Making a hard decision

For most of my life, making decisions has come quite easily for me. And that was partly because of the way I handled them.

Often I already have the necessary information I need to decide swiftly and effortlessly. Daily choices made in life and business immediately come to mind. For instance, I don’t agonize over what to wear on any given day. Nor do I characteristically hesitate whether or not to take on a new project.

“Troubleshooter” is my middle name, meaning I am adept at seeing both problems and solutions. Arriving at resolutions typically call for choices to be made along the way.

Even for bigger decisions, those with weighty consequences if wrong, I excel at doing the necessary research, including listening to other perspectives, not being impulsive or emotional, and then weighing the pros and cons. An illustrative example in this category would be my hard decision to end a business partnership that wasn’t working for me, even when it meant giving up “my baby”—and that’s happened three times in my life (!)… so heartbreaking at the time, yet so right (each time!) when I look back.

On an important decision one rarely has 100% of the information needed for a good decision no matter how much one spends or how long one waits. And, if one waits too long, he has a different problem and has to start all over. This is the terrible dilemma of the hesitant decision maker.

Robert K. Greenleaf (The Servant as Leader)

I am satisfied that most, if not nearly all, of the more difficult decisions I’ve made along the way, have turned out better than well. In the long run, almost no regrets.

So does that mean I think I’ve made no mistakes? Heavens, no!

I’ve made countless decisions that turned out to be downright wrong or led to an undesirable outcome. For instance, I’ve hired people whom I’ve later had to fire. I’ve bought clothes I ended up never wearing. I’ve befriended people who turned out to be disloyal. I’ve driven down dead-end roads.

Yet each of my wrong decisions just led to another decision to be made. And I continue to make them boldly, without fear, without dwelling on worst case scenarios. Without drama.

You can’t make decisions based on fear and the possibility of what might happen.

Michelle Obama

Are you curious what my secret is? Since I’ll tell you, it’s really no secret. I’ve said it so many times.

My main principle is this: I make my decisions intentionally, as informed as I can be, then I let go of the outcome.

I don’t second guess my choices. Once I make the decision, I’m committed until life shows me a new decision is needed.

Do the best you can until you know better. Then when you know better, do better.

Maya Angelou

Wrong decisions at best are excellent lessons. Very, very few decisions are permanent (such as deciding to give birth to a child or taking a life).

What will happen, will happen. I don’t look back and beat myself up when the outcome isn’t what I had hoped or expected. In most cases, too many factors are at play that determine the outcome, factors that are beyond my control.

I see life as a continuous stream of decision-making. We decide every minute how we want to live that minute and the next.

Living in the now means being aware of, and present to, what is happening now and what is important to us now, yet in the context of a future we want to have.

The end of this post gets rather granular, so that is for those who are following my treatment journey. Below I share how I moved toward a solution to the problem that was raised in my previous post on the hormonal therapy my oncologist prescribed.

This post was inspired by the fact that it took me a bit longer than usual to decide this possibly life-affecting issue. I wanted to consider not only the rational reasons, which I list below, but I also wanted to give myself more time to ponder my intuition, my gut feels, my emotions.

As my friend Rose asked me, “what is the wise woman in you whispering?”

Visionary decision-making happens at the intersection of intuition and logic.”

Paul O’Brien (Great Decisions, Perfect Timing)

As I see it, most of my choices over the years have included this intuitive component. It was, I feel, my intuition that knew to let go of an outcome once I decide.

I am about to do so again.

How I decided about my hormonal therapy

I was having a hard time getting my oncologist to have a discussion with me about the prescription he had given me without consulting me for my post-chemo hormonal therapy. So, I decided to do the research and tell him my conclusion as I thought it best for me.

This is what I wrote to my oncologist yesterday:

Here is my current thinking on my hormonal therapy for ER+ breast cancer. It is clear that today the more effective therapy for post-menopausal women is the aromatase inhibitor (AI), as you had prescribed.

Nonetheless, there are other valid considerations, and frankly it’s down to a numbers game (ie, a crapshoot).

I consider that:

These considerations lead me to the conclusion that starting with tamoxifen for 2-3 years would be worth trying, both for physical and financial reasons. Of course my body’s reactions to the tamoxifen would need to be monitored.

I’d like to hear your response to this. IF you agree with this course of action, I would need from you

(1) a prescription for the tamoxifen (although I’d still rather wait to start until the radiation therapy is completed mid-Feb), and

(2) a note stating that a different course has been decided on that does not include the Arimidex that I can take to the pharmacy to get reimbursed for the Php10K I was charged (they won’t accept the return without your note)

Thought writing this down would help expedite a decision. Thanks.

My oncologist’s immediate (and only) answer:

Agree given the limitation.

If you obsess over whether you are making the right decision, you are basically assuming that the universe will reward you for one thing and punish you for another. The universe has no fixed agenda. Once you make any decision, it works around that decision. There is no right or wrong, only a series of possibilities that shift with each thought, feeling, and action that you experience.

Deepak Chopra

How at ease are you about making decisions? Is there anything that prevents you from confidently making choices? Do you have regrets?