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Lee Lipsenthal, M.D.

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Dying Awake

Posted: 08/02/11 09:22 AM ET

"The cancer is back."

On the other end of the line, there was a moment of silence and a deep sigh as my wife registered my news.

"Are you sure?" she asked, then quickly shifted into physician mode. "What's the cell type? Is it herceptin sensitive?"

"I don't know yet. This sucks," was all I could say in response.

We hung up the phone, and I found myself standing just a few blocks from my friend Donald's office. In addition to being a close friend, Donald is an oncologist, so I decided to stop by and talk to him. Being a physician has its perks: quick answers, even if they're not the answers I want to hear.

"It's been a miracle that you've been alive for these past two years," Donald told me. "At this point, it's about controlling symptoms only. There is no cure." Though Donald's words were professional, his eyes were wet. We are not just colleagues, but friends. The news was hard for both of us.

Two years earlier, I 'd been diagnosed with metastatic adenocarcinoma of my esophagus. I had endured eight months of chemotherapy and radiation, and for the past year, I have been cancer free. Despite a 90 percent mortality rate, I felt hopeful. I was planning my career moving forward and preparing for my book tour -- blocking out dates, scheduling talks and travel -- for Enjoy Every Sandwich; Living Each Day as if it Were Your Last, which is being published in November.

Now, two days before a family vacation, all had come to a halt with the news that I have eight, maybe 12, months left to live. There are lots of stories of miraculous cures out there, lots of programs to beat cancer, but none with consistency or solid evidence. Outside of a miracle, it seems that I am toast.

On our family vacation the next week, we laughed and had a great time. At night, Kathy would hold me and say, "Don't leave me." What could I do? Whether I died or not was not my choice. I could seek out other therapies (and I did, consulting friends in the alternative medicine world about what was available for me now that the allopathic world was only talking about pain control), but I had no control over the final outcome. All I could do was to hold my wife of 28 years, while she suffered with the thought of losing me.

I have spent the past weeks telling people about my prognosis, watching them get sad, angry or depressed. I am powerless in my dying, aware that those whom I love are hurt by the news. I have also spent the last few weeks in pain from my cancer's spread, sitting up and meditating to distance myself from the mental agitation of suffering. On most nights this works well, as I remind myself that, though I am in pain, this will pass or I will pass, but it will not be forever.

A sense of peace prevails. I am still alive.

It may seem peculiar that I am calm while others in my life are suffering. I can assure you their suffering makes me sad; I wish this weren't happening. Yet after almost 30 years of meditating, I have learned to embrace optimism, gratitude and the knowledge that I am not in control over my life or death. Instead of being mad at the hand of fate, I am focused on what is going on -- mentally, physically, and emotionally -- with myself and those that I love. In spiritual language, I am awake.

I have no bucket list of things to do. I have been living my bucket list for some time now, and when I was first diagnosed, it came to me that the real list in my life was not the places I wanted to see, but the list of friends in my life with whom I want to spend my time.

I am focusing on the playful parts of life: Buying concert tickets, traveling while I still can, enjoying nature while the weather is still good. This jump to acceptance is a little premature for Kathy. She is still holding out for miracles, while my view is that a miracle would be great, but I'm not going to wait around for it, so why not play. Just enjoy life, stay awake and see what happens.

If I have eight months to live, there is a lot of fun to be had. Once I am too sick or tired, I can watch movies, read books and have friends over. When I become too weak for that, I can enjoy the peace of our sweet home and the hugs of my wife. Not a bad way to spend the rest of my life.

My mantra of "it is what it is" means more to me now than ever. Regretting anything left undone would be a waste of time and energy. I will enjoy what is left.

My meditation practice has eliminated my fear of dying, opening me up to what might come after death (I know I can't possibly know until it happens) and allowing me to just be there for the ride. I am at peace: awake and aware. So, here I am, dying awake.

LEE LIPSENTHAL, M.D., ABIHM, is an internist, trained in the prevention of heart disease and in integrative medicine. A popular and respected speaker and author, he was the medical director of Dean Ornish's Preventive Medicine Research Institute for a decade and has also served as president of the American Board of Integrative Holistic Medicine. He is the author of the soon to be released ENJOY EVERY SANDWICH (Crown Archetype)

 
"The cancer is back." On the other end of the line, there was a moment of silence and a deep sigh as my wife registered my news. "Are you sure?" she asked, then quickly shifted into physician mode. ...
"The cancer is back." On the other end of the line, there was a moment of silence and a deep sigh as my wife registered my news. "Are you sure?" she asked, then quickly shifted into physician mode. ...
 
 
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06:41 PM on 09/22/2011
Lee's friend and colleague Nick Jacobs, FACHE has written a beautiful and inspiring tribute to Dr. Lipsenthal's life and work: http://healinghospitals.com/blog/2011/09/22/in-memorium-dr-lee-lipsenthal/
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mrsL
marriage & motherhood with mirth and grace
04:56 PM on 08/10/2011
I think you're very wise. The best parts of life include the people we love and you are making that your priority. I don't think you or they will ever regret it.
09:13 AM on 08/08/2011
A beautiful article. You are helping us all remember that this phase is temporary. Your choice of how to live right now is valuable to me. Thank you.
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horsenomad
06:24 PM on 08/07/2011
Now Thomas (called Didymus), one of the Twelve, was not with the disciples when Jesus came. 25So the other disciples told him, “We have seen the Lord!”

But he said to them, “Unless I see the nail marks in his hands and put my finger where the nails were, and put my hand into his side, I will not believe it.”

26A week later his disciples were in the house again, and Thomas was with them. Though the doors were locked, Jesus came and stood among them and said, “Peace be with you!” 27Then he said to Thomas, “Put your finger here; see my hands. Reach out your hand and put it into my side. Stop doubting and believe.”

28Thomas said to him, “My Lord and my God!”

29Then Jesus told him, “Because you have seen me, you have believed; blessed are those who have not seen and yet have believed.”
09:13 PM on 08/04/2011
Thank you for writing this. I am incredibly touched by your courage and outlook. Thank you for the reminder of how powerful regular meditation is. Peace and love to you on your journey.
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Ljilja
http://graciouslivingdaybyday.com/
03:56 PM on 08/03/2011
Your words are beautiful, and very inspiring.

When my time comes, I hope I will have the courage and grace to face death the same way - with my eyes wide open.

http://graciouslivingdaybyday.com/
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Tree S-B
Well, you know...
08:32 AM on 08/03/2011
I wish you the best on your next great adventure.
Namaste.
03:36 AM on 08/03/2011
Hey fellow readers. I'm sure many people who read this blog think if they were in Lee's situation they would not be able to handle it with the peace and grace he communicates in his writing. But the capacity for peace and grace has played out in front of me many, many times during my career in healthcare. Witnessing it is profound, humbling and reassuring. What is in Lee is also in each of us and when our time comes it will be expressed, although to varying degrees. Lee just shows us how to handle it exceptionally well. Peace be with you all.
12:41 AM on 08/03/2011
Truly inspiring, thank you.
11:31 PM on 08/02/2011
This article is truly 'moving' - it reminds me that we always have a choice to ask for help; that there are always people made available to help us if we are just willing to ask.

I believe that we never really have to be alone; although often when seriously unwell it often feels like we are.
08:42 PM on 08/02/2011
Dear Lee,
Thank you for sharing yourself with us in the way that you have -- with this piece and your very presence. None of us knows what's around the bend. Over the years you have helped me wake up, in so many ways. I wish this was not happening with you and your family. Yet I thank you for expressing yourself in a way that helps us all appreciate the preciousness of our lives and loved ones, much more deeply than we might have been doing.

With all blessings for you and your family,
Pam Pappas
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BJ Gallagher
07:06 PM on 08/02/2011
Great story! Thanks for sharing it with us. We are ALL dying awake, but most of us don't want to think about it. The big difference between you and the rest of us is that you know what will take you out and the rest of us are waiting for our own diagnoses. It's just a matter of time till we learn what will take us out, too. Life is a great adventure and death is, too. Something to look forward to. God bless you on your journey!
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izekman
06:28 PM on 08/02/2011
Thank you for sharing such a heart felt piece Dr Lipsenthal.
03:49 PM on 08/02/2011
Dear Lee, how wonderful that you can say you lived your bucket list. I have had a good life, but lost my job and health insurance a year or so ago. I know I have precancer in my uterus, cannot afford to get it out. It is weird, a person like me who has had insurance all my life, now I'm at the mercy of not having it. I must say, you took the news well. I too enjoy and notice all the little things - the smell of the air in summer, the taste of watermelon. I rarely took things for granted before, and notice them even more now. I pray that you don't suffer, and that when your time comes you will still have the peace that you seem to have now. Don't discount miracles, they sometimes do happen. My Mom was stage 4 ovarian, that was 15 years ago. I hope you do alot of swimming (my favorite) and just live every day to it's fullest. You have obviously been a hard working contributor to this world, the world is going to deeply feel the loss of you. God bless you.

Peggy
03:20 PM on 08/02/2011
I was moved to tears when I read this, as my mother has been given a terminal diagnosis also.She has lung cancer stage 3.She was given 2-5 yrs, 2 years ago.I can't even tell you how many times she has said to all of us in her family "It is what it is".as she just keeps on going.I cried not out of sorrow for the both of you,but for the strength you both seem to have.It is admirable and I wish you many, fulfilling days with all of your friends and family.I know we are celebrating every moment here.