Is there any Hope?

Wally Retan

I have struggled through a tough time recently. We all have experienced the pain of the pandemic, political and social unrest and life in the fast lane. But this is selfishly personal. So this post is about either embracing the inspiration that comes from maintaining Hope for the future, or falling into Hopelessness. Or maybe finding something in the middle.

During my recent struggles, I met with a man to talk about Hope who has a blunt opinion of our future as a species. He is not very Hopeful about our long term survival. This is a concept that we would all rather not contemplate too deeply or with conviction. He has environmental concerns and worries about a lack of compassion in the health care industry.

Dr. Retan prefers to be called Wally. It is difficult for me to default to this when talking to a man who is 90 years young, and has had such a long meaningful life of service to his fellow man.

Wally has practiced medicine for years, passionately championing health care for all, including the underprivileged. He had his own successful internal medicine practice for over 50 years, retired, felt useless, and then jumped at the opportunity to function in a county-run health clinic, chiefly seeing the low-income patients with chronic pain that few other providers like to see.

He is still seeing patients and adapting to the new technology of tele-care. His preference is to see patients in person. He has empathy for people in pain. Wally’s practice is about finding moderation of the chronic pain that plagues many of us.

“The system condemns people with chronic pain, not so much for complaining as for being weak, lazy, demanding, drug-seeking, putting on…whatever.  We humans seem to have a great ability to project character flaws on those who differ from us, whether justified or not.”

Wally explains: ”Chronic pain is a miserable thing.  Once it’s there, it often stays…and stays…forever.  Sometimes, as with arthritis, just getting worse with time.  Medicines, including opioids, morphine and the like, don’t make pain go away.  They just make it milder, easier to live with, even for just a few hours at a time.  And so the person with chronic pain lives with the chronic pain, the shame of taking pain medicine and the disgust in the eyes of pain-free friends.  

Patients taking pain medicines sometimes overdose.  Some die intentionally…suicides…tired of living with constant pain.  Well-intentioned authorities would remedy overdosing by reducing the supply, the availability of opioids, the availability of pain moderation, trying to force all people with chronic pain to reduce their doses.”

Wally’s take on that well-intentioned policy? “For the most part, the patients that I’m seeing need to have their medications reduced just about as much as a diabetic needs to have his insulin dose reduced.”

Treating mostly chronic pain patients, in a government-run clinic for low income folks, isn’t a career target for many physicians.  There’s no “stand-in” waiting to step into Wally’s shoes when that becomes necessary.

“So my function at the moment is to stay alive as long as I can. And, if there is another solution out there for these patients, I haven’t run into it yet.”

Given the gloomy nature of his situation, and that of the patients who depend on him, my inevitable question to him is, where does he see hope in this all too familiar depressing societal healthcare dilemma?

“I feel that life is pretty much a matter of going along from day to day to day, and each day is sort of in a repetition of the previous one, and pretty predictable. I feel that hope is sort of a beacon that maybe tomorrow is going to be different and better in some kind of a way. I am a realist and I don’t think of myself as being hopeless, but I just feel that this kind of beacon of a utopian future, isn’t something that’s part of my life. To me the word hopelessness, or any losing of hope that that implies, is something that is foreign to me. I operate with a sense of absence of a need for hope, not some kind of a vision of a more optimal future. I just go along from one day to the next”

We talk about our precarious human future, and it is clear that Wally is of the impression that we are a doomed species. After much discussion about healthcare, climate crisis, unsustainable population growth, resource depletion and generational challenges, I want to know what keeps him buoyant and afloat. It is apparent that it is his love of his patients and a fear of what will happen to them after his retirement.

“I get my juice from patient interaction…that gives me joy in the moment!”

After we talked, Wally wrote a follow-up text later that day:

“If one accepts the premise of the 6th extinction…that global warming, or nuclear war, or uncontrolled disease or something similar will…relatively soon…end mankind’s occupation of this earth…then hope becomes irrelevant.  This isn’t hopelessness. It’s just realism. For that matter, I view my own life expectancy in the same way. The outcome is known. So what?  Hope of Heaven?  Irrelevant. Just live today, one day at a time. But get all the good you can out of each day.  Generally, speaking only for myself,  I find that I have to do some good to get the good.  And then put that day away and go on to the next.”

I am inspired by Wally’s dedication to staying in the now and not getting distracted by the past or the future. And it is his focus, his experience and the ability to HEAR the patients in front of him, that is as much the comfort they need as is the medicine they get.

Thank you Wally for helping me better understand the choice I have to wake up each day and attempt to disregard the failures of the past, the fears of the future and to stay in the wondrous moment of today…..in other words, to get out of my selfish head!