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Regret



​
Yangon, Myanmar
April 2015

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From time to time, I think about a patient and friend of mine from last year. A former paramedic in his 40s, I met him on the ward after being requested to make a diagnosis on his somewhat mysterious medical condition; for three years, he had been losing weight and noticing "twitches" in the muscles of his chest and arms. Consequently, my friend had visited several different general practicioners during that time, and for whatever reason, had always left the office without an answer, usually being told "not to worry about it." These apparent blow-offs inevitably resulted in a heated departure, with my frustrated friend storming out of the office after aiming a few colourful expletives in the general direction of the general practicioner.

When I met him on the ward, a cursory inspection allowed me to be reasonably sure of the nature of his condition. This is not to give myself any credit; after three years of progression resulting in enough weight loss and wasting to result in a hospital admission, the condition was in its later stages, and moreover, having experience with neurological conditions, I recognized this particular condition like an old friend - or enemy, I'm not sure which.

After a lengthy chat and examination, I took a couple of days to perform several investigations before gently confirming to my friend, and later again to him and his family, that he had amyotrophic lateral sclerosis (ALS), a condition with a median prognosis of about three years.

My friend spent a couple of more days in hospital during which time we commenced the meager medical treatment available for ALS, arranged a few home and community supports, and sent him home. Although the diagnosis was difficult to accept, he was in much better spirits, knowing the specific nature of what had ailed him for so long.

Over the next few months, we met for follow-up appointments and spoke over the phone a few times. I distinctly remember one such phone conversation, where I asked my friend how he was doing, to which he replied, "Mate I'm doing great, out here on the beach with the family, chucking a few shrimps on the barbie" - that's Australian slang for barbecue - "and just doing what I want, no work."

Before departing nearly a year later for a long journey, I saw my friend and his wife during my last week at work; he was thinner, but still smiling, still enjoying, though things were getting harder for him and his family. We shook hands and smiled at each other. Being on that journey now, I may never see him again, but those words still resonate within me:

"Just doing what I want, no work."

The Regrets Of The Dying

The most obvious observations are often the most profound, for they usually go unnoticed by those who are preoccupied with "more important" thoughts. In her book, The Top Five Regrets of the Dying (1), an Australian palliative care nurse named Bronnie Ware questioned patients in the final weeks of their lives what their biggest regrets in life were.

The most common response was:

"I wish I'd had the courage to live a life true to myself, not the life others expected of me."

Instead of choosing to follow at least some of their dreams, most of these patients had lived great portions of their lives under the burden of trying to satisfy the expectations of others. Expectations of society are one thing, but how many of the expectations thrust upon these patients arose from loved ones? Even more to the point, if something is "expected" by one person with regards to another, can that really be love?

The next most common response - stated by every male patient - was:


"I wish I hadn't worked so hard."

According to Ware, all of the men that she nursed "greatly regretted spending so much of their lives on the treadmill of a work existence." Now, the work of some people may be driven by passion and flow, but for the majority, it probably is not; if so, what is the impetus behind all of this hard work which deprives a person of more time with their family and doing things that they enjoy? Perhaps the answer is "financial security" - and yet how much security does a person, or even a family, really need?

Learning From Regret

Regrets are often associated with negativity, but for now we will view the regrets of the patients in this study as positive, for we are trying to learn from them. It is not unreasonable to suggest that if one were to base most of their life on simply avoiding these top two regrets, it would be a life worth living. 

Regarding living a life true to one's self, this can be difficult if one is "locked" into a role expected by other people. To follow through on this requires both honesty and courage - the honesty to admit that certain necessary dreams are slipping by unfulfilled, and the courage to perhaps shatter the expectations of others. Some might take the view and suggest that such an approach is selfish, but this is a narrow view, for by being true to one's self, one is ultimately able to give more to others later on.

Regarding not working too hard, this might seem next to impossible for those who are just barely keeping their head above water financially. However, a closer inspection of one's material possessions might shed some optimistic light on the situation. Quite simply, an individual or family does not need that much stuff to live on. So many things deemed necessary - the bigger house, the better car, the new iphone - are actually superfluous; and while these material possessions pile up so too, apparently, do the future regrets.

To wrap things up, it might be apt to mention a couple of final quotes from Ware.

Regarding living a life true to one's self:

“... to be in any sort of relationship where you do not express yourself, simply to keep the peace, is a relationship ruled by one person and will never be balanced or healthy.”

Regarding not working too hard:

“Don’t work too hard. Try to maintain balance. Don’t make work your whole life.”

Can anyone afford not to act on this?

Solace.

References
(1) Ware B. 2012. The Top Five Regrets of the Dying. Hay House.

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