Moving forward.

"When there is no place to go, I guess we still have to move forward."

A patient with end stage ovarian cancer said that to me yesterday as I was organizing her discharge home onto our hospice service.  She is young and pretty and kind and smart, and she is right. Moving forward is her only option.  And ours, too.

Sometimes we don't want to move forward.  We like things the way the are. The status quo. We want to stay put.

We may have a good thing going right now.  A great job, neighborhood, family.  And we love it. Life feels good and we want it to stay like that.  But then something alters it. A death in the family.  A friend who moves, kids who grow up and change. And even though we see the change and know that we need to keep moving along with the change, it is hard.  And some of us dig our heels in deep and try to remain with things just as they were, ignoring the changes all around us.

Some would call that denial.  And that may be true. But life keeps going forward even if we don't want it to, denial or not.  And I think that is difficult for so many of us to embrace.

Facing death is certainly difficult. But we die a thousand tiny deaths all of the time. And we mourn them without realizing it.

Holidays without loved ones who shared those good times with us for decades. Kids who grow up and leave and don't want to do the things we  always did when they were younger. Friends who get divorced or move out of town or simply vanish. Neighborhoods with for sale signs, new teachers at school, co-workers who retire.

All of these are life altering in their own way. We think that they are not that important, but they are.   And what many of us do is to hold tight and pretend that things are the same without thinking about it much.  We say, oh well, these things happen. We try to pretend all is well, even though we know deep down they are not.

And we don't really move forward. We stay stuck in the past, or try to hold onto a  present that no longer exists.  We try to make things the same.  And they are not.

"We will try to keep things as normal as we can for the kids." This is what my patient's husband said to me when we talked about him bringing his wife home on hospice.  And by that he meant that they would keep schedules the same, have them go for playdates and keep their routine as close to "normal" as it had been when mom was in charge.

But his wife, who was lying in the bed listening, did not agree.

"Life is changing for them, whether you want to believe it or not. I don't want them in their normal routine, there is nothing normal about what is happening.  I want to be with them as much as I can. Do special things with them. They have to move forward and I want to point them in the right direction. We will move forward for as long as we can together, and then you will all move forward without me.  It will be hard, but that is the best we can do."

As she said this, her stoic husband slowly sat down on the chair next to her bed, covered his face with his hands and wept. He said he didn't want to move forward. Couldn't face a life without her.  He lamented how mind-blowing this all was and that he thought if they just kept things as "normal as possible" then they could just stay put. 

I think we all want to think like that. But it simply cannot be done.

Life moves forward even when we don't want it to. Changes happen each and every day. We really have no control, although we think we do and hold on like hell. And short of staying in bed with the covers on over our heads, we have to eventually deal with them.

And that is the problem. We don't know how to do that.  We don't always know how best to move forward, especially when we don't want to.

I pray for the best for this family. The one thing that they will have is a lot of support.  The wife is wise and gets it.  Most people refuse to think this way. And that takes it toll after all is said and done. So, these kids are lucky in that sense.

But most of us don't get it, or don't want to.  Our lives feel off, but we are not sure why.  And the reason may be that we are just not allowing ourselves and those around us to move forward. We may be grudingly holding on to a life that has simply moved beyond us, even though we are holding fast. And that in itself can make us sick or depressed or anxious.

So, what is the trick.? How do we move forward?  How will this family move forward? Wish that I knew for sure.  But if you asked my patient, she would tell you, just like she told me and her husband, that to move forward you simply have to just let go, just be. Accept the changes and as much as you hate them, find something that feels good and head there one step at a time.

Wise words and a good lesson for all. Death is a great teacher. If only we would listen while we all still have so much time.


All changes, even the most longed for, have their melancholy; for what we leave behind us is a part of ourselves; we must die to one life before we can enter another. ~Anatole France

If you're in a bad situation, don't worry it'll change. If you're in a good situation, don't worry it'll change. ~John A. Simone, Sr. 

Our only security is our ability to change. ~John Lilly