What Keeps Me Living
What has been will be again, what has been done will be done again; there is nothing new under the sun.
This axiom, found in Ecclesiastes, surfaced in my mind last New Year’s Eve as the final hours of 2018 bled slowly away. As I stared glumly into the bathroom mirror at yet another volcanic eruption studding my 51-year-old mug, echoes of my pimply-faced adolescence began ping-ponging around my brain. In a perfect world, zits wouldn’t occupy the same territory as hard-earned wrinkles — nor should one ever need reading glasses to properly inspect them.
I have my oncologist to thank for this pimpled absurdity. One year earlier, as 2018 rose unsteadily from the ashes of 2017, the stubborn beast of a cancer in my head reincarnated itself alongside the new year, thumbing its nose at all previous efforts to slay it. I wasn’t keen to risk another craniotomy after four mighty kicks at that can. I’m all for being open-minded, just preferably not via surgery. So, after lengthy discussions with my cancer specialists, I pinned my hopes on a novel drug, arming myself with the lotions and potions needed to keep the inevitable side effects at bay.
Wondrously, despite the affront to my dermatological vanity, the drug appears to be working. I’m still here, more than a dozen years after the initial shock of my diagnosis, when I first stared at MRI images of the malignant octopus strangling my brainstem, its cancerous tentacles thrust deep into my grey matter. And remarkably, I remain reasonably functional to boot.
When I was initially diagnosed in 2007 I was “given” seven years to live, in the grim language of this disease, that being the average length of survival for those with this particular brand of cancer, with my own case more serious than most. And yet, somehow, here I am, still breathing. That fact serves, if nothing else, to illustrate the utter foolishness of using that type of language — it’s nonsensical bunk which should be put to rest in place of the patients it threatens to extinguish.
The time we have on this earth, that precious allotment of sand in our own personal hourglass, is not something any doctor alone has the power to “give.”
A diligent physician, when confronted by a shell-shocked patient asking, “How long do I have?” should provide guidance and insight, based on the available evidence. Of course it’s important for patients to be acquainted (as much as possible) with the landscape of their illnesses. But sadly, all too often that “useful” information is deeply absorbed in those traumatic moments as a straightforward and shocking, “The doctor gave me ‘X’years to live!” which is patently ridiculous. Every patient is different and every patient’s illness is different, and prognosticating individual survival times is an educated guess at best — and wildly wrong at worst.
Consider, as an example, the case of famed astrophysicist Stephen Hawking. When diagnosed with Lou Gehrig’s disease as a 21-year-old student at Oxford, he was “given” two years to live. Two years. Yet he died 55 years later, in the spring of 2018, at the ripe old age of 76.
Rivers of ink were spilled in the aftermath of his departure, celebrating the extraordinary accomplishments of this brilliant man who plumbed the depth and breadth of the cosmos. Column after column lauded his tenacity in overcoming his death sentence and proving his doctors wrong. “The world is unquestionably better for their error,” read an editorial in the Globe and Mail.
But his doctors were not wrong, in fact. Their diagnosis was correct: Hawking had Lou Gehrig’s disease — amyotrophic lateral sclerosis, or ALS. On average, patients suffering from ALS usually die within two or three years, a sad metric that hasn’t changed all that much since Hawking was tagged decades ago. But the disease can be variable: More than half of those diagnosed with ALS continue to live for more than three years.
It’s important to emphasize here what should be glaringly obvious: averages cut both ways.
It just so happened that Hawking was afflicted with a particularly slow-moving version of the disease. That fact, combined with his willingness to tolerate living with tremendous physical disabilities, served to elongate his “brief history of time” on this earth to its seemingly remarkable length. While his life was unquestionably exceptional, the span of it was not. His disease was simply his version of the disease. His intellect was unparalleled, his resilience incredible, his accomplishments other-worldly; but Hawking could no more take credit for the slow progression of his illness than anyone else can take credit for not being stricken with ALS in the first place.
It’s important to emphasize here what should be glaringly obvious: averages cut both ways. Many individuals diagnosed with ALS don’t even make it to two or three years, and to suggest that they are less endowed with grit and tenacity than Stephen Hawking is to do them, their memories, and their loved ones a profound disservice.
The same is true for any other terminal condition; many people don’t make it to the number they are “given” despite marshaling all of their resources to remain among the living. In the end, no matter how mightily one resists, their disease is simply their own and it progresses at its own rate. During my own odyssey, I’ve come to know numerous individuals battling the same rare cancer as mine. Some have lived far longer than I, but many have succumbed to the Grim Reaper’s call long before their “seven-year sentence” is up. You can fight like a cornered bobcat to survive, but you don’t get to pick your opponent. “Life is like a box of chocolates,” said Forrest Gump, “You never know what you’re gonna get.”
When Arizona senator John McCain lost his battle with glioblastoma last August, four days before his 82nd birthday, rivers of ink flowed once again, commemorating yet another magnificent life. Among the torrent of commentary were a few voices lamenting the military jargon used to describe McCain’s last stand. “Martial language propagates the dangerous myth that death is the result of a personal failure to fight hard enough,” said one prominent physician.
But that too is nonsense, unfortunately. Take it from someone who knows: It’s all-out war, and there’s no shame in fighting the good fight only to lose the battle. History’s battlefields have always been littered with the fallen, warriors no less valiant and no less worthy for having fought and died.
McCain, as almost everyone knows, spent more than five years as a POW in North Vietnam, captured after breaking both arms and a leg bailing out of his plane when it was shot down during a bombing run over Hanoi in 1967. Despite horrific deprivation and years of torture, he survived by dint of tenacity, faith, and good fortune. But many of his fellow POWs did not, even though they possessed resilience, courage, and faith in no less measure than McCain. To his great credit, McCain never forgot how blessed he was to survive, and rendered his gratitude for the rest of his days in long and singular service to his country.
I sat among thousands of others a few years ago listening to Nick Vujicic, the inspirational founder of Attitude is Altitude. Born without arms or legs, Nick suffered enormously in his early life, physically of course, but especially psychologically. After describing his journey, detailing the bullying, the suicide attempts, the hardships, and the distillation of all that pain into the man he has become, Nick looked out at his audience and asked, “What about you? What’s yourproblem? Why are you living?”
That’s a great question: Why are you living? Life is full of great questions. “Judge a man by his questions rather than his answers,” advised Voltaire. When I was confronted with my cancer at the age of 39, my “great question,” a plaintive cry hardly unique to my circumstances was, “Why me? Why me, God?”
It’s a question often asked in the negative, but rarely in the positive. I had never badgered God, for instance, with questions like these:
Why was I born in Canada, one of the richest countries on earth, to parents who cared deeply for me and gave me every opportunity to succeed?
Why am I blessed with healthy children and a wife who loves me?
Why am I so fortunate as to have access to the very best medical care in the world?
“Why not me?” coupled with “Why am I living?” would be the healthier, balanced response to life’s tough challenges, it seems to me.
At the time of Stephen Hawking’s passing, I came across an absurd comment posted by someone that said, “He lived his entire life with a death sentence.” In reaction I thought, “Don’t we all? Isn’t the leading cause of death being born in the first place?”
Living life to its fullest requires far more than simply surviving.
It may seem like a bit of a downer to point this out, but we will all die someday — no exceptions. In the end, all doctors lose precisely 100% of their patients. It’s simply a question of when. Along the way to that fateful day, many of us become as intimately acquainted with the adversities of life as did Hawking, McCain, and Vujicic; just as aware of its excruciating detours, agonizing setbacks, and bleak wilderness experiences. But, as these three men have demonstrated by their shining examples, the surest blueprint to mining life’s many riches is to navigate bravely through the darkest of times, and stubbornly tackle the obstacles that arise, no matter how difficult they may be. Living life to its fullest requires far more than simply surviving.
“When the great oak is straining in the wind,” wrote the poet Edwin Markham, “the boughs drink in new beauty, and the trunk sends down a deeper root on the windward side.”
“However difficult life may seem,” said Stephen Hawking, “there is always something you can do and succeed at. It matters that you don’t give up.”
“But I’m no John McCain,” some of you are thinking, I’ll wager. Well, consider this: As a young man in the United States Naval Academy, John McCain graduated fifth from the bottom of his class; 895th out of 899 midshipmen. Any reasonable observer might have concluded that he didn’t seem destined for greatness. Yet behold what became of his life, shaped as it was by the crucible of his harshest experiences.
As any student of literature knows, the most famous work of Welsh poet Dylan Thomas is his rant against death:
Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.
Happily for me, thanks in no small part to the wonders of modern medicine, night has not yet descended. The sun is still shining brightly as I tend to the garden of my life.
But this will not always be so. My time of departure will come, and when it does, as the shadows lengthen, as the sun of my vitality is lowering, its rays bleeding inevitably into mortality’s horizon, then I expect that I might rage against the dying of the light.
However, I hope that I don’t. There’s far too much rage in our world as it is. I hope when my time comes that I, like John McCain after a life well-spent, can go calmly and gently into that good night. The final moments of my life may come tomorrow, or perhaps they remain far in the distance, but I hold this one truth high, as a flaming torch to light my way: It’s not the length of the time we get to spend on this planet that matters most, but rather what we do with the time that we are given. Young or old, pimply or not, our greatest challenge is to look squarely in the mirror every single day and ask ourselves:
“Why are you living?”