“Woulda-Coulda-Shoulda” Syndrome

Sarah walks calmly into the office, her face is flushed and her clothes disheveled. As her eyes take in the caring expression of her counselor, she sighs, eases herself into the brown leather chair, and starts to cry.

Like a recitation, she mulls over her three options: treat the tumors more aggressively — and risk new side effects; allow time for the current protocol to continue to shrink the tumor — and risk further tumor growth; cease treatment — and allow natural death. Her body tenses and nausea rises in her gullet in as she registers the sickening weight of making life and death decisions each day.

Mother-love floods her with emotions that are anything but clear and rational. She longs for a crystal ball that will analyze the “risks and benefits” and tell her what to do. “I don’t know how to do this!. Nothing feels like enough!”

Sarah searches the familiar and compassionate face across from her. Maybe he is her crystal ball. Her counselor’s reply is startling in its brevity: “You are facing the ‘woulda-coulda-shoulda’s.’ There will be times throughout this process, and after it’s over, when you will question everything you would have, could have, or should have done differently. When those doubts creep in, immediately remind yourself of this moment and say out loud to yourself : “I am doing the best I can, with the information I have, with the resources I have, and who I am.’ Make this your mantra.”

Simple, and yet profound, these words speak directly to the daily questions that plague her with a sense of constant inadequacy. Validating her questions and insecurities provides some comfort, even though she knows that, for her, this is going to be excruciatingly difficult. Now she feels understood and not quite so alone. She lifts her head with a new resolve to adopt this new thought: “I am doing my best. It’s all I can do. . .  It’s all I can do.”