A Good Day
by Kristine Kopperud, BJW Contributor
I live in what folks in my close-knit neighborhood refer to (jokingly) as a modern “mixed marriage,” meaning, my partner and I cancel each other out at the polls. Most days of the year—across our years together—this is not a deal-breaker. We share values that make our home life and our relationship functional, reliable, and above all, fulfilling. But as any American citizen can tell you, headlines keep hitting that seem designed to widen the gap between our political identities. We each have friends, colleagues, and beloved policy wonks who are really fired up—and increasingly insular about who they talk to. There’s a frightening amount of tribal us-versus-them going on.
(In other news, my teen just finished reading The Lord of the Flies in school, so I’m thinking a lot about tribes and what attracts flies right now.)
In Being Mortal, Dr. Atul Gawande, an endocrine surgeon, Harvard Med professor, and public health expert, writes that the inability to articulate what we value can lead to or prolong suffering. He points specifically to modern medicine, in which ailing or dying patients have precious little interaction with their doctors and other care providers—certainly not enough familiarity, in either direction, to be vulnerable, to have hard conversations, or to make tough decisions, particularly as we near the end of our “healthspan,” and of life itself.
To prevent this misunderstanding, Gawande has learned to lead with, “What is a good day like for you?” This question cuts immediately through any medical-ese or perceived disconnect, he says, as patients tell the story of what brings them joy and meaning, a simple yardstick by which to measure their treatment options. What good is a debilitating and risky round of in-patient chemo, Gawande asks, if a person desires to live their remaining days at home, surrounded by people who know how they like their coffee?
In these consequential conversations, Gawande writes, words matter. It’s easy, he says, to default to data blasting: rattling off dizzying and complex "truths,” as though that’s where the relational responsibility ends: that the recipient must make sense of it and choose what to do. A better way, he explains, can be scaffolded from three words: “I am worried...”
After giving a patient unsettling facts about their condition, Gawande says, those three words communicate several things. They’re a shared moment to recognize the seriousness of a situation, Gawande says, but also a signal of commitment to sharing the burden of decision-making. "I am worried” is also shorthand for the two elephantine forces in the room: fear and hope. “Though I feared something serious,” Gawande says of the first time he approached a patient with this understanding, “there remained uncertainties—possibilities for hope within the parameters nature had imposed.”
Here’s my truth: I know I can’t influence the course of political history, at least as we are experiencing it right now. As a voter, that time has passed. But I can stay mindful of my concerns by communicating what really matters to me—health, safety, community—a yardstick by which to measure what I say and how I act, in the everyday, in my own house. And I can stay committed to discourse and shared decision-making. I can reach across fear and hope by leading with, “I am worried...” again and again.
If I do that, then it’s been a good day.
—
KRISTINE KOPPERUD’s nonfiction appears widely in literary journals and anthologies, and she is co-editor of the forthcoming collection Root Cause: Stories of Health, Harm, and Reclaiming Our Humanity, in association with the Project for Advancing Healthcare Stewardship at the University of Minnesota. She works with several worthy nonprofits, including BJW, and serves her community as a trained death doula. You’ll find her curating hope and agency in end-of-life care at otherwaysout.substack.com.