This letter begins with a somewhat rhetorical, yet philosophical, question. I sometimes have viewed the pathway of critical illness like entering a dark tunnel. When one enters an ancient cave or mineshaft, one does not know if it branches, reaches a dead end, follows a maze where one could get lost, or emerges with light at the other end. Giving up the light of day to enter an unconscious state of anesthesia has always both interested and worried me. Long ago I asked the anesthesiologist to quit telling me "Well, here we go." I can remember the first stage of general anesthesia where I dropped into a black hole not knowing where it ended or what would follow. Upon awakening, I had the answer that more life lay ahead. So it is with many people who struggle to battle both acute and chronic illnesses.
There are times when the battle must be halted and a détente declared. I called this a détente with death.
There will be a time, guaranteed, for all of us when the struggle to survive is not only futile, but meaningless. I believe the journey to find one's spirituality takes final hold at this point.
Those of us who have suffered serious and critical illness quite naturally have had to endure suffering in order to reach our goal of survival. This may be painful, frustrating, depressing, fraught with periods of exhilaration only to be followed with the crush of despair. All I can say is that the struggle for survival is worth it until the end of life is at hand.
I'll be in touch next month!
Thomas Petty, MD