We all know that we will shuffle off this mortal coil (die) sooner or later. But, most of us assume it will be later. If you are reading this I will be willing to wager that you do not expect a visit from the grim reaper today.
Yet, I would also be willing to wager all of those people who died sitting in their offices on 9/11 had dinner plans later that evening. We might all concede life is fragile, tenuous at best and some day we are all going to die, just not today. Right?
Recently, I had a patient come into my office complaining of a cough with blood streaked sputum, hemoptysis in medical jargon. This is not necessarily a cause for alarm. Patients with a bacterial or viral bronchitis can often have blood streaked sputum until properly treated or until it simply resolves on its own.
What made her presentation somewhat unsettling for her and for me was her smoking habit, one pack per day for 30+ years and she had lost some weight. A chest x-ray revealed the worst possible scenario, advanced lung cancer. She was not yet 50 years old.
I looked back in her chart. Due to other chronic medical problems I had been seeing this patient every four months for the past seventeen years. At every single encounter I had counseled her on smoking cessation. This was recorded under every Assessment and Plan section of every office note every four moths for seventeen years.
She had plenty of warning. All the warning signs were there. Without exception, they are printed on each pack of cigarettes. Her family had warned her, begged and pleaded for her to stop. I had warned her in the strongest terms, repeatedly. At almost every turn theses days there are ads giving smokers food for thought and reasons for quitting. But, she would never consider quitting.
Then, there we were sitting across from one another in my office. I had called her in to see me as soon as I received the x-ray report. Of course, the news was devastating to her. I could see it all over her face, the shattered look, the fear, her quivering chin below a flood of tears. Her sister, who had come in with her, sat gaunt and pale in grim silence.
In that one clear moment the patient knew there was little time remaining. Unfortunately, she was trapped between feeling sorry for her past and sorry for a bleak and foreshortened future. She resolved to stop smoking that day. This was bargaining, one of the five stages of dying. She had waited until it was too late.
Why do people have such a difficult time entertaining any thought of quitting such a dangerous and self destructive behavior? Part of it is addicted brain thinking. The other part, perhaps the greater part, is no one thinks it is going to happen to them. It is in the same way you think you will not, can not, die today.
Many people have no warning of their eminent demise. Over the years I have lost patients suddenly to automobile crashes, burst aneurysms, heart attacks, and strokes. I am stone cold certain that none of them expected to meet their maker that day, the day they died.
Now, if all of this seems a bit depressing I do not mean for it to be. I want this to be freeing, enlightening and empowering. I tell you all of this not to despair. It is because I have something I want you to realize – because we simply do not know how much time we have remaining, just consider this – there may be little time remaining and how liberating this realization can be for you right now. This is a call for action!
We put off so many things in life, too many things. We have an opportunity to change, to be different, to grow, to be challenged, to learn, to build, to produce, to love, to help others in profound ways. We must strive to set aside our fears. Fear is what holds us in place until our end comes, if we allow it.
I say no more fear. Stop putting off and setting aside what you know you need to do, what you must do. Try to do something today that will move you from where you are to where you want to be. Do that everyday. Make that a promise to yourself.
It is time to fling caution to the wind and set sail. Lets hear it for change while we still live because life is short and there may be little time remaining.
Have you accomplished all that you want to accomplish? Are you putting things off because you feel you have the luxury of time?