“It’s not that we have a short time to live,” the Roman philosopher, Seneca wrote in his treatise, On the Shortness of Life (49 AD), “but that we waste a lot of it…life is long if you know how to use it.” Knowing how to use life is something that requires, for most of us, occasional review and re-setting of our goals and intentions for ourselves. But I have come to believe that my most important life lessons have come from loss, hardship, and living with progressive condition. Such experiences force behavior changes on us, like it or not.
I’ve experienced challenging life events as we all do from time to time, but more than any experience, it’s living with heart failure that has forced me to confront the reality of mortality and relative shortness of life. Diagnosed in 2008 after collapsing on the pavement, my initial panic and fear gradually subsided the first few years as my life, for the most part, seemed to go on as usual. I’d never had my defibrillator go off, and as a result, even questioned one doctor if, in fact, it had really been necessary! For the first few years, at every follow-up appointment, the routine, “you’re doing just fine” reassurance from my then-cardiologist lulled me into a less “vigilant” state, and gradually, my life became as hectic and busy as it had been before.
When we returned to Toronto in 2017, I had the good fortune to become a patient of one of Canada’s top cardiologists, and in the first appointments, the thorough examination, tests and education I experienced (a far cry from anything I’d gotten when I was first diagnosed) were somewhat unnerving. I realized that “doing just fine” had not exempted me—or my heart—from the progressive nature of heart failure. Medications, diet, and exercise could help slow the progression, but not cure it. I felt the fear and anxiety rise to the surface. I think it was only then that I truly began to face the prognosis and ramifications of the heart ailment I was living with. I doubt I had truly confronted my own mortality, or rather, fear of a shortened life, despite the fact so many of the men and women who’d come to my expressive writing groups had often written about it. It was my turn to confront my fear. Yet again, and as I met so many heart patients with far more serious conditions than my own, I slipped into that mental zone of “by comparison, I am doing really well.”
Then last week, my heart served up a reminder to me of its progressive nature—and of my need to periodically re-assess my life, change what needs changing and keep my sites on what matters most. I admit an initial bit of denial. I tried to ignore the symptoms—some lightheadedness, then nearly passing out one evening, and finally, at the insistence of my husband, notifying the clinic a day later to report the symptoms. The response was immediate. I spent much of last week in the cardiac clinic for a thorough going over of my defibrillator function, bloodwork, ECG, and at week’s end, being fitted with a Holter monitor (a small, wearable device that records the heart’s rhythm) to better evaluate what is happening with my heart) for 24 hours a day for two full weeks. (I am now relegated to my most unfashionable gear to cover up the device as much as possible—nevertheless, it’s a trivial inconvenience.)
I believe that many of my greatest teachers are the cancer and heart patients who have shared their experiences, fears and challenges in my writing groups. There is no false bravado. They write courageously and honestly. By writing, they release the emotions and experiences triggered by serious and unforgiving illnesses and progressive conditions. Some are painfully aware they’ve been given a death sentence—a terminal diagnosis—and they grapple with impending death. Others experience the after-effects of surgeries and treatments that permanently alter their bodies and their lives. Time and again I am moved and humbled by their honesty, courage and determination to live whatever life they have left as fully as possible. They are clear about what matters most. Living intentionally requires not only the will to do so, but courage, and for many of us, real change and commitment.
Perhaps the question to ask ourselves is not so much, “how do I want to live?” but “how do I want to live the life I have left?” That’s the irony I suppose, that Seneca referred to in his treatise: we need to be faced with the “shortness” of life to truly learn how truly live.
I recall a poem a former mentor shared many years ago in a creative writing workshop. Entitled “What Matters Then,” the poet, Margaret Robison, asks the question “what matters then? of the reader and, beginning the image of a single gardenia on a branch, moves us quietly to the essential, from bush to branch to a single flower. For me, it speaks of the necessity of winnowing down to the essential and the certain beauty of it.
…What matters then?
A single gardenia broken
from the dark-leafed branch.
What matters then?
The dark leafed bush.
What matters then?
–Margaret Robison, Red Creek, A Requiem, 1992
What matters to me? That I live as fully as possible each day. That I have time with close friends and especially my family: husband, daughters and grandchildren. Especially my grandchildren—funny, bright, loving– they are the best medicine for my metaphorical and physical heart. That I give back for as long as I am able, continuing to volunteer in leading writing groups for those living with life-threatening illnesses. I must make time for solitude and reflection; my morning writing practice, part-meditation, part-creative work, is critical to my daily life. I am intent on continuing to live as healthy and active daily life as I can. Yet, I must practice humility, recognize and accept my limits, and not unimportantly, make gratitude as a daily mantra.
What has living with a serious condition like heart failure taught me? I think it has taught me how I want to live to live for however long a life I have. And that’s a lesson worth living, isn’t it?
Waking up this morning, I smile.
Twenty-four brand new hours before me.
I vow to live fully in each moment
and look at all beings
with eyes of compassion.
-Ticht Nhat Hahn, Buddhist teacher
Write about the experience of becoming a patient, of living with a life-threatening illness or condition. What have you learned about yourself?
- How has your life changed—for the positive and the negative?
- How do you want to spend your days–to live your life?
- What matters most to you?