My grandfather wrote in his autobiography: “Sometimes a storm seems to blow up out of nowhere, a tiny cloud on the horizon which brings rain, hail, and winds so fierce that everything is devastated in its wake. So it was with Steffanie’s illness.”

My aunt Steffanie was the third of six children in her family. They lived in Orem, Utah, in the shadows of the Wasatch Mountains. She was a kind and helpful youth, a natural teacher, and was famous for making delicious brownies. Her temperament was described by her mother as “happy, gentle, fun-loving,” and “the joy of our home. I often marveled to think, ‘This child is pure 100% joy!'”

Steffanie’s father, my grandfather, had served overseas in World War II and had missed important parts of the early childhood of his two older boys. Consequently he developed a special bond with his third child, Steffanie, whom he saw grow up from her infancy. “How he doted on her!” wrote Grandma. “If ever I saw two kindred souls.”

When Steffanie was eleven years old her mother had a serious and prolonged illness. During this time Steffanie baked a large batch of bread every other day and picked up the slack in doing all of the household chores. A few years later her mother said to her, “I know your young arms became weary with that heavy kneading and all the work of a large family, but never have I heard you complain or refuse to do what was asked. Instead, you took pleasure in doing it all as well as you could, in making good meals to surprise your family.”

The Storm Breaks

Steffanie was exceptionally healthy until her cancer first appeared. She was 16 years old at the time, and the week before she became ill she had helped her team win a volleyball tournament. On the day after Thanksgiving 1963 Steffanie experienced a severe pain in her abdomen which increased to intolerable levels over the next two days. The family doctor was consulted, and he took her to the operating room to remove what he presumed was a ruptured appendix. He expected the surgery to take about an hour and a half, but she was in the operating room for much longer than that. Various memories list the time as anywhere from three hours up to eight and a half hours. Grandma and Grandpa heard a call over the hospital paging system for another doctor to assist in the operating room. As the time passed in the waiting room my grandmother was filled with a sense of foreboding and panic. She said to Grandpa, “They are not finding what they went in after,” and she later wrote that she “felt sure that Steffanie would die.” Finally the “weary, gray-faced doctors” came to the waiting room to debrief the parents, and Grandma recorded their conversation as the following:

This dialogue is almost certainly inaccurate. Very little of the first conversation is remembered by patients or family members when doctors deliver bad news. Typically all they remember is the doctor saying, “You have cancer,” or whatever the bad news might be. I have on many occasions spent 20-30 minutes with a patient answering all of their questions about the bad diagnosis I just gave them, only to discover that they remember almost nothing of our long conversation the next time I see them. More likely Grandma’s record reflects a composite memory of several interviews with the doctors, or perhaps a concise literary merging of them.

At any rate, things were looking bad for Aunt Steffanie at this time. She received a priesthood blessing from her father, grandfather, and uncle that night as she lay in the ICU. When she woke up some hours later Grandma told her about the tumor, but lied to her that it was not malignant. This was done at the advice of her doctors, who repeated that counsel several times during her early disease course. In those days it was common to withhold knowledge of a diagnosis from the patient, when it was thought that the full truth would be psychologically damaging to them. Nowadays doctors usually err on the side of full disclosure, which I certainly prefer.

The pathology report on the tumor was inconclusive, and the sample was sent to a referral center for a second opinion. In the end it was thought to possibly be a fibromyxosarcoma, but the pathologists were not agreed, and as far as I can tell this was the only tissue sample ever analyzed. Fibromyxosarcoma was a tumor type discussed in the medical literature frequently during the 1960’s, but the term does not seem to be used in the modern literature. Of course this part of the story would read a lot differently if it happened today, with the higher resolution diagnostics available now. The initial discovery of the tumor would have been on an ultrasound or CT scan instead of an exploratory laparotomy. The cancer cells would have been genotyped, and her therapy tailored to her unique disease. As it is, her exact tissue diagnosis will have to remain unknown, although likely it was some kind of sarcoma. It is quite clear from the history that this was an extremely aggressive cancer.

Steffanie recovered from the surgery, but she had severe abdominal pain as the tumor began a phase of rapid growth over the next several weeks. Within about three weeks her abdomen resembled a six month pregnancy. The tumor grew so rapidly that her doctors decided to give her radiation therapy even though they didn’t think it would work. Cancer chemotherapy was in its primitive stages at the time, as the major innovation of combining agents together to improve their effectiveness did not happen until 1965. There is no indication that her doctors mentioned or offered any type of chemotherapy, and it seems likely that such therapy, and the expertise to administer it, was unavailable in Utah at the time. With her prospects so bleak, Grandma felt certain that Steffanie would die soon.

An Application of Faith

On a Sunday evening, December 9, 1963, during this phase of rapid tumor growth, a group of over 100 friends, neighbors, and family members knelt together to join in prayer for Aunt Steffanie. The adults in the group had been fasting for two or three days. A few children in the group were also fasting, though not for as long as the adults; they were members of a junior Sunday school class which Steffanie taught. The sacred prayer was given by a close family friend, and was recorded in Grandma’s history as the following:

This prayer really touches my heart. It is sincere and heartfelt; humble yet powerful. It acknowledges God’s power and requests its operation on Aunt Steffanie’s behalf, but also clearly defers to God’s sovereign will. Those who were present on this occasion record that the room was filled with a powerful spirit. Grandma reported that it was “so intense one could hardly breathe.” One of the central petitions of the prayer was answered immediately, as a great peace filled their hearts. This experience didn’t settle all of their questions, but it did calm their anxieties to a great degree. Grandpa wrote, “There was a strong manifestation of the Spirit at the close of [the] prayer. Because the witness was so strong and its influence so pervasive, many of those in attendance, including me, felt that it had to be interpreted as a sign that Steffanie would recover from her malady. I determined that I would hold fast to the hope these feelings gave and not let the feeling erode and dissipate.”

A few days before Christmas the pain reduced, so Steffanie was able to go home from the hospital. By New Years her parents had decided to tell her the whole truth about her illness for both practical and spiritual reasons. They felt that she should have the privilege of exercising her own faith on her own behalf, which was not possible to the fullest degree without her having full insight into her desperate condition. They also feared that one of her friends or a neighbor would inadvertently tell her the truth.

Through the month of January another request from the prayer began to be granted, as Steffanie observed that the tumor was visibly shrinking. Perhaps the application of Steffanie’s own faith was successful in calling down the powers of heaven, as her parents had hoped. Her doctors were reluctant to admit it at first, but after three weeks it could not be denied that the tumor had shrunk from the size of a small melon to the size of an apple. Around this time Steffanie had a consultation with another surgeon who had been called in to the case. Grandma explained to him about the prayer, and how they had felt the assurance from the spirit that she would recover. She explained how the tumor had grown so rapidly and then how it had started to shrink. After her explanation, she recorded, “He put down his pen and looked at me. ‘As far as I’m concerned,’ he said, ‘it was the prayer that did it. Fibromyxosarcoma does not respond to X-Ray.'” Other doctors involved agreed that “this reversal was simply a miracle.”

In late January Steffanie’s older brother Ivan Doug left to serve a mission in South America, and she played “You’ll Never Walk Alone” on the flute at his missionary farewell. She wore a dress that day which her mother had given her for Christmas, thinking that she would never wear it. But with the reduction in the size of the tumor it fit her perfectly.

Grandpa remembers this time as being “the high point in my hope and faith. Whenever Glenna and I fasted and prayed, a spirit of peace came to us and carried us along. I was sensitive to all of the signs and feelings that had been with us since the incidence of Steffanie’s illness. The conviction grew within me that, if I could perfect my life in all of the Christian virtues, I might achieve a more active faith — a faith equal to the blessing of healing. I tried to clear my conscience of past errors and to sustain a constant faith to bring about her complete recovery.” This belief was also held by other members of the household; children and parents united in their belief that Steffanie would be healed through the powers of heaven if they lived as righteously as possible. “We had very great faith,” Grandma remembers. “We were just sure that she was going to get well.”

Into Remission

On January 30, 1964, two months after her first surgery, Aunt Steffanie went back to the hospital for a second operation to remove the cancer, which took somewhere between seven and nine hours to complete. The tumor was peeled off of the other organs and taken out in one piece. The doctors felt certain that they had gotten all of it. My grandmother was even escorted into the operating room after the procedure was over (against the protests of the head nurse) so that she could see for herself the ten-pound mass of tissue sitting on the table. Aunt Steffanie recovered well from the surgery and was discharged home sometime in late February or early March 1964, just before her 17th birthday.

Life for the Sanderson family went back to normal. During the month of March 1964 she was feeling well enough to take a road trip to the warmer climates of St. George, Las Vegas, and Tempe to visit family. March is a good time to get away from the Wasatch Front, which is typically still snowy and cold at the time. In Las Vegas Steffanie went out with a cousin to see a movie, enjoying a carefree evening. Grandpa remembers: “Her strength seemed to be slowly returning and she savoured being able to get out in the sun. … After being hospitalized and encumbered so long, it seemed that all the little ordinary things in life were vitally important to her and she seemed deeply happy. […] Glenna and I were animated by a sense of relief from the anxiety and emotional burden of her illness. I felt a genuine, deep happiness and peace of mind that the miracle I required was taking place before my eyes.”

But then he continued: “In reality this peace was the calm in the eye of the hurricane which would soon batter us from another direction.” On June 16, 1964 Steffanie confided in her mother that the tumor was growing back.

Recurrence and Metastasis

The timing of her recurrence was probably earlier than June. Her missionary brother Ivan Doug flew from Utah to South America in early May. He said, “I remember, as I met with my family briefly at the airport after my three months at the LTM (Language Training Mission, it was called back then), Steffanie walked slowly and with a heavy limp. I asked my dad what was happening with Steffanie, and he replied that the ‘original problem’ had returned.” Grandma herself remembered that Steffanie had “two months when she felt quite well,” and these were probably the months of March and April 1964.

At any rate, by the end of June Steffanie was bedridden by horrific pain from bony metastases. Cancer pain was not treated as aggressively in those days, and the concept of “palliative care” was in embryo form which would not fully develop for decades yet. She did have prescriptions for Demerol and morphine at various times, which were helpful but were used sparingly due to concerns about addiction. On nights when the pain was particularly intense Grandpa would stay up with her, squeezing her painful bones in his hands to give her relief. He would call a neighbor to come over and help give her a priesthood blessing. These blessings would result in relief of her pain for up to a few days at a time, but the pain would always return worse than it had been before. Twice a day Grandpa would massage Steffanie’s sore and cramped limbs and back. “It always ended with a symbolic fleck to the tip of her nose, a detail she would never let me forget,” he recalled.

On July 4 she was carried on a sheet to the back garden of the house, where she laid on a camp cot for about three hours and watched two ducks play in a tin tub of water. She fed them crusts of bread, and obviously delighted in their antics as they quacked at one another and pushed one another out of the tub. Later as she was carried back into the house Steffanie exclaimed, “Oh, this is the best Fourth of July I’ve ever had!” Grandma wrote: “Astounded, I tried to think how it could be, with her thin, bent, painful body — yet I could plainly see that it was so.”

Steffanie and Grandpa had many scripture study sessions during this time, where they studied the miracles of Jesus and tried to understand how they could meet the requirements to receive one of his miracles of healing. The passage in John chapter 9 where Jesus heals the man who was born blind was mentioned specifically and prominently in the accounts written by both of her parents. Grandpa had read this passage early in the course of her illness, and took special note of the Lord’s explanation that no one had sinned to cause the man’s blindness, but that the purpose of his affliction and its healing were “that the works of God should be made manifest in him” (John 9:3). Grandpa explained, “This last phrase came to me with such force that for several months I felt that ultimately Steffanie would be healed if I could exercise sufficient faith.” No doubt he shared this belief with Steffanie in their study sessions, as he did with the other children in the family.

Grandpa was persistent in his belief that she would survive, despite the gathering signs of her impending death. “I did much soul searching,” he recalled, “but my faults seemed hydra-headed and two grew back for every one I was able to cut off and change.” Part of his coping strategy during these months was to throw himself into his work to keep his mind distracted on other things. “Everything I did at work seemed to go well,” he explained, “and a strong, loyal organization began to emerge. I tended to see my success in the store as a link to my personal struggle, and the growing confidence in my work seemed a presage of the final achievement of Steffanie’s well-being.”

As Steffanie’s condition worsened through the summer months, Grandma became worried that her husband’s faith would be mortally wounded if their daughter died. “Ivan couldn’t let go of her,” she recalled. “He just couldn’t. But I felt that it was the Lord’s will.” She counseled with their bishop about it and determined to try to intervene. In late August they had a frank conversation in which she asked him to consider the possibility that her death might be the will of God. He had been “doggedly persistent” in his belief that she would survive, “because I could not face any other conclusion,” but he gave Grandma’s suggestion serious consideration. “I was led to re-evaluate the sincerity of my willingness to let the Lord’s will take precedence,” Grandpa wrote. “I came to recognize for the first time that the rightness of death had to be considered as an alternative. Late one night in August, I found peace and was able to pray sincerely, ‘Thy will be done'” (Matt 26:42). Steffanie died the next day, August 27, 1964, on her parents’ 23rd wedding anniversary.

In her final hours Steffanie drifted in and out of consciousness several times, and between Grandma and Grandpa’s writings there are recorded at least five occasions that morning when some meaningful communication occurred. It is clear from her recorded statements that Steffanie knew she was dying that day, as did both of her parents.

Early that morning Grandpa knelt at Steffanie’s bedside and held her hand and kissed her forehead as they said their final goodbyes. After a long pause where the two looked into each other’s eyes, he got up and went to the office for a few hours. His formidable emotional defenses had entirely crumbled within the previous 12 hours, and that must have been a terrible experience for him. I can’t blame him for wanting to escape that day.

Grandma stayed with her that morning. During a lucid moment Steffanie dictated a brief and grammatically broken letter for Ivan Doug in Peru. He still has the letter in his possession today. Perhaps she would have dictated two letters, one for her other missionary brother Stewart, but just then her mother noticed how icy cold her hands and feet were and tried to warm them.

Steffanie’s pain continued as she awaited death. At one point Grandma watched her lips form the question, “Where is the pavilion?” This was a reference to one of the great stories of adversity in Latter-day Saint history and culture, the imprisonment of Joseph Smith in the Liberty Jail through the winter of 1838-39. After nearly four months in the jail he pleaded with the Lord, “O God, where art thou? And where is the pavilion that covereth thy hiding place?” (Doctrine and Covenants 121:1).

The last words that Steffanie said were, “I love you,” spoken to her little sister Jan and her mother who were in the room with her. A few minutes later Grandma observed, “the rattle of the breath out of her lungs came up and then I knew she was gone. And it was a perfectly peaceful, absolute feeling of assurance.” Later when Grandpa returned home she told him, referring to the feeling of peace which attended her death, “It was just beautiful.”

Aftermath

An outpouring of love and service came to the Sanderson family after Steffanie died. Financial donations paid the cost of her funeral and medical bills. Neighbors volunteered to put in a new sidewalk in front of the house. The local Boy Scouts weeded the flower garden. Great-Grandpa paid for a new roof on the house. Women from the neighborhood brought cooked meals to the home faster than they could be eaten.

It took some time to heal the emotional and spiritual wreckage from this storm, and some of the scars can still be seen. Both parents expressed regret that they had not adequately prepared the other children for the death of their sister. “With a feeling of panic,” Grandma wrote, speaking of the morning Steffanie died, “I realized I had totally neglected all the other children in my intense concern for Steffanie and that they were not going to be prepared for the shock.” Grandpa similarly wrote, “I had been so caught up in the struggle that after it was over I wondered what, if anything, had been done to help the other children adjust to Steffanie’s passing.”

Grandpa had expressed the hope that he could save Steffanie by perfecting his own faith and Christian virtues, as a sort of vicarious sacrifice on her behalf. This notion was also held by other members in the family, and after she died the obvious implication was that they had failed to live virtuously enough. This caused an intense feeling of shame and guilt for young children, who felt that they were personally responsible for her death. My aunt Jan recalled, “When she left I wondered whether everything I had been taught was wrong/mistaken or I was personally to blame for her death due to my insufficient faith and purity. I was unable to immediately determine which alternative was correct. I was 10 years old.” Uncle Jon concluded that “the plan and structure of life somehow did not work as advertised.” Uncle Eric also struggled to find any positive meaning in the experience. “To remain a religious person,” he said, “I have had to reconstruct the religion of my fathers.”

Steffanie’s two missionary brothers received word of her death in the following days. It was a surprise to her oldest brother Stewart. Ivan Doug wrote of Stewart, “She was healthy when he went on his mission, and she had died before he returned. So it was hard on him. [He was] severely damaged but I think his faith returned.” Of his own experience, Ivan Doug wrote, “Despite my having been close to Steffanie throughout our early years, I shed tears only once after I was notified of her passing.” He had been aware of the cancer’s recurrence by his observation of her limping at the airport when he flew to South America. “So as I left,” he explained, “I was sure that I had seen her for the last time. This knowledge enabled me to devote myself completely to my missionary work and not pause, even slightly, due to emotional baggage. I had not been caught up in the narrative that all the spiritual evidences indicated her eventual restoration to health and strength.”

This story is a cautionary tale about over-interpreting spiritual manifestations, which is a common pitfall that I have also fallen into before. God did not reveal to anyone that Steffanie was going to survive her cancer. All he revealed was a feeling of peace and comfort: an assurance that he was there, that he was listening, and that he cared. Reading too much into this feeling led my grandfather to set up impossible expectations for himself and for his family. Some of the sorrow in her death may have been avoided if they had simply taken the feeling of God’s love at its face value, moving forward with faith and resolving from the beginning to accept his will whatever it might be. The story is also a reminder that children need to be prepared, as much as possible, to face tragedies with faith.

Grandpa’s testimony was more secure than that of his children, but he had to recalibrate his faith to accommodate the fact that he had been wrong in his interpretation of spiritual feelings and events. Aunt Jan wrote, “I think it was a heavy burden for my father – to believe with every fiber of his being and then to lose his precious daughter. I do not blame or hold it against him – I honor him in his fight for her. What a terrible and devastating learning it was for him. And he survived and continued to grow.” Uncle Eric wrote, “I see my father as being incredibly innocent […] After she died I remember him standing in testimony meeting and saying something like, ‘I have stood before you several times and testified that I knew my daughter would be healed. Now that she’s gone I realize that what I was feeling was the Lord’s reassurance that all would be well.'”

After decades of reflection on these events, Grandma summarized her understanding with these words:

I recently spoke with my grandmother on the telephone, who is now 96 years old. She remembered all of the important events and confirmed my observations about the characters in the story, particularly about Grandpa. I said to her, “One of my impressions from reading about this was that Grandpa was a good and honest man. He was a man with character flaws, but he was honest and he sincerely wanted what was right.”

“That is absolutely true,” she replied. “My Ivan was a very good man.”

After a short pause I added, “You know, Grandma, the same good things could be said of you, too.”

“Well, if that is true I owe it all to his influence.”

“That is quite a tribute to him!”

Final Thoughts

This old family story took on new meaning for me recently as I reread the accounts. I saw the story with new eyes this time because now I can understand it from the perspective of Steffanie’s doctors. Perhaps the most interesting and unexpected thing in the story is the regression in tumor size during the month of January 1964. At the time this was viewed by the family as God’s healing hand, and as a sign that he would ultimately cure her entirely. It soon became easy to see that the second part of this interpretation was untrue, but Grandma and Grandpa continued to believe that God had healed her temporarily in order to acknowledge the faith and prayers of so many people who loved Steffanie and to accomplish some good purposes in refining her character through trials. I agree with this interpretation.

But I think there is another explanation which seems to have been overlooked by the characters in the story: Steffanie’s tumor responded to the radiation therapy administered in mid-December 1963. That is why the pain stopped just before Christmas, and why the tumor could be completely removed about 6-7 weeks later.

At first glance these interpretations may seem incompatible, as one is based on empirical observation and scientific reasoning, and the other is based on faith and spiritual intuition. How can I simultaneously believe that the hand of God temporarily healed my aunt and that it was the radiation therapy that did it? The trick is to recognize that these two interpretations are not mutually exclusive. It is easy to imagine that God had some purpose in temporarily prolonging her life (such as those listed above), and radiation therapy would be a practical way to do this.

Returning to Aunt Steffanie’s deathbed reference to the Liberty Jail, it is instructive to consider the Lord’s answer to Joseph Smith’s prayer. Joseph pleaded with the Lord: “let thy pavilion be taken up; let thy hiding place no longer be covered” (Doctrine and Covenants 121:4). He knew that the Lord had power to intervene, and he was desperate for that intervention to occur, but the Lord did not grant the request. Neither did he cure Steffanie of her cancer, which clearly he had power to do. Instead of conquering Joseph Smith’s enemies, he offered him a blessing of peace and perspective: “My son, peace be unto thy soul; thine adversity and thine afflictions shall be but a small moment; And then, if thou endure it well, God shall exalt thee on high; thou shalt triumph over all thy foes” (Doctrine and Covenants 121:7-8).

Concerning Joseph Smith’s trials and afflictions, the Lord declared that “all these things shall give thee experience, and shall be for thy good” (Doctrine and Covenants 122:7). Unsinkable optimism is a defining characteristic of our faith and of religion in general. The ability to find value in suffering is part of what makes religion such a powerful tool for enduring life’s trials. And the Lord is not a blind optimist: “The Son of Man hath descended below them all. Art thou greater than he?” (Doctrine and Covenants 122:8)

God was neither absent from nor disinterested in the lives of the people involved in this story. There was no pavilion hiding him. Another reading of the prayer and a review of the events of the rest of Steffanie’s life indicates that all of the requests in the prayer were literally and entirely granted, although temporarily. Steffanie did rise from her bed. The tumor did disappear. She did return to health, rest in comfort, and feel the positive influence of the prayers and service of those around her. Her family was blessed with peace which was renewed periodically through her illness. All of these requests were granted by God, but could only be granted for a season. Remember that they had also prayed to know his will, which he eventually revealed in her death.

“I’ve never had the slightest, slightest doubt that she is alive,” Grandma declared in a 2003 interview, “and that we can be with her if we’re worthy, and that she is busy and happy, and accomplishing great things. It was absolute. It was a doctrine that we had believed in academically, but it was an absolute testimony.”

Someday I will meet my Aunt Steffanie, who died before I was born. Death is not the end of existence, and like my grandmother I fully expect to find her on the other side when I pass over there. I imagine that from her perspective today the affliction does seem “like a small moment.” She did “endure it well” and I have no doubt that God will “exalt [her] on high.” Until then, I hope that her story will help those of us who are passing through similar ordeals.

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Alan B. Sanderson, MD is a member of The Church of Jesus Christ of Latter-day Saints and is a practicing neurologist. Quotations were taken from Aspens and Meadowlarks by Glenna C. Sanderson (unpublished), Through the Fields and Woods by Ivan L. Sanderson (unpublished), Ivan and Glenna video interviews by Mark and Tom Sanderson (unpublished), and personal correspondence with Glenna C. Sanderson, Ivan D. Sanderson, Eric Sanderson, Jon Sanderson, and Jan Sanderson Taylor. Note that Ivan L. wrote his autobiography in the third person voice, and quotations have been converted to the first person for this article. Minor spelling or punctuation errors were corrected from all sources.