Someone told me Roman soldiers invented craps using knuckle-bones of a pig as dice and their armor shields as a table. Others said the game originated from an Arabic dice game called Al Dar, which means “dice” in Arabic. The most commonly accepted version of the game’s creation is that it was invented by Sir William of Tyre in 1125 during the Crusades and named after a castle called “Asart” or “Hazarth.” No matter; what matters is the look in your clinician’s eye saying, “Craps.”

Fifteen months ago, my doctor said they would do everything possible. Today, craps. “There’s not much more we can do. We can replace your knee, but that will not repair arthritis in your feet, shoulder, elbow, wrist, or fingers in both hands. We could perform a hell of a lot of surgery, but you would not feel a huge benefit.” Gently grabbing the back of my neck, “Your back is a mess—severe osteoarthritis in your neck, and the tumor. There’s the Parkinson’s, and a lump at the base of the finger,” she said while finger outlined the lump. “My guess is that this lump is not cancerous, but we’ll require Xrays.”

Her words required no steeping. “Craps,” I said.

Shifting across from me, “I will do what you want, but I suggest the best approach is to keep you moving and pain management.” A deep exhale, “Keep you going until…” she faded.

“Craps,” I repeated.

“Craps,” she affirmed. “I can refer you to a pain specialist. Maybe neurology has something up their sle…”

“No,” I interrupted. “Anything more invasive may prolong my life, but it’s unlikely to save it.” Gently laying my hand over her pen, she looked up, “Doc. You’ve done all I can ask. It just is. It’s life,” I affirmed.

I already knew the progression. I knew this moment inched into my future every day. With all the experts I’ve sat across from, the hospital shift work, and camaraderie, I couldn’t place the ultimate responsibility for my care on one individual: my physician. Instead, it’s how you guide patients through the last month (or year(s)) is essential.

Doctors must be sure to take the time to remind their terminally ill patients that even though a cure might be out of the question, patient health is still relevant. I gave my physician affirmation that she performed exemplary. I know my diagnosis is terrible. And surely, I still have to figure out precisely what flavor of bad it is. But the real message from God is, ‘I only have so much time to do the things I want to do.’

In The Shawshank Redemption, the fictional character Andy Dufresne said, “I guess it comes down to a simple choice, really. Get busy living or get busy dying.” Time to find out the best way I can live. “[Red] Get busy living or get busy dying. That is goddamn right.” No time for craps.