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On Purpose

by Wendy S. Harpham, MD, FACP

Inspiration image

During the disorienting weeks after a diagnosis of serious illness, people often ask “Why me?” This question never once enters my mind in the weeks after my cancer diagnosis, which I attribute to all I’ve seen over the years as a physician. If anything, “Why not me?” Then, after weeks of wrestling with fear of death, an unexpected concern erupts: “What if I survive?”

Suddenly I am grappling with existential questions of purpose. Assigning purpose to my ordeal beyond physical healing lessens the aloneness of lying in a scanner and the sucking pain of bone marrow aspirations. But finding purpose in my illness only increases my need to figure out the purpose in my life.

My answers begin when much-needed sleep is disrupted by my anxiety-induced and medication-tampered dreams. The varied details always fade within seconds of my awakening, but their collective message is unshakable: “Wendy, the purpose of life is to help others.”

Some friends insist this insight comes directly from God. Others believe it is simply the soul-less expression of the complex neurochemical workings of my drugged and stressed brain. Whatever, the notions of goodness and helping others give me direction. But the infinite number of possibilities nearly paralyzes me. I wonder how I should be helping others. I feel unsure of what I should be doing right this minute.

Seeing how I’m swayed to ignore my children or my body, the intoxicating power of purpose begins to scare me.

I’ve always prided myself on living purposefully. Goal-oriented and driven, I’ve appreciated the power of purpose to clear a straight path through all the confusing and tempting choices and to confer a sense of control. Now stripped of my white coat and freed of my frenzied schedule, I feel lost.

Not a week goes by that some kindhearted person doesn’t assure me, “Wendy, I know you are going to survive because you have a purpose on earth.” Nodding politely, I resent the unintended implication that my friends who died didn’t have a purpose. However, the corollary catches my attention: I can pursue purpose because I am surviving.

Of all my possible purposes on earth, my children are clearly top priority. As I undergo tests and treatments, knowing I must do all I can to be here for them releases fountains of courage and fortitude I never knew I had.

Physically unable to care for my patients, I discover I can write guides for them. The wordsmithing distracts me from my nausea and pain. My favorite joke – “I can’t die because I’m in the middle of a book project” – helps me feel in control. The more I repeat it, the greater confidence I enjoy.

I am riding the wave of purpose when a telephone call from a mentor-friend alerts me to potential problems with purpose. He’s been living with metastatic disease for over a year. I admire his passion for helping survivors, and I want to emulate his example of living joyfully no matter what is happening medically.

Partway through our conversation, I press the receiver against my ear, his words nearly drowned out by the whining of his son in the background, “Da Da! Me need you.” The episode sensitizes me to the cries of my own children and the danger of competing purposes.

On more than one occasion, I’ve stayed up too late supporting other survivors or writing at my computer instead of shutting down and getting enough rest. Seeing how I’m swayed to ignore my children or my body, the intoxicating power of purpose begins to scare me.

I almost can’t believe it when other survivors, swept up in the emotional high of gratitude and purpose, quit their jobs, spend money they don’t have, alienate loved ones, or make life-altering decisions without thinking through the potential negative consequences.

The culture of the illness warrior feeds dangerous illusions of purpose. The extraordinary accomplishments of high-profile survivors can make any effort short of running a marathon or founding a national nonprofit feel insignificant. And though I am always kidding when I make the crack about my book projects protecting me from dying, other people seem genuinely convinced that their devotion to purpose confers invincibility. Worrisome symptoms are ignored. Follow-ups are neglected.

To help me find balance between competing purposes, I seek counseling with a social worker and with my rabbi. I come to see that on some days my primary purpose might be just to get through treatment. Fulfilling my purpose, at times, might demand I decline invitations to interesting survivorship projects to make room for embracing my non-cancer life. Above all else, I must guard against a sense of purpose backfiring and hindering my recovery.

I can’t imagine living without purpose. It would be like hugging air. Illness has taught me that self-care is the first step toward fulfilling my purpose. Then whatever I am doing, if my words are said on purpose and my actions are done on purpose, I am living fully.

♦ ♦ ♦ ♦ ♦

Dr. Wendy Harpham is a doctor of internal medicine, survivor of chronic indolent lymphoma, wife, and mother of three.

Excerpted with permission from Only 10 Seconds to Care: Help and Hope for Busy Clinicians by Wendy Schlessel Harpham, MD, copyright © 2009 by Wendy S. Harpham, published by ACP Press.

This article was published in Coping® with Cancer magazine, January/February 2011.