Just Because We Can, Should We?

In the end-of-life planning workshops I facilitate, the same question comes up again and again: How do I deal with my family? More specifically, how do I tell a son, daughter, niece, nephew, or spouse what I want to happen when I can no longer speak for myself?

What sits beneath that question is something deeper. Most families are very good at solving problems. They are much less comfortable with simply supporting a person through uncertainty, decline, or hard choices. One of the goals of these conversations is to help families move from fixing to supporting.

Modern medicine complicates this in powerful ways.

I’ve had my hips and knees replaced. Those conversations were straightforward. The surgeries were likely to improve my quality of life, and they did. The promise was clear, the trade-offs manageable, and the goal, returning to function, made sense.

But not every medical decision fits that pattern.

A friend of mine is living with rectal cancer. We visited him in the hospital a few weeks ago. According to his daughter, the medications he’s on allow him to function, but he is largely bedridden. He went home a few days later, knowing, and with his family knowing, that if he stops taking those medications, he would not survive.

He understands this. His family understands this. And still, the situation exists in a kind of suspension.

When people phone or visit, he sounds upbeat. He’s pleasant, engaged, and reassuring. I’ve seen this before. When my mother was dying of cancer, visitors would come for short visits, half an hour at most. She put on a brave face. My niece did the same when she was ill. For those brief moments, everyone participated in the illusion of wellness.

It’s a kindness, in a way. But it also sustains the unspoken belief that “normal” might return if we just try hard enough.

Modern medicine offers extraordinary possibilities, surgeries, injections, replacements, and medications that extend life and relieve suffering. But alongside that promise comes pressure. The pressure to keep going. The pressure to pursue the next option. The pressure to treat uncertainty as something to be solved rather than lived with.

The question: Just because we can, should we? isn’t about rejecting medical care. It’s about informed choice. About weighing risk against reward. About recognizing when treatment supports a person’s life, and when it merely postpones a conversation no one wants to have.

Families often support the idea of “getting back to normal” because it feels hopeful and loving. But sometimes that hope delays clarity. It postpones decisions that deserve time, honesty, and shared understanding.

Medicine can do remarkable things. The challenge is knowing when its role is to restore and when it is to support comfort, dignity, and choice. Wisdom lies not in doing everything possible, but in doing what aligns with the life and the ending that a person wants.

Can We Apply That Wisdom Elsewhere?

When I was a young teacher, I experienced burnout. I reached a point where I was genuinely prepared to walk away from the profession altogether.

In the mid-1970s, burnout wasn’t something we talked about. At least not in my circle. If you were overwhelmed, exhausted, or questioning your choices, the message was simple: deal with it. So, I did. I pushed through, worked my way past the doubts, and stayed in education for another forty-two years.

In that sense, the strategy worked.

But years later, when I developed problems with my knee, I responded very differently. I went to the doctor. I was given medication and exercises. When those helped for a while but weren’t enough, surgery became the next step. The process was practical, structured, and supported.

That contrast has stayed with me.

What if I had treated burnout the way I treated my knee?

What if I had talked to someone who understood the strain I was under? What if I had received guidance, perspective, or simply permission to pause? Would things have turned out differently? Maybe. Maybe not. But I suspect the road might have been less stressful, and the weight I carried might have been lighter.

Physical pain gives us a script. We recognize it as legitimate. We respond to it with action. Emotional and cognitive exhaustion, on the other hand, often gets dismissed as weakness, impatience, or a lack of resilience, especially in earlier generations. So we endure, assuming that persistence is the same thing as wisdom.

Aging gives us something younger versions of ourselves didn’t have: perspective.

With time, we begin to see patterns. We notice how energy ebbs and flows, how commitments accumulate, how relationships can nourish us or drain us, and how expectations, our own and others’, can quietly exhaust us. Self-regulation expands beyond joints and muscles into the wider terrain of life.

Asking for help when you’re overwhelmed isn’t failure. It’s discernment. Knowing when to slow down, when to say no, and when to ask for support is a skill, one we’re often better equipped to learn later in life than earlier.

A friend once said to me, “Do you realize it’s been sixty years since we were twenty? That’s scary.”

I said, “No. It’s been sixty years since we were twenty, and that’s amazing.”

He paused for a moment, thought about it, and then agreed.

That pause matters. It’s the space where wisdom lives. Not in pretending we can still do everything the same way, but in recognizing that experience has given us tools we didn’t have before. If we’re willing to use them, aging becomes less about loss and more about pacing, learning how to keep going without wearing ourselves down.

Pain Is a Very Clear Teacher

I have rheumatoid arthritis and have lived with it for several years now. So far, I’ve been lucky. The disease has shown up in my shoulders, my back, and my ankle, but with treatment I’ve been able to keep going.

When I was first referred to a specialist, she was skeptical. Rheumatoid arthritis, she told me, doesn’t usually manifest in the shoulders. Tests showed that, in my case, it did. Treatment followed, and the pain in my shoulders eased. Then the disease shifted to my back. More medication helped. Now it has settled into my ankle, and I’m waiting for surgery.

In the meantime, I still get around, just more slowly, and with a noticeable limp.

My wife jokes that I have my own pharmacy. I laugh and agree. The truth is those medications allow me to function. Physical pain is something we can name, measure, and explain. It shows up on scans and blood tests. It has protocols and prescriptions. Other people understand it without much explanation.

And because it’s so clear, we tend to respect it.

Emotional pain is different.

My father was killed in an accident more than fifty years ago. My mother died over forty years ago. I still feel the pain of those losses. I see how my wife continues to carry the loss of her mother. I see my daughters living with the grief of losing their best friend. Emotional pain doesn’t fade with time; it changes shape, but it stays.

My adopted daughter lost her sister a few months ago. On the day before her birthday, we were talking about her sister, and she suddenly broke down in tears. She apologized, instinctively, as though grief needed permission. But there was nothing to apologize for. The loss of a family member never truly leaves.

Unlike physical pain, emotional pain is harder to locate. It doesn’t limp. It doesn’t show up on an X-ray. People understand it in theory, but often struggle to express it; or to recognize when it has crossed from sadness into strain.

Cognitive pain may be harder still.

We are starting a program for caregivers of people living with dementia because there are so few resources to help them manage the constant mental and emotional load they carry. The vigilance. The worry. The grief that arrives long before loss. This kind of strain is exhausting, yet largely invisible. And because it doesn’t announce itself the way joint pain does, it is often ignored, by others and by the caregivers themselves.

Physical pain teaches us clearly. It draws a line we can’t cross without consequence. Emotional and cognitive pain whisper instead. They ask for attention long before they demand it.

Self-regulation, then, isn’t just about responding to what hurts most loudly. It’s about learning to hear the quieter signals before they overwhelm us. Wisdom lies not in enduring everything, but in knowing when something needs care, support, or rest; even when there’s no limp to point to.

If physical pain is a teacher, emotional and cognitive pain are subtler instructors. The lesson is the same, though harder to learn, ignoring discomfort doesn’t make us stronger. It only delays the moment when listening becomes unavoidable.

Choosing Not To, or Being Unable To?

Golf has been part of my life for about twenty-five years. I enjoy it, though I’ll be the first to admit I’m not very good at it. and never will be, for a number of reasons.

One of those reasons is simple: I don’t spend enough time on it. I play once a week with friends, starting in May and wrapping up in September. When I first took up the game, many people offered to help me improve. At the beginning, I believed I could. I practiced. I paid attention. I worked at it.

After a few years, something became clear. Starting a new hobby at fifty-five meant I was never going to reach the level of proficiency of friends who had been golfing since their twenties. That wasn’t failure; it was reality.

At that point, I had a choice.

I could continue chasing improvement, measuring myself against standards I was unlikely to reach, or I could change my relationship with the game. I listened to my friends’ advice, adjusted my swing as best I could, but I stopped going to the driving range and the putting green to practice. I stopped keeping score.

Instead, I chose to play one hole at a time. I tracked the game, but I no longer judged it. I went out to enjoy the walk, the conversation, and the shared experience.

Something interesting happened.

I now golf with a group of friends, none of whom keep score anymore. We enjoy each other’s company and the game itself, but we never talk about numbers. Competitiveness quietly gave way to companionship. Once we made that decision, new doors opened. New friendships formed. And we still hold our heads high at the nineteenth hole.

This wasn’t giving up golf. It was choosing how to play it.

That distinction matters.

There’s a difference between being unable to do something and choosing not to do it the same way anymore. One strips you of agency; the other affirms it. Adaptive choices allow us to stay connected to what matters, even as circumstances change.

The friend I mentioned in the previous post is still wrestling with his decision to seek help. For someone who has always carried responsibility alone, allowing others in feels uncomfortable, even threatening. But I can already see the possibilities lining up; people ready to step forward, contribute, and share the load only when he’s ready to see that asking for help doesn’t close doors. It opens them.

Just as my golfing friends eventually faced their own limits. As their skills declined, they had to choose stop playing altogether or stop keeping score. They chose the latter, joined my team, and discovered a lot more joy than they expected.

Dignity isn’t found in doing everything ourselves. It’s found in deciding how we remain present, connected, and engaged. Choosing differently isn’t surrender. It’s often the clearest expression of agency we have.