When do you give up? When do I give in?

Written by Dr. Geeta Sundar

Sometimes, life throws at you the kind of agony you don’t know what to do with. I have witnessed the agony from all ends. The front, the side and the back. I’ve reflected on it. I have absorbed it and been too shaken to cry or work, and I have been so plastered with it that it has left me numb with disarray. I’ve been tasked with being too easy, a pushover, and someone easy to trample with. But my determination is a sword hard to clatter. 

As a doctor, I have seen diseases rip apart families, ties and love. I have seen enough grief to know when a strained relationship will succumb. I can predict the mishaps that will await a young couple burdened with a terminal diagnosis, or a sibling break away under pressure of money, or a father get violent under the wrath of the unforeseen. 

But you know the most impactful thing? 

Everyone wants one more minute to live, one more second to grasp, one more day to see, and one more hour to enjoy their life, warts and all. They don’t give in. They don’t want to give up. They don’t want to say goodbye. They don’t want it to end – the bad, the good or the ugly and even if it’s the worst life they have led, they don’t want it to cease. 

This feeling of constantly wanting to live another minute/second/day confuses me. They hate their lives but they don’t want it to stop. Honestly, I don’t think I’m like that. I’d give in. I’d give up. Enough is enough. Long drawn painful, terrifying hauls are scary and it would be a disgrace to be so unforgiving to my hurt self in such an-end-of-life/end-of-most-likely-good-scenario condition. I assume correctly that there will be a sect of people who will see another spectrum of this situation and refuse to give in and fight. But for me, it’s all about choosing your battles. And every once in a while, when the stakes are high, it’s best to just let go. Let everything go. The universe will right itself. 

Quite similarly, as a doctor, I don’t know when to give up care/give into the inevitable, but I think with time and experience, it has become easier to segregate. In neurosurgery, there is more than what meets the eye. There is a sense of a constant foreboding that signals you even before the patient cones/herniates. You become accustomed to picking up these signs and become attuned to understanding what a human body is trying to communicate with you. But when do you exactly throw a Hail Mary and ride the blackening storm with horrible peri-op complications to reach the other side of calm, versus, when do you manage it to the best of your ability and be less aggressive than your peers, only to reckon that you lost your one chance at saving a life? Again, I’m speechless. I wish I knew. I see such cases and think to myself in agony, what would I do if I were alone – whichever way I see it, it appears round, no edges, no clarity, just a lot of hearsay and a lot of advice, noise from all those who care to give an opinion. ‘Everything is fair in love, war and surgery.’ 

So do I give in? Or do I give up? How do I balance? How do I choose the right decision, each time, every time, and be a materialistic part of saving a life? How? I wish there was an algorithm. A scoring system that could help me decide. But no, it must come from within me and I need to own it. And oftentimes than not, I hardly ride the storm, and neither do I enter the calm and the hot outpour of agony from the trusting patient’s family is a recipe for another sleepless, sad night and gets tucked away into the mobile graveyard I carry. 

As a person, third party, involved on the other side of patient care, as a close family member, giving in and giving up are not options. But even then, I think, I’d draw a clear line. If it crosses the very principle of saving a life, where each measure is just supportive, not definitive and the overall prognosis is doomed and poor, then I don’t think I’d continue. I’d give in. I’d give up. I’d walk away. I’d make that decision for a close family member too. I’d give them that dignity. I’d let them stay happy in whatever final moments they have. I’d appreciate it. I’d choose the same for myself too. But, if the interventions were elaborate and could save a life in statistics or on paper, then I’d push, I’d push and persist and constantly pursue till we reached a point of no return. 

I think relationships overall have the same basis when it comes to hanging up the towel. When an individual invests time, effort, money and emotions into another person, there is always a reaction of unequal quantities that is shared between them. One cares too much. Another shares too little. One is too strong, another is too sublime. Experiencing emotions on an unequal level can mess with your head. Especially in damning stressful careers of highly intense medical fields. Not wanting to quote or mention Grey’s Anatomy – but we do have and invest in toxic relationships and a lie just for the heck of it when we can, coz it’s so much easier to find someone equally lost, harmed, battered, cynical like you in the vicinity, than go on a long search online to find an individual who just doesn’t get ‘why’ you love surgery! And I’ve seen many of my friends get sucked into this vortex of needing companionship, of some intimacy over what is the most sound choice. 

How much would you chase a person, an individual, or a relationship till you realize that it’s over, that it’s a done deal, that now it’s time to give up? When it hits on your primed principles? You can love and fight for someone, but fighting for their feelings is never going to be justified. The same feelings are bartered when you chase anything passionately. (Interject – a proof of mine often smirks and tells me – ‘We should never chase anything in life’). Moot point – to everyone on this twirling boat – learn to move on. Give in to the surreal, and give up the castles you built in the air. The page will turn, the agony you face will dissolve, and time will heal. If I count the lives I’ve lived, the experiences I’ve embraced, the world I’ve seen, I have a deep sense of feeling that I’ve seen almost everything that this planet has to offer. I have no more wild desires, and no more hidden agendas. I’d carry the pain I bury, happily, till the grave or into a pyre. I’d give up easily. I’d give in easily. I’d just let go. Freedom and peace come at a cost. Mine would be at the cost of a losing battle.

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