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Atul Gawande

Two weeks ago some of my closest friends from college were in New York for our annual gathering, a tradition we began nine years earlier.  The amazing thing about my friends is that they’re game for almost anything, which is how we found ourselves on a beautiful Saturday morning inside a massive auditorium listening to a lecture entitled “How to Live When You Have to Die” by the physician and author Atul Gawande.

Atul Gawande is the new American “Dr. Death.”  I mean that in the most optimistic of ways.  While Jack Kevorkian made headlines for championing a terminal patient’s right to die via physician-assisted suicide, Gawande is “instinctively against” Oregon and Washington’s assisted suicide laws, which he fears may lead to a mistrust of doctors.  Gawande’s focus is on exploring end-of-life care, including ways in which terminally ill and their families come to grips with death .

He opened the lecture by talking about the phone call he received from his wife’s cousin, whose 12-year-old daughter had Hodgkin’s lymphoma, a disease that is 85% treatable.    Unfortunately, the treatments weren’t working for this little girl, who was emaciated and so ill that she hadn’t been able to see friends for over a year.  The cousin wanted to know if they should try the last recourse of treatment — a bone marrow transplant that had a slim margin of success.

Atul Gawande found himself “utterly useless” in this conversation.  Years of medical training had taught him to say that there’s always something more we can do.  But how to weigh one more radical treatment against the suffering of a loved one?

That question lead him on a journey.  If you get the chance you should read his latest piece in the New Yorker:   “Letting Go: What should medicine do when it can’t save your life?”

The real take-away from Gawande’s latest work is this — patients benefit most by having someone to talk to about death.  In his article he states that “… people who had substantive discussions with their doctor about their end-of-life preferences were far more likely to die at peace and in control of their situation, and to spare their family anguish.”

Above all, there are 4 simple questions to talk through with those who are ill:

1)    What do you understand to be your prognosis?

2)    What fears do you have about what’s to come?

3)   What are your goals as time grows shorter?

4)    How much suffering are you willing to go through for the possible trade-off of added time?

One person he talked to said her ailing father thought through these questions and concluded that he’d still want to live if he could eat ice cream and watch football on TV. It was the benchmark she used in deciding upon all medical interventions until the day his condition no longer allowed for these simple pleasures.   Gawande reports that a conversation based on these four questions with his own father was “incredibly hard but completely transformational.”

Of course, the premise of the Year to Live class I’ve been taking is that it’s never too early to have these conversations about death with ourselves and with our loved ones.  Some day we won’t get life’s winning lottery ticket, as Gawande would say.  And having thought about death would hopefully have meant that we used the time we had being as committed to life as possible.

So what happened to the 12-year-old daughter in Gawande’s family?

Her family took her home from the hospital and stopped all but palliative treatments.  Ten days later he got the email sent to close relatives and friends saying that she had passed away.

All is well,” the message read.  “Our home is full of peace.”

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Ann Dunham, the President's mother, visiting a Balinese duck farm

248 days remain

I’ve just returned from 240 hours of silence.  No coffee.  No chocolate. No NPR.  No Facebook.

It was amazing!

It will sound like a case of the dog ate my homework.  But here I am, jumping into a week of work which will involve speaking a lot — sometimes even in Spanish.  Life is funny that way.

So I thought I’d share with you something I wrote that was published in On the Issues Magazine while I was gone.

It’s really not about death.   It’s a personal story about travel and life.  There’s a short section on how I came to know President Obama’s mother.  It still saddens me that Obama said of her final days:

She was 52 years old when she died of ovarian cancer, and you know what she was thinking about in the last months of her life? She wasn’t thinking about getting well. She wasn’t thinking about coming to terms with her own mortality. She had been diagnosed just as she was transitioning between jobs. And she wasn’t sure whether insurance was going to cover the medical expenses because they might consider this a preexisting condition. I remember just being heartbroken, seeing her struggle through the paperwork and the medical bills and the insurance forms.

My blog isn’t about debating the health care system, to be sure!  But it’s sad for me to think of Ann — or anyone — in this way.

You might prefer to read my story here with the nice layout and all.  I promise I’ll be back to you soon about what I really gleaned from my meditation retreat!

Dispatches from the Road: A Travelogue of True Stories

Two decades ago, an encounter with a now-famous global trailblazer helped point me on a path of international travel from which I’ve never looked back. The lessons I’ve learned on the road have informed my career choice, my activism, and even my willingness to be open to perfect strangers.

Recently I began to pass along the simple delights of travel to my two young sons. If their generation doesn’t learn to cross borders and become citizens of the world, what are the prospects for solving the critical issues facing the planet?

Crossing borders aboard the Dogu Express

The Dogu Ekspresi train runs from Turkey’s far eastern border near Armenia to Istanbul in just under 40 hours. Earlier this year, my husband and I, vacationing with our children, climbed aboard in Central Turkey for the train’s remaining 18-hour route to Istanbul.

We were warned that it is one of Turkey’s slowest and oldest trains. Perhaps we’d be better off considering an hour and a half flight back to Istanbul? Or the 10-hour bus ride, at the same price?

We’d also heard that there were warning signs in the sleeping car reading: “Recently some persons with bad intentions have approached our passengers and offered them food or drink containing sleeping drugs, and have then stolen their valuables…. We wish you a pleasant journey.”

The truth is, I had agreed to this meandering mode of travel because of the children. It’s hard to describe the light in our six- and ten-year old boys’ eyes at the very thought of a sleeper car (with bunk beds!) and a dining car (with tablecloths!)

Plus, I’d warmed up to the idea of nearly a day on the train after having met a fascinating and friendly family from Iran who had crossed the border into Turkey and taken the Dogu Express from its starting point in Kars.

Indeed, one of my chief criteria in selecting travel destinations is the opportunity to interact with people from cultures and backgrounds I don’t usually encounter at home. If interesting people like that were on this “express,” how could it not be a good idea?

On the day of our departure, the train was already over an hour delayed. We waited in the Kayseri station as the boys curiously eyed the automatic guns of the dozen soldiers standing about, and I strategically lifted our bags to higher ground while the janitor threw buckets of soapy water over the grooved marble floor.

On The Issues Magazine -
On the Train

Once the train finally pulled into the station and we ran along the track to find car nine, we were greeted enthusiastically by an older woman wearing a headscarf and fingering her worn prayer beads. She took my hand, smiling, and starting speaking in rapid-fire Turkish.

Pretty much the only thing I can say in Turkish is, “I’m sorry, but I don’t speak Turkish.” I gave it a try. She laughed heartily and continued talking. Maybe she was speaking Farsi? Armenian? Eventually she waved goodbye and went back to her compartment.

A few hours later, I was sitting alone while my husband and the boys explored the train, when she came back. She smiled and sat down in the empty seat right next to me. And she started speaking quickly again, as if we were old friends.

I took out our Turkish phrase book and tried to make conversation.

“Where are you from? I’m from America.” She just laughed and continued right on.

“Where are you traveling to?” Nothing. “Istanbul?” Now she was nodding her head, still smiling and talking.

This went on for a while longer, and I figured I’d join in the only way I knew how.

If interesting people like that were on this “express,” how could it not be a good idea?

So, in English, I told her about my life. How we were on something called spring break. How my husband looks Turkish, but his family originally came from Russia. That my parents and my husband’s parents live not-too-far from us and that we see them often. And how my brothers and their families are nearby and how that might all seem like we live in a small village, but we’re really from New York.

She listened along, nodding vigorously as if she understood every word I said. Then she told me her story. I offered her a bag of raisins we’d bought in the outdoor market in Göreme. She accepted, patting me on the shoulder. Then she went back to her compartment and returned minutes later with a half-drunk bottle of orange soda. We joined hands for a moment and said goodnight as the sun set over the hills outside our window.

Years ago I taped a phrase by the Austrian philosopher Wittgenstein to my college German folder: “The limits of my language mean the limits of my world.” At the time, I took its meaning more literally than Wittgenstein ever intended, believing that a facility with languages could expand my understanding of the world. While this is no doubt true, the conversation with my new travel companion had defied the boundary of words entirely.

A day is a long time to spend on a train, but the interaction left me feeling more refreshed and connected than I’d been in a while.

Sound advice from President Obama’s mother

I received a lot of encouragement to travel “off-the-beaten path” by following the advice of an academic whose approach to education went far beyond the world’s ivory towers.

It was 1994 and I was happily ensconced in a post-graduate school internship at the United Nations, helping to develop materials about revenue-generating activities for low-income women. Internships can either be monotonous times filing away a supervisor’s paperwork or stepping-stones leading to exciting new opportunities.

As luck would have it, that position brought me in contact with Ann Dunham, a pioneer in microfinance who helped set me on a new direction for my career — and my life.

Ann Dunham with a villager in Lombok, Indonesia

When I met her, Ann was leading a newly formed International Coalition on Women in Credit in preparation for the UN Beijing Women’s Summit in 1995. She and her colleagues at Women’s World Banking understood communications in a way that was pretty rare at the time.

Ann felt that she would have the chance of convincing the international community gathered in Beijing of the benefits of lending small sums to poor women if she could help them to see the results for themselves.

In other words, she wanted her audience to look into the faces of poor women instead of merely hearing economic statistics about successful programs.

Knowing that I had been involved in producing videos, she asked me to edit two pieces for broadcast in Beijing, featuring microcredit programs in Nepal and Bangladesh.

“Make sure it’s about the women,” she instructed.

I admired Ann for her wandering spirit as an American anthropologist whose PhD research led her to Indonesia to examine the role of women in cottage industries. When my video editing project was finished, she encouraged me to follow my dream to travel to rural Bangladesh and study the granddaddy of all microfinance groups, the Grameen Bank. It would help ground my ideals in real life experience, I remember her saying. And while I was there, she wanted me to produce a longer film about a poverty alleviation program in Dhaka to air at the Beijing Conference. I gladly accepted the challenge.

It’s hard to put into words how fortuitous this was for me. Going to Bangladesh and producing films for Ann married my dual loves of international campaigns for justice and communications. Finally I had a tangible way of combining the two.

By the time I made it back to the United States, Ann, only 53 years old, was living out her final days with cancer in Hawaii. She never made it to Beijing.

Now that the world knows Ann as the mother of President Barack Obama, her enormous contributions are being given the recognition she deserves.

And from the perspective of this former intern, I am grateful to Ann for opening my eyes to the imperative of learning directly from the source – from the people themselves, no matter where they may be.

Leaving the world a little better than you found it

In the 1940s, Robert Stephenson Smyth Baden-Powell — who was credited with founding the Scout Movement — wrote a letter found in his desk drawer after his death. Within it was his now-famous advice to Scouts around the globe: “Try and leave this world a little better than you found it.”

When we take to the road, there’s no telling what we’ll put into motion

Baden-Powell’s words represent a worthy aspiration for anyone concerned about the fate of the planet and the seemingly intractable issues of our time – including poverty, disease, conflict and climate change.

But when we brush off our passports and take to the road with a few essentials, there’s no telling what change we’ll put into motion. For some, risk-taking may mean trekking in a remote land. For others, risk-taking may be acquiring a new skill set or finding meaningful employment overseas. And for many more, it may mean developing a one-on-one relationship that surmounts language or cultural differences, even right in their own backyard.

An enormous map of the world covers a wall in my children’s bedroom. Many nights since our trip to Turkey, they point to a new area and ask me what it’s like there. Then, as their eyelids grow heavier and their breathing deepens, I imagine that their dreams are carrying them wherever they want to go.

Travel well, little ones. May you see the world not only as it is, but as it could be.

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This week I bring you two heads-up pennies that I gathered along my way.

  • The first is a letter about an encounter with a woman who was “too mean to die”  from my friend Kathleen,  a volunteer hospice worker.    It’s a great reminder to begin again when life gets the better of us.
  • Second, a poem by Mary Oliver that we read  in our Year to Live class .  I’m told that Mary Oliver lives on the tip of Cape Cod and draws inspiration from long walks along the beaches and salt ponds.

Wishing you time to muse this week as you stroll along under the open sky!

Letter from Kathleen

Your recent hitting the restart button post and the premise of one year left to live reminded me of a hospice patient I once had.

When the volunteer coordinator called me, she said she had a woman who was “too mean to die” and that she trusted that I was the right person for her.  (They used to send me all the “hardest” and “most unusual” cases!)

With that introduction, I left with an open heart and open mind, intending not to judge, but send loving energy to her.

She was the most miserable, unlikable, complaining, woman I have met!  She was staying with her granddaughter, who had escaped to Florida for a break, leaving behind her husband who needed to study for an exam.  She made his life pure hell!

She complained that the hangers in her closet were not hers and that other people had taken hers.  She wanted me to rearrange the furniture in her bedroom. When I told her that I was the volunteer and didn’t move furniture around, she demanded to know why I had come if I was going to be worthless!

When the nurse came, the woman went into the bathroom and wouldn’t come out.  When she finally did, the nurse examined her, changed the bandages on her legs, with the woman telling her how to do it all along the way.

When the nurse left, she cut off the bandages and called for the grandson to re-do them another way.  She complained about how he did it to!

This kind of thing went on and on all day… but I kept to my plan of open heart/open mind.

At the end of the day, I was putting her into her bed, and she looked up at me and told me this:  

Every day I go into the bathroom and look in the mirror and promise myself that I will be nice to everyone today, and I try very hard….but I find myself not being nice…..so I go back into the bathroom and look again into the mirror and start again! and again, and again…

My eyes filled with tears and I embraced her and told her that God knew what was in her heart and that was all that counted.

She was not too mean to die, she was refusing to die until she could be nice for one full day.

Talk about restarting!

When Death Comes

Mary Oliver

When death comes
like the hungry bear in autumn;
when death comes and takes all the bright coins from his purse

to buy me, and snaps the purse shut;
when death comes
like the measles-pox;

when death comes
like an iceberg between the shoulder blades,

I want to step through the door full of curiosity, wondering:
what is it going to be like, that cottage of darkness?

And therefore I look upon everything
as a brotherhood and a sisterhood,
and I look upon time as no more than an idea,
and I consider eternity as another possibility,

and I think of each life as a flower, as common
as a field daisy, and as singular,

and each name a comfortable music in the mouth
tending as all music does, toward silence,

and each body a lion of courage, and something
precious to the earth.

When it’s over, I want to say: all my life
I was a bride married to amazement.
I was the bridegroom, taking the world into my arms.

When it is over, I don’t want to wonder
if I have made of my life something particular, and real.
I don’t want to find myself sighing and frightened,
or full of argument.

I don’t want to end up simply having visited this world.

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"Early Morning" by CW Ye

300 Days Remain

One of the most common reactions I hear from people taking in the concept of the Year to Live project goes something like this:

“Before I die, I really want to walk on the Great Wall of China.”  Or see the Grand Canyon, go on a safari, explore Angkor Wat, hike the Pacific Crest Trail.

It seems that children also put travel among the top priorities for their lives.  The Make-A-Wish Foundation, for example, grants requests from young people with life-threatening illnesses.  Many of these heartfelt wishes are for cruises, visits to Disney, and seeing the Eiffel Tower.

There’s something so vital to travel.  It’s almost antithetical to death.

While I flat out refuse to buy the ever-popular book  “1,000 Places to See Before You Die”, the very concept of which seems – well – a little greedy to me,  I must admit that I too am smitten by travel.

I feel like I’ve been lucky in this regard.  Early in my young adulthood, I was overcome by a desire to see the world outside of the New Jersey suburb where I grew up.  Without hardly a second thought, I applied for a summer job as a “house parent” in a home for teenage foster kids in Appalachia.  (I still marvel at their judgment/desperation in hiring an inexperienced  19-year old Yankee to manage a high-risk group of kids who had been hardened by years of abuse and humiliation.)

One “break” from the action which I always looked forward to during that Kentucky summer was accompanying the librarian of the BookMobile on her excursions into the heart of Appalachia.  In her beat-up old 4-wheel drive, she’d navigate dirt roads which were sometimes barely passable from the landslides caused by strip-mining, all the while compulsively eating Snickers (donated by the crate-load to the foster system).   With a heart full of compassion, she’d carefully explain the situation of each impoverished family we’d be visiting.  It seemed to me that delivering books was a convenient excuse for checking in with people to make sure no one was starving to death.

After that experience I ventured a little farther, spending a year studying anthropology in California, where I didn’t know a soul.  And then I crossed the Pacific and lived in Japan for a couple of years, choosing to teach English over accepting a coveted slot in the management training program of an insurance company back home.   (Some of my elders were none too pleased!)

By the time I was in my mid-twenties, I was so hopelessly addicted to travel that I vowed to combine it with my ideals – vaguely defined as anti-poverty and women’s rights – and somehow cobble together a career out of it.   As part of my jobs, I traveled to Bangladesh, Thailand, Kenya, Egypt, Israel, Palestine, Peru.  I loved being invited into the lives of locals, thinking about how we were different on the surface, but so fundamentally the same inside.

Now that I have a family, my adventures have mostly been closer to home.   Four hours in a car gets us to the beauty of New England.   Well-planned stay-cations visiting with my brothers and their families are fine by me.

Last fall, my husband asked me where I might like to go with the kids during our long spring break.  He said I’d get 51% of the vote.

I started thinking about all that I’d want to show the kids if this were to be my last year.  What would I want to impart?  What culture would I want them to soak in?  Where would my heart sing?

Tomorrow we leave for Turkey  — land of my favorite poet, Rumi.  The crossroads of Europe and Asia.  Home of baklavah.  Muezzin calling the early morning prayers.  Multitudes of opportunities to talk about how much better the world is when we don’t see things as Us vs. Them.

For now, as we leave our laptops behind, I wish you happy spring and joyous holidays.  No matter how far or near you venture, travel well.

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If you can spare 10 minutes, take a look at this beautiful video about the organization co-founded by one of my Year to Live teachers, Robert Chodo Campbell.  (He and Sensei Barbara Joshin O’Hara of the Village Zendo facilitate our monthly sessions.)

To Rose, the woman who allowed the filmmakers to capture her final days, three bows.

Simply click on this link:

NEW YORK ZEN CENTER FOR CONTEMPLATIVE CARE

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321 Days Remain

Like unexpected money found in last season’s coat pocket, I discovered a scrap of paper in my wallet this morning.

It’s a quote I must have torn out of a magazine and tucked away for a rainy day, by Charlotte Joko Beck.

On this gray day that’s neither winter nor spring, when my mood seems to match the weather, I’m glad to have found it.

Life always gives us exactly the teacher we need at every moment.

This includes

every mosquito,

every misfortune,

every red light,

every traffic jam,

every obnoxious supervisor (or employee),

every illness,

every loss,

every moment of joy or depression,

every addiction,

every piece of garbage,

every breath.

This gets me thinking of my wise friend Dana.  When I start complaining about various and sundry things/situations/people in life, she likes to say, “What’s the gift in this?

The question always takes me by surprise, followed quickly by irritation at the seeming Pollyanna-ness of articulating an answer.

But sometimes I can catch the shadow of a teacher and a vague feeling of hopefulness.

The big question for the Last Year to Live is, of course, can I learn to accept even mortality itself as a teacher?

And how to do that?

Only by parceling down situations into minuscule moments, and then even further.  Breath by breath.  Atom by atom.

By the way, if you don’t know Charlotte Joko Beck, I’m very pleased to be making the introduction!   It was only around age 40 that this mom of four — newly separated from her husband and working as a teacher and a secretary — began meditating.

She went on to write  one of the most engaging books I’ve read about living fully in the face of the pesky challenges of daily living — relationships, work, fear, ambition, and suffering.

I love the interaction she had with an interviewer for this article:

Donna Rockwell: I read your books.

Charlotte Joko Beck: Oh you read. Well, give up reading, O.K.?

Donna Rockwell: Give up reading your books?

Charlotte Joko Beck: Well, they’re all right. Read them once and that’s enough. Books are useful. But some people read for fifty years, you know. And they haven’t begun their practice.

That said, I’m signing off to get on with it.  Have a wonderful weekend, everyone!



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This essay was written by a 17-year old in 1938.  It was reprinted in the Wall Street Journal on Feb. 6.    It’s a passionate look at the 5 things the young man wants from life before he dies …

  1. Doing something truly great
  2. Friendship
  3. Travel
  4. Love
  5. And – yes – even sorrow

Before I Die

By Edmund N. Carpenter, II

The following essay was written by Edmund N. Carpenter, age 17, in June 1938 while he was a student in Lawrenceville, N.J. Carpenter would go on to win the Bronze Star for his service in World War II and to a civilian career as an attorney. A graduate of Harvard Law School, he became president of Richards, Layton & Finger, a law firm. He died on Dec. 19, 2008 at age 87 and is survived by six children and 15 grandchildren:

It may seem very strange to the reader that one of my tender age should already be thinking about that inevitable end to which even the paths of glory lead. However, this essay is not really concerned with death, but rather with life, my future life. I have set down here the things which I, at this age, believe essential to happiness and complete enjoyment of life. Some of them will doubtless seem very odd to the reader; others will perhaps be completely in accord with his own wishes. At any rate, they compose a synopsis of the things which I sincerely desire to have done before I leave this world and pass on to the life hereafter or to oblivion.

Before I die I want to know that I have done something truly great, that I have accomplished some glorious achievement the credit for which belongs solely to me. I do not aspire to become as famous as a Napoleon and conquer many nations; but I do want, almost above all else, to feel that I have been an addition to this world of ours. I should like the world, or at least my native land, to be proud of me and to sit up and take notice when my name is pronounced and say, “There is a man who has done a great thing.” I do not want to have passed through life as just another speck of humanity, just another cog in a tremendous machine. I want to be something greater, far greater than that. My desire is not so much for immortality as for distinction while I am alive. When I leave this world, I want to know that my life has not been in vain, but that I have, in the course of my existence, done something of which I am rightfully very proud.

Before I die I want to know that during my life I have brought great happiness to others. Friendship, we all agree, is one of the best things in the world, and I want to have many friends. But I could never die fully contented unless I knew that those with whom I had been intimate had gained real happiness from their friendship with me. Moreover, I feel there is a really sincere pleasure to be found in pleasing others, a kind of pleasure that can not be gained from anything else. We all want much happiness in our lives, and giving it to others is one of the surest ways to achieve it for ourselves.

Before I die I want to have visited a large portion of the globe and to have actually lived with several foreign races in their own environment. By traveling in countries other than my own I hope to broaden and improve my outlook on life so that I can get a deeper, and more complete satisfaction from living. By mixing the weighty philosophy of China with the hard practicalism of America, I hope to make my life fuller. By blending the rigid discipline of Germany with the great liberty in our own nation I hope to more completely enjoy my years on this earth. These are but two examples of the many things which I expect to achieve by traveling and thus have a greater appreciation of life.

Before I die there is another great desire I must fulfill, and that is to have felt a truly great love. At my young age I know that love, other than some filial affection, is probably far beyond my ken. Yet, young as I may be, I believe I have had enough inkling of the subject to know that he who has not loved has not really lived. Nor will I feel my life is complete until I have actually experienced that burning flame and know that I am at last in love, truly in love. I want to feel that my whole heart and soul are set on one girl whom I wish to be a perfect angel in my eyes. I want to feel a love that will far surpass any other emotion that I have ever felt. I know that when I am at last really in love then I will start living a different, better life, filled with new pleasures that I never knew existed.

Before I die I want to feel a great sorrow. This, perhaps, of all my wishes will seem the strangest to the reader. Yet, is it unusual that I should wish to have had a complete life? I want to have lived fully, and certainly sorrow is a part of life. It is my belief that, as in the case of love, no man has lived until he has felt sorrow. It molds us and teaches us that there is a far deeper significance to life than might be supposed if one passed through this world forever happy and carefree. Moreover, once the pangs of sorrow have slackened, for I do not believe it to be a permanent emotion, its dregs often leave us a better knowledge of this world of ours and a better understanding of humanity. Yes, strange as it may seem, I really want to feel a great sorrow.

With this last wish I complete the synopsis of the things I want to do before I die. Irrational as they may seem to the reader, nevertheless they comprise a sincere summary of what I truthfully now believe to be the things most essential to a fully satisfactory and happy life. As I stand here on the threshold of my future, these are the things which to me seem the most valuable. Perhaps in fifty years I will think that they are extremely silly. Perhaps I will wonder, for instance, why I did not include a wish for continued happiness. Yet, right now, I do not desire my life to be a bed of roses. I want it to be something much more than that. I want it to be a truly great adventure, never dull, always exciting and engrossing; not sickly sweet, yet not unhappy. And I believe it will be all I wish if I do these things before I die.

As for death itself, I do not believe that it will be such a disagreeable thing providing my life has been successful. I have always considered life and death as two cups of wine. Of the first cup, containing the wine of life, we can learn a little from literature and from those who have drunk it, but only a little. In order to get the full flavor we must drink deeply of it for ourselves. I believe that after I have quaffed the cup containing the wine of life, emptied it to its last dregs, then I will not fear to turn to that other cup, the one whose contents can be designated only by X, an unknown, and a thing about which we can gain no knowledge at all until we drink for ourselves. Will it be sweet, or sour, or tasteless? Who can tell? Surely none of us like to think of death as the end of everything. Yet is it? That is a question that for all of us will one day be answered when we, having witnessed the drama of life, come to the final curtain. Probably we will all regret to leave this world, yet I believe that after I have drained the first cup, and have possibly grown a bit weary of its flavor, I will then turn not unwillingly to the second cup and to the new and thrilling experience of exploring the unknown.

365 Days Remain

Tonight begins my “Year to Live” journey.  Twenty-five of us are assembled in an open loft space in SoHo, sitting on black plastic folding chairs, facing the front of the room.

Robert “Chodo” Campbell, the co-founder of the New York Zen Center for Contemplative Care, asks us to close our eyes.

In his sonorous British baritone, he instructs us to visualize ourselves going to the doctor’s office.

“Really feel yourself in that space,” he instructs.  Gravely, he begins:

“We’ve got the results of your blood work and the scan, and I’m afraid it’s worse than we thought.  You have, at most, 12 months to live.  Go home and put all of your affairs in order.  The nurse can call someone to come and pick you up.  You can stay here as long as you need and collect your thoughts.”

I feel my palms getting moist.  Would my doctor really say, “Go home and put all of your affairs in order,” I wonder.  I’d like to think he’s got more soul than that.

What would he say?  “Go home and be with Dave and the boys.”  That’s better.  Dave and the boys are a hell of a lot more comforting than my “affairs.”

Chodo rings the large gong at his feet, and we slowly open our eyes.  Then he asks us to think about a couple of things.

  • Who will you tell?

Dave.  I’d have the nurse call Dave right away.

My mom and dad?  I wonder.  My dad recently turned 80, and my mom is in her late 70s.  They’d need to know, but not right away.

The boys?  This is unimaginable.  How do you break such news to a 9 and a 6-year old?

My brothers and sisters-in-law.  Yes, I can do that.  I need their support.

Susan, Deb, Joy, the Lisa’s…  My list of friends grows and starts arranging itself neatly in my mind.  I feel a bit of relief.

  • What does this change for you?

Wow.  It’s immediately apparent.  “I’ve got to get off FaceBook and email,” I say to myself with certainty.  Superficial, I know.  But it’s a start.

It’s clear that I’ll need all of my remaining days to think about these things.  I’m grateful that the Year to Live program gives me that chance.  Judging by the reaction of my friends, most people would rather re-do the SATs before putting themselves through a course like this.

As the evening winds to a close, seven of us jam ourselves silently into the tiny elevator.  Before we hit the lobby, we stop at the 3rd floor where a woman moves to get in.  Seeing that it’s full, she backs away with a start.

“I guess she doesn’t want to be with 6 dying people,” I quip as the doors close.

A classmate behind me says softly, “But there are 7 of us.”

“I wasn’t counting myself,” I respond.  Full denial has already set in.

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