Sunday, September 21, 2008

An Unwanted Journey: Day 1033 - A Tragic Optimism

"Unconditional faith in an unconditional meaning..."

I've mused on occasion in this blog about the future, about the loss of thinking about the future during my first bout with colorectal cancer, about the return of future thinking as I entered my "no evidence of disease" period, and finally about this second challenge and its frontal attack on my personal future. I've also recently reflected on narrating one's life story in the face of prognoses of one's own death.

At other times, I have railed against the tyranny of those who demand optimism or positive thinking on the part of cancer patients. The implication of those making such demands is that somehow one has a choice to live or die depending on the degree of optimism one can generate. Personally, I think this is pure nonsense, a cruel and insensitive way of shifting guilt around like deck chairs on the Titanic. It's something like the implied guilt of some religious people who act as if a lack of faith is the reason people die of disease. At best, such thinking is unsophisticated, at worst mean spirited.

But I'm left with a quandary. If optimism cannot be generated willy nilly, but if a positive attitude really does make a difference at least for quality of life, then we still have a problem about how one can realistically assess one's future while capturing the essence of hope or optimism.

Logotherapy suggests that optimism cannot be generated, but must be perceived or found. One analogy is true laughter. You cannot make someone laugh without giving them a reason to laugh. Once the reason has been given, the laughter is automatic. Optimism is discovered when one perceives meaning. When one discovers the meaning of one's life, optimism arises naturally, even as one faces one's own imminent death.

Logotherapy then goes on to suggest that one discovers meaning through one of three things: work, love, or suffering. Doing something useful clearly establishes meaning. Mutual care and concern for others also generates meaning. But suffering?

Suffering can be a means of transcending oneself, by taking the raw materials of loss and pain and constructing an opportunity for growth. This isn't about masochism. The suffering must be unavoidable. But once the unavoidable occurs, the opportunity is present.

As I anticipate Plan B palliative chemotherapy discussions tomorrow, I think some of my ruminations may be starting to reach pay dirt. Right now, I'm not sure about the future of work in my life, although I can obviously continue to do deeds that help others whether or not I am paid to do so. Love? Well, here I'm very lucky. Love will always provide meaning for me. And suffering? We'll see. I may have to develop some new skills, but I feel confident that I'll find resources not just in myself as I dig deeper, but in the biographies and stories of others. People like Randy Pausch and Leroy Sievers whose memory and example offer me a pattern to follow.

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