Have you ever had to make a decision, the result of which would change -- or end -- your or someone else’s life forever? If so, I suspect you remember almost every Nanosecond of that process. I do. I have come to refer to these moments as “Existential Decision Making.”
It has come to my mind in two different, bright moments the past few days. Each moment raised a different yet equally compelling urgency to the importance of lifting up the searing, aching and often unbearable personal moments into broader contexts.
First, was the article in The Washington Post on April 30th on the issue of “watchful waiting” for women with “stage zero”, “ductal carcinoma in situ” breast cancer. The article explored the question of finding out if women should consider a formal “watchful waiting” of the cancer before taking any specific medical action. Similar research is going on for men with respect to prostate cancer, which is explored here by the American Cancer Society.
So, you have ‘cancer’. How about we just watch it and wait and if it starts to spread or get worse then we will do something? Weigh the impact of aggressive medical treatment, loss of breasts or the prostate, against the possibility that the cancer won’t be the thing that kills you. The Post article is about a large scale clinical trial that is going to test out comes and results from woman who opt for watchful waiting and those who opt for immediate treatment. My question, though, is how do you – the woman and the woman’s family -- decide? To me it is an “existential question.” Your answer to that question may well determine when you die.
Second, I attended a presentation by a young post-grad student about her final thesis. In her voice I could hear the strength of her outrage and the quiet energy of her cause: Men (legislators) making decisions over women’s bodies is not just wrong, but I have articulated in my thesis the moral basis for why it is wrong. No one should tell you, a person (though in this context a woman), what you can do with your own body. And in particular men telling women. I internalized this presentation though differently than I think the student expected. You see in our family we had a situation in which a late term abortion was deemed medically appropriate and was carried out. As it turns out, within a year the Commonwealth of Virginia legislature passed legislation that had it not been vetoed would have made that procedure illegal. Yet we had witnessed the “existential decision making process” on making the choice and how it had people doing things – being in a position – that they didn’t want to be and making irrevocable decisions that one could never know were “right.”
"Existential decision making” While each case is different and could be discussed at great length, the common thread to me is the depth of challenge. As it happens, I have been “touched” to some degree by each situation. There is rarely, if ever, any training or preparation for these moments. In good times there are resources, like the Chaplains in hospitals, the Hospice Care professionals, and pastors and Rabbis or other religious figures. There are emerging public forums for discussing these questions in a movement called “Death Cafes” These are public, self-organized conversations about “existential” matters.
One of my goals in presenting The Actual Dance is to lift up the idea that there is a place for sharing this process and that by doing so it is possible to help people find a place of wholeness again. It is the experience of my own journey with Susan and having heard hundreds of people share their stories at our post-performances dialogues that open sharing of these “existential decision making” experiences can be positive and transformative.
I also believe that academia, science and the medical profession need to reconsider the role of these moments in both analysis and recommendations. There are many things we do not understand well or at all. “Existence” is one of them. Why is it some people are miraculous survivors against all odds. (Is it just a matter statistics?) Why is it in senior communities that the “other spouse” dies shortly after the loss of their partner? What role does the mind and heart play in figuring out “the right thing to do” in the face of the more “scientific” and “data driven” recommendation. How do we account for that?