This piece was originally published on AlterNet.
I’ve written about how loss, including death, is necessary for life and change to be possible. I’ve written about death as a natural, physical process, one that connects us intimately with nature and the universe. I’ve written about the idea of death as a deadline, something that helps us focus our lives and treasure the people and experiences we have now. I’ve written about the idea that our life, our slice of the timeline, will always have existed even though we die. I’ve written about how things don’t have to be permanent to be meaningful.
In the last few months, I’ve been dealing with some of death’s harsher realities.
So I’ve been thinking a lot lately about how atheism, and humanism, can help us deal with death — and with life. Not just in an abstract philosophical sense; not just in a “creating a meaningful frame for our lives” sense. I’ve been thinking about how we can apply atheist philosophies in a practical way. I’ve been thinking, not just about how these philosophies can help us face death, but about how they can improve the way we live our life.
So our cat Lydia was recently diagnosed with cancer, and it’s been very difficult on both me and my wife Ingrid. And it’s been especially difficult because we’ve been having to make lots of difficult decisions, often with limited and incomplete information.
Lydia’s not so sick that our decisions are all really obvious — and she’s not doing so great that our decisions are all really obvious, either. She’s kind of in the middle. She’s been having a hard time a lot of the time, but she’s been doing okay a lot of the time, and there’s reasonable hope that, with treatment, the cancer will go into remission… or at least, that she’ll have a few more good months. And our information has been very incomplete. Tests on the cancer have been inconclusive, and we didn’t know at first whether the cancer was a slow- growing kind that would very likely respond well to milder treatment, or a faster- growing kind that would need aggressive, difficult- to- tolerate treatment, with real uncertainty about whether it would even work. One test even suggested that she might not have cancer at all, and that the positive cancer tests might have been mistaken. As a friend who also has a sick cat put it: Rollercoaster is the new normal.
And all of this is making decisions about her care really, really hard. The last few months have been a parade of difficult, often wrenching choices, on an almost daily basis. Should we stop the chemo that seems to be making her sick… or keep going? Rush her to the emergency vet when her appetite drops… or keep an eye on her and see how she does? Hold off on the cancer treatment altogether until we can get the digestive stuff under control, and take the risk that the cancer will advance too far to be treatable… or pursue the cancer treatment, and take the risk that the resulting loss of appetite/ weight will make her already poor health even more fragile? Pursue aggressive surgical options for the digestive problems, in the hopes that it’ll make her feel better and make the cancer treatment go better… or don’t put her through that trauma, since she has cancer and may not have that much time left anyway?
It’s been a parade of small, difficult decisions, all framed by one very large, very difficult decision: When do we keep pursuing treatment, and when do we let go?
But there is one thing that’s been making all our decisions easier.
And that’s that we accept the inevitability of her death.
Lydia is mortal. She’s an animal, and all animals eventually die.
So when we’ve been looking at these hard decisions, we haven’t been looking at them in terms of, “Is she going to live or die?” We’ve been looking at them in terms of, “When is she going to die?”
Does she have a few weeks, a few months, a few years?
We understand that, someday, she’s going to die. We understand that we can’t make her live forever. We understand that her time here is limited, and that all we can do for her is to make that time — whether that’s a few weeks, a few months, a few years — as happy as we possibly can.
So when we’re making decisions about treatment, we can look at them with frankness and clarity. We can ask questions like, “Should we give her a somewhat traumatic treatment, for a decent chance at a few more happy months/ years… or should we drop it, and give her a few weeks/ months of relative peace and comfort?” That’s not an easy question, and the balance shifts back and forth almost every day: with new information, and with new responses to treatments, and with new developments in Lydia’s own mood and health. But we can face it directly. We don’t have to dance around it.
And this isn’t just about our cat.
We understand the same thing about ourselves.
And so, when it comes time for us to face these difficult decisions about ourselves and each other, I think we’ll be ready. If one of gets (for instance) cancer, we’ll be able to ask questions like, “Would I rather face a traumatic and horrible few months for an X% chance at a few more years… or would I rather let go and make my last few months really count?” And we’ll be able to answer those questions based on a candid, hard-headed evaluation of how horrible the horribleness is likely to be, and how much time we’d probably have left even if everything goes perfectly, and how much fun that time would be likely to be, and what the likely value is of that X percentage.
We’ll understand that the questions won’t be, “Am I going to live or die?” We’ll understand that the questions will be, “When will I die?” And we’ll be able to make our decisions accordingly, with frankness and clarity.
Now, at this point, you might be wondering what any of this has to do with atheism. You might be thinking, “But religious people know that their pets are going to die! They know that the people they love are going to die! They even know that they themselves are going to die! They disagree with atheists about what happens after we die… but they know that death is real, and inevitable. What does making clear-eyed choices about death and life have to do with atheism?”
And that’s a fair question.
In other words: People who are most strongly attached to a belief in an afterlife are more likely to try to delay death when it’s clearly imminent.
That doesn’t make any logical sense. If people believe in a blissful afterlife, then logically, you’d think they’d accept their death gracefully, and would even welcome it. But it makes perfect sense when you think of religion, not as a way of genuinely coping with the fear of death, but as a way of putting it on the back burner.
So when religious people are faced with the harsh realities of death — and with the possibility that their beliefs might be bogus and that death might really, truly be the end — they’re often not prepared. They haven’t had to think about the inevitability of death, and its finality, and what kinds of choices they would make when faced with it.
Hence, the the lack of practical preparation for death… and the pointlessly aggressive medical care in the last week of life.
It’s like an inoculation.
So when it comes time to face it for real, we’re ready. Of course we’re frightened by it; of course we’re upset by it; of course we want to delay it if we reasonably can, for as long as we reasonably can. Life is precious, and of course we grieve for its end. But it doesn’t take us by surprise. We’ve had time to think about it. We’ve had time to think about questions like quantity of life versus quality of life, and what we personally think about how these balance out. We’ve had time to think about questions like what makes life meaningful even though it’s finite… and how to make that meaning still be meaningful, even when that finiteness is looking very finite indeed.
When people with life-threatening illnesses like cancer or HIV are given a good prognosis, they’re sometimes told, “You’ll live long enough to die of something else.” That may sound grisly and morbid to some. But to me, it’s oddly comforting. It offers the comfort of the solid foundation of reality. It offers the comfort of understanding that yes, we’re going to die someday… and so, armed with that understanding, we can make good, thoughtful choices about our death, and about our life.
If you’re a believer who’s questioning your beliefs, leaving your religion does mean facing the finality and permanence of death. That can be a hard pill to swallow. But when I think about those religious believers frantically pursuing aggressive and pointless medical care in the last week of their life… it seems like a bargain.