On December 22, 1944, at about 11:30 in the morning, a group of four German soldiers, waving two white flags, approached the American lines using the Arlon Road just south of Bastogne.

The Germans sent soldiers to take the American surrender. Awoken from a deep sleep, Brig. Gen. McAuliffe, said “Nuts!” The response was typed and delivered by Colonel Joseph Harper, commanding the 327th Glider Infantry, to the German delegation. It read accordingly:

December 22, 1944

To the German Commander,

NUTS!

The American Commander.

In March, I read of a Kaiser Permanente robot rolling into a patients room in the intensive care unit and telling an elderly patient by video he would likely die within days. In some ways, I felt more fortunate. Mine were posted on my EHR account. It was ‘transactional.’

A tumor in the neck measuring 4.1 x 2.3 in transaxial dimensions and 3.7 cm in height (1.6 inches x .9 inches x 1.4 inches), surrounding the spinal cord and C5-C6. Preliminary indication benign. Requires biopsy. Metastatic or secondary tumors may spread from another site. Delicate neural structures will complicate treatment, resulting in nerve compression, spinal deformation and compromised bone strength.

There’s good news and bad news. Good news: Highly likely the tumor is benign. Bad news: Tumor is the size of a walnut, surrounds the spinal cord and or nerves. Prognosis? Nuts.

Nuts!

Every day someone gets the news that a loved one has been diagnosed with a terminal disease. The shock, accompanied by a ferocious sense of foreboding and a powerful dose of premature grieving, can be overwhelming and paralyzing. However, my first inclination was not despair. The gnawing torment some experience never occurred. No nausea. No dread. No anxiety. Using the Kubler-Ross five stage model as a measuring stick, I leapfrogged denial, anger, bargaining, depression and landed on acceptance.

I’ve known since 2014 that my internal clock was running out. I cannot explain it. I instinctively knew death was nearing. My time working in hospitals reveals that even if loved ones refuse to discuss death, the patient knows it is coming. I just presumed it would have been quicker, for five years later, I’m still around. However, in the annals of life, 5 years ago is just a moment ago.

“So, what’s next?” my boss asked.

I doled out a usual quip, “Burning a hole through my deductible.”

What I really thought was “Relationships.”

Author Karen J. Warren wrote in 2016 that she was diagnosed with terminal illness. As she confronted the truth about her medical condition. She articulated the personal, philosophical, and medical issues when discussing end-of-life options. However, the following stays with me.

I knew that what gives my life meaning, what really matters to me, are relationships—relationships with myself, with other people, with animals, with the natural world. Creating or nurturing these relationships is what I value most.

The precious time I have left matters! I found myself asking, “Will doing this or saying that make a positive difference to my health or enhance my well-being?” For example, does it make a difference to me whether I participate in a research program, take an X-ray or have a mammogram? My guiding principle has been this: “If doing something makes a positive difference in my life or enhances my well-being, then do it; if it doesn’t, then don’t do it.”

So, nuts.

I will do something that many fail to do: Focus on things that will make a positive impact.

You should too.