A TGB READER STORY: The Redemptive Power of Sunsets
The Limits of Longevity

Thinking Out Loud: Shifting Perspectives Toward the End of Life

Perhaps it is the time of year. Or maybe it is my natural bent in life. Or something else. It doesn't really matter why, in the past month or two or so, I have been taking stock of these past two-and-a-half years living with a fatal disease.

Not that I planned to do that. Such thoughts bubbled up from somewhere and now I feel like I've been tagging along for the ride while another part of me examines how I've been dealing with my predicament.

For most of the first six months after diagnosis – June to December 2017 – I was recovering from the massive Whipple Procedure surgery. As the doctor explained then, it takes that long to be fully functional again and I have few memories of those six months beyond resting, healing and learning the daily practicalities of navigating such an unexpected reality.

Almost no one with pancreatic cancer lives longer than a year after diagnosis so even as I regained strength, I began planning for an imminent demise. Looking back from today on that period, I see that I was irising down my life to the basics.

End-of-life documents had been completed before my health issues came to be. I had no bucket list or, at least, no travel I wanted, no big experiences to arrange before I die. I wanted just to live my normal daily life in my home, spend time with friends near and far, ponder the great unknown, and most of all, read books.

That's what I do, what I have always done going back to when I first learned to read: I do it to find out what other people know, what the world is like in its many of its permutations, how others have interpreted life, what great lessons endure and the pleasures of a good story well told.

Overall, I am quite indiscriminate in what I read. Nearly half a century ago, a woman I worked for said to me, “Everything is interesting if you pay attention.” It is one of the truest things I know.

Weekly doses of chemotherapy over three rounds of it during 2018 and early 2019, left me tired to the bone. Concentration on anything was difficult, sometimes impossible for several days after each session but then I was fine. Or so I thought. I see now after six or seven months without those chemicals that I was good way from being mentally functional. I'm much better now.

In early spring of this year, a CT scan showed no cancer. Doctors are careful about how they say that: “no visible cancer.” I remember my surgeon telling me that day, “Go,” he said, “enjoy your life.”

Just a few weeks earlier, I'd had a psilocybin (magic mushroom) session with a guide to deal with my fear of dying. It worked well and to a reasonable degree, remains so.

Since then, the aftermath of that drug and the CT scan may have had something to do with my loosening the restrictions I had imposed on myself in reducing the size of my life.

So I've been watching myself this year. Even while my physical life becomes more difficult due to the COPD, I have been broadening my horizons again, feeling more attached to life than I had been, eager to keep up with a fast-moving world.

Each day I worry more about the political future of the United States while looking in nooks and crannies of the internet for an explanation of the apparently large right-wing rush to authoritarianism, some say fascism.

How can that be? I ask. And no one answers. At least, not satisfactorily.

And then I worry that in addition to terrible outcomes we know such a political movement creates, we will have lost the fast-shrinking window in which we might be able to stave off at least some of the terrifying results of climate change.

What a pickle Earth and the United States are in – and I don't mean that lightly. That heavy, heaving word, “existential,” was invented for such a time as we are living in not to mention, for the age group that mostly reads this blog, end-of-life issues that must be faced in the natural order of the cosmos.

Elderhood is often thought of as a time to take stock, to make peace, to tie up loose ends. Most of us slow down a good deal in these late years, rarely by choice, but it comes with old age, with bodies wearing out. Supposedly, life gets simpler but we, early boomers and late silent generation, got plopped down in one of the most frightening and dangerous periods in modern human history. Oh, goodie for us.

For a large part of this year, as much as a diagnosis like mine isn't ever far from one's mind, I have become more attached to life again.

Back and forth I travel: life, death, life, death. Maybe I am learning something about Viktor Frankl's belief that the one thing no one can take away from anyone else is the ability “to choose one’s attitude in any given set of circumstances.” I can't say mine has been a conscious choice. Mostly, I'm just watching what happens as these days and months and years pass by.


As a late Silent Generation woman, I feel for the generations who have succeeded us. They have neat toys, but what a scary world situation, physically and politically. We have succeeded in breeding ourselves nearly into oblivion. What part of "Don't overdo a good thing." don't we understand? I wish I could foresee much happier world times for my great-grandchildren who are now pre-teens.


"Everything is interesting if you pay attention.” Thanks for that!

Your blog and its varied subjects have informed us and I thank you for that. I also thank you for your contribution to the medical world by sharing your path with pancreatic cancer. The whipple surgery is a step for some. Each step is a step forward for anyone with that diagnosis and possible further treatments. Thank you Ronni, keep "stepping" forward.

I would encourage you to read this book: Love Your Enemies: How Decent People Can Save America from the Culture of Contempt by Arthur C. Brooks. I am only on Chapter 3, but he has some great insights (I believe) about how each of us can help deflate the contentious atmosphere we are all suffering from.

This man is a conservation, and makes no bones about it, but I think he might really be on to something. The narrative is a little repetitive, but maybe that is intentional.

Blessings to you on your amazing journey!

Ronni, your Thinking Out Loud is so rich, so evocative, so lovely. I felt as if I was moving
along with you, at first with your title [which left me slightly nervous and uneasy, worrying about you] -- but then as I read on, sort of moving with you through this thoughtful piece, worry when I sensed uneasiness in you, but then encountering your wonderful ability to continue to think, to muse, to remain your relentlessly honest self.

By the time I finished, I felt as if I was privy to your thoughts. And I felt lighter too, relieved that life is grabbing hold of you again.

What a wonderful gift you are for all of us. Thank you.


Congrats on the "no visible cancer" award. Hope it continues. Yes, books are a re-awakening friend from my youth. Not a "nook", a real book. Amazing, Ronni, at a later age I have had to relearn how to read a book. It's not a short newspaper article, or even a longer magazine article. A book is a time and brain commitment forgotten in the rush of life survival. It is nice to reacquaint oneself with an old friend.

Yes it is an interesting time. I often say I was born one generation too late (WWII) and one generation too early (the computer age). I am an amateur historian, so the current events are interesting from that perspective. I only wish we could read the treatises fifty years from now. B

"one of the most frightening and dangerous periods in modern human history. Oh, goodie for us."
Goodie for us, actually true. We'll be long gone soon enough. Not-so-goodie for the youngers. This terrific essay reinforces my relieve at having never reproduced, but I worry still. Let's encourage and practice mentoring and participation. God help us all.

Thank you for this. I am in the process of diagnosis at the moment after a terrifying health incident and appreciate your reasoned thinking and celebration of the life you have left. I needed to read that today.

We just don't know do we? Australia is the current canary in the coal mine and it is terrifying what is happening there. I don't know what will get the pols' attention. As some wag put it: " if the sun comes up unexpectedly at midnight would that get their attention?" I doubt it somehow.


JMW Fleming and others...

Re "Congrats on the 'no visible cancer' award. Hope it continues.". As I mentioned in these pages a month or six weeks ago, cancer is visible and growing though slowly.

I too am grateful for the "everything is interesting if you pay attention."

I love your words..so evocative, and as one reader wrote above...feel like I am traveling with you. I feel ease, dignity and a gradual expansion as I read them, and feel all the same, with a smile on my face for the NVC and the possibilities of a continued richness of your very special life.

Ruth- Ellen said it for me.

May the coming holidays fill you with pleasure and joy!

Like Rosie, I'm glad at this point that I never reproduced, but I fear for my husband's adult children and succeeding generations, especially if this insane swing to the Far Right continues. For us at TGB--mostly born just before, during or soon after WWII--it's inconceivable that we could be headed down that road again. "When will they ever learn?" to excerpt from a popular song of the '60s. Humans squander their developed brains in many ways, and not learning from history is surely one of them.

I'm SO glad that you are doing relatively well and wish you many more almost-no "visible signs" CT scans and many more books to read.

Oddly, as I age and slow down, I find myself worried about an apparently large left-wing rush to socialism, and left-wing authoritarianism, every bit as bad its right wing counter part. I am amazed that I even get worked up over such things, but this blog proves to me that maybe I'll just have to live with it to my last days. Sad.

Ruth-Ellen said it best. I read at this stage in my life in the hope of reading something like what you wrote today. Thanks, Ronni.
There is a wonderful poem by Ruth Hadas in the Nov 18 issue of the New Yorker that touches on some of the same themes you wrote about today. It’s called “Love and Dread”. It’s too long for me to reproduce (and I don’t know if that’s legal), but here’s the link to the poem (may not work for non subscribers):

"Of a certain age", LOL is that even relevant anymore?

All I can contribute, beside hand-wringing and over-thought paranoia, is some very wise words of my cousin who is 83:

"It'll be alright; everything works out, and it's gonna be OK." It is his long life mantra. I could write a long biography of cousin Gary, but suffice to say, he doesn't get overly wrought about much. Maybe he DOES have the secret to life. Comme ci, comme ça.

Well, maybe he stole it from Doris Day.

Couldn't agree more that everything is interesting if you just examine — doing so has certainly been a boon to formulating and maintaining my mostly positive attitude through the ups and downs in my life travels. I, too, read an eclectic selection of books that might appear to others as having no unifying rhyme or reason as to why I might select them, but resonate for me for varying reasons at different points in my life.

I recently delighted in The Library recommended by my son and DIL, numerous other unrelated books including fiction to scientific which brought me to Great Britain’s Science Outreach Fellow at Magdalene College, University of Cambridge. Author Dr. Hannah Critchlow has been named a Top 100 UK Scientist for her work in science communication. Her book, The Science of Fate, challenges us to consider our future is more predictable than we think as neuroscientist’s research is revealing. Perhaps free will doesn’t exist to the extent we may think it does.

Maybe “...our lives are largely predetermined, hardwired in our brains — and our choices over what we eat, who we fall in love with, even what we believe, are not real choices at all?”

Perhaps our genetics have a greater bearing on our lives than we may think in relation to our decision-making that forms our own reality. What might all that mean in terms of the world in which we live today? How can we alter what’s in store for our futures?

Once again thank you. Your thoughtful remarks and observations are so welcome. In a world of hype and "fake everything", your words are like nourishment for the soul. I am so happy and grateful that you remain a HUGE part of my life and of so many others.

Thanks for your reference to Viktor Frankl. I was lucky to have an unorthodox high school catechism teacher assign Man’s Search for Meaning as the only thing we read and discussed that Spring 1968. His ideas have stuck with me since then. Best wishes always sister Ronni.

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