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I immediately felt a kinship. This was exactly how I approached neurosurgery: have a plan A, B, and C at all times.

“With chemo, our main decision will be carboplatin versus cisplatin. In isolated studies, head-to-head, carboplatin is better tolerated. Cisplatin has potentially better results but much worse toxicity, especially for the nerves, though all the data is old, and there’s no direct comparison within our modern chemo regimens. Do you have any thoughts?”

“I’m less worried about protecting my hands for surgery,” I said. “There’s a lot I can do with my life. If I lose my hands, I can find another job, or not work, or something.”

She paused. “Let me ask this: Is surgery important to you? Is it something you want to do?”

“Well, yes, I’ve spent almost a third of my life preparing for it.”

“Okay, then I’m going to suggest we stick with the carboplatin. I don’t think it will change survival, and I do think it could dramatically change your quality of life. Do you have any other questions?”

She seemed clear that this was the way to go, and I was happy to follow. Maybe, I began to let myself believe, performing surgery again was a possibility. I felt myself relax a little.

“Can I start smoking?” I joked.

Lucy laughed, and Emma rolled her eyes.

“No. Any serious questions?”

“The Kaplan-Meier—”

“We’re not discussing that,” she said.

I didn’t understand her resistance. After all, I was a doctor familiar with these statistics. I could look them up myself…so that’s what I would have to do.

“Okay,” I said, “then I think everything is pretty clear. We’ll hear from you tomorrow about the EGFR results. If yes, then we’ll start a pill, Tarceva. If no, then we start chemotherapy Monday.”

“Right. The other thing I want you to know is this: I am your doctor now. Any problem you have, from primary care to whatever, you come to us first.”

Again, I felt a pang of kinship.

“Thanks,” I said. “And good luck on the inpatient wards.”

She left the room, only to pop her head back in a second later. “Feel free to say no to this, but there are some lung cancer fundraisers who would love to meet you. Don’t answer now—think about it, and let Alexis know if you might be interested. Don’t do anything you don’t want to.”

As we left, Lucy remarked, “She’s great. She’s a good fit for you. Although…” She smiled. “I think she likes you.”

“And?”

“Well, there’s that study that says doctors do a worse job prognosticating for patients they’re personally invested in.”

“On our list of things to worry about,” I said, with a laugh, “I think that’s in the bottom quartile.”

I began to realize that coming in such close contact with my own mortality had changed both nothing and everything. Before my cancer was diagnosed, I knew that someday I would die, but I didn’t know when. After the diagnosis, I knew that someday I would die, but I didn’t know when. But now I knew it acutely. The problem wasn’t really a scientific one. The fact of death is unsettling. Yet there is no other way to live.