon, our bucket lists - whether formally written or silently held in our hearts - undergo constant revision. Some dreams get fulfilled, others become physically impossible, and new aspirations unexpectedly emerge from the ashes of abandoned ones. Rock climbing might be replaced by bird watching, marathon running by poetry writing. The fundamental question shifts from what we can accomplish before we die to what deserves our precious attention now, in this moment, with whatever time and capability we have left. Each day becomes an exercise in discernment, choosing not just what to do, but what to let go.
5장
Ambition and the Cost of Calling
I've always been driven by ambition, raised in Winnipeg's open prairies where stillness makes me restless. Despite "ambitious" not being a compliment for women, I embraced my father's advice that ambition meant keeping "your bum in a chair for an extremely long period of time." This drive led me to Duke University's campus, where my father once joked he'd murder me if I ever left. Returning to my office after medical leave, I confronted shelves of specialized books representing years of academic investment, questioning whether my work had cost me too much.
At Duke, I learned the brutal math of academia: accomplish ten things in seven years-two weighty research books and eight scholarly articles-or lose my job. Women faced the additional challenge of timing pregnancy against what was aptly called "the tenure clock." I discovered every male colleague in American religion had three children while women had one or none, unable to be simultaneously biologically and intellectually productive.
My father's career struggles shaped my perspective on academic ambition. As a first-generation college graduate with a doctorate from an English university, he patched together an income teaching at three universities, mastering any undesirable class from Medieval English crime to Canadian colonialism. The grueling schedule pushed him away from our family until he finally secured a full-time position in Calgary with "his name on the door and his own research center." The job transformed him into someone almost unrecognizable-a man who threw Tupperware parties for students and coached hockey. We believed it saved his life, though as I learned from my liver diagram, everything costs something.
Despite my ongoing cancer treatment, I drove to Virginia Beach to lecture at Regent University. Over forbidden margaritas with academic friends, our conversation shifted from evangelicalism to my unfinished research. When I confessed my fear that continuing my work was pointless given my uncertain future, my friend Doug offered profound wisdom: "If the worst happens and this book is the last thing you ever do, Zach can still find you there." Their encouragement propelled me back to the library, where I enthusiastically began scanning entire magazine archives for my research, recommitting to my scholarly passion despite everything.
As I prepared for liver resection surgery, Bishop Will met me in the pre-dawn hours, placing his hand on my head to pray: "Lord Jesus, bless these surgeons and the work of their hands... God, if you please, keep this one alive. Her best work is yet to come." In that moment, I understood that my ambition wasn't merely professional-it was a way of remaining present in the world, of leaving something behind that my son might someday discover.
6장
Apocalyptic Time and False Alarms
After my liver resection surgery, I spent the summer healing from the seven-inch incision across my abdomen, experiencing the strange aftermath of "exquisitely restrained violence." Unable to hold Zach, I watched Toban play with him while I slowly recovered. When I finally met with the radiation oncologist, she arrived with unexpected news-my remaining tumor had disappeared, becoming what she called a "pancake tumor." While family and friends celebrated this miracle, I recognized how people eventually stop worrying about chronic suffering, finding it difficult to stay awake to fear for so long.
My friend Luke explained that we experience time in three ways: tragic time (grappling with suffering and loss), apocalyptic time (seeing the world's brokenness with terrible clarity), and pastoral time (the ordinary rhythms of daily life that most people prefer). I was caught between these temporal experiences, unable to fully return to pastoral time after glimpsing the apocalyptic.
During what should have been a routine follow-up appointment, my surgeon unexpectedly showed me scans revealing a new tumor. Something that "no one said could happen" had grown inside me. The surgeon left me alone with the news and paperwork for radiation treatments. When the intake nurse gently asked if I brought anyone with me, I could only explain, "it was just a follow-up." There were no explanations for this devastating reversal.
While preparing for Zach's fourth birthday, our bedtime ritual involved retelling his birth story, culminating in our favorite part: "It was you. It was you the whole time." When Zach connected his great-grandmother's recent burial to mortality, he demanded reassurance: "Moms do not get buried." I struggled to explain death gently, telling him people normally get old before they die and go to be with God.
I shared the news of my returned cancer gently with loved ones, but without the drama of the first diagnosis. Despite my upcoming radiation treatments, I numbly followed through with travel plans to northern Alberta. For three days, my friend Joe and I stayed up late walking the town, drinking Slurpees with vodka, debating religious history, and even skinning an elk.
On Zach's birthday, I celebrated with unbridled joy, singing loudly as he woke up. After the festivities, my doctor friend Max arrived to discuss my scan results. Together we pored through hundreds of pages of medical reports until we discovered something remarkable-the "tumor" was actually just a "signal dropout" in the scan, later amended to be a "fat deposit." When I told Dr. Cartwright, he gave an anemic acknowledgment, seemingly surprised I believed I had cancer after being told I did. Exhausted but relieved, I crawled into bed beside my sleeping son, grateful to be there.
7장
The Impossible Return to Before
When Dr. Cartwright told me I was stable-neither progressing nor regressing-I struggled to understand what this meant for my future. I'd been giving away Zach's outgrown items to pregnant friends, transforming our second bedroom into an office, erasing possibilities. But suddenly I blurted out, "I could have that baby"-imagining restarting our lives as the family we'd planned. Dr. Cartwright's tight smile and comment that it "would be a publishable event" quickly deflated my hope. I soon learned that by signing consent for immunotherapy, I signed away my fertility for as long as I needed the treatment.
I reflected on America's cultural aversion to regret, where even celebrities emerging from scandals insist "it made me who I am today." The self-help industry peddles narratives of endless progress-eat this, lose weight, unleash your power-while suffering quietly erodes your life through attrition. I tried to maintain normalcy, mentioning upcoming scans casually to reassure loved ones it was safe to remain in my orbit. But when I experimented with not initiating contact, the phone went quiet except for a handful of calls. I was left feeling like "everyone's inspiration and no one's friend." Despite being constantly asked to say I wouldn't go back given my new perspective, the truth remained: before was better.
I called my widower friend Steve about this second wave of loneliness. Three years after his wife's death, he felt similarly adrift. We spent hours dissecting what we'd lost: our innocence about love's astronomical cost, our confidence in the future. We agreed on not wanting pain to make us narcissistic, on allowing friends to call trivial problems "tragedies." And we acknowledged the paradox-that within our suffering, we stumbled into moments that felt unmistakably like gifts.
Back in my psychologist Peter's office, I struggled with moving forward without knowing what came next. Despite seeking answers from famous oncologists about my prognosis, I received philosophical deflections rather than concrete information. When one doctor asked "what is mortality anyway?" I snapped back that it's "dying before your kid goes to kindergarten." Peter gently named this as betrayal-I'd been left in a "heightened present forever." We discussed how fear had kept me vigilant but now prevented me from living.
8장
Flesh and Blood: Reconciling with the Body
After cancer treatment, I struggled with my relationship to my changed body, caught between profound gratitude for survival and a deep, unsettling disconnection from my physical self. The mirror reflected someone I barely recognized - not just in appearance, but in how I moved through the world. While my mother made chocolate chip pancakes for Zach one morning, steam rising from the griddle, I casually suggested training for a race, trying to reclaim some semblance of my former vitality. She responded with that careful, measured tone mothers perfect, saying my body "has been through a lot." Her maternal concern had always been evident, from my rebellious teenage years of staying out too late to now seeing my surgery scars, which she once tenderly kissed when exposed during a summer afternoon. This visceral love extended to how I viewed my son-"flesh of my flesh"-a miracle I created with this same body that had both failed and saved me.
My friend Chelsea and I, over coffee and half-eaten muffins, worried about "losing our luster"-that mysterious, indefinable quality that makes people sparkle in a room. Middle age brings an avalanche of targeted advertising about "crow's feet," "muffin tops," and "age spots," insidiously suggesting we should hate these markers of survival. Every Instagram scroll became a reminder of what we were losing. I questioned whether we were simply mourning youth's departure or acknowledging something deeper about how the wellness industry profits from our desperate attempts to stop time. After cancer treatment, I found myself missing "being decorative," despite having sworn never to be so superficial when sitting among emaciated patients in sterile chemotherapy rooms, watching poison drip through clear tubes.
During a plastic surgery consultation in a sleek medical office, a resident named Derek suggested, with clinical detachment, that I should be grateful my scars weren't worse, treating me like "a human display case" rather than a person who had fought for survival. When I challenged his perspective, the supervising doctor offered a menu of procedures that would "look significantly better" but compared surgery to choosing between "the new car and the ski vacation," reducing my healing to a consumer decision. I called my friend Sarah afterward, sitting in my car in the parking garage, confessing through tears that I wanted to feel "more like sunshine again and less like a well-functioning sewer system." We reflected on the cruel irony of how "working so hard to stay alive makes you feel less human."
Paradoxically, I felt most whole during the depths of cancer treatment when surgeons were "cutting tissue into ribbons." Despite being physically reduced to my most basic elements, I experienced a profound spiritual completeness-"God's love was everywhere, sticking to everything" like morning dew on grass. On a challenging hike with my friend Laura, breathing hard against mountain air, I tried describing this transcendence. She wisely cautioned, "You have felt the mighty and indescribable love of God. It is wholeness and beauty and holiness...but it is not Disney World." These "moments of transcendence" are scattered throughout our lives "like breadcrumbs," revealing life's fundamental truth without providing the neat resolution we crave. They remind us that our bodies, however marked or changed, remain vessels for something far more profound than physical perfection.
9장
Unfinished Cathedrals: Finding Peace in Incompleteness
My father's great failure had been sitting in a filing cabinet for forty years-a rejection letter from Cambridge University Press for his overdue doctoral dissertation. After decades, he discovered his unpublished work was still being cited, and at seventy, he finally published it himself with my sister's watercolor on the cover. These small decisions-trying again, getting back up, loving extravagantly within our numbered days-define our lives.
We remain caught between our beautiful, terrible finitude and the hope of something more. We're cobbled together by laughter, pets, long talks with friends, God's love, and communities where we belong. Our lives aren't problems to be solved but can still hold meaning, beauty, and love without resolution.
At a Portuguese cathedral, I discovered the Batalha Monastery with its unfinished chapel-seven kings had overseen its construction but none lived to complete it. An elderly visitor explained its perfection: "We're never done, dear. Even when we're done, we're never done." All our masterpieces are ridiculous, our striving unnecessary, our work unfinished and unfinishable. We do too much, never enough, and are done before we've even started.
I realized I still wanted so much-to raise my child, relearn French, write a children's book, and visit Disney World. Laura reminded me, "There is no such thing as a finished life." Life's magic exists alongside "crappy regular stuff"-like the frustrated father at the airport who threw down his Mickey Mouse ears and shouted about making family memories. In this imperfect reality, I found unexpected joy.
At bedtime, Zach told me we have "gorilla hearts that beat: love-love, love-love." His words reminded me of a rainy zoo trip with my sister Amy during chemotherapy. Despite my attempts to acknowledge the metaphor in Charles and Samantha's separation by death, Amy insisted "We are only talking about gorillas!" We raced through the empty, rain-soaked zoo, delighting in the drenched animals taking shelter. At the gorilla enclosure, we paused to see Charles sitting in the dirt, his massive frame elegant and still, giving our respects to hearts that go on beating, "never sorry to be broken."
There is no cure for being human. We live with our limitations, our unfinished cathedrals, our gorilla hearts that keep beating despite everything. And somehow, in the midst of this beautiful, terrible, unfinished life, we find moments of transcendence, connection, and love that make it all worthwhile-even when we know it will never be enough.
