Impossible Decisions

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Scott Drotar FDR
Our world leaders have to make impossible decisions where they know people will die, but these are “acceptable losses” if in the long run lives are saved.

Last week, I thoroughly enjoyed watching the three-part, docudrama, “The World Wars,” on the History Channel. As I listened to the historians and former political dignitaries discuss the difficult choices that have to be made during times of war, one of the things that kept jumping out at me was the idea of “acceptable losses” or “collateral damage.” When you are talking about human lives, obviously no loss is acceptable, yet in times of conflict we ask our leaders to make decisions where people are going to die no matter what, the only question is how to minimize the number of casualties. While most of us don’t have to make these life or death type decisions very often (thankfully), we do all have situations in our lives where we end up having to choose the lesser of two evils. In these trying circumstances, you have to weigh the pros and cons of your options and try to predict what course of action will be the least harmful and unpleasant. This crucial life skill is something that took me a long time to master, even though I have to make lots of these challenging choices every day. In developing this ability however, I have been able to more effectively make these decisions and improve my life.

The human body has evolved to endure a certain type of use. It is built to walk, bump into things, and build muscle as you grow. My body has not done any of these things due to my Spinal Muscular Atrophy, and as a result I suffer from numerous ailments and injuries to nearly every part of my body. It is impossible for me to address everything that is wrong with my flesh cage all at once, so everyday I have to decide what parts of my body are in the most dire need of care. It is basically like doing a full body triage every morning when I wake up. As an example, I currently have a wound on my hip that I should relieve pressure on by getting out of my wheelchair as much as I can. If I lay down too much though, it puts me at risk for respiratory problems, and I also will lose what little muscle I do have if I am not up and active (not to mention bed rest is boring as hell). So, I have to try to find the optimal balance that allows my wound to heal without keeping me in bed for long stretches of time. Sometimes though, it is not possible to achieve both objectives, and in those unfortunate cases I have to determine which potentially harmful outcome I would rather risk occurring. I have to choose the lesser of two evils and ask myself, “What part of my body is an “acceptable loss?” How do you choose between your lungs and your skin?

Scott Drotar Acceptable Losses
I have to decide whether my pressure sore or my lungs need more care, and then gauge how long I can be out of my wheelchair.

In addition to my daily triage where I play “Let’s Make a Deal” with my body parts, I also face an even more difficult set of decisions every moment of my life. Every second of every day I am in pain. This misery is tolerable with copious amounts of narcotics on my good days. And on my bad days, I not only hurt so much that I feel like I am dieing, I hope that I am dieing. Now, if I wanted to, I could take stronger painkillers to alleviate my suffering, but in reducing my pain these medications would also reduce my ability to think, feel, and function the way I do. I have to choose between living a life of constant, agonizing pain with my mental faculties in tact and living a pain free life as a zombie. Additionally, every time I go to take a painkiller I ask myself, “Do I hurt badly enough that it is worth one of my 10 doses?”, since I can only take 10 doses of Fentanyl every 24 hours. These are decisions that I struggled with for years, and it will always be something I have to deal with, but fortunately I have recently found a balance that allows me to function without being in so much pain that it sucks the life right out of me. Even though I have been presented with an impossible situation where every possible choice ends with me losing something of great value, I have been able to determine what I consider “acceptable losses” and found an option that allows me to live and function successfully.

Learning to make these incredibly heavy life decisions is something that took me years to do well, and it required an enormous amount of effort, perseverance, and determination. I cannot tell you how many times I made the wrong choice during my daily triage, and ended up with an illness or injury that was much worse than I had started out with due to my poor choice. How many days I hurt so much that I just pumped myself full of high-dose opiates and drifted away mentally. How many times I made myself suffer through the pain because I took too many doses of Fentanyl earlier in the day. I failed in these ways, and numerous others, as I learned how to most effectively make these tough choices. In addition to not giving up and getting back up when life knocked me down, there are two things that were critical in my development of this skill. First, I made a point to learn something from every failure. When I failed to make a good choice, I would analyze what happened and store it away as another way to not achieve my goal. Eventually, I accumulated so much information from my never-ending run of failures and mistakes, that it was much easier to compare my options and find the lesser of two evils. Second, I never stopped believing that there was a choice out there that would lead to a balance that would allow me to be happy and successful. Even after years of constant pain and experimenting with dozens of different painkillers, I never lost hope that I would find a workable solution. This everlasting belief that I was going to achieve my goal, and find a way to live a healthy, happy life, is what fueled me as I fought tirelessly to strike up the best possible balance for my life.

Scott Drotar Scales
You can learn how to effectively manage these difficult decisions and weigh your options.

No matter how much experience you get making these types of decisions where no matter what you decide you end up losing something, these situations will never be easy to deal with. You can learn to more effectively weigh the pros and cons of your options though. If you remember to learn from your mistakes and never lose faith that you will eventually find a solution that works for you, you will gradually develop the skills to make the best possible choice. By keeping these two ideas in mind, with enough effort, strength, and determination you will be able to navigate through these difficult circumstances. You will be able to identify the lesser of two evils and minimize your losses. Keep fighting and refuse to look at any loss as acceptable until you have exhausted every possible avenue to save it. You only get this one life and one body, so it is important to make sure that you are maintaining and protecting it to create the best life you can.

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