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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)