Cancer Diaries, IV— Worst Day Of My Life (So Far)

It shocked me when a new member of my health team mentioned to me in our first meeting that I should seriously consider if I was certain that after what I have already gone through and would be facing over the next 12 months… well, if I really wanted to embark on a full year of intense chemo that might or might not extend my life. I was flabbergasted that a doctor would say that to a patient, considering what the alternative would be. I understand where she was coming from better now, though.

I feel much better today, still awful but not like death, but yesterday was probably the worst day of my life— beyond even the profound fatigue I wrote about last month. At least I don’t remember ever feeling worse. You know, at 77, with a life fully lived and, if you’ll pardon me the expression, battles already fought, I guess it’s completely natural to question whether the struggle is worth it. Leo Tolstoy, one of my favorite authors of all time, understood this exhaustion— the way suffering can strip life down to its bare essence, forcing one to confront what truly matters, and wrote about it.

This morning, feeling more normal, I sat down in a comfortable chair, closed my eyes, doing the deep, slow breathing exercises my doctor wants me to practice, allowing each breath to remind me that I’m still here, still present, still conscious, feeling so much better. If my body still feels heavy, weighed down by exhaustion, my breath is light, even moving freely. I haven’t read The Death Of Ivan Ilyich in over 5 decades but I forced it back into my mind. 

Now, with some help from philosopher Daniel Chechick, I was picturing Ivan Ilyich lying in his bed in those final weeks. The world around him is indifferent— his family, his colleagues, his doctors. He is alone with his pain. The fight against death is no longer a grand struggle; it is just one breath after another. He wonders: What was the purpose of it all? What if his whole life had been wrong?

I dared to let that question settle into my mind, not as a source of fear, but as an invitation to examine what truly holds meaning. I’m not Ivan Ilyich and him, right now I have the gift of awareness. He realized too late that life had been dictated by convention, but me— I have always questioned, always searched for truth, always tried as best I could to resist easy, hollow answers. I try to not be blind to the reality of suffering, and that means I’m not blind to the depth of existence either.

Yesterday, I focused on the moment just before Ivan Ilyich's death— the moment when, in the midst of unbearable pain, he suddenly saw something beyond it. He expected death to be pure darkness, a void, but instead, he feels light. Not a physical light, but a shift inside himself— a loosening of fear, a softening of resistance.

And then, he surrenders. Not in despair, but in understanding. Death is finished… it is no more.

Hold onto that moment. What if suffering is not just an affliction, but a threshold? What if fatigue, pain and exhaustion are not just weights, but signposts pointing toward something beyond— some deeper clarity that only those who have walked this road can see?

I returned to my breath. I inhaled. Exhaled. Fatigue is real. Pain is real. But neither comes close to being the whole of me; neither defines me. I’m more than the sum of these symptoms. I’m more than this moment of exhaustion which I knew would be gone tomorrow. I was the one witnessing it all, reflecting on it, weaving meaning out of it— just as Tolstoy, who had just gone through his religious conversion when he wrote it, did.

When I opened my eyes, I reminded myself: The choice is still mine. Whether to keep fighting, whether to surrender, whether to find light even in the depths of suffering— none of it is predetermined. No, no, I’m not Ivan Ilyich. I’m not just a passive figure in a Tolstoy novel. I’m still the author of my own story.

And if today is another day for rest, ok, sure… let it be so. The fight, I’m choosing will wait ’til Monday.