What makes life worth living?

What makes life worth living? Good question, huh?

I just read the book When Breath Becomes Air. It is the memoir of Dr. Paul Kalanithi who died in 2015 from lung cancer at age 37. Dr. Kalanithi was a neurosurgery resident when he was diagnosed with advanced cancer.

It is a beautiful book.

Dr. Kalanithi describes parts of his life as he tries to answer one of life’s most important questions. What make life worth living?

Of course, a life-threatening illness changes your perspective, and when you face mortality, it’s hard not to contemplate the meaning of life.

Did your life have meaning?

Did you live it well? Did you accomplish everything on your bucket list?

I certainly thought about all of those questions after my cancer diagnosis. One of the many things I found incredible about Dr. Kalanithi was that he thought about how to have a meaningful life well before his tragic diagnosis, even as a young man.

There is a captivating discussion in the book when, as a college student, he is deciding between working as a prep cook at a camp vs. working in a prestigious research lab. He felt it was a choice between experiencing life first hand while at the camp or studying life while researching macaques. Against the better judgment of some of his professors, he chose the camp and never regretted it. Not the usual choice for a college student thinking about going to medical school.

After college, he first obtained a masters degree in English literature before becoming a physician and then a neurosurgeon. He thought medicine in general and neurosurgery, in particular, was the right mix of direct life experience while pursuing something meaningful.

He lived for almost two years after his diagnosis during which time he finished his residency.

Find your values

Throughout that time, as he grappled with learning how to live when you know you are going to die; he sought out his oncologist for help. Her advice was “find your values”.

Figure out what is important to you and go with that.

For him, it was returning to work as a neurosurgeon. For anyone who doesn’t know neurosurgery is a particularly grueling specialty. All medical training programs are challenging with long work hours and plenty of stress, but neurosurgery is one of the longest and toughest.

Dr. Kalanithi was so dedicated to his profession; it was part of what made life meaningful for him, that he willingly returned to complete his training after his cancer diagnosis. He went back to the hard work, stress and long hours of neurosurgery training even when he was not sure how much time he had left.

I wasn’t willing to do that. At the time of my diagnosis, I was miserable at my job. I was working when I received the call that informed me I had cancer. An hour later, I walked out and never went back.

Two reasons my life is worth living

For me, I most certainly did not want to spend however much time I had left toiling away in a job I hated. I felt my work environment, and my negative feeling about it contributed to my cancer diagnosis.

It was a no-brainer to leave that wretched job. The hard part was figuring out what to do next. I needed to find my values. At first, I thought I would leave medicine altogether. Walk away from years of hard work and training.

But the reasons I went to medical school in the first place were still present. The biology and physiology of women’s health still amaze me. Interacting with patients, informing and educating them on health issues, helping others understand and make good decisions regarding their health and wellness are all aspects of medicine that I enjoyed and wanted to continue.

Just not in the traditional hospital-based Ob-Gyn practice I had worked in for almost ten years.

While I enjoyed operating and delivering babies, the pressure of being responsible for someone else’s life outweighed the satisfaction. At the time, I was not able to enjoy my life in the moment. My life was overwhelmed by my work. When I wasn’t actively working, I worried and dreaded going back.

Searching for my values, I found I did want to continue practicing medicine but in a different way.

Learning about life

Sheryl Sandberg spoke about what she learned about life from her husband’s death at a commencement address this spring. If you haven’t read it yet, do so now. It’s well worth the time.

The part that I remember most is when she describes breaking down 11 days before the anniversary of her husband’s death, as she realized one year ago, her husband only had 11 days left. She then thought how would you live if you knew you only had 11 days left? She encourages everyone to do just that. Live every day like you only have 11 days left.

It is terrible but true that we learn more about life from death. Of course, I wish I did not have breast cancer, but I am grateful for the perspective it has given me.

At times I want to feel sorry for myself. At times I am angry that it happened to me. But then I remember that I am in a much better place now. I wish that I had obtained the clarity and perspective that I have now, without a cancer diagnosis.

Why did I let my life get away from my values and what I know to be most important to me? Why couldn’t or didn’t I do what I knew I should be doing before my cancer diagnosis?

My advice to you: don’t wait for a life threatening illness.

Appreciate what you have now.

Be thankful for at least one thing in your life every day. Even better, go for three things and write them down.

Live like you have 11 days left.