As days become week, and weeks, month, and months year, the angering for your life lingers. As days become week, and weeks, months and months year, memories of you, and echoes of Osodieme, lingers still. Days will be weeks and weeks will be months and months will be years, yet what will become of all this anger, the memories, the echoes of you that continue to draw air on their own, as if life has barely moved, as if death nourishes us still. Your cervix may have won this time, but we are up fighting as nothing else matters.
Keep 4 girls and women with ending cervical cancer!
Each day, nearly 28 women die from cervical cancer in Nigeria. Angela Akumuo, my sister-in law, was one of them in the summer of 2021. She was 53 years old. Her death, like those of many women who continue to die from cervical cancer in Nigeria and globally, could have been prevented. It was also discovered late. She lived in pain for years, and died within 3 months of finally opening up about her illness. There are so many effective evidence-based tools to prevent, diagnose or treat cervical cancer. Research too, with the field of dissemination and implementation science, my chosen field of study. Yet, why are women, like my sister in-law, in the prime of their lives, still dying from cervical cancer in Africa?
Look at the state of cervical cancer in Nigeria and many other African countries and you’ll understand. With an estimated population of 206 million individuals, Nigeria has over 56 million women aged 15 years and above who are at risk of developing cervical cancer. Most cases of cervical cancer are caused by human papillomavirus, with 67% attributed to HPV 16 and 18. As a result, the government recommends screening for cervical cancer from aged 30. Young girls and women are recommended to get vaccinated as well from age 9. Yet less that 10% of eligible women are screened and 14% of girls are vaccinated. Is it any wonder that cervical cancer remains the second most common cancer among women in Nigeria, also one of the most preventable?
In 2020, nearly three years ago, the World Health Organization (WHO) and 194 countries, pledged for the first time to eliminate cervical cancer by pursing three key steps: vaccination, screening and treatment. A recent costing exercise by WHO for the Nigerian government’s strategic plan on prevention and control of cervical cancer estimated that $18.1 million will be needed to fully immunize Nigerian girls at $3.98 per girl aged 9-13 years, $919 million will be needed to provide 24.8 million screening services and 2.2 million pre-cancer treatments, while $59 million will be required for cancer diagnosis, treatment and palliative care. Right now, Nigeria dedicates 5.75 percent of its budget to health with about N81 billion naira (roughly $100 million dollars) to health care services, all of which are insufficient to help the country reach its global goals for cervical cancer elimination by 2030. The cost of vaccination, screening and treatment remains an obstacle for many Nigerian women and girls. So, it’s no surprise then that Nigerian researchers and key stakeholders are turning back to Nigerians themselves to find innovative ways to lead the national response to eliminate cervical cancer.
Enter For girls and women by girls and women. This new crowdsourcing program led by myself and researchers at the Nigerian Institute of Medical Research led by Dr. Oliver Ezechi and the University of North Carolina, Chapel Hill, led by Dr. Joseph Tucker, is the latest from our, for youth by youth group, that has spent the past five years working to promote HIV self-testing with Nigerian youths themselves using crowdsourcing open calls, 48-hours designathons, month-long innovation boot camps and subsequent implementation of finalist programs in community settings. Crowdsourcing allows large number of people to become involved and engaged in developing solutions to health issues. Our program, now in its fifth year, boldly displays how Nigerian youth themselves can be partners and leaders with HIV prevention interventions and not just beneficiaries of interventions designed by researchers alone. Interventions created by the group, has led to an increase in HIV self-testing from 29% at baseline to 90% at 3 months follow.
We are striving to repeat the same success but this time with HPV vaccination among girls and HPV screening among their mothers or female caregivers. We know that the thought of cervical cancer may strike fear in people’s heart, producing a deep sense of powerlessness. But it is possible to act against it by partnering with us to lead the design and implementation of HPV campaigns, particularly HPV vaccination of young girls and HPV screening of eligible women. Our crowdsourcing open calls will be launched in Nigeria this January and it is our hope that through our program goals, Nigerian girls and women can become prime leaders in designing, implementing and evaluating interventions that increase uptake of HPV vaccinations and HPV screening, while eliminating cervical cancer as we know it.
Angela Akunmo may have died from a disease so preventable. However, through the launch of the crowdsourcing open calls for HPV campaigns for girls and women by girls and women, her death will not be in vain.
Keep what you see!
‘What you see is what you are and what you will become.’ Ben Okri said it best in his book ‘Astonishing the Gods.’ These days, what I am seeing is beyond me. They are truly wonderful things. Things that make one’s heart full. My heart is indeed full. I tried to dwell on it over the weekend. I’m still trying. Words fail me but know that I am grateful. January is cervical cancer awareness month and I get to launch a project that is near and dear to my heart in Nigeria tomorrow. I saw the project immediately cervical cancer came knocking at my door. In fact, I wrote the first version and submitted it before I knew how deep it would bury itself in our home. It buried itself and we are finally making sense of the journey ahead. Which is why I am all for those prepared to go on the journey. This isn’t a favor. Lord knows anyone around me isn’t doing me a favor. Know you came into my life. In situations where it is the reverse, know that my addition to your life is always for good. So whatever you see is me, is what we shall become. I will continue the journey with or without you. I know who started it and I know he will lead me all the way. Keep what you see!
Keep dreams that are bigger than you!
What I am carrying is mighty? I am carrying dreams that are bigger than me. I am learning that everyday. It also takes time. Nothing happens by accident. Even the good news I shared yesterday, first has to go through failure for success to become ours. I am learning to be patient with time. The me of before, the one that rushed into grant writing early, was so anxious and ready to get any that I just wrote and wrote and failed and failed. It should never be that way. Didn’t I have any mentors, a dear friend of mine once asked? Why did you write all those grants and kept failing but still kept writing?
Honestly, I was eager to learn? I knew that this business of writing grants was full of rejections. My very first grant was initially rejected before it became successful. So I know too that to get one, you have to fail. What I didn’t know was that I would fail so many times and yes I had mentors? I just thought I was on to something and if only reviewers believed in me like I believed in myself, than that something would be the greatest work ever. It has taken years and learning past failure to know that truly, what works is a vision, a story.
Ideas are plenty. I get them everyday. I have many that failed. What is necessary is your will to endure all that comes with the ideas and may your endurance be bigger than you imagine. Yesterday’s success was a difficult grant to write. We initially wanted to keep it simple, but our local leader pushed and pushed us to go big or go home. I initially refused and then bought into his vision reluctantly. It’s his field and I thought all I was doing was helping him visualize how far we would take it.
What I didn’t know at that time, was that cervical cancer had buried its roots in our home. We initially submitted the first version of the grant June 4th 2021. I got the news of my sister in-law’s illness, something we thought was just minor on June 5th. That was the day I knew what our leader had been warning us about all these years. He always said cervical cancer was a problem. I said ok, but didn’t know the extent. But on June 5th, my world changed. I moved from anger to fury to denial and anger, wishing and praying that this was a bad dream. We tried everything. In the end, everything we did was not enough.
So I continued to do what I knew how to do best, write grants so no woman would die from cervical cancer again. As we begin, this new research, I am leaving this year to remind myself to never forget to dream and dream big. None of this is possible without a dream, and a story to propel you though what may be a tough writing experience. Those grants I failed, they were always well written, but lacked vision and ways to become impactful. I am learning that everyday. The need to move past failures to spaces where dreams soar. Those bigger than you. It’s my keep for today.
Keep for girls and women by girls and women!
I said I wasn’t going to cry. Said I would be strong as we still have miles to go. I have typed and retyped what I would say when a day like today arrives and honestly I stand in awe. To think that the news of our victory came on 9-22-22 keeps me numb. Thank you Angie for fighting in heaven for this one. Thank you for letting it be known that death does not have to have the final say. To be in this work is rough. Tough too. There has been days and nights in which all is given and nothing is received in return. But then I remember Chinua Achebe’s word, his reminder that until the lions have their own historians, the story of the hunt will only glorify hunter. So then I set out to be a lion. Set out because your death was overpowering. Your living too. But your death continues to haunt me.
I have been haunted by how it all transpired, haunted by the fact that we had no idea until it was too late. Years of figuring out the public’s health meant that I couldn’t even use all my knowledge to save my loved one’s life. So I have been trying to figure out how we lost our way. When did it become all about health and not enough about the public. I first discovered what was killing you when it was too late. You were not able to walk. Not able to talk in the last days and nights of your life. We couldn’t even get you on the plane to travel from Jos to Lagos as your condition was to dire to take chances. We still did. Living, we figured, was far better than dying. Everyone pitched in where they could. Bathed you and fed you. Prayed over you and anointed you when the end seemed so close. We all kept wondering and asking why and how and why and how only to end up with a grave that now belongs to us. We have been having a very hard time adjusting to your death. An equally hard time with the absence of your being. Your voice still echoes in my minds. All the things you called me, like Osodieme. We still vividly recall mama screaming and crying as she watched her only daughter die while she lived. Still hear her questions and wondering if we had any idea that you were dying. We did and we tried everything was all we could mutter. Afraid she would die too, we kept all this from her until the last week you both had together. Here was a woman who brought you to this world. Now she watched you die, wishing she was the one dying and not you.
These are all the things that have played in our head and minds since cervical cancer came to our door. You have taken us back to ourselves, back to all we know, just so we stand fierce and ready to do the battle necessary. I expect us to struggle. We are lions and the history of the hunt has never been in our favor. But we will tell our story one day, share of all the ways we struggled and all the ways we triumphed, just so no other woman dies from cervical cancer. We have kept moments of silence, done due diligence to your sunset, just so your sunrise will remain sterling again. This is the start of your sunrise and from today, may your story, like you, be fierce and ferocious as we bear witness to voices silenced, yet triumphant, those prepared to live and begin again, beyond their cervix, beyond the thing that tried to silence them forever. It failed. We are living proof. Beyond our fury, for girls and women by girls and women are all the ways your light shines past your death. We stand in awe.
Keep simple things!
Nobody gave her anything. Not the one she loved. Not the ones that loved her. Not even the ones she confided in, all things great, all things small. And so she sailed through life. Not giving. Not laying it all down. Not showing how she endured and endured until her last breath when her cervix got the final world. It did.
Keep notes to Angi’s cervix or cervical cancer!
In a little over a year, now, our life as we knew it came tumbling down. We called her Angie or Angi and to know her was to know life. I am reminded again, that death should never have the final say. Not when those alive can continue the story of a live well lived. One that became a blessing, a symbol of persistence, and collaboration laced with empathy, though the pain of loss of her physical presence lingers. Since her death, I have been writing notes to her. I wrote other things too, like grants and stories and everything that would enable the pain to lessen. Yesterday, I submitted the 4th grant in her memory.
Cervical cancer came knocking furiously at my door in the summer of 2021 and since then I have been answering the call. Two things are clear to me: No woman should die from cervical cancer. And we must eliminate it period. It helps that there are polices for elimination. The 90-70-90 strategy for example which calls for 90% of girls vaccinated, 70% of women screened and 90% of women with positive results linked to treatment. The fact that such a policy with evidence-based tools exists infuriates me. The fact that we also know what to do about cervical cancer also makes me angry. Her death could have been prevented. I get it now. It’s the reason why I keep writing anything that would make her living more memorable.
I personally bear responsibility for her death, blame too. I could have asked more questions, checked in more often and maybe, she would have disclosed this in passing. I will never know why she kept this as a secret, not just from me but her mother. I will never know why she didn’t trust the health system long enough to truly take all the symptoms she was experiencing seriously. I only have questions, many that I know I will never have answers for now that she is gone. But for tomorrow and, beyond, I am willing to begin with trust, will to begin with listening, willing to learn and hopefully willing to work with any one to lead a concrete and path-breaking strategy focused on cervical cancer elimination. I expect the struggle to come. Many have warned us of it. But I close with this, at least generations will know we struggled, we did it our way too, so no woman would die from something so preventable. I have been dreading writing anything on the one year anniversary of your passing Angi. Dreading it because I’ll rather hear you say my name or ask about the kids or just simply chat about makeup or anything else your heart desires. So these little notes are all I have with the hope that someday, someone will asked how you died and I will be quick to say, ooh but you lived. You lived.
Note on desire:
A long desire. To see and be. Another encounter. Longer than the first. Two eyes locked. Or lips talked. These notes are for you. Though dead but living. Something tried. Your cervix, a thing. Follow its form. Learn it’s lines. Then see you. It takes a long time to see. Even longer to be.
Note on Something so small:
They need to know your name. Not the way you died. Not the cervix that caused you to die. Not the pain we fail to hide. Not the tears we still shed inside. About how something so small, can kill an Angel with all its might.
Note on Seed:
I will find you again. Not like a stalk , but a seed. Death is undeserving of you. Life resembles a birds foot. Only that we chose to soar, choose to fly above the pain your cervix caused. We know pain. But we also know life. And return to you not with fury, but with force, not when your death planted this seed.
Note on She lived:
I imagine someone will ask one day, how did Angi die? I will remind them again, of how she lived. How in life, she personified all our hopes and vision. For a better recognition of what the public envisions. For their health, like their life. We will neither reject nor denounce her cervix. Not when it reminds us to be careful. Reminds us to remember the power of endless beginnings. Reminds us to bear a responsibility to something. Or one day someone will ask the same question, wanting to know too, how we died or lived.
Keep running in rain!
She said to me, Isioma, we have a problem. It’s been 15 months since these words were first uttered to me. I still remember them like yesterday. With all the pain those words caused, with all the anger and despair, we have been told only time will heal. Or trying running now and then. So I did. Today a perfect blue sky, the lightest of the color blue, glided my way as I ran through the pain of losing Angie to cervical cancer.
An innocent peace flooded my heart too. This run, something I haven’t done in awhile, was the gift I needed today. I thank the heavens for opening up. Rain, the softest of drops, fell along the way, as flowers, in perfect pink colors greeted my way. I fell into a trance and listen to the queen remind me of the spirit within. I listened and watched the heavens open, surely as rain turned to tears.
The past year has been trying. Cries, led to change, which led to moving on as if death had the final say always. Within my grief, I let words lead, some I never knew was within me, some I remain in awe off. Either way, a year of grief, is slowing turning around, slowly plowing our fears, even our audacious dreams, into change I never expected. Beyond your death, beyond your cervix that had the last word, beyond even these words I write, know that you will live. Angie, you will live and as sure as I run through this rain, so shall this pain, turn around for good. Your life, even in death, will be a gift to many.
Keep Osodieme or a word now gone due to cervical cancer!
Her story, like many, are untold. Her pain, unknown. Her cervix, unforgettable. But her death, free.
Think of the depths she took. Think of the blood she hid. Think of the control she fought. Then think of the words unspoken.
Lusting for life, she only spoke to friends. Insisting her cervix was a private affair. Her bleeding, common. Her pain, of strong purpose. With an extraordinary will to survive. She hid it all, even from her mother. Then think of the fears unnamed. See the pain unnameable.
We called her Angie. The one who held us together. Who spoke of things being alright. While she walked around quietly in pain. But underneath, she was stronger than leaves of palm trees. Brittle, but wiser than tapped wines of palms. When you taste her, you taste joy that lingers for six hours. When you feel her, you feel love that lasts from dawn to dusk.
I still hear her calling my name. Still hear her saying, Osodieme. Osodieme. Osodieme, with a smile that remains buried deeply. Tears still flow. Words remain unspoken. For pain unknown, and fears unnamed. Anger still spills over the purple embroidery clothes so soft to hold, she once made for me, now persevered like fine pearls.
Those who live good lives find peace and rest in death. Was she not good enough? Like rain falling from the sky. Was she too hard, like drops on window pane? Or was she just dark like grey skies amidst heavy rain? Nothing and no one at all was there for her cervix. Within three months of poking at her cervix. Three months of energy slowly disappearing. Our angel was gone.
It’s been eight months of hell. The pain in her mother’s eyes unknown. Her fears too unnamed. We live with nothing but storms in place of words we long to hear, Osodieme.
I am looking over the prayers she shared last Easter. Keeping them here for I so miss her and truly sad that I won’t get her prayers anymore.
Really the children are having fun. Thank God for them.Everyone of them are looking fantastic. Happy Easter to you all. (2021)
He has risen and has taken away every of our affliction away in Jesus name Amen. Have a wonderful celebration. (2020)
Keep stories with implementation science and cancer research in Africa.
I presented at the 2021 AORTIC Cancer research in Africa. There was a pre-conference the past two days and I was asked to lead this morning with a discussion on why implementation science research for cancer in Africa. What many people do not know was that the invitation which came July 12, came exactly one month before my sister in law passed August 12. I took it as her parting gift. She knows I love to talk. She also knows that I do research, implementation science research in Africa. But I have never done Cancer work. Never even felt it was my place to do so until her cervical cancer came knocking at our door steps. The preparation for the presentation has been one giant healing process for me. I literally wrote poetry, yea or maybe verses on ways to disseminate cervical cancer research using her experience as an entry point. I was so tempted to do so at the presentation that I opted out last minute. Not because I don’t think they were great and I will publish them here one day, but more because ours is still a very conservative field and the idea of decolonizing how we present research or even saying anything anti racism scares people, though I am working on verses for research. But I digress. For now, here is the standard presentation I gave and yes, I gave it in her memory as stories still, to help guide those who want to fight like hell so we don’t have to tell anymore stories like Angie’s.
I know we have heard a lot about implementation science the past couple of days, with a lot of talks about what it is and how to do, but let me paint another picture if I may of why this matter for the region.
So I am an implementation researcher, interested in how you sustain evidence-based interventions in resource-limited settings.
I am also a storyteller.
I grew up in Lagos, Nigeria, with a show called Tales by moonlight which is similar to what griots do in many other African settings, and so stories are all I know, and it was refreshing to hear Dr, Eche tell his implementation story these past few days. I think we heard yesterday for example, that policymakers respond to data, I agree.
As someone who used to work in the UN, I would also add that policymakers respond to stories, especially stories about data, stories about what works or doesn’t work, even stories about the constituents they serve. So let me tell you a story If I may of why implementation science matters for cancer research in Africa
And I want to begin from with the story of Angie. Angie, a 53-year-old woman, as is typical in most African countries, presented in the clinic with stage 4 cervical cancer.
There were no warning signs, or least when she saw some, she didn’t take it seriously. She never had pap smear in her life until she presented. She didn’t even have any access to universal health care insurance.
Only reason she presented actually, was because she couldn’t eat anymore, and felt something was obstructing her ability to eat, and was seeing blood in her stool. Angie’s story is typical in many African settings, and in particular for understanding why context matters for implementation science cancer research in the sub-Saharan Africa.
And to illustrate that a bit, I allow me to use some analogies. In our settings, analogies are like proverbs, they are like miniature tales, building blocks if you like in simple form of ways that the field can proceed.
This recent paper by Haines in implementation science describes context as a fabric. A blue fabric in this case, and just as embroiderers must first understand the fabric they are working with, researchers and practitioners of implementation science must obtain an understanding of the context in which they work in before selecting or adapting an intervention or any implementation strategy.
The red needle in this case represents the implementation strategies and thread is the intervention you may have in mind, and all of that have to be in harmony with the context in which you find yourself in.
I really like this paper, but let me address context in another way. Enter Yucca which many of us in Africa, may know as Cassava.
But if you traveled to South America, it is called yucca and it is used to make empanada, yucca fritters or yucca chips. Now this same tuber, if you come to my home country of Nigeria, can be found in local dishes such as Abacha, or what the Igbos’s call African salad, or eba and soup, eba being a typical Yoruba dish, or quite simply garri and groundnut, something we all eat in Nigeria as a favorite meal.
I use Yucca and Cassava here to illustrate again context matters. It the same tuber, but if you went to South America, its used differently, if you come to Nigeria, even within one country, it is also used differently. Context, like all the stories we will tell with implementation science it matters.
Another reason why context matters is that, the past couple of days was spent on ideas of what works with implementations, the how to do it literature of implementation science, and to all of that I want to add one thing that was missing and is this idea of starting with Why. And So for implementation science in the region, always start with why.
And if we stayed with cervical cancer, Remember to start with why for something so preventable and treatable, Remember to start with why for something where one in four women will die, unless they have access to life saving evidence-based therapies that exisit. Remember to start with why with resolutions that exist, the historic 90-70-90 resolution last year for example which calls the 194 member states of the World Health Organization (WHO) to achieve specific targets by 2030. Resolutions like this are actually fertile grounds and justification for implementation science in the region.And when you start with Why, you will find out that implementation science is an open and inclusive field that basically means workings not only within the context you find yourself in, but also broadening your collaborators, to include working with multiple experts and non-experts that you can work with to expand the field.
And as you do, as you pick out which outcomes, or frameworks or strategies you will use, be prepared to optimize them for your context. Many of them will not fit ERIC, storytelling isn’t in ERIC as an implementation strategy and that’s ok.
I say go for what works for you, let all that was shared these past few days be a guide, so long as you remember your why and that your context matters. This is the time to begin to galvanize efforts to decolonize even all we know with implementation science and just because it has been done in the West doesn’t meant it has to be in your setting.
In addition, and if we stay with decolonizing the field, also maintain what you know works in your setting, in your context.
You live there, so you know it better than any expert that may come to your setting. So harness that knowledge, it is just as vital as whatever knowledge you will bring from IS to your context.
And finally, be prepared to evolve. Change is evitable, CoVID 19 being a great example Of the need for example to embrace disruptions. Embrace whatever struggles you come across as you evolve. That and be open to other ideas, like the idea of health or implementation science occurring beyond a Western Paradigm.
Professor Collins Airhihenbuwa, my mentor, over 30 years ago, developed a framework called the PEN-3 cultural model, which helps to situate some of the work many of us do in the region, and it asks that we begin always by interrogating what is positive about our context, what is existential or unique about where we find ourselves, and then ultimately what are the hurdles, or challenges to be mindful of along the way, and for me the past few days of listening in, has allowed me to see first-hand, that the leadership within Aortic, in fact all they have done with setting up this conference, is the right start for tackling cancer research in the region.
I wholeheartedly believe that AORTIC is going to be a great resource and leader for anyone in the region try to navigate the rugged complexity landscapes of doing implementation science research in the Africa. And the stories we will tell, for example with the Aortic implementation science special interest group will be the escort that propels the field forward in the region. It’s your story that will convey all our gains, all our failures, and all we hold dear, or should condemn or de-implement for example with implementation science in the region.
So finally as you think through context, one thing I want to emphasize is that we all get into the habit of doing is rapid cycles of what will work or not work in our setting. Some of the speakers, Donna Shelley for example, talked about rapid cycle evaluations. The response to the COVID pandemic has been one massive rapid cycle evaluation, that I believe everyone trying to do work in the region should seize upon because the tools for cancer, whether with prevention or treatment exists and have been in existence for decades yet they continue to remain out of reach to the people who need it the most.
This idea of making a plan, then doing, then studying, then acting, or making another plan will do the field well and help save lives now. If you choose to move in this direction, let me stay in the issue of just planning and tie it squarely to the issue of sustainability. I believe that it is unethical for people to implement interventions in regions with limited resources without even a simple plan on how you last.
Most of the research you will come across implemented in the region, are never sustained. This paper for example by Johnson et al on NIH R01 grants in general with an implementation science focus found that none had plans to last.
We found the same thing in a systematic review I led, about 5 years ago about the sustainability of research in the region. We also noted that if you are going to come do any implementation science work in the region, the least you can do is plan to last.
It should not be done in the end, not even in the begin, but throughout the lifecycle of whatever interventions you have in mind. Having a plan, can be as simple as gathering the right stakeholders to work with, learning from them, be willing to change or adapt along the way, while nurturing what truly matters in within the context in which you find yourself.
And so in recap, I loudly and enthusiastically appeal to the group to come do implementation science work in the region particularly with cancer, and as you do, with whatever frameworks or strategies you use, plan, plan, plan to last.
Thank you to the organizers of this conference for allowing me to speak, Drs. Odedina, Alaro, Bello, I thank you for the invitation. Your invitation came at a time when my family was dealing with the stage 4 cervical cancer burden of Angie my Sister in-law. We lost her to cervical cancer this past August 12th. But I give this presentation in her memory for the many other Angies we all have to fight like hell for, so they live, in a region where context matters. Implementation science needs more storytellers and I hope that AORTIC works to cultivate the next generation of storytellers truly making a difference in word and deed for cancer research in the region.
Keep asking questions!
Maybe we should have talked more often. I should have asked more questions too. Not just hello, or how are you or Ke maka Di gi, or Chekwube? But have you checked your cervix lately? When was the last time you checked? Did you collect the sample by your self? What did the results say? Why are you still bleeding then? Fibroids will not cause you to bleed this long. Treatments are deficient, I know, but what did the doctor say? It’s a developing country and cancer is a death sentence. Maybe, just maybe if I had asked these questions always, all the time, then maybe Angie would still be here. We would have found out early. Angie, would still be calling me, my name, Osodieme. Check your cervix, for Angie. For me.
Keep welcoming mama home!
Mama returned home today. About two months after the greatest heart-wrenching ordeal, the longest mutterings of sorrow, of hearts completely in despair. Our hearts are still broken, still shattered in pieces. But seeing the glimmer in her eyes, made it clear; we would get through this deepest darkness. And the darkness is so deep, still so raw, and still so full of pain, as if we lost Angie yesterday. Nothing will ever change all we know. That Angie should be here. That her death shouldn’t be. That her living is all we know, all we hoped for, all we still long for. To know death, is to know a longing that time still can’t heal.
We’ve contemplated why her fire dimmed, asked how we missed the signs, wondered when we will ever meet. I still have plenty unanswered questions for her. The valleys of our pain, to feel it, to know this emptiness skillfully threading around our edges, is to know the bottom of a well, so deep, so hollow.
We know there is light above. We see it, feel it even, but here in this darkness lies our pain, our sorrow for a life gone too soon. They call it cancer, we call it, a dying sun, contemplating even why a sun dies too. We are still in mourning, burning with passion for a new morning, one where we will gloriously lift our selves from this sorrow. Lotanna made a card, to welcome mama home. She decorated it with pink crinkled paper flowers and blue ribbons. It made mama smile. We are all sorry about Angie. We all welcomed mama home.