VII/62. Reality
Better to anticipate reality than get hit in the face with it.
The world is full of spin, lies and deception, but nothing threatens the practical reality that should govern our lives more than our own illusions and wishful thinking. There is nothing wrong with optimistic hopes while facing uncertain or extremely pessimistic outcomes, so long as one does not ignore the facts. We live in the hands of science, the epitome of reality.
––John Roberts
Humankind cannot bear very much reality.
––T.S. Eliot, Murder in the Cathedral, 1935
Facts do not cease to exist because they are ignored.
—Aldous Huxley
I can think of nothing more gallant, even though again and again we fail, than attempting to get at the facts; attempting to tell things as they really are. For at least reality, though never fully attained, can be defined. Reality is that which, when you don’t believe in it, doesn’t go away.
––Peter Viereck, Last Lecture, Mount Holyoke College, 1997
(Quoted in Profile, New Yorker, October 24, 2005, by Tom Reiss)
IN 1835 the Church withdrew the works of Galileo (1564-1642) from her Index of Prohibited Books. The broken and defeated man had triumphed over the most powerful institution in history.
––Will & Ariel Durant, The Age of Reason Begins, 1961
Reason deserves to be called a prophet: for in showing up the consequence and effect of our actions in the present, does it not tell us what the future will be?
––Arthur Schopenhauer
The more knowledge we have about the realities of lethal illness, the more sensible we can be about choosing the time to stop or the time to fight on, and the less we expect the kind of death most of us will not have. For those who die and those who love them, a realistic expectation is the surest path to tranquility.
––Sherman B. Nuland, How We Die, 1993
Reality is the essence of life. We may try to avoid it, sometimes we can fool ourselves for a time, sometimes we can change it, but it will not go away and it, or a new version, eventually triumphs. Regardless of where we are in the cancer sequence from diagnosis to remission, cure, or death, there finally comes a time when most of us are better off accepting reality than entertaining false hopes. Most of the way, however, the objective is to maintain the optimistic attitude and fighting spirit that is essential to improving the odds, however positive or dismal they may be.
This, however, may not so easily carry over into illness which is entitled to more compassion than the hard realities of daily life. The judgment about how much truth to give a patient, especially a dying one, can only be left to the individuals involved. This is a very difficult subject. I am certainly no expert and I advise the reader who may face it in any role to consider the thorough books on dying in the Bibliography by Kubler, Nuland and Byock. I have solved my own problem easily, and I have prepared my mental state for dying without knowing when. My doctors give me facts and scientific opinions, and I make my own motivation, hope, and optimism. I can only suggest that others try.
In some cases, it may be better to avoid the pain of reality and continue the comfort of pretending that the outcome will be OK. Some patients may move quickly toward a drugged or comatose state where there is no need to discuss what is to come. Others will know when the time has come, and slip into a state of peace and acceptance. Others will deal with it frankly and openly.
I have always insisted on straight talk so that I know what I am dealing with, and my doctors have had no trouble in shifting into that mode. It eases their burden. Others around me, trying to be compassionate, are bothered at first by my unemotional acceptance and black humor of the combat veteran; but they soon adjust, knowing me for what I am, and we will still have time for some loving words and tears when we say goodbye.
Sometimes it works in reverse, when the ill patient must comfort a loved one who is having trouble dealing with the impending loss. And, sometimes a loved one can be insensitive and hurt the patient unnecessarily by speaking bluntly. All must be careful.
