I considered myself a teacher right up to the moment they removed my voice box. After that, I wasn’t sure. As a former preacher, instructor, and trainer, I’d spent most of my adult life educating people from all backgrounds. How many times had my students asked me, “Will this be on the test?” I had no idea the day would come when I would be the one tested.

The Head and Neck Center on the tenth floor of the MD Anderson Cancer Center is unlike any other place on the planet. It is made up of two circular loops joined in the middle to create a warped figure eight, or perhaps an infinity symbol. Here you find people who have lost portions of their face, tongue, voice box, and identity. Devastation and heartbreak hang in the air like the Texas humidity while battles are being waged all around. One such battle is between odors. Disinfectant, bile, plastic tubing, freshly washed gowns and sheets, defecation, and antibacterial salve all contribute to create that dreadful hospital smell. But if you look closely, you will notice something else beneath all the heaviness and heartache. Something called hope. 

For someone reading this story rather than living it, I might sound too sentimental or idealistic, but the truth is simple — without a pulsing, living sense of hope in this place, the Center wouldn’t exist. Maybe I wouldn’t exist either. Because when you’ve lost what makes you, you, the only choice left is either madness or hope. 

By the time I was on the tenth floor, madness had already crept in. I’m not sure when it first took up residence, but I have pictures of myself from that season, and the madness is clearly visible. I can see it there, in the wild glare of my eyes. It might have happened when I realized my twenty-two-year marriage was over the same day I received my cancer diagnosis. Or when I resigned my position as the bi-vocational pastor of a tiny, country church the year before. But it most certainly won a decisive victory when I was told the cancer in my throat was still there two weeks after I’d been laid off from my job with a major airline and two months after my radiation treatments had concluded. I just remember thinking, It may be too late for me. I may have already lost my grip. Looking in the mirror and seeing the gaze of insanity frightened me. A lot. I shook my head sharply and opened my eyes wide, hoping to look like me again. But the madness was still there, and the real me was not. 

I knew then I was in for a fight.

It became clear that cancer wasn’t my worst enemy. I was confident I would find a way to beat that beast, especially with my team of world-class doctors on my side. But the madness was another story. It could ruin me and, worse, start in on my children. I couldn’t allow that. I would have to fight my way back. 

I wanted to fight. I was ready to fight. Fight cancer. Fight madness. Fight anyone who would dare stand up to me. Everything I’d been through in life was now coming into play in a new way. All the pain, heartbreak, failure, humiliation, loss . . . it had all shifted into a collective preparation. Preparing me for this. This fight. 

One of the first questions I had to answer on this exam was, “What does hope look like?” Many of us search for hope while waiting or passively praying for a hero to save us. But in my life, hope showed up as a warrior, leading me onto the battlefield. 

A couple days after my voice box had been completely removed, I was sitting in the hospital bed watching a golf tournament. The pain was a faint numbness, more like a tightness, as if dried glue coated my neck. Occasionally I would feel a cottony sense of discomfort, but not nearly as bad as you might think. That day, a young woman came to the doorway and asked if it would be okay if she and her friend came in to talk. I nodded and smiled. She turned toward the hallway and signaled.

The woman wore regular clothes, but her friend was a fellow patient. Spherical drains dangled from safety pins that dotted her blood-spattered gown. She smiled with a grossly swollen face as she entered the room. I could tell she was an attractive woman beneath the veil of the tenth floor. She looked to her friend, giving permission for her to be the mouthpiece. 

“Um . . . well, she wanted to tell you how much she appreciates you walking around saying hello to everyone.”

I picked up my electrolarynx, the machine that allowed me to speak by casting vibrations through a rubber tube aimed at the back of my throat. “Thank you,” my mechanical voice echoed. I didn’t know what else to say. The robotic sound of the device still made me feel ridiculous, but writing on the mini whiteboard seemed even worse. 

They exchanged another glance. “She also wanted to tell you about what she’s going through.”

“That would be great,” I replied like an idiot robot. Great?

The young woman began relaying the story of her friend, with a few prompts and corrections along the way. She told me about how this fellow warrior was in the prime of life, the single mother of an eight-year-old girl. She’d been diagnosed with cancer on the extreme back of her tongue, and she’d just had it removed and replaced with a portion of her shoulder. This would have shocked me a year ago, but this was my second tour on the tenth floor.

The doctors usually take tissue from the non-dominant side of the body, but her left shoulder held a tattoo of her daughter’s name. She was right-handed. The surgeon asked if she would prefer to keep the tattoo intact and use her dominant side instead. She insisted she wanted to use the tattoo side because the presence of her daughter’s name might keep the cancer away. Plus, she would be the first person on record to have a tattoo in the back of her throat. 

Her face lit up, beaming at the hilarity of it all. The terror and oppression of our situation was momentarily held off while we laughed silently, chests vibrating and drains bobbing, the only signs of laughter. 

We had found our silver lining: impossible tattoos and the power of the names of our children. With about a half mile of stitches, a gallon or two of bodily fluids bouncing around in the drains, and a mantle of sorrow knotted around our hearts, we chose to make that connection and laugh rather than collapse and go mad. 

The two visitors stood at my bedside for some time, and we discovered broken ways of communicating about the shambles of our lives. Then we went back to the battlefield, determined to win our fights.

I haven’t ever seen that woman again. But the story of her tattoo taught me a lesson I never could have learned without first having been given a scar from one of my ears to the other. She taught me that hope isn’t passive. It’s a fistfight. 

The woman with the impossible tattoo chose to fight by sharing her story. In doing so, she inspired me to do the same. In this book, I will share more stories that have helped me see what truly matters in life. And while my faith is a big part of my journey, I don’t intend to preach. I only aim to passionately share the experiences that have opened my eyes to the purpose behind the pain and the hope beneath the horror.