Being Mortal: Medicine and What Matters in the End

He also complied with the instructions not to attempt to get around without help. The hospice helped my parents hire a personal care aide to stay overnight and assist my father to the bathroom when he needed it. After that, he had no more falls, and we gradually realized how much each one had set him back. Every passing day without a fall allowed his back and neck spasms to reduce, his pain to become better controlled, and his strength to increase.

 

We witnessed for ourselves the consequences of living for the best possible day today instead of sacrificing time now for time later. He’d become all but wheelchair bound. But his slide into complete quadriplegia halted. He became more able to manage short distances with a walker. His control of his hands and his arm strength improved. He had less trouble calling people on the phone and using his laptop. The greater predictability of his day let him have more visitors over. Soon he even began hosting parties at our house again. He found that in the narrow space of possibility that his awful tumor had left for him there was still room to live.

 

Two months on, in June, I flew home from Boston not only to see him but also to give the graduation address for Ohio University. My father had been excited about attending the convocation from the moment I had been invited a year before. He was proud, and I had envisioned both my parents being there. Little is more gratifying than actually being wanted back in your hometown. For a while, however, I feared my father might not survive long enough. In the last few weeks, it became apparent he would, and the planning turned to logistics.

 

The ceremony was to take place in the university’s basketball arena with the graduates in folding chairs on the parquet and their families up in the stands. We worked out a plan to bring my father up the outside ramp by golf cart, transfer him to a wheelchair, and seat him on the periphery of the floor to watch. But when the day came and the cart brought him to the arena doors, he was adamant that he would walk and not sit in a wheelchair on the floor.

 

I helped him to stand. He took my arm. And he began walking. I’d not seen him make it farther than across a living room in half a year. But walking slowly, his feet shuffling, he went the length of a basketball floor and then up a flight of twenty concrete steps to join the families in the stands. I was almost overcome just witnessing it. Here is what a different kind of care—a different kind of medicine—makes possible, I thought to myself. Here is what having a hard conversation can do.

 

 

 

 

 

8 ? Courage

 

 

 

In 380 BC, Plato wrote a dialogue, the Laches, in which Socrates and two Athenian generals seek to answer a seemingly simple question: What is courage? The generals, Laches and Nicias, had gone to Socrates to resolve a dispute between them over whether boys undergoing military training should be taught to fight in armor. Nicias thinks they should. Laches thinks they shouldn’t.

 

Well, what’s the ultimate purpose of the training? Socrates asks.

 

To instill courage, they decide.

 

So then, “What is courage?”

 

Courage, Laches responds, “is a certain endurance of the soul.”

 

Socrates is skeptical. He points out that there are times when the courageous thing to do is not to persevere but to retreat or even flee. Can there not be foolish endurance?

 

Laches agrees but tries again. Perhaps courage is “wise endurance.”

 

This definition seems more apt. But Socrates questions whether courage is necessarily so tightly joined to wisdom. Don’t we admire courage in the pursuit of an unwise cause, he asks?

 

Well, yes, Laches admits.

 

Now Nicias steps in. Courage, he argues, is simply “knowledge of what is to be feared or hoped, either in war or in anything else.” But Socrates finds fault here, too. For one can have courage without perfect knowledge of the future. Indeed, one often must.

 

The generals are stumped. The story ends with them coming to no final definition. But the reader comes to a possible one: Courage is strength in the face of knowledge of what is to be feared or hoped. Wisdom is prudent strength.

 

At least two kinds of courage are required in aging and sickness. The first is the courage to confront the reality of mortality—the courage to seek out the truth of what is to be feared and what is to be hoped. Such courage is difficult enough. We have many reasons to shrink from it. But even more daunting is the second kind of courage—the courage to act on the truth we find. The problem is that the wise course is so frequently unclear. For a long while, I thought that this was simply because of uncertainty. When it is hard to know what will happen, it is hard to know what to do. But the challenge, I’ve come to see, is more fundamental than that. One has to decide whether one’s fears or one’s hopes are what should matter most.

 

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