By Andrea Mabey

Dr. Gawande’s boundless energy powered his busy urology practice, his Rotary Club service, and his thrice-weekly tennis games. He also poured his heart into a rural college in India, transforming it from a single building into a thriving campus with 2,000 students. For thirty years, he had never missed an operating schedule due to illness. Then came the tumor on his spine, causing tingling in the tips of his left-hand fingers.

At first, Dr. Gawande felt fear. His doctors recommended surgery, but he feared the surgery’s impact on his life more than the tumor’s relentless pressure. His top priority was to keep practicing urology. Just beneath that was a deep desire to visit his family in India and see his grandchildren again.

This tumor, painful as it was, sharpened his focus on what mattered most. The fragility of life changed how he wanted to live. He made the trip to India. Though the tumor grew slowly, he experienced what he called ODTAA syndrome—“One Damn Thing After Another”—as medical challenges piled up. Two and a half years later, the tingling became muscle weakness, and he started dropping things. Reluctant to give up his practice, he ultimately decided it was time to retire.

Instead of sinking into despair, he drew a new line in the sand. He accepted a leadership role with the Rotary Club, engaging with people across Ohio while carefully managing his symptoms. He even changed his email signature from “Atmaram Gawande M.D.” to “Atmaram Gawande, D.G.,” marking his new chapter as a Rotary leader. Letting go of his medical career allowed him to focus on what mattered—people. He declined treatments that would isolate him and instead set a bold goal: to speak at all fifty-nine Rotary Clubs in Ohio. After his term, he agreed to the recommended surgery.

When surgery finally arrived, his concerns shifted from fear of the procedure to worry about the tumor’s damage. Mid-operation, his body showed signs of a heart attack. The surgeon paused to ask the family whether to continue. Dr. Gawande had already made his wishes clear: death over becoming a quadriplegic. The family, knowing this, chose to resume surgery. Three weeks later, he returned home walking, nearly pain-free.

But the decisions didn’t end there. With a clearer diagnosis, doctors recommended chemotherapy, promising it might restore his abilities. Hesitant and clear about his priorities, Dr. Gawande wrestled with the choice but eventually consented.

The chemotherapy failed to shrink the tumor, narrowing his horizon once again. He and his family explored hospice care options, which surprisingly opened new doors. Dr. Gawande found calm in this narrow space of possibility his tumor allowed. “He found that in the narrow space of possibility that his awful tumor had left for him, there was still room to live.” (p. 229)

As you reflect on his journey and its uncertain outcome, it might be hard to see the good. Our brains tend to fixate on intense highs or lows, overlooking the ordinary moments. “When our time is limited…we are forced to deal with [both what we experienced and what we remember.] Certain pleasures can make enduring suffering worthwhile. The peaks are important, and so is the ending.” (p. 239) Despite cancer, Dr. Gawande experienced many moments of joy. The end wasn’t in his control, but he was not helpless. He maintained agency over his story, even within a shrinking realm of happiness. While on hospice, he continued hosting dinner parties, planned a new building at the college in India, and met his daughter’s fiancé. “Each day, he found moments worth living for.” (p. 250) A peaceful ending is possible, and joy can be found—if we choose to see it.

—Source: Gawande, Atul. Being Mortal. Metropolitan Books, 2014. pp. 193–250