How can I live peacefully with a terminal diagnosis?

In the Jewish tradition, we very much pray for someone's healing. We say a healing of body and a healing of soul and sometimes a healing of soul transcends the end of living on the physical plane. Healing is not the same as cure. We pray for healing knowing that healing can happen in many different realms.

There was a woman I've written about a lot. She was really angry. She was thought to be the difficult cancer patient on the oncology floor. And no one wanted to deal with her because she was oppositional and non-compliant. I went into the room and she was throwing things at me and like the little weird kidney shaped thing and her pillow and all these things, and I was just dodging what she was throwing at me. And she said, "What are you still doing here?" And I said, "Well, I'm just really curious about what you're so angry about." And she said, "You are?" I said, "Yeah". And she said, "Well then have a seat." 

It's almost like you had to meet her anger to hear it to receive it. What we of course found out was that she had taken care of her two parents at home for more than 20 years with serious, Parkinson's and dementia and when they finally died, like a year before, she felt like her life was about to begin. A few months later she was diagnosed with stage four ovarian cancer. And her husband left her. 

As many caregivers over long periods of time do, she lost much of her social network and she was alone. She was so angry, and we just got into her anger. When she ended up dying, in her last breath, she actually shot up in her bed with her fist to the sky, fist to the ceiling. And she just went, "Aghhhhh," and she died. And it was so beautiful and felt totally appropriate. Sometimes we can get romantic about peaceful death. To me, it was actually one of the most inspiring ways I've ever seen someone die. So full of rage and vigor.

I'm in the middle of leading an eight week course now called Living Fearlessly. I give them their terminal diagnosis on the first night. We then do advanced directives, memorial planning, funeral planning, writing your own obituary. So these are the kinds of things that one can do if you want to journey towards their death in a way of accepting. Some people don't. Some people are going to kick and scream throughout the whole journey. They're angry about the prognosis, angry about their cancer, whatever it is, and they're gonna die. Like all of us.

I don't know that I'm qualified to answer this, but when I spent a lot of days thinking I was dying because I was critically ill, I learned that, for myself, there was very little utility for staying in that space because all it truly did was deprive me of the time that I actually had and my ability to enjoy it. We are all dying in some way, all the time, but our life happens around that fact. So allowing your life to still happen with meaning and purpose and joy in whatever moments you find is the only way to live and the only way to die. 

Illness for me, opened up the ability to have serious and meaningful conversations that I might not have otherwise had. When time is limited, we tend to shy away from superficial things and allow ourselves to say what we mean and really love the people we love in a way that we don't otherwise. There are gifts and opportunities that are made available to us when we're confronted with mortality, so really inhabiting that space is, for me, the only way to live.

I took a small journey to be alone with my thoughts when I was diagnosed. Turns out I was not terminal because I'm here now, but there was a very good chance that I would be. So I took a lot of time to be alone with my thoughts and forced myself to think through how a series of events might play out. Doing that brought me a lot of peace. 

I knew I couldn't possibly anticipate things that might go wrong or how I might react to treatment or to palliative care. But I gave some consideration to how it could play out. And in so doing, when you make yourself imagine those scenarios, you see them play out in your head and you think, "Okay, well, I want to make sure we avoid this, but I want to make sure to not avoid that". I remember thinking about how things might feel and I had this serenity come over me, so I started thinking about what environment could give me that serenity. 

My mind immediately went to vacations I had taken in Italy. I kept thinking about it, and I thought, as much as I love New York, it isn't the right temperament, for me, at least, if I'm facing death. So at that moment, my wife and I decided that if I did get a terminal diagnosis, we would move to Italy. We picked where we would live in Florence. This is going to sound horrible, but a small part of me was almost looking forward to it. I still ended up going to Florence quite a number of times afterwards, but thankfully not for that reason. 

Imagining all the scenarios gave me such confidence that there could be nothing that could go wrong in the sense that if this treatment doesn't work, well then I'm spending some time in Florence with my wife. That was the road to a sort of peace with any diagnosis.