William Breitbart Meaning of Life after Cancer Podcast episode

How do you make sense of life after cancer? What are you even supposed to do with yourself after all of this? And how do you go on living and living well knowing that death is real? This is Joe Bakhmoutski and welcome back to the Simplify Cancer Podcast! I have a fascinating conversation for you today with the one and only, the incredible Dr. William Breitbart, the founding father of psycho-oncology. Dr William BreitbartHere is what we cover in our discussion today:

  • How self-love is crucial to human experience
  • Dealing with existential guilt
  • Meaning centered psychotherapy for cancer patients
  • Why nobody loves perfect people
  • On living a meaningful life
  • Being connected through love
  • And much, much more!


The Redeemer of Grand Street by William Breitbart, M.D.

And check out my brand new book on thriving in times of uncertainty:

Full transcript:

William:                    Off the bat, I had thyroid cancer when I was 28 or maybe 29. I don’t remember how old I was. Yes, 28. In the middle of my medicine training. It was a rather quick experience. Surgery, boom, bang, out. That’s not what brought me into the field of psychiatric oncology. That’s not what brought me to Sloan Kettering. Believe it or not. It had more to do with my parents’ experience of being holocaust survivors as very young teenagers hiding in the forest and things like that and my experience growing up in that home with them.

The story of all of that. What my parents needed me to be in the world, so that it would justify the fact that they survived. That’s a lot of what drove me. If you Google search me and you look for something. I edit a journal, and international journey called: Palliative and Supportive Care. If you Google search my name and the title of an essay called the redeemer of grand street. You’ll hear my life story. You’ll hear that story. You’ll read that story. With all the typos I put in.

Joe:                             I will absolutely do that. That’s so fascinating, Bill. I totally get that what you’re talking about with what you wanted to be in the world from your parents. I have a similar sense of growing up with my grandparents who were also holocaust survivors. Both of them were medical specialists who completely went into this world of basically saving people. Just wanting to be that change. Yes, I think I totally understand that what you felt you had to be something in the world that made a difference in some way.

William:                    To make a very specific difference, yes. There were a whole group of I would say about 30 families on the lower east side of Manhattan who were survivors from the same general area of Poland, which is now Ukraine, whatever. From towns like Lvov, Bialystok, Turka. Places like that. They all organized together into what they called a Turka young men’s benevolent society. The main function of that society was to make sure everyone had a cemetery plot. We have a big section of Jewish cemetery out in Queens. Everybody from the lower east side that I grew up with, nobody had relatives, so we were all each other’s relatives.

My Bar Mitzvah, these were the people who came. The same thing with that. The main practical purpose was having cemetery plots. Obviously, it was a network to be able to stay connected. My mother in particular, my father was always working very hard. My mother in particular was a very philosophical person and a very emotionally expressive, thoughtful person. I think if she had the ability to have had her education not interrupted so seriously at a young age, she probably would have gone into something like medicine or something like that. She felt so guilty about surviving and everyone else dying. Everyone of her family died, that she would come up to me. Giving me and my younger brother breakfast every morning, she’d ask, why am I here? The more complete question was, why am I here and everyone else is dead? Why did I survive and everyone else didn’t? She felt a lot of survivors’ guilt. Either verbally, I think mostly non-verbally it became very clear to me that my burden, that I had to become, the burden for me was that I had to become someone who achieved something of such significance and impact in the world.

Particularly in the arena of suffering and particularly in the arena of how one can live a life in the face of death? How one can live a life knowing that they’re mortal and life just is so long? To be in that space between life and death and to have such an impact on the suffering that comes from that experience. That it would then justify my mother’s, my parents’ survival. I went to an orthodox Jewish school through eighth grade and then I escaped. My younger brother didn’t get a chance to escape because I took off my yarmulke and I started eating cheeseburgers and I started running after blonde girls in catholic school with those short plat dresses and things like that.

Yes. I wasn’t the only one who had this mission. A lot of kids who I went to school with had this same burden. For me, the burden was an inspiration. For some of my classmates, it was a crushing burden. I sometimes joke, I say, for those of us, it was an inspiration. A lot of kids who I went to school with who are psychiatrists, psychologists, great scientists, philosophers, creative artists, rabbis, very famous rabbis. Then the ones who were crushed, those were the kids who went on to become dentists.

Joe:                             Wow, that’s an astute observation.

William:                    Yes, poor guys, you know.

Joe:                             That’s an incredible thing to realise at what was a really young age. How did your perspective…?

William:                    I didn’t realise it.

Joe:                             You didn’t. You made sense of it with time, right?

William:                    Yes. I really didn’t know who I was and who I was trying to become until… what month is it now? It took a while. I was working at Sloan Kettering, doing research on drug treatments for depression, delirium, interventions for pain, fatigue. I had no idea what I really should be studying, what I came here to study was how people can live in the face of death or why someone would want to hasten their death, which led me to how does one deal with despair? After doing all of the medical psychiatric things in the interface of psychiatry and psychology, that’s when I started to get to the real reason I was there, which were the meta diagnostic problems. Not just you have this disorder, here’s this pill. It was more the existential despair. That’s when I finally started to look at it. That’s when I realised why I was there. That’s when I realized who I was trying to become. Why I went into all of this. I was trying to figure it out for myself, but I was also trying to fulfil the obligation that I have. This legacy existential obligation.

Joe:                             It’s fascinating that you talk about it as a transition, that you still had this internal compass that said even though maybe you didn’t have consciously the direction where you want to go, but you still went there.

William:                    Yes, because we don’t teach people. We don’t educate people in the right way. We educate people and our society is all geared toward what job will you do? When you’re at a party and someone asks, they don’t ask who are you? They ask you, what do you do? It’s really hard for people. People never really think about who they are, they think about what they should be doing. Now, if you’re lucky, what you do allows you to express who you are. A lot of people, most people don’t know that the real task in life is when you create a life, you have to create who you will be in the world. Who are you going to be in the world? What is your intention in the world? Who are you?

Then what do you want to do in the world? What job would allow you to express who you are and have an impact on the things that you care about as a who? If I talk to young doctors, young psychiatrists, young palliative care doctors in training. I sit with them to make sure that they’re not burning out because they see too many people dying. I meet with all of the palliative care fellahs in Sloan Kettering once a month. You ask them, who are you? They don’t know. Who do you want to be in the world? “I want to be a really good palliative care doctor.” I said, that’s a what. Who are you? They don’t know how to think in that way. We’re not taught to think in that way. We’re thought to think about what we should do. What role we play in the economy? What do I do to make a living? What do I do with my life instead of who I want to be in my life?

Joe:                             Yes. We’re not taught to reflect on our experience on what we do. Every week I talk to my grandma on the phone. She’s still alive. She’s an incredible person who’s still the sharpest mind possible. One of the things that comes up often, she’s 96 or something, one of the things she always tells me is, I should have done this. I should have done more with research. I should have pushed myself there. I was like, but, grandma, you have a diseased named after you. You’ve done a lot. You’ve helped so many thousands of people. She goes, “No, one thing you realise when you get to my age is all the things that you should have done.” I often think about that, Bill.

William:                    This is what’s called existential guilt. The idea that when you’re born and you start to grow up, a few hundred years ago, Kierkegaard hypothesised that human beings were the only form of animal, and he may have been wrong about this, at least it’s true what he said about us. We may not be the only lifeform that is capable of this, but human beings he felt were unique in that we had the ability to become aware of our own existence. That happens usually late childhood, early adolescence. Suddenly, you realise, I’m here, I exist. Then you’re overcome with a couple of emotions. Awe, it’s awesome to be alive, and dread. Oh my god. I’m a human being. Human beings die. You can die at any moment.

Human beings have responded to dread or death anxiety over the last several dozens of thousands of years by creating cultures. Most early cultures were various forms of religion. A lot of them were polytheistic and then there were just a few gods and not we’re down to religions with one god. We’re getting closer and closer to the truth. We keep cutting away the number of gods. These cultures basically help you with death anxiety by supplying the answers to the big questions. Like, where did you come from? Where was I here before I was born? What am I supposed to do here? Why am I here? What do I do now? Where am I going after I die? They supply some kind of concrete or metaphorical answer to these questions, all of these cultures. The other thing that happens besides this experience of awe and dread is you become overwhelmed with this sense of responsibility; how do I respond to the fact that I exist?

The responsibility is your existential obligation to your existence. Your obligation, the way you respond, what is my ability to respond to existing? I have to create a life. I have to create a life. I have to become a who in the world. I have to create a life that’s unique to me. Oscar Wilde said live your life, everybody else’s life is taken. You have to live a life that is not only unique but that you live to your fullest potential. A life of meaning, of direction, of self-efficacy, become a valued member in a culture and in a world of meaning. Things like that. You create a trajectory for yourself. you imagine an arc of your life. Shit like cancer happens that blows you off of that trajectory.

Also, things like that. Very few of us actually are able to live our lives to our fullest potential because the world conspires against us in all sorts of ways. It’s called existential resistance. The world makes it difficult. Shit happens. Like a World War II breaks out. Or there’s a pandemic. Or you get cancer. Or the economy tanks. All sorts of things happen that you can’t control. You don’t necessarily get to do absolutely everything. Even the extraordinarily accomplished people have what’s called don’t live to their fullest potential. That gap between what you think you should have been able to achieve and what you ended up achieving in life. Whether you lived to your fullest potential or got close enough or whatever.

Everyone has some sense of guilt, existential guilt that they didn’t quite do enough. Albert Einstein’s last words on his death bed were, if only I knew more mathematics. He’s basically dying, and he goes, “The theory of relativity was pretty good, but if I knew a little bit more mathematics, I could have done something even better.” Or at the end of Schindler’s List where Schindler is helping the Jewish workers in his camp who he helped, Liam Neeson is sitting there, dressed in prison garb and he’s overcome with the gratitude of the workers and they’re helping him escape before the Russians catch him. He breaks down and cries and says, “If only I could have saved one more.”

Even your grandmother, look back at her life. When you face death, it’s like a wall, it forces you to turn around and look at your life. The question is, can you accept the life that you live? That’s the real question. Not can you accept death, because your brain isn’t designed to just go ahead and accept death. Every neuron that says run is lighting up. Can you accept the life that you’ve lived and face death with some sense of peace and equity? Your grandmother has a sense of the finiteness of her life. She’s looking back. She goes, maybe I could have done more or this or that. Sometimes you can write that last book, or you can do that last experiment or something like that.

Ultimately, what it takes is forgiveness. To be able to forgive yourself for being merely human. Loving yourself enough to forgive yourself. Self-love is a very interesting topic. We human beings are imperfect and we’re fragile and we get cancer and shit like that. We can either be ashamed of it, or we can take another attitude of loving ourselves and being empathic of ourselves. When you realize that you’re imperfect, it actually teaches you empathy toward others. It’s what allows you to love somebody else. Empathy. As it turns out, nobody loves perfect people.

Joe:                             Wow.

William:                    I have had such a difficult time with women falling in love with me because of how perfect I was. I’m teasing. Nobody falls in love with a perfect person. They’re impossible to tolerate and actually, they don’t exist. You end up loving the flaws of a person. The tiny little imperfections. That’s what really gets the hooks into you. Actually, being imperfect is what allows you to love, and what allows you to be loved in return. It’s something to cherish and value and celebrate, your imperfections. It’s what makes us human and what makes our experience unique among all other animals. We’re living a very unique experience as a human animal. When we are living our lives as only a human being can, that’s when we feel full of a sense of meaning. When a woman is giving birth to a human baby, as only a human woman can give birth to a human child, that fills her full of meaning. When you’re sitting at the edge of the coral reef or you’re diving in the coral reef and you’re experiencing the grandeur of nature and stuff like that, you’re overwhelmed with the beauty of the universe.

You’re having a very different experience than the little fish who is swimming beside you. They’re not experiencing the coral reef with that sense of awe or joy or wonder, or connectivity to the entire universe. I usually use the Grand Canyon as an example, but I figured since you’re Australian, I should use the coral reef. It’s a very interesting thing being human. During the pandemic, it’s still difficult. It was a difficult experience. I was thinking about my parents an awful lot because what happened to my parents was at aged 14 for my mother, 17 for my father, they had to escape into the woods, into the forest. My mother and father were second cousins. They ran away and joined a group of partisan fighters and other families. They slept in the forest. They didn’t know when they were going to eat again. The forest floor was their bed.

They never had a shower or a change of clothes. My mother and father would have to sleep holding each other not to freeze at night, which is a good way to setup a 65-year long marriage. They didn’t know when some Ukrainian soldiers or German soldiers would come upon them and kill them. They didn’t know where their next meal was going to come from. I started thinking about their experience. At least I have my own bed to sleep in while I’m isolating. I have my own bed; I can take a shower. I can order food in. I have Netflix. I can work from home. It’s a very different experience. It was reminiscent of their experience. I remember one morning I got up and I went to the kitchen to get some coffee. I said out loud to my parents who are passed away now, I said, can you believe this is happening?

Of course, you believe it’s happening. It’s nothing compared to what you had. I was looking out the window waiting for the water to boil on my teapot. I was thinking, it’s an absolute randomness, the incredible odds against me every having been born or even existing were so stacked against me. All that needed to happen was for my mother or my father to make a left turn one day instead of a right turn and I would never have been here. Just the incredible randomness and the luck. The odds. That I would even have this opportunity to exist and have the experience of living a human life. Disney Land at the human life ride. Here I am. Why question it? Why question it? Why complain about it? Enjoy it. Go for the ride. Good, bad, all of the things that happen. Live it until it’s over. Go for the ride. Would you rather not have ever had the experience? Maybe. You’ve got it, you might as well live it. The biggest problem I find is living, being able to live despite the knowledge that bad shit can happen. The difference between you and me and most people walking the street who’ve never had cancer, or a serious illness is we have concrete proof that something life threatening that can kill us actually happened to us.

Joe:                             That is so true, Bill.

William:                    We fucking believe it, we know it. We believe it. For other people, it’s theoretical. It’s not theoretical. It’s real. The question becomes, how do you live with that knowledge? In the way you live, you try to live life as meaningfully as possible and with intention. A lot of people live their lives, they don’t know why they’re doing what they’re doing, they might be living unintentionally meaningful lives, but they’re also wasting a lot of time. You don’t have that much time to waste. The Seneca wrote a book on this, the shortness of life. His premise was, life isn’t that short, really, but we waste a lot of time.

Joe:                             That is so true.

William:                    Really. The real challenge is not how do you die? It’s how do you live knowing that you die someday? It can come at any moment. Some people think that’s worse than knowing that you’re going to die. The fact that it could come at any moment. I could drop dead before our Zoom call is over.

Joe:                             It’s almost a wake-up call. For me, it feels like the reality of knowing that I can die is my way into living into what could be called mindfulness because I realise that today is every single day that I’ve been given. If I’m stuck in traffic or if I’m in a place where I feel like there is too much going on and I’m busy. I remember, what if this was my last day on earth? What would I do now?

William:                    You’re absolutely right. It is a wake-up call. Sometimes I describe it as you need to know your destination before you chart out the course of your life. It’s like if you’re in a car and you’ve got a GPS system and you’ve got one of those things on your phone, the first thing you need to enter to plot out the route is the destination. I was once in a rental car, early days when they had GPS in the cars. It was a voice. The GPS voice was a woman’s voice. Where would you like to go? I put it in. It gave me a choice; would you like to take the fastest route there or would you like to take the scenic route? I want to take the fastest route. I want to go straight to death. I don’t want to meander.

It’s like a GPS in a car. It helps you plot the direction of your life. It helps you understand. There was some TV show on cable TV, HBO called Six Feet Under and this family, the father owned a funeral home and he died, so the sons had to take it over. They don’t know anything about this funeral business. The young man who died who’s married to this young woman. She’s crying and talking to one of the sons. She says, “Why is there death in the world?” He said, “I don’t know, I guess so we know how valuable life is.”

Joe:                             That’s exactly right. It teaches us about ourselves.

William:                    Right. When you’re creating a life, you’re not creating jut any life, you’re creating a human life. You’re creating the life of a human animal, which by definition is finite vulnerable and involves both developing an attitude, a relationship, a connection to the awe and the dread of life. The living, the fact that it involves creating connections in that relationship and attitude toward living and also the possibility of dying at any time. You have to develop an attitude. Most people don’t even think about that in creating their lives until they’re confronted by something. Like what you or I were confronted by as relatively youngish people.

Yes. I remember one time 30 years ago; I was called in to do a consult on a patient and it was a 65-year-old man had prostate cancer and he virtually said this to me. He said to me, “Dr. Breitbart, up until I was given this diagnosis of cancer, I never once thought of death in my entire life.” I said, what? He said, “I never thought of death.” I said, you’re kidding me. That’s impossible. “I didn’t really. I’m 65, my grandparents are still alive. My parents are still alive.” Something like that. He went into his father’s business and he made that business. He never wanted for anything. His life was like an MTV video. He never really had any hardship. He never had a pet that died. Nothing. I don’t quite believe him. Imagine. Living most of your life not even with the thought of death. On some level, I envied him. I would have had a lot of really good restful nights. Just saved up the worrying for the last period.

Joe:                             That’s something that we are all confronted with as we go through cancer. We go through this trajectory. Whether we have been thinking about death or dying or whether we haven’t. We’re on this trajectory. We’re going. All of a sudden, whether you hit a wall.

William:                    You get knocked off. This guy was on a trajectory that never got disrupted. He never thought of death. It was really very interesting. I suppose there was no drama in his life. It was a comedy. I was a chemistry major at pre-med going to med school. Then I was also an English major with a concentration in writing. Poetry writing and playwriting. Mainly poetry. My playwriting teachers would say, “Bill, I hear you’re a very good poet.” The way you create drama, you take the arc of the character, which is the trajectory an then you put some obstacle in the arc of the character. Boy meets girl. Boy falls in love with girl. Girl falls in love with boy. Boy loses girl. The drama is falling off that arc and then finding some way to reconnect or even transcend that original arc to something even greater than you had imagined you could become, which is your life and my life.

Joe:                             That’s exactly right. How do you do that with people who feel they’re going through this transition and they feel lost, and they feel unsure about themselves and how to make sense of things?

William:                    Yes. That was my question. That was the biggest question I had about 15 years ago. I started seeing people, I’d come into the room and I’d say hi, I’m Dr. Breitbart, your oncologist asked me to come in to say hi and see you. They’re a little bit concerned that you’re a bit depressed. Is there anything you think I can help you with? This one guy said to me. He’s a Chinese fellow, he was a scientist himself. He said to me, “You want to help me?” I go, yes, I’d love to be able to help you. “If you want to help me, you’ll kill me.” I said, why is that? “I’ve got such and such cancer. I’m going to be dead in three months. I see no reason, purpose, meaning, value in hanging around. If you want to help me, kill me.” I didn’t have an answer right away.

I probably said something like perfect, you’re the perfect kind of guy that I can help. At that point, I had been dealing with other patients like that, I started to look at research that looked at what makes people want to have desire and hasten death. I found that depression, about 50% of people who speak like that guy does are clinically depressed and haven’t been treated. I did studies looking at treating depressions, desire to hasten death goes away. That’s only 50% of these folks. He wasn’t clinically depressed. If he wasn’t depressed, why else? We did more research. We found that there are a couple of things. Lack of social support. Extreme pain. Things like that. What really popped out was loss of meaning and hopelessness. Synergistic independent.

I went searching for some kind of intervention to help with loss of meaning. It’s interesting now that I have a few colleagues and friends who are doing psilocybin research.  It seems to have some effect on that. I’m involved in some of their studies now, I wasn’t in the earlier studies. I turned to the work of Victor Frankl who you may know, a man’s search for meaning or whatever. I took some of the basic concepts of Frankl’s work and I developed something called meaning-centred psychotherapy for cancer patients. It’s a brief seven-session intervention. It works very well. You have to want to be able to do it. You don’t have to necessarily do the structured intervention.

I’m so familiar with all the elements of it, I could do it at the bedside in one session. I look for that existential guilt. I look for who they are and if you identify yourself and your dignity as residing in who you are as opposed to what you do and what you’re capable of doing. In ways of who you are being as opposed to what you can do. What’s very interesting is who you are doesn’t quite change. If you’re a loving person before, you’re still a loving person.

Joe:                             Is it about reconnecting with that?

William:                    Absolutely. It has to do with these various understandings of the importance of meaning and being able to actively go search for creating it and re-experiencing it because you’ve lost it. Knowing that there are certain sources of meaning that you can go search for. You take a tree that’s routed in the ground. That tree is completely dependent on the universe and the weather for its existence. It doesn’t make chlorophyll unless the sun comes out. It doesn’t get water unless it rains. Birds can come by and peck on it and all sorts of diseases can come by and squirrels can inhabit it and all of that. It’s very passive.

It can’t go, get up, and get the things it really needs to really nurture itself. We human beings are different than trees. We are actually mobile. We can go and search for the awe. We can search for the meaning; we can search for awe. We can search for joy. We of course are like trees in that we are subject to what life brings us, what our inner bodies do to cause us to stress and despair. What the world brings us in terms of service and difficulties. We have the ability to respond. To choose how we respond. Both in terms of our attitudes and in our behaviours.

Joe:                             How do you guide that? It’s really hard to navigate at the best of times, particularly when you are face-to-face with mortality, with the fact that you could die, or you know that you are likely to die? How do you reattach that meaning and how do you go about that search?

William:                    Part of it is an intellectual process and if you have lost that ability to think, it’s very hard to do that. Ultimately, what it boils down to is emotion and love and connection. If you can experience that, that is meaning in the most basic, elemental form for human beings. When my father was dying, and I was sitting at his bedside and I was holding his hand. He looked at me and he recognised me, and he said, “My son is with me, I can die now.” That was a meaningful moment for him. He experienced meaning in the very last breath he took. It’s emotion. Love. It’s corny. It comes down to love, doesn’t it? It’s corny.

Joe:                             Exactly. Love. Sometimes love is a guilty feeling. Especially when it’s self-love.

William:                    Yes, which is so hard.

Joe:                             Where do you stand on self-love? Is it even okay to do?

William:                    It’s probably the most important thing you can learn to do in your life. It’s the most difficult. It’s the most important. That’s what allow you to forgive yourself for just being human. If you don’t love yourself, it’s harder to forgive yourself. I have a son who I love unconditionally. I know what unconditional love feels like. I know my mother and father loved me unconditionally. I once asked myself, does my son love me unconditionally? Did I love my mother unconditionally and my father? Certainly, I had my battles and all that to get my independence. Ultimately, I loved them unconditionally. I loved who they were, not what they were, but who they were. If there’s only one thing I know about who I am, I know that I’m the son of Rose and Marge Breitbart. That’s the only thing I’m sure of in the world. Everything else is probably imaginary. I wonder if my son loved me unconditionally. I asked him, he said he did. It’s hard to believe that someone loves you unconditionally. I try to believe it.

Then I said to myself, look, I helped create this incredible human being, that’s not too shabby of an achievement. Just for that, I achieved a creature who is unconditionally loved. That’s not a shabby thing to do, so maybe I deserve a little bit of love for myself. I didn’t do a bad thing there. There’s something about that. For me, it’s still the hardest thing to forgive myself. Even during this pandemic, you write a book or something like that. I wrote three fucking textbooks. One of them is 100 chapters long, weighs 10 pounds. It’s the bible of my field. I wrote the fourth edition of it. I took over writing it from my mentor who died three years ago who wrote the first three editions. When it came out, I felt nothing.

Joe:                             Why is that?

William:                    I enjoyed the process of doing it. I loved every minute of the process of doing it, but once it was finished, it wasn’t like that was the goal. The goal was creating it. Once it was done, that wasn’t the achievement. The achievement was all of that work that went into it before it got printed by the publisher. It was really competitive. We’re competitive creatures.

Joe:                             In the work that you do, will there ever be a point where you feel like this is enough. I’ve done what I’ve had to do?

William:                    When I was 50 years’ old, I had a birthday. My mother wrote me a birthday card. She wrote in the card, she said, we’re so sorry, we know that growing up we had such extraordinarily and impossible expectations of you and what you would achieve in your life, but you’ve surpassed them all. Please, stop. Relax. You’ve done enough. You don’t need to do this anymore for us. She was aware of this burden she gave me. I turned to my mother and I said, “Mom, I stopped doing it for you quite a number of years ago.” I stopped doing it for you. It’s very hard to stop. One can reach a point where you have a sense that you perhaps achieved something of some significance, and you can look back at it and feel a sense of pride and a sense of completeness in a way.

I’ve trained myself to be someone who is constantly trying not to waste my life. The time of my life. I enjoy so many things that give me a sense of reward and meaning. I love writing. I love music. I love writing essays and poetry and things like that. I love thinking of ideas for research and I love teaching. Those are things that I probably would never want to stop doing. There’s a difference between feeling that you may have achieved and there’s a sense of completion of your life’s work. I did something significant, but I think for me and I don’t think it’s that healthy really, even, to stop being alive and living meaningfully. That’s what I worry about in terms of retirement. People work and then they retire. They retire to sit and wait for death, which is not a fun thing to do.

Joe:                             I find it fascinating that you had this insight, which I think is very powerful. That you’re doing this for yourself.

William:                    I’m not doing it for you, I’m doing it for me. In other words, it’s mine. It’s who I am, I’m not doing this to fulfil your dream only, it’s my dream too. It’s who I am. It’s my intention. It’s not necessarily done for me. It’s done as an act of generosity and love and healing for the world. I get rewarded, but it’s not like I’m trying to accumulate stuff. I own it.

Joe:                             Exactly. There’s a sense of freedom in that, Bill. I remember talking to my wife about going through cancer. I remember going and telling her through difficult moments, I almost in a way did it for you because I wanted to be with you and with our son. Then something made me think, something she said, made me think and realise, I was doing it for myself. Yes, I wanted to be there, but something around that was I was doing it for myself. Just to even admit that, it was hard, but it made me more free because it felt like now it’s okay to do things that I feel are right for me.

William:                    A lot of what’s necessary in living is to try to, under whatever circumstances you are, to remain and to preserve your authenticity as a person. to remain authentically who you are. That’s the part where you come in. I have to be me. I’m doing this to sustain who I am, me. Who you are is someone who loves their wife and loves their child or children? These are the more precious people in your life. These are the most precious relationships in your life. They help define who you are too. You’re authentically a husband, a loving husband, a loving father, part of a family. You’re part of something greater than yourself. You are a part of this family that you’ve created. You didn’t just create your life; you created a family. You create new life. You created a future.

Joe:                             Exactly. Do you think that’s something that then is also a part of creating meaning, is being something that is bigger than yourself?

William:                    Absolutely. Connection is a big source of meaning. You can be connected through love, through all sorts of ways. Connected to people you love, people in your family, your friends and all of that. You can be connected to your community. Connected to your past, the future. You can be connected to something greater than yourself. That’s transcendence.  For some people it’s a relationship to god, being connected to god. For other people, it’s being connected to something that’s even more significant than just me. It’s my family. It’s something that I believe in. It’s the legacy of my family. It’s the idea. For me, it’s the science of my work. It’s the impact of my work, whatever.

Joe:                             You mentioned god, it made me think of when I would be in my oncology ward. Someone came in, I don’t know for whatever reason. They said, “Would you like to see a rabbi?” I remember thinking, I said, no, because I thought, does this mean that I’m dying? All sorts of weird things came up. What would I say? A part of it, this whole idea of being in some way having that feeling of discomfort with religion or spirituality or finding a place within that, what does it mean for you? Is it even helpful?

William:                    What does what mean to me? Spirituality?

Joe:                             Spirituality, yes.

William:                    For me, spirituality is any experience that a human being engages in in trying to understand their place in the universe. That’s Carl Sagan’s definition. Anyone human being who contemplates their place in the universe is engaging in a quintessentially spiritual experience. I would say it’s even a religious experience in the sense of the word religion comes from the Latin - to tie together. It’s all about trying to make sense. How do I tie together the big questions? Where did I come from? What am I doing here? Where am I going? Whenever you do that, you’re actually making the infinity sign. That’s for me what spirituality is. It’s also the mystery. I don’t know the answers. I’m a scientist, but I don’t know.

There are people that taught me as a young child who had all of the answers, but for somehow, someone told them exactly how the universe was created and what happens after you die. They were authorities on this. From a book. A whole little religion that was created. I wasn’t that old before I figured out, this doesn’t make a lot of sense. What I do know is, I don’t know. I have a pretty good idea, but it’s mysterious. The only solace I take within that mystery is infinite possibilities. Judaism is a very interesting religion in the sense that it doesn’t have as much emphasis on heaven or afterlife as Judaism version two, Christianity and all that kind of stuff. Actually, a lot of people mistakenly think that Jews don’t believe in heaven.

Apparently, we do. We have that pretty worked out, as well. It’s not like heaven is our reward. In Judaism, life is what’s precious. You hold onto it every moment. That’s why I have 98-year-old rabbis that are intubated on ventilators and nobody wants to let them die. He has to live ever last second that god intended. Life is the precious thing. Not the afterlife. This is the adventure.

Joe:                             I’m fascinated when you said infinite possibilities. What does that mean for you?

William:                    It means, I may be surprised.

Joe:                             In a good way.

William:                    In a way I didn’t expect. Yes. In a way I didn’t expect. Physics is kind of interesting. There may be a parallel with quantum physics and string theory. Me at birth exists somewhere right now in a different space-time slice. It’s very complex. I don’t know what to expect. I expect nothing. Nothingness. In physics, the big bang was created out of nothing. What they’ve discovered is that nothing actually has a few things in it. There were a few particles of something in nothing. I don’t know. A lot of possibilities. I don’t rely on them very much, that idea. I don’t rely on it very much. Another Greek philosopher, Epicurus. He had this idea of something called symmetry. The idea is that wherever you’re going after life. Yes, once life is over and you die, you’re probably going to be in that same state or space or whatever that you were in before you were born. There’s a symmetry. Before death, after death, it’s the same space.

I don’t spend a lot of time being freaked out about where was I before I was born? I do spend a lot of time being freaked out about what happens after I die. I say to myself, before I was born, I was not in despair or distress. I wasn’t trapped some place. Existence was no painful or distressing in any way. Maybe that’s what it’s going to be like, like before life. My mother used to say something to me every time we were at a funeral. Over the years, we went to a bunch of funerals. We were at the cemetery and the person being buried and we were walking back to the car. My mother would find me, or we might be walking together already. She’d grab me, she’d hug me, she’d hold me very close. She’d say to me, “Don’t be afraid of death. Death is normal. It’s natural. It’s part of the cycle of life. Everything is born and lives and dies. It’s natural. Don’t be afraid. At least today, it wasn’t you or me, sweetheart.”

When we buried my mother, I grabbed my son and I held him close to me and I repeated the same thing to him. At least today it wasn’t you or me, sweetheart. That’s my religion. My son was eight years old. We sent him to Jewish Hebrew day school. Synagogue. Which we stopped going to as soon as his Bat Mitzvah was done. He said, “God watches over every human being in the world, right, dad?” I go, yes. I think so. He says, “There are billions and billions of people in the world, aren’t there?” Yes, I think there are billions. “I think there are several billion people.” Yes. “God has to keep track of every single one of those billions and billions of people.” I go, I guess so. “You think there’s any chance that he might not notice me, and I won’t have to die?” I said, I think there’s a chance. Let’s hope he doesn’t notice both you and me.

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