This weekend, I find myself in a situation where I must make a potentially life changing decision with very limited understanding of the facts. But since “time is of the essence” (a legal phrase indicating that potential, devastating consequences may occur without actions made within a set timeframe), a choice will be made with lots of hope expressed that it will produce the desired outcome.
The short story is this. I am a late stage, pancreatic cancer patient. My latest test results demand a return to chemotherapy, but my blood counts are too low to start treatment. I have two oncologists with widely differing views of what to do next, and I must decide who’s care to place my life in. Both options are risky in that either may be right and prolong my life, and either may be wrong and bring about a series of consequences I may not recover from. So… how to proceed?
Ever been there? Trust me, by nature, I’m the kind of person that can’t easily decide what to pack for a weekend trip! I’m the epitome of “buyer’s remorse” even when I purchase the right item! I usually agonize over the smallest decision, fearing that the outcome will somehow bring ruin to my life. The worst part is, I know all this strife is ridiculous, especially considering that most poor choices can easily be rectified, usually by a simple course correction. Yet my struggles continue, so I’ve needed to find some guidelines to help me through the process.
Here are the steps I’ll be taking. They are shared here because I know that you may also face similarly difficult decisions. My hope is that these four steps will help us all while making important choices.
First. Take as much time as is available to be sure you understand the choices at hand. We never want to act on impulse to later discover it wasn’t based on truth. This means that we must confirm what our real options are and think them through. It may mean studying up on the issue academically. It may mean consulting with experts in the field, or people who have more experience. It usually means taking responsibility for your own life, and not letting others dictate your fate. And it always means wisely using the time given. No procrastination allowed. We must deal with issues directly and not put them off.
Second. Come to a place of acceptance for all possible outcomes. This removes the fear of what your answer may bring. The reality is that we never really know what will happen later today, tomorrow, or next year. How sad it is when we make choices based on “what if’s” when honestly, the ultimate outcome is unknown. Pushing all those potential fears to the side is an important step in dealing with reality rather than the undeterminable. In my circumstances, that means finding peace with both surviving medical treatment, and also with the possibility that my disease may be incurable. Either outcome has to be okay, or my decisions will be prejudiced by thoughts truly impossible to know for certain.
Third. One of my favorite hymns says, “It is well with my soul.” You’ve got to get in touch with the soul to determine what IS okay, deep inside. This transcends fear, scholarly opinions, the voices of loved ones, finances, past experiences, and even our self-imposed limits of what’s possible. For me, I pray and ask God to guide me. Then I wait in meditation until I feel confident I’ve found the right path. God does promise to answer if we call on Him (Ps 91:15) and who knows the future better than God? The soul is that part of us deep inside, that place of communion with Him. The soul is what remains long after our body and life fail. It is the essence of who we are. It is also the source of how we ultimately express ourselves to the world around us. If our decision making is not rooted in answers that spring from the soul, then our lives are confused and filled with change, turmoil, and often, regret. When choices are at peace with who we are in our core, then we can be at peace with the outcome of those choices as well.
Finally. Once you’ve taken time to understand the issues, accepted all possible outcomes, and found a place of peace in your soul, you must take that difficult step and choose the option that best represents who you are. Your choice may seem illogical in the moment, but we don’t live for the moment, we live by faith… by what we believe in. Your choice may not make the most sense to others, but that’s not important. It only needs to make sense to you. And most importantly, your choice may end up being the wrong choice, even by your standards. You might discover an hour from now, a day or week from now, or years from now that after doing everything possible to choose wisely, the choice was still wrong. If that happens, take it in stride and learn from the mistake. It will help you make better choices next time. And since you also chose to accept all possible outcomes (remember step two?), honor that and move forward. Hopefully our choices will, from time to time, produce the results we are really looking for in the end. Hopefully those choices will give you a sense of satisfaction and clarify your purpose in life. If so, well done! All the more reason to remain confident in the future. Because it’s inevitable, more difficult decisions will arise throughout life.
So back to my current dilemma. Where will I be treated for cancer? I know my current oncologist is well experienced, genuinely cares for me as a patient and person, and did a great job with my care in the past. I am choosing a different path now, however, for other reasons as outlined above. 1. During the last six months of care, my wife and I have dug deep into the world of cancer, pharmaceuticals, alternative care options, and my particular diagnosis. We’ve learned a lot, and though we’re not experts in the field by any stretch of the imagination, we have formed opinions on what is helpful and how we want to see medical care universally offered in the future. 2. I have accepted that stage IV pancreatic cancer is generally incurable. I’ve also accepted that there are the rare miracle stories of survival, and I hope to be one of those. Either outcome, however, is something I can now live with, enjoying each day as much as I know how, and seeking new ways to enjoy the life I’ve been given. 3. In my soul, I know what I want to live for, and what I want to be remembered for. When it comes to medical care, I want to trust God for the miracle of life, the miracle of our amazing immune system, the amazing foods He planted on this earth, and the power of nature and faith. I also believe in the ability He gave mankind to reason, solve problems, and develop sciences to improve healthcare and save lives.
No one in the medical science field is promising me a cure. My care is classified as “sustaining” and not “curative.” That means that the best modern science has to offer, is to prolong my life a bit and keep me comfortable as long as possible. Any cure needs to be less of science and more of something else. My first oncologist may indeed have proven her medical experience, accentuated by her years of practice. But she is bound by a system where licensing, insurances, liabilities, and regulations create an obstacle between that and everything else out there for cancer care. Those limitations are not something I choose to be bound to. The new clinic I visited last week incorporates oncology, nutrition, naturopathy, faith, emotional therapy and more under one system of care. Do I believe they are the best in all those areas? No. But it is my higher hope that eventually, all medical care will embrace not only science, but the whole person and the powers found in God’s amazing creation as well. I choose to participate in this system, not to save my life, but because it is closer to who I am, what I believe deep inside. There are times when we must choose the path of our soul whether it brings life or death. Remember… that outcome is too far in the future to be afraid of. So today, I choose what I know, what is well with my soul.
I hope this article helps you with whatever difficult decisions you may be facing. Please, feel free to share your story here or via email.
– Sanford Kravette