This Is Why - Nathan Goates

In April of 2008 I went for a bike ride. I’d had a rough day. An emotional day. I needed a release.


My six year-old daughter was a patient at the Children’s Hospital of Philadelphia. We were prepping her for a bone marrow transplant. Trying to save her life. Or that was the narrative.

When seen from a distance, it’s an easy narrative. Kid is sick. Kid goes to the hospital. Kid has a procedure. Kid recovers. Kid comes home.

But the easy narrative arch that distance affords is far from the lived experience. The lived experience is excruciating.

Imagine this, for instance: As parents, you’re weighing the decision to treat your daughter’s unnamed illness by bone marrow transplant. You’re told, by the appropriately credentialed authorities, that if you opt for the transplant, there’s about a 33 percent chance your child’s health will improve substantially, there’s about a 33 percent chance that she will experience no real improvement, and there’s about a 33 percent chance your child will die from complications. How does a parent make such a decision? How does anyone make such a decision on behalf of another human being?

Or this: Having chosen transplant as the treatment option, you watch as the “medicine” slowly weakens her, takes her energy, her hair, her pep. Because the reality of the thing is that to prep her tiny body—a body which has been its own worst enemy thus far—for this potentially life-saving treatment, we’ve got to weaken it to something that looks very near death. It’s part of the protocol. It’s called treatment, but it feels like something very different. And then there are surgeries for PICC lines. And delays for fevers because of worrisome infections. And really a hundred small tortures en route to this thing call “treatment.”

It was in the midst of all this, on a lovely spring day in 2008, that I went for a bike ride.


I’m not from Philadelphia. At the time, I didn’t know the roads well. I was told there was a trail that followed the river northwest out of the city. I found the trail, but as it dissolved into the city streets of Manayunk I lost my way. Wandering around I saw another rider, who I followed, and we began to talk. First, of directions. He was going where I wanted to go, I could just ride along with him. Next, of other things. Noting that I was unfamiliar with the area, he wondered if I was new to town. I explained why we were there. I explained that it was a rather hard day. I explained that I needed a moment to myself, to get out, to sweat, to ride my bike. I found it was easy to talk. I felt like maybe I shouldn’t, but I also needed to. I couldn’t help it. I needed to unload.

The next day, a care package arrived at my daughter’s room. Cookies.

It turned out this random bicycle commuter I’d met the day before was a physician. He worked at the children’s hospital. I’d given him just enough details for him to figure out who my daughter’s oncologist must be. He got in touch. He shared the story. He didn’t know my name (and didn’t ask; you know, HIPAA). But he left the package with our doctor and our doctor did the rest.

Treating cancer is an expensive enterprise. It seems impossibly expensive. And I’m so thankful for the avenues of funding that developed the procedures, medications, treatments, facilities, and expertise that allows for its treatment. Cancer is a betrayal. A cellular uprising. We may treat the betrayal by quelling the uprising, but the effect of the cellular treachery transcends the corporal and wounds the soul, as betrayals do. Wounded souls also require treatment.

During the months and years of watching our daughter descend into illness and then, slowly, miraculously, climb out, our souls were wounded by a thousand small daggers. But these weren’t left unattended. By countless acts of kindness and compassion of family, friends, and strangers—like a bicycle-commuting physician to whom I just happened to ask directions—our souls were healed. Well… A little. Some. Eleven years on and I’m not sure one ever really heals from such a thing, but we do get better.


A dollar spent on treating or researching the physical treatment of cancer, while still sacred, seems hardly a drop in the bucket given the enormity of it all. However, a dollar spent to care for wounded souls of those impacted by cancer… Well, that can go a long way.

The Flatwater Foundation provides mental health services to people impacted by a cancer diagnosis. It’s a cause I believe in. It’s such an important, beautifully compassionate service. I believe it’s a cause worth a buck or two.

Michael Walsh