by Robert J. Lanz, LCSW

Most people view life, if they are paying attention, as a linear track developing in a logical way. They measure progress in increments of time—in years or semesters or even decades. The timeline may be marked by obvious milestones such as graduation day, the first job, first kiss, a 21st birthday, joining the army, leaving home, or even in some cultures, an individual’s first arrest or stabbing. In any case, no matter how chaotic the person’s life may seem, each person has markers by which progress is measured. It is typically middle class to plan for these markers, to prepare for them, and in effect, to arrange for them to take place. That feels normal to me, because I’m pretty much a middle class guy.

Our lives are measured by how well things are going for us at these critical junctures, and can be viewed as a series of defining moments or events. If things are going well in life, these events will be eagerly anticipated and more or less welcomed. If things aren’t going well, then these events, these milestones, are often awaited with some sense of dread. Most people go around with ideas about life pretty well set, believing there is some degree of control, some pattern of justice, some predictability, and they live their lives accordingly. They are future oriented and believe that goals will be met as a result of hard work and preparation, i.e. at the end of the semester, I’ll graduate, or when I reach a certain age I’ll be in a certain financial position.

The trouble is, it doesn’t work out that way a lot of the time. There is a randomness to life that can be so unfair, so unjust, so terrifying, that most people are unwilling to accept it. No one wants to accept that, despite your hard work, your karma, your love and devotion, your religious beliefs and decent behavior, your life can be irreparably damaged by someone for whom these ideals don’t seem to matter. No one wants to believe that their lives can be altered by someone, who, in the grand scheme of things, is lucky to be alive and well despite all the bad he has done, the harm he has caused and the penalties he has evaded. We who work in the ER observe this outcome with tragic regularity. It is difficult sometimes to think about all of the bad things that can happen to anyone at any time, and especially difficult when the bad things that happen are the results of someone’s deliberate actions. That is why we discover, painfully sometimes, that life doesn’t unfold in accordance with by anything as neatly defining as a semester or anniversary. Frequently, a difference of milliseconds and millimeters can determine how someone’s life will turn out.

One way that helps me to keep the vicissitudes of life in clear perspective, is remembering there is a state run lottery in California making weekly and monthly payouts, sometimes in the millions of dollars. When you see who takes the prize, you see there is no logical reason why one person wins over another. It has nothing to do with being a great guy, a good dad, a devoted friend or a hard worker. It has nothing to do with anyone’s values or perseverance. It’s all a matter of being in the game. When you buy your ticket, you have the same chance of winning as anyone else who bought a ticket. The more tickets you buy, the more chances you have to win. Your chances don’t increase just because you need the money or have made frequent deposits in the karma bank. It may be, in fact, that you are morally and spiritually bankrupt and still become an instant millionaire—the same way you can be a bishop in the church and be gunned down in the parking lot of an airport because a paid assassin mistakes you for the real target, who is probably playing golf with the president planning some nefarious deal.

Maybe I need to go back to high school and reread “The Bridge of San Luis Rey” and see if it makes any more sense now than it did then. Or maybe I need to read “When Bad Things Happen to Good People” again. I wish there was an answer to why things happen the way they do. If there is, I haven’t seen it in thirty years on the night shift.

What I do know is that there are people who work for the California lottery, and every week they watch someone become a millionaire and ask, “Why him?”, which of course really means, “Why not me?”. Every week, they see several people win a hundred thousand dollars apiece and they wonder, “Why them?” (and not me), and they see hundreds of people win five or ten thousand dollars and wonder why they didn’t get to win the money. Then they see enough 100 dollar winners to make them go out and buy a few more tickets, because they see that it really can happen. They observe so many fifty and twenty and ten dollar winners they know that someday, they themselves will win something.

The real problem is with the ones who are discouraged because they don’t win big. Week in and week out they see the winners and somehow think it should be them winning. They measure their lives by the good fortune of others and will always come up short. The chances of hitting the big one may be as much as fifty million to one. Who would get discouraged by not winning against those odds? A lottery worker might because, he bears witness to the good fortunes of so many lucky winners. He sees it all the time.

In the ER, we see it all the time too. Every month somebody gets burned up or crushed and dies a horrible death. Every month millions of people don’t. Every week, we treat a heart attack death or an auto accident trauma, but every week we have a hundred chest pains that turn out to be nothing and millions of drivers make it home safely. Every day we see broken legs or broken arms or a case of pneumonia, and every day most people don’t suffer with a broken bone or a major illness. And every hour we treat painful injuries, illnesses that are uncomfortable, and pain requiring medication. We treat them and they go on their way.

We’re all in the game. Somebody will win a million bucks this week and somebody will get paralyzed or squashed. Odds are it won’t be you or me. A small number of people will win 500 grand and a small number of people will get hepatitis or lose a limb. It probably won’t be me. Every day hundreds of people will win fifty or a hundred bucks and every day hundreds of people will sprain an ankle or cut themselves to the point of needing stitches Might be me some day. Probably will. Maybe I’ll win the fifty bucks too, if I keep buying tickets. And I’m sure I’ll hit the two dollar or five dollar ticket on a fairly regular basis just as I’m sure to catch a cold, stub my toe, bite my lip or have a hangnail. Those things will probably happen to me because I’m alive and in the game.

To me, there is no sense in living my life believing I will get paralyzed or meet a fiery death. There’s also no sense in living my life believing I will win the lottery or a big chunk of it. Something terrible will happen to somebody but it probably won’t be me. Someone will win the lottery, and that probably won’t be me either. The scary thing about it all is there is no sense to who gets what. I wonder if the lottery workers get as depressed about that as we in the ER do.

Dividing line


About robertjlanz

Author and health care professional.
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