Julia Marsh reflects on how God's paradoxical and sometimes upside-down economy has worked in her life.

My work as a Consultant Oncologist is a major part of God's calling on my life and an important expression of service. I came to faith at the age of 18 as a first year medical student and my faith has shaped most aspects of my life. To live out my faith consistently has been a battle at times, as I'm sure it is for most of us. It's especially true once children come along and work responsibilities increase, with life always full on.

In March 2010, as an established consultant after ten years in post, I moved to fresh opportunities in a senior consultant role at a new institution. About five months later I was diagnosed with breast cancer at the age of 48. This came out of the blue and was a huge shock. It was complicated to deal with. Not least because of the nature of my own work in the field of cancer and my senior role in the same hospital in which I would need treatment.

I was well supported through the diagnosis and treatment by my husband, by those treating me and by a number of Christian friends. Even so, there were many struggles: the news was broken to me in a rather unintentionally clumsy way that haunted me for a long time afterwards. How did we tell our teenagers that mum has cancer? What about telling the rest of the family and colleagues locally, nationally, internationally? Some of them had to know I was unwell because of my involvement in various research activities. There were people at church who seemed to be avoiding me, unable to offer any words of comfort. There were others whom I hardly knew who felt entitled to discuss my illness with me because I had been mentioned in the corporate prayers.

From the time of diagnosis I had a strong sense of Jesus' presence with me. I was determined to try to walk well with him, learning whatever lessons there were to learn, trusting him for my future and for that of my family. Some people wanted to pray for my physical healing, and I was glad of such prayers. But I was not afraid of what the future might bring and was more concerned about what God wanted to do through this. How might he refine me? What impact would it have on others? It was hard to explain to well-meaning Christian friends that actually the real struggle was inside and that, at least for me, the spiritual aspects of this cancer journey were profound.

Struggling with brokenness

I was fortunate to need only surgery and radiotherapy (no chemotherapy). So the physical treatments were fairly straightforward. However, during the radiotherapy I felt increasingly unwell and really began to struggle emotionally. I became overwhelmed by feelings of distress and pain and the sense of my own physical and emotional strength having been stripped right away. As the pain eased, it evolved into a feeling of being completely broken. I did not know how I would ever be able to return to my work, which requires considerable emotional strength in supporting patients experiencing their own cancer diagnosis and treatment. I prayed continually for God's help and healing in this area, asking him to shape the way forward. Healing came only slowly, helped by professional counselling.

It was hard to understand why I felt so broken. For a while, despite feeling the reassurance of his presence, God seemed silent. The only answers to my prayers seemed to be 'The righteous shall live by his faith' 1 and 'My grace is sufficient for you, for my power is made perfect in weakness'. (2) Getting back to my work with cancer patients seemed too hard. But I was reminded of Jesus in the garden of Gethsemane, choosing to be obedient to God's will, however difficult that would be. Choosing to trust Jesus and to be willing to go with him back into a working environment where everything revolved around cancer was an important step.

Healing through brokenness

The feeling of brokenness began to make some sense a little later when, reading the story of the feeding of the five thousand, (3) I was reminded that Jesus took the bread, offered it to his Father and broke it. It was the broken pieces that were used to feed the hungry people. Later, on Easter Sunday we were taking Holy Communion and I was struck by similar words: Jesus took bread, gave thanks and broke it. 4 The bread, his body, was broken; the forgiveness and healing for us comes from his brokenness. Maybe sometimes our Father allows us to be broken too in order that those broken pieces can be used for his purposes.

My own 'broken pieces' remind me that when I give the news of a cancer diagnosis, I must take care to do it gently and with care in order not to increase the burden. When I see patients or families struggling to know how to tell relatives and friends of a diagnosis, I must listen and reassure. I need to be sure that I am appropriate in my own interaction with others who are struggling, whether in the context of home or work. I need to show acceptance of those who are distressed even if it's not really clear to me why things are so difficult for them; I need to do my best to ensure that spiritual care is available to the patients and families I care for when needed, and that the gospel is accessible to those who want to hear. Above all I learned the need to remain completely dependent on Jesus and to be content to live out the paradox that it is when we are weak that we are strong.

Learning from brokenness

Looking back, there is a strong sense that in all this, God has worked for good. 5 Especially I have learned that his grace is sufficient and that there can be great strength in weakness. 6 During my illness I had more time than usual at my disposal to read the Bible regularly, to pray and to read Christian books. My journey of understanding and spiritual growth has continued and has been helped since by involvement in the Alpha course at our church and a Growing Leaders course.

I was able to return to work in a phased way and to manage the challenging emotional aspects of this with time. Quite quickly I took on new senior management responsibilities. I found myself facing the most challenging of work situations which seemed to test every aspect of character and integrity. The lessons learned during my illness that God's grace is sufficient and that we can trust him completely were very important during that period.

So did my illness result in triumph or disaster, success or failure? I would never have chosen the experience, but neither would I turn the clock back now. In reality it brought both. The experience was hugely painful and difficult, but yet the lessons learned are extremely valuable and go on having an impact in the way I am in my workplace, my home and my church. I am thankful for the spiritual growth it has produced and for the increasing sense of journeying with Jesus in the everyday. I am free of the shame brought on by my sense of brokenness. But I am also humbled, released perhaps from some of the inevitable pride I would tend to take in my role and position.

Julia Marsh is a paediatric oncologist in London. This article was inspired by talks at the CMF London & South East Conference, 2013.