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There and Never, Ever Back Again: Diary of a Dark Lord

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Jeff Mach

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“I think of Gould and his essay every time I have a patient with a terminal illness. There is almost always a long tail of possibility, however thin. What’s wrong with looking for it? Nothing, it seems to me, unless it means we have failed to prepare for the outcome that’s vastly more probable. The trouble is that we’ve built our medical system and culture around the long tail. We’ve created a multitrillion-dollar edifice for dispensing the medical equivalent of lottery tickets—and have only the rudiments of a system to prepare patients for the near certainty that those tickets will not win. Hope is not a plan, but hope is our plan.”

RealityDeathHopeDyingPossibilityMedicineIllnessOddsTerminal Illness
Book:Being Mortal: Medicine and What Matters in the End
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“Spirits and ghosts are probably powerless creatures, you know. I know they’re supposed to be able to influence humans — to be able to read their minds, and so on. But they don’t have physical power over people, or objects; I don’t think they can even see them. And what happens when from the other side they try to reach people whose minds are insensitive, and who don’t react? Or who are too sensitive, so they overreact? I’m sure lines get crossed all the time: it must be easy for a ghost to get frustrated and lose interest. Besides, after a while, seeing into people’s minds must get quite boring and annoying. And aren’t ghosts supposed to be bundles of irritation and resentment? No, I dread dying all the more when I think of such an eternally painful existence. If anything, I envy people who can believe in nothingness after death.”

DyingGhostsSpiritsThe Afterlife
Book:Toddler-Hunting & Other Stories
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“When there is no way of knowing exactly how long our skeins will run--and when we imagine ourselves to have much more time than we do--our every impulse is to fight, to die with chemo in our veins or a tube in our throats or fresh sutures in our flesh. The fact that we may be shortening or worsening the time we have left hardly seems to register. We imagine that we can wait until the doctors tell us that there is nothing more they can do. But rarely is there nothing more that doctors can do. They can give toxic drugs of unknown efficacy, operate to try to remove part of the tumor, put in a feeding tube if a person can't eat: there's always something. We want these choices. But that doesn't mean we are eager to make the choices ourselves. Instead, most often, we make no choice at all. We fall back on the default, and the default is: Do Something. Fix Something. Is there any way out of this?”

LifeDeathDyingDoctorsIllnessUncertaintyQuality Of LifeMedical SystemHeroic Measures
Book:Being Mortal: Medicine and What Matters in the End
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“Dying is really inconceivable in the way it comes about, even though it is easily predictable by the very nature of our existence. However, it is as though man does not believe in death. Even though he witnesses it, he conceives and recognizes it only at a safe distance to be able to ignore its threat of finality at his own peril and the peril of those he loves. It appears as though the “world of dying” around us is not sufficiently close to become emotionally acceptable (that’s why perhaps we live as though we will exist forever), and even the disappearance of our loved ones does not serve as a lesson of any sort.”

Dying
Book:Unveiling reality
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