Jake Seliger On Cancer, Acceptance, And The Gift Of Life

0:00You probably heard the headlines about all the different cuts to foreign aid and food benefits. This is having a profound impact on the world's poorest people and the world's poorest communities. But, you know, just hearing about that, that's not what stoicism is about. Stoicism is, to me, what you're going to do about it. And that's where GiveWell comes in. GiveWell is trusted by tens of thousands of donors each year because they provide free and independent research that helps you understand how to have a big impact. GiveWell has spent the last 18 years researching global health and poverty alleviation, and they direct funding to the highest impact opportunities.

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1:13To claim your match, go to GiveWell.org and pick Daily Stoic from the drop-down menu under podcast. That's how they know that you heard about GiveWell from the Daily Stoic and you'll get your donation matched. That's GiveWell.org, code the Daily Stoic to donate or find out more. My family owns a 2023 Toyota 4Runner, and honestly, it's my favorite vehicle that I've ever owned. Around town, it's smooth and reliable, but where it really shines is on our trips into the backcountry. We've taken it on backpacking adventures to Colorado and New Mexico, loaded it up with gear, and never had to think twice about whether it could handle the terrain.

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2:28Welcome to the weekend edition of The Daily Stoic. Each weekday, we bring you a meditation inspired by the ancient Stoics, something to help you live up to those four Stoic virtues of courage, justice, temperance, and wisdom. And then here on the weekend, we take a deeper dive into those same topics. We interview Stoic philosophers. we explore at length how these stoic ideas can be applied to our actual lives and the challenging issues of our time. Here on the weekend, when you have a little bit more space, when things have slowed down, be sure to take some time to think, to go for a walk, to sit with your journal, and most importantly, to prepare for what the week ahead may bring.

3:23Hey, it's Ryan Holiday. Welcome to another episode of the Daily Stoic Podcast. I wanted to open today's episode with the last words that Mark Sabriolius writes in meditations. This is per the Gregory Hayes translation, which, by the way, we carry our own edition of them. Drawing here from the leather edition, if you hear that. Gregory Hayes renders this quite beautifully. And I think it's, we can imagine Marcus writing this at the end of his life as he was dying of the plague, as we suspect. It says, you've lived as a citizen in a great city, five years or a hundred. What's the difference? The laws make no distinction.

4:03And to be sent away from it, not by a tyrant or a dishonest judge, but by nature who first invited you in. Why is that so terrible? Like the impresario ringing down the curtain on an actor. But I've only gotten through three acts. Yes, this will be a drama in three acts. The link fixed by the power that directed your creation and now directs your dissolution. Neither was yours to determine. So make your exit with grace, the same grace that was shown to you. Again, we can imagine, as we know of Marcus's last days, you know, his friends gather around him weeping. You know, he has this troublesome son.

4:39The future of the empire is uncertain. He's dying of this painful pandemic. it's scary you know even if he'd prepared for this very moment for many many years nobody wants to die and here Marcus was trying to talk himself through it to be philosophical about the most philosophically challenging thing there is in the world and that moved me when I first read it in my 20s and as I've gotten older and have kids it's moved me even more and I was moved by it most recently when I sent that passage to a friend of mine actually today's guest Jake Seliger And I sent it to him because, barring a miracle or massive advancement in science in a very short amount of time, Jake is dying.

5:27In October of 22, Jake found out that he has a carcinoma of the tongue. They call it SCC. And he had to go and have surgery to have half his tongue removed due to the cancer. And as they were removing it, they found that it had spread much quicker than expected and they had to remove his entire tongue. They thought they got it, but it wasn't. And it returned on July 21st. CT scans showed that he had eight new tumors, four in the neck and four in the lungs. Now, Jake is a great writer. I've read his writing now online for many, many years. He's the author of two well-received novels, The Hook and Asking Anna.

6:04He's the principal of Seliger and Associates, where he writes and edits grants proposals for nonprofits. And he's been writing on his website now for many, many years, which I'll link to. And he does this great link collection and he writes about political issues and cultural issues and fiction. He and I, we met at a conference. I forget exactly why or where we met. We stayed in touch. I followed his writing. You'll see in today's episode that I've been touched by and provoked by a lot of the things he's written about over the years. And then when I saw the news about Jake, I was heartbroken and sort of reconnected and we've been chatting.

6:43And I didn't want to impose on his time because I don't know how much time he has left, but I noticed this sort of outpouring of creativity and wisdom coming from him. It was just something I wanted to bring to the Daily Stoic audience. He's familiar with Stoic philosophy. We've been chatting about it. And actually, I noticed this book over his shelf while we were recording. And I said, what book is that? Is that the book I think it is? And it was Massimo's book, How to Be a Stoic. So he's very familiar with the ideas that we talk about here at Daily Stoic. And he was kind enough, generous enough to share one hour of his time with us.

7:20His wife, Bess, was there. She's been writing beautifully on his website also. and it's just really moving stuff. I would really urge everyone to follow both of them, to check out his writings and to listen to this interview. Look, it's going to be a tough interview as he tried to warn me before we got together. He's not the easiest to understand. That is the perils of having your tongue removed, your tongue destroyed by a vicious, relentless, you know, merciless cancer, but his brain's still there. The insights are still there. His writing is fantastic. His spirit is inspiring to say the least.

8:04And I'm really excited to share this with all of you. I think it's a must listen. It's okay if you miss a couple of things here or there, because you can't understand, just push through. That's what I did. And I think you're really going to like this. And there's also a GoFundMe page that's helping Jake and his wife deal with the enormous and catastrophic expenses from going through something like this, which the American healthcare system is not at all well-suited to helping patients with. If you go to dailystoic.com slash Jake, it'll take you to the thing. I'll also just link to it, but I'm going to create a URL shortener so you can make a donation.

8:44If you've gotten anything out of Jake's writing over the years. If you've gotten anything out of today's episode over the years, do go and be of service or contribute what you can. I think it would mean a lot. But in the meantime, take the wisdom of a man who has stared death now in the face, who is wrestling with his own mortality. The curtain is coming down, as Marcus said, and there's some real Stoic lessons and wisdom here. And I'm really honored to share this with you. And it's one of the more personal episodes we've done here at Daily Stoic in quite some time. And I hope you enjoy.

9:24I wish we were talking under better circumstances. It's been a long time. So do I, obviously. Well, I thought we'd start with something that we both were clearly thinking about as we wrote similar pieces on things that we wish we did earlier. Yours obviously coming from maybe a less flippant, more introspective place than mine. But talk to me about, as you wrestle with all this, what's coming back to you as, regrets isn't the right word, but what's coming to you as things whose significance or urgency has changed, in your opinion? Sure, I think probably the biggest things, excuse me, I can't feel saliva normally, so it makes it challenging, but the biggest things are around people.

10:18but how to say it, my family is not very people-sensual they are not highly socially distilled and so when I was younger I had a lot of time and a lot of problems dealing with people and so I was very very isolated when I was young because of that and so So a lot of what I wish is that I had constantly tried to learn and practice how to better interact with people, how to make friends. Most of the time I make friends, how to interact with holidays, all those kinds of things. So if you're not necessarily prioritizing people, like if that's not what you grew up with, what are you prioritizing instead?

11:13sort of without thinking, is it ideas, accomplishments, stuff? What did you find you were putting above people? Probably stuff and probably just science. So, you know, do one through or do one through, these kinds of things, which are not bad, right? Sure. Do one through is good. Having a positive career is good. but at the same time like and Beth and I have both been writing about this lately at the end of life or even in the middle of life people are not saying oh my god I wish I had gone through better cause right for the most part what are they saying what are they thinking about they are thinking about their relationships with other people and how other people made them feel and also how I made other people feel, right?

12:17Sure. At the same time, I don't want to say I am, I don't know, Mother's Lisa or something, saying, by the law, I love everyone. That's not true either. One time rule of life is non-recipacity, right? Sure. You want to find people who are willing to put back what you live out into the world. So if someone is a jerk, I don't want to hang out with them. I don't want to talk about them too much. They make me feel bad. I want to talk about them. But there are a lot of people out there who you wanted to get more positive connections with. And I personally was very bad at that when I was younger. So, I mean, there might be other people out there who were very good at getting positive connections.

13:08And they might have other words. I was sort of going to a better place or I sort of had a better fear or whatever. I was reading this book about the poet William Stafford, who won the Pulitzer Prize, who's a pacifist. He tells this story, you know, his kids are visiting. He and his wife, they're older, their kids are, you know, in their 20s, 30s, something like that. his wife and he get tired, they go to bed and he hears his kids sort of stay up and just talk like at the living room or the kitchen table for like a couple hours. And he knows they're talking about them and they're joking, they're having fun.

13:48And he says something to her like, I think this is the eulogy that we get to hear. Right. And I thought that was really beautiful. And it goes to the point you're saying, and one doesn't have to have kids to have a meaningful life, But it is the idea of the people that come together around and through you, the relationships that you facilitate, the conversations that you have, the time that I think we all kind of intuitively know at the end of our life, that's what we're going to value. But the interesting thing is then when we evaluate our day-to-day decisions or when we look back at just the choices we were making relatively recently, it's not usually around that organizing principle for some reason.

14:36Right. And that is what is hard for a lot of people, including me, which is connecting the day-to-day to the long term. And that is part of what I have been writing about too at times is in a way, you are what you do every day, right? Yeah. So I don't know. To take an easy example, if you go to the gym every day, that becomes who you are. Sure. And if you don't, that is true as well. so and oftentimes it is hard to wrestle with these questions of how is everything since the month to the year to the let end well i was curious about that because so i think we all wrestle with or contemplate what it would be like to suddenly get a terminal diagnosis to know we have a certain amount of time left to be thinking about that right but i was a friend of mine her mother is dying and they gave her something something between like 18 months and three years that struck me as a as a difficult period of time right a month almost awkward yeah a month is very urgent uh 10 years is impossible to contemplate you know but but right in the middle there how would you we know it would change us but then we also know it's like, hey, you know, you're driving and you almost get in an accident because you were paying attention to your phone.

16:15You go, I'm not driving with my phone ever again, right? But it would creep back in, you know, bad habits creep back in. And so I wondered like the day-to-day-ness of it. You've obviously had this perspective shift. It's hovering over you. It's there. But even with that, is it always top of mind for you or do you find yourself drifting? How do you think about that? It has changed for me somewhat because I got the return diagnosis on July 21st. And that was very silly because I did not know if I have one month left. So I did a bunch of good vibes with people that may have turned out a little bit too mature.

17:06Like when you're saying goodbye at dinner and then you both walk to your car. Oh. This is weird. I mean, it's a horrible problem to have, right? But I prefer that problem to other problems. But I didn't know. And so I sent a bunch of advice very quickly just in case. but one of the principles has been to not leave anything I've said so to tell people I love them or appreciate them and encourage them to do the same thing right? I have had some friends and family visiting and I have just told them that I want to visit her a moratorium on being out of seat so So that more term I've been out with means no talk about the weather, nothing about dogs.

18:07I like weather and dogs, don't get along, but, you know, I don't know. Nothing about inflation. But those are the small stuff. We want to do that. We want to try and facilitate the conversations that let us into talking about whatever you want that last impression to be, right? Oftentimes the last impressions are what people take forward. But it's like breakups, right? If you do a breakup well, this doesn't always work. But ideally, the men or women or whoever will have a somewhat better opinion of you than if you say, you suck, you smell bad. I'm going to get your sister, right? Even if the relationship is good, probably the girl is not allowed to laugh at that.

19:02It has to be a bad impression. It is funny, though. You're basically saying, look, I don't have the luxury of small talk at this point. Let's not waste the interaction. But it is this sort of arrogance or entitlement for the rest of us to assume that we do have the luxury of small talk and pointlessness and dodging around the issue and saying, I'll get to it later. I mean, most of the time we say that and it's a safe bet, but it's not really based on anything we can say for certain. I mean, you get hit by a bus, you get struck by lightning and there could be a nuclear attack. The idea that the rest of us have time to indulge in these things is interesting.

19:53Seneca in one of his, in his essay on the shortness of life, he says, it's the craziest thing in the world. He's like, if someone stole money from your pocket, you would be upset. He says, if your neighbor built over the property line, you would get upset. But we let people steal our time as if we have an unlimited amount of it. And it is kind of crazy. Yeah. And there's this question too about what is time, right? And you don't always know where what is time is going to come from. I think you have written about that, which is his, right? Yes. Oftentimes, it's just time to set up what is time.

20:37It doesn't always work. But sometimes it takes time to look there, right? But I have a family member that is in the other weekend. And it took like a whole day. So that's the point where we have a conversation that we really want you to have. So sometimes it's not really predictable. Sometimes you think to yourself, I'm going to run some errands with a friend, and that's where the magic happens. So there's also this element of sensitivity. Well, I think, you know, the problem with quality time deliberately, right? Setting up quality time is there's an expectation, right? There's a sense of how it should go.

21:22I think I've experienced this and I've heard people talk about it. The problem with distance relationships is when you come together, there's been so much anticipation of how you want it to go or how you'd like it to go that it's not fair to either of you because it's never going to go that way. And I think, you know, when you plan the perfect trip or the perfect birthday or whatever it is with your kids or a loved one, you know, then life gets in the way. There is something freeing, I think, about what Jerry Seinfeld calls garbage time, which is just, as you said, get running errands, talking on the phone, watching TV together.

22:02How do you think about that time now? Like, would you let yourself sit on the couch and watch TV or do you feel like you have to make every minute count? And what does that pressure feel like? I am closer to every minute counting. And for me too, I also don't know how long. I mean, I just hit over time really fast, right? But within a month, I should be on the down result. but I believe I did that into a clinical trial with the optimal job for what I have, your DRDZ. If that somehow works, I could have a year or more. So I'm in this, like you mentioned, I could be in this in-between step. So, but I am trying to prioritize what seems important to me and what seems important to best.

23:06And that is how we have been writing these essays about our relationship and what matters in life. But her next essay is actually about how she spent 15 years wanting to write but not writing. And now she also feels like my time as an editor, is limited and I'm actually doing it and the outcome I think is fantastic. Yeah, there's a forcing function to the experience that maybe dispenses with some imposter syndrome, procrastination, fear, self-consciousness. All of that goes away, I imagine. Oh, yeah. Well, I'm writing things that are intimate enough I would probably not write them if I thought I was going to visit it for 30 minutes.

24:05But I'm not, so there's an element of, we're putting it out there. Well, I mean, I've read your stuff for a very long time, and I noticed, I emailed you about this, but it was like, you know, you do like a roundup of links every couple weeks, and then every once in a while you'd write something, and it was clear that you'd sort of thought a lot about it. You had, you know, a big idea you were trying to get across. And then it does feel like more recently, though, like the floodgates have opened and perhaps your internal standard for what you think is postable or important, like that's been reduced, but actually to a positive outcome, which is now your it's like, actually, this goes to the idea of quality time.

24:51Quantity is a way to get to quality, right? And so you're publishing much more. So the average, the chances of you publishing something great are higher because you're putting more out there. And because you're less self-conscious about it, I think you're actually being more vulnerable and more authentic and just more inherently you. So it does feel like something got unlocked for you creatively, which I'm sure is only a small comfort. I would much rather you have remained a blocked writer. Oh, absolutely. It is unfortunate, but I have this topic now, and so I am going with it. I mean, but there's also this element, too, of what are the best topics in human life?

25:43love, death, friendship, other other science and technology, and maybe one or two others, you know? And I am anticipating this incredible pain of premature loss, especially for those around me. And so we are writing about, like, what does that really feel like? What are the implications of that? and Beth is an ER doctor. So she talks to people all the time who are at the end of their lives. Sometimes they don't realize it until she walks in the room, right? And says, by the way, you know, you might have hours left, you might have days left, and some of their confessions to her are extraordinary.

26:40But also, no one ever says to her, I'm really just writing about this. You know, when I saw the sermon, I wish I had held on to my petty grievances. Yes. But at the same time, see this around some of the suit and now the tables have stones. And don't you think it's not just, hey, I wish I, no one's thinking, hey, I wish I'd held on to these petty grievances. But also don't you think the enormity of it also makes us realize how petty those grievances are. Very rarely are we aware while we have the grievance that it is a petty one. You know what I mean? Totally. I think sometimes we realize that I was older.

27:30When I was 20 or whatever, why was that I mean to me? Why was that so stupid? Whatever. Five or ten years later, why are they in this hair? And he has no answer. And so I think that perspective does suit you all the time, but how is the science focused on the more positive aspects of life and not on reminding stuff. Someone said me, someone whatever. Yeah, there's a Bruce Springsteen lyric I like. He says, we fought over nothing until nothing remained. And then he says, and I carried that nothing for a long time. and I love that and that's kind of a Peter Seale comment too right? Companies that are right fight the most people who fight all of right are the ones that actually fight people who are different are off doing something else so he talks about that in 0 to 1 Do you feel like this sort of outpouring of creativity that you're doing how much How much of it do you also feel, because I think all writers deal with it, there is some sense when you're writing, or you wouldn't be compelled to write, that like, this will live on after me.

28:49This is my way of, this is my force multiplier. This is my denial of death. This is my immortality. How much of, as you're writing, did you find that it got stripped down and you're just writing to yourself and to your loved ones? Or do you find kind of an empowerment in feeling like this is my way of trumping the trump card that is the end that's coming closer? Some of both. But my ideal leader is best. So a lot of what I have been writing, I have had certain minds. but when you are writing or doing any kind of art or business or entrepreneurship, it is hard to write for everyone, right? Sure.

29:40It is hard to create a business for everyone. Most people can't say, this business is for all men's hands. You have to decide who is your customer, who is your leader. and so for me that is my ideal leader so a lot of what I am writing is just to her and then hopefully everyone else likes it right but I'm trying to select stuff that is very particular and it has a point of view and hopefully other people write it and maybe some people don't but that is okay so I'm writing partially to the you know, say this is what I have learned in this life for us to come after, as you said. But overwhelmingly, it is for Beth.

30:34And I have also been, I haven't posted these, but I have been making videos for her. So after I'm gone, she's been watching. That's very beautiful.

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33:49As I've tried to sort of figure out what makes me tick, I go back to this image of like being a teenager and having feelings or thoughts or views about the world that I would have loved to communicate to my parents, teachers, etc. But being unable to do so and channeling that, like the reason one develops the acumen of writing or I think a lot of artistic mediums is because you have something you want to say and you don't feel like you can communicate it like everyone else. You sort of channel it. And I wonder for you if this sort of creative outpouring is also as the power of speech has slipped from your grasp slightly, if you've gotten better at these other mediums.

34:32And so part of what you're trying to do is go towards your strength, and you're getting stronger in those strong areas. And so that's what's powering some of this great writing that you're doing. Yeah. And it is hard for me to talk, and it is obviously hard for me to be understood. Yeah. Although apparently I am doing very well, relative to what has happened to me. but last week I saw an ear, nose and throat surgeon just stuck a needle into my left to do a biopsy but he said I spoke amazingly well so but that is relative obviously but it is very tiring to talk and so yeah, the question is I mean even back and up slightly, the question is what is the most meaningful thing I can do right now in this moment?

35:35And the answer has been written for both me and for Beth. When we are not doing chemotherapy or taking therapy, a lot of problems with health and healthcare are still here, right? But in those moments when I am not doing chemotherapy or working cynical trials, this is the most meaningful thing for both of us. And it is something that we can do together, which is also nice. But I can't remember if your wife is also a writer or not, but I need to help us find something to do together. it thankfully she is not i'm not sure if the relationship's big enough for two miserable writers but uh i i think um i think the other thing about writing for people who are not writers maybe it's difficult to understand writing is not just like there are very few great writers who wrote via dictation for instance church churchill is probably the only example um Or I'm powerless to ask Milton.

36:46Milton has not been. Yes, sure. Right. Yeah, you're right. I forgot about Milton. But very few writers can speak as well as they write. That's the irony of being successful as a writer is people want you to talk as though you're as good at that. But I think part of what writing is is sitting down and going, what do I really think? Like, let me really wrap my head around this. And then what's the best way to communicate that and articulate it? And that practice of sort of communicating something that's sort of ineffable or disorganized and getting clarity through it is really, really powerful. So I imagine as you're wrestling with literally the biggest philosophical complex problems there are, which is mortality, you know, which is an afterlife, you know, which is what's fair and unfair.

37:43You know, as you're wrestling with all this stuff, I imagine there's something quite therapeutic, cathartic, but also clarifying about writing about it as you go through it. So yeah, best is your audience, but you are also your audience. Yeah, absolutely. And there's also this question of how do you make something very general, very particular, right? Sure. But everyone knows, in theory, that prematurely dying sucks. but as you say to almost every normal person the experiences of the design suck they'll be like yes so how do you take that general fact and make it interesting right and make it particular and make it unique to whatever is going on in this case in my life or your life or whatever and that's what kind of supplements people with that sort of dramatic cancer stories.

38:49I had cancer and it was bad. Someone I know had cancer and it was bad. But everyone will say that yes, that is bad, but how do you take that and say, okay, but what is specific about it? What can you take from your own very specific experience and make it universal? And that is part of what we have been trying to do as well. But don't you think also, like, I think my love affair with Marcus Aurelius' writing is tied up in the fact that here you have a guy who had, was only interested in the particular, right? Marcus Aurelius is writing meditations for himself, never expecting it to be published, not even writing in his native language.

39:34He's writing in Greek and he's writing, you know, in this kind of shorthand to himself about what he's specifically dealing with and thinking about with no eye to the audience. And yet it somehow becomes this enormously successful, timeless and universal work of art. And so there's also something I think about the specific is the most universal. Like if you strip out everything else and you're authentic and real and you talk about what a human being is actually going through, by definition, other humans are going to have been or will go through it. But there's also just something vulnerable and raw and real about it that I think speaks to people in a way that the more inherently performative writing does not.

40:22Yes, totally. And that is probably the reason why when I am actually writing, I am trying to think of one person and not, you know, 10 ,000 or 10 million people. I'm trying to think of one person, what was he thinking of this, etc. And they're hoping that, as you just said, the particularity of it, that people will learn to have something of their own experiences in it. Well, and, you know, it's like I'm reading it and I understand it at some level, right? Because it's good writing and you're doing a good job communicating and you're going through experience. But there are also some writing that you can't understand until you've gone through something similar.

41:13And so it kind of sits inside the reader and it has this sort of long underground sort of latency period. And then you come back to it or the words come back to you when someone you love is going through something similar or you are going through something similar. And so I think that's the other thing about great writing and great art is like maybe it doesn't land with you because you're not ready for it, but it's still you're still storing it somewhere inside you. and later an experience unlocks what the message was. I'm sure, you know, as this news came into you and you've been adjusting into this period, I'm sure things that you read 10 or 20 or 30 years ago have come back to you in ways that maybe were a bit unexpected and you're now thinking about some quote or some line or maybe some movie or play that you watched.

42:12Yes, I think I should say that was exactly what you are talking about. Because I have read a number of essays like How Doctors Die is one. Have you ever read that? What's it called? How Doctors Die, V-I-E. No. Well, a lot of people, when they look at them and they're alive, they or their families will say, I want everything done to me, right? Yeah. I want the ventilator. I want the ECMO machine. I want all kinds of medical stuff. A lot of doctors, they know the limitations. They know, especially if you're old or you are sick with cancer, that any of those treatments can be both futile and almost like torture, right?

43:07Yes. So a lot of them will say, don't do it. Right. don't hold CODE, don't hold me hard, etc. because they know, but they know it's basically torture and it doesn't work. Sure. And so that would be one example. I would just be like, I've read writing about hospice nurses or palliative hair doctors. And then, what do people talk about and what? flesh. And that was actually what we were saying earlier. So as soon as happens, there's things that I've read years or decades ago. And suddenly, there are relevant, unfortunately. But there are relevant. Well, I see you have all those books behind you.

44:03I've noticed this weird phenomenon where I'll be writing about something and I'll go, you know what, I think Herodotus or Plutarch, I think there's something in this book that might be connected to what I'm talking about here. So I'll go back and check that source. And I'll notice like, oh, yeah, not only do they talk about this, but I had underlined 10 years ago the exact quote that I like. It was almost like I had traveled into the future and seen what I would need or I went back in time. And there's something magical about that where it's like your body or your mind is sensing, hey, I'm going to need this later.

44:46Because think about all the things that you did learn that you immediately forgot. But there's some part of you that's like, let's tuck this away. You know, something's going to happen down the road and you're going to want to use this. And then there you are. You're using it. Yes. That actually happens to me every day. So I'm going to ask one second.

45:10All I'm going to ask right now was the return of the thing, but they are all certain, right? Yes, yes. And so I was talking to my appendices when Erdogan is dying and Argonne is betting him precisely said, and he says, I don't want to wait until old age has unmanaged me. and man's U-M-M-A-D-M-N-E-Z. And I was like, that is exactly what I want to talk about because I don't want to be the person who is dying of cancer and who is having troops stuck in their body to try and survive for what? A matter of week? Sure. But I would rather, I think,

46:05save everybody's total morphine and accept the end. Well, that ties into something you were writing about, which I thought was beautiful, and it made me sort of tear up when I saw it. But you were referring, I think, is that the phrase? You were talking about life as something you would have to give back or you'd have to return the gift. What was the phrase you were using? I found it very beautiful and profound. Yeah, that was it. Return me the list. But life is a gift, and it is yours only time to let it, and then it is not. And that is just an answer, I think. And you can accept that, or you can worry about how unfair it is, but I find it to be, I don't know, more dignified and beautiful to kind of accept it.

46:54Yeah, the Stoics sort of talk about how the physical form is ours only in trust. Exactly. I have heard that before, but I wasn't constantly thinking about it. Same idea. That's what I'm going on. Yeah, that we're the temporary owners. And then at some point, we came to embody a thing. And at some point, we disembody that thing. and we know right scientifically that the energy the cells all of that gets regenerated and goes we know that it does continue after us in that sense but we don't possess it any longer it is like the whole statement comment we are all made of stars right yes but the heavier elements all come from stars and supernovas.

47:49So they combine into us, call us who that is, or a sensor or whatever, and then they go back. And that is to my life right now. Yeah, it is interesting that we don't think that, like, a lot of people do think about death, right? What happens. But we don't, and I guess it feels very foreign and incomprehensible. like you only experience it once but many philosophers have talked about this but they go for some reason you don't think about that before you were born right you don't think you you you actually have in inhabited that state before for for long for far longer than you have been in being you were out of being right um and that doesn't scare us the same way but yeah and so I don't know of it and for me part of this comes from having said insight and loss because insight and adult realms I have seen myself as one tiny part of the lives of humanity and so I feel kind of sublime when that happens I kind of awe at the vastness of humanity and my small part of it and it is comforting but humanity will go wrong I'm not saying I want to die, I don't I'm not saying I'm so happy about this but humanity will go wrong if there is something to do that I like the beauty of seeing it as a gift too because it does kind of reorient our perspective about what we had and what we have, right?

49:41So I imagine seeing life as a gift that you have been given notice that you will have to return, right? That the product's been recalled, right? You got the letter in the mail that it's been recalled. I imagine that that perspective shift has informed how you're thinking about everything right now, right? Like instead of thinking about the things that you didn't get or you didn't get to do or what and why and all this, seeing it as a gift that you continue to possess for however much less time. I imagine that was an interesting way to start thinking about things. Yeah, totally. And so I am 39 right now.

50:28So I don't know, in a way I feel like I have not lived a complete life, lived an 875 or whatever. But I have managed to live a full life, you know. I have gotten to experience the full range of humanity. I have gotten to experience love, friendship, and many, by all the things that humans experience. And so, in that respect, I am lucky. I think there are some people who live through a very old age, but they don't manage to live a full life, if that makes sense. It totally does. Yeah.

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53:28well i mean one of the things seneca talks about he's like you want to make sure that at the end of your life you have more to show for it than a large number but but i think you you said that all humans experience those things that you went through that you got the full range of experience i don't know if i agree with that i think you might be underselling it slightly I just mean, there are definitely 70 year olds right now that wish they had the relationship that you have. There are unfulfilled writers, you know, that wish they could have published or written some of the things that you've written.

54:08You know, there are people who are angry and pissed off and want a certain resolution or peace that maybe you have that they don't have. And so I think more than just saying, hey, I've experienced these things, I think, you know, in reality, you've experienced a lot of things that many people do not get to do. Right. And maybe that is something for me as well, because... you know, again, I wish this would not be the end, but I feel like I have learned to do a lot in the time I have had. And then obviously I don't have a source in the matter, right? But I am doing all that I can, but hey, I'm not for myself personally.

55:02normal. But once it estimates it is very unlikely that I will survive a long period of time. And so, but since May 25th, since that massive surgery and that horrible recovery, I have looked at this all as bogus time. So I have gotten to say goodbye to something fine with it. But you mentioned earlier that it was hit by a bus, right? But actually, maybe around years ago, I almost got hit by a bus on 77th Street in Manhattan on Halloween. And then I would have just been here and been wrong. And I would not have gotten to say all of my new biceps and bottom sizes have them, whatever is most in my heart.

55:54The terrible thing about life is that it can get taken from you, as we're talking about. and it can be taken from you like painfully. I don't mean that it's painful to lose it. I mean, like what you've gone through has not been a walk in the park, right? But I've been thinking about this, like when you have kids, what's in a way you become less worried about yourself and your worry transfers to them. Joan Didion talked about how like once you have kids, you're a hostage to fortune because now all you're thinking about is their mortality. You're thinking about something that's happening to them.

56:34And that sort of keeps you up at night and it terrifies you and it worries you. And one of the ways I've tried to cope with that, I'd be curious, you think about it. I try to say to myself, something can take my kids from me. They can take my life from me also, but it can't take from me that I had them, right? Like, a future can be taken from you, but the moment that you just experienced, you own. You know? And how do you think about the relationship between what's being taken from you and what you've had, I guess? It's basically what you just said, which is that, you know, I am controlling all that I can control.

57:20I am trying to say you know I am trying to think about the positive experiences I have had and that I have tried to enable for others and you know I'm trying to take comfort in that and recall those things and I'm trying to tell best to what you just said which is that it is said that we are being part of this way, but on the other hand, we have done this many all these years together. So in some sense, are we lucky or are we unlucky? We are lucky that we have spent this time together. We are unlucky that things are ending, but we have to tell us what we have while we can. So that is what I am trying to do.

58:14I read this story about Richard Feynman. You know, Richard Feynman falls in love with this woman. Her name is Arlene when they're in college. And she comes down with tuberculosis, which was at that time, basically a death sentence. They didn't know whether it'd be a couple of years or a year or whatever. And they have about 18 months together, I think, before she ultimately dies of tuberculosis. And he gives this talk later and he explains how, you know, when he was with Arlene, they had this sort of perfect happiness and this wonderful relationship, this wonderful time together. And he said, and his life was amazing and happy and good.

58:52And then obviously he lost her. But he said what he took from that was that the future didn't have to be so good anymore because he'd had that sort of perfect moment of happiness and goodness. And it strikes me as that's sort of the opposite of how most of us think about these things, which is we get something, whether it's a person or an experience, we win something, we make a lot of money, we get this thing. And, and our first instinct is I must keep this forever. Yeah. Don't lose it. Not that I actually can, I actually am less vulnerable now because I've experienced it because nothing can take away away from me that I've had it.

59:41And I'm sure, Feynman didn't talk about this specifically, but to me, one of the most real and a little depressing mathematical concepts is that everything regresses to the mean. And so I tend to think like, if you've been blessed and gotten a lot of amazing stuff, it's inevitable that it would even out at some point. Yeah. Well, we also get used to what we have, right? Yeah. But before this happened, I wouldn't say I was an underfoot or tourist about what I have had, but I wasn't quite as focused on the positives. Yes. I was more focused on trying to build stuff up later, later, later. And so, but, you know, when you get close to the end, to step back a little bit and say what is really happening here.

1:00:33So, yeah, I have had some of that. But we do have some, I think what the other concept too is the environment effect. Once we own something or have something, we think it is more valuable. And so we don't want to let go of things, often for good reasons. But if we have to let go, then what do you do with that? What do you do with things you have to do whether you want to or not? How do you deal with hope? I imagine part of what's difficult about your situation is that it's not 100 % certain, right? There's some ambiguity, and the human mind goes in two directions. One, when things are unlikely, we tell them they're impossible.

1:01:26and then other times you know we do like uh in dumb and dumber you know so you're telling me there's a chance you know that there's there's the part of us that sees the 0.0001 probability as what we deserve slash what is going to happen because we so desperately and understandably want it to happen. Yeah, and so I try to be realistic, but I also, like I said, I am starting this clinical cycle this month, right? So the science is not really zero right now, but it is so low. I mean, it's almost like writing, right? You have to trust the process. Yes. If you focus too much on the outcome, it will be very hard to achieve the outcome.

1:02:22So I am focused on, I am going to go through the treatment process. We are going to do everything we can, and probably it won't work long term. But I am doing what is within my power, and Beth is doing what is within her power. but we're also accepting that I'm just trying to work on our acceptance is the short answer. Yeah, and then plus all those thoughts and prayers are obviously moving the needle too, right? I'm not myself a religious but if people want to pray for me I will for it.

1:03:09Probably of all the things you've written about over the years The one that sticks with me the most that is most relevant here, but that changed how I think about things is is during the pandemic, especially you wrote about the idea of the invisible graveyard, which I know Tyler Cowen and Alex Terevich have talked about, too. But this idea that, you know, the injustices or the failures of society are not just measured in the very concrete things that we do and go badly, but also the things that we fail to do. Right. You know, had the vaccines gone faster, how many hundreds of thousands of people would be alive right now?

1:03:49Had society not politicized the vaccines, how many people would be alive right now? Um, had, you know, we responded to the crack epidemic with a better infrastructure for, you know, recovery and rehabilitation might fewer people have died in the opioid epidemic, epidemic, right? These sort of invisible graveyards. Talk to me about that concept and then where specifically the invisible graveyard is not so invisible in your case because i think it's really really powerful and to me that's a that's a thing that all of us can do a much better job wrapping our heads around right so you have a description of it um but it is mostly like it's not something with the fba the FDA doesn't want to it's like there are multiple kinds of errors, right?

1:04:53And let you say there are errors of doing something or not doing something, right? And people treat them differently. So there's a simple example. If you stab someone and kill them, you'll be fired as a murderer for a reason, right? But let's say you'll have a life preserver and you see someone drowning and you don't quote it for them. I don't think you have to be guilty of anything, apart from being a terrible person, right? But, like, literally speaking, like, asking and in-asking is different. The FDA does the same thing. The FDA does not want people to die from taking any kind of treatment, right?

1:05:41So they don't want bad press they don't want the New York Times saying if there are those five people's diet of hamster treatment that doesn't work. But the problem is there is a cost to that. And the cost to that is well what happens if there are 20 hamster treatments and one of them saves 100 ,000 people and the only one of them kill five people each? You know, what is better for the world? And so the FDA is always concerned about people taking something and they're suffering, but not about the results that are in the treatment system is this. And so I'm thinking about that because there are treatments out there, like the one I'm about to take, or like Missouri's personalized, automated, mRNA, intensive vaccines, that might actually save me, but they are caught up in this FDA limbo.

1:06:51And so everyone who has had, well, maybe not everyone, but many of us who have had cancer or know someone who has cancer or know someone who died from it, there is a lot of human suffering out there through an action. And I personally am advanced move or suffer. Yes. Yeah, it's risk aversion, obviously, that has a cost. And so does just bureaucratic slowness. I remember during the pandemic, it would be like, okay, the FDA has met about the vaccines and they've approved it. And it's like, next week, the CDC will meet. And it's like, Stack the fucking meetings together, guys. You know, like like you're you are putting in a needless 12 hour, 36 hour, 72 hour delay.

1:07:52And people are dying in that interim period because you're either too slow or you value the appearance or the perception of deliberation more than the act. You have valued optics over the thing that actually matters, which is the suffering that you could be preventing. Right. It's like socialism, where you tell more about science who appears cis than actually doing whatever right thing is. And once you see it, once you learn about it, it can be very frustrating. It's hard to uns... It's weird. The invisible graveyard is something you can't see, but once the concept is explained to you, it's very hard not to see it in lots of places.

1:08:52and I especially see it because like I said there are these treatments like from Missouri that are just out here right, they're just out of these and so there is no reason why we cannot try and speed up the process but we are not doing that and so a lot of people myself included are suffering and dying Well, that's what was interesting and fascinating and then hard to unsee after the pandemic is when everyone was suffering from the same thing simultaneously, we moved heaven and earth to solve the problem. Right. But but when little pockets, little ghettos of people are suffering, one percent of the population here, point one percent of the population here, a thousand people over here, then it's easy for all of us to go back to our regular lives and go, that doesn't affect me.

1:09:55as usual yeah and you know it's this idea that it might not be registering on your radar but for someone else it's their entirety of their radar it's the only like it's the one thing that you want slash need more than anything in the world but because the rest of the world has collectively shrugged, you are left to suffer needlessly or individually when collectively we could do something about it. Right. And so, but even with cancer, it is interesting to me because so many people are touched by it at some point in their lives, right? Sure. are friends or relatives or mother. And a lot of the people who are on the ground shooting people that are called this, they're understanding the problem.

1:10:54But for some reason, we can't transfer the fact that everyone will be touched by a student or later into action. And so I guess there is some point of human psychology But it has been a top of mind for me because of them. The treatments that might send me are just out of this. I mean, I think this is true for so many of the profound injustices of our time, right? It's like mass shootings are something you see on the news and you go, oh, that's bad. But until it comes much closer to home, you're able to delude yourself with certain fictions, right? Or you can tell yourself that it's politically impossible.

1:11:45And it's like, it's only politically impossible because we've decided it's politically impossible. If we actually set our minds to it, we could do something about it. And I think the idea that there are these invisible graveyards, there are these little pockets of suffering, not even little, but there are pockets of preventable suffering all over the world. and that I think the task of one's life should be trying to... Improve things. Yeah, you don't have to do all of them, but just be satisfied if you did one. Right. Well, I sometimes write about, too, that about 40 ,000 people in the U.S. drive in car classes every year.

1:12:29Yes. And hundreds of thousands or more are serious to help. No one seems to help. It's a mess to me. During the pandemic, people would go, oh, you know, this many people die of car accidents every year. This many people die of the flu. It was interesting to see how, because it had been happening for a while, people decided that was acceptable. When in reality, that number, you could, like, I mean, during the pandemic, we solved the flu death problem. Basically, nobody died of the flu during the pandemic, right? And a lot of these things we could do something about, we just don't. And I think of, have you read Camus' The Fall?

1:13:18No. It's beautiful and haunting. I don't know if I'd put it on my list of final books to read potentially. But basically, he's walking through the streets of Amsterdam and he hears someone jump into the water or fall into the water and scream. and he kind of he's like what was that and then he shakes his head and goes back about his life and basically he's haunted it ruined it ultimately the guilt and the uh turmoil of having ignored and not saved a suffering person you know sort of turn this guy's life all upside down and And I think Camus was ultimately writing about the Holocaust and the sort of indifference to what the Nazis were doing in Europe.

1:14:07But it is this idea that I don't think it's costless for a society to allow invisible graveyards to fill up. Not only can that come back and, you know, claim you, but I also think there's a profound moral injury involved also. and I think it's really powerful that you've been writing about it. Right. Well, that's why I hope is that other people in the future do not suffer in the way I am suffering or in the way that Beth is suffering or my family or my friends, right? Because my policy is about me, but it's also about everyone else around me or even Bill that I have taught English off and off for many years.

1:14:57There are students that will actually see in the future. There's a lot of things that are done, and so my hope is that in the future things are better for people. To me, that's the meaning of life right there. Could you leave the place better than you found it? And hopefully everyone gets as much time as they possibly need to be able to do that, but it's also the sort of sobering, haunting reminder that you might have less time than you think. Oh, I was very surprised. Everything about this in the course of the last year has been very, very, very surprising to me. I can imagine. I can imagine.

1:15:45Well, I'm so glad that we reconnected and your work has meant a lot to me. and this conversation means a lot to me and I appreciate you taking the time to have it and I know it's not easy for you not just to talk about it but just to talk period so I think it means a lot and we all appreciate it and I wish you much more writing and I hope Bess keeps writing too because it's also very very good yes well if my fingers are crossed we will see what happens I have a somewhat optimistic outlook but But again, we're doing it all over time. I do too. My fingers are crossed and we're pulling for you. And we really appreciate it.

1:16:29Great. Thank you, Ryan.

1:16:41Thanks so much for listening. If you could rate this podcast and leave a review on iTunes, that would mean so much to us and it would really help the show. We appreciate it. I'll see you next episode.

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