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When You’ve Done All You Can

During a recent Shiva call, the topic of competent medical care was discussed. The deceased was an elderly woman and her children and spouse wondered if the medical system had done all they could for her or if her age had played a factor in determining the type and amount of care she receive at the hospital. The family felt that it had. They said that they had discussed treatments with the doctor that hadn’t been administered, found out once it was too late about other means of dealing with the medical situation and, in general, felt that if they had acted differently their loved one might have been alive today.


It did not help the family sitting Shiva that some of the people who had come to lend solace and console them in their time of grief told them that they should have done this or that, now after the fact. And though all this may be true, in the end, it is important to remember that it is Hashem that rules this world and when it is our loved one’s time there is nothing we can do to change the result.


Having said that, it is important and comforting to know that we did all we could with a system that is frightening, overwhelming and foreign to most of us. A system that intimidates us easily and sometimes even bullies us into agreeing to decisions we do not agree with.


But how do we determine when we have done enough? Chances are we will always feel we could have done more and should have tried this or that.  But, we are human and limited by the boundaries of the circumstances we live in. A young mother of six children all under 15 with a chronically ill husband who is hospitalized, no family in town and a job, can truly only do so much. She cannot − and should not − compare herself to how another well spouse, who is older and retired, handled a similar crisis.


The retired woman’s children are probably adults who may live in the same city and can share the visiting and decision-making. One may be computer literate and able to research the illness and look into alternative means of care.  The only commonality in these two scenarios is that both women are well spouses.   For anyone to expect both of them to be able to handle the situation in the same way is naive.


For them to make this comparison of themselves is precarious and fraught with misguided and inappropriate expectations. To do this can only lead to feelings of guilt and inadequacy.  Because their life styles are so different, and where they are at this point in their lives is so different, their approach to dealing with the illness will be very different. And while the younger woman may wish she could do all that the older woman is doing to care for her loved ones and deal with the medical system, it is a fantasy. She is limited by her reality and needs to know she did the best she could at that point in her life.


Each of us is an individual with all kinds of differences and we all cope differently. Many caregivers are just too exhausted to fight with the system after fighting with it for so many decades, no matter where they are in their life’s journey. Most of us trust the doctors to do their best and most of the doctors do their best, but it may not be enough to keep our spouses alive in a crisis.


More important than whether you decide to accept what the medical system did was the best that could have been done for your loved one, is for you to accept that you did all you could for those you love, based on your situation at this point in your life. To “beat yourself up” because of others telling you how you should have handled the situation, or even expecting yourself to do more than was possible for you to do at the time, not only doesn’t help, it causes pain to everyone around − but is also mostly not true. And, most important − you must take comfort in knowing that whatever happened was meant to happen and it is Hashem who rules and decides the outcome, no matter what we are able to do.


You can contact me at annnovick@hotmail.com.

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More Articles from Ann Novick

When one is blind one learns to use Braille to read. When one cannot walk, a wheelchair gives mobility. Sign language allows a mute person to speak and ocular implants assist in hearing when one is deaf. These are all compensatory strategies that help a person function despite his disability. But compensatory strategies are not just for physical problems. Understanding our psychological weaknesses and setting up our lives to ensure that we are not tempted to repeat our past mistakes, is as necessary as any aid to the disabled.

Well spouses have often discovered that their friends and relatives, despite their closeness to the situation, often don’t realize the tremendous emotional impact living with chronic illness has on the family. With the best intentions, suggestions, ideas and criticism are offered, based on the non-experience of those with healthy families. Even when the good intentioned get a taste of the difficulties, it is sometimes not enough for them to then identify and understand what the family of the chronically ill must face on a constant basis.

Over the past two weeks I have shared letters from a therapist and a well spouse. Both of the letters gave personal insights into the process of losing hope, how we react when that happens and some ways of coping when test scores, diagnosis and just simple repetitive behavior indicate that change for the better is impossible.

Dear Ann,

I’ve read your last few articles on psycho-neurological testing (Oct.8-22) with interest. As a therapist who has counseled couples dealing with chronic illness, I’d like to give you another perspective.

Dear Ann,

Your articles on the Neuro-Psychological Testing were right on (October 8-22). My husband underwent testing twice and your articles explained it things exactly the way they were. Besides the test, we also tried therapy.

Very often when we can’t face our big hurts or big loses we focus on the little ones. We can discuss those. We can cry over the small loses, be angry at the smaller hurts even though it may look trite and sound ridiculous to others.

Over the last two weeks we have been discussing one way in which well spouses can determine whether behavior displayed by their ill partners is caused by their illness or is a way they have chosen to act. We have focused on Psycho-Neurological testing, what it can tell us, as well as its pros and cons.

Last week I discussed a question that haunts many well spouses: not knowing if the difficult and often inappropriate behavior frequently displayed by their partners are caused by the disease and therefore not-controllable, or if the behavior is a choice the spouse makes and can therefore be changed. This doubt can be the source of much frustration and many marital disagreements. One way of alleviating this doubt is by having a psycho- neurological work up done. But that path is not so simple.

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