Living while dying has been a prominent topic in the media this past month. Two physicians, one at the beginning of his career and the other nearing its end, both wrote about their impending deaths.
Paul Kalanithi, a 37-year-old Stanford neurosurgeon and new father, simultaneously saw the glass as half full and half empty: “Time for me is double-edged: Every day brings me further from the low of my last cancer relapse, but every day also brings me closer to the next cancer recurrence — and eventually, death….”
When his cancer was in remission, Dr. Kalanithi was able to finish his residency, resume his work as a neurosurgeon, and write and speak about medicine and his “dual citizenship” as a doctor and a patient. He spent time with his family, friends and colleagues, enjoyed nature and football and, to sum up, kept on.
Oliver Sacks, who is 81 and also a physician, has had a long, productive life as a neurologist, author, and amateur chemist. In February he was diagnosed with a terminal illness, which he addressed in his Op-Ed piece in the New York Times, “My Own Life.” Like Paul Kalanithi after his diagnosis, Oliver Sacks has things he wants to do:
“It is up to me now to choose how to live out the months that remain to me. I have to live in the richest, deepest, most productive way I can… I want and hope in the time that remains to deepen my friendships, to say farewell to those I love, to write more, to travel if I have strength, to achieve new levels of understanding and insight. There is no time for anything inessential. I must focus on myself, my work and my friends.”
For both men, facing death also brought a deliberate detachment from certain aspects of their lives.
Kalanithi: “The most obvious [impulse] might be an impulse to frantic activity: to “live life to its fullest,” to travel, to dine, to achieve a host of neglected ambitions…. Most ambitions are either [already] achieved or abandoned; either way, they belong to the past. The future, instead of the ladder toward the goals of life, flattens out into a perpetual present.”
Sacks: I shall no longer look at “NewsHour” every night. I shall no longer pay any attention to politics or arguments about global warming….This is not indifference but detachment — I still care deeply about the Middle East, about global warming, about growing inequality, but these are no longer my business; they belong to the future. I rejoice when I meet gifted young people — even the one who biopsied and diagnosed my metastases. I feel the future is in good hands.
I have quoted from these writings at such length because both men are so wise and write so well that it is difficult to pick out “the good stuff.” It’s all “good stuff.” I hope that you will read their complete essays at these links: Before I Go in Stanford Medicine magazine and My Own Life in the New York Times.
And they will have the last word.
Oliver Sacks: “It is the fate…of every human being to be a unique individual, to find his own path, to live his own life, to die his own death.”
Paul Kalanithi (in a message to his baby daughter): “When you come to one of the many moments in life when you must give an account of yourself… do not, I pray, discount that you filled a dying man’s days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more, but rests, satisfied. In this time, right now, that is an enormous thing.”
Paul Kalanithi, MD died on March 9, 2015 at the age of 37.