the five questions

i read recently that, in the UK, cancer diagnosis is more common than weddings. and that this disease is most common in people over 65. and that this disease is the most feared of all diseases, surpassing heart disease by 33%, even though heart disease is the cause of many more deaths. what does that mean to we who are 65+? do we live in fear? do we allow this fear to colour all of our remaining days? because we are living longer and therefore might have more fear-filled days, how do we manage?

my immediate family have all died of cancer. none of those forms of cancer are hereditary, but the odds of my dying of cancer are high. i used to think i would die of heart disease, since that too has taken its toll in my extended family. but since 2009, when my brother was diagnosed with multiple myeloma, i switched to cancer.

well...we will all die of something! really, it’s the treatment of cancer that is so dreadful, and so likely to fill me with fear. what will i choose? chemotherapy? radio therapy? alternative therapies? surgery? i have no answer, nor do i imagine i will have one until, and if, the time comes. it is only when faced with the reality of disease and death that i will know what is right for me.

being mortal is a wonderful book by an american physician of indian descent, atul gawande. he suggests that we ask ourselves five questions as we face the difficult decisions of disease and its treatment.

1. What is your understanding of where you are and of your illness? 2. What are your fears or worries for the future? 3. What are your goals and priorities? 4. What outcomes are unacceptable to you? What are you willing to sacrifice and not? And later, 5. What would a good day look like?

there is truly no way to answer these questions ahead of time, but they do provide food for contemplation. how will we live? how will we die? how can spiritual practices support the decision-making and the actions that must be taken? what is the influence of  belief on these decisions?

more questions than answers...for now.