Day by day we are either choosing to live or we are choosing to die. I do not believe that the fact that three of the first five presidents of the United States - John Adams, Thomas Jefferson, and James Monroe – died on Independence day is a mere coincidence. While physical condition of the body may dictate the season of death it is often the human will which determines the day and hour of death.

Many decisions affect our physical health: to smoke or not to smoke, what to drink, what to eat, to take supplements or ignore them, to be active or sedentary. Our choices in these matters have a great effect on the quantity and quality of our lives. Our physical condition, however, is not the sole determinant of the length of our life nor does it dictate what we get out our life.

Longevity and enjoyment of life are determined more by our attitude than by our circumstances. It is ultimately our “heart”, our will to live, which moves us forward. I have witnessed many instances in which individuals consciously chose to live or die in opposition to the outcome that their physical condition should have dictated.

I shall never forget Velma, an active lady who, in her early sixties, had entrusted me with overseeing her medical care. She appeared to be in good physical health, but despite this she was a chronic worrier. She was always concerned that something was seriously wrong.

One day she came to me concerned about recent and unexplained loss of weight. She still possessed her usual vitality, but a study of her upper abdomen revealed pancreatic cancer. Her lifelong concern over having a serious illness had finally come true.

Velma’s cancer was in an early stage. While the prognosis was not good, there was no reason not to expect her to live relatively comfortably for at least four to six months. At the insistence of her family she consulted an oncologist to discuss her options. He outlined a proposed course of treatment, including chemotherapy, something she had always dreaded. Inexplicably, she died within 48 hours. She had willed herself to die rather than face what she saw as a long and painful ordeal.

One of the most profound voluntarily exercises of the will to die I have ever witnessed was performed by an elderly lady who had lost her husband and did not wish to be a burden to her family. She came to see me on a Monday morning complaining of cough and shortness of breath. A chest x-ray revealed a small pneumonia.

I admitted her to the hospital and her condition rapidly improved. She became afebrile and her breathing eased. When I visited her on Wednesday I advised her that she would in all likelihood be going home in the morning. I was shocked when I learned that she had died in her sleep that night.

Only when I visited with her daughter-in-law did I understand. Linda had spent Wednesday evening at her mother-in-law’s bedside. As they were saying goodnight her mother-in-law asked, “Did I hear Dr. Peterson say that I have pneumonia?”

“Yes,” Linda replied.

“Then that could be my ticket out of here!” was the response.

Nothing more had been said on the subject. Linda gathered her things, said goodnight, and went home expecting to return to bring her mother-in-law home the following morning, not realizing that the grand lady had other plans.

Just as people can choose to shorten their life, they can also choose to extend it. I have been privileged to know many people who survived far beyond any reasonable expectation simply because they chose to do so.

One of the most inspirational persons I have ever known was Cindy, a young mother who, in her thirties, was found to have an extremely aggressive breast cancer. She fought valiantly, but the disease was unrelenting. It spread throughout her body, draining her energy and eating away her bones.

Cindy rolled over in bed one day and felt an excruciating pain in her left hip. An x-ray revealed that the bone was so completely replaced by tumor that the simple act of turning to her side had caused it to break. The bone was so eroded that it was not even possible to stabilize the fracture with a plate or rod.

I was certain that the end was near. I could not imagine someone in this condition surviving longer than one or two weeks. Astoundingly, Cindy fought back and lived another two years solely on the power of her will fueled by her earnest desire to be there for her children. Although it was cut short, her life was not lived in vain. She demonstrated to all who knew her how to rise above any and all circumstances and live victoriously.

These are more than interesting anecdotes. The message for each of us is that life is a choice. We are either about the business of living or we are in the process of dying. We are either growing or we are deteriorating; it is impossible to remain the same.

Life is a choice. It is a choice we make each and every day. The human will is one of the most powerful forces in the universe. It transcends physical appearances and expectations. Paul clearly understood this for he wrote to the church in Corinth, “We do not lose heart. Even though our outward man is decaying, the inward man is being renewed day by day.” My hope for you as we approach a new year is that you actively live each day, rather than passively letting life pass by; that you choose to live rather than to die.