How To Live Like You're Dying

Live like you're dying, replied one of my friends a few weeks ago after I jokingly brought up the idea of dropping everything and moving to Portugal. Amidst our conversation about work stress, we both laughed the moment off, but I went home and that one line just kept ringing inside my head. What does it really mean to live like you're dying?

For most people, including myself, when we hear statements like these, cool experiences flood our minds. Things like running a marathon, learning a new language, flying in a hot air balloon, and being part of a flash mob. While these things seem exciting, I just couldn't help but wonder if I were on my deathbed, would the fact that I had gone skydiving or could speak French really bring me any peace?

It seems like underneath our modern and somewhat glamorized understanding of what it means to live like we're dying lies much more sober and pragmatic questions that we rarely ever take the time to ask ourselves until circumstances leave us no choice. Imagine you wake up tomorrow with a minor headache, one of many you've been having recently. They've been manageable, so nothing alarming. "It's probably nothing," you say to yourself as you pop in Advil and get ready for the day.

But by bedtime, the pain is just so unbearable that you have to go see a doctor. As you lie on the hospital bed facing the bright white lights flooding the entire room, your doctor walks in with a file in his hand and a very grim look on his face. He says to you that they found a brain tumor. "That can't be," you say to yourself. Just yesterday, you were planning on taking a trip with your friends for the summer. To make matters worse, the doctor tells you there's nothing they can do about the tumor but manage it; it’s terminal and you have less than 18 months.

Walking out of the hospital with the realization of your own mortality staring you right in the face, in what ways would your perception about life and what matters change? This might not be the case for many of us, but the lessons in it are universal. How would you change the way you live your life day to day if you found out you only had 10 more years to live? How about five or one year or even six months? If you only had just one week left here on earth, what would you cherish the most?

These questions are intense, and it makes sense why people who are fortunate enough to be able to avoid them for the most part choose to do so. But what if the answer to our questions about what makes life meaningful lies not in the quality of our experiences, as we're so commonly told, but rather in the process of letting all of those experiences go?

There may be no profession that grants a person a closer look into the experience of death than palliative care nursing. This caregiving approach aims to ease the suffering of patients with terminal illnesses. One palliative care nurse, Ronnie Ware, who assisted patients through the last 12 weeks of life, wrote in her book "The Top 5 Regrets of Dying" of the experience that she gathered from her patients in the face of mortality. The top five regrets were:

1. I wish I let myself be happier.
2. I wish I stayed in touch with my friends.
3. I wish I had the courage to express my feelings.
4. I wish I hadn't worked so hard.
5. Most commonly: I wish I had the courage to live a life true to myself, not the life others expected of me.

As I read through the list, what struck me the most was the second most common regret: I wish I hadn't worked so hard. I found this regret so ironic because of how incompatible it is with the way that we, as not-yet-dying people, so commonly seek to derive meaning from our lives.

The truth is that most of us don't have the privilege of working fulfilling jobs. Many of us are stuck in the rat race, doing boring jobs with no altruistic value—just to fend for ourselves. There's only a handful of people who get to find fulfillment and meaning in their work. People like Paul Calamity, a neurosurgeon who was diagnosed with stage four lung cancer at the age of 36.

During his last year of residency, Paul spent the final year of his life continuing to work as a surgeon, even when he was forced to stare at his own mortality in the face. In his novel "When Breath Becomes Air," Paul wrote: "I don't think I ever spent a minute of any day wondering why I did this work or whether it was even worth it. The call to protect life, and not merely life, but another's identity was obvious in its sacredness."

He spent the last few months on earth powering through excruciating pain to complete shifts that at times spanned multiple days and nights and required his non-stop focus. It's amazing that Paul was able to find meaning and fulfillment in his work as a neurosurgeon, but for many of us, we spend 40 hours every week working a job we wouldn't consider worth it.

In the final moments of life, the types of jobs that on our deathbeds will end up wishing we hadn't worked so hard at. The reality is that finding a career that provides both economic security and a personal sense of meaning is quite a difficult balance to strike and may be one that not everyone will be able to achieve.

So is all hope lost for us who cannot have meanings tied to our jobs and are forced to continue in our unfulfilling endeavors? Matthew Ricard, a renowned writer, philosopher, and Buddhist monk, once wrote: "We try to create outer conditions that we believe will make us happy, but it's the mind itself that translates outer conditions into happiness or suffering."

This is why we can be deeply unhappy even though we have it all, and conversely, we can remain strong and serene in the face of hardship. What if it wasn't the profession itself that gave Paul meaning in life? What if it was the way his mind translated his profession that gave him strength and serenity, even in the final days of life?

A recent survey in the United States found that around one in five physicians plan on leaving the practice within two years, while about one in three health professionals plan on at least reducing their workload within the next 12 months. So even in a profession that's altruistic in nature, there's still loads of people with a desire to quit, whether it's for stress-related reasons or simply because it doesn't fulfill them in the way they perhaps thought it would.

Imagine again yourself with a terminal illness, except this time you’re lying in a hospital bed experiencing the last few days of your life. It's been 18 months after the tumor was first discovered. In the past six months, the illness had progressed rapidly, causing more deterioration to your mobility, cognition, and overall identity than you ever would have imagined on the day of your initial diagnosis.

The illness has left you with no choice but to gradually say goodbye to all of the activities that once brought you joy. Even simple everyday things like brewing yourself a pot of coffee in the morning or going on a spontaneous walk around the lake with a friend are long gone. Now, as you lay there in that bed, listening to the beeping of the machines that are struggling to keep you alive, will you be able to still feel any happiness?

Will you be able to feel as though your life still has meaning, or will all semblance of meaning and happiness be lost? Thinking about these questions is unpleasant, and it makes a lot of sense why so many of us avoid them. In fact, some people are so terrified of death that it becomes a taboo subject; something they avoid talking about at all costs.

But emerging evidence suggests that the fear of death might just be the root cause of some of the real dangers in our world today. Terror management theory proposes that there's a connection between the awareness of our own mortality and the ways in which we will go on to impose and force our worldviews onto others. If this theory were to be proven true, it could expose that things like nationalism, terrorism, international conflicts, and racism are caused by our individual and collective awareness of mortality.

There have been several hundred studies done on TMT, yet thus far the results are still a bit scattered. But one conclusion that can pretty much be safely made is that when someone is reminded of their mortality, a common coping mechanism for the terror they feel is to enter an unconscious fear-driven state of mind. Within this sphere, people are more likely to double down on whatever attachments they have to the social, political, racial, or other cultural groups they identify with as a means of seeking comfort in community.

Although these findings are extraordinarily telling about the ways in which our fears of death influence the ways we act in our lives, what they don't account for are the people who aren't afraid of death. The people who have found ways to soothe their unconscious terror surrounding the topic of mortality and have found a way to accept it, allowing it to be instead a motivating factor for the ways they choose to live.

Take Claire Weinland, for example, a girl who was born with cystic fibrosis and given about 10 years to live. Despite the tremendous pain her disease caused and having to grow up with the ever-present awareness of death looming over her shoulder, Claire spent most of her younger years playing games with nurses and elaborately decorating her hospital rooms, exploring every opportunity to feel happiness and a sense of meaning.

Sadly, things became much more sinister when Claire's lungs collapsed at the age of 13 and she fell into a medically induced coma with just a one percent chance of survival. Claire miraculously emerged from the coma after 16 days, but as she came back to reality, she soon realized that the near-death experience had radically transformed her understanding of what mattered most in life.

A year later, at the age of 14, Claire started a foundation called the Clarity Project to raise money for other terminally ill children with cystic fibrosis. She then spent the rest of her teenage years giving inspirational speeches filled with insights such as, "The quality of your life isn't determined by whether you're healthy or sick or rich or poor; it's determined by what you make out of your experience as a human being."

"And the moment you realize it's not about avoiding suffering, it's about making something from your suffering, you're incredibly free." When you listen to Claire deliver these insights, it's hard to believe that she was just a teenager at the time she said them. Her wisdom allotted her the nickname "Little Buddha" among her followers.

Although Claire only lived to the age of 21, so many would say that her awareness of her mortality, combined with the near-death experience, accelerated her understanding of who she was and what she wanted to do in the world. While many of us spend our entire lives from zero to 80 without any sense of meaning, faced with her own mortality, Claire was able to live meaningfully with the knowledge that she might not have as much time as everyone else.

And Claire's story doesn't exist in a vacuum. Reports that people discovering newfound clarity about what makes their lives meaningful within terminal illness diagnoses and near-death experiences are rather common. On her experience of being diagnosed with breast cancer, Audre Lorde, an infamous American poet, writer, and activist, wrote: "In becoming forcibly and essentially aware of my mortality and of what I wished and wanted for in my life, however short it might be, priorities and emissions became strongly etched in a merciless light. What I most regretted were my silences. I was gonna die, if not sooner rather than later. Whether or not I had ever spoken to myself, my silences hadn't protected me."

"Your silence won't protect you." That message about the importance of speaking your truth rings loud and clear throughout the entirety of Lorde's book "The Cancer Journals." It also ties in perfectly with the most common regret reported by Bronnie Ware's patients: "I wish I had the courage to live a life true to myself, not the life others expected of me."

We live in an exciting, rapidly growing, and ever-evolving world during a time where the invention of things like the internet, virtual reality, and electric cars have created more possibilities than ever before. Every day, we face an immense amount of pressure to be more successful, make more money, connect with more people, achieve larger-than-life accolades, break world records, and traverse the unknown.

Yet despite all of this, our core values and what matters most in the end have remained the same for millennia. We all want to have lived a life with a sense of purpose, meaning, and fulfillment. But despite how seemingly obvious these core values seem, the day-to-day chaos of being alive can make them quite difficult to live by.

The trick to do so lies in learning how to hold these deep truths close, despite their commonality, and to continuously remember to prioritize what matters most, even in situations where doing so isn't the easiest or even the most beneficial choice. Imagine yourself lying in that hospital bed again, one last time, except now you are in your final minutes on this plane of existence.

You reflect back on the pivotal moments of your life with newfound clarity, watching little snippets of memory swirl around your head like a 3D movie. Why not everyone will suffer a terminal illness, all of us in one way or another will have to come face to face with death. Would you be happy if that moment came today, tomorrow, seven days from now, or even six months from now?

If you won't, then you need to start living like you're dying.