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The Art of Medicine

The world I'll die in

Reed, Harrison MMSc, PA-C

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Journal of the American Academy of Physician Assistants: May 2020 - Volume 33 - Issue 5 - p 58
doi: 10.1097/01.JAA.0000660192.36220.a2
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I am supposed to die on the morning of December 3, 2066.

It's a Friday.

Of course, that assumes I make it to the average male life expectancy of 78 years, 8 months, 8 days, 9 hours, and 36 minutes from the moment of my birth.

That's a long way off, with what feels like an ocean of time stretched out ahead of me. Time to make mistakes and accomplish goals. Time to fill life with experiences and have them fade into memories. Time to watch my retirement account creep forward and my hairline creep back.

The day I expect to die is so far away that everything around me will have changed. In fact, I can't even imagine the world I'll die in.

I don't know what problems will threaten the planet. I don't know what questions science will have answered or what new uncertainties will have emerged. I don't know which of our current views and societal norms—through the lens of time—will seem archaic or even barbaric.

I don't know what my proudest moment will be. I don't know what I will have built or what legacy I will leave. I don't know who I will marry. I don't know what my children's names will be. Or if they will even exist. I don't know who will be at my bedside on that last day of my life.

I don't know if regrets will crease my mind or if time will have smoothed those sharp edges. I don't know what scars will mark my wrinkled body. I just hope I will have left a mark on the world.

I'm glad I don't know these things. I'm encouraged by the uncertainty. That murky future holds possibility. It holds excitement and adventure. It holds forgiveness and redemption. It is an opportunity for life's path to twist and turn in wonderfully terrifying directions and deposit me, at the end, in a world that does not yet exist.

But today I met a man who knows the world he will die in.

He knows it down to the city and the street. He knows the weather forecast: cool and sunny all week. He knows the last room he will inhabit—G6-W-09—and the color of the last walls he will ever see. (They're beige.) He knows the last meal he will eat—the same food as yesterday—and he knows the plastic tray on which it will arrive. He knows it will include a little white tub of applesauce that he won't touch. (Yes, he tried it and, no, he doesn't like it.)

He knows he won't see the Yankees win another World Series—and he's grateful for that. He knows he won't have to say goodbye to the last polar bear, either. He knows the make and model of the last car he will ever own. He knows it will never fly like The Jetsons promised. He knows he will never own any pets; he knows he will never meet any grandchildren. He knows the last woman he will ever kiss. And he knows she won't be here.

He knows what will kill him. He made me say it, syllable by syllable, so he could repeat it to his nephew over the phone. He knows it started growing in his chest a few years back and he knows every flattened cigarette butt sprinkled on the ground outside of his shop didn't help. He quit last year and he knows that doesn't matter now, but he's still proud that he did. He knows that there is nothing left to stop the inevitable. Or even slow it down. But he knows it won't be very painful. We talked about that.

He knows the last conversation he ever has will be with someone who will leave him at 7 o'clock.

I wondered if it made him sad, to replace the hazy promise of the future with a reality so concrete. I wondered if he had once looked ahead and found comfort in the unknown, in the idea that the best part of life was still behind a curtain, waiting to be revealed. Or is it enough knowing that, when he was my age, he never could have imagined this world he'd die in.

He just looked at me and smiled.

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