Why, given its poor track record of extending life and its torturous effects, do so many people willing submit to cancer chemotherapy? Why, knowing the suffering that will be inflicted on a person they love or care for, do so many friends and family members demand that a person with cancer accept chemotherapy?

I believe the answer lies primarily in the fact that few people in our society have confronted their mortality. Gone are the days in which parents expected to lose children to epidemics of smallpox, scarlet fever, or polio. Gone are the times when death was accepted as an inevitable aspect of existence.

Death today is sanitized. It takes place in institutions, away from the flow of daily life. To many people today, death is something that happens to other people at other times. It is not something that they will experience; medical science will have an answer to any affliction. If someone dies it is because a mistake was made – there was a missed diagnosis or the physician was not aware of the most advanced treatment available for the condition. Death, they reason, is always preventable if an illness is correctly diagnosed and treated.

People who view death in this way are avoiding reality. They are living in a dream world, where magic is in the air and everyone lives happily ever after. It is not the physical world, in which people die every minute of every day.

I know of only two individuals in all of human history who reportedly did not die. One was a man named Enoch who lived between five and six thousand years ago. It is written of him that “he walked with God and was no more, because God took him.” The other was Elijah, one of the prophets of ancient Israel who was observed ascending to heaven in a flaming chariot. The odds are therefore infinitesimal that anyone’s physical body will survive forever.

I am amazed at the number of physicians who do not appear to have confronted the reality of their own mortality. I believe this is why they wage an all out battle against death in every circumstance without weighing the consequences or considering the alternatives.

I shall never forget caring for a young man in his early thirties during my first year in practice. I was twenty-nine at the time. We were not only close in age, but each of us had preschool age children. He came to see me because he had been feeling more tired than usual. I discovered that he had Hodgkin’s disease, a cancer of the lymphatic system. He did not respond to treatment. I provided support to him and his family as his condition declined. He died within six months.

It was a valuable experience. Had I gone through my career dealing only with the death of elderly individuals I could have avoided confronting the reality of my own mortality until I too was old and gray. Had I only dealt with the death of premature infants or even children I could have avoided the reality of my impending death. I could not remain aloof to the possibility that I too could die at any time watching someone my own age slip away.

My father’s death solidified my acceptance of my own mortality. Becoming the eldest surviving male member of my family was a sobering experience. It was clear that one day it would be my turn to join my ancestors on the other side of this earthly life.

Acceptance of one’s own mortality is, I believe, a very liberating position. When one begins to view physical existence as temporary it becomes subjugated to that which follows. When a life of 70 or 80 years is measured against eternity its joys and sorrows can be taken in stride and seen in perspective.

I enjoy life. I love to be with family and friends. I am in no hurry to leave. On the other hand, I am ready to move on when the time for my departure arrives. I have no need to subject myself to physical and emotional suffering in a desperate attempt to stay alive a few more days or months. I will deeply regret leaving a grieving family here on earth, but if I am ever found to have a terminal illness I would far rather have them remember our last days together as enjoyable times rather than days of caring for someone whose treatment had left him too weak or too sick to laugh and play with them.

If you have not done so, I strongly encourage you to confront your own mortality and that of those you love. Once you have accepted the reality that death is a natural and inevitable result of living you will be freed to make decisions that are not based upon how to postpone death as long as possible, but upon how to remain fully alive until death arrives.

People who have not confronted mortality fear death and are slaves to those who hold out hope of survival, no matter what the cost. Those who have accepted their mortality are free to choose their own destiny. That is the most effective therapy of all.