As a physician for many years, I have at times been faced with patients suffering from diseases from which they will not recover, that they are going to die, and soon. While we are taught to help such patients and their families during these very difficult times, each situation is unique and so we have to be prepared yet flexible.
We physicians often don’t think about the end of our own lives unless we are also faced with such a situation. Almost everyone thinks they are somehow immune from death until it becomes clear otherwise. We are very talented bodily repairers who pride ourselves on our special abilities to fix what makes others feel so helpless. When patients die, we often ask ourselves whether we might have failed in some way, though generally the answer is no. Too often, people just die.
To wake up to find out this would be the last day of my life would be frighteningly horrible, especially if I was reasonably healthy and cognizant beforehand. For this exercise, we will say that I have a worsening disease that becomes terminal, rather than an unexpected accident that kills me. My disease worsens, and my own physician tells me that it is terminal, and one morning I wake up to find out it is today that I will die. It dawns on me that today is my last one. The sun rises as always, and yet I will die, today. This is all I can grasp so early, and I know I will end up wasting too much time today, my last one, trying to grasp its meaning. Life is always about grasping its meanings.
We will say that it is then that I remember to fulfill a request to write about what my life has been like, what it has meant to me, and how others might better live your lives. It is perhaps feeble advice given in the midst of a personal shatter-time. My head spins every moment because I will be dead by midnight. Time stops. I will stay up, if I can, until midnight because time stops. It is all today, present time. Wisdom never felt so sickly.
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In the span of really no time, I must summon some ability to reflect upon my life, from its beginnings in boyhood, through marriage, children and medical practice to try to suddenly answer that old question: What has been the purpose of my life? On any other day, this would be easily put off and promised for some future time to more seriously consider. But today, it is now or death. I will do this as quickly as I can, since I have much else to do. You shall die today, someone else keeps saying, the worst mantra.
What I figured out in my childhood was that I was smart, that I had a future with which to contribute to public health, and so studied hard to get that going. I had the beginnings of a personal purpose as a teen-ager, studied hard in high school, and thought about what being a doctor would entail. I would see sick people and corpses, I would see fright and hear screaming, I would try to console patients and give others the best news. Later on, I wanted to marry another doctor who understood the dreams I had, who was not afraid of sickness, death and seeing the insides of people. Medical people have to have a stomach most others can not, well, stomach. I knew I would be an important person who truly helped people, sometimes saving their lives. Performing surgery itself is a strangely singular talent to focus to help someone I barely know. Sometimes I will be remembered forever by patients whose faces and names are often only briefly familiar. All I knew was that I wanted to do this work, that sometimes it would be hard, but I knew it was important and I could truly make a difference in peoples’ lives, unmistakably so.
Through all the years of medical training and subsequent practice, everything and nothing has changed. The hours are long, the demands are heavy, I probably neglect my own family at times, but they try to understand. The work is its own reward, it is still what I must do for a livelihood, to stop being a doctor would have been to kill my soul. What else could I purposefully do? To that degree, I have had a good life, until today. Today is a bad day, the worst day, because all of that stops, forever. If I go to Heaven at midnight, I will not be a doctor there, since God does not need this from me anymore. I will be like everyone else there. Doctors are special you know, that’s why we are called “M.D.,” for “Me, Doctor.” But God creates the bodies that I repair, I could never do that, so I have to become more humble before midnight. I still have a little time.
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I am being asked to give you some life lessons, particularly from the perspective of a physician who has loved my work. I could talk about being a husband and father, about trying to balance work and home life (better) or what it is like to live in America for foreigners to try to understand our life here. But I will offer what I can as a physician, because it is a very unique job, and affects everything I can tell you.
Do your best to fashion a personal purpose in your life as soon as possible. Or really the capacity to have such a purpose, since its form and texture may well change with time and age. Don’t be afraid to be serious and ambitious about what is achievable, within reason, as what your lives must be about. Having fun by itself is not enough, nor even being in love. Plenty of people are in love, but still have no larger purpose. It is not an either / or. Love and purpose are both important, both necessary, they are what keep us going, and what now allows me it say anything useful to you at all.
Don’t waste time. I don’t mean seconds or minutes, but days, weeks, months and years of time. If I can die peaceably on this my last day, it is through knowing that I have not unnecessarily wasted time in my life. To not be self-destructive is so important. Those who become suicidal have lost their purpose, and become hopeless about getting it back, so keep your purpose and use of time in mind all the time.
Befriend and love those who have something to offer you, and reject those who sap your energy. This sounds selfish, and it is, but you will not help such people by befriending them in their dispiriting manner. Befriend those who offer you themselves in a positive way, particularly if you can gain something new from them. Friendships are reciprocal in the best cases, not one-sided. To give and to receive.
Finally, know that God made you to serve Him on this earth in your best capacity, so stop wasting His time.
July 2017
Note: I was asked to write this by someone who was then working for a doctor at a nearby medical center, from his perspective.
Every Day Easter 