They May Be Dead In The Morning
Doing good is its own reward.
This is a guest post by — a Medical Doctor, Human Anatomist, Molecular Biology Specialist and Artist. The entry is entirely written by the polymath and I’ve not edited anything except the artwork, some typos and syntax errors.
As you kiss your son good night, says Epictetus, whisper to yourself, “He may be dead in the morning.” Don’t tempt fate, you say. By talking about a natural event? Is fate tempted when we speak of grain being reaped?” — Epictetus
Vander will always be my favorite character, not Vi nor Jinx.
I waited each week for the next episode, like an addict anticipating the high. Arcane will always be an absolute recommendation for more reasons than the exceptional production. Vander is one of these reasons.
He was the beacon of hope for the undercity. Everyone knew him. He didn’t announce his arrival. You felt it. A leader without titles, his presence commanded respect. In that way, he reminded me of Marcus Aurelius.
The last great emperor tried his utmost not to be tainted by the purple cloth. He didn’t let his position get to his head. He kept a journal of his daily mental battles, offering us a front-row seat to the mind of the most powerful man in the planet at a time when all roads led to Rome.
In contrast, Vander didn’t keep a journal. Yet, he faced his battles ever so often. His fists replaced Marcus’ pen.
These two leaders understood the essence of avoiding the "third thing." The first thing was doing the good deed; the second was the impact it had on others; and the third was recognition. Ironically, they were recognized for not seeking recognition.
What’s most important, though, is that they both knew doing good was its own reward—because you might wake up one morning to find the person whose company you enjoyed gone.
Quantum Mechanics in the ICU
I’m writing this while at work. I cannot sleep. It’s around 3 a.m. I have a patient who was wheeled to theatre to repair one half of her heart valves and replace the other. She has an irregular heart rhythm, the kind textbooks don’t intend to capture.
She has been stable for most of the night, but as the nurses know, 3 a.m. is the devil’s hour. Call it what you may, but if you have a critical patient, 3 in the morning is when a wave of dark energy floods the unit. It’s also the time when sleep is its sweetest.
I recall a geography textbook I once picked up in high school quoting the time, 3 a.m., as the hour when the Earth is its coolest. That is, the side of the Earth facing away from the sun. It’s the same time when sleep is at its best, and patients are at their worst.
I couldn’t sleep.
Patients in the ICU are like Schrodinger’s cat. They exist in a superpositioned state. The team’s actions determine the fate — death or survival.
When the critical care team senses a patient is nearing the grave, we have to call the next of kin. I often contemplate if I were on the other side of the call. It’s four a.m. in the morning, you’re expected to give a presentation at the office, then you get the call.
Hello, am I speaking to…
It’s a terrible idea to break bad news over the phone, so we call a patient’s family to come to the hospital. We have a room. This room, too, is like the box where Schrodinger kept his experimental cat. You can never know the outcome of a heart that gets to hear about the death of their loved one.
The effects range from wails to outright violence. I once imagined what a family would do after giving them hope, only for their patient to pass on a couple of hours later. I can never forget this patient. I pictured the brother coming for my neck and gorging my eyes out through my glasses.
The nurse I was with at the time could hardly sleep that night, as she confessed to me later in the week.
The ICU and quantum mechanics are synonymous. Both work with probabilities. Algorithms for saving patients are not a sure path to saving lives. If it were the case, AI would have already taken over our health care centres.
Probabilities turn more certain when the numbers are large, not when dealing with a single patient. A question I get asked often by families is:
From your experience, how many such cases [like our loved one] have survived?
We rarely box patients in that manner.
Visits and conversations are life-infusing forces. Numerous times, we get to witness patients clinging to the last thread of life, waiting for that single person to show up. At such times, I wonder what goes through their mind.
Most of these patients are intubated. We try as much as we can to keep them pain-free. But they know their time is almost up. Others get delusional. How do you stomach the sight of your lecturer, the one who ensured you become a doctor, who has a few days, at best, to live?
Some think out loud, like labour. Mothers in pain don’t have the luxury of keeping their thoughts to themselves. They blurt it out as it comes, unfiltered, hoping the child comes out just as easily. Hoping.
But patients in the ICU are usually intubated. They cannot speak. They may be sedated, mildly aware of their surroundings. Visiting hours may be uncomfortable. Words may fail them, the family members. A state where there is little you can do, a state of helplessness, is the worst state to be in.
Yet, the Stoics remind us that you could either let life drag you by, or actively take the reins and direct the chariot. It starts by noting what you have control over. The rest is usually out of your hands. By the time someone is bedridden in the ICU, the most you can do is show up and help contribute to the bill. You only hope they have caring clinicians.
The sad truth is that families could have gone to bed, wishing their relatives would get well, but in truth, they may wake up in the morning to find they are dead.
The Stoics
The only real change comes from inside — J. Cole
Ryan Holiday writes:
In 147 AD, Marcus Aurelius welcomed the birth of his firstborn, a daughter named Domitia Faustina. He would bury her before her 5th birthday. In 149 AD, Marcus and his wife had twin sons, Titus Aurelius Antoninus and his brother Titus Aelius Aurelius. Neither survived infancy. And so it would go for Marcus Aurelius and his wife, again and again, a nearly unfathomable amount of times. In the end, they would outlive all but four of their 13 children.
Seneca buried an infant son and Cicero an adult daughter.
Winning hardly gets you seated, thinking, what sprang you into victory. Losses are barely handled when standing. You have to sit down. A loss as significant as death can not just prompt you to think and reminisce, but can well your eyes with tears, as it often did Marcus.
It is such times that the wisdom of Epictetus hits us:
As you kiss your son good night, says Epictetus, whisper to yourself, “He may be dead in the morning.”” Don’t tempt fate, you say. By talking about a natural event? Is fate tempted when we speak of grain being reaped?
In Arcane, Jinx and Vi had to find a way to move on after their father died. Allegedly. Unknown to both of them, a scientist took Vander’s body and tried to harness his unrelenting will to live.
The scientist may not have known what he would have discovered, but he knew what he had control over. It was not death.
Jinx and Vi, too, hung onto what they could. It’s all you can do and hope, much the same way as when J. Cole sings, that there will be better days:
My intuition is telling me there’ll be better days
I sit in silence and find whenever I meditate
My fears alleviate, my tears evaporate
My faith don’t deviate, ideas don’t have a date
All the while, acknowledging death as a natural process, just like life, can be liberating.
What I’m trying to say is…
Arcane is an apt name. It’s hidden, and from the underground city, timeless insights abound.
There is a lot we have no control over. Mulling over them serves little purpose.
What we can handle is what we can mould. The rest happens. Underneath this nugget lies another truism — that our world shrinks or expands depending on our courage.
Courage is one of the Stoic pillars. Courage to move on when your life is shattered by the death of your loved one. Vi and Jinx had to continue living without their pillar of strength, Vander. So did the underground city.
We all need this courage, because one day we may wake up and find that the people whose company we enjoy are gone.
This song inspired some of the lines used in this article — YouTube
Did you like this entry? I’d love to read your thoughts on this matter.
I always enjoy hearing from you, and for you to hear from each other.
Please leave a like (❤️), tell me what you think (💬) in the comment section and share this post with someone so that more people can discover and benefit from it.
Support The Stoic Manual and access 170+ premium in-depth essays: lessons & mini-courses in the art of living, consolations for difficult times, relationship mini-courses, leadership skills, social skills and health tools for a virile and distinguished life. Plus Annual/Patron members get a free copy of my book, ‘THE TOOLS’ + over 40,000 words of bonus content + a free copy of my next book dropping next year.
Join 48,500 other readers,
 | A guest post by
|
I got the call for my mother at 3 am. She was in ICU, dying from stage 4 cancer and unfortunately (or who knows fortunately) accelerated by sodium given too quickly by the ICU staff about a week ago. Normally the visiting hours allowed only 15 mins but that previous evening the nurses said I could stay longer if I wanted. They were kind.
I remember watching as she struggled for those 10 mins and then I told my brother I am going to step out so she can go easily and she did.
I found this reflection powerful and worth a second look thh