By: Dr. Robin B. Dilley, author of In A Moment’s Notice: A Psychologist’s Journey with Breast Cancer and a licensed psychologist.
Certainty is a word that we use often but usually do not think much about what the word means. When you think about about the word certainty what do you think it means? Are you certain? Do you know for sure? How do you know?
Allow me to take some creative license and play with the word for a bit. In reality the concept of the word certainty is an illusion. An illusion is a perception of something but not necessarily reality. For instance, in couple’s counseling the words certainty, illusion, and perception become hot-topics of debate. In the medical field the debate is similar. As patients, I am fairly certain that you have come across doctors that know everything about your disease and exactly how it should be treated. When you dare to throw in a question or contradictory opinions you might find yourself dismissed and patronized. The Buddhist Monk, Shunryu Suzuki, describes that phenomenon like this, “In the beginner’s mind there are many possibilities, in the expert’s mind there are few.” As a cancer patient you are a beginner. You have many possibilities, the expert has few.
You are now painfully aware that certainty can be changed in a moment’s notice. One day you were doing your thing, raising your family, building your career, practicing meditation and yoga and the next day you were given the diagnosis of cancer. All of a sudden the world as you knew it changed and you are now a Cancer Patient. Maybe one day you will be a Survivor. But that is not certain. Now, you understand the word certainty and uncertainty from an experiential viewpoint. Sometime during my journey I acquired a t-shirt that simply said, “Living with It.” Those three words seem to state it clearly. From this day forward you will learn to live with uncertainty. Your mortality has snuck into your perception and your reality has changed.
In an attempt to reduce cancer to some sort of understandable logic, I often explain: “Everyone has cancer cells (mutant cells) in his/her body all the time. However, something goes awry in the cancer patient’s immune system and those mutant cells get together and build a tumor and from there feed off of your blood system. The goal is not to issue a building permit.” But as you and I are quite aware, people build add-ons, garages, and other permit required structures all of the time, and if the city does not catch them they have what they want without a permit. You and I can do our job to make sure we don’t issue a building permit, but we cannot be certain that cancer is not having an underground building party. Cancer is stealthy. It does not announce itself and it is not particularly noticeable until it has fully invaded.
It is important to make educated and calculated decisions in your life but do not let yourself drop into a dark space if those decisions do not pay off just like you thought they would. You are responsible to investigate, research and educate yourself about the decisions you are moving toward but you cannot know the future. Do the best you can and always do your homework. Certainty is elusive and not something that one can count on finding. Can you name the things in your life that you think are certain? Go ahead and list those certainties. Think about those certainties by asking yourself, what is plan B? Plan B is a necessary insurance policy about the certainty that you think exists. Certainty is easy to default to, especially if one does his/her homework and certainty can help you cope and feel safe but it cannot be counted on. Certainty is a helpful target and the target needs to be as stable and planned as possible. Certainty is also helpful when making important choices in your life. Choosing the right college, the right health plan, and the right retirement plan. But with any of those issues a Plan B is always helpful. It is certain as you go through this medical maze of important choices that you will be met with some unsolved puzzles and uncertain outcomes. But remember in the mind of the beginner there are many possibilities. Learn to enjoy the possibilities and lighten your load. Learn to enjoy the moment, your favorite ice cream, your favorite book, movie, and most of all have your favorite people around. Live lightly and discover something good about being alive today.
You may also find it helpful to ask the question, “If I choose this, what is the worst that can happen?” If that happens then what are my options? Maybe you think that the worst thing is that you will die. Remember if the worst that can happen is that you might die, it may be helpful to keep in mind that death is one thing we all have in common. We will all die. That is certain. So, the questions really are ”How do I come to live with this uncertain diagnosis?” “How do I become my own investigative reporter and explore uncertain territory when it feels like the odds are life and death?” Do your best and that is good enough.
Dr. Robin B. Dilley, author of In A Moment’s Notice: A Psychologist’s Journey with Breast Cancer is a licensed psychologist in the State of Arizona. Her eclectic practice allows her to cross diagnostic barriers and meet clients in their need assisting them to respond to life in healthy and empowering ways rather than react to life’s circumstances.