Trust

I have only two emotions/Careful fear and dead devotion.
I can’t get the balance right/With all my marbles in the fight.
I see all the ones I went for/ All the things I had it in for
I won’t cry until I hear/ Because I was not supposed to be here.

The National, “Don’t Swallow the Cap”

When I think of the people and relationships in my life, I find that I often group them into two extremes. Those on the “in” and those on the “out.” This is very much driven by a desire to not get hurt.

I watch. I take notice. If something is done to break my trust? Or causes me to become suspicious? I stop investing. I push away. It’s just in my nature to be that way. I’ve always been very selective about the people that I allow to be close to me. But if I do let you in? If you pass the test? Look out. I fall hard, and I am fiercely loyal. For example, nobody unleashes my inner fighter like someone targeting one of my kids.

Those in my small inner circle get total devotion. And anyone outside of that ring? Those people will never understand me. Those people could hurt me. They don’t need me, and I don’t need them.

This code, and these rules were written by my heart. But my pesky brain keeps getting in the way. My pesky brain keeps telling me to challenge my beliefs. It tells me to not get stuck in cycles. It searches for ways that I can improve. It searches for ways that I can rise above the habits and mental blocks that have seen imprison other people.

As a result, the last 15-20 years have been a long, slow experiment in challenging my comfort boundaries. If I didn’t have a growth mentality, I would never have made it through college. I would never have made it this far in my career. I would never have made it through those rough years of balancing a full-time career, filling blocks for advancement, and raising 3 small children.

But defense mechanisms are like cockroaches. These are reflexes so ingrained that trying to hold them back can feel at times like pushing a door closed against a flood.

Let’s take trust, for example. Some people have an unyielding trust in authority. I do not.

Trust is one of those things that is shaped by our experience with the world. The more we get hurt, or the more we have experience with those who are in positions to do right and yet still fail to do so, the less we are inclined to have faith that things will be different in the future. I could go deep mining into my past and find lots of examples of these hurts and failures. But I can also find the exceptions. The people who did take a leap. The people who did care when they didn’t have to.

I can probably follow the threads back on my strains of resilience and find at their origin these sparks of light. Sometimes, the littlest moments shine the brightest.

I can still remember clear as day something as simple as my 8th grade English teacher exclaiming “she can read!” when we were taking turns reading out loud in class and it got to me. She encouraged me to sign up for speech my freshman year. She encouraged me to enter a competition to write and present a speech at the optimist club. I got second place. What started with a simple act of someone noticing me turned into a lifetime interest.

Authority is a precious thing.

• Those who hold it have the power to fuel a person’s fire or vanquish it entirely. And it all starts with a single comment. A nod of respect, or a dose of disdain.
• Those who hold it also have responsibility. If you are a doctor, the decisions that you make can save or extend a person’s life. The things that you miss and the risks you don’t take can shorten someone’s life. The words that you say can give hope, or can send someone into despair.

A childhood of being the “new kid” actually taught me some valuable lessons about social constructs and norms and how people tend to manoeuvrer themselves within them.

Every new school meant reading body language and micro-expressions to try to determine which waters would be safe for me, and which would not. Honestly, by high school I had largely stopped expending much effort. Every encounter with my mother meant reading similar signs. Would I annoy her, set her off? Or was this a good time? These skills did help me later to become a better poker player.

I’ve seen humanity at every level of social and political order up close. I believe that the higher up a person goes, the more important it is for that person to have a healthy supply of both ethics and empathy. And the more they should be held accountable. In reality I’ve found that too often NOT the case. Instead, they end up getting buzzed on their own Kool-aid and become blissfully unaware of their weakness and blind spots.

The first 2-3 doctors I dealt with after receiving my diagnosis did a hit-job on my faith and trust in medical authorities.

• The first one taught me that you cannot have blind trust that a surgeon will always be right, and that he/she will always be forthcoming.
• The second taught me that you cannot trust that just because someone is an oncologist that they will have empathy for people dealing with the disease. Or take the time to make sure that they are getting the best care.
• A third taught me that a doctor can crush all hope with nothing more than the language that he uses. This same doctor later used his position and rigid beliefs (clinical trials are only for people who have first been through both lines of first line treatment) to potentially exclude me from a trial that I should have been eligible for (luckily, it became OBE when I became eligible for resection).

But I can’t stop there. And I didn’t. The same logic that tells me to not blindly trust authority tells me that I can’t blindly dismiss everyone in that position everywhere.

There are “good guys” and “bad guys” in every profession. There are “good guys” and “bad guys” at every level of authority. There are good and bad people in high school and good and bad people in life.

But most fall somewhere in between. There are lots of people with good intentions who simply make mistakes. I am one of those people. I’ve been learning to expand my heart to let those people in.

My stage 4 diagnosis kick-started a lifetime of slow change into a forced high speed. Let down the walls. Let them see all of you. But it has to go both ways. I have to see all of them as well. To see their humanity. To allow their mistakes.

When it comes to my medical team? My standards will remain higher. Because I deserve BOTH the best care and the best expertise. Everybody does.

I have a local oncologist who has gained my trust. I have a surgical team at the Cleveland Clinic who has gained that trust. Even so, I still research on my own. I still read my reports. I still ask questions.

I am one week out from a major surgery that will have significant implications for both my length and quality of life. The stakes cannot possibly be any higher. There is plenty to be scared about.

But there is a time and place for everything. I have done the groundwork in choosing my team. I have read their expressions. I have listened to their words. I am being operated on by the second highest-rated institution in the country for GI surgery.

I have attended to all of the things that I can control. Now? I need to let go. Now? I need to trust.

See you all on the other side of surgery.