Learning What’s Important by George Merrill

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One of the highlights of my life is a bi-weekly meeting I have with a small group of elders. We are men and women of “riper years” who, in the latter days of our lives, remain curious and wonder what this business of being alive is all about. Some of us are religious in the conventional sense. Others more eclectic, some atheistic and agnostic, but none nihilistic. The thread that connects us all is a feeling of wonder at being alive, the mystery at the heart of it and as we watch the shadows of our days lengthen, we examine what the afternoon light reveals in the landscape of our lives. The conversations can be moving, funny, or sad, but always life-giving.

For me, it’s an opportunity to grow in wisdom. I once thought wisdom was knowing something about everything. It isn’t. It’s knowing what’s most important.

Dr. Lucy Kalanithi is a physician who has learned what is important.

She’s a lovely young woman who exudes heart felt authenticity. She met her husband while studying at Yale. He, too, was a physician. They married. Shortly into the marriage he was diagnosed with stage four cancer; tumors in the lungs and bones. In a presentation she made in a TED talk, our group watched and listened as she shared how she learned what was important. It was not easy to hear, but her message was clear and convincing; knowing what is truly important is doable, because if we can remember it, we always have some choices in how we live. Making those choices together with those we love leads to wisdom, and in themselves become expressions of that love.

“Out loud” was a pivotal metaphor in how both she and her husband negotiated their lives in the face of the husband’s impending death. The metaphor arose when one day he looked at her and said, “I want you to marry again.” She was floored at the directness, the generosity and love implied in his wish. “Whoa,” she exclaimed. “I guess we’re going to have to say things ‘out loud’ from now on.” And so, they did.

In preparing advanced directives, she spoke of their conversations as an affirmation of their love for each other, something about advanced directives that had never occurred to me in that way. She described how she felt when discussing the particulars in what he wished to have happen and what he would need from her. It was a statement about how neither would have to live this tragedy alone. As each spoke “out loud” the hopes and fears of their hearts, they grew closer in an unexpected way. Advance directives became for them not just an exercise in organizing their affairs, but also tangible expressions of their love story.

A particularly moving piece of their story was about making choices, specifically, within the limits of time they had together. Should he undergo extraordinary measures to sustain life? Should they have a child? They measured the time scrupulously to consider the realities of such a move. They calculated that with his life expectancy, he would be there for the birth for sure, but little beyond that. The decision was made to have a baby and she delivered a baby girl. About the time she delivered, he was failing rapidly. He told her he wanted no extraordinary measures. He asked her to bring the baby so he could hold her. Four hours after he held her, he said “I’m ready.” He died.

Light shines through some people. They transmit the light like saints in stained glass windows. The light can be generated in the crucible of white-hot suffering. Wisdom is refined in that crucible and it is offered for us to see, or in the case of Dr. Kalanithi’s story, to hear her account. She speaks “out loud”, too.

She speaks of a life lived fully not as one free from suffering, but because of it. An adversarial relationship to our suffering is often expressed by “fighting” the cancer, “beating” the heart disease, or “conquering” the illness. She does not see us as victors by winning battles. What she and her husband experienced was the discovery that there were shepherds there to guide and sustain them, not soldiers to fight for them. That is something very important.

Freedom, I once read, is not the absence of constraints, but the art of living freely within them. Dr. Kalanithi goes at some length in describing how living in the constraints of the illness, their oncologist worked with them as a co-creator in framing a medical regimen that realistically supported the ways the patient chose to live the remainder of his days. Her husband once told her that things would be OK. Was that to mean that they’d return to the things had been? They were OK if one understands, as she had come to understand, that to live a life fully, is to recognize that we are free enough to make the choices offered under the circumstances. There are typically more than we first imagine.

The opportunities that we have to compose a life in the face of adversities is getting more recognition. As a society, we’re beginning to accept the inevitability of suffering as a condition of being alive. As physicians, both Dr. Kalanithi and her husband knew this, but she says, “It’s another thing to actually live it.” The other message that we gleaned from her talk was the importance of candor, the ability to speak directly to the suffering and not hide or deny it. What grows from the open and shared acknowledgement of pain, the “out loud,” she describes as an increasingly deep intimacy following in its wake.

I know that everyone in the room that day was engrossed in listening to Dr. Kalanithi’s story. Most had been through significant loses; spouses, children and friends and many knew the anguish involved. But for all of us there was something hopeful in her story. I think it was the thought that when tragedy strikes, we’d remember the essence of what she said. And if I could summarize it I’d say, that at end of the day, it’s loving well that’s most important. The unendurable is endurable if we have someone there who loves us enough to walk with us in the time of shadows.

Columnist George Merrill is an Episcopal Church priest and pastoral psychotherapist.  A writer and photographer, he’s authored two books on spirituality: Reflections: Psychological and Spiritual Images of the Heart and The Bay of the Mother of God: A Yankee Discovers the Chesapeake Bay. He is a native New Yorker, previously directing counseling services in Hartford, Connecticut, and in Baltimore. George’s essays, some award winning, have appeared in regional magazines and are broadcast twice monthly on Delmarva Public Radio.

Letters to Editor

  1. Richard Skinner says:

    It’s good to know that the author’s group includes those for whom there is no afterlife, as those of us who do can bring a fierce urgency to living life as fully as possible since it is all we know as conscious beings, especially as our time draws toward an end. Not that such urgency is exclusive to non-believers. Indeed, those of faith place a premium on how they live their lives in this life to insure another life.

    I suspect the diversity of beliefs about an afterlife enriches the group’s gatherings. My experience is that those who hold a conviction that there is another existence following death sometimes falter in that belief as mortality closes in and are understandably fearful (the part of Hamlet’s To Be” soliloquy that speaks of the “undisver’d country” awaiting some or perhaps many of the faithful captures that fear of what awaits them after death) may wrest a measure of comfort from those who believe death is death, the end.

  2. Perhaps we ought t o remember Henry Drummond’ comments:
    “There are some {persons] in whose company we are always at our best. While with them we cannot think mean thoughts or speak ungenerous words. Their mere presence is elevation, purification, sanctity. All the best [parts of] our nature are drawn out by their [companionship], and we find a music in our souls that was never there before.”
    Life is Good,
    Bobhallsr

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