Friday, November 16, 2007

Diagnosis: Life

There's a Buddhist proverb that goes something like this:
If you don't think about death in the morning, the whole morning is wasted;
If you don't think about death in the afternoon, the whole afternoon is wasted;
If you don't think about death in the evening, the whole evening is wasted.
By many benchmarks, I'm lazy. But if the proverb above holds any wisdom, I don't waste much of my time.

It's not that I have an obsessive, pathologic/phobic preoccupation with death. Partly, it's just that, being on the cusp of the age of forty, my awareness of death is more heightened than it was at twenty-five. To be fair, circumstances have also conspired to provide me with what I consider a damn good reason to think about death a lot: though I'm a reasonably healthy man, I'm also HIV-positive.

Upon further consideration, I'd probably say that I think a whole lot more about life than about death. More specifically, I wonder and worry about how much more life I've got.

Even in "the best of times" (whatever that means), that kind of speculation is a fool's game. As anyone who reads a daily newspaper knows, we can't be guaranteed that we're going to make it to work or back home again on any given day. However, the laws of probability are still on our sides most of the time: If you make it to forty, your chances of making it to eighty — all things considered — are better than not. Nothing is guaranteed, of course, but it's still an average life expectancy. Probability...

There are times I've wanted to corner my doctors and demand that they tell me: What can I expect? How long do I have? What's the best I can expect?

For the most part, I've come to understand that those would be foolish questions, and I'm a voracious enough reader regarding HIV that I know (sometimes, I think, too well for my own good) the details of a slew of various "best" and "worst" case scenarios. Still, I can't stop my brain from wondering: What's going to happen to me? In that regard, I may not be different from any other human being on the planet. Don't we all wonder? What's going to happen to me? How will the end come? Maybe we're not all thinking that, but somehow I'm convinced we should be. And therein has been the blessing of Buddhist philosophy in my life.

I hesitate whenever prodded (though that's rare) to call myself "A Buddhist." But I admit that "Buddhism" has had a profound effect on my life, both as a cause and an effect: my first ten-day meditation retreat prodded me (in a purely undramatic way) to finally get tested after years of being afraid and "assuming" the worst without accepting the responsibility that "confirmation" would confer on me. In turn, after receiving my not-quite-surprising diagnosis, I found that many Buddhist-oriented writings helped me make sense of the "impermanence" that is perhaps the central hallmark of "all of this."

Last weekend, I read and saved the obituary of a physician, R. Scott Hitt, of whom I was perhaps only peripherally aware at some point, but whose death notice was somehow as striking to me as the handsome photo that accompanied it. In 1996, Bill Clinton appointed Hitt (a prominent and high-profile HIV physician in the Los Angeles area) chairman of the Presidential Advisory Council on HIV/AIDS. In 1999, at the age of 40 or 41, Hitt was diagnosed with the colon cancer that eventually led to his death last Thursday (I haven't seen any references that indicate that Hitt was HIV positive, so I assume he was not). He was a physician who certainly knew and cared for many who suffered and succumbed in the pre-HAART era; he would have seen many virtually resurrected in the mid-1990s with the advent of protease inhibitors. He was a man at perhaps the apex of his career a mere ten years ago. Ten years! How easy is it in thought to flash back through ten years as if they were just an eyeblink! In the same eyeblink, ten years hence, where will we be...?

Of course, medical situations similar to Dr. Hitt's play out for thousands or millions of people every month. What draws me to his death notice is that it's a sharp reminder to me — a clarion call — to focus on exactly that which I don't know and will never know, but which I must expect, if not greet as an expected guest, without surprise and without lack of preparation.

I'm not really ready for a visit from death or severe illness, and I'm afraid of them. Terrified, at times. But I like to think I'm somewhat prepared. I know they're in the neighborhood somewhere. They may not knock for awhile, or they may be right next door, or on their way up the front path. They may visit a close friend, relative, or acquaintance first, and then stay far away for some time. It could be a swift, surprise visit that's over before I know it, or it could be a long, drawn-out affair. But I know, at least, that I've contemplated what I might say to them, how I might greet them, the conversations we might have, and the unfathomable places they might take me.

If you don't think about death in the morning, the whole morning is wasted...


Stash said...

I have to look no farther than a scar on my right arm that happened when I suffered from a bout of MRSA nearly four years ago shortly after having been diagnosed with HIV.

As I recall, I was in the gym roughly a month or so after the diagnosis. At the time, my CD4s were high enough such that meds weren't a consideration.

So while I don't ruminate on death a lot much less mention my serostatus on my blog [because I post on it from work and you never know what the IT guys might be looking at], the thought of my own mortality isn't far from my mind.

Maybe that's why I get a horseshoe up my butt whenever someone plays the "self-righteous" card.

I think the best thing you or I or anyone in our situation can do is to live each day to its fullest. The future will come when you least expect it.

Huntington said...

I think it would be hard to show anyone who doesn't think about death at least once in each of those periods of the day. What we think about death is the real question, since there are an infinite number of jumping-off points and just as many places to go with it.

Harry: "A fleeting thought that drifts in and out of the transom of your mind. I spend hours, I spend days..."

Sally: "That doesn't mean you're deep or anything."

(You knew I was going to go there.)

kusala ~ joe said...

H: That sounds snarky, and it annoys me, but maybe I'm just in an annoyed mood because of that HIV immigration thread. What was your point? You think almost everyone really things about death several times a day? I don't, really. And no, that's not one of the WHMS dialogue quotes I have memorized.

Stash: Thanks for the comment.

Papagayo said...

hey kusala, i just wanted to let you know i enjoy reading your blog and appreciate hearing your perspective on your life. i don't have a lot of homo friends right now, and it's been heartening to read about peoples' lives in their own words. and for guys like me who don't have a lot of positive gay role models, it's helpful to see guys who have their shit figured out a little more than the guys i regularly meet in ny. not like being a "role model" is any job you requested, but reading the blogs i do does make me feel more connected to something. thanks.

m00nchild said...

i feel connected to you through your text, and the comments you send me. and i share the mindset you express here.

mortality has been on my mind a lot. i found out a few weeks ago that my tcell counts had dropped to 350 which was unexpected and shock, not just for me, but also for my friends and family.

for those who don't know, this is when i should seriously start considering meds. which of course i'm doing. but all i can seem to play out in my mind over and over is that question: how much time do i have. and what am i going to do with the time i have left?

the obsessive aspect of the question has generated much discomfort -- much of which you have read the past few weeks.

i'm not a Buddhist either. but i am a mindful sojourner. and i'm very grateful to have found you on this same road at this point in our lives.

Huntington said...

Yes, I believe everyone thinks about death several times a day. I also believe they think about money, sex, food, love, and how unfair life is (at least to themselves) several times a day. I believe that there is a universality to human concerns that, while it isn't expressed as frequently or eloquently as we'd like, and certainly not acted upon with anything approaching "rightness," can't be denied.

I didn't mean to sound snarky, especially in response to such a thoughtful post; my comment was what occurred to me upon reading that bit of Buddhist wisdom. The great thing that I've noticed about many sayings coming from that tradition is that rather than prescribing a course of action, they gently describe and explain how people are, From that, right action becomes fairly obvious.

And yes, that particular exchange from WHMS is one that Heather and I relished, if only for Harry's clearly adolescent obsession with death. Sally wins that round be noting that he's going to ruin his life if all does with it is think about death. We'd all like to know how long we have, but none of us does, so we might as well get on with the living part, no?

Huntington said...

Here's a question, by the way: how much of the Buddhist way becomes untenable if the cycle of death and rebirth doesn't actually exist? (And yes, I know "existence" itself is a sticky concept in Buddhism.)

kusala ~ joe said...

Now it's my turn to apologize in advance if this sounds snarky: Maybe you should read up on these questions. There's hardly any "preoccupation" with reincarnation in any Buddhist texts or teachings that I've personally come across.

Yes, we may as well "get on with it" to avoid ruining our lives.

We may be at cross purposes here. I'm not trying to be ultra defensive, but your responses here have had a "Well, yeah, duh!" tone to them, at least to my "ear." Hmmm.

kusala ~ joe said...

Perhaps a better answer to your questions how much of the Buddhist way becomes untenable if the cycle of death and rebirth doesn't actually exist?" is this:

While I haven't delved deeply into looking for answers to that particular question (which frankly, hadn't even occurred to me), I would say "None of it."