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Posted: July 07, 2006

Spiritual Caregiving

Alive with Passion -- Part 2

(Editor’s Note: This is the second part of a 4-part feature -- one amazing woman’s triumph over our cultural habit of fear of illness and fear of death. This article received more mail than any other feature published by Spirituality & Health magazine. It appears, with illustrations, in the February 2006 issue, which is available by special order via email:
"You are going to have that cut out, aren't you?" asked the wide-eyed mammogram technician.
"Oh, yeah, sister. And after the surgery I will surf until I can't stand up -- and then I'll body-surf. From now on, I'm going for ecstasy in everything."
"I wish I knew how to surf."
"After the surgery, I'll teach you," I promised.
"Uh-huh," said the tech.
I am a child of Mother Ocean. My blood streamed with salt water as well as tumor cells. I knew the sea would never fail me. And that moment, looking right at my death, was my first, spontaneous, flippant, but deeply passionate affirmation of my life and my death: it was okay that I had cancer; it was okay to die; it was not okay to suffer because of fear of dying, because . . . I'm not afraid.
Has working with death for so many years made me insensitive, numbed me into stupidity? No. My lack of fear stems from two things:
1. I've looked at death almost every day. I know death is normal. I know death is not evil.
2. Every time I step on the beach and look out at the infinite blue horizon, I'm looking right into God. Every day I see God. And, as a surfer, most days I dance with God and death. Any wave can kill me. I don't take it personally; I just enjoy the Zen ecstasy, the joy of being one with the sea and gliding into the beauty of the shining light — even when it's raining. This is passion. This is love. This joy originates in a completely different part of the brain, the nucleus accumbens, and the chemicals released, I believe, heal.
The Second Affirmation

Instead of my white lab coat and identification badge, I wore my best red board shorts, black tank top with a beer logo, and rubber slippers to my appointment at the cancer center.
"Your best bet is a mastectomy," said the surgeon as she slammed the mammogram the radiologist had called "grave" onto the lighted display panel.
"Take one, take 'em both," I said. "
The surgeon exhaled and gave me a hard look. I looked at her. She dropped her gaze first. "I'm only 90% certain it's cancer and you want me to take both your breasts?"
"I've worked in medicine since I was 13 years old and now I'm 49. I'm 100% certain it's cancer. That is one big, classic crab tumor in my chest. And one month ago both my breasts were swollen and excruciatingly painful. That, by your definition, is inflammatory breast cancer. Could it be something else? Maybe a fat necrosis secondary to a surf contusion?"
The surgeon pursed her lips, trying to swallow a smile. "Probably not."
"Okay, then. You can do anything except cut muscle or tendon, because I am going to surf again."
"What about reconstructive surgery, chemotherapy, radiation? I can recommend an oncologist."
"No. You, and you alone, get one crack at this in one surgical session. And then I'm back in the water. No other hospitals, no other doctor visits. I'll surf until it's time for hospice."
"You're only 49," she said.
"And I have had a grand life," I answered. "The point is to live fully until it's time to die, and to do both without fear. The ocean washes away fear. Hospitals are all about fear. You know about this fear as well as I do."
She looked down at her feet and then at me. I knew she wanted to tell me I was nuttier than a fruitcake, that what I proposed to do was suicide, according to current medical theory. Perhaps she thought I would change my mind. To her credit, she said only, "My nurse will schedule the surgery and call you."
(The third installment of this story will appear in next week’s Spiritual Caregiving column. You can read the first installment by clicking here.)
Mandi Caruso is a passionate hospice volunteer, surfer, and author. This article is excerpted from her unpublished book Doors to Heaven. In addition to teaching her mammogram tech how to surf three months after her own surgery, she has taught other cancer patients how to surf. See for more.

This article originally appeared in Spirituality & Health magazine, For subscriptions call 1-800-876-8202 or see Editor Stephen Kiesling and his staff contribute weekly columns, features and articles published every Friday as "Spiritual Caregiving" at Contact staff directly via email at

© 2006 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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