Wednesday, February 18, 2009

Branching Uncertainty




One morning many years ago while lying in bed, I felt a lump in my breast. It had not been there before, and it did not feel normal to me. I decided that it was cancer. After all, my aunt had died of breast cancer when she was only 35, and my mother had gone through a lumpectomy and radiation for breast cancer only seven years before. It was my lot to have cancer myself with this history. For a brief moment, I felt uncanny relief. For how many years had I fretted over this? Uncertainty was a weight that never strayed far enough away. In that moment, knowledge was sufficient to lift the burden.

But just as quickly, questions formed. Certainly I would never permit chemotherapy, or would I? How could I find a decent breast surgeon in the god-forsaken town I lived in? Could I continue to work? If I had to quit working, how would I support myself? Would I die of this?

Within three weeks, I was forced to reassess. Witlessly callous, a doctor declared that it was "nothing" but sent me for a mammogram. But it wasn't nothing, it was what it was, a fork in the road, an opportunity to ask myself difficult questions, to answer without the benefit of facts and prognoses. Although I didn't respond with such equanimity at the time, I have learned to indulge in the "what ifs" of life more and more as I get older. It is this rich imaginative internal conversation that I find so revealing. I learn things that I didn't know about myself. Before certainty, I know that as things progress—for better or worse—I will not have access to the na├»ve wonder of what all of this really means to me. I do not know what might be in store for me. For me, that is an awesome time for looking inward.

Fortunately, the mammogram also was "negative". I decided that there was no cancer. Relief, like a flood, washed me clean of worry. But this was a brief spell of relief also. Could there be a mistake? Would next year be too late to treat what I thought I had found this year? If I was simply wrong, what did that mean? I had decided that I had breast cancer, if only for three weeks. Was that long enough to let my guard down, and allow a cancer to begin? Or would my vulnerability to the suggestion of cancer simply stay with me until, in my own incompetence and neurosis, some doctor would, in fact, misdiagnose cancer and subject me to unnecessary treatment?

The crux of the dilemma was with my inability to handle uncertainty. But I have come to appreciate that there is no certainty, or no "certain" truth. I decided that I had cancer, I later decided that I did not have cancer. I made a number of other decisions based on each of these potentially false decisions. Each question raised at least one additional question. But more ominous, each answer to a question seemed to generate a branching network of new questions.

Upcoming, Part 2: Another View of my Left Breast

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