Four Questions
IT'S SEVEN MONTHS since I received my terminal diagnosis. Cancer is now the reality that looms over each day, and it's been a rocky road, though the latest abdomen scan suggests I'll be around for a while longer.
Where’s my head at? Here are four questions I’ve been asking myself—questions, I suspect, that might also be interesting to those who aren’t facing a terminal diagnosis.
1. Am I afraid of dying? No, but I am afraid of not living. In particular, there are two things I’ll miss.
First, I love the day to day—the blue sky, leaves dancing down the sidewalk, morning coffee, afternoon naps, an evening glass of wine, chatting about the day with Elaine. Words like mindful and intentional tend to hit my gag reflex—too touchy-feely for my taste. Still, that’s what I’m trying to do, to be mindful of all that’s around me and intentional about how I use my time. The world is an amazing place, and I hate the idea that I’ll no longer get to revel in its daily joys.
Second, it pains me that not only won't I get to grow old with Elaine, but also I won’t see what the years ahead hold for my children and grandchildren. Who will they become? What triumphs will they enjoy? How will they cope with the hardships thrown their way? Most of us get to the point where we focus less on our own life, and instead live more through the eyes of others. I was just starting to enjoy that new life phase, but now it’s about to get snatched away.
2. Am I using my time in the best way possible? Mostly, I’ve spent the past seven months doing what I’ve done for years, which is to sit at my laptop, writing and editing. Maybe this work doesn’t bring happiness in a laugh out loud kind of way, but it does give me a profound sense of satisfaction.
Are there other things I ought to be doing? Even before my diagnosis, Elaine and I had a travel wish list. Over the past seven months, we’ve managed three trips. But we’ve also canceled one because I landed in hospital—and we’re aware that, from now on, every plan we make is tentative. It feels like time is increasingly short, the world is getting smaller, venturing far from our Philadelphia home is more daunting, and perhaps our “bucket list” time could soon be over.
Am I upset? When you know time is running low, it makes you think hard about how you use your days and weeks. Would I be distraught if I never went to Europe again? Probably not. Instead, what I fear most is the moment when I no longer have the energy to make some small difference in the world, which is why you’ll find me sitting in front of my laptop tomorrow, and the day after, and—I hope—the day after that.
3. Why aren’t I angrier about my diagnosis? I consider myself fortunate. I’ve spent my career doing what I love and—despite some rough times—I’ve had a mostly happy life. What if it had been otherwise? If I’d been stuck in a job I hated, waiting for retirement to get my reward, I imagine I would indeed feel cheated, and I wouldn’t be nearly so sanguine about my diagnosis.
Do you hate your job? Are you in an unhappy relationship? Suppose that, like me, you were given a year to live. Would you regret the life you’ve led and, if so, should you take steps to change it now?
4. How can I prepare to be my future self? In an Oct. 25 Forum post, I wrote, “As best I can tell, my stage 4 cancer hasn’t had any impact on my physical abilities. Indeed, most days, I feel pretty good. I’d always thought death would be easier to accept because of the pain involved and the endless interactions with the medical establishment, which would slowly sap my will to live. But so far, it hasn’t been that way.”
Ironically, it was about then that I started feeling a whole lot worse, thanks to the back pain caused by the cancer spreading to my spine. Radiation earlier this month brought substantial relief. Nonetheless, I feel my illness has moved me fast forward into old age. It can be difficult to imagine who we’ll become—but, as I’ve discovered, there’s a risk we’ll become that person with extraordinary speed. How can we better prepare ourselves? In retrospect, I’m grateful for two lifelong habits.
First, before my diagnosis, I was in good physical shape, and that’s stood me in good stead over the past seven months. I’ve worked out pretty much every day for three decades, ever since I started training for my first marathon. Clearly, this didn’t stop one of my genes from going rogue and causing cancer. On the other hand, because I was in good shape when I got my diagnosis, it’s helped me to weather the treatment reasonably well and, I believe, bought me a little extra time.
Second, my financial affairs were fairly well-organized before my diagnosis. Since then, I’ve made a big push to simplify my finances even further, and to throw out old papers and unwanted possessions. The amount of work has been significant. Still, without my earlier efforts, it would have been far more onerous.

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