Last night I attended a talk by William S. Breitbart, MD titled “Confronting Our Mortality: A Crisis of Spirit, an Opportunity for Meaning.” The event was held by IDEAS in Psychiatry, a non-profit institute affiliated with the University of New Mexico Department of Psychiatry. Dr. Breitbart’s insightful lecture provided much to ponder regarding end-of-life issues.
William S. Breitbart, MD
Breitbart has dedicated much of his career to helping people find hope and meaning as they face their own mortality. He helped establish the American Psycho-Oncology Society (APOS) and has worked with dying cancer patients for a long time. He is Chief and Vice Chair of the Department of Psychiatry and Behavioral Sciences at Memorial Sloan-Kettering Cancer Center. He is also the child of Holocaust survivors, so he grew up with parents who talked about death a lot yet had a vital, loving outlook on life.
He presented two key ideas as we face our mortality. One, the philosophy and the wisdom of the ages has something important to impart to us, and, two, the importance of the integration of mind-body-spirit to our contentment and happiness.
In ancient times, philosophers were the doctors of the soul. They prescribed the proper attitudes and practices to foster health and happiness. After polling the audience for nominations, some of today’s philosophers might be Oprah, Deepak Chopra, and Lady Gaga.
Breitbart said that we can’t look at death constantly. Our minds won’t allow it. Human beings are animals designed to form meaning and identity. “We start cancer centers and have plastic surgery,” he joked.
And still, we are a death-denying society. He shared that great Woody Allen quote, “It’s not that I’m afraid to die. I just don’t want to be there when it happens.” Allen also is credited with the line, “I don’t want to achieve immortality through my work. I want to achieve immortality by not dying.”
The Search for Meaning
Awareness of death is a call to life. It raises three fundamental existential questions: Where did I come from? Why am I here? Where am I going (i.e. what lies beyond death)?
Human beings can objectively contemplate ourselves. We’re aware that we are alive. We also stand in wonder, awe and dread that we can die. To address this awe and dread, this death anxiety and existential terror, we create culture to offset death. To make meaning is the defining characteristic of human beings as a species.
The search for meaning is almost more important than finding it. Breitbart showed a chart titled Cancer and Meaning. Cancer can lead to three things:
- Suffering – When we encounter a limitation of our lives, it opens the door to enhance meaning in our lives
- Death – Ironically, death can help maintain meaning
- Guilt – This is when we have a loss of meaning, feeling like we have not accomplished enough with the life we were given, or failed to live up to our full potential
Breitbart quoted Albert Einstein’s last words before he died: “If only I had known more mathematics.” Can you believe Einstein felt he failed to live up to his full potential?
Cancer causes us to ask the existential questions. It gives us a sense of urgency and an awareness of the preciousness of life. But not everyone. Some don’t experience any type of meaning, and often those people become depressed, disconnected and hopeless.
Cancer as a Transformation Agent
Cancer is an interruption, an obstacle that causes a deviation in the trajectory of the arc of a life story. It prompts a transition, moving into a new phase that takes a while to incorporate into one’s psyche and accommodate the new information. Our physical limitations reveal our vulnerability and make us more aware of our existential guilt (not living up to our full potential).
In the face of cancer, it takes courage and will to find meaning. We still have the freedom to make our lives as we will, to create meaning in the lives that we still live. The task of facing death is to relieve that existential guilt, forgive and accept ourselves, and restore or sustain meaning.
Attitude is a Choice
The choice of one’s attitude in the face of death informs meaning. One can choose to form a connection to others, foster meaningful, authentic relationships, dedicate oneself to someone else or something greater than self, and seek transcendence with hope and acceptance. Or one can choose depression, anger, blame, judgement, shame and demoralization.
How to live in the face of the fact of our mortality? Breitbart suggests these three keys:
- Be Upright: Realize you are still alive and standing. You’re not dead yet. You still have wants and wishes and can exert your will. Continue having the courage to live, despite the finiteness of life.
- Be Whole: Remain connected to all that gives your life meaning. Relate to others, don’t isolate yourself, engage in the activities you love as you can.
- Be Careful: Care for yourself and those you love. Be aware of your legacy and have compassion for yourself and others.
“The only thing uncertain about death is when it happens and how it happens,” said Breitbart. “Even when people lose hope for a cure, they still have hopes. Acceptance of death is the acceptance of the live that you’ve lived.”
So the task is to accept how you live your life, today and every day. The meaning in your life can’t be given to you, you have to find it in yourself.
Reminds me of what the Good Witch Glinda told to Dorothy in The Wizard of Oz. Thank you, Dr. Breitbart, for an illuminating talk!