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PART II

Cease Not till Death If I were a writer of books, I would compile a register, with a comment, of the various deaths of men: he who should teach men to die would at the same time teach them to live.—Michel de Montaigne, “That to Study Philosophy Is to Learn to Die”

LYING NEXT TO LUCY in the hospital bed, both of us crying, the CT scan images still glowing on the computer screen, that identity as a physician—my identity—no longer mattered. With the cancer having invaded multiple organ systems, the diagnosis was clear. The room was quiet. Lucy told me she loved me. “I don’t want to die,” I said. I told her to remarry, that I couldn’t bear the thought of her being alone. I told her we should refinance the mortgage immediately. We started calling family members. At some point, Victoria came by the room, and we discussed the scan and the likely future treatments. When she brought up the logistics of returning to residency, I stopped her.

“Victoria,” I said, “I’m never coming back to this hospital as a doctor. Don’t you think?”

One chapter of my life seemed to have ended; perhaps the whole book was closing. Instead of being the pastoral figure aiding a life transition, I found myself the sheep, lost and confused. Severe illness wasn’t life-altering, it was life-shattering. It felt less like an epiphany—a piercing burst of light, illuminating What Really Matters—and more like someone had just firebombed the path forward. Now I would have to work around it.

My brother Jeevan had arrived at my bedside. “You’ve accomplished so much,” he said. “You know that, don’t you?”

I sighed. He meant well, but the words rang hollow. My life had been building potential, potential that would now go unrealized. I had planned to do so much, and I had come so close. I was physically debilitated, my imagined future and my personal identity collapsed, and I faced the same existential quandaries my patients faced. The lung cancer diagnosis was confirmed. My carefully planned and hard-won future no longer existed. Death, so familiar to me in my work, was now paying a personal visit. Here we were, finally face-to-face, and yet nothing about it seemed recognizable. Standing at the crossroads where I should have been able to see and follow the footprints of the countless patients I had treated over the years, I saw instead only a blank, a harsh, vacant, gleaming white desert, as if a sandstorm had erased all trace of familiarity.

The sun was setting. I would be discharged the next morning. An oncology appointment was set for later in the week, but the nurse told me my oncologist was going to drop by that night, before leaving to pick up her kids. Her name was Emma Hayward, and she wanted to say hello before the initial office visit. I knew Emma a little—I had treated some of her patients before—but we had never spoken beyond passing professional courtesies. My parents and brothers were scattered about the room, not saying much, while Lucy sat by the bed, holding my hand. The door opened and in she walked, her white coat showing the wear of a long day but her smile fresh. Trailing behind her were her fellow and a resident. Emma was only a few years older than I, her hair long and dark, but as is common to all those who spend time with death, streaked with gray. She pulled up a chair.

“Hi, my name is Emma,” she said. “I’m sorry to have to be so brief today, but I wanted to come by and introduce myself.”