A question I often ask people facing cancer, chronic illness, or a major life crisis is this:
What makes you glad to be alive?
Not what keeps you alive, lowers your risk, improves your biomarkers, or extends survival.
What makes you genuinely glad to wake up tomorrow morning?
The question often catches people off guard.
Because when life becomes difficult, our attention naturally narrows. We become consumed by appointments, medications, scans, treatments, symptoms, side effects, and uncertainty. Our days begin revolving around managing what is wrong.
And understandably so - when something threatens your life or your health, it demands attention.
But there is a danger hidden inside that process.
Slowly, almost imperceptibly, life can become about avoiding death rather than embracing life.
I was recently reading a passage that captured something profound about the human condition:
“Why do any of us do anything? Living, in itself, is a risk, with only one guaranteed outcome.
And we get up each day, and we make our toast and kiss our spouses or kids or parents or cats or dogs and go to work or school and come home to yet another pile of laundry. We do all of these things with no guarantee that we’ll even make it through the day. See the sun come up the next morning.
Somebody could make the argument that it’s pointless. Somebody might say that it’s insane. And maybe it is.
But maybe it’s something else, too: hopeful.
Every human being—every single one of us—wakes up each morning hoping, believing, that today is not our day. Not our time. That the storm is not yet here. That our island will not be wiped out. That we will see the sunrise the next morning. That life is worth living. Otherwise, we wouldn’t bother getting out of bed.”1
When you stop and think about it, this is remarkable. None of us knows how much time we have. None of us is guaranteed another year, another month, another day.
Yet every morning we make coffee, kiss our partners, text our friends, plan vacations, plant gardens, or buy concert tickets six months from now.
From a purely rational perspective, it might seem absurd - and yet every human being does it.
Why?
Because somewhere deep inside, we are making a declaration:
Life is worth participating in.
And perhaps that declaration is what keeps us moving toward tomorrow.
The Question Lawrence LeShan Asked
More than fifty years ago, psychologist Lawrence LeShan began asking a question that was unusual for his time.
He wasn’t only interested in what was happening biologically in people with cancer. He became interested in what was happening existentially.
What kind of lives were people living before they became ill?
What gave them meaning?
What gave them joy?
What made them feel most fully alive?
As he worked with patients, he noticed a recurring theme: Many were extraordinarily responsible people – caregivers, providers, peacemakers.
People who took care of everyone else, who learned to suppress their own needs. People who spent years doing what was expected of them.
Many had become disconnected from passions, dreams, creativity, adventure, authenticity, and self-expression.
Importantly, LeShan never argued that this caused cancer, that oversimplification has done tremendous damage over the years.
But he did notice something else.
Many patients who experienced profound shifts in their lives began reconnecting with parts of themselves that had long been abandoned.
A painter started painting again.
A musician picked up an instrument after decades.
A woman who had spent her entire life caring for others finally gave herself permission to matter.
A businessman left work he hated and pursued something meaningful.
LeShan observed that healing often seemed to involve reclaiming life itself—not merely fighting disease, but recovering aliveness.
Again and again, he found that many people weren’t just searching for a cure, they were searching for a reason to fully inhabit their lives again.
Bernie Siegel’s Observation
Bernie Siegel noticed something similar.
As a surgeon, he expected his work to revolve around operations, pathology reports, and treatment plans. Instead, he found himself increasingly fascinated by a different question:
Why did some patients seem to thrive despite difficult odds?
What distinguished them?
Again and again, he found people who had discovered a compelling reason to live.
They weren’t necessarily fearless, optimistic, or cured.
But they were engaged. Creating. Loving. Connecting. Growing. Expressing. Participating.
Many had stopped postponing their lives, stopped waiting for permission, for retirement, for certainty, or until everything was fixed.
Instead, they began living now.
Siegel often spoke about moving “toward love rather than away from fear.”
I have always found that phrase deeply meaningful because fear is a terrible architect for a life.
Fear tells us to contract, protect, avoid, postpone, or stay small.
Love does the opposite – it expands, creates, connects, and participates.
Fear asks: “How do I avoid loss?”
Love asks: “How do I fully engage with what is here?”
What Are You Staying Alive For?
One of the most heartbreaking things I see in medicine is that people often know exactly what they are trying to avoid.
They know they don’t want more pain.
They don’t want disease progression.
They don’t want disability.
They don’t want suffering.
But when I ask what they are moving toward, there is often silence.
Not because they lack answers, but because they haven’t been asked.
When was the last time someone asked you:
What excites you?
What lights you up?
What brings you alive?
What are you curious about?
What are you creating?
What adventure still calls to you?
Who do you love?
Who loves you?
What would make you grateful for another ten years?
Or another ten months?
Or another ten days?
The answers to those questions matter - not because they guarantee health or survival.
But because they remind us why survival matters in the first place.
Building a Life You’re Not Ready to Leave
The older I get, the less interested I become in the fantasy of control.
None of us knows what is coming – disease, loss, heartbreak…
Eventually death comes for all of us.
The question is not whether the storm arrives. The question is what we do before it gets here.
Do we postpone our lives?
Do we spend our years waiting for conditions to become perfect?
Do we organize our existence around avoiding discomfort?
Or do we participate? Create? Connect? Love?
Do we become more fully ourselves?
Perhaps the goal is not simply to live longer. Perhaps the goal is to build a life so rich with meaning, purpose, connection, wonder, creativity, and love that we wake up each morning and instinctively say yes to another day.
Not because tomorrow is guaranteed, but because today is worth showing up for.
A life that, when your time eventually comes, leaves you saying:
“Not yet. There is still so much here that I love.”
Bernie Siegel often encouraged people to become so busy living that they forgot to die.
Not because death isn’t coming, but because life is here.
Right now, waiting to be lived.
And perhaps that is the quiet act of courage asked of every one of us.
To love people we cannot keep.
To cherish moments that cannot last.
To invest ourselves fully in a life that offers no guarantees.
And to wake up each morning and say yes anyway.
May we all be loved and love each other so insanely.
And may we all build lives that we are not quite ready to leave.
1The Invisible Husband of Frick Island by Colleen Oakley
For Paid Subscribers: The “Life Worth Living” Reflection Guide
It’s one thing to agree with the idea that life is worth participating in and another to identify what actually makes your life feel alive.
In this week’s companion guide, I’ll walk you through a series of reflection exercises inspired by the work of Lawrence LeShan, Bernie Siegel, and decades of conversations with patients facing cancer, chronic illness, and major life transitions.
Together we’ll explore:
What genuinely lights you up
What parts of yourself may have been left behind
What you’re moving toward (not just what you’re trying to avoid)
The people, experiences, and pursuits that make life feel meaningful
How to begin building a life you’re not quite ready to leave