What It's Like to Write and Give a Sermon on Mortality

The material below is adapted from a piece I have submitted to the smartpatients.com patient support website.

The phone call took me by surprise. Jon M., a man I’ve known and respected for many years, called me on behalf of the Worship Committee of the Unitarian Universalist Church of Canton, New York. He told me that it was hard for him to call me, because he was asking me to give a sermon at the church on my experiences and thoughts as a stage IV lung cancer patient. My response surprised me even more. I said yes. I knew it wouldn’t be easy, but even more than whatever good such a sermon could do for others, I knew that doing this work - writing and delivering a sermon on my discovery that I am mortal - would be good for me, and it would be consistent with how I live my life. I also could not think of a more supportive audience for what I might have to say. I agreed to give the sermon on March 1, 6 weeks from the date of the call. My gut told me not to wait too long.

My gut was correct. First, our daughter asked if she could be married in our home, and she chose the day before the sermon as the date. When I asked her if she was certain she wanted that date, she said it was good timing - it meant she would certainly be able to attend the sermon. You could have knocked me over with a feather when she told me that!

Then, I picked up the CD of my latest CT scan. I wasn’t going to be seeing my oncologist for several days, but I gathered my courage and read the lab report. It was sobering reading. The primary tumor in my upper left lung, that had nearly disappeared 3 months prior due to targeted therapy, was back.

Writing about my mortality and how I was moderating my hopes for my future with the reality of my diagnosis with so much change pending in my life was challenging. I fact-checked and honed my words and stared my situation in the eye for a few concentrated days as I pressed to finish the sermon before the week that would include an appointment with my oncologist and end with our daughter’s wedding. When Jon M. asked me to chose a graphic for the cover of the Order of Service, I found one that was perfect given everything that was going on in my life: “Keep Calm, It’s the Circle of Life”.

As expected, the oncologist said my scan was “not stellar”. She was not willing to say that I’m progressing, but it is clear that I will not be one of the fortunate few who use Tarceva for many, many months with success. Managing cancer as a chronic illness is a complicated business for all of us who attempt it. Decision points are harder to identify than I thought they might be, and both the information we have and our choices are limited and imperfect.

The first Sunday of March found me in front of the congregation in my best hand-knit sweater. With me were Jon M. and a dear friend and musician John D., who had agreed to provide special music for the service. When it came time for me to give the sermon, I found myself more emotionally stirred than I had expected. There in front of me were my husband, my daughter and her new husband, his parents and brothers, my step-son and his girlfriend, some special friends, and my three grandchildren. My voice was shaky as I spoke about how the hardest part of my terminal diagnosis is the sadness my friends and family feel because of my illness, and how helpless I am to take that sadness away. Even as I spoke the words, I was telling myself “this is the worst of it, from here on out it will be easier.” It was easier, but I was so emotionally drained by the end that I didn’t know what I was supposed to do, and Jon M. gently told me I could sit down.

Music is very important to me. I studied it as a young person, and I still think it is the art with most direct access to our deepest feelings. John D. and I chose the music together, beginning with “What a Wonderful World”. He played Iris Dement’s “Let the Mystery Be” for the offertory, a song that has been deeply meaningful to me for many years. After my sermon, he played a song by david m. bailey called “If I Had Another”. I didn’t tell the congregation this, but david was a man who lived with brain cancer for 14 years. He left his corporate job upon diagnosis to devote the rest of his life to singing about his faith and the beauties of being alive. In the song, he wonders what he would do if he knew he only had a short period to live - a week, a day, an hour, a minute - and ends by asking us what we will do with the lives we have ahead of us. It is a perfect summary of the meat of my message: that all of us have the same prognosis in the end, and that life is best lived in the present moment. Two members of smartpatients.com allowed me to use their words in my closing. Sarah Kugler Powers asked, “When do we allow ourselves to try to live again, not just survive, but truly live a fulfilling rich life in the aftermath of all we experienced?” John, a survivor of esophageal cancer, answered, “When do we allow ourselves to live again? Today. Then do it again the next day.”

The feedback from the sermon has been very positive. Many people have asked me to email it to them, and more than 340 people have listened to it via the recording posted online at soundcloud.com. It is probably one of the best things I have done in my life, and it came out at the perfect time. There has been much in the news of late about cancer and about facing mortality: The PBS series based on Siddhartha Mukherjee’s The Emperor of All Maladies, the Frontline show on Atul Gawande’s Being Mortal, the op-ed piece in the NY Times by Oliver Sacks on his terminal diagnosis. I feel like I’m not alone in realizing that my lifespan is limited, and that I am joined by many who are paying attention to the end of life.

I didn’t fully realize when Jon M. asked me to write a sermon that he was offering me a gift.

Winter has come slowly to a close here in northern New York and I continue to live with realistic hope even as this danged disease is changing things up. My oncologist considers me to be showing progression, and a new PET scan has disclosed the first metastasis to my spine. I’m continuing my targeted therapy for a bit longer, and I have traveled to Roswell Park Cancer Institute to enroll in a rociletinib phase I/II trial, pending biopsy results. Next month, one way or another, there will be a change in my treatment. In the meantime, I still feel pretty darn good, able to bring in firewood and walk our spirited labradoodle. And I will see the crabapple tree that was planted for me last year bloom this spring, and I will pass my first cancerversary with style. I am also very aware of how uncertain the future is beyond that blooming tree and that anniversary marker. The uncertainty, however, cannot diminish the joy I feel from the fact that I am alive right now on this wonderful world.

To hear david m. bailey’s song “If I Had Another”, please visit

To hear me deliver my sermon “Realistic Hope: Living with a Terminal Diagnosis”, please visit


  1. Thank you, Anita. I am digesting this. In the morning, I will listen to your sermon. Hugs to you - and I look forward to another Ottawa trip!


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