“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.” (From Through the Fields and Woods, by Ivan L. Sanderson, hereafter referred to as TFW)
These words were written by my grandfather, Ivan L. Sanderson, about his daughter, my aunt Steffanie. Her illness happened before I was born, but when I was a child I could see the lingering aftermath of this family storm.
To really understand this story we need to start with Grandpa. He was born in 1920 in a small central Utah town. His family had lived there for three generations before him, sharing in all of the sufferings and glories of the territorial years. (Most of the glory was enjoyed by the pioneers posthumously.) As a young man he attended Brigham Young University, where he met and married his lifelong sweetheart, my grandmother Glenna C. Cottam, who descended from the intrepid and storied pioneers of southern Utah. They started a family.
Then Grandpa went to war. He saw heavy combat in the Philippines, where his life was in danger behind enemy lines on the day his second son was born. During his service he saw hundreds of men get killed, and often he was the killer. These experiences changed him.
The human mind does not react well to such terrible violence. Back then they called the result of these experiences shell shock; now it is known as post-traumatic stress disorder. This condition would change the course of his life and of his family, not for the better. No effective treatments existed for a malady that was poorly-defined in the 1940’s. His wife simply learned to cope with his triggers. His sons learned to fear him.
But in time he found a soothing balm for his troubled soul. It came in the form of a little girl, his third child, Steffanie.
When Steffanie was 15 years old, her mother wrote this:
“Perhaps my happiest memory of your early childhood was the love and delight your father had in you. You were his first baby whose whole development he could live with and enjoy. War had damaged his nerves and body; pressures of a heavy schedule, small-paying part-time jobs and a sickly wife made his life not easy. But he would come home to our little apartment; you would run or crawl full speed to him shouting ‘Daddy!’ and he would toss and tumble with you, totally filled with love and delight in you.” (From Aspens and Meadowlarks by Glenna C. Sanderson, hereafter referred to as “AM”)
The older boys would not develop a good relationship with their father for decades yet, but Steffanie had a special connection with him from the start. More siblings joined the family, but none were more beloved by him than the one who had done so much to calm his heart.
~~~
In medical school I learned about the differential diagnosis, a mental exercise which lies at the heart of a doctor’s special skills. The process is laborious at first attempt, but eventually it becomes second nature.
“Make a list of possible diagnoses,” my instructor said. “Start doing this from the moment you hear the patient’s chief complaint. This list is a hypothesis which you continually test and revise as you interview and examine the patient. Every differential must include at least three diagnoses.” He held up his fingers to count as he listed them: “First, the most likely. Second, the most interesting. And third, the most devastating.”
Let’s make a differential diagnosis for young Steffanie, age 16, on the day after Thanksgiving, 1963. As we might say in a hospital note, “the patient presented with abdominal pain.”
The more common causes for this symptom are quite benign. Her father suggested one of these when he teased her that it was from eating too much pie. But someone who eats too much pie should feel better the next day; Steffanie felt worse. There were no other symptoms of gastroenteritis, urinary tract infection, or menstrual cramps. It was time for a medical consultation.
The second category is where doctors really shine, because they are familiar with conditions that most people don’t have everyday experience with. Might Steffanie have had acute intermittent porphyria, inflammatory bowel disease, or sclerosing mesenteritis?
I suppose, but you shouldn’t go hunting zebras when the first category still contains something as obvious and mundane as acute appendicitis. Steffanie’s doctor took her to the operating room for an appendectomy, guessing that it would take him 1-2 hours to complete.
But we have thus far neglected the third category, the most unpleasant one. In routine cases I don’t even like to mention these things at the first visit. But as Steffanie’s parents sat in the hospital waiting room watching the hours go by, and especially after hearing an overhead page for another doctor to assist in the operating room, her mother’s fears began to register the likelihood of a devastating diagnosis. She fixed her eyes on her husband and said, “They are not finding what they went in after.”
Finally the weary doctors came to the waiting room to debrief the parents. “We found a tumor in the right abdomen,” one of them said, “a very large one.” It could not be removed because it had engulfed the blood vessels and nerves going to the right leg, and the ureter on that side. “It looked like a sarcoma,” he said. The tumor had ruptured and spilled debris inside of Steffanie’s abdominal cavity, which was the cause of her pain in the days leading up to the surgery. The doctors simply rinsed out her abdomen and sewed her back up. There wasn’t much else to do.
Steffanie’s pain only worsened in the weeks after the operation. The tumor went through a period of rapid growth in early December. Within about three weeks her abdomen resembled a six month pregnancy. Steffanie’s physical pain was matched only by the existential pain of her parents; their daughter was dying.
The doctors seemed to be scrambling to find something — anything — to do. Today’s oncology-industrial complex didn’t exist in 1963, and most of the tools we could use today to help Steffanie were unknown. Researchers on the cutting edge of medicine were just dabbling in chemotherapy at the time, and had not yet made the breakthrough innovation of combining agents together. They also didn’t have the advanced diagnostics available today: 2D ultrasound was in its infancy, computed tomography was still a decade away, positron emission tomography was even further off, and probably no one at the time could even imagine the technology to personalize therapy based on tumor genotyping, now a routine part of oncological practice.
They decided to hit her with the only other tool they had: radiation therapy. But they didn’t have much faith that it would help her.
~~~
1960’s medicine, particularly oncology, was not worthy of having much faith placed in it. (Maybe future generations will say the same thing about medicine in the 2020’s.) But the Sanderson family had another deep well of faith to draw from, one that had been quenching their thirsty souls for generations. Steffanie’s parents decided to call upon the Lord.
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 Steffanie. Some of the adults in the group had been fasting for two or three days. The prayer was offered by a close family friend, and included the following petitions:
“We know that thou canst perform miracles, and if it be thy will and we are worthy, we pray that a miracle might be done here. We pray that Sister Steffanie might arise from her bed. Cause that the growth may disappear, and that she may be restored to her health.
“As we conclude our fasting, we pray that [her family] may have peace in their hearts, and that we may also have peace in our hearts. We pray that we may all know that thy will has been done. May she rest in comfort and feel thy healing influence, that she may be relieved, and know our prayers are with her.” (AM)
One of the central petitions of the prayer was answered immediately, as a great peace filled their hearts. Those who were present at the prayer said that the room was filled with a powerful spirit, “so intense one could hardly breathe,” as her mother wrote. This experience didn’t settle all of their questions, but it did calm their anxieties to a great degree. Steffanie’s father 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.” (TFW)
Within two weeks of this prayer the pain in Steffanie’s abdomen remarkably and rapidly improved. The doctors let her return home for the holidays — a real-life Christmas miracle. But there was more! A few days later she noticed that the tumor was shrinking. Her doctors wouldn’t admit it at first, but after three weeks it could not be denied: the tumor had gone from small melon-size to apple-size.
In January Steffanie had a consultation with another surgeon for a second opinion. Her mother 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.
“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.'” (AM)
On January 30, two months after her first surgery, Steffanie went back to the hospital for a second operation. In the space of seven to nine hours the tumor was carefully peeled off of the other organs and taken out in one piece. The doctors felt certain that they had gotten all of it. Her mother 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.
Steffanie recovered well from the surgery and was discharged home a week or two before her 17th birthday in March 1964.
~~~
March is that blessed month when the hard frost melts and the snow storms turn to rain. The earliest signs of spring begin to shoot up between the lingering snow drifts. On an afternoon towards the fourth week you can feel the warmth of sunlight on your skin for the first time in months. You might even take your jacket off.
On the Wasatch Front in Utah, where the Sandersons lived, it is easy to get impatient as springtime struggles to break through the winter ice. For Steffanie, who had spent two of the previous three months in the hospital, and for her parents, whose emotions had been so strained through the winter, spring couldn’t come soon enough. So they went looking for it.
They found it by driving south. In Las Vegas Steffanie went out for the evening with a cousin to see a movie. Her father wrote:
“Her strength seemed to be slowly returning and she savored 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.
“In reality, this peace was the calm in the eye of the hurricane which would soon batter us from another direction.” (TFW)
In late spring Steffanie confided to her mother that the tumor was growing back.
~~~
If I could describe my grandfather in one word, it would probably be tenacious. This quality he inherited from his progenitors, and passed on to me. You don’t survive and thrive in territorial Utah, just like you don’t make it through the Pacific War, without a goodly measure of the stuff. I think he had a few heaps more than just a goodly measure, though. Tenacity, when overdone, is a virtue especially prone to becoming a vice. You might say that Grandpa was stubborn.
The summer of 1964 was a particularly hard test for the strength of his grip. To outside observers it was obvious that Steffanie was slipping away, but he still held hope for her recovery. Knuckles white with desperation, his grasp on the reality of her situation became increasingly distorted.
“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.” (TFW)
The whole family studied the miracles of Jesus in the scriptures and tried to understand how they could meet the requirements to receive his healing blessings. They read John chapter 9 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 his affliction and his healing had a purpose: “that the works of God should be made manifest in him” (John 9:3). Grandpa wrote:
“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.” (TFW)
~~~
By the end of June Steffanie was bedridden with horrific pain from bony metastases. Palliative care almost didn’t exist in the 1960’s. These days we would pull out all of he stops to get Steffanie’s pain under control, but the approach was different back then. By different I mean inadequate.
Imagine young Steffanie enduring hours, days, even weeks of mind-bending pain. This was her mother’s helping hand! This was the girl who did laundry, baked brownies, made bread that she would knead by hand! Now she was confined to her bed, stuck within the four walls of her room, dependent on others for everything.
Was she lonely? Was she scared? What went through her mind in those dark hours of night when everyone else was asleep?
When the pain was particularly intense her father would stay up with her, squeezing her painful bones in his hands to give her relief. Sometimes he would call a neighbor to come over and help give her a priesthood blessing. But the pain would always return worse than it had been before. Twice a day he 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.” (TFW)
~~~
As Steffanie’s condition worsened through the summer months, Grandpa’s toxic perfectionism reached a fever pitch. He recalled:
“I did much soul searching, but my faults seemed hydra-headed and two grew back for every one I was able to cut off and change.” (TFW)
Grandma watched all of this with increasing alarm. Steffanie was dying; she could see that with her own eyes and knew in her heart that it was true. But her husband was stuck in a rut, blinded by self-doubt and misdirected faith, and unable to accept what was actually happening. He was a good man — she knew it better than anyone else — but when he got something in his head like this it was hard for him to see another perspective. His religious fervor was careening toward a brick wall of reality, accelerating every second, and the collision was not going to be pretty.
She finally determined to intervene. It was the evening of August 26, 1964. The next day would be their 23rd wedding anniversary, but they weren’t really thinking about that. Grandma was not the type to lecture her husband, and he wasn’t one to be lectured to anyway. But perhaps he could be persuaded, with love, to consider another perspective. Could it be done without triggering his anger? She had to try.
Their conversation, as far as it can be pieced together, went something like this:
“Ivan,” she said. “Steffanie is dying.”
He didn’t look up from the book he was reading, but his eyes stopped moving and stared at the same spot on the page. His face clouded.
Grandma continued, “She’s getting worse by the day. It can’t be long now.”
“She can’t die, Glenna,” he said, looking up. “I can’t let her.”
“We can’t stop her from dying.”
He looked down again. His lips became tense and his eyes squinted. She could see that he was holding back an emotion that threatened to burst out.
“Ivan,” she said, “What if Steffanie’s death is God’s will?”
His eyebrows furrowed and he looked up again. “How can that be?” he said. “We were promised.” He struck his fist on the open book.
“We were comforted,” she said. “The Spirit let us know that everything would be alright. We know that God loves us.” They stared at one another in silence for several seconds, then Grandma ventured a final question: “Can we accept God’s will, if his will is for her to die?”
With this question she penetrated through the swirling fog in her husband’s mind. He later wrote:
“I was led to re-evaluate the sincerity of my willingness to let the Lord’s will take precedence. 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.'” (TFW)
Steffanie died the next day. She was 17 years old.
~~~
Grandma nursed her daughter through those final hours. Like Jesus on the cross, Steffanie spoke nothing but love in her final moments of suffering. “It was … just beautiful,” Grandma said.
But Steffanie’s father was not there when she died. At sunrise of that fateful day he knelt at her bedside, held her hand, and kissed her forehead for the last time. “How he doted on her!” wrote Grandma. “If ever I saw two kindred souls.” After a long gaze into the eyes of his little girl, he left the house and went to the office. Rather than stay to face the ultimate collapse of his defenses, the old soldier retreated.
His only refuge now was the Lord, and the promise of ultimate victory over death.
~~~
Ivan and Glenna Sanderson spent the rest of their lives trying to repair the damage inflicted on the faith of their children by this experience. They had mixed results. Their son Eric wrote:
“After she died I remember [my dad] 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.'” (Eric Sanderson, Personal correspondence, 2017)
Grandma wrote a detailed account of Steffanie’s illness in her autobiography more than 20 years after Steffanie died, focusing on the silver lining of that dark cloud in her life. Here is the lesson she wanted her descendants to take from the story:
“Who can fathom the Father’s educational process? In those seven months, the perceptions of her soul became more alive. She became intensely aware of beauty, of people and their kindness, of God and of life.
“Five added months of genuine happiness with relative health and strength she was given, plus this light that triumphed over the pain that followed. Who can say that this was not a miracle? Strength and understanding to accept came to us in that time, with the absolute assurance of God’s will in her death. But without the burning of the spirit at the prayer circle and that feeling of assurance of God hearing our prayers, WE WOULD ALWAYS HAVE WONDERED IF SHE DIED BECAUSE WE HAD NOT FAITH ENOUGH TO HELP HEAL HER. The intense and humble supplications of so many persons to the Father could not be rejected even though the answer was ‘No.’ We had to know that we had done all we could do, and that God had his own work for her. We had to know this.” (AM, emphasis in the original)
Time and the Lord can smooth over a lot of things, including PTSD, and even the sting of death. But some things reverberate through generations.
~~~
Grandma died last summer, and was buried in the plot between Ivan L. and Steffanie Sanderson in the Orem City Cemetery. That piece of ground has known much of sorrow through the years, but now it is the site of a happy reunion.
Can we see ourselves in this story? Do we react to our trials like my grandfather did, trying to be helpful but sometimes causing more harm? Have you ever struggled to have faith during those times when it seemed that “the plan and structure of life somehow did not work as advertised?” (Jon Sanderson, personal correspondence, 2017) And have you ever reached out in concern to try to correct the misconceptions and to save the faith of someone you love? Sometimes we are like Steffanie, suddenly and inexplicably stricken with a terrible burden to endure. Maybe you feel like Steffanie’s doctors, wielding tools and possessing knowledge that all seems inadequate to the task at hand. I have played all of those roles, to some degree, in my life.
The title for this post comes from a song that I recorded this year with a group of cousins, telling the story of our aunt Steffanie’s illness from Grandpa’s point of view. She passed from this life within a dark tempest, but her life was mostly one of sunshine. It seems fitting for us to remember the aunt we have never known, but have missed.
Much of the emotional impact of this family tragedy will be lost in another generation or two, but I hope that the lessons of her story will live on for my children and grandchildren. Every generation will face its own tragedies, and, like as for Grandpa, our last refuge will be the Lord’s promise of victory over death.
Medicine and Faith 
This was beautiful and insightful. Thank you.
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What beautiful life lessons!
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