It is a cold dawn in Wellington. My computer keeps giving me error messages. It is full and it seems tired—the battery dropping from full to nothing in just two hours. What a metaphor for mid-December—for all of us, probably, but surely for me along with my computer.
I have had my last gig of the year, a shining success that made me proud beyond words at the difference we were making in the lives of our clients at this massive global tech firm, proud at the way we have built the team inside Cultivating Leadership, proud of the way we partner with our clients, proud of the work Keith and I did to write Simple Habits and Wendy did to lead the design team for this particular client.
I have met with Carl who has asked me interesting and difficult questions that will swirl around me as I try to decide what my next move should be and what community I most want to marshal.
And I have met with the final oncologist of the team, the radiotherapy oncologist, and now I know for sure that nothing can be known for sure.
“How can I know whether radiotherapy is the right treatment for me?” I asked.
“I usually recommend radiotherapy in those cases where there’s a 15% chance of recurrence, because then the risks of the treatment are worth the benefits,” Dr. Kim answered, reasonably.
“Ok, and what are my risks of recurrence?”
He smiled kindly. “There is no crystal ball for you, so we cannot know your risk. So you should definitely have radiotherapy.”
And then there was the question of 5 weeks or 3 weeks. Here the normal course of treatment has moved to 15 sessions rather than 25. I asked whether there were new studies about this. Actually, the studies were in the 1990s but they wanted to look at long term ramifications, so the protocol here in NZ has just changed in the last two years. And the studies did not include women with implants and so there will be no recommendation on women with implants for decades perhaps, or maybe never. So I should have the typical 5 week treatment. What is the difference between these protocols? Other than the 2 weeks? Well, the shorter one seems to be easier on the side effects for women—a surprising finding because it’s more radiation each time. If it’s easier, shouldn’t I try it? No because the research isn’t in yet about that.
It is simply never clear and the more questions I ask, the more the doctors tell me they don’t know. What starts as a totally certain façade when I walk in the room turns into a kind of educated guessing game after a few questions. And that guessing game leaves me totally confused. The big side effects: Radiotherapy damages your lungs, heart, and ribs a little. It changes your skin so that it is rubbery and can be uncomfortable forever. In 40% of women with implants, it damages the implant, sometimes requiring more surgery to fix it. It’s not a small decision.
I stayed in the hospital afterwards to visit with a friend who has surgery tomorrow. As her doctor walked her through the procedure—sounding very sure about what would happen, unless it didn’t—we had an earthquake, and the whole hospital shimmied and rattled for a few moments.
We have no idea what the future holds. We scramble to make decisions about a future that we cannot predict, as the very ground beneath us reminds us that unpredictability and uncertainty shimmer everywhere in the fabric of our lives. I’m realizing that my choices are less about what will happen as about who I want to be as I make decisions. Do I want to be the one who took every single precaution? Do I want to be the one who pursued alternative possibilities? Do I want to be the one who tried a therapy that wasn’t yet researched on her population and opened that way for others? There is no telling which of these treatments would work for me or what the benefits might be or whether they will keep me on the planet for longer. I won’t even know afterward whether I made the right decision or not. So as I think about what to do next, I will try to think less about what will happen next and more about who I want to be. At least that one–who I want to be– is about the present and not the future, and that one I can control a little, and that one can withstand earthquakes and cancer and even a full and cranky computer.
Now for the next question: Who do I want to be?