IV/25. Living
The more you live, the less you die.
There is a lot more to living than the absence of dying. There is a lot more to dying than waiting and suffering.
––John Roberts
I want my patients to live their life living. I don't want them to live their life dying.
––Robert Fine, M.D., Columbia University, Comprehensive Cancer Center, Newsweek, June 23, 2008
I finally figured out the only reason to be alive is to enjoy it.
––Rita Mae Brown
Dream as if you'll live forever, live as if you'll die today.
––James Dean
Where life is more terrible than death,
it is then the truest valor to dare to live.
––Sir Thomas Brown
As a well-spent day brings happy sleep,
so life well used brings happy death.
––Leonardo da Vinci, The Notebooks, 1508–1518
Philosophy is perfectly right in saying that life must be understood backward. But then one forgets the other clause––that it must be lived forward.
––Sören Kierkegaard, Journals and papers, 1843
There is also the thrill of living “to the fullest,’ taking chances, enjoying challenge and the rush of adrenalin. Seeing life as an adventure is like that. It is living life by taking risks, even risking life, and thrilling in that sense of skill and uncertainty. It is certainly not an image for everyone. But for those who see life this way, there may be no other way to live. Everything else is boring and tedious. And unlike life as art or as literature, life as adventure never plans a proper ending. When it’s over, it’s just––over.
––Roberts C. Solomon, The Big Questions, 3rd Ed., 1990
Fighting cancer is the fight to live, a simple goal that all experience. At the fundamental level, the human brain has evolved and is programmed to do it instinctively. But, the threats to life may be simple or complex. Simple threats are the bear in the woods, a car wreck, a heart attack. Just take precautions. A complex threat has many devious weapons and we must fight with multiple defenses, over an extended period, with sustained and powerful motivation. Those threats are old age, a war of national survival, or cancer.
The cancer fighter seeks not just the absence of death, but quantity and quality of life that are mixed together as one. Why make a massive, enervating fight if there is no reward, not only at the end but in the fight itself? Thus, it is a prolonged and organized effort that has built-in compensation, a state of mind and pride that thrives on the challenge and the anticipation of each additional, noble moment of inspired life.
Survey the list of personal qualities in Section V: each one of them has the built-in spirit of life. To live is our strongest automatic impulse. As humans, we put something extra into it because we can anticipate the future and strive to create it as animals cannot. This must be true even more so when death threatens or, to be kind, when we are not taking full advantage of our gifts. To be unkind, we have misplaced our courage or have given up. Death provides a release from bad life rather than the stealing of good life in the time left.
If, then, we are to fight well, it is the life force in all of us that must be better organized and motivated to enable success. Much of life just rolls in like the waves; we learn to swim, learn to evade the jelly fish and sharks, and enjoy the sea, on board or beach. We must manage our cancer so that we renew and nurture the desire for life we all have, preserve as much as possible of the good life we have led, and then add to it a new dimension of life that comes from challenge, from mustering our resources, from taking back some of the future, from achieving victory.
We must not forget, as we fight, that it is possible to die in victory. Since we all die, it is necessary that we all master that form of humble triumph that, like success, is a journey not a goal. It will not be a victory parade, a crowd cheering at our prowess, or a tranquil marathon. We do, however, try to make it a transcendent nirvana in which we have liberated ourselves from the dust and pain of battle and focused instead on the establishment of our self-respect and the contentment with what we are and how we have fought to create it.
This may seem ethereal in our condition, with our organs under insidious assault and our mind doused, confused, and frightened. How can we think of such lofty constructions when it seems all we can do is try to smile weakly and make it through another difficult day? Living? What is that but the waning of survival of body and spirit beyond our control. All the beauty and happiness of the wide and wild world has shriveled down to medications, appointments and the cancellation of the future.
The secret is to prepare in advance, even before the news, before the effects build and the defenses start to crumble. How do we fight for life? What do we have to learn just to start? What are the things we most enjoy, and how can they be preserved? What can be added now that time is finite? What problems and daily chores can be set aside because they have lost relative importance? What help can we get from loved ones and the medical system? What can we do to build an impregnable optimism and positive attitude? What changes must be made for better fitness, health, and care? Where do we start, and how do we select, organize, and begin to implement the appropriate suggestions in this book? The war has started, it is time to mobilize, and defeat must be put out of mind before it can be put out of life. The very first thing we do, regardless of what we have learned and how we feel, is whatever it takes to make tomorrow a happy day, to live to the fullest, and keep doing so all the way.
Secondary only to the professional treatment of the cancer is the preservation and improvement of the quality of time remaining. Many people have led quiet, happy, protected lives, and may be happy just to continue them as long as possible, surrounded by familiar people and things. Nothing wrong with that. Others, who have experienced much of life may want to add the crowning touches to a busy and active lifetime. Either way, the interference of the cancer threat must be minimized. If cancer is conquered, a whole new kind of life may await.
