Reflections on Being Terminal
We all are making our way toward the check out lanes in the supermarket of life. Some people shuffle behind long-lived ancestors with good genes while others of us suddenly find ourselves in the 10-Items-Or-Less line and closer to the exit.
It can be a shock to wind up in the express lane earlier than anticipated, which for Americans is any age shy of 100. But everyone has to leave the building eventually. We all know this, and yet consumerism keeps us absorbed in the moment—until someone crashes into our cart; we slip in the soap isle, or we get a bad chicken salad sandwich in the deli. That’s when we think about what line we’re in.
I paid attention when I learned I had Non Hodgkin’s Lymphoma. It put me in a shorter queue than my peers, but I know enough not to be fooled by mere geometry. The shortest line isn’t always the fastest moving.
When someone hears the diagnosis “cancer” the next word they think might be “terminal.” Then they’ll want to know, “how long do I have?” and they’ll sooner than later find a survival graph for their type of cancer.
This graph plots a survival curve on an x-y axis showing the number of patients and the amount of time they live. A survival curve CANNOT BE REDUCED TO A SINGLE NUMBER such as the “median” survival or the “overall” survival rate (OS = five years), but this is exactly what everyone looks for.
This rush to data can do more harm than good. Consider the experience of the noted biologist Stephen Jay Gould, who contracted a rare cancer in 1982 and was given eight months to live.
“What does ‘median mortality of eight months’ signify in our vernacular? I suspect that most people, without training in statistics, would read such a statement as “I will probably be dead in eight months” – the very conclusion that must be avoided, since it isn’t so, and since attitude matters so much (emphasis mine).” – The Median Isn’t the Message
Gould outlived his “number” 30 times over and died in 2002. Survivability rates are improving for most cancers. Still, having any number put on the right side of your lifeline is a reminder that your shopping days are limited.
It makes you stare into your cart to see what you’ve collected so far. Things don’t count. Nothing physical ever leaves the store. All items here are for rent only. (Come on; you knew that.)
I’m blessed in that my basket is full of meaningful relationships, wonderful memories and acquired wisdom. My relationships and memories are personal and wouldn’t mean much to you, but I can share from my cache of wisdom. It’s the fruit of a life spent grappling with questions large and small.
Wisdom is distilled truth. It is absorbed through the skin—not the eyes or ears—and passed on through touch. It evaporates when hoarded and expands when shared. In that spirit, here’s what I’ve learned:
- And now these three remain: information, knowledge and wisdom. But the greatest of these is wisdom.
- Being alive means learning something new every day.
- People are more important than possessions.
- Relationships matter more than reputation.
- Responsibility comes before reward.
- “Courtesy is owed. Respect is earned. Love is given.” (aka Biker’s Creed, Ruth Brown)
- Always thank the pilot. You get where you want in life because of the skills of others.
- Don’t obsess over what people think about you: they don’t.
- Avoid books with numbers in the title: it’s never that simple.
- Change the world: spend time with your kids and grandkids.