As someone just diagnosed with metastatic breast cancer, my only hope is that one person, somewhere through all my paths, will remember me.
You sound like the rarest of therapists--one who really listens. I can see you writing the next "When Breath Becomes Air." I've got metastatic breast cancer and yes indeedy it's an unsettling condition: "could be eight months, could be twenty years," said the oncologist. And I say to myself "it's just death!" Lukewarm comfort, that. Read your Bangalore Review Story--nice twist.
http://www.thecriticalmom.blogspot.com
"Sometimes, though, I worry that all the time and mental energy I spend in those therapy sessions will be lost to the vapors of the universe when my story ends."
SOLUTION: write a book about it! your thoughts will live on, and will help countless people who struggle with the "terminal illness" challenge. as a cancer survivor who has recently had a new diagnosis after eleven years, i know that there are many who could benefit from your experience and insight, and i am one of them.
p.s. best wishes to you and your family, with love.
We never know the impact we have on those around us. I have had people approach me years after we have had a conversation and say “your words changed my mind that day” “I never forgot what you said and over the years it has really helped me”. Like you stated they usually aren’t the words that I deemed insightful or significant at the time, but they were valued in a way I couldn’t have imagined. Now ... I will remember you and what you expressed in this article and moreover I will pass your words on to others. If you won’t be forgotten by me, someone you have never met, someone who read just one of your articles, then imagine the impact you have had on those around you. I wish you peace, I wish you strength, I wish you love and I wish for you joy in the life you have yet to live 💕
12
My odds are bad too, but I have much more sympathy for Dr. Stern than I do for myself. I've had twenty-six years more life than he has. Also, when I die I'll be losing far less than Dr. Stern; I never married, fell in love, had a child or a career that meant anything to anyone. I have no legacy to worry about and I'll be largely forgotten by the few friends I have within a couple years after my death. My only goals are to not be a burden to anyone in my last years and to make it to November 3 of 2020. Election Day!
18
@Bridgman Really, you have no idea of all the impacts you have had on the world. I get random memories of high school friends I haven't seen for 50 years, and I'm sure someone has such thoughts about you too, And you still have time to continue to create your legacy, whether it's through a random act of kindness such as buying a cup of coffee for the person behind you at the coffee shop, or sharing your words and thoughts with us here - you will be remembered.
19
@Bridgman In addition to Ariana's eloquent reply, may I add that you are a superb writer - a rare gift. And your heart is certainly in the right place!
Best wishes to you.
14
@Bridgman One of the messages of this article is the value of talk therapy. I wonder if it would be affordable for you. I just had this discussion with a loved one for many reasons different from what you are going through. Facing a tough career year, she will have a therapist to reflect with. The vote you look forward to, presumably for the Democratic candidate, would also be a vote for awareness of mental health issues, including all the "adjustment disorders" people have to face alone.
5
Dr. Stern, thank you for this moving, heartfelt, and insightful piece. May you be blessed as you go on your way, whatever and wherever that path takes you. Your words shall be a blessing to all who read them, now and in the future.
12
Thank you, Dr Stern, for your wise words. In an age where it is often difficult to communicate, you have expressed what we all feel: the need for connection, to feel we belong. None of us knows when our time will come. All we can do is live the best life we know. Thank you for helping me realize that. I hope you continue in remission.
13
As a retired mental health professional, I was extremely touched by your willingness to share some of your innermost thoughts with all us who will have the privilege of reading your story. In any therapeutic experience the relationship is key. Therapist have no special wisdom in most situations but if the client is made to feel they are heard and cared for healing can take place. It is I believe the miracle of talk therapy. I wish you peace in your journey. You are obviously a brave young man.
15
Dr, Stern- I suggest this is your best, greatest and most lasting publication. I predict It will become required reading in a number of clinical training programs. Long live your wisdom.
32
Thank you for sharing your most personal, profound and intimate life story.
My spiritual Teacher Adi Da Samraj was once approached by a woman student who in despair announced to him.."I've just learned that I have a terminal illness". With full compassion and without any sense of irony he responded..."Don't we all".
Rare is the person who has an "expiration date" defined such that they can contemplate the deeper meaning of a life (however long) and focus on what is truly important, what truly matters in a life well lived". To that end I was once told by a hospice nurse that at the end of life people usually talk about the people they have loved...(not the people who have loved them).
So it seems that the Heart only wants to love (not possess or control) and the most appropriate gesture to make in this very mortal life of unknown duration to reach out to someone you love and have them feel it, know it, hold it.
19
@dano50
This is beautiful, thank you.
6
@dano50 What a terrible, flippant thing Adi Da said to this woman who as you said was in despair. Like most "Spiritual" experts, they are full of themselves and not very helpful when true emotional contact is needed.
4
@dano50 Hi Dan, I appreciate what the spiritual teacher said. Being in touch with your own mortality is not easy but if we were able to see the universality of it we would be better off.
Thank you for sharing your story. My mom wondered if she would be forgotten after her journey here was complete. She left an indelible mark on family, friends, neighbors as well as the medical team at Georgetown. You will not be forgotten.
9
Moments ago, a dear and close family member, a grandfather of a nine-year-old girl in China whose family accords me grandfather status, too, died. As it is for most of us, there is no NYTimes article to add to a list of publications (he didn’t have). We simply will always honor him and his memory for the important role he played in our family. We also know that “dust to dust” isn’t said for nothing but we also know that the “good ripples” he made in our lives will continue through what we and others do in our lives.
For most of us, our “mark in life” is pretty much in our everyday little things. These are things like the hugs grandfather gave to his granddaughter, the nice way we saw him treat others, the respect he earned from others, the modesty he always displayed, and the hard work he did to sustain his family.
This is all – and it is enough. In fact, it is plenty. And when we realize that, we are not only able to die in the best way but also able to live in the best way.
Adam Stern has done much good and can still do more. I wish remission for him and the best he and his family can have.
28
Our tradition, the Jewish experience, arises from the knowing that we are part of something bigger than whatever we believe we are.
As part of this path, we know that we love Nature, we love Life, we love to feel love and all the beautiful things in Life.
I went to a wedding ceremony yesterday. It was held in a public park, the temperature was in the high 90s. I had been quite ill and was not sure that I could even make it.
I went because I wanted the couple, who are both on their second marriages, to know that I love and support them in whatever they choose to do in life.
Honestly, I doubted I could make it. I had almost collapsed at work the previous day. Like you, I am a physician. I go to work in large part because I love serving, helping people who are going through life in all of its vagaries.
G-d has nothing to do with what we think He/She does. He is bigger than all our concepts and beliefs. He has nothing to do with religion. He is the absolute center of You.
For years I hated that word and what went with it, the religion that had been shoved down my throat. One day I found myself bereft, lost and called out for help. I immediately noticed that something changed. I began my journey home.
The body will die for all of us. However, what we love in the person, their smile, their humanity, their laughter, their goodness is not physical and will never die.
Thanks for you, Adam.
The world is incomplete without you.
45
Dear Dr. Stern – We don’t die at death and our mind and spirit exist apart from our bodies – and these truths have been documented in a number of ways at the highest level of academia. If you want a scientific exploration of the ongoing existence of the soul, read “Irreducible Mind: Toward a Psychology for the 21st Century." It's a deep review of scientific literature and research on the eternality of consciousness and the soul by professors at the University of Virginia.
Here’s the blurb from Amazon: “Current mainstream opinion in psychology, neuroscience, and philosophy of mind holds that all aspects of human mind and consciousness are generated by physical processes occurring in brains. Views of this sort have dominated recent scholarly publication. The present volume, however, demonstrates empirically that this reductive materialism is not only incomplete but false. The authors systematically marshal evidence for a variety of psychological phenomena that are extremely difficult, and in some cases clearly impossible, to account for in conventional physicalist terms...”
For something lighter, try “Soul Survivor: The Reincarnation of a World War II Fighter Pilot." Their son began talking at a very early age about dying when his WWII plane was shot down. Eventually, his exasperated father took him to a reunion of his fighter squadron, and his son named all of them before talking to them. He then spoke with them in ways that left no doubt that he knew them very well.
5
While I know as a student engaging in the NYT reading contest I am only supposed to answer the question “what interested you the most this week and why.” I feel as though I may have answered the question all to quickly. This article is one that I will remember for a long while. Living with the fact that you could die at any point in time is painstaking and I could not even begin to fathom that being my day-to-day life. After working so hard on research, establishing an impressive practice, building a family, etc. I could not live with the agony that is unavoidable death. With all this being said, I do also think that there can be some comfort found within those same things that would make it hard to go. The inspiring author of this piece has done so much good and so much to be proud of in his time so far and has therefore crafted a legacy beyond compare. On another note, as someone who is interested in the realm of psychology as a whole, I found this article utterly fascinating. The idea of a physiatrist seeking help from a physiologist at first is kind of ironic until you realize that despite their occupation at hand, people need someone to talk to and especially in these circumstances, professional help is an asset.
8
Dear Doc,
Please don't worry about immortality. It is but a selfish fantasy, and will always be outside our grasp as everything will return to ash when the sun breaths its last gasp.
Focus on you, the sensation of being, the moment, and the love that you feel from and towards those that you know. Whether you are dying or not, life and the consciousness of it is really so brief that half or twice as much is still almost nothing.
Consider also, based on what's shared here, that your main conscious or unconscious challenge is how to lessen the pain of others resulting from your absence. Framing it as a problem that you can try to do something about is better than focusing on the pain, both yours (justifiably) and theirs (expectedly).
17
Thank you for sharing your story with us. I deeply appreciate you.
Life as a human on Earth is a wild ride even if everything goes right.
I was 45. I could run 5 miles and was in the best physical shape of my life. I had a 9 year old daughter who was so dear to me. Our business was thriving. My dreams were coming true and then...cancer.
I woke up. Wow. Like being pushed into a really cold lake on a hot day.
I had surgery, chemo and recovered.
And I realized nobody "beats" cancer.
It's not a competition. Cancer humbles it's participants...if a person is still defiant after cancer I don't think they've learned anything.
Cancer is a harsh teacher but still a teacher nonetheless. And I sure wasn't going to pass up the opportunity to learn the lessons it presented.
I was so happy to be able to raise my daughter. She's now 29 with kids of her own. I hope she will never have to feel what I felt when I contemplated my early death and how to prepare her.
It either makes you or breaks you.
37
@Sparta480
Thank you for sharing your story. I deeply appreciate you.
9
I am a child psychiatrist and therapist. I understand the connection with your therapist. I did therapy for 5 years, weekly, now only occasionally, and it was invaluable. (The humanity more than the insights I gained, which were helpful in their own way.)
What I want to say to you is this:
You are immortal. You will love on forever. You touched people in your life, in person and through this, and those people will change towards others, who will then affect others differently. A hundred years from now, whether or not people are saying your name, you will live on through others.
43
Dear Adam
It was seven years ago that I was diagnosed stage 4. I too had a science background (and a bunch of publications and a book) so I was confident I could handle a simple prognosis based on what they had found. I read everything at the end of which I found myself in my favourite Italian village with my wife and two kids on a vacation that had been arranged months before. The problem was that my prognosis was six days, max seven, days left in life in which I spent my time crying in a beautiful apartment while the kids and their mother were on the beach.
Obviously I gave myself a badly flawed prognosis as well as stole a a week of happiness from us all. My talk therapy goes on, as well as my life with no breakthrough in sight. I doubt I'll have one ever but I try not to commit the irremediable loss of valuable and inherently limited (for us all) time that we all have. You are right of course, just having one person who truly cares is what we all need but not what we all have. I'm sure you count yourself lucky on that score and so do I. Good luck. Don't look back.
16
I read only half of the comments, many of which are beautiful expressions of support on so many levels. What I'd like to add is that the urge to be remembered is really a shortsighted aspiration which many people, both people with a life-threatening disease and those who have advanced enough in years to glimpse their inevitable end, share. It's likely that there are artists whose names are now unknown who created art or fashioned an artful vase which people may view today in one of the great museums had a similar thought about their work preserving their memory. Yes, their work has survived but the individuals who may have thought that they were leaving something for posterity to remember them, are now erased from the human memory, as are the names of their later counterparts who built, for example, the Bank of England, or the names of the real estate barons who built their skyscrapers in New York. The names of a few explorers lend their names to landmarks such as Balboa park in San Diego or Amerigo Vespucchi, who gave our country its name. The sum achievement of the real estate titans or the explorers and artists wasn't what they created or accomplished in the physical realm, it's the authentic and sometimes heart-felt connections that they made with others who they knew while they were alive. All of us share the same destiny and eventually find ourselves at the edge of the abyss; now to be trite but absolutely sincere, Adam: Please, please, "go out and enjoy the day."
16
Cancer is enhanced life. That has been my experience. Nobody who has had to face a cancer diagnosis can ever, ever harbour the illusion of immortality—and that is what enhances the experience of living.
A wonderful piece, indeed.
29
And now everyone who read your words will never forget you, Adam. Maybe eternity has nothing to do with time, but everything to do with moments of knowing another knows and hears your heart.
40
I cannot fathom the dread that one must feel when facing such a diagnosis. I am very hopeful that the therapy that is being researched regarding small controlled doses of LSD under highly structured environments continues. The results so far are nothing short of miraculous.
8
"I was a mere assistant professor of psychiatry"....Doctor, may I please suggest that you reconsider that statement. My work places me in direct contact with physicians from multiple disciplines and the consensus I have gotten over the years is that psychiatry is the most difficult medical profession to practice. The human brain and how it operates is and will continue to be a mystery for generations to come. I am not in any way demeaning orthopedic surgeons, however, if they are presented with a patient who has a compound comminuted leg fracture, the problem and solution are obvious and well-established. Not so with psychiatry. In an episode of MASH, Hawkeye Pierce (surgeon) said to Sydney Friedman (psychiatrist) , "My job is a lot easier than yours. At least I can see where they bleed."
I am sorry to hear of your diagnosis and struggle against the beast. Perhaps keeping a journal or eve writing a book about your experience and inner-most feelings will provide strength and comfort. It would be a first-person iteration of Tuesdays with Morrie.
16
@rich I would add to your well-taken suggestions, that Adam begin a correspondence with his son, as well; to be read when the boy attains his maturity and who may have the strongest of needs to "hear" from his Dad.
10
Will your son remember you? No. He won't. My father died when I was 15 and I still only have a handful of memories. That's why you may want to think about sharing your deepest thoughts with him. Give him insight into who you really are. What do you think about? What do you want for him? What fatherly advice do you have? What are your fears? Give your son the gift of seeing you with a honesty and forthrightness that few children ever experience. Allow one of the people in the world who will most deeply feel your passing to have the gift of truly knowing who you are.
30
You will live on through your son. And his future children. That is your legacy. Much more important than any of your successes in the field of psychiatry. Make videos for your son. Write little books. And live each day as if it were the last. This is the meaning and the memory. May G-D bless you.
20
Yes Adam. You matter and you will leave a legacy that matters. We are not defined on this planet by material possessions or even academic accomplishments. The only thing that matters are the human connections we have made and that will be here long after our physical lives have ended. Your family, your friends, and your patients will remember you after you leave this world and in that sense, you are never really gone.
17
The author states he has incurable cancer and views his longevity as very limited. That is only the conventional view of cancer treatment. I urge this author and anyone reading this column to seek out holistic treatments and most specifically the Gerson therapy. These cancers are indeed curable. It takes work, persistence and dedication, but there are decades and decades of success stories of curing cancer and living long lives after conventional medicine so sorry, there is nothing more we can do.
Search out all possibilities. Educate yourself before you decide to believe your oncologist and give in the not curable diagnosis.
13
@Dawn - Hi Dawn. Thank you for your post. I'm wondering, do you have cancer? If you don't have cancer, then I suggest that you educate yourself. When you do educate yourself regarding all the complexities that exist with all the many types of cancers that plague us, then you might conclude that the Gerson therapy is a hopeless form of cancer treatment. There are and there will always be incurable forms of cancer. Eating certain types of foods may help someone's t-cells to fight off invading cancer cells, but once the cancer has taken hold, it will do everything it can to survive. Suggesting that people who have cancer might be cured by eating certain types of foods is as nonsensical as blood-letting. You made an outlandish claim that there are decades of proof that some people have cured their cancer by the methods you suggest. Where are your links? Where is the proof? Until someone has cancer, they have absolutely no right to suggest to anyone how to manage their cancer.
173
I write as someone who has had bone marrow cancer and a stem cell transplant. One of the biggest emotional pressures I found stemmed from all sorts of people recommending all sorts of holistic treatments with a fervour that was, frankly, often overwhelming in its insistence that unless I approached things as they suggested, I would be responsible for not curing myself. Some would even “diagnose” why I had cancer. My simple point here is to propose that while the motivation to help in this advisory way is surely compassionate, it is not helpful. I eventual@Dave
57
As a stage 4 colon cancer warrior who fights every minute for more time... I thank Dave for and echo his comment.
39
Thank you Stern for identifying the essence of therapeutic relationship and what really matters in therapy. I am a retired Professor of Psychiatry and a 6 year cancer survivor. During the last 6 years, and continuing, the challenges that confront me are not only to make sense of the illness, live with the ravages of the treatment( I have severe neuropathy) but also to find a new meaning to life. Living with uncertainity and living every day as the most precious is both a challenge and an opportunity. How am I addressing it? I devote my time to share my experiences and support others in a similar situation, by bringing their experiences to the awareness of the general public. The biggest challenge of cancer in the society is to think of the experiences as black and white- either you are a victor or loser. The truth is that each individual will react/respond differently. The goal help is to assist in this rediscovery of the self. Good luck to you and prayers for your wellbeing.
20
Hi Adam, I’m also a physician and also dying of but of a different cancer and one of the things that I have more fully realized is the knowledge that, in the end, nobody remembers anybody and, if they did, who cares because we (the dead person) won’t realize it. I have older children than you and was entirely clinically focused in my career. I greatly appreciate all I learned from my patients and hope that many of them feel the same. During this time, though, I am loving not working, spending time with friends, watching live sports, and re-watching the tv shows that I have loved. I wish I could be here longer for my daughters and hope I am setting an example for them of how to deal with a bad card when they are dealt one. That is how I hope to be remembered—not necessarily specifically but by the impact I may have had on others. One of my favorite places is actually the hospital where I am treated now but where I was also treated for my first (different) cancer eight years ago. All the other patients and their families are so genuinely nice to each other. Everyone wants to allow someone else onto the elevator first. We all smile at each other. When I am sick, these small acts of kindness are noticed and even more appreciated. Good luck to you with the time you are still here.
51
Years ago my first cancer diagnosis came. Age 30.
My therapist came immediately to the hospital. She asked “what do you need?” And then smiled and said, “should I lie down with you?”
Nothing could have been more comforting, more therapeutic, more connected to what the child in me needed most at that painful moment. She was with me. I survived.
35
Magnificent description of how one “sees” oneself in this dynamic and often miraculous setting. And, talk about countertransference!
10
What a moving and powerful commentary on what is really important in psychotherapy -- a relationship between two humans. Thank you for sharing this Dr. Stern. As a long-time psychotherapist who also teaches and supervises other therapists, I will be sharing your article with my students and supervisees for years to come -- yet another way that you will be remembered. You are clearly a special person, and I am grateful that your words have come into my life.
31
This is a most perfect description of the power of psychotherapy or psychoanalysis. Other sciences (and insurance companies) criticize psychotherapy because, they claim, it cannot be measured like other sciences. But unlike other sciences psychotherapy’s cure is found in love, which cannot be measured but can heal beyond measure.
Adam, I will be thinking of you.
38
There is little doubt in my mind that most of the people fortunate enough to have read your essay will remember you simply from what you have shared with us. I send heartfelt thanks and wishes for far more days, months, and years on this earth than you can anticipate.
42
This was beautiful -thank you. As a clinical psychologist and marital and family therapist who almost died of Acute Myeloid Leukemia and a stem cell transplant to live, I appreciate recognizing the intimacy that is in therapy to be known. It is a powerful gift to give to ourselves. In this article, that aspect of yourself was just shared vulnerably and vastly-thank you. You are seen and heard. Sending strength to you and your family as you are facing your mortality.
30
Not discounting the genuine care that is behind the climactic interaction in this article, I cannot (as a non-therapist) help but wonder what it is like to be a therapist treating a therapist with a terminal disease.
The emotional hall of mirrors.
7
I remember a girl who drowned at camp - almost 50 years ago. I wish her parents knew that.
72
Life before cancer and life after bear no resemblance to one another. The specter of recurrence changes everything. I wrote a book when I didn't know if I was going to survive, Sorry I Was No Fun at the Circus. Each time someone reads it and reaches out to me, I am comforted. I wish you the peace that surpasses all understanding.
38
Thank you for sharing this. As both a client and therapist, it is these moments, the "I and Thou" connections, that forever change me and still bring tears of gratitude to my eyes years later.
19
Thank you for sharing your somewhat rarified AND profound experience. Clarifying, helpful.
9
You are a rare special gem Dr. Stern.
I have had the cloud of cancer worry over my life since I was a 14 year old child with cancer and as adult with secondary malignancies. Feelings of isolation and pain have frequently defined my experience.
Youth should be carefree. Worry of death and legacy should be only for the very old.
You have achieved something special in your essay - Thank You.
So sorry about your cancer.
39
Dr.Stern's courageous sharing of his feelings as he makes the inevitable transit all of us ultimately make when the time comes clearly indicates that having someone with us who sincerely cares about us and discusses our innermost thoughts with us is ,hopefully,someone each of us will seek or fortunately already possess at that time approaches be it friend, family,psychologist our faith.
All work once confidence is real
7
I too am a therapist although retired. I worked many years in an institutional setting with severely mentally ill.
I know that I was a lifeline for many who had no hope. I remember many of them and wish them well when they come into my thoughts.
They taught me about humanity and I for that I am grateful.
29
Thank you for writing and sharing this lovely piece. May you have many more encouraging follow-up scans.
21
Very moving - as you have with many thousands of other readers , you made me cry as well with the beauty of the poetry of the moment you painted so vividly shining bright in my imagination . The light glinting of the tears that began to well in your therapists eyes as he said that he would never forget you. I am so glad he embraced the sadness and pain of the moment instead of turning away. So glad!!
That moment is precious .. and I hope and pray Adam that as you live this temporal life we are all gifted with - ‘man is like a flower that blooms in the field today and is gone tomorrow’ - that many more precious moments like this with those who love and cherish you will play out. Each one leaving a ripple that will echo on for years after you have left.
39
What a wrenching, lovely piece that asks "who will keep alive the authentic me when I'm gone? Who will be the durable archive? Will there be one?"
May your remaining time be whatever you wish it to be and thank you for this highly unusual perspective.
I've been seeing a grief therapist for two major losses and intended to stay focused on those. One recent visit, something shifted and I suddenly told him things neither family nor friends know -- or will.
They were secrets kept at my own great expense to shield other people. I walked out of that session feeling lighter than I have in decades. I thought "Someone I trust knows me and I'm liberated."
It would be wonderful to confide in a friend, but the best of friends can find it hard to keep confidences. Perhaps you have friends who are absolute lockboxes; I know my friends are not. I love them, but they cannot be trusted with the authentic me.
50
@hotGumptionTrust everyone with the "authentic you," hotgump, and let the chips fall where they may. The authentic you is really the only "you" that has a reality, everything else is fictitious.
4
While we can never truly know our effect on others, I think we should all give more thought to our legacy and our effect on the world than we do. Instead the world operates as if we are immortal and as if we can walk around doing whatever we want without any consequences. We are not sufficiently conscious of our mortality. I think if we lived our lives in a way that seeks to maximise our positive impact and connection with others and the planet and to minimise our negative impacts then our lives would be more meaningful. Our relationship with the environment would also be different. We would act more as true custodians, instead of acting as though we are it and there is no one coming after us. Therefore, I think you have reached some important insights and pray that your future is better than you dare think it is. Best wishes. We can all learn from you.
29
@Kay never have truer words been said: "We are NOT sufficiently conscious of our mortality."
11
Everyone faces the same reality as they approach death, whether by disease or by old age. That reality is that (with few exceptions for people who do extraordinary things like Queen Elizabeth II or the Beatles) no one will remember them for long. No one.
I faced this reality through the deaths of my parents in their 50s. They poured their lives into their careers and were successful in their worlds. No one in those worlds remembers them 40 years later. None of the thousands of students I have taught will remember me for long. And if I have any descendants they won’t either, except at most as a line in a genealogy chart.
That’s just the way it is. It’s sad when someone like the author of this article must learn it prematurely, as I have had to do through my parents’ deaths. But there is nothing unique about worrying about it. And there is nothing that can be done to change it.
22
@Barbara8101
You'd be surprised how many people will remember you, and you may end up ultimately influencing lives that haven't begun yet.
"We are part of all we have met." and who knows which of our actions will eventually have "an equal and opposite reaction or inspire a similar action." like Ellen de Generes "Be kind to each other."
Write your biography and that of your parents and grandparents if you can go back that far, whatever you do remember. Think how excited people get with genetic testing and ancestry .com!
Actions can speak as loudly as words. Words are actions.
23
I remember the head teacher of my school who died of cancer prematurely. Almost once every month or more often, in different circumstances, many of which makes me realise the influence she had on me as a kid. When I’m singing rhymes to my babies, I remember the teachers who taught me those. People do remember teachers. Can’t say the same for a software engineer like me :) Till they are dead and the generation is gone.
19
Thank you, Dr. Stern, for sharing this very personal struggle. You remind us, in this age of algorithms and treatment by decision trees, that deep human connection is ultimately the most powerful and meaningful thing we can offer another human being. I pray that you find peace on this journey, and I’m certain that those you love, and who love you, will also never forget you.
51
In this age where psychiatrists are often primarily trained to give drugs and few go into therapy themselves to learn something about the art, we forget the healing power of connections. Cancer is frightening but also isolating, as those who are afflicted hesitate to burden their friends and families with their fears and anxieties, sadness over hopes dashed and the physical pains that are often present. It is not surprising that Dr Stern found solace in the humanism, listening and empathy of his psychiatrist since for many cancer patients this connection can represent a source of optimism and solace. I am sad for him but happy that he found such a compassionate soul.
41
Dr Stern;
The answer is yes. Your professional accomplishments will surely mean something, but your personal connections are your real legacy.
With the time you have left (you know very well that you have energy and mobility now that will fade) make more memories for your loved ones. Your wife and son will read the letters you write now and watch the video that you shoot. Your family and friends will remember the meals you share now, the events in which your warmth and humor came out and surrounded them, even with the awareness that it will someday end.
Far more than your professional accomplishments, this is your real legacy of life on this earth.
36
I’m an attorney whose practice concentrates in estate planning and administration. I discuss legacies (and administer them) on a daily basis. I have lost many family members, friends and, of course, clients. What I am about to say may be misconstrued. To be trite, we are all terminal. Some of us just have a better sense of when we will be hit by the meteor. Maybe we should all live life as if this year will be our last. Like Dr. Stern, I, too, would want my professional legacy to live on. And I sure hope that my loved ones will miss me, too.
18
It's all about connection... therapeutic intimacy is a beautiful healer.
22
Must be me. I am totally unmoved by this piece of writing. I saw no humanity at all in this Dr. Humanity is what everyone seeks. This man is a Psychiatrist and the most central lesson of all was lost to him early on. There is only love in this world. We can always operate from a place of love. It costs absolutely nothing. Yet it is priceless and does not exist in solid form. You cannot buy it anywhere, you can only live it. People will not remember what you say, only how you make them feel. When we die and people remember, they speak of the humanity of a person and their heart. Your heart is sorely lacking in having been unearthed. You cannot give to patients what you do not possess yourself which is why you thought the mentor's advice bogus. It had no meaning for you at the time. You are young however and this wisdom is usually not gained until we are older or we face adversity very young. Just be good and kind to all, kinda how you want to be treated. Everyone wants to be seen and found acceptable.
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@This just in, does your comment, made to a very vulnerable human being, reflect your realization that there is only love in this world, and your edict to be kind to all?
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@This just in
I had a similar response. Dr. Stern is possibly nearing the end of his life and is most worried, it seems, about his professional legacy.
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@farhorizons
What should he be worried about instead? Climate change? Trump continuing as president? The numbers of animals man is driving into extinction? The federal budget?
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Dear Adam,
allow me to be recklessly hopeful,
Fantastically so,
in wishing that, against all odds,
you turn this around.
that connection you have to yourself and to others is gold,
it is wonderful energy,
and it just might reach those cells that have not yet
been fighting well for you.
one day at a time, good man.
22
I was supposed to be dead a year ago. I wake up surprised every morning.
It is an awful thing to think about yourself all the time. Wrecks your head. To me life is more bearable if one turns outward.
Keep thinking about others. Engage with others, with causes, up until the very end.
Cancer itself seems to be coming to an end. 30-40 years ago it was relentless.
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@Liz
YAY..
Keep waking up. The world needs you and your fantastic attitude.
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I have found that connections is most therapeutic. Whether I am working with my patients or sitting with a friend or family member. When we are in emotional or physical pain we need to have moments where we don’t feel utterly alone.
Some people prefer connecting to people and others to animals or music or art.
Always find a way to connect somehow. It really helps.
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@BSR
No one is utterly alone. We are all of the infinite, and never apart. A human alone is always a companion of god/life/wholeness/mystery.
3
I went through an incapacitating, 10-month long depression, during which I, someone who had always been leery of shrinks and therapy, found myself in and out of pyschiatrists and therapists' offices because I needed the medical leave they could give me, and because I couldn't find any other way out of the predicament.
I had a basic layman's understanding of psychiatry before entering these spaces. Nothing worked — not the various meds or the occasionally flippant comments from shrinks who had obviously seen so many like me, helpless and unmoored. When I abruptly stopped attending sessions, on one occasion because I couldn't bring myself to go, and on another because I thought I might be on the way to recovery, the doctors never followed up with so much as a call or an e-mail.
I'm not sure whether I was expecting too much there and whether this is just par for the course among psychiatrists, but when working with patients for whom life's meaning has suddenly dropped out from under them, who are in such fragile mental states, and for whom the ability to fight the illness is the very thing that has been undermined, I would have expected a little more care and a little more concern. I'm glad Dr Stern found that in his psychiatrist.
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@Enid Coleslaw I hope you have found your mooring again.
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@Enid Coleslaw Hi Enid, as a psychologist I wonder if part of the problem may have been confusion on your part about how talk therapy can help, as well as a bad match between you and your therapists.
If you entered therapy primarily to obtain medical leave or out of desperation to feel better quickly, you may have inadvertently given your therapist the impression that you weren’t interested in doing the work necessary to understand your feelings and life challenges in a new light that would make them more manageable. It’s hard for a therapist to know how to move forward with a patient who doesn’t “get” that therapy is collaborative work. It’s not like going to a doctor with a bacterial infection and being given an antibiotic.
When patients stop attending sessions, therapists have different ways of addressing that. I usually make an attempt to contact the patient. Some patients appreciate this, but I’ve had other patients tell me that such contact felt intrusive to them and they would prefer that I just respect their decision to discontinue treatment.
With that said, no therapist should ever be flippant or disrespectful to you in any way. If you have that experience in a therapy session, you should feel perfectly justified in letting the therapist know that their comment was hurtful. A good therapist will welcome this feedback and work with you to heal the disruption caused by their comment.
I hope this is helpful for you! All the best.
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Agreed. I am a therapist, too, and hold the same view.
Thank you to Dr. Stern for sharing his experience and the wisdom gained in that moment with his therapist. We cannot fully know how our being open and present with another person will be experienced and remembered. This essay suggests that both Dr. Stern and his therapist will remember that moment for a long time. And that both are richer for it.
17
The moment in time when he made eye contact with his therapist, which wasn’t merely an eye contact but a connection of souls as to what I feel, bringing about tears, made it a beautifying moment to behold even as a reader. I wish only one thing for him: peace with his inner conflicts, which after all is one of the hardest things to come to terms with.
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Dr Stern,
I too am a psychiatrist. The most important aspect of any treatment by any doctor is the therapeutic alliance. All else follows from that. You and your psychiatrist have developed it. And having seen many patients over many years and some until their deaths, I can say that I have never forgotten any of them and each patient taught me something. And so the line goes on and on.
There are things you will be able to say to your psychiatrist that you may not be able to say to anyone else. The relationship is unique.
I wish you, my distant colleague and your family the best.
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Thank you Adam. I am a psychotherapist and it is this kind of experience that makes what happens when sitting with patients such a gift and a privilege. Your vulnerability here is so deeply moving. I am now going to share this with my mentees and my psychology community. You shared something here that is now reaching well beyond your therapist's consultation room. I won't forget your writing. I hope there will be more. With deep gratitude.
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I too am a young cancer survivor with a 7-year-old daughter at the time of my diagnosis of advanced lymphoma. These words resonate profoundly. Godspeed, Adam.
54
Though I do not have cancer my life is also limited due to age it is a netherworld one is not able to escape ,however I feel that to be thought of and often my our friends,co workers and family is so
soothing
I have even found myself talking to my loved ones who have died as if they were still with me ,well they are ..in fond memories but with the sadness of losing them, remembering them in some wonderful way tantamount to a prayer or more apt for me listening to music we both enjoyed is just wonderful and curative.
16
With all due respect, facing death from old age is not anything like facing death at a young age. Nor is it like watching a young loved one die prematurely.
Adam, this is not the first time that your writing has stilled me. We rush around our busy hospital hallways each day and can’t possibly know the back stories in the lives of our colleagues. Thank you for sharing yours with us, again. All at once, perspective. We’re with you dear Doctor!
38
My psychotherapy clients will often tell me that they heard me "in their head."
I am always silently pleased to hear this.
Adam, you are now "in my head".
35
As a fellow assistant professor of psychiatry, thank you for your touching reflections on what makes psychotherapy meaningful. I plan to share it with trainees (now and in the future). Best wishes for many future stable scans.
42
As a psychiatrist since I began residency in1957, I have learned that observing participation with a patient will move the therapy more than drugs. In this vignette we can feel with both psychiatrists. Analytic therapy without a match can also cause harm.
6
I was profoundly moved by your recent article. I remember you as an adolescent attending high school with my daughter. It was apparent even then that you possessed a depth and sensitivity that made you stand out among your peers . I was saddened to learn of your illness . Your honesty and willingness to share your pain and hope is truly brave. You have given those who have followed your struggles, both physical and emotional, a gift, borne of your extraordinary intellect and sensitive soul. I wish you and your family the very best.
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Dr. Stern shows that he cares enough about us, the readers, to share his experiences, and I hope this insightful writer will favor us with more episodes of his gripping narrations.
31
While I can't speak for psychotherapy, my experience with my wife battling for consciousness, let alone life, tells me that what gives comfort lies deep within and without. During her three week period of trial, her surgeon told me that during his daily examinations of her he could distinctly see that she got alert every time I spoke, presumably when she heard my voice. And her partner in their Neurology practice (irony everywhere) told me that I should speak to her at length even if I saw no visible response because the deep recesses of her brain would recognize my voice and (hopefully) process the message but surely would be comforted by it. I like to think so, and Dr. Stern's experience, in its own way, gives me assurance of that.
64
There are times in therapy when it is clearest that it is simply one human being with another human being, hopefully connecting at a deep level of our humanity. I am glad your therapist was able to meet you and care for you at that level, and not try to avoid the pain and sadness of the moment.
Regarding the ephemeral quality of psychotherapy, as a clinical psychologist I have come to think of each session as a Tibetan sand painting. Together, we create something, and then it is gone, blown away by time and the distractions of life. However, something does remain, which can be the insights gained, but is mostly the lasting resonance of our hearts being touch and moved, of being truly seen, and loved--all of which are transformative in ways that are often not conscious.
Thank you for sharing your self with us, openly, human to human. It's a gift that will stay with me and many others throughout our lives in a subtle but real way.
I am sorry that your are having to face the prospect of death so early in your life, but I am heartened that you have loving people with you, and that you can let them move you and sustain you through what is to come.
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@PinkFreud; Your response to Dr Stern was beautiful and moving. Thank You!
15
@Adagio Thank you so much for taking the time to say this.
Dr. Stern, I am saddened to hear your story; however, I want to make an important point with you:
Psychiatrists and psychologists (and psychiatric social workers and MS counselors), should always be required to get "therapy". Some call this "supervision". It is always required when you are counseling others. Capitalism and cost should not ever supplant the medical ethics of this necessity. The helping professions too often put cost and burden in front of their primary duty, which is helping people.
Again, I appreciate your courage, desired legacy and sympathize with your personal suffering.
Bert Gold, PhD, FACMGG (genetics)
San Mateo, California
20
First of all, thank you for reflecting, sharing, and having the courage to do so.
"Being in therapy as a psychiatrist is an odd experience, a bit like Peter Pan chasing his shadow."
Psychologists are encouraged to engage in their own therapy and perhaps view it as a necessary step in their own training. Processing deep emotions, trauma and the like are less necessary for the provider when one's primary intervention is to medicate. I am happy that you have begun to appreciate the benefits of talk therapy. I wish that medical training gave it more 'air time.'
Lastly, talk therapy, psychology, and psychiatry often fall short of addressing existential angst. This is why many believe that it will never take the place of developing a healthy religious or spiritual life.
12
@David
My "Rats and Stats" @ Princeton friend had 5-6 y of analysis, required in the 50s even if not aiming to be clinical.
It was helpful to him and to his innumerable grad students--and his teaching esp Hx of Psych!
6
That's exactly why we say Kaddish: to demonstrate that we remember, to give us a chance to focus on that person and our interactions together.
49
@Perry Kaddish does not contain any reference to death. Nor to any individual. It is entirely a praising of God.
2
In Mexican tradition there are three deaths. The first is when you realize that you are mortal. The second when death takes you. Third, the last time someone says your name. We all go through these deaths except the most exceptional but even they are forgotten one day. What is most important is to live for the day and to be true to yourself each day. And love, always love.
117
Importantly, even after the last person says your name, the ways in which you have touched this world live on. They become a part of the fabric of the world, perhaps indistinguishable from the other "threads", but nonetheless an essential part of it.
This is how I think about the ways in which a grandfather and great uncle of mine touched my life, despite dying when I was young. I have occasionally shared memories of them with my sons. Maybe they will carry memories of this. Probably not. But what my sons will carry is the ways in which I connect with them, which is surely influenced by my Grandpa Marty and my Uncle Joe.
24
@North Carolina
I agree ~ Beautiful advice!
2
Beautiful; thank you for writing this piece. I lost my father to cancer during my youth and his spirit is with me every single day. Best wishes to you and your family, and I truly hope you have encouraging scans.
57
this made me cry. thank you for sharing your thoughts with us and being so brave, adam. your writing is beautiful.
19
When I say I feel for you, I mean that in every aspect of the saying. I am a 26 year old (also) dealing with stage 4 kidney cancer, albeit an exceedingly rare sub-type. Every now and then, you find solace in the smallest and most unexpected of gestures - a concerned friend holding the door open for you a fraction longer than usual, an unexpected "how are you doing" asked sincerely instead of in passing.
These remind me that people do care, and although their memory of me may fade, just maybe, every now and then, they'll remember my sense of humour, my characteristic squint due to one cancer-ravaged eye, or some other odd quirk about me.
As Warren Zevon put it, "These wheels keep turnin' but they're runnin' out of steam, keep me in your heart for a while" - that's all I hope for these days.
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Paul, based on your writing, I am sure you will be carried in people's hearts and memories. I can also say that, as a parent of a young adult who has died, that is the most fervent wish of bereaved parents as well.
20
@Paul
Oh my goodness. Paul, I've simply read what you've written here and feel that your eloquent commentary will always be part of me. It is touching. I believe many of us here and those more closely entwined in your life will absolutely keep you in their hearts.
15
Best to you dear person.
4
Thank you for sharing your experience, your ruminations, and especially your wonderings about what is the legacy of the "time and mental energy" spent, expressed, in the therapy sessions - what is the value there? (How) is it worthwhile?
It's such a good question. As a trauma therapist with a trauma history, similar wonderings show up in my process.
I don't think I know the answer. But what I get sometimes, from the angle that the purpose of our lives is the experience of living and the ways and moments in which we touch one another, physically or figuratively, are the most significant, is that those moments in therapy sessions are ones where we touch ourselves and our life experiences with sensitivity, with sincerity, with honesty - they're moments of tremendous growth, and it matters that they are witnessed, shared, and supported by our therapist.
I wish you grace and peace on your journey. Thank you for composing and sharing this piece. I am greater for your sharing of it. All my best wishes go with you.
31
There clearly was something profound in your therapist's words. What a gift to you as well as to those of us who get to experience - and benefit from - your story and strength. Thank you.
20
Brushing away tears at my desk. I love reading something that makes me feel. Thank you Adam, and best wishes.
28
This was profoundly moving. Thank you for writing it.
39
I hope that you continue to have "encouraging scans" resulting in time to spend with your family and sharing your insights with your patients and more broadly through your articles (I've read those for WBUR also). I'm a radiologist and writings such as yours are a welcome reminder of the humanity behind the images.
81
@NYG
May I add that my best man at my wedding has had stage 3 and four bladder cancer which lately turned into a Dx of kidney cancer ,he is still alive and visiting Italy as I write with his wife from NYC.
By the way I almost forgot, he was diagnosed 15 years ago.
The accepted tenstion is that he lives from test to test now having lost his bladder ,one kidney and prostate about 3 years ago to cancer, I have asked hm to explain what that feels like and he states "Well I am a child whose mother survived the Bergen Belsen Nazi camp ,nothing compares to what she went through and her parents and sisters murdered there .her surviving was a miracle, I can't go now!".
44
I am sorry for your diagnosis, and I'm glad you are in talk therapy. It is my lifeline. We find what we need, even (or especially) when we didn't know what we needed.
I read somewhere that we 'live' until the last person who knew and remembers us, dies.
The drive to be 'remembered' after our death seems to be very strong.
I have some musings:
1. I obviously do not remember the long line of those who went before me in my family, and yet of course the line is unbroken back to an original life form. I only really remember one grandmother, my mother and my sister, all deceased. Everyone else died before I was five years old.
2. Do famous people (Ghandi, for example) continue to 'live' if the memories are not personal and are only second hand?
3. I believe that some notorious mass killers are seeking just this 'life in posterity through fame, or infamy'.
4. I have decided to focus on here and now and stop worrying about posterity. There is no there, there. We do not control the future.
39
I'm sorry Dr. Adam Stern. I can't change your outcomes or save you from dying. I probably won't remember this article tomorrow or next week. But please remember that by writing this piece you have sent a little ripple of humanity and human caring out across the universe, and in the end you have done all any of us can do--tried to make the universe a better place. Love and caring are transcendent, a gift across the infinite gulf of time. Thanks.
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