In an essay in the New York Times called "My Own Life," neurologist Oliver Sacks announced to the world with characteristic bluntness that he was "face to face with dying." An eye tumor whose treatment nine years earlier had cost him the lost of one eye had metastasized. The 81-year-old best-selling author was counting his life in days and months, not years.
Three months later Sacks published his Last Book: On the Move: A Life. In reviewing the book for The New York Review of Books, Jerome Groopman of the Harvard Medical School admitted that Sacks' revelation changed the way he read the autobiography:
"Reading On the Move and knowing that Sacks is facing a terminal illness heightens certain parts of the book."
Even the title of Sacks' autobiography -- On the Move -- resonated differently when you realized that this would be Sacks' Last Book.
Readers sense that authors writing "somewhere towards the end," to use the phrase that nonagenarian Diana Athill chose for her very late-in-life memoir, have a unique perspective to share. They aren't wrong.
Remember Randy Pausch? He was the computer science professor who was scheduled to give a routine end-of-the- school-year speech at Carnegie Mellon entitled "Last Lecture: Really Achieving Your Childhood Dreams" when he was disagnosed with metastatic pancreatic cancer. Professors commonly call these talks "Last Lectures," but this time the label took on a more poignant meaning: It really was going to be the last lecture for 47-year-old Pausch. Suddenly phrases that he uttered, phrases that we might have heard before and even thought of as cliches -- "time is all you have...and you may find one day that you have less than you think" -- took on a burning intensity. Pausch's Last Lecture, posted on the Internet, instantly went viral and was later published in book form.
Those who measure their time in months -- either because of terminal illness or advanced age -- have a different take on what matters. They are no longer projecting far into the future. They are feeling the fierce urgency of now.
In his New York Times essay, Sacks expressed that sense of exigency: "I feel a sudden clear focus and perspective. There is no time for anything inessential. It is up to me now to choose how to live out the months that remain to me. I have to live in the richest, deepest, most productive way I can."
Sacks said he took inspiration from the last words of philosopher David Hume who, upon learning of his terminal illness at age 65, wrote "My Own Life," a short autobiography in a single day in April of 1776:
“I now reckon upon a speedy dissolution. I have suffered very little pain from my disorder; and what is more strange, have, notwithstanding the great decline of my person, never suffered a moment’s abatement of my spirits. I possess the same ardour as ever in study, and the same gaiety in company.”
Life becomes more, not less, intense when we are aware of its shortening. What characterizes these Last Books and Last Lecture is not their focus on death, but their focus on life. With death in sight, life does not diminish but is augmented. A life of striving to achieve some sort of recognition -- a job, a sale, a marriage proposal -- gives way to a life that concentrates on internal measures of success: "ardour in study...gaiety in company." No wonder the words of someone who is "somewhere towards the end" take on heightened meanings.
I first wrote about Diana Athill and her memoir Somewhere Towards the End in 2013. Back then I lauded her for her late blooming publishing successes: a memoir, chronicling her 50 years working as an editor, published at age 83; a second book about her English childhood published two year later, and, best of all, a National Book Critic Circle Award for Somewhere Towards the End, written when she was 91.
"Success in old age, when things have stopped really mattering, has a frivolous sort of charm unlike anything one experiences in middle age," Athill said after receiving that award.
In quoting Athill's reaction to all the attention she was receiving, I conveniently glossed over that phrase "when things have stopped really mattering." Now I realize that one of the "things that stopped really mattering" to Athill were all those pats on the back from others. Not that she didn't enjoy her late-in-life fame. I'm sure she did. But what really mattered to Athill ran far deeper than a search for celebrity.
I should have been tipped off by Athill's choice of title. Calling her book Somewhere Towards the End reveals just how acutely aware she was that that memoir might be her Last Book. When facing such a formidable main event as death, success is a side show.
Of course, even when we think death is in sight, we can never be certain just when that end will come. When best-selling author and evolutionary biologist Stephen Jay Gould was told at age 40 that he had a deadly cancer with a median mortality of only eight months, he reasoned that the median is a halfway point. That meant that 50 percent of those with his cancer would die in eight months, but another 50 percent could live longer, even a lot longer. He was determined to be on the latter side of that statistic. Gould lived another 20 years before dying of a totally unrelated cancer at age 60.
As for Athill, Somewhere Towards the End wasn't her Last Book after all. Now 98 and living in a retirement home with others who are 90 and older, she is still writing and publishing. Last year she came out with her sixth memoir with a title that tells us she's as surprised as anyone that she is still Alive, Alive Oh!
In that memoir, subtitled And Other Things That Matter, Athill evokes French philosopher Michel de Montaigne who suggested that we think about our deaths every day in order to get used to it as a natural part of life. When my grandmother reached her late nineties, one of my sisters complained that all she talked about was death. "Well," her wry husband pointed out, "it is her next big event."
In Alive, Alive Oh!, Athill devotes the Last Chapter to her "next big event." Calling death not an "end of life" but a "part of life," she writes about her own death -- and the death of her fellow residents -- in a stark, unsentimental way:
"Death is no longer something in the distance, but might well be encountered any time now. You might suppose that this would make it more alarming, but judging from what I now see around me, the opposite happens. Being within sight, it has become something for which one ought to prepare."
Oliver Sacks, who died six months after his New York Times essay appeared, also talked about preparation and about focusing on things that matter in the months that he had left:
"Over the last few days, I have been able to see my life as from a great altitude, as a sort of landscape, and with a a deepening sense of the connection of all its parts. This does not mean I am finished with life.
On the contrary, I feel intensely alive, and I want and hope in the time remains to deepen my friendships, to say farewell to those I love, to write more, to travel if I have the strength, to achieve new levels of understanding and insight. This will involve audacity, clarity and plain speaking; trying to straighten my accounts with the world. But there will be time, too, for some fun (and even some silliness, as well.)"
A good prescription for all our lives, don't you think?