It has been a while since I wrote a blog post. And this one, although related to the field of Medical Speech Language Pathology, is more about certain situations I have experienced in life, while working in the healthcare setting and the lessons learned along the way. Often, I run into patients whose life stories really touch me and make me examine my own life as well. I wish I could list all of them, but this particular post that I was inspired to write is about love and loss, life and death and most importantly, about holding on and letting go…
Some of the hardest decisions and challenges in life boil down to one choice; the choice between holding on and letting go.
How long do you hold on to someone you love? When is it time to set a loved one free?
How long do you hold on to your personal beliefs about life, loss and death? When is it time to let go of them in the face of the changes in your life?
Should you hold on to a decision you are unhappy about? Or must you decide to let go and be at peace?
The pushing and pulling between holding on and letting go is inside all of us. We all have things and people that we care about in our lives. We all have our reasons that push us to one side of the equation, but we also know the other side has some merit, too – and THAT is the real struggle!
I recently treated a patient who woke up after a Laryngectomy (removal of the larynx), unable to speak, breathing through a hole in his neck, knowing his voice and life will never be the same again. I could not help but imagine the thoughts going through his head. How does he wake up every day with the will to go on? What was he thinking minutes before the surgery? How do we prepare ourselves for life altering changes such as these? How do we get the strength?
There are patients I have had to tell that they can never eat anything by mouth again because they cannot swallow safely and are at risk for death. There are patients who have been given the diagnosis of a degenerative disease or a terminal illness for the first time in front of my eyes. What does that person do in such a situation? What do the people who love that person do? Is there a right way to react? Do you hold on? Or do you let go? Is there a right choice?
Sometimes, letting go is the right choice.
I had a patient a few years ago at the start of my career, with one lung. She was told that she would have to be dependent on a ventilator for the rest of her life. She was 45. This woman decided she could not spend the rest of her life hooked on to a machine, not being able to breathe on her own. ‘Breathing!’ she told me. “What is more natural than breathing? If I cannot breathe on my own ever again, will I really ever be alive?” She requested her family and the doctors to take her off the life support. There was a day when I was waiting outside her room and she was saying her goodbyes, knowing in a few days, she will no longer be alive. Honestly, it frightened me! It was the first moment in my practice that I realized how fragile life really is. I cannot imagine how much courage it must have taken to make such a decision. To make the decision of letting go… Not just for her. But for those who loved her as well. They let her go because they did not want her to suffer any more. In this situation I realized, there was real strength in letting go…
I often quote this to some of the family members who are unwilling to let their parents or loved ones pass away comfortably, because they are in denial of loss and death.
“Giving up does not always mean you are weak; sometimes it means that you are strong enough to let go.”
The ability to hold on
Society tells us that we should fight hard against age, illness and death: “Do not go gentle into that good night,” the Dylan Thomas poem says. “Rage, rage against the dying of the light.” Holding on to life and to our loved ones is a basic instinct for all of us. I have come across many patients who have told me that they believe that there is courage and strength in holding on. To hold on means to ‘hang in there, to wait, to manage, to deal with something that is difficult, and to keep trying to succeed.’ It may be holding on to relationships, situations, people or things. Holding on gives us a sense of purpose and control.
People explain such situations in many ways. They salute the efforts of those who try really hard and fail in relationships, quoting Alfred Lord Tennyson, “’Tis better to have loved and lost than never to have loved at all.” They insist that perhaps, staying the course a little longer could have tilted the results in their favor. They believe giving up implies weakness. They don’t believe in letting life take its course. They are the ones who want to create their own destiny.
These are the people who may have successfully fought cancer and other terminal illnesses. The patients who undergo as many procedures and treatments as necessary to survive. The family members who will do what it takes to let their loved one be in the physical world with them as long as they possibly can, even if it involves pain or suffering. We all have been there, because we all have held on to something that mattered.
For those of you who know Stephen Hawking, he has beaten the odds of a daunting diagnosis of ALS (a motor neuron disease) by more than half a century. He was given a life expectancy of two years at the age of 21, but somehow he held on and continues to make history even today from his wheelchair. He said in one interview, ‘We are all different – but we share the same human spirit. Perhaps it is human nature that we adapt – and survive.’ That has stayed with me a long time. Stories like his make me appreciate that perhaps there is real strength in holding on, fighting the odds with all you have and not giving up.
How do you know which one to choose?
The answer is as simple as it is complicated. That holding on and letting go are two sides of the same coin. The best way to hold on is letting go. Or vice versa.
I end with one of the personal battles I have been facing for a few years. Someone very dear to me has Alzheimer’s disease. It makes you gradually lose your memory, your ability to take care of yourself, your emotions, your language and your ability to function normally in everyday life. I have seen this person change in front of my eyes, from someone who made decisions for me and looked after me, to someone who still loves me but can no longer love herself. Someone who can sit beside me but no longer is aware of my presence. Who knows she loves me but forgets as soon as she remembers. This is not just my story. It is the story of millions around the world.
Do you keep loving in situations like these, when you know a certain relationship has an end? Knowing that the more you love, the harder it will be to let go? Or do you stop loving and prepare for loss, knowing you might regret later that you didn’t love enough?
I think you keep loving. That is what I continue to do. After all, love is impossible with the fear of loss . You cannot have one without facing the other. I have seen family members in the hospital struggling to clear out their loved one’s belongings after they pass away. Some people clean out the closet as quickly as possible because the memories are just too painful. Others leave entire rooms just the way they were before their loss. How do you decide what to keep and what to let go of when you lose someone you loved? This is not just about closets full of belongings. It is true for life itself.
I have come to the conclusion that in life, we will be faced with decisions where we need to do both. It is best to learn to ‘hold on tightly and let go lightly’. Sometimes you plow ahead; sometimes you choose to step back. Sometimes you follow a dream; sometimes you make room for a new one. Sometimes you continue to love, sometimes you let go and move on. Both choices need strength, both need courage and both are about making life as comfortable as possible, for ourselves and those we love.
Choices are not right or wrong. Just better or worse. Understand your true intentions, listen to your instincts, and then make the best choice based on what you feel is right. The key is to listen to your ‘inner voice’. Not what you think you should do, or what you think other people would do, or what you think looks good. But what you know is true in the still, quiet place within you. After all,
“All the art of living lies in a fine mingling of letting go and holding on.” -Havelock Ellis