Last February neurologist and Awakenings author Oliver Sacks learned he had terminal liver cancer. He shared this news with the world in an op-ed piece in the New York Times. I was moved by his thoughts about dying and I wrote a blog entry about it. As you may already be aware, Sacks died Sunday. He was 82.
His cancer was metastatic, and I’ve read that liver metastases is considered an absolute contraindication for liver transplantation. However, it was treated. Sacks stated in a July 24 Times piece that in February, the cancer was treated with embolization, a procedure where substances are injected to try to block or reduce the blood flow to cancer cells, and the metastasis was “wiped out.” But a July 7 CT scan showed the metastases had regrown and spread beyond the liver.
He’d started immunotherapy treatment, but it was only to buy him time, and obviously it did not buy much of it.
In an appraisal written for yesterday’s edition of the Times, Michiko Kakutani wrote that in his work, Sacks cast light on the interconnectedness of life. The interdependence of life is a well-known Buddhist doctrine. There is, too, an interconnectedness of death, as stated so well by John Donne:
any man’s death diminishes me,
because I am involved in mankind.
And therefore never send to know for whom
the bell tolls; it tolls for thee.
Life and death are interconnected. What Buddhism calls “the cycle of birth and death” is a continuum. Life is the active phase and death is the passive phase. It is said that the continuum of a human being, or more precisely consciousness, is beginningless. As to whether it is endless or not, there are divergent opinions.
From my perspective, finding myself in a situation very similar to that of Sacks, beginningless and endlessness are not so important. What matters most is the indivisibility of life and death. Fear is one of the greatest sources of anxiety, particularly fear of one’s own death. When we realize the oneness of life and death, its interconnectedness, and the emptiness of all things, there is, as the Heart Sutra says, no fear and no illusion. This is wisdom and with this wisdom we enter into nirvana, which is nothing more than this mundane world of life and death.
That is from the ultimate truth. The relative truth was stated by Sacks himself: “I cannot pretend I am without fear.”
To my mind, “no fear” does not refer to the absence of fear, but rather to how we handle fear. It means the absence of anxiety, or better, winning out over the anxiety that fear brings. It means facing even death with hope and confidence.
Was also very moved by Sacks’ passing; as a music lover (and frustrated musician), I devoured his Musicophiia, and really appreciated his input/commentary in the “music and dementia” documentary Alive Inside.
And another (so) well-written piece, David; your thoughts on our universal connection really resonate with me (I just shared that Donne poem with my 19 year old son last week, which was a catalyst for a conversation about precisely this topic). And I confess I think/wonder about your health whenever I read your pieces (and they all get read), and hope all is well with you.
Mark, thank you very much for your thoughtful comment. I am not very familiar with all of Sacks’ work. Musicophiia sounds like something I read, as a music lover (and frustrated musician).
Right now, my health is very good. I can only hope that it continues like that for some time to son. My best regards to you and your son, and for that matter, your entire family.
David, that is great to hear about your health. Every time i read your posts I do wonder how you are doing. Best wishes for your continued well being.
Thanks, Red. As long as I keep writing posts, you know that I am hanging in there.
Thanks for this David. As usual you hit the nail on the head. This was a timely peice for me. My mother died this past Saturday. She was 84 and quite ill. Her deepest wish, for her last two years, while she was still lucid enough to voice it, was to die. She said she wasn’t afraid at the very end but she had been full of anxiety for most of her life and especially so up to the last few months of her life. Mom was not a Buddhist. The work for us Buddhists, it seems to me, is to keep living as deeply aware and as fully as we can until we are no longer “alive” (define as you will). That requires being “ready” long before the “end.” How wonderful for us that we know that there is nowhere to go. I think Mom was afraid of where she was going having not realized yet where she had come from. So I think of my Mother, of the brilliant Dr. Sacks, of you, of me, and I’m glad we are all here – always. I’m ready for that. I bet you are too. With wishes for you to be well and happy… Namaste – Cary
Thank you, Cary, for this comment. My condolences on your mother’s passing. I lost my birth mother 25 years ago. My step-mother died this past June and she, also, at the end, wanted to die. I wasn’t there so I don’t know if she had any anxiety. I was told it was very peaceful, and yet, I can’t help but feel that some anxiety would be only natural.
I, too, am glad we are all here, for now, for as long as we can be here.