The Lonely Vigil

Huddled together in an unfamiliar hospital room, loving family members and friends sit at the bedside of the dying cancer patient. Hours turn into days, or longer.

It’s only a matter of time, we hear, think, and sometimes say. But what kind of time is this? Isolated from the vibrancy of life just outside the hospital room, it’s difficult to escape feelings of bewilderment and isolation. Exactly how do we quantify measures of loneliness and fear?

A matter of time provides small consolation to someone fighting for each breath, or to those watching death take someone they love. But during that wait the most ancient of questions visit patient and watchers: Is there life after death? What’s next — for me, you, us? What, what…is really happening now?

Take a step back and you might wonder why, after a lifetime, these issues seem at this moment so sudden and so strange. You may ask yourself why stories and assumptions we’ve accepted so long—explanations of death, promises, assurances — all feel so ephemeral, just when we need them the most.

This much I can tell you from experience: for many of my patients, part of this dilemma results from an unspoken conspiracy of silence.

People do not want to talk about imminent death in modern Western culture, save possibly with a few trusted family members or friends. Even then, we often stick to practical matters or heartfelt farewells. If we are able, we express love and pride, grief or regrets —- but talk about death? To speak of death itself?

To whom can we talk about overwhelming doubts and apprehensions? Describe the sense of this great unknown approaching closer, but never defined by conscious light? Even if we could frame these thoughts and emotions, who would listen and could bear to hear?

Me. I listen. I have done so for thousands of patients over three decades. I write this book to share with you what I’ve heard, what I have learned, what I’ve come to believe and, honestly, hope you will believe too. Too often we speak of death as a “last frontier” even while living our lives as if we will never go there. What’s obvious to the intellect is unbearable to our emotional selves.

Some say death is the reason people developed religion; and for millennia, religion has given us answers. But in an increasingly secular world, faith’s answers fall to whispers, or fail us altogether.

Count me as one of those for whom this was true for a very long time. How long? Until I found it almost unbearable. Until the urgency I saw and felt in my patients’ eyes all but overwhelmed me. To a point where a part of me deep within, distant from my professional detachment, forced me to contemplate those ancient questions with something like the immediacy manifest by my dying patients and their loved ones…to ask, in advance of my own demise, what is happening here?

Asking is one thing. But finding the answer to “how long?” is this: When at last I made the discovery that allowed me to believe differently.

After years of addressing the physical needs of my cancer patients with CAT scans and chemotherapy, I eventually became more and more concerned with something less obvious than the gross symptoms of cellular carnage.

That something is as ancient as our time on earth, as immediate as “only a matter of,” and in special moments, became as obvious to me as any empirical fact published in scientific research….


You may understand that this subject is among the most dangerous of all for a doctor of our time. I certainly do. And for most of my career I considered the issue completely irrelevant. Listening to whatever a patient believed and wanted to share; that’s one thing. But discussing such a concept was unthinkable, offering opinions or challenging a patient’s…was misguided and presumptuous; and, of course, as professionally perilous as a malpractice charge. But again…I wasn’t tempted. In fact, if I would not have carried a pitchfork in a mob determined to confront such an heretical MD, I might have at least lit one of the torches. And for years after that, during a period of doubt, I would have still held back in the shadows.

Oddly and ironically, I began to surrender that attitude — slowly, reluctantly, at my patients’ insistence—for the same reasons I became a doctor: to relieve suffering, to nurture, to heal. Patients taught me that our current approach to the cancer “experience” breaks hearts and leaves people spiritually bereft; that while cancer itself may be physically devastating, it is our neglect of the spiritual and emotional manifestations arising from this disease that prevent us from glimpsing something of vital importance. And that something, I will tell you now — the thing I hope to prove to you over a few hundred pages — is the true existence of what I call the Undying Soul.

I don’t imagine that will be an easy task. Certainly not for people as “science-centric” as I was for most of my life; perhaps not even for those whose convictions are prescribed by one religion or another. But believe me when I promise you that this a journey worth taking.

Slowly. I ask for your patience, and will begin by trying to win your trust.

Also ironically, I will establish that trust, I hope, even as I erode the foundation on which it is built.