We all want to experience joy rather than sorrow, pleasure rather than pain, and victory rather than defeat. These binaries usually seem clear, but when that clarity seems elusive in a time of testing, is it possible to live with hope in the space between them?

Living with a diagnosis of Stage IV metastatic colon cancer, Amy Low has confronted this question in the context of her own mortality. In her new book The Brave In-Between: Notes from the Last Room, Amy has drawn insight from the writings of the apostle Paul in his own “last room,” and found a space of hope between tragedy and triumph.

We held an Online Conversation with Amy Low on June 7, to consider how we can live with hope in this in-between time we all inhabit.

Thank you to our co-host, Hachette Books, for their support of this event!

Online Conversation | Amy Low | June 7, 2024

Cherie Harder: Thanks so much, Campbell, and welcome to all of you joining us for today’s online conversation with Amy Low on “The Brave In-Between.” We’re delighted that so many of you are joining us today, and I wanted to add a special welcome to those of you who are joining us from around the world—at least 14 different countries that we know of; we so appreciate you being here—as well as to our first-time registrants. And if you are one of those first-time registrants or are otherwise new to the work of the Trinity Forum, we seek to provide a space and resources to engage the big questions of life in the context of faith, and ultimately to help equip others to come to better know the Author of the answers. And we hope today’s Online Conversation will be a small taste of that for you today.

Even with the recency of the global pandemic, we live in a time and in a culture that does not like to think or talk about death. We work hard to avoid suffering, to distract ourselves from fear, to numb ourselves to pain. But every day one of us receives terrible news: of a diagnosis, an accident, an end of something or someone deeply loved. And each of us will one day inhabit what our guest today has called “the last room,” the setting for the final chapter of this life and the anteroom to the life beyond.

Our guest today is both a resident of that room and a keen observer of the illuminations and insights it offers. Her new work grapples honestly with this big question: how do we live fully and well in the shadow of death? And she offers an invitation to see the harmony between joy and sorrow, to discern the miraculous amidst the mundane, to add abundance to dwindling days. 

Amy Low is the managing director for fellowships and nonprofit journalism at the Emerson Collective, which works to solve problems in the areas of education, health, and climate. She’s previously served as a chief engagement officer at Landesa, an NGO aimed at reducing rural poverty, as well as working at other nonprofits and foundations. She is also a writer and a storyteller with a remarkable story to tell. In 2019, as a 40-something and in seemingly perfect health, raising two gorgeous teenagers, she was diagnosed with stage-four incurable colon cancer. She has since navigated dozens of rounds of chemo, two surgeries, and multiple rounds of radiation. And while she sustains hope for breakthrough medical solutions, the prognosis is grim. 

In her new and luminous book just released this week, The Brave In-Between, she chronicles the revelations and vantage points offered by inhabiting that last room in the final stage of this life, and I am so glad to get to welcome her here today to share some of those stories and illuminations with us. 

Amy, welcome. It’s really good to see you.

Amy Low: Hi Cherie, this is such a treat. I’m so glad that you thought to invite me. So thank you and thanks to everyone joining. I want to give a preface in the beginning: I promise we’re going to have a lot of fun. I know this might seem like ominous topics and material, but I think we’re going to find more joy here than sorrow. But we’ll see where the conversation leads.

Cherie Harder: Oh, absolutely. I mean, this is really just a delight for me. You and I obviously knew each other and hung out in our twenties, as part of the same circle of friends here in D.C., and I would certainly like to be having this conversation under other circumstances, but it’s really a joy to have you here. And I should start off by just saying, how are you? How are you doing? 

Amy Low: Yeah, it’s an important question. So why don’t we just kind of level-set the physical part of the story because it does tend to shift a bit. I appreciate some who might be on [the call] have been familiar with some of the plot details of what’s going on with cancer with my blog. Others might think, “I don’t know who this person is.” So I’ll give a very short primer here. So, as you mentioned in the beginning, I was diagnosed in July of 2019 with stage-four metastatic colon cancer. At the time, I was too young to be screened. I was 48. You can get screened now at 45, so everybody that’s 45 [or older], make sure you get screened. I didn’t have any classic symptoms. I didn’t have any family history. I was just playing a lot of tennis and feeling a little more tired than usual. And, lo and behold, a couple of weeks later, I was told the most grim news that you can hear, which is you have a terrible health diagnosis. And the five-year survival rate at the time, which is more or less still true today, is about 14 percent. And it was a shocking set of developments. 

Here’s a quick primer on how colon cancer works. It typically moves colon, liver, lung. That’s how the trajectory— so, not everybody, but that’s the classic kind of move. For the last four years, my gut has actually been fine. I sometimes say it’s actually gotten an upgrade. I’ve never felt better in my gut. I started with a 15-centimeter tumor on my liver, which is massive, but chemotherapy worked beautifully for me; I had an amazing surgery team. Livers are miraculous organs. They grow back. There was a brief moment where it was like, “Oh my gosh, this is— I’m out of the woods.” However, we noticed early on there was a small little amount of activity in my lung. And for the past four years, what I sometimes say is the story of my health is really the story of my lungs. Some people think, does she have lung cancer? I don’t have lung cancer. I have colon cancer that moved to my lung.

So I moved through a lot of different treatments, have been chipping away at it. I was on a trial at UCSF this winter that looked initially fairly promising, and then an extraordinarily terrible turn happened at the end of March. I had experienced some headaches. I was a little dizzy. Because I was in a trial, I was telling them every little symptom that I had. My team thought an MRI made sense. We did an MRI and we discovered, as it turns out, the cancer had actually moved to my brain, and my team was shocked. I was shocked. You wouldn’t have pulled me out of a lineup. I didn’t look like a classic person that—. So it was a very terrible April.

However—and this is an important maybe duality we can hold in our conversation—in the same conversation where the head of cancer trials at UCSF called me and said, “This is terrible news. You’ve got metastases in your brain. You’re out of the trial. We can’t do anything more for you about what we wanted to do with your lung”—and I had to hold that, and it was awful. And then within about 30 seconds, she said, “But I want to tell you something else. UCSF is one of the small number of places in the United States that has a radiation technology now that we know how to address these lung mets. As it turns out, Japan taught us how to do this. And we can address this. And, you know, we’ve got you on the schedule next week. Do you want to do it?”

And I thought, how do I look at this? I mean, this is devastating. And it’s a miracle. I live 27 miles from one of the only places in the world that does this. And I think of that as a bit of an exhibit A of the last five years of my life, of both of these things are not just true, they actually sit in harmony. And you might think of them as paradoxical, but that duality is what really brought me to this question about whether or not I should capture some of these contradictions in this book.

Cherie Harder: Speaking of capturing the contradictions, one of the things that I have to ask about is the way that you’ve organized this book. So you’ve taken, as your organizational structure, Paul’s letter to the Philippians—Philippians 4:8: “Whatever is true and good and beautiful and excellent and pure and praiseworthy.” And those are actually your chapter titles. And you’ve also talked about how you saw Paul’s words as a lamp for the last room. So I wanted to ask you why you chose that organizational structure, because nothing about a cancer fight feels pure and lovely and excellent. But also what Paul’s words illuminated for you—why you called it a “lamp” in terms of the last room.

Amy Low: Well, first, let me give a little context on the metaphor of why I’ve chosen this idea of a last room. Metaphors, as we know, are kind of vehicles that hold ambiguity. And I knew immediately I needed a place to name or something to give this a name, this odd spot. I inhabit what I call the last chapter, last room, of my life in a slightly unusual way. Most days I feel and look just fine. You might not know that I’m gravely sick. And yet my prognosis is terrible. Most of us, if we’re really fortunate, reach the end of our life very aware that we’re there, but hopefully you’re really tired, which is to say, maybe in your late 80s or 90s. Your knee has hurt forever. You know you’re there, but you’re exhausted and hopefully you’re surrounded by good care. Or—say you feel great. You wake up today feeling wonderful. You have no idea you’re in the last room. And, unfortunately, tomorrow we might lose you to a terrible bike accident. Okay. I inhabit it in a slightly different way. I know I’m there, but most days I look and feel just fine. And I thought, this is unusual. It’s not unique. There have been other people. But this is really an odd spot.

So I went looking for wisdom, others who had inhabited this space the way I had. And I went to Paul and I thought, well, look at the end of his life, when he was in a Roman prison, he must have known, you know, “I’m in the last room.” I mean, he might— but I think he knew. And the letter that he wrote to his dear friends at Philippi was the last letter he wrote to a church community. And I just thought this space that he occupied, I think I can relate to, and I’m going to glean everything I possibly can out of the love that he gave to his dear friends in Philippi. And then Philippians 4:8 just lit up for me, and I realized, wait a minute. This last room, first of all, to your earlier point, is a room all of us are going to be in. All of us. It is the most human room of all. And because I inhabit it in such an unusual way, I need as many lanterns as I can to help me understand the darkest corners, the scariest places. If Paul inhabited it the way I did, those words have become lights that I am convinced have relevance for all the rooms of our lives, not just the last room.

And I will tell you, yes, this book deals with good questions about cancer, but it’s much more about people. Any hard turn of our lives, any trauma, any loss, what’s really happened on the stage is, like, the setting has changed, but the characters are still who you’ve got. And this is a book that deals with rich storytelling about the people on stage. And as it turns out, these virtues, as I call them, that Paul gave us, can become illuminations for us in how we think about our relationships with all the people in our lives, no matter the setting. 

Cherie Harder: Let me ask you about another paradox, which is that of faith and fear. Right at the beginning, you quote Friedrich Buechner—and, of course, allusions to Buechner you’ve kind of included throughout your book. But you quote him as saying, “Here’s the world. Beautiful and terrible things will happen. Do not be afraid.” And you mentioned that the command most frequently given in Scripture, too, is “do not be afraid.” You know, at the same time, it is somewhere between likely and inevitable that when terrible things first appear, we’re going to be afraid. That’s, you know— those are fear-provoking things. And it does seem like you don’t equate the presence of fear with the absence of faith. I’m curious how your fear has affected your faith and vice versa.

Amy Low: Well, as on a practical level, one of the things that I’ve learned is, even the most awful scan, or even that phone call I got in March, the first human response is your heart starts to race and you think, this can’t be happening, this can’t be happening. And panic will start to sort of cascade throughout. And what I’ve learned over the last five years is, oh, well—. I don’t want to diminish— I mean, so that’s a real thing. But part of it is this reminder that God makes us to love being alive. We are called to be living, human, vibrant creatures. We are not looking for exits too early. Everything in our biology and our emotions and our brain tells us, cling to life. Be alive. You have something to contribute today. The notion of exiting is terrifying. So to me, it’s the ultimate reminder that we were created to be living people.

Now the tricky thing is we’re also created to be people who are delighted with the notion that, after this life, there’s going to be this amazing upgrade. It’s going to be so good. But the bridge to get there, let’s just be honest, can be terrifying when we are hard-wired to be living people. And I will tell you that the paradox for me is that, because most days I actually feel okay, that terrible news is so much more jarring because what I want to say is, “No, no, no, I feel okay. It must be wrong.” And I appreciate I live with those extremes perhaps more than most people who are going through a hard health time because you think, “Well, no, no. Every day I actually feel a little worse and a little worse and a little worse.” And the notion of bridging over starts to sound better and better and better. I have an unusual situation where bad news comes with often the first wave of panic.

That said, after I get to sit with it and really ponder it—this is the bigger point that I want to make—one of the grand wisdom pieces that I’ve gotten over the last five years is this deeper, deeper appreciation that I am part of a much bigger story. And I will tell you, that comes with such delicious, calming reminder that no matter the plot twist—and there has been a lot—when you know you are part of something that is much bigger than you, there is this deeper anchor of “let’s see where this is headed. Let’s just hold on here because we don’t know what the next scene is going to be.” What we do know is the scene has been taken care of. It may not go the way that we think we want. But that is one of the deepest places of joy. 

And that’s why I can say sometimes the last room offers the best vantage point of all, because that abstract notion of, “oh, I get it, we’re all part of a bigger story”—when you’re a last-room person, there’s nothing abstract about it. It’s visceral, and your vantage point changes. And what you see in the world is animated in a way that, I hope with this book I’ve been able to export, that it’s got relevance to previous rooms as well.

Cherie Harder: There’s so much I’d love to unpack with that. But one of the things I do want to ask you about, just in terms of the illuminations, is you’ve talked a lot about the beauty of the mundane, which, in some ways, the illuminations of the last room have helped you see more clearly and more vividly. And you’ve said that one of the things you most grieve is, you call it, “a surrender of the magical mundane of the future.” For those of us who may not know if we’re in the last room or think we’re not in the last room, how do we gain that kind of clarity of vision to see the magical in the mundane? I was so taken by the fact that you said, you know, to kind of the bowl question of like, “oh, how would you spend your last two years?” You’re realizing quite vividly you would actually spend them doing a lot of the ordinary things that you are doing now.

Amy Low: Yeah. So that’s a gift. And I want to acknowledge that, because I think the classic dinner-party conversation of “what would you do if you only had a year left?”, you tend to get a wide variety of answers. I am really fortunate that after getting to sit with that question for real, I thought, “Oh, well, most of my days I’d actually be doing what I’m doing right now.” See, not everybody can say that. So I’m really fortunate that professionally, relationally, I’m sort of in a place where I’d say, no, no, I wouldn’t make a radical change. However, I have become an observer to what I think are moments of magic that I candidly missed in the earlier rooms because I wasn’t paying attention with the urgency that I have now.

So one practical example—I’ll give two, but I’ll just start with one—one of the kind of through-lines of the book, I really do view this as a love letter to medicine. I was never sick before. I never worked with the medical world. I just, I was never sick. I wasn’t one of those people. I missed the beauty and the sacredness and, frankly, the heroism of healers. I just missed them. And I got to know doctors and nurses. And that’s not to say every doctor’s appointment for me went well. Some of them were, like, really terrible. But I became so grateful for the fact that there are a wing among us who, even as children, realize “my calling is to heal.” And if you miss the beauty of healers, I promise you’re not paying attention.

One of the doctors in my book—and it’s a chapter framed on “lovely,” as it turns out—always wore the most gorgeous suit to every appointment he ever had with me. And in the beginning I thought, well, he must have a very important conference after he spends time with me. And I became a little bit obsessed with his suits because I thought, you know, Silicon Valley, it’s a Friday. You’re lucky if somebody’s not wearing pajamas sometimes at work. And he was wearing these gorgeous suits. And then it dawned on me. I thought, no, no, he’s putting on that suit every morning for me because it’s his way of saying “you are the most important part of my day.” Now, other doctors can use different lanes to give that. He chose to bring his sort of A-game through his physical appearance. And it was a gift and I might have missed it, I’ll tell you, if I was just going for a physical ten years ago. I would have thought, you know, this guy’s like a little pompous. Why is he wearing a suit? This is the vantage point of the last room. I thought, this is a gift he’s giving me. And I have so many other examples from other doctors who found other ways to provide those gifts. Nurses as well.

And then with respect to what you might think of as the mundane as a parent— and one of the other reasons I thought to write this book is that I did go looking for contemporary memoir among other single parents who had a terrible health diagnosis. I’ll tell you what, I found nothing. And I certainly found nothing with a faith anchor underneath. And I thought, okay, there’s got to be millions of us. I don’t think I’m alone. And I wanted something relatable because the questions that single parents can sometimes ask when facing such terrible health prognoses, we work with different questions at night. I just promise you that we do. We think through different scenarios, and it can be a lonelier place. 

And, you know, at the time—my kids were 16 and 14 when I was diagnosed—I started listening to our conversations in a slightly different way. I hope everybody in life who’s got the privilege of raising a kid captures those car moments and those dinner-table moments. But again, one of the gifts of the last room is you pause with, “Bup-bup-bup. Go back. Say that one again.” Oh, that one matters.

And I have some great little stories throughout the book of what my kids have taught me, because time became a slightly different equation. And the miracles of parenting, I promise you, all come from the mundane moments. And that’s the magic. And we tend to, I think, falsely equate those mountaintop moments, like the finals in the soccer game or the birthday. Those aren’t the mountaintop moments. The mountaintop moments are the quiet questions that get asked at the stoplight on the way to dance, and you realize, “Oh, I’m sitting on holy ground here.” And I like to think I would have been a parent who would have paid attention and had ears for that, even outside of the last room. But that’s one of the gifts of the last room that really helped me listen better and observe even more and with more intentionality.

Cherie Harder: You mentioned that as a gift of the last room, but it seems like one of the—I don’t know if you’d call it a project or a challenge or a trial of the last room—is related, which is your divorce was not all that— a few years before the cancer diagnosis. And it seemed like one of the priorities that you encountered in the last room was forgiveness. And, you know, in many ways kind of renewing a relationship of sorts for the cohesion of your family. And you also noted that you had real fears around that. I think you said that you feared that you would be erased from your own story, but found something quite different. And I wanted to ask you just sort of how you approached that challenge of forgiveness in the last room.

Amy Low: Yeah. Well, you know, I was raised in a Christian home. My dad was a pastor. This was the language that I’ve always embraced. And, sadly, my marriage ended, in a rather shocking way. And it certainly wasn’t something that I thought would ever happen to me. And one of the practical quirks of my story is that my ex-husband chose to live in Los Angeles while my two kids and I had moved to the Bay area. And he was a very involved dad, my kids adore him, have great relationships with him, but as a practical matter, for several years I just never saw him because he would come and stay with them when I was traveling or they would go see him. So we had an unusual situation where there wasn’t hostility, but we didn’t have that thing where we sat together at the school concerts and caught up on the kids the way that other divorced couples do.

So then I got sick and I thought, oh gosh, the whole story has changed. And he reached out immediately and he said, you know, “Can I do this with you? Can I be part of the story?” And I thought, well, sure, initially, and then I realized I have unfinished business here because I used what I would consider sort of the platitudes of forgiveness. I thought, okay, I’m getting over it. I’m recovering. He’s fine. The kids are rebuilding. We’re going to be fine. But I in my mind, I kept thinking, oh, there is going to be that magical day when I’m in my 60s, we’re going to have coffee, and I’m going to say, “Look, I am finally there. I can just walk through this kind of core marrow of the bone forgiveness, but that is a project for another time.” 

That is not what happened to me, obviously, with my last room and you can read about it in the book, but it was very difficult in the beginning. We didn’t quite know how bad this was. And I had a really big surgery about four months into this, and it was like, yeah, we don’t know. This is going to be harrowing. And it was Christmas time. And I realized the very best person who could enter in back into my story and care for me in the most vulnerable, most physically intimate way, would be my ex-husband because I needed to go through my own process of receiving that care and truly forgiving him.

And what I learned was forgiveness isn’t what I thought. It was looking at him completely and fully and saying, “You are a child of God. The decisions that you made that ended our relationship, I no longer associate with you. That is your project now to work through. I only see you as your beautiful essence of who you are.” And once I fully embraced that, I was also deeply aware and able to receive his care. But the best part about that, even though to your point, I thought I might be erased from the story, what I realized was, no, the incredible bridge that I can give to my two kids to cross over, and if I don’t make it to the other side, they’re going to see their dad and their mom giving and receiving care the way that it was intended to be for our family. And I didn’t want to leave that unresolved. I wanted them to know if I exited too soon, that they were in such good, loving, wonderful hands of his and that there was no unfinished business from my end.

That is an easy and elegant thing to say. It took me a while to get there, but it is part of the magic of the last room is that fictional coffee wouldn’t happen in my 60s, wasn’t part of the story. And it was a surprise, but it was a liberating surprise. I did think I might get erased because I thought, well, there’s nothing left for me. And, of course, Scripture reminds us over and over it’s actually the opposite. My story then becomes all the more relevant.

Cherie Harder: You know, in just a few minutes, we’re going to turn to questions from the audience. But before that, I want to ask you both about some of the things that you’ve had said to you and what those of us who are watching can learn from it, both in terms of the good and the bad. And in terms of the good, I wanted to ask you about a piece of advice that you got from a friend of yours who I think has been the president of a Christian university as well. And she told you that the invitation of the last room is to become more of who you are. And I wanted to ask you, what did she mean by that? And why was that so valuable to you?

Amy Low: Yeah. Once you get to the third act of the book, you’ll realize, oh, it’s a little spicy. So I say, come for the cancer. Stay for the spicy. I like to say it’s a beach read. There’s a lot more to this than just being sick. I, like so many other last-room people— because, as it turns out, like, oh gosh, I’m still here. And most days I feel pretty good. And I thought, hey, this last room could last for years and years and years. This is interesting. And like so many people, I started giving myself like a little hall pass. I thought, “Oh. You know what? I don’t know that I need to floss anymore.” I mean, this is great. Who needs to floss if you’re not going to live to be in your 70s? Those really fancy knives that I thought you have to [hand wash]? You know, throw them in the dishwasher. Doesn’t matter. And I started having a bias toward yes, in all the most joyful, lovely ways that you think, “well, I’m going to get the most out of this room as I possibly can.”

Unfortunately, that can come with a cost. And I started playing this game that I talked to my friend about, and I said, what I think I’m doing is I’m playing the short game in the long-game world, and some of the short game is great, like you get these bursts of joys. But I also found myself tangled up in a relationship that wasn’t as healthy as it ought to have been. And I thought, “I don’t think it matters because, you know, I don’t have that much time left, so who cares?” And what she said to me in a beautiful way was, “You’re settling. You’re not being fully who you are, and you are occupying this chapter of your life in the most unusual way. This is holy ground, and if you squander it, you’re missing it.” 

Now, she would be the first to say, well, look, see, that has relevance to first room and fourth room and eighth room, like, that’s core across. But you squander it in your last room when you know you’re there and most days you feel okay? You’ve missed it. And what she said was, “Those moments when you take your daughter to New York and you sort of have this very fancy weekend, you’re actually being true to who you are. Now, you’re going to have to deal with your finances and all of that, but you are not betraying the core of who you are. It’s an extension of who you are.” That’s a wonderful lesson for all of the rooms. But when you give yourself permission to say, “Oh, you know what? This one, I’m going to take a pass. I’ll just do the short game.” The stakes are really high. And I would argue that the core of, frankly, the deep dilemma of our days that we live in—and we live in very high-stakes days—you can almost bring down an essential truth to, “I think this person might be choosing a short-game decision over a long-game investment.”

So I appreciate I’m drifting a little bit into platitude territory, but there’s nothing abstract about that, at least how I’ve lived it. And it’s an interesting gut check. Now, does that mean that you can’t have ice cream every once in a while? No, no, no. Have ice cream. Should you have it every night? That’s up to you. But I think we can all take those kind of small examples and then level them up to the larger ones around ethics and about truth in our society and about how we, you know, can advance goodness in the world. And usually what you come down to is, okay, if I make this decision, it’s going to be a hard one. It’s going to be worth it. And that’s how the third act of the book is constructed.

Cherie Harder: What was the worst piece of either advice or counsel that you received?

Amy Low: Yeah, I’m going to give everybody a little something to keep in your hip pocket, because this is going to go for, like, the worst possible thing that you can say to someone, especially in a health situation, but I would argue in any kind of terrible life turn. And it’s not been said to me too much. And I don’t think people of faith fall into this trap, but I’ll just give it to you. I’ve had just enough people look at me and say, “This is, like, really bad luck. I mean, it’s so random what happened to you. I mean, you don’t even have any family history. It’s just so random.” And if you want to knock the wind out of a person who’s a last-room person, that is the thing to say because what you’ve basically suggested is, “Well, look, none of this actually has any grander meaning or purpose.” And, you know, if you want to move someone to the darkest corners and the most terrifying little nooks and crannies of the last room, that’s the way to do it.

Now, the tricky thing is, on the farthest edge, if you say, “Oh, well, this is all part of God’s plan,” see, that’s not helpful either. I mean, that can be very, very harmful. We want to hold the mystery in between. There is a beautiful space—and that’s why I’ve called this book The In-Between—that I think God calls us to, to say, “Hold both truths. Understand there’s nothing random here at all. No, no, you’re part of a much bigger story. And also understand that you may not understand the contours of the story. There is meaning and purpose here, but do not think that this is happening to you because I think it would be awesome for you. Not at all. This is heartbreaking. It’s terrible and it matters.” And that’s the space that I inhabit. So I would say avoid words like “random” and “bad luck.” That doesn’t go down well. People smile and are like, “Oh, okay.” And then they go probably back to their car and sob. So, not helpful.

Cherie Harder: Amy, there’s so much more we could talk about, but we’re going to turn some questions from our audience. And for those of you who are joining for the first time, you can not only enter a question into the Q&A box, but you can also “like” a question. And that helps give us some idea of what some of the more popular questions are. So our first question comes from Suzanne Hogran. And Suzanne says, “Amy, thank you for your generosity. In addition to reading your book, please share some self-care and soul-care starting points for someone facing a new cancer diagnosis.”

Amy Low: Yeah, it’s such a great question. Soul care: I would say, a great comfort for me is I’ve gone back and I’ve read the Gospels again because it turns out the through-line of the stories that we’ve all grown up with are really about hardship and fear. You find a companionship that, again, before it’s like, “Oh, those were tough days. Those were kind of—”, and all of a sudden you find an allyship through the stories that the disciples move through, where, frankly, most days were just terrifying and full of confusion. I mean, I will say especially with health, you are constantly confused. You think, but why? But where? Should I get another opinion? How should this work? And you want to outthink it. And I’ve gone back and found such allyship with so many moments and scenes in the Gospels where it’s just so clear that there’s this constant quest of “help us understand,” you know, “where is this going?” And one of the lovely things about moving through this is that you realize our utter humanity in all of this. And I’ve actually found great comfort in knowing that that first human response is exactly where most of us begin. 

I will say that every patient—and now I’m just going to speak to health issues—navigates this chapter of their life very, very differently. I have friends who just immediately went to online forums and found community among other patients, and immediately started swapping stories. I wasn’t one of those people. I do have some other patients now who I know quite well, but I actually chose not to do that. I surrounded myself with people who actually didn’t really know what I was going through, but who had incredible friendship and devotion to offer. 

I’m really lucky that I have the kind of career that most days I go to work and it’s very life-giving as opposed to life draining. So I never took a medical leave. And yet I’ve talked to others that the best thing they could ever do was step out of their career and really care for themselves and their family. So this is a deeply individual kind of response, but I think that my friend’s advice is the best one of all: is be true to who you are. And hopefully most of us really know that. And for me, it was finding allyship and kinship. 

I did look for a lot of other last-room people. I mean, I’ll just say, as a quick aside, over Memorial Day weekend, I remember watching Saving Private Ryan again. I thought, this is a movie I haven’t seen a long time. But what I realized was, those first scenes, you know, coming into Normandy on the boats, I thought, “Oh, all these guys are last-room guys. And they knew that.” Now some of them survived, so many of them didn’t. But I promise you, on those boats, they knew. And I fell in love with them in a way that I never did before. And I thought, well, I mean, that is the essence of courage, is to keep going. 

So I would say, find some kinship in another last-room people, if that’s the reality of your diagnosis, and then stay true to who you are.

Cherie Harder: So a question from Robert Mayes, and Robert says, “I have had multiple myeloma and recently completed a stem-cell transplant. How does one rethink one’s relevancy when many around that person may already be seeing that person as if they’re part of the past?”

Amy Low: Yeah. Oh, isn’t that such a hard dilemma? One of the things that I’ve become keenly aware of over the last five years is that every cancer is so different. In some ways, Robert lives on a different planet than I do because he and I receive different medicines, different approaches, different statistics, different prognoses. It couldn’t be more different. And yet we both kind of share this, like, larger solar system of what happens when a set of cells go left instead of going right. Like, that’s the essence of what happens to us. I know within the colon cancer community, most of us are sort of like me. We sort of present as being well, and then I tell people like, “I’m not well at all. It’s so terrible.” They’re like, “You’re doing great. You seem fine.” I’m like, “No, you missed it.” Like, it’s just a quirk in some ways of my kind of cancer. And then I have other friends who you think, “Oh my goodness, they are really sick.” Because physically you just, you end up being transformed. Especially anybody who goes through a deep transplant process.

So, living fully, even though physically you’ve been through the hardest parts of the woods, I think, can be really difficult because our physicality is our opening bid to our communities. And my very practical advice is surround yourself with people who can be your ambassadors, who can help people understand, “Look, while physically there may have been an adjustment here, you have a full living human person here who is deeply vibrant, deeply a part of our community, and has as much to give and probably more to give than they could even before.”

But I’m really aware that I’m part of a slightly unusual group in that I can walk into church or I can walk into a store, and very few people pull me aside and think, “How are you?” That’s a blessing. And it can also be tricky because I’m like, does anybody know what is going on here? This is terrible. And so I have that, again, it’s another funny duality that I hold. So, I don’t know if that’s all that helpful, but I do think having some of those ambassadors can be really helpful because they can translate sometimes the physical to the actual soul part.

Cherie Harder: So a question from Heidi Metcalf-Little, who asked, “Can you tell us about your experience of friendship in the midst of your journey?”

Amy Low: Yeah. It’s such a great one. A couple of things. One is that I have had the good fortune of friends from very different rooms, like chapters-long ago, hear about what’s going on, and they have come back. And as I like to say in the epilogue of the book, as it turns out, there’s plenty of couches in the last room. You can come visit whenever you want. Sometimes you got to knock a little hard because sometimes the person inside doesn’t know how to answer the door. But I’ve had friends from, like, decades back—high school friends, college friends—we have had a resurgence of sweetness in our friendship. I hate to think it’s that I had to get sick in order for this to happen. It might have happened on its own. I don’t know that it would have, but they’ve shown up at just the right time. So that’s been a big surprise.

What I consider kind of my lifetime friends— this is what I’ll say that is maybe a practical piece of advice for others. What I say to those who are going to accompany, who are going to walk alongside others who find themselves in these hard, hard rooms, lead with courage. Understand that our first instinct of, “Well, you know, let’s hold on. There could be good news here.” Or, “Isn’t it wonderful that you live right next to UCSF, and they’re going to do the—? Don’t you have a great medical team?” Those are beautiful, beautiful opening bids. But they’re not always the most helpful opening bids.  My core friends, my core friends are the ones who say, “Let’s talk about the hardest possible thing right now. What are you most afraid of? And I’m not going to leave. Like, let’s just sit with that. And if you want to do best-case, we can do that a little later. But let’s— why don’t we go to the scariest part of all?” That takes a very certain kind of friend, and it takes a certain kind of relationship. 

But as it turns out, I have another friend of mine who’s a patient like me, and she and I have this sort of code to say, we’re skipping over all of it. Now let’s get to the heart of it. And she’ll call me and she’ll say, “What’s the worst possible thing?” And I’m like, “I’m going to tell you. Here’s the worst possible thing.” That’s an unusual moment sometimes for friends to hold because you think, well, no, no, I’m going to make this person really sad. It has the opposite effect. What it says is, oh, you’re as interested in being as brave as I am. Because guess what? I don’t have a choice. But you do. And you just chose to get to the scariest spot.

If you have that kind of relationship with the friend, don’t hesitate. You’ll actually be amazed how it’s such a gift. You’re like, thank you, thank you for stopping pointing out the bright side. It’s not bright, it’s awful. And then once you work through that, then weirdly, later, you’re like, well, on the other hand, you can find yourself in a really joyful place. But lead with courage. Say the thing that you’re most afraid of. And as it turns out, it may be the best gift you can give.

Cherie Harder: That actually might relate somewhat to the question from our next guest, Jean Gerin, who asked, Jean says, “I am in the last room myself with kidney cancer and found myself with overwhelming and inexplicable peace during the first diagnosis. But then some follow-on health issues have brought panic. How do you handle the whiplash between deep trust and sporadic anxiety?”

Amy Low: Yeah, I still have it too. I think it goes back to what I said in the beginning, that the panic, I think, is a reminder that we were made to be creatures who are meant to be alive. I mean, that is how we’ve been beautifully and wonderfully made. So I worry a little bit when I sometimes hear a grim scan or something, and I think, huh. I think, wait, what’s happened to me? Like, no, no. Like, if I’m not panicked and I’m not upset, maybe I’ve lost the larger project here, which is to be as alive as I possibly can. 

And yet there’s a reckoning. There’s a reality here that, again, we’re all going to be last-room people. We’re all going to face our mortality. And I think this pendulum swing that we hold is one of the grand places of trust that we have as people of faith because we’re told over and over and over again in the Scriptures, first of all, this is going to happen to everybody. Don’t be afraid. Live fully in who you are. And again, you read it, you think, oh, that all makes good sense. But when it is your life, when you look at your phone and you read the lab results, you hold it in such a more visceral way.

I think at the core, the hardest part for me is the notion of, I don’t want to leave early in a way that will cause harm or that will cause grief. And I’ve had to go through a long process of understanding that story that I know is bigger than me is also bigger than my son, is bigger than my daughter, is bigger than my family. It’s a terrible hand to be dealt if you lose your mom too young. I’m not going to sugarcoat it. I think it’s absolutely awful. And I also know that my kids are grappling with this and know that if this is part of their story, it will be a redemptive story. I have a dear friend who says something, who I go back to over and over again, and she said, you know, nothing is squandered in God’s economy. Nothing. And sometimes God’s economy is awful. It is full of tragedy. It is full of heartbreak and loss. And yet, if we are true people who believe, even the most profound disappointments will have a redemptive value.

Now, here’s the hard part. It may take decades for it to be realized. I am not somebody who thinks these things can be revealed fast. I really don’t at all. I think part of being a person of faith is holding on to the notion this may be a lifetime endeavor to find what’s revealed. But this is the ultimate contradiction that we hold. And we so deeply want certainty, and we’re not going to get it. We’re not. And then the question is, do you embrace the grand mystery of the unknown, or do you try to litigate it and outsmart it? And I think there’s actually a lot more magic to be revealed in the mystery.

Cherie Harder: You know, you mentioned children just a minute or two ago, and we’ve had a few questions about advice in terms of interacting and relating and guiding kids. And so I’ll combine two of them. Claudia Bryce asks, “From where are your children finding sources of support or growing relationships that can hold them through their tumult? What resources have been helpful for you in navigating this?” And then, somewhat relatedly, Valerie Flynn asked, “Do you have advice for parents of adult children facing a terminal diagnosis?”

Amy Low: Yeah, such good questions. Well, I do think it’s very important to come to this question with a deep eye of discernment, of understanding kids at different ages. So I know somebody who’s going through, not cancer, but another terrible health situation. But see, her kids are four and two. So she’s working with a very different set of questions than I did when initially I was diagnosed, when my kids were 16 and 14. And where I began is where I continue to be, which is, I have never, ever, ever lied to my kids or told them anything that wasn’t core truth. Now, like everything in life—and truth is really the first chapter of the book—there’s a really interesting kind of space of how far out on the possibility spectrum does it make sense for two adolescents? So what I told them when I was first diagnosed was, “This is really bad. If you guys Google this, and you’re really smart, you’re going to realize the odds are not good. Here’s what’s also true.” You know, I already had a line in my arm, and I said, “This bag of liquid is called chemotherapy. Some people are going to call it poison. We’re not. It’s not poison. It’s a miracle. Someone went through trials, fifteen, twenty, ten years ago, and did something extraordinary for us. And that what’s happening inside me now is a miracle, and if it works, it’s going to add a lot of years to my life.” Those are two very true realities.

What I didn’t say is, now let’s just talk about how awful this, and it’s the second-leading cause of cancer death in the US, and we don’t know why it’s spiking early. I didn’t necessarily think that was helpful space for them at that time. As they’ve grown—so now they’re 21 and almost 19—we grapple a little more. My son happened to be home for his spring break the day that I got this call about what on earth has happened to my brain. And so it was a really interesting moment because he looked at me and said, “Well, what’d she say?” And I was still in shock. And I was like, “It’s gone to my brain.” And he was like, “Is that bad?” I’m like, “I think it’s really bad.” And so we were able to talk about it more like adults, but not quite. And then I was quick to say, I’m like, “Yeah, but there’s this thing called a gamma knife and it’s at UCSF. And they said they can treat it.” And he’s like, “It’s called a gamma knife?” And I said, “Yeah, it’s a laser beam. I know, it’s crazy.” And so we sort of moved it to a 21-year-old space. And I said, “I think if you don’t understand how big of a deal that is, you’ve missed the story.” And I think it was him or maybe somebody else, he’s like, “Well, every good story needs a gamma knife. Like, that’s amazing.” I said, “I know, it’s crazy.”

So, we sit with it sort of in the reality of what it is. I will just acknowledge both of my kids are incredibly brave, or they might just say good sports, that I’ve chronicled so much of the relationships of my life, the stories of our family, in this book. So, you know, my daughter has spent time with it and she’s like, “Well, that’s your vantage point. That’s not exactly how it was for me.” And I thought, okay, well, welcome to memoir. That is tricky. I hope you write your story too, someday. But any good memoirist knows you pull people up on stage, you tell a true story. And it’s your vantage point. And so truth to me has been the core. Walking through the farthest edges of the worst-case scenario I honestly don’t do with any of the people in my life. I don’t find that to be super helpful. There will be time and space for that. But while I’m in the world of hope, of treatment, of maybe there’s another trial, we spend most of our time there.

Cherie Harder: So time is going away. We’ll have one more question. And this is from your Uromi Ralph. Uromi says, “You clearly rely on your faith to traverse these challenging roads. Do you have any thoughts for those who are facing the realities of the last room, but who may struggle with turning to faith for comfort or understanding their circumstances?”

Amy Low: Yeah, a couple of the patients that I know best don’t hold a faith tradition, and I’ll tell you, they are the hardest conversations that I have because their fear, frankly, is so much more palpable. So, I’ll start with kind of the theology side of this. One of the things that I’ve said to my friends—and I’m really interesting or, I think, fortunate in that I move throughout my day through kind of faith worlds and secular worlds. So I’m always happiest moving back and forth between the two. My colleagues and friends who don’t hold a faith tradition, the one thing I’ve learned that I can say with a bit more candor today is, you might not subscribe to, you know, Buddhism or Judaism or Christianity. I understand that. But to be clear, you do subscribe to something. You’ve decided to put your weight down on, perhaps, the world of no faith. And what I’ve just said is, like, “Look, I’m a last-room lady. I get to say whatever I want. I am here to tell you, I could never have a faith that big to basically put your weight down on what I would say is this notion of, ‘well, look, see all of this is random.’ That is still a massive act of faith. There is no way I could have the kind of imagination and trust to ultimately land there.” So my gentle reminder to my friends is, you are a person of faith. In fact, yours is bigger than mine, probably, because you’ve decided on a cosmic piece of chaos.

And that tends to be a little bit of an opening of, like, well, no, no. Help me understand how chaos isn’t a grand gesture. And I find that those conversations can be really beautiful because it’s like, “Oh, well, I didn’t realize it, but yeah, you’re right. I’ve kind of put my stock down on this nothing really matters. And yet it does matter.”

I will say I’ve grown far more compassionate and far more imaginative about how to think about heaven and how to think about our eternity. You just can’t sit alongside someone else who’s really sick and realize, well, they really aren’t a Christian and not bring your whole heart and your whole imagination to that dynamic, because viscerally, you’re taking the same medicine. You’re feeling the same way. It’s so terrible. I suppose I overindex on there’s a mystery here that God has in mind, and I’m lucky that my story brought me to my faith in a really beautiful and elegant way. For others, I think it’s a harder, more rugged road. These are some of the questions I’ll never be able to fully resolve. But when you’re sick and you’re surrounded by other people who are sick, I have found it’s not helpful to say, “If we could just figure out your faith element, then everything’s going to be working out.” Like that— I don’t think that’s quite where God calls us to be. Where God calls us to be is present to hold a hand and say, “Let’s talk about the scariest part.”

Cherie Harder: Well, Amy, this has been a real joy to get to talk with you. And in just a moment, I’m going to give you the last word. But before that, a few things just to share with those of you who are watching. First, immediately after we conclude, we’ll be sending around a survey, and we really welcome hearing your thoughts. We read all of these. We try to incorporate your suggestions to make this ever more valuable. And as a small token of appreciation, if you fill out that survey, we will give you a code for a free Trinity Forum Reading download of your choice. There’s quite a few that we think are quite relevant to this conversation, including “Wrestling with God” by Simone Weil, “The Long Loneliness” by Dorothy Day, “Devotions” by John Donne, “Pilgrim at Tinker Creek,” Augustine’s “Confessions,” and “Bulletins of Immortality” by Emily Dickinson.

In addition, tomorrow we’ll be sending around an email with a lightly edited video link of today’s conversation, along with a list of readings and resources to go further. So be on the lookout for that, and we’d love for you to share this conversation with others.

In addition, I wanted to invite all of you watching to join the Trinity Forum Society, which is the community of people united around Trinity Forum’s mission of cultivating, curating, and disseminating the best of Christian thought for the common good. There’s a number of benefits of being involved as a Trinity Forum Society member, including a subscription to our quarterly Readings, a subscription to our daily What We’re Reading list of curated reading recommendations, and as a special incentive, with your membership or gift of $100 or more, we will send you a signed copy of Amy’s beautiful book, The Brave In-Between, and really hope that we can welcome you into that society.

In addition, if you would like to sponsor an upcoming Online Conversation, we would love to hear from you. You can either just email us or let us know in that follow-up survey.

And speaking of future Online Conversations, later this month, on June 21st, we’ll be hosting British author Elizabeth Oldfield on “Seven Deadly Sins in a Secular Age,” which will be moderated by my colleague Tom Walsh. And on June 28th, I’ll be moderating a conversation with David Bailey from Arrabon and Mia Chung-Yee, who is a classical musician, as well as the founder of MIT’s Octet Collaborative, on the topic of “Creativity, Reconciliation, and Flourishing.” So there should be a link to sign up in the chat feature and hope that you will join us.

Two other events to let you know about this. Coming Tuesday, June 11th, we’ll be hosting a YouTube premiere of our in-person event with John Inazu on “Learning to Disagree” that will be held at 8 p.m. on Tuesday. Please join us. And on June 24th, we’ll be hosting our next virtual reading group on navigating 2024 faithfully, where we will discuss together Vaclav Havel’s wonderful essay, “Politics, Morality, and Civility.”

Finally, as promised, Amy, the last word is yours.

Amy Low: Well, this has been such a treat. The last word is: give yourself permission this weekend to spot what I sometimes call the miraculously mundane moments. Pay attention. I promise you, if you pay attention, you’re going to see it. Spot that moment of something going right in the world, of a person making a choice for kindness, of a blossom that’s a color that you’ve never noticed before. And don’t just spot it, name it, and share it with someone else. I know that can be kind of smaller, trite. It’s not. It is the goodness and the gifts of what every room of our lives calls us to. But it’s just a friendly reminder that it’s so easy to miss when life is sort of cruising along at the right gallop. Get off the horse for just a quick minute. Pay attention. Look at the person who’s telling you a story and say, “Wait, back up. Tell me a little bit more about that.” And share it with others. It’s the magic of the last room, but it’s magic that you can grasp in any room of your life.

Cherie Harder: Amy, this has been a real delight. Great to talk with you.

Amy Low: Good to see you, Cherie!

Cherie Harder: Thank you to all of you for joining us. Have a great weekend.