The Ideal and the Real

Many of us devote ourselves to pursuing the ideal.  We set our standards high then feel frustrated when we can’t achieve them, even when our lofty goals may have had much in common with “impossible.”   

In oncology, multiple experts participate in “tumor board” conferences to discuss how each cancer patient’s treatment will proceed. The various specialists – surgeons, medical oncologists, radiation oncologists – reach consensus on optimal strategy, including resection, chemotherapy, radiotherapy, or some combination of all three. 
I recall an early-career situation when we physicians agreed on radiation as the best therapy. Radiation being my specialty, I examined the patient right after the meeting.  Engaging reality, I saw clearly that one important fact had been omitted during the board’s theoretical discussion: the patient had severe scoliosis. Spinal deformity would make it impossible for him to lie in the position necessary for optimal delivery of radiation treatment  We found a resourceful way to compensate, but the problem underscores that fact that, sometimes, an idealization – the theoretical, "conference” answer – requires tempering by feasible reality.   
Maybe you have encountered a similar need to adjust or re-set expectations – perhaps when you’ve been trying to pick a partner, choose a job, hire an applicant, or select a neighborhood. Is there a flawless spouse, idyllic professional position, truly consummate professional candidate, or utopian place to live?  Yet even in the absence of an ideal situation, we can be happily married, enjoy our work, conduct meaningful exchanges with our co-workers, or experience wonderful communities.  As we adjust to various realities, often, we comprehend the essential value of compromise.
The intersection of “ideal” and “real” is marked, I find, by useful questions:  Our original plan may reflect "best case scenarios," but when our desired outcome doesn’t materialize, can we relinquish expectation to avoid disappointment?  If we anticipate obstacles, might we plan ahead by fashioning alternatives a priori?  If we see that things are not unfurling as we''d hoped, can we go with the flow and persevere, realizing that the outcome might be still acceptable and that we may even grow during the process?  Those questions are not for perfectionists only, because even those who don’t suffer from perfectionism may steadfastly seek the ideal.
Rather than setting ourselves up for failing at the impossible, if we try to establish more realistic goals, we might emerge in a happier state.  It can help to remember that life''s challenges are complex and frequently multi-dimensional with internal goals that may be at odds with each other. 
This past summer, with some twenty colleagues of diverse backgrounds, I attended an outstanding course at Duke University. I was the only Jewish Orthodox participant.  As the week concluded, a farewell dinner came into view on our schedules.  Although an endearing gesture, the meal created a personal dilemma for me.  In the area around the North Carolina college, there were no kosher restaurants.  While I knew I wouldn''t have to . . . endure ham in Durham (sorry, can’t resist the pun) . . . an ethical conflict did seem likely to emerge.  What then?  Would I adhere to a strict interpretation of Jewish law?  Should I decline to enter a restaurant lacking food with rabbinical authorization?  Must I risk offending the lovely people with whom I''d established intimate bonds? Or should I compromise on an exacting religious requirement in order to foster the relationships that I’d begun to cultivate? 
As the event approached, I made my choice about how to deal with the dissonance. I decided to attend the dinner, my assumption being that the menu would offer something that, ethically, I could eat.  From a religious perspective, electing that less-than-ideal option saddened me, yet my choice seemed like the best "real world" option.  
Even so, I felt concern about others noticing my dilemma.  Worried that my situation could interfere with group dynamics and taint the evening, I chose an incognito seat at the periphery.  But as fortune would have it, within minutes, one of my new buddies – a husky Minnesotan at the other end of the table -- tapped knife against wine glass and intoned, "Ben, will you lead us in the grace?" Nineteen heads turned synchronously to me as tension reached crescendo. Should I utter a sterile platitude or stop hiding who I am? 
Opting to reveal myself, I recited a Hebrew benediction. I translated it into English. Fortuitously, my choice served as a springboard for discussion of the concept of "blessing."  Talk then segued to one of my most cherished topics, gratitude.  For three hours, as I got by with the simplest of salads, our conversation feasted on the meatiest of issues, satisfying our appetites for mutual friendship and understanding while enhancing appreciation for the individual lives to which we’d soon return. Our farewell dinner couldn’t have fared better. 
Sometimes, the real turns out to be the ideal.
Until next Monday, Shalom.
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