A few hours ago, I found a box of old pictures. The first picture had to be twenty years old and looked like someone else. “Wow, I’ll never be that person again.” Followed by, “Yeah, that person does not have death shadowing my every movement.” Still, when others are seen enjoying activities without reservation, I do not become overly nostalgic. Sure, I once enjoyed running, playing football, or swimming, but I know those I see will one day be like me, someone for whom the bells have either tolled or will toll.

Admittedly, I have thrived where others have not. (Or, I have thrived up to this point.) I could claim that my ability was due to modern medicine or that I was such a physical specimen that my body was bound to overcome anything thrown at it. But the reality is likely to involve a good dose of luck. I hear this all the time when walking the ICU. If one dies, a lack of luck is blamed. “Ma’am, we did our best, but his luck ran out.” If one survives, ‘luck’ is stated differently, “Ma’am, we’re unsure why he survived, but a lot of things worked in his favor.”

Over two-plus years ago, doctors stated my body was incurable and that the marvels of modern medicine could only post-pone the demise. Yet, 29 months later, could a champagne toast be raised to good fortune and feelings, regardless of how fanciful, that somehow I escaped inevitability? There is this part of me that wantonly dismisses the ‘Angel of Death’ by claiming, “Yeah, that transient ischemic attack (TIA) was a quick shot over the bow. Nothing more will happen.” Yet, the analyst within understands that just as a Las Vegas gambling casino knows the odds are on its side so does the Angel of Death. And as each month passes without significant incident, I grow confident this will end one day – sooner than later.

In the medical world, I have seen people survive exceptional life-changing circumstances. For example, one person I know survived bladder cancer. After so many years post-treatment, he was pronounced ‘cancer-free.’ Of course, there are others like Victoria “Tori” Tomalia, whose blog ‘A Lil Lytnin’ Strikes Lung Cancer’ started in 2005, but passed in 2021. Julie Yip-Williams fought just as against Stage 4 colon cancer but died in 2018. So, I’ve never concluded as being lucky. On several occasions, I do ask God, “Why me? Why have I been spared when Ms. Tomalia and Ms. Williams are better examples of true grace?” 

Let me tell you, maintaining the veneer is hard work. This week, I had to deal with post-Hurricane Ida issues and the potential loss of employees in the storm. (Actually, I am unsure if we lost anyone or not. We cannot locate them.) I have to assist in coordinating the relocation of hundreds of patients, deal with a family pet’s death, and comfort another family member who became COVID positive while simultaneously keeping my march toward the unknown together. Yet someone who saw me today quoted, “I don’t know how you handle it.” I mentally snarked back, “Handling it? Do you believe I am handling it? Listen, you’re looking at a man who can die at any moment via stroke. I could collapse from nerve compression from whatever remaining tumor residing in my neck. Then again, my heart could give out. Half the nights, I can’t sleep. The other half requires masses doses of pain medication. But thanks for acknowledging I can handle it.” I want to say I am scared shitless, but I don’t have time.

The reality is you can’t ever push death out of your mind. The harder you try, the more ‘life’ death has. I wish I could feel sadness for what I will miss. I want to be jealous of those who live. But, most days, I am exhausted. I remember Thanksgiving 2017. I wrote of being thankful for family, for all they had provided, for all the effort in which they’ve loved me. Just as the song Seasons of Love captured, I noted days filled with sun, sunsets, midnights, and cups of coffee; there were inches, there were miles, there was laughter, there was strife. There was hope, reconciliation, and heart, but most of all, there was love. If not for Apple engineers, technicians, project managers, and leaders, my family and I would not have gotten one more hour. (Borrowing from The Hours) But, today, I still have to face the hours, the hours after tonight, the hours tomorrow, and the hours after that. I am exhausted on so many levels.

Compared to other great authors and writers, I view the bulk of my life as fairly unproductive. Yet, like all searching for their own True North, I ask, “Is what I do essential to the world?” Will others understand that my own slow roll to God’s arms has been occurring for an extended period of time? Even with that admittance, I feel continually moved by an urge to create something of lasting significance to both myself and others. And even on painful days, there are moments of perfect harmony that have helped to mitigate the losses one must inevitably face. 

From a spiritual perspective, death and dying evoke such profound and disturbing emotions that most try to live in death’s denial. But nothing has benefited me more in my efforts to overcome pain, disease, and impending death than the disarmingly simple tools of prayer, meditation, and self-inquiry. I admit I will never discover nirvana. And the disease in my body cannot be cured. But there is a small pinch of fear within that I will no longer exist, and that all I’ve accomplished will disappear like yesterday’s trash.

In assessing such thoughts, it is essential to understand that the fear of nonexistence is, in fact, only a fear. Most fears are not reality. Yet, we all give empowerment to such fears. For example, suppose I let the fear of being in pain or not knowing my future seep into my soul. In that case, I would become a victim of my tumor, a victim of a potential TIA, or a victim of someone labeling me ‘unlucky.’ Whether I live for another three days, three years, or three decades, I do have a choice on how to live at this very moment. I can embrace God. I can embrace life. Or I can embrace fear.

I found it was ok to cry for the days of lost youth throughout this ordeal, knowing that my dreams near an end. However, I know God has given me an ability to weather the storm(s), to ‘handle it.’ Terminal illness has an unbelievable power to destroy lives and relationships (if you let it). And while my body has chiseled me to the point of being a ghost of my former self, the UnknownBuddhist lives. When the UnknownBuddhist goes to work to assist in the evacuation of stranded hospital patients, my life matters. When I provide comfort to a COVID patient, the UnknownBuddhist lives. When I assist comforting family members with the passing of a very special pet, the UnknownBuddhist lives.

So, what is luck? I am ‘lucky’ to be surrounded by so many professionals and so many other clinicians who help me take care of myself, from my neurologist to my internist and those friends and family I have entrusted my secrets to. What did I do to deserve such good and kind people? Well, God gave them to me. So, “Thank you, God.”