Dear Impossible Decision

Dear Impossible Decision,

I wish you hadn’t turned up. I have enough on my plate without you arriving uninvited, demanding my attention and refusing to leave until I’ve made up my mind.

Of all the challenges life has thrown at me, you might just be one of the most difficult.

I’ve faced incurable cancer, survived two admissions to intensive care, endured major surgery, pneumonia, a collapsed lung, major organ failure, a perforated duodenum and more medical complications than I care to count. I’ve learnt to live without being able to eat or drink, and I’m still trying to recover my strength while my heart insists on beating to its own irregular rhythm.

And now, just when I could do with a little breathing space, along you come.

You have presented me with a choice I never wanted to make.

What makes this especially difficult is that I don’t want to stop living in order to protect myself from the risks of living. But neither do I want to gamble recklessly with a body that has already endured so much.

I’ve tried looking at you from every conceivable angle. I’ve weighed up the risks, considered the consequences, consulted the experts and interrogated my instincts. Unfortunately, you remain stubbornly impossible.

Whichever path I choose, it will be walking into a fog of uncertainty.

Continuing immunotherapy means accepting risks that nobody can fully quantify. Stopping means potentially surrendering a treatment that has helped keep me alive, with no opportunity to return to it.

I cannot wait indefinitely for the fog to clear. The decision has a deadline, and certainty isn’t going to arrive in time.

So I must do something extraordinarily difficult: choose a path without being able to see its ending. And perhaps that is the hardest part of all. Not the walking, but the not knowing.

I’ve come to realise that you aren’t necessarily a test of my courage, intelligence or judgement. Sometimes life simply presents us with choices that have no obvious right answer. The best we can do is gather the information available, listen carefully, think deeply and make the decision we can live with.

I also know that making a decision doesn’t mean I have to stop being frightened of its consequences. Courage and uncertainty are perfectly capable of occupying the same room.

I want to live. I want more mornings, more walks, more conversations, more ordinary days and more extraordinary moments with the people I love.

I want the opportunity to keep being me.

And that is precisely why this decision matters so much.

So, Impossible Decision, here’s what I intend to do.

I will listen to the medical expertise available to me. I will ask difficult questions, examine the risks and resist the temptation to manufacture certainty where none exists.

I will acknowledge my fears without allowing them to make the decision for me.

I will remember that hope and caution are not enemies. They can sit at the same table and help me think.

And I will remind myself that whatever happens, I am not being asked to prove how brave I am. I’ve already done enough of that.

I’m being asked to make the best decision I can with the information available, knowing that the outcome cannot be guaranteed.

I cannot control everything that happens next. I cannot negotiate a cast-iron promise from cancer, immunotherapy or my own body.

But I can insist that this decision is approached with care, honesty and a profound respect for the life I’m trying so hard to preserve.

I don’t know yet which path I’ll take.

I do know that I won’t mistake uncertainty for surrender, or caution for cowardice.

And if the outcome isn’t what I hoped for, I will try not to judge today’s decision using knowledge that only tomorrow could have provided.

Because an outcome is not a verdict on the wisdom of the decision.

So, Dear Impossible Decision, you may have arrived at my door without an invitation, but you don’t get to take away my determination, my gratitude or my appetite for life.

You can make me think. You can make me worry. You can make me lose a sleep.

But you cannot make me stop hoping.

Yours, ever vigilant, forever hopeful and still ploughing on,

The Head of Not Giving Up

P.S. In the meantime, please stop pacing around my head. You’re wearing out the carpet.