Last February neurologist and Awakenings author Oliver Sacks learned he had terminal liver cancer. He shared this news with the world in an op-ed piece in the New York Times. I was moved by his thoughts about dying and I wrote a blog entry about it. As you may already be aware, Sacks died Sunday. He was 82.
His cancer was metastatic, and I’ve read that liver metastases is considered an absolute contraindication for liver transplantation. However, it was treated. Sacks stated in a July 24 Times piece that in February, the cancer was treated with embolization, a procedure where substances are injected to try to block or reduce the blood flow to cancer cells, and the metastasis was “wiped out.” But a July 7 CT scan showed the metastases had regrown and spread beyond the liver.
He’d started immunotherapy treatment, but it was only to buy him time, and obviously it did not buy much of it.
In an appraisal written for yesterday’s edition of the Times, Michiko Kakutani wrote that in his work, Sacks cast light on the interconnectedness of life. The interdependence of life is a well-known Buddhist doctrine. There is, too, an interconnectedness of death, as stated so well by John Donne:
any man’s death diminishes me,
because I am involved in mankind.
And therefore never send to know for whom
the bell tolls; it tolls for thee.
Life and death are interconnected. What Buddhism calls “the cycle of birth and death” is a continuum. Life is the active phase and death is the passive phase. It is said that the continuum of a human being, or more precisely consciousness, is beginningless. As to whether it is endless or not, there are divergent opinions.
From my perspective, finding myself in a situation very similar to that of Sacks, beginningless and endlessness are not so important. What matters most is the indivisibility of life and death. Fear is one of the greatest sources of anxiety, particularly fear of one’s own death. When we realize the oneness of life and death, its interconnectedness, and the emptiness of all things, there is, as the Heart Sutra says, no fear and no illusion. This is wisdom and with this wisdom we enter into nirvana, which is nothing more than this mundane world of life and death.
That is from the ultimate truth. The relative truth was stated by Sacks himself: “I cannot pretend I am without fear.”
To my mind, “no fear” does not refer to the absence of fear, but rather to how we handle fear. It means the absence of anxiety, or better, winning out over the anxiety that fear brings. It means facing even death with hope and confidence.