Abby's Road: Live like the end is always near

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What do we do with the time we have left?

That question has provoked great thinkers across religions, cultures and epochs. It also inspired an essay by Paul Kalanithi, a Stanford neurosurgeon writing for his institution’s medical magazine, the Stanford Medicine.

On March 9, Kalanithi died, at 37, from metastatic lung cancer. “Before I Go” is his reflection on time management, in an operating room and in the face of his looming death. If you haven’t read the essay yet, you should.

We do not know when we will die, we just know that we will. Kalanithi knew that he was going to die sooner than most, sooner than he should. He knew that the timing of his death would be untimely.

Within earshot of that loudly ticking clock, he described time as becoming double-edged. He acknowledged an impulse to cram his days with experience and meaning. That inclination was tempered by the plodding march of reality: his body was tired, his disease demanded attention.

Gratefully, most of us are not battling a terminal illness. Kalanithi’s essay resonates nonetheless. We cannot pretend to understand the immediacy of his mortality, but we cannot avoid the eventuality of our own. His writing is like a report back from a final frontier, telling us what to pack and how to pack it.

If death is a certainty, but its timing can never be known until it is upon us, how much power over life do we give that intervening question mark?

Some would tell us to live like we were dying. Tim McGraw even sings that advice to us. Others encourage an attitude of abandon, for if you only live once, you have nothing to lose. Put differently, #YOLO.

There is a certain freedom in embracing the finality of death as your motivation for life. Consequences appear fleeting, repercussions superfluous. If materialism, morality and responsibility are earthly limitations, they can be escaped with a broad enough perspective on our future unearthliness. (Or, alternatively, our very literal earthliness, depending on your post hoc persuasions.)

That seems too simple a formula, though. Life is riddled with practicalities. Our social construct would crumble if instant and selfish gratification were tantamount.

Pleasure is a luxury, afforded with some basic cushion that can absorb a departure from the routine. Spontaneity depends on some earlier dependability. We cannot take the trip, or the nap, or the long way home if we have not saved or planned in advance.

If I knew I were going to die tomorrow, I would shut off this computer forever. I would take my children out of school, tell my husband to hide the phones. I would buy plane tickets for my parents, my sisters and their husbands and children, and shuttle them to Maine on nonstop flights. I would stay awake all night, talking and laughing and thanking and eating the most decadent chocolate cake I could find on short notice. I would close my eyes and hold as many hands as I could and I would be full.

But I don’t know that I’m going to die tomorrow. Assuming I’m alive, I do know that I will have to help get two children clothed, fed and out the door. I must cooperate with my husband to provide for that. I go to work, and I come home to help with homework and showers. I quiet, and I tuck into bed.

Kalanithi offers a solution to the riddle with a closing message to his infant daughter. He tells her that when she is called to account for what she has meant to the world, she must not discount the joy she brought to her father. They were an unlikely power couple, one unwittingly capable of creating joy, and the other surprisingly capable of experiencing it.

Maybe that’s the secret. Maybe, within the moments of daily life we must attend to, we can sustain ourselves with an effort towards joy, both being it and seeing it. Maybe then, when we do our own reckoning, we will take a deep bow as the curtain closes, and rise up with a sense of fulfillment.

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Abby Diaz grew up in Falmouth and lives there again, because that’s how life works. She blogs at Follow Abby on Twitter: @AbbyDiaz1.