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  • Writer's pictureEric Knabel

Thoughts From Six Feet Away: Live Like You Were Dyin'!

My profession is a psychologically taxing one. While no one will pity me because I’m well compensated for my efforts, the path of a healthcare worker exacts a heavy toll. There are patients who are demanding, and there are those who have unrealistic expectations. And while these folks can derail even the best of days, nothing is as soul-crushing as the moments you stare into the Abyss, knowing that It is looking back at you. In those moments, our mortality is defined, a grim reminder that the number of days we get to spend on this Earth is finite, and that eventually, it will end for all of us. I often tell my patients that in my 20-year battle with Death, Death remains undefeated. I can only hope to make the game interesting.

Every time the natural course of things claims another patient, a small part of me is taken with them. If you’ve ever marveled at the morbid senses of humor your healthcare worker friends possess, know it is their defense mechanism to prevent a descent into uncontrolled fits of sobbing for those lost pieces of their selves. I’ve always had a keen awareness of how precious Life is, but lately that focus has become much sharper. I blame a variety of things – my first colonoscopy, receiving my AARP card, and doing some simple math to realize that odds are, I’ve lived at least half my life already.

There’s an adage that says a boat doesn’t sink because of the water around them, but by the water that gets inside it. You can certainly apply that to medicine – we are surrounded by illness and death all the time, but it only becomes dangerous when we internalize these things. We’ve all had our moments when we examine the plight of our patients, and we start to think things like, “Man, I had an upset stomach at lunch today – maybe I have such-and-such disease.” We also have the burden of knowledge, an awareness of all the things that could go wrong. Let’s just say when we go hypochondriac, it’s a sight to behold. And I will confess here today (this blog is as much for me as it is for you this time), I’ve let it get inside of me. And it’s crushing.

Why do we fear death so much? Maybe it’s because we as a species have learned to master our environment, and with that mastery comes the illusion of control. And nothing is more petrifying to most humans than a loss of control. I see byproducts of this struggle every day, manifesting as anxiety and depression or even worse, devolving into actual physical disease. And what is death other than the ultimate loss of control? Some fear death because they feel as though they haven’t accomplished enough, haven’t “lived” enough. Maybe we fear dying because we’re afraid to admit how much of our lives were wasted in frivolous activity and worry about things that will never come to pass. We approach our final chapters kicking and screaming, running through Kubler-Ross’s stages of grief like Fonzie rifling through his little black book (for you younger readers that don’t get the reference, look it up). And for the noble creatures we were made to be, we end up being reduced to cowering animals, and in the words of Jerry Maguire, “that’s not what inspires people.” I’ve used that quote a lot lately, and if you’ve heard me say it before, deal with it…I like that quote.

But I’m continually reminded that it doesn’t always happen that way. I have recently watched a friend struggle with her own terminal diagnosis recently, a punch to the gut, even for a hardened veteran like me. We have laughed and cried together, and I know there will come a day when I’ll cry without her. And it sucks. But you know what I hear in her voice when I speak to her now? Hope. Peace. A zest for LIFE. She knows the timeframe she’s been given, but she plans on going as long as she can. I also think about Randy Pausch, and his book based on what was called “The Last Lecture,” a program at Carnegie Mellon that invited teachers to present what they would give at their last lecture. He was dying of cancer when he gave his, so it was literally his last lecture. I remember seeing an inspirational billboard that described it as him “writing a book about living while dying.” Why do you think that is? Why do we wait until we know our days are numbered to make them truly matter? Why do we make “bucket lists” when our legs are already cocked back to kick said bucket? Maybe it’s because when we’re dying, the reality of our limited days smacks us in the face, and we are forced to confront that truth. No longer content with wasting energy on dumb things or pointless worries, we set out to do things that have meaning, to right past wrongs, and to make peace with grudges that lived rent-free in our heads for too long.

It’s a rough cycle to break for sure, but regardless of the amount of time we have left, let’s do our best to make the most of it. Too much of our world is based on conflict, and we’ve allowed politics to divide us. Forgive your friends. Try to understand them, even if they disagree with you. As I’ve heard in so many 5Ks over time, “run your race.” Tell your family and friends you love them. When a friend asks you to get together, do it. And for God’s sake, don’t tell them you can’t because you have work around the house to do. If COVID should have taught us anything, it’s that there are no guarantees of tomorrow. And never has it been more appropriate to say – be excellent to each other, and:

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