Our Angel

God brought an angel to join us six months ago on our round three cancer journey. I will not share info about our angel, only that he is a retired chair of the head and neck department of a leading American medical center. He is the friend of a friend with whom I have worked on international projects for the past 25 years.

Some who read this will say that they don’t want to be bothered with medical portals, but Emory’s portals are chocked full of great information. They give results of MRIs, CT scans, blood work and more. The problem is that a layman like me can fairly easily read the results, but I don’t understand much of the content.

Last night we had a telephone visit with Dr. Angel. I had given him passwords to get into my portal, and for an hour he interpreted all our tests from two weeks ago. Note: our medical team will explain the results on April 29 when I will have my seventh infusion treatment. But they will do it quickly and give me only what they think I need to hear.

The CT scan of my chest looked normal with no evidence of cancer. This is good because if my cancer metastasizes it will most likely go to my lungs. There is extreme fibrosis all over the left mandibular (jawbone area).

Back to Dr. Angel’s report. The MRI showed that the nerve at the base of my skull looks less plump than in the last image. This is good news because this is the result of the infusions. At this point, the treatment seems to be working. However, some of my fibrosis is affecting my swallowing mechanism. That was not good news.

I still have those mouth sores, and I am biting on some of them. We discovered at my dentist’s office this week that my jaw teeth were not coming together properly, and that has made chewing difficult. He ground all the high points of the teeth on my left side and that was a big help. After my dentist finished his work, it was like I had someone else’s teeth. Hopefully, I will be able to chew once again with my left jaw teeth. It has been over a year since I have chewed with those teeth because I was afraid of chewing on my jaw or my tongue.

These teeth problems have contributed to my severe weight loss, as well as lack of appetite and choking issues. My medical team has brought up the possibility of getting a stomach tube. Then Dr. Angel talked about it last night. Cheryl is also an advocate of my getting the tube even though it will be a big daily chore for her. I can see her slipping some Brussel sprouts into that tube while I am listening to a book or watching a John Wayne western (Did you know that John Wayne was the star of 78 westerns?). I fully understand that the tube can be removed at any time.

I just see this procedure as the beginning of the end. My Emory medical team would probably say that I am being melodramatic—or at least they would think that.

I am not afraid of death.  I guess I am thinking that I am delaying death by getting a stomach tube. But then I recall that everything we are doing is palliative, not curative. Therefore, everything is delaying my death, or better stated everything going on now is to prolong my life. I am being encouraged to think of the feeding tube as a means to prolong my life and give me a better quality of life. Anyhow, it seems that I am being encouraged from all sides to get the plumbing done!

My attempts at gaining weight are not working even though I am eating ice cream every day and multiple times on some days. I am drinking whole milk and using heavy cream. I am eating a lot of pasta. Millions of people trying to lose weight, and I am trying to gain weight so that I won’t have to get a feeding tube.

But I am concerned that I will aspirate and get food in my lungs, and that would not be good. In the end I will concede because all those who are recommending my getting a feeding tube will win the day.

I have much to be grateful for as the review of my portal results and comments are very positive. The infusions are working. I am so grateful to be a part of these clinical trials. I have an army of people from many other countries praying for me and those who care for me. Anything that has happened in my life since we started seeking treatment six months ago is all for the glory of the Lord. If God wants to show off and use my story to bring others to Him, so be it. I do not want to stand in His way, but I want to be a vessel that God will use to magnify the name of Jesus.

More Treatments

This past Tuesday was my sixth infusion. As usual, we (me and Cheryl and Jason, our driver and encourager for this visit) checked in at the reception area and they gave me a badge and the traditional plastic band to wear around my wrist. The badge is a tracking device that lets my caregivers know where I am.

We proceeded to the reception area on the 10th floor and shortly a nurse came to escort us to our assigned patient room, but on the way she had me get on the scales. I weighed 171pounds. When I started these infusions, I weighed 192.

After I got comfortable in my lounge chair, the nurse began taking my blood pressure and oxygen level. As the nurse and I were talking about what large veins I had, the port was anchored on the top of my left wrist.  Blood was drawn through the port.

Originally when I met with my medical team at Emory, the coordinator for the clinical trial stated that I would get six infusions on three week cycles. I asked why only six, and I did not get a good response.

I am sure that my medical team explained to me a lot of things that did not soak into my mind. In that first meeting we were in shock after hearing that this cancer, Round 3, was going to take my life. There were very different opinions about the prognosis. The radiation oncologist said a few weeks. Another suggested months and possibly a year. Doctors today just do not want to give any info about their thoughts on a patient’s prognosis.

I am telling you this: No matter how close to the Lord you may be, when a group of physicians tell you that you have terminal cancer, you are probably going to react in a similar manner. My eyes filled with tears at the thought of leaving my family. My first thoughts were about Cheryl. Who was going to help her? Who is going to sit with her in church? Do we have enough in our savings and investments to take care of her? In the big scope of things these all seem so trivial now. I know that the Lord is going to take care of Cheryl and our family. That is not something that I need to worry about. That is a good feeling, and it gives me comfort in my soul to understand these things.

Last Tuesday was my sixth infusion, and my coordinator had told me at my fifth infusion that it was possible for me to have more treatments. There was no excitement or enthusiasm in the way she said this, so I decided not to get excited about more infusions. I thought that after the sixth one that they would put me on the infusion that the other group was taking. I did not fully understand the importance of what she was saying during my sixth infusion.

The coordinator stated during my appointment that I could have 24 cycles if I remained healthy, and my body did not react to produce more side effects. Twenty-four cycles! That means that I could be in the trial for 72 weeks.

Nothing has changed in my routines. I still am in awe of the Lord’s ability to do so many things at one time. With all the lives that He has to take care of, He has chosen to work with my sicknesses. Thank you. Lord, for walking with me during this time.

Beard

Folks ask me questions about my beard, but I am going to answer only the one question asked the most in this post. Why are you sporting a beard? I have never had a beard for more than a few weeks until the past few weeks. Having a beard at this point in my life is a practical thing to do. It covers some of those old age wrinkles. However, those wrinkles represent challenges I have faced. The greater concern is when I have facial spasms, my whole face looks like I am in a circus side show. The beard helps to cover up those contortions. Just to be clear once again: we do not think that the spasms and contortions are related to my cancer, but to the Blepharospasm in my eyes. However, I have fewer spasms in my face since I started the infusions.

The pains on the left side of my face, where the cancer has manifested itself, have greatly reduced since starting my infusions 3+ months ago. I am on a three-week cycle now. On April 8 I will have my sixth infusion, and every three weeks we will go to Emory for another treatment. The actual time for the infusion is only 30 minutes, but the preparations, procedures and protocols take much longer. However, I am in a very comfortable chair from 8 a.m. until 1:30 p.m.

Radiation has modified my smile. I haven’t had any directed radiation on my mouth since 2020, but I have had numerous scans and MRIs on my head and face in the past year. Back in April 2024 I started having a tingling on the left side of my chin and lip. None of my physicians at that time could diagnose why the left side of my mouth would not open properly. The numbness continued to spread upward to my ear and my cheek bone. By that time, we knew that this pain and numbness was related to the reappearance of my salivary gland cancer. Children and more than an occasional adult were staring at my crooked mouth, so I decided to grow a beard.

But behind my crooked smile and my beard lies a heart full of love for people. In a eulogy for my mother and his grandmother, Jeremy talked about how Mimi made people smile through the acts of service she made all her life. Like Mimi, I want my life—and even my crooked smile—to make others smile about their relationship to God through Jesus Christ.

I give thanks every morning for another day to live. Why do I pray for the Lord to extend my life when I could be in his presence? God did not create us to live Christ-like lives and then make our own plans to die. So, every day I thank the Lord for the ability to talk openly with family, friends and colleagues about my death. I thank Him even more for the opportunity to talk with someone about my walking into the arms of the Lord as I make the transition from life on this earth to a more abundant life in heaven.

New Normal

If you are wondering what questions and topics about my treatment and accompanying illnesses go round and round in my mind, I am going to express to you some of those cogitations.

How many more side effects will be added to those I already have? Side effects from my cancer and its treatment and those of Blepharospasm get mingled —I write about Blepharospasm frequently because the side effects of this neurological disease of the eyelids, which has no cure, overlap with the side effects of my cancer. If you want to know more about Blepharospasm, look it up or look at some of my past blogs about this problem.

The Blepharospasm is causing me to gasp for air during several periods of the day. Each episode lasts from a few minutes to a couple of hours. I am asking myself if my condition of feeling like I am drowning when I am trying to catch my breath will ever happen during the night and I wake up gasping for air. That’s a scary emotion, but I have already taken care of this challenge—I turned it over to the Lord. I am actually living in His body because I am wonderfully made by the Lord. So, I have made up my mind that if I choke and die having one of these spasms, so be it. That does not release me from any of the discomfort, but it completely takes away the fear.

What will happen to my clinical trial if the government funding is cut off? The obvious answer is my trial will be halted. I have read where DOGE has already cut some funding for clinical trials at Harvard, Yale and Johns Hopkins medical centers. No government funding, no clinical trials—however Harvard and some of these medical centers have enough reserves to cover most of their trials.

What to do about the problem of chewing on my left jaw while eating and not realizing it because it is numb. This one really makes me tense because no one on my medical team has mentioned anything to fix this problem. The only recommendation that I have received is from my former college roommate who is a retired oral surgeon: pull the teeth that are causing the problem.

Numbness of my ear all the way to the left gums and all of my face down to the middle of my chin.  This is not going to go away according to my medical team. It is irritating, but it is not life-threatening, so I am learning to live with it.

Some of my medications are causing me to have some serious dry mouth. A mouthwash called Biotene is very helpful, as well as some – that I can order online. Sometimes it is so dry that I cannot speak. Water soothes the dryness for a few minutes only.

My vision is impaired. In the last two weeks I have developed a sagging or drooping left eyelid. Not sure yet whether it is caused by the cancer or Blepharospasm. We were able to get a handicapped registration which helps me get into places more easily. Just a few months ago, I was playing pickleball, and now I am one of the handicapped people who fusses at all the people who get the handicapped spaces and there is no evidence of their impediments.

I have unexpected dizzy spells that cause me to pass out for a few seconds. I have lost some sense of balance but fortunately, carrying a walking stick has helped that.

Because of my Blepharospasm, I cannot drive. Who would want to ride with an old man who may blink his eyes and not open them for 5-10 seconds?! Cheryl has stated that she is not a safe driver in the Atlanta traffic, so for every appointment at Emory Winship Medical Center, we need a driver. So far our children, grandchildren and a friend have handled those responsibilities. They sacrifice a lot of time because no matter what kind of appointment I have, it is an all-day trek. There is also the tension about not driving. I have been driving legally since I received my driver’s license at age 15. I have not been happy about this, but over the past few months, the Lord has been sending spiritual drones my way to remind me that getting up every morning and taking my first breaths of the day are a much greater gift than driving a car. I would love to go ride go karts to get my driving urges filled.

Writing down all these cogitations seems overwhelming to handle all of these plus the normal pain associated with my submandibular salivary gland high grade carcinoma. But the only thing that overwhelmes me at this moment is how could our God take a poor Mississippi farm boy and let him be a part of an exciting and challenging life working for Mississippi College, International Mission Board and Chick-fil-A nonprofit organizations.

This is a new season for the Cox family. Cancer affects everyone in the immediate family and some of the grandkids, also. I am only sorry that some of my family have to cater to me to get me to any appointments, church, pharmacy, and the bit of shopping that I need to do. My family has been amazing, and I am so proud of all of them, and I cherish each day with any of my family members.

Everything is a new normal for us. I do not remember what my old normal life felt like.

Driving Mr. Larry

Every third Tuesday we go to the Winship Cancer Center at the Emory Medical Center in midtown Atlanta. Cheryl sits in the passenger front seat, and I sit in the passenger rear seat. That has become my normal seat placement because we can darken the back seat with the pull up window shades on the back windows.  Who is going to “drive Mr. Larry” today? It’s Allison! Our kids decided that one of them or a grandchild would drive us to Atlanta for these appointments because their mother dreaded driving in all that traffic. Plus, they wanted to have one of them listening and asking questions at my visits with Dr. Shin, my medical oncologist, and the rest of my medical team.

After checking in at the reception desk on the first floor of the 18-story building (all for the cancer center), we are asked to wait in the three-story lobby until 15 minutes before our appointment on the tenth floor. All cancer patients are treated in one of the 60+ “care suites.” I always feel like I am sitting in a first-class airplane seat because the seat has six different buttons to adjust to my comfort. Other amenities are a wide screen TV and a private toilet.

We were a little nervous about my appointment yesterday because we would hear for the first time about the effectiveness of the treatment. At the beginning of every treatment appointment, a nurse draws blood for testing. They really like me because I have what the nurse called them yesterday: A+ veins. Those are the big and bold and easy to thread the catheter.  

Dr. Shin came in soon after the nurses were finished with the other prep work—temperature, oxygen level, blood pressure, pulse. He told us that I am in the ARM 2 test of the clinical trial which means that I am receiving the molecular target agent only and no toxic chemo drugs. This agent has been very effective with treating breast cancer, but it is not approved by the FDA for any other use.

These drugs do not attack any cells directly, but they assist in the production of other good cells that will fight the cancer cells and replace them. Dr. Shin reported that there was some improvement in the area of cancer cells alongside my mouth and nose, and that the cancer cells in the cavity below my brain are stable with no evidence of more growth.

Dr. Shin also informed us that I can continue these infusions on the same three-week schedule indefinitely as long as the treatments show positive results. We were so encouraged and relieved to hear this good news.

This may seem like a small step, and it actually is in light of all the cancer research that is going on, but this is a huge step for me. Maybe the Lord is not finished with me yet.

Et Cetera

Some friends and family have recently asked me: Barring a miracle from the Lord, this cancer is going to take your life. There are no cures. Then why fool with all these treatments and participate in the clinical trial?

Four things I considered in volunteering for the clinical trial:

1.     I prayed and felt that God was leading me and Cheryl to do this. Our bodies are the temple of God, I needed to check with the landlord before making a decision.

2.     The treatments would help with the pain in my face and head, and they have done so. They might thwart the rapid growth of the cancer. We will learn the results of the scans and MRI at my 4th infusion on February 25th.

3.     This is part of me wanting to show my children and grandchildren that dying is part of living. In dying, I want them to see Papa as being brave in fighting to live and facing death. I want my family to know that we celebrate births, birthdays, graduations, getting accepted into special educational opportunities, academic and athletic achievements, and special anniversaries. So we need to celebrate dying by talking about death and how it leads to walking into the arms of our Lord and Savior.

4.     I want my family to remember that with this clinical trial physicians may learn something that could help save someone’s life down the road.

Three grandkids have been in our home today, and I have not felt like playing games or cards or anything with them. I have not engaged with them because I do not want them to see me in a sick mood. To the point, I have felt lousy today. I have a nagging cough and congestion. I have not been hungry, but I must eat something. But nothing sounds good to me. My stomach feels upset, and I must keep taking my medications.

On days like this I usually push myself to make it through the day, but the only thing pushing me today is that I need to get this blog post finished and posted. I know that no one is dying to read what I will write, but I like to think that on days like this I am letting friends and family down if I don’t send something out.

Cheryl and I have been in self-imposed isolation for a few weeks--even from our family. We finally decided that we would rather risk getting sick from whatever virus or cold or flu that was going around than to be separated from family and friends. During the time before our isolation and since we lifted it a week ago, we have had friends who drove or flew to our home just for a couple hours visit. These visits have lifted my spirit, and I believe that they have also been healthy for our visitors.

That has been a benefit of having a terminal disease—friends want to come see me before I pass away. Also, I get to talk to my wife and children about memorial and burial services. I feel like I am attending my own funeral.

One thing that I encourage everyone to have regardless of their age is a death dossier. It should include information that your family will need to know about credit cards, properties owned, bank accounts, insurance policies, investments including retirement plans, social security information, email accounts, travel accounts and award programs and other accounts that have passwords, etc.

Treatment 3

Has anyone out there never tried to lose a few pounds? I have never been on a diet to lose weight. But I have been intentional about what kind of foods I digest.

During my clinical trial, my appetite has diminished significantly.  Cheryl has encouraged me to drink smoothies, and she has prepared some interesting ones. My favorite has these ingredients: a frozen banana, a big heaping spoon of peanut butter, some non-flavored protein powder, milk with lots of chocolate syrup, and add as an option two heaping soup spoons of malted milk powder. The “coup de grace” is a dip of either vanilla or chocolate ice cream. I also enjoy some healthier smoothies like strawberry, mixed fruit, and my second favorite one is mango.

I have only lost a few pounds. My medical team does not want me to lose any weight as they have mixed my chemo cocktail for the weight that I registered when I took my first treatment.

I had my third treatment last week and it went well. Cheryl and Allison accompanied me to this appointment. Our children decided that one of them would drive us on these trips to Atlanta. Letting one of them drive relieves a lot of tension for us. It’s also great to have friends who will step up to help. Since we had to go to Emory three times last week, we asked Mark, one of my pickleball buddies, to drive me to one of those appointments.

Although the actual infusion only takes 30 minutes, it takes a half day to complete the process. First, they take my vitals, followed by a conversation on any new pains or stomach or other digestive problems.

Med techs place an IV port in my arm and draw blood for a complete evaluation. After the results have been reviewed, the doctor gives the order to proceed to the Emory research pharmacy in Decatur.  The cocktail cannot be mixed up until the approved order is received. As the crow flies, Decatur is not too far from Emory Cancer Center, but with Atlanta traffic—Pshaw!! When the cocktail finally arrives in my room, two RNs come in to confirm the contents of the infusion bag.  One reads out a series of about 25 numbers on the bag while the other verifies the numbers on the computer.  Finally, after a wait of 2 ½ hours, the infusion begins.

After all the meds has dripped into my body, I begin a period of waiting to make sure that there is no immediate reaction to the drugs. After a nurse removes the tubes and about three feet of tape, I am ready to leave. Well, I did not measure the tape, but it sure felt like three feet of hair on my arm being removed from its follicles.

Questions that may be raised: Are you still playing pickleball? No. I am weak, and I walk only with a cane. Why is your mouth contorted? The doctors I have seen do not know why. I look like I have had a stroke. I have a white beard that helps to camouflage my crooked grin.

Big Week

You would think that getting a new computer would be a great experience. However, the joy of getting a new one to replace the 11-year-old one is over-shadowed by the difficulty of moving files to the new one. I get so disgusted with trying to perform this seemingly easy task. Where are the technologists that helped me with this before I retired? No one ever told me that I would not have a support department to help me!

Everything has been a hassle for the past week, and there is still a lot to be done in getting set up and working at 100%. In this post I have a request for you and then I will close with a brief story.

This week I have three appointments at Winship Cancer Institute at Emory Medical Center in downtown Atlanta. That means that we have to tackle the traffic on Tuesday for my third infusion, on Thursday for scans and an MRI, and on Friday for an echocardiogram. There are some other tests thrown in there, but you would think that they could do the echocardiogram on the same day as the scans. We have a good advocate working with us to coordinate these appointments, but even with her assistance we will still be making three trips.

Would you please pray for family and friends who drive us to these appointment? Cheryl says that retirement for her meant no more driving in Atlanta, so we are thankful for family and friends who chauffeur us to Emory Medical Center.

I fell two times in the last two weeks. One time was onto some cardboard boxes in the garage with no injuries, and the second time was in a parking lot. I bruised my hip and skinned my elbow and my hand, but nothing major for which I am thankful. I have been using a cane and that has helped with the dizziness and lack of balance. I have been having a lot of shortness of breath, and lack of appetite, but there is some good news from the first two infusions. I have reported this and I want to keep remembering this: no more of the major pain in the left side of my face. I have been able to reduce some of the pain medication that I have been taking.

In closing I would like to share a short story. When I was a boy, my granddaddy would take me for walks in the woods. He did not talk much, but as we walked, he would tell me some family history and sometimes he would give me some advice such as how to identify the species of trees.

One time he told me that when I grew up that I should spend the most money on two things—my bed and my shoes. He was waiting for me to ask “Why?” I did as I usually did and said, “Why, Granddaddy?” He replied that for every hour of the day I would be using one or the other!

I have practiced his advice throughout my adult years.

Keys

Can the grandkids reach the keys? That question has been raised in our home over the past 25 years. Now that Noa, the youngest grandchild, is four years old, we don’t have as much of a challenge of losing keys. We have a “keys bowl” and I am not 100% sure of this, but I don’t think that Noa knows about the key bowl. But she is still capable of knowing but not telling.

Now, when we have a special event with all our grandkids present, one of the older grandchildren will yell out, “Has anyone seen my keys?” It is quite normal for one of the two youngest grandkids, Noa and her six-year-old brother Pete to look under the cushion of a chair or sofa and present the keys. I can’t help but think that they do these type things because it draws attention to themselves. And there is a lot of “It’s just fun to trick my cousin.”

When I was a preschooler, I watched my dad as he carefully clipped his key ring on his belt. He was the general manager of a food vending company, and he had to carry a variety of keys. Most of these 12-15 keys were master keys for a particular vending machine company. I would go with my dad to “help him.” One of the best gifts I ever received was a key ring exactly like my dad’s. It was round and shiny and stayed clipped to my belt. When I grabbed a key and pulled it out and up to open a machine, the key had tension on it. When I let it go, it quickly returned to its proper position on the key ring.

Ever since getting my own key ring, I have had a keyring with my own keys. One of the most celebrated times in our lives was when we received keys either to a family car or even better when we got our own car or truck. The make and model of my first car may not have made the Consumer Report’s top ten vehicle list, but all the same it was my car, and I also proudly carried the keys to that car.

So, for the past 60 years, I have carried keys in one of my pockets. For those who do not know, I was diagnosed with Blepharospasm in 2021. Three months ago, my movement disorders neurologist told me that I could not drive any more. She also said that Cheryl would have to be the bad cop and enforce this decision. My doctor said this in such a nice, gentle way that I did not argue or even get mad.

Can you imagine never driving a vehicle again? Cheryl, our children, and our grandchildren have stepped up to the plate to drive me to all my medical appointments—which are numerous and are mostly at Emory in downtown Atlanta.

If you are wondering how it feels to give up your car keys, it stinks. But my mind was trumping my heart to think like that.

My life is bigger than the ability to drive. I thought about all the blind people who cannot drive. The amazing thing is I feel like I am blind with 20/20 vision. I have perfect vision with my glasses. I just cannot control when my eyes are going to blink and how long my blinks will keep my eyes closed.

I have always thought that if I could not drive, then I would feel like I was not in control of my life. But deep in my heart I know better. I gave my heart and my life to Jesus Christ long ago. God is in control of my life. He’s got this.

“For my thoughts are not your thoughts, neither are your ways my ways,” declares the LORD.  “As the heavens are higher than the earth, so are my ways higher than your ways and my thoughts than your thoughts” (Isiah 55:8-9, ESV). 

Report on my high level mucoepidermoid salivary gland cancer:

I have experienced reduced appetite, shortness of breath, extreme dry mouth, dizziness (I have fallen twice. First time at home with no damage. The second fall was three days ago in the Walmart parking lot with damage being very large strawberry on my elbow and bruises on my hip). Extreme fatigue--after never taking a nap during the daytime, I am now napping for 50-90 minutes every day.     

Next appointment is 4Feb25. That will be Infusion number 3. After that infusion, my medical team will take more scans and MRIs.

It is tempting to fall into the pity pool and feel sorry for myself. So far I have avoided this. But it would be so easy to feel sorry for myself for all my health challenges. But I choose the high road here—Joshua 1:9.

Round 3 part 9

Post first treatment

How do I explain my cancer to a grandchild? The easy answer to that is “Let their parents do it.” Granted parents certainly are ultimately responsible for handling questions like that, but there are occasions where the parents are not present when questions like that are asked. “Papa come play chase with us. Tag, you are it.” I want to play chase with them, but physically, right now, I cannot. “Papa come on. You are it.” “I am sorry, honey, but I can’t play right now.” “Why?” I have to break up their tag game to explain why I can’t run and chase my grandchildren.

I don’t remember exactly how I responded, but it was something like this: When you were just a baby, Papa had this same disease called cancer. God chose to heal me, so I got well. Now the same cancer has come back. It is much worse this time.

Many times you can look at someone and they don’t look sick. That is the way it is with Papa’s disease called cancer. In my body, there are these nasty bad cells that are attacking and destroying good cells. We go to the doctor’s office or the hospital to find ways to get rid of these bad cells.

That’s about the limit of what you get to say as everyone wants to get back to playing chase. Our grandchildren range in age from 24 to 4. You certainly don’t tell the 7-year-old the same thing as a 16-year-old.

It’s hard for the grandchildren to understand because I go through periods of looking and acting perfectly normal, but I may be feeling absolutely terrible. I must grit my teeth and move on because I want to set the bar on how to live while I am dying. This is important to me even while knowing that death will come sooner than later for me. I must accept what is and what the Lord intends for me and be honest about my condition to others and myself.

Having blepharospasm and salivary gland cancer at the same time presents an even larger challenge. The blepharospasm causes some facial dystonia which causes contortions and unusual movements that aggravate the cancer in my face and head. It is extremely difficult to do any productive work during these spasms. But I have to push on and work through the spasms to finish tasks.

Mouth sores and lesions on the left inside of my mouth cause a lot of pain, and often mask pain from the cancer—although I believe the issues inside my mouth are caused by the cancer even though they have been an issue for three months.  I only chew on my right side because I have bitten the left side so much that it makes it difficult to heal. These mouth sores have been a pain! I am sleeping mostly in the recliner in our bedroom because the pain from these lesions combined with the pains from the cancer make it difficult to get into any horizontal position where there is pressure on my face or head.

Since I had the first infusion 13 days ago, I have had less stabbing pain in my jaw and chin. No change in the shortness of breath. Feeling of unbalance and dizziness still bothering me. No nausea, yet.

The plan for me is a total of six infusions—one every three weeks during an 18-week trial.

Life is brief and I should not take my days for granted. All of us who have faced terminal cancer understand this more than others. I ought to do the things that will last today. I ought to pause and listen to others' stories. I should spend time with my wife, children, and grandchildren without being rushed or distracted. When God puts individuals into my life, I must listen to their stories.

As I was writing this blog posting, I could hear children playing outside. I looked out the window to see what crazy kids were out in this low 40s weather, and I saw four of my grandchildren playing with two neighbor’s kids. A couple of them had shed their coats. The Lord urged me to get out of my warm seat at my desk and join them in our front yards. All four of our grandkids greeted me with a hug. Soon after our hug, Will, their dad told them it was time to come inside. The neighbor’s kids’ mother had called and said it was time for them to come home. All four grandkids and I went for a cool-down walk, so I got to spend a little more time with them.

In the scope of eternity, this time with the kids was only a blink in our way of keeping track of time, but it was a valuable blink. I was able to spend some time this day with my grandkids.

“For you are a mist that appears for a little time and then vanishes.” (James ‪4:14).

Round 3 part 8

A friend said to me recently: “You don’t look like you have cancer.” Or several friends have said to me on the phone things like: “Well, you sound so much better than the last time we talked.”

Our greetings in the USA are really perfunctorily responses. “How ya doin?” “ Good. And you?” “Good.“ Most times we are in such a hurry that we do not really want the details about that person’s health.

So, when someone asks me how I am doing, I have begun saying “I am just ok.” They do not usually ask me any further questions. I could tell them about the piercing pain in the left side of my face or tell them about how all the medications I am taking four times a day make me dizzy and fearful of falling. I could also tell them about the painful lesions and ulcers in my mouth and throat.

While it is true that this third round of cancer took away my smile and the feeling in the left side of my face and mouth, my cancer has not and will not take away my life-long effort to develop a loving heart for people.

I realize that these friends referred to above were just trying to say encouraging words to me, and I greatly appreciate all the awesome ways that family and friends have helped me.

Many of my friends and even two of our four children have battled and beaten cancer. And some friends have succumbed to their cancer. I have been able to live for 12 years after my prostate cancer and five years before we knew the salivary gland cancer had returned with a vengeance.  

The big challenges that I am dealing with now are ”How can I help others who will follow me with this kind of cancer?” and “How can I help someone who is afraid to even say the word cancer.” “Will I be able to show my children and my grandchildren how to die as a believer in Jesus Christ?

My team at Emory has been working hard to get me into a national trial that will have 116 participants. This morning, we received word that I have been accepted for this clinical trial. There were many factors in my getting into the trial but one of the requirements is to have recurrent salivary gland cancer that has the protein HER2 at high levels (HER2-positive) and that has spread outside the salivary gland and cannot be removed by surgery.

Some would ask, “Why do you want to participate in this clinical trial?” My response would be, “Why not?” My cancer is not going away unless God decides to perform a miracle. This cancer will take my life eventually. It is not curable even with the treatments. But research scientists are not going to find a treatment that is curative unless they have these clinical studies.

This morning, we received notice that I will have my first infusion on Friday, December 20 at Emory Winship Cancer Center. This treatment I am choosing will not heal the cancer. Presently there are no treatments that will heal all the cancer in my face and neck. I am consoled by many scripture passages that my friends and family have sent to me. Today I am living by this one:

“For I am the Lord your God
   who takes hold of your right hand
and says to you, Do not fear;
    I will help you.” Isaiah 41:13

 Am I afraid? That is a big “yes” for things like I do not know what to expect from the infusions. Once I have my first infusion, I will be more comfortable with the second one. Generally, I have a high level of tolerance for pain, but I HATE to throw up, and I understand that I have a lot of that coming in the next 18 weeks.

I am not afraid of dying. I want to live, but only as many moments that God has planned for me. I heard this recently: “Ain’t nobody getting out of this world without dying!” I am confident in my relationship with Jesus Christ to say my last breath in this world will launch me into the presence of God.

***I promise to do my best to continue to publish these blog posts and not to wait for three weeks to send the next epistle in this blog.  

Round 3 Part 7

“When you come to a fork in the road, take it.” I have been a fan of Yogi Berra since I was 10 years old. His influence on me drove me to be a catcher. I loved that position because the catcher controls the whole team.  He is the only player on a baseball team who can see every player on his team without moving his head.

During the past couple of weeks, we have been facing a lot of forks in dealing with my third round of cancer. I say “we” because I would miserably fail in making the right decisions without Cheryl in my life. Our kids and their spouses have been troopers with this health challenge. They are changing their schedules to make sure that one of them drives (or flies) us to our appointments. And they are not just serving as drivers, they are participating in our discussions and asking hard pertinent questions.  

Allison, Cheryl and I came to a fork in the road this past week, and we took it. We have chosen Dr. Dung Shin of Emory to be our team leader. We had consultations with physicians at three different medical centers: Winship Cancer Center at Emory, Wake Forest Baptist Medical Center, and Fred Hutch Cancer Center at the University of Washington.

At our meeting on Tuesday, we decided to enroll me in a clinical trial at Emory. I will be having six infusions over an 18-week period. During the treatment Dr. Shin will be consulting with physicians from the other two medical centers.

In the past month we have dealt with 12 physicians about my cancer. None of these oncologists could help me with what would seem to be a minor issue to resolve. I have three places on the inside of my left gum where small pieces of bone have broken through the skin under my molars, and small pieces of sharp bone are rubbing against my tongue. Most of my oncologists agree that this is a problem that has roots in the proton therapy that I had in 2020.

My tongue makes hundreds of movements against my gum each day to the point where a lesion about the size of my fingernail has taken up residence. My dentist felt sorry for me and gave me a prescription for a bottle of Lidocaine. The medicine does just what you would expect—it temporarily deadens the skin, but the irritation and pain continue.

I have learned that when you are dealing with oncologists you can assume that for every ailment there is an assigned oncologist for that malady. We are praying the Lord sends the “right” physicians and other staff to work on our case.

After Dr. Shin and his nurse practitioner finished telling us about the clinical trial, we learned that I would be the first patient that Emory would work with on this treatment, and there will be about 116 participants from the USA.

We are not afraid even though there are a lot of things that we do not know about this clinical trial. Just a few weeks ago when we first learned that another round of cancer was well established in my neck and face, we proclaimed Joshua 1:9-10 as our battle cry. We know that this trial is not curative, but I will fight until the Lord lets me know that He is ready for me to transition to eternal life with Him.

P.S I will be posting updates and new information at this website:  www.jameslarrycox.com

Round 3 part 6

This trip to Seattle did not go as expected. After five hours of meeting with four physicians from the Fred Hutch Cancer Center at University of Washington, Cheryl, Jason and I came away disappointed that we did not get very far down the “Git ‘er done” road.

We had expected to get affirmation that would put me on a fast track with plans to get us ready to return to UW cancer center for treatment. That did not happen. We were impressed with the facilities, all the different types of treatments for my cancer, and with the facilities staff and medical staff.

But the physicians said that we should go back to Emory for another biopsy. Before any kind of treatment is specified, the physicians must compare the samples that were taken in 2020 with a good present sample.

What we do know:

·     I definitely have cancer in inaccessible places mostly at the base of my skull.

·     This cancer is causing all the pain in the left side of my face.

·     The cancer may be a different strain than the tests revealed in 2020.

·     Once our medical team knows more about my 2024 type of cancer, the physicians from Emory and UW will collaborate to recommend a treatment plan.

·     Any treatment is not curative, but palliative.

 The BEST thing we know is that God is in control, and His plan is perfect.

P.S. Kudos to anyone who has read this post to the end. I have talked with several people who regularly read my blog asking them if I should continue posting about my cancer experience, and all of them affirm that for the present I should continue writing about this journey.

Thank you to anyone who continues reading.

Round 3 part 5

Joy in Waiting

I just have not felt like composing another blog post these past two weeks. I look in the mirror and I don’t see anything on my face or neck that suggests cancer has spread across the left side. Of course, there is the scar that I have from my neck dissection in 2020. And a small scar located on my lower lip where a physician cut and stitched to pull my lower lip down and to keep me from chewing on it.

The procedure worked, but it also pulled my swollen cheek in such a way that I bite the cheek with my molars while eating. Sometimes I pinch my swollen face on the outside to pull the inner cheek away from those hungry grinders. My dentist gave me something that he said would block the inner cheek from the molars. Dentists use these triangular pads to protect the inner cheek while doing work on the molars. That got me excited because I have only eaten in a restaurant a few times over the past few months. I tried the pads at home a couple times, but I could not completely close my lips while chewing.

My dentist recommended that I see an oral surgeon about removing the scar tissue on my inner cheek. For a moment my dentist did not remember that I have greater health challenges to deal with. For about ten seconds after he talked about me taking care of the scar tissue, he said, “Well I suppose you better wait on the scar tissue because you have a more urgent problem to take care of first.”

Americans annually spend 37 billion hours waiting in line, according to the New York Times. Think about all the wasted time in traffic, supermarket waiting lines, pharmacies, doctors’ offices, traffic lights, etc.

Waiting is a part of everyone’s cancer experience. We cancer victims and our families, our friends, and our work colleagues dread the waits.

Waiting to find out if I have cancer felt like an endless cycle of anxiety and uncertainty. Each passing moment was heavy with what-ifs, as thoughts race through my mind, oscillating between hope and fear.  From previous experiences in a hospital waiting room with family or friends, I have learned that the silence of the waiting room seems to amplify worries, and every tick of the clock feels like a reminder of the unknown. I like to have family or friends waiting with me to give me company while waiting. But my wife knows me well. If a road is blocked by construction or a wreck, she knows that I will not give away 5 minutes of my life to wait. I am always looking for a detour. Granted some of the detours took longer than the original blocked road, but at least we were moving and we saw some awesome farms.

The waiting at home for lab results was just as difficult. I tried to stay busy or distract myself, but the weight of the situation lingered, shaping my thoughts and emotions. In those moments, I found myself grappling with questions about my life, my health, and what the immediate future might hold. I prayed for a good report, but braced for the worst.

Once my cancer was confirmed, my mind went into high-speed mode. I had already decided that I would not waste any time I had to live. My mission is to embrace life more fully as I walk with the Lord and serve Him and others in the name of Jesus.

After five years in Round 1 and after three years in Round 2 my medical teams respectively each told me that I was cancer-free.  I reflect on my current diagnosis as a reminder to appreciate and enjoy everyday moments.

Am I angry that I am now in the midst of my third bout with cancer? No. I trust God leading my life. I believe that all a person’s life is expressed by knowing some facts about the season we are presently in. Life is a series of seasons. Some seasons are short, and some are long. Some are just awful, and some are very positive.

Through these past two seasons of recovery from cancer and now during this third round of cancer, I focus on the recognition and expression of joy. My doctors have told me that this cancer is aggressive, and it will end my life. Who wants to be around someone who seeks pity because their cancer is terminal. That is not the path that I will pursue during this season.

I will be looking for opportunities to recognize and celebrate joy. Joy is all around us. We sense it in the sunrise and the full moon. Joy may be the deepest thing in the universe. And it may be a lot more important to our lives than we think it is.

Joy energizes. It’s for today, not someday. Over the past month, several members of my family and friends have come to visit Cheryl and me. With each of them I have tried to express optimism, humor, playfulness and stories. We shared stories of past adventures. We laughed as joy makes life feel more meaningful and even helps us cope with stress. Joy is the flip side of anger. I want my circle of family and friends to know that they can trust that God has a reason and a plan for us as we walk through the seasons of our lives. 

“Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day. For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all. So we fix our eyes not on what is seen, but on what is unseen, since what is seen is temporary, but what is unseen is eternal.” 2 Corinthians 4:16-18 NIV

Cancer Round 3 part 4

While we were arranging appointments for me this past week and getting my medical records together, I started practicing what I said I was going to do—living as if every day was my last instead of spending a lot of time thinking about dying. It’s been a great week. Dozens of text messages, lots of email, gobs of phone calls, and several cards in the mail came our way. Several of our kids and grandkids have come for visits. Our granddaughter, Emma, spent four days of her fall break at our home.

This past week we played cards and board games with the grandkids. We watched grandkids in their soccer games. We celebrated Jordan getting an internship with an accounting firm for her last semester in the spring. We rejoiced with Shelby getting her first job out of college with the Indiana Highway Patrol as a CSI. We prayed with Darby about her health challenges that kept her out of college this semester. Madelyn was home last week from New Orleans Seminary, and we enjoyed time with her. We attended Naomi’s volleyball game where she and the other seniors were recognized. We booked a vacation house for next summer on Lake Hartwell for all 27 of our family. Libby worked with me in my greenhouse. We celebrated two birthdays this past week. It has been an amazing week, and I expect each week will be just the same.

When I received the confirmation that my salivary gland cancer had popped up its ugly head up again, a retired cardiologist friend in southern California told me that I needed to go to the research/teaching hospital that had the best reputation for treating my kind of cancer. We started with what we already knew. I had two surgeries by our local ENT surgeon, and I was treated with proton therapy at Emory University for Round 2—the neck dissection and proton therapy for the high grade mucoepidermoid carcinoma in 2020. I am also being treated for Blepharospasm at the Emory Brain Center.

We wanted a second opinion, so a very good friend in Winston-Salem, NC, who is on the medical center board arranged for us to get an appointment quickly at Wake Forest Baptist Medical Center. We are grateful to the medical team we saw there as they were the first to actually see the cancer in an MRI.

God sent us an angel through our friends at Wake Forest Baptist. Dr. Ed is a retired chair of Radiation Oncology. He has taken a keen interest in my case and has done significant research, and he and other physician friends have informed us that the best place for us to go for treatment is the Fred Hutchinson Cancer Center at the University of Washington Medical Center in Seattle. I will have a biopsy done on November 6 at Emory as the physicians at UWMC need that to determine if they will use targeted therapy, immunotherapy or neutron therapy. UWMC has the only clinical neutron therapy system in the USA. 

Having three different bouts with cancer, here are some things I have learned:

1.       Get the facts about your cancer diagnosis. Ask questions. Take a family member with you. Information is power.

2.       None of the “coulda woulda shoulda” and more of “no regrets.” Don’t waste time worrying over what is already past. Live in the present and enjoy every day.

3.       Tell everyone who is interested that you have cancer. You do not want to walk this journey alone. The more people who know about your health challenge, the more people who will be praying for you.

The greatest lessons I have learned are from the encouragement, prayers, and shared Bible verses from family and friends. These have been the greatest prescriptions that I have received.

Cancer Round 3 Part 3

Terminal. Rare. Uncurable. Aggressive. Embedded.

Cheryl, Allison and I were in the room reserved for us at Emory Cancer Center to get reports from the scans that I had earlier in the day. We were told that our appointment would last 3-4 hours. We knew that we would be meeting with 2-3 oncologists after they had discussed my high grade mucoepidermoid carcinoma with a panel of other specialists.

I was diagnosed with my Cancer 2nd Round in October 2019. But in the examination room number 63 at the Emory Cancer Center, we were waiting for a prognosis. In a visit with our physician in North Carolina, he identified a tumor and showed us the abnormality on his pc. We were expecting the tests and scans that we had would reveal more information on how to deal with this tumor.

But sitting in room number 63 and waiting to hear from the panel of professionals, what we wanted to hear was statements like these: “We are certain that we can contain this cancer with immunotherapy.”  “We are recommending that you have proton therapy directed toward the area above the submandibular from the middle of your chin to the area in front of your left ear.” “The cancer is confined to a small area in front of the ear, and we have decided that the best course of action would be a gamma knife procedure.”

But we were not prepared to hear from my radiation oncologist that this cancer would bring to a finish my earthly life in a few months. Cheryl, Allison and I were in shock. Allison recovered quicker than her parents, and she asked several good questions.

As I was thinking how this could be true, the doctor left our room, and we all looked at each other with dismal expressions. You know how everyone at some time(s) imagines this scenario: you have been told that you have a few months to live, and you begin to think about what you will do differently during those months. I have played out that scenario at least a few times during my lifetime. But, sitting in room number 63, this was no imaginary scene. This was the real thing.

My first thoughts after hearing those words were about Cheryl, and they were trivial thoughts: How will she make it without me? There will be no one at home to welcome her when she has been grocery shopping. Who is she going to sit with in church? Who is going to hug her like I do?

Then my mind turned to thinking about the things I used to be able to do. In the past month my ability to work landscaping our yard or working in my greenhouse has gone from 4 hours to 15 minutes. I must stop and rest for 15 minutes before resuming my work. I thought about some plans that we have made  for the family that may not get fulfilled. The realization that I would be leaving my family and my friends. Then, my heart derailed the mind, and I decided to focus on improving the quality of my life instead of trying to prolong it. Get out of the mindset of dying and focus on living. 

My children all know that I am a fighter and some of them want to tell me, “Dad, you just can’t fix everything.” And I certainly cannot fix round 3 part 3. But I will look at what I can control and not what I cannot. I will focus on things worthy of my time and energy. I will continue my routine of listening to the Bible, spending time in prayer, walking, working, visiting with family, setting dates and events in the future to look forward to, and encouraging others.

“I have received full payment, and more. I am well supplied, having received from Epaphroditus the gifts you sent, a fragrant offering, a sacrifice acceptable and pleasing to God. And my God will supply every need of yours according to his riches in glory in Christ Jesus.” Philippians 4:18-19 ESV.

Cancer Round 3 part 2

Many friends reached out to me to respond to my “Cancer Round 3” post, and I am grateful for such an outpouring of encouragement and prayer.

Some said that I was being vulnerable, and I accept that because many people when diagnosed with some type of cancer do not even say the word “cancer.” I have heard some say the “C word” or “the big C.”

I truly am not afraid of the future for I know who holds my hand when I die and walk into God’s presence for eternity. But in this missive, I will go full disclosure and expose where I hurt.

First of all, I would leave behind Cheryl, the love of my life. We have walked through some challenging times living in difficult places overseas and in the states, but we have faced every challenge hand-in-hand, trusting in God’s leadership in our lives.

I know I may not live to see all our grandchildren launched after their high school experiences. With Naomi and Caleb graduating from high school next spring, we will have been a part of eight grandchildren finishing high school—that’s half of the grands. We love getting family together so much that Cheryl prepares lunch every Sunday, and we will have between 13 and 18 of our family eating lunch in our home. Sunday afternoons are a special time for playing games and learning what has happened in their lives during the past week. Some go to one of the bedrooms and take a nap, and some doze in a chair or on the sofa in our family room. But our home is a destination for all our family, and it is our joy to provide a safe and loving space for them.

I have a fear of lack of control. Once I heard the diagnosis from my doctor at Wake Forest Baptist Medical Center, my mind started working in warp speed. We have done this two times, so it will be easy. But the doctor went on to say that the tumor is imbedded in such a way that surgery is not a possibility. Then before he could say there is no chemo treatment because this cancer is so rare, my mind had already started focusing on what can I do or where do we go for more answers to questions that are unanswerable. My mind was spinning, and my heart was telling me to be calm.

I have a fear of the powerful treatments that will be proposed. The most pressing question for me is would there even be a treatment plan? If there were a choice, what would we choose. And the intensity of the treatments. What would the side effects be?

But I am an optimist. A friend who lives in Palm Springs, California, is a retired cardiologist. A month ago he gave me some advice. He said that I needed to choose an academic institution to treat what we suspected at that time to be some type of cancer. Last week I received a call from Emory Winship Cancer Center. They have scheduled a meeting on October 8th called Multi-Disciplinary Panel. The physician who led the team when I had proton therapy treatment at Emory is leading the panel of physicians who will review my diagnosis and possibly come up with a treatment plan.

Having another cancer season makes me love each day as if it is my last. I am more sensitive to loving on my family—especially the great hugs I get from all my grandkids and seeing them more regularly.

The greatest fear I experience every day is not about cancer. I fear that my actions, words, body language, or something that I write may not honor my Lord Jesus Christ.

And whatever you do, in word or deed, do everything in the name of the Lord Jesus, giving thanks to God the Father through him. Colossians 3:17

Cancer Round 3

After experiencing some strange symptoms such as facial paralysis and pain over a few months, in July a friend helped me get connected to a specialist at Wake Forest Baptist Medical Center. At my appointment this past week, the doctor diagnosed the problem and the radiologist confirmed it—cancer. The submandibular salivary gland cancer has manifested itself attached to the trigeminal nerve in the left side of my face.

In 2012 I had proton therapy to treat prostate cancer, and I have had no problem related to this cancer. In December 2019 I had two surgeries: one to remove the submandibular salivary gland and another to remove 19 lymph nodes. I had follow up proton therapy at Emory for six weeks. All has been well since I finished my treatments until the news this past week that the cancer had raised its ugly head once again.

This time around my Wake Forest doctor says that there is not a chemotherapy formula for this cancer since it is so rare. He will consult with my radiation oncologist at Emory to determine if my proton therapy treatment covered the area immediately above my mandibular. This doctor told us that once an area is radiated it cannot be radiated again. I have read some research that with newer and newer technologies, some medical experts have re-radiated certain areas such as the pelvic area and the head and neck. And, who knows? A chemo cocktail may have been used effectively in another medical facility.

The Lord knows me well. He knows that some lessons from Him must be repeated or given to me in bite-sized pieces.

In 2012, I had  first proton therapy treatment at the University of Florida’s Proton Therapy Center in Jacksonville at Shands Hospital. A friend let us use their beach house and we actually had a “radiation vacation” for those six weeks of treatments. We had the most relaxing and fun time during those six weeks.

In 2020, we chose to have proton therapy for submandibular salivary gland cancer at Emory’s new treatment center. The American Cancer Society provided a motel room for me to stay in Monday-Thursday nights while getting my daily treatments in downtown Atlanta.

Receiving a cancer diagnosis can be a profoundly life-altering experience, often bringing a sudden and intense awareness of one’s vulnerability. My first two cancer diagnoses each launched a long, emotional journey involving traumatic medical procedures, cycles of hospitalization and recovery, and then the fear of possible relapses and thinking about end-of-life care. 

The first proton therapy treatment was so easy that I did not think as much about my vulnerability. But, before I finished the treatments, one of my colleagues undergoing treatment passed away, and I began to realize that the treatments were not 100% guaranteed. In addition to the proton therapy the second treatment involved two surgeries including a neck dissection where they started the incision behind my left ear and cut along the line where the neck meets the shoulders. The incision continued to the right side of my trachea as the surgeons had to cut out the right side of my thyroid gland. After the surgery one of my family gave me a mirror to look at the incision. It looked like my head was attached to my body by a plethora of staples and those nasty-looking drains that were among the staples and stitches. The first look at that ugly incision made me realize that this was serious business.

The initial shock and fear can be overwhelming, as the reality of the diagnosis sets in and the future becomes uncertain. This moment often strips away the illusion of invincibility, revealing the fragility of life. It can lead to a deep introspection, where one grapples with feelings of fear, helplessness, and the need for support.

My family has walked alongside me during the first two bouts dealing with cancer, and they will be right beside me through this third challenge. But in the end the first two experiences drew me closer to God, and I expect this third journey to bring me even nearer to my Lord.

During the first two experiences I claimed Joshua 1:9 as my treatment verse, and I will claim it again for Cancer 3. But I will add another verse for this go round. Jeremiah 32:27 says, “Behold, I am the Lord, the God of all flesh. Is anything too hard for me?”

Body Language

I was giving some tips to one of our granddaughters today about being interviewed for a job. I talked primarily about the importance of body language.

After that phone call, my mind wandered across the years, and some interviews among the hundreds that I have had with prospective team members stood out. For example, the young lady who wore spiky heeled shoes that were obviously new and were rarely worn. She was obviously uncomfortable with the shoes as her feet fidgeted constantly.

I recall a young man who wore no sox to his job interview, and he crossed one leg over the other. I hired that young man and later told him: “Do not dress for the job you have but for the job you are pursuing.”

I have hired some people who were not the most qualified for the open position, but their chemistry matched that of our staff with whom the candidate would be working. 

The interview actually begins when you enter the building, greet the receptionist, and sit down in the waiting room. When I interviewed a candidate, before we began our conversation, I would take the interviewee around the office and introduce her to our staff. After the interview, I would ask our staff things like “Did you have a positive or negative reaction in your brief encounter with the candidate?” “Give me one positive remark and one negative remark about the applicant.”

Body language goes far deeper than fidgeting with your ring or pen, biting your lip, picking at a hang nail, crossing your legs or arms, letting your eyes wander around the room, or smelling like a perfume or cologne bottle.

Here’s my take on the importance of body language in a job interview:

First impressions matter, and your body language plays a crucial role in shaping whether that initial impression will be positive. Body language is more important than your resume or references.

In a job interview, body language is critical for making a good first impression and can have a big impact on the outcome. Aside from vocal responses, the way you present yourself physically reflects confidence, professionalism, and passion. Maintaining good posture, making eye contact, and giving a firm handshake can all indicate that you are engaged and prepared.

Negative body language, such as slouching, avoiding eye contact, or crossing your arms, may indicate apathy or insecurity. Overall, learning positive body language can help reinforce your qualifications and make you a more memorable candidate, complimenting the strengths emphasized in your resume and responses to the interviewer.

Dale Carnegie has penned a lot of good stuff about relationships, and the following quote from his book “How to Win Friends and Influence People” is good advice for not only a job interview, but for life.

“Become genuinely interested in other people.

Smile.

Be a good listener.

Make the other person feel important—and do it sincerely.

No matter what happens be yourself.”

Jim

New requests were coming in every week for vaccinations for cattle in the Diabo region of Burkina Faso (known as Upper Volta at that time). Phil was a Journeyman who was serving with us, but there was too much work for us to get around to all the requests. I decided to write a job request for an agriculturist to help us.

I carefully prepared the job description so that anyone with some farm experience could fill the request and come to help us. While Phil and I were in Ouagadougou to buy supplies, Phil dropped me off at the Post Office so I could call our office in the states.

Placing an international phone call was an ordeal. You had to stand in a long line of people, but thankfully not all of them were going to place an international call. When it was my time to give my call request, I asked the clerk for an international operator to call the USA. He told me to be seated in the chairs along the wall.

I took a seat along the wall per the clerk’s instructions. I watched as the clerk called out some names who were in front of me in the line, but also some people who were behind me in line. Since the line was still very long, I went to a window that sold stamps. I asked the clerk why some people who were behind me were getting to make their calls before me. He said, “We work hard in our positions, and you know that we do not get paid very much.”

I knew exactly what he was talking about: I did not tip the clerk for his hard work in getting me an international operator. In this case a tip meant a bribe. In all the years that we lived in West Africa, I never gave a bribe to anyone, and I was not going to start with this guy. So I sat down in my chair along the wall and waited another hour until the clerk told me to go to one the phone booths.

My call was finally connected. I learned that our company was going to send us a young man named Jim who had just completed his master’s degree in mechanical engineering. I was happy about Jim’s degrees in engineering, but I had to know if he had any farming experience. The consultant at our home office told me that Jim lived on a farm while growing up. That sounded even better than the engineering degrees. Someone who had grown up on a farm would be very valuable in our agricultural work.

When the day came for Jim to arrive, I drove to Ouagadougou to meet his flight and bring him to our home which was about a three-hour drive depending on the number of stops by soldiers or policemen. When we were settled in the Land Cruiser, I started asking Jim about his story. His dad had passed away while Jim was in college. His mom lived in northern Virginia. Jim had secured a job with General Dynamics in Texas, but he delayed starting to work so he could have a mission experience.

Finally, I asked Jim to tell me all about living on a farm while growing up. Jim did not immediately respond. There was such a silence that I wondered if he was not feeling well. Jim quietly said, “Well, I once visited my uncle’s farm in Canada.” I was stunned. I had high expectations of how this young man would contribute to our cattle, sheep and goats vaccination programs.

Fortunately, Jim was a fast and eager learner. On Jim’s inaugural trip to vaccinate some animals, he was surprised to see the corral which was made of thorn bushes that were piled up to create a circular “fence.” The corral was big enough to accommodate about 25 cows. We had no head gate or other corral equipment, just thorn bushes. Phil and I led two teams of helpers who would help us throw the cows down on their side and control the cow’s feet while Phil or I would render services to the cow. Every cow would be vaccinated, some would have a wound that needed attention and sometimes sutures while some males needed to be neutered.

Jim worked with me a while and then he would work with Phil. Early in the day I heard Phil laughing out loud. It was rare that you would hear Phil laugh out loud as he was a quiet, reserved young man. I hollered at Phil and asked what was so funny. Phil yelled back at me, “Jim just asked me what is the difference in a bull and a steer?”

Before the end of that day, our agricultural student worker not only understood the difference between a bull and a steer, but he also actually made a bull become a steer!

Despite my low expectations for Jim because he was not a real farmer, God had other plans for him. The four months that Jim worked with us in Burkina Faso solidified Jim’s calling to serve in international missions. After he completed his commitment to serve alongside us, he began his job in Texas, and he started taking some courses at Southwestern Baptist Seminary. He met Penni who would become his soul mate and the mother of his three children. Cheryl and I shared marriage counseling with them, and I led their wedding ceremony.

Jim and Penni and their family have been serving as workers in Central Asia for thirty years. Jim has been like a member of our family since he served alongside us in Burkina Faso. It has been a great joy to walk alongside this beautiful family as they have served God obediently and served others in the name of Jesus.