Monday, August 11, 2014

Decisions, Decisions, Decisions

This is not another attitude post, I promise.

I'm learning that one of the challenges of cancer is finding the appropriate balance between optimism, pessimism, and realism. As a cancer patient you're given a bunch of statistical averages and, if you're lucky, some vague uncertain prognostications, and you have to make your choices based on that limited information. It can be challenging, especially when you layer it on top of the human being's seemingly infinite capacity to deny that death is not only possible, but inevitable. 

By way of example, I currently have absolutely no documentation regarding what I want to happen to me and my stuff when I'm no longer capable of managing me and my stuff. No will. No power of attorney. No medical directives. Nothing. Now is it optimistic or delusional to ignore all that stuff? Realistic or pessimistic to suddenly decide to write a will? I have no idea. 

Similarly, if I suddenly decide that my life will be incomplete if I die before I visit, say, Toledo (to pick an absurd example), is it pessimistic or realistic to quickly cash in some vacation and head to Ohio. Again, hell if I know. But since I'm never more than two weeks from the next round of chemo, a mad dash to Toledo -- or Auckland or Dublin or Hanoi or Shanghai or Hong Kong or Mumbai or Johannesburg or any of the zillion other places that I really do want to see before I'm gone -- is pretty much impossible right now anyway.

More generally, I keep thinking back to my experience of my Mum's final months. I'm far from the expert on what she experienced, but the striking thing I experienced is that we never really directly addressed the fact that Mum was dying.* The assumption always seemed to be that there was more time -- until suddenly there wasn't and it was too late to ask Mum for the secret to the universe or if there was anything she wanted to do with her final days or any of the other things that should've been dealt with when Mum was conscious and engaged with the world. 

What are the realistic, pessimistic or optimistic expectations for the outcome of this little adventure? I have no clue. But unfortunately, it makes a big difference; a bad decision can have a huge impact. Take the optimistic view and assume you'll have more time, and you may not; take the pessimistic view, pull the plug and run, and you may end of giving up years you could've otherwise had. 

Maybe I should just buy a Magic 8-ball and use that to make my health care decisions. Continue chemotherapy? "Reply hazy try again."  Quit and make a run for it? "Better not tell you now."

How much worse could the decisions be, really?

* The closest we came, at least as a group, was when all four of us went out to see Mum and she decided it was time to part with exactly one piece of furniture. Mum had my brother and I bring out a small radio cabinet that my Dad had renovated and had been in our house since we were all kids. She had us place it in the middle of the living room and she turned to the four of us and asked, "Who wants the radio cabinet?" Based on our reactions, you would have thought she'd asked, "Who wants to hold the nuclear warhead?" None of us were touching that cabinet. I wound up with it only when Mum added that she thought I should take it since the XS and I had recently moved into a house that had more room than furniture. 

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