One of the key things a distance runner learns over time is how to deal with a world of hurt. Among track athletes, it is those who circle the oval multiple times that learn to deal with sustained levels of pain and discomfort. That is why my former track and cross-country coach offered sage advice when he learned that I was about to enter into caregiving for a wife with ovarian cancer. “Your whole life has been a preparation for this,” he told me.

In his later years, that same coach was diagnosed with lung cancer, the likely result of decades of cigarette and pot smoking. I never heard him complain or bemoan his circumstances during his long struggle with declining health. In part, that’s because the disease did not result from circumstance. Cigarette smoke is a known carcinogen.

The source of my late wife’s disease was unknown. Ovarian cancer is also known as the ‘silent killer’ because its symptoms resemble so many other conditions in women’s health; bloating, a feeling of fullness, that females of the human species experience during menstrual cycles and other daily or monthly patterns. I watched my wife go through a year of odd bleeding and prolonged periods and figured it was time to push her to see the doctor. She was not eager to do so. For financial reasons, we’d opted for the HMO version of the company health plan and our regular physician didn’t accept the coverage. The doctor we found was a nice enough soul, but kind of ‘old school’ in his approach. He’d gotten his medical degree through the military and his bedside manner fell into the “kind male” category.

She didn’t have a gynecologist at the time. I looked up a women’s health clinic and made an appointment for her. That turned out to be a reasonable resource. When the doctor found what looked like a cyst on my wife’s ovary through ultrasound, laparoscopic surgery was scheduled to have a look. My wife had a history of ovarian cysts. We’d met on October 23rd, 1981, and began dating right away. That hardly prepared me for the news a month later that she was having surgery in December to remove ‘orange-sized’ ovarian cysts. At that point, we might not have even slept together, so the whole female region was not a part of our daily discussion. Our dates were mostly nature hikes, parties, and the occasional dinner out with friends. But when I visited her in the hospital the day after her surgery she yanked her medical panties down to show me the ‘bikini scar’ where the surgeon cut the abdominal muscle to remove the cysts. “Well,” I thought to myself. “I guess this is a serious relationship.”

Those cysts were benign tumors, an apparently common condition for many women whose hormones kick into high gear. So here’s the deal. In case this information ever helps a woman reading this blog. If you are experiencing issues “down there,” don’t waste time. Get checked for ovarian cysts. Here’s a summary from the Ovarian Cancer Research Alliance website about the difference between ovarian cysts and ovarian cancer.

“Having an ovarian cyst does not mean you have ovarian cancer. Ovarian cysts can be fairly common, while ovarian tumors are quite rare; ovarian cysts are fluid-filled while ovarian tumors are solid masses. Most ovarian cysts are not harmful, don’t cause symptoms and are not indicative of risk for future ovarian cancer, though some complex ovarian cysts may raise the risk. Ovarian cysts are common in women with regular menstrual cycles, and less common in post-menopausal women. Approximately 8% of pre-menopausal women develop large ovarian cysts that require treatment. Ovarian cyst symptoms are uncommon unless they twist or rupture, or become large enough that a woman can feel the cyst.  While many ovarian cysts come and go with a woman’s menstrual cycle (functional ovarian cysts), or go away without treatment, some may require surgery to remove.

While ovarian cyst symptoms are uncommon, they can include some symptoms similar to ovarian cancer, such as:  abdominal pain or ache, bloating, pain during intercourse, menstrual irregularities, and more rarely in ovarian cysts, frequent urination. More specific to ovarian cysts, unusual growth of facial and body hair may occur due to an increase in the production of male hormones called androgens. And in rare cases, sudden sharp abdominal pain, fever, and nausea may indicate a cyst has twisted or ruptured, and requires immediate medical attention and likely emergency surgery.”

I do know that my wife qualified in several risk factors for ovarian cancer. One of them was a prior medical procedure before she met me. She also used talcum powder for feminine hygiene, and there are class action cases actively working on that issue. I found that information out far too late to gain any compensation from that legal action. There may have been HPV issues too, mine or hers. We can never know the true source of her cancer.

Once the cysts were out, we didn’t think about her ovaries again until we got married four years later in 1985. She got pregnant with our son on our first try. From there, it was off to the races for nine months after which she delivered a healthy baby boy following a fifteen-hour labor in which she did as instructed and blew on my finger as they taught us to do in Lamaze class. Our son Evan was born on October 30, 1986. Our daughter Emily was born on April 26, 1990, and none of that activity resulted in complications of any sort.

In other words, we headed into the rest of our lives figuring the whole ovarian cyst thing was done and over. She went back to teaching at our church preschool and I lumbered along in my up-and-down career in marketing until that fateful day in 2005 when the gynecologist broke the tumor on her ovary while trying to remove it.

That mistake let loose an array of cancer cells that spread throughout her abdomen. After we found a gynecological oncologist through the HMO network, he frowned upon hearing what the previous gyno doctor had done and vowed to get in there and fix things. Following that surgery, he informed me that her abdominal walls were peppered with what felt like “sandpaper” across the muscle where the cancer had attached itself. “I excised everything I could,” he told me calmly in the post-op interview. “Now we’ll do chemotherapy and try to kill any cancer that I might have missed.”

That doctor was one of the most amazing men I’ve ever met. His focus on helping women survive ovarian cancer was relentless. We trusted him completely, and for good reason. She lived another eight years under his care, as he performed multiple surgeries, directed chemotherapy regimens, and kept regular checkups to monitor CA-125 numbers as we swerved in and out of remission.

My job was keeping our kids informed and coordinating her care on top of the jobs I held. And keeping myself mentally and physically healthy at the same time. By 2006 I’d taken up cycling more seriously and in 2007 purchased the Felt 4C road bike and started racing it in criteriums. I needed that exercise along with running to keep my brain from overloading. That said, I still took some Lorazepam to help me through anxious periods. During long chemo sessions, I’d sit and write while the prescribed poisons dripped into her system through ports in her arm or belly. I used those hours of support and companionship to complete my first book, a treatise on theology titled The Genesis Fix. I published it in 2007. That was one of my big goals in life: to write and publish an actual book. I’ve now written and published three.

But now, a confession. I’m not sure I ever believed she’d be completely cured of cancer. The statistics about ovarian cancer survival are too stark and real. My experience as a runner taught me that you can’t fudge reality. Even she knew that. Our pet statement was, “It is what it is.”

My hope from the get-go was that we’d somehow find a path to a longer survival rate, and we did that. Living eight years was a massive accomplishment. She had to go through a world of hurt to get there. Even our trusted gynecological oncology physician admitted to her, “I don’t know if I could do what you’re doing.” He admired her toughness. So did I. For all the pain I’d experienced in endurance events, at least I knew the pain was mostly temporary. In her case, as she writhed on the couch with pain and discomfort after chemotherapy, there were no laps to be counted or finish lines to cross. I was humbled by her determination many times over the years.

The will to live is one of life’s most obvious mysteries. While she had tons of encouragement from family, friends, and strangers, it still came down to her wanting to go through the world of hurt necessary to keep living another year. I like to think that I might do the same thing, but none of us is ever sure about that. We don’t know for sure what our bodies and minds can take until we face the trials set before us. Then we find out.

That’s what made me mad when employers wrenched me around during caregiving for my wife. One of them put me through a 360-degree review. That stress didn’t help our situation during those first years of taking care of her. Other companies found reasons to fire me out of fear that their insurance rates would rise with my wife included in our healthcare plan. That misinformed approach came with initial promises of “support” followed by cynical claims that I’d unforgivingly breached some company policy or that my performance wasn’t up to par.

That was my “world of hurt.” I share it in this book I’m writing through my WeRunandRide website because the injustice of the healthcare system in the United States is an inexcusable travesty. Her situation as a person with a “pre-existing condition” was somewhat ameliorated by passage of the Affordable Care Act, but the corporatized healthcare system we have in this country is a horrible example of a mistaken policy gone wrong. The fact that Republicans cling to the idea that our healthcare system was ever a ‘free market’ solution is a farce.

The basic fact is that healthcare equality does not exist in this place we call America. The best coverage is leveraged to the advantage of people working for corporations that foot the bill, and from there, insurance companies play actuarial games while healthcare organizations scramble and re-scramble to grab as much of that insurance money as they can. The result is perpetually rising healthcare insurance costs (which went up by 96% during the George W. Bush administration alone, Source: Crains) and consolidation of healthcare providers into ever-larger networks in a Darwinian race to market domination. All of this economic nonsense is cloaked in corporate healthcare slogans or mission statements promising the best while pretending to the public that it isn’t all about the money in the end.

Here’s one example. I’m a patient of Northwestern Medicine. Largely I do get good care, but that’s because I’m now a Medicare patient, which is a wisely socialized form of medical coverage for people enrolled in Social Security. This organization does a good job. That doesn’t mean the healthcare system in the United States is either fair or ideal.

Mission. Northwestern Medicine is a premier integrated academic health system where the patient comes first. We are all caregivers or someone who supports a caregiver. We are here to improve the health of our community.

What people need to realize, especially dispassionate conservative people claiming to care about others while passing laws that discriminate or produce healthcare inequality is that the entire world is a “world of hurt,” and that truly caring about the health and welfare of other people and our environment requires something more than a blanket of ideology and a transfusion of dogma to protect and value life on this planet.

I’ve earned my opinions on these subjects, having been the beneficiary of great kindness as a caregiver, so I know what gratitude feels like. I’ve also seen what healthcare non-profit charities can do to help people in this world. The people who make that happen, including many wealthy people with hearts for society, deserve great credit. Thank you.

Yet I have also witnessed what it looks like when disinvestment rules the day and people don’t have access to decent healthcare either for insurance reasons or lack of available resources.

We all live in a world of hurt and it’s disturbing that some people feel that the solution to that problem is to dispense more hurt through selfish beliefs and try to tell you that it’s the best medicine God our country or political parties can buy.