Death. We don’t like to think about it. We certainly don’t like to talk about it.

But it is going to happen to the people and things we love. And to us. It is one of life’s few certainties!

Smiling in the face of death

Buddhist teachings remind us of the sense of impermanence and that nothing stays the same forever. The more vigorously we try to hang on to our sense of control, the harder we will fall when our world comes crashing down.

I see my acceptance as the inevitability of death as one of the greatest gifts which has come with living with my congenital heart condition. I am often reminded of the fragility of life and how easily circumstances can change.

Four years ago, I faced emergency open heart surgery to try and save my life before the infection which had been ravaging my bioprosthetic heart valve won the day. When the surgeon came into my room to talk me through what was going to happen, I felt surprisingly calm. Having described his surgical plan in detail he asked if I wanted to know about the potential complications and risks.

I remember him smiling at my response when I said something to the effect that the percentage risks were not overly important to me. The choices were to do nothing and likely die or to take a big risk and potentially live. Going through with the surgery seemed like a reasonable punt to me!

Here I am again, just a few hours from my next valve replacement, facing markedly better odds but uncertainty all the same. This procedure is elective and hence not so urgent in its timing – in fact I have waited over 14 months since it was first scheduled due to the coronavirus pandemic. I could even choose not to follow through right now and wait until my symptoms get worse.

I have had to play out the various options in my head and assess that risk versus return conundrum. Our lives are often full of choices and there isn’t always a clear-cut answer. The options are to delay and continue as I am, waiting for my symptoms to worsen and further diminish my quality of life. The alternative is to do it now, expecting the outcome to be positive but facing the possibility of complications or even death – ranked at 1 in 100 and 1 in 300 respectively to add concrete numbers to that equation.

Our choices are very personal, and what is right for one person may be different for another. Equally, our decisions may change over time, based on our circumstances, values and experience.

Luckily, I have not had to figure this out alone. I have a congenital cardiologist I respect and trust, and what he describes as a partnership where we reach these decisions together. I can access to multiple scientific articles and research papers to back up my understanding. Perhaps most importantly, I am privileged to have amazing friends and family with whom I can talk through my feelings and concerns.

I was on the phone with a great friend last night and she asked me if I was scared? Now in case you are expecting me to give the bravado answer of ‘no’, I will share that I said ‘yes’. I would be lying if I said otherwise. The difference for me is that this is not a paralysing fear or something which plays continuously on my mind.

I accept death as a possibility, but at the same time fully intend to live!I can’t know what the future holds, and sometimes this feels a bit like a gambling game where the stakes are not financial but potentially fatal.

If we really think about it, every moment of our lives comes with some element of risk. I could drop dead of a heart attack whilst writing this. I could fall down the stairs on the way to the kitchen to make a cup of tea. I could get electrocuted turning on the kettle. A meteor could drop out of the sky and crash through the ceiling, killing me instantly.

Alright, so the chances of each of them happening is increasingly remote, but you get my point. Life is filled with risk and whether we like it or not, we are making judgements based around it every day.

I am not one to push the boundaries too far or be reckless, but perhaps my multiple brushes with death have given me a greater fear of not really living, rather than a fear of dying! I am pragmatic and honest in my approach. This is my one life, and I am not getting out of here alive.

Bad things will happen to us all when we least expect or deserve it. The same will be true of good things. That is the reality of how little control we really have. Far from being a reason to throw up our arms and sit back – the laisse faire, what will be will be, lazy answer for people who rarely reach their full potential – my suggestion is that we don’t hugely weight a specific outcome, but rather invest in living the best life that we can every day.

I can’t control every aspect of my future. I know my beginning and there will certainly be an end. The life in between is mine to fill out however I choose.The only failure for me would be to waste it.

The fabulous thing about embracing the probability of death is that it frees us up to dive fully into our life as it is now. If you acknowledge that death is around the corner (as it is for us all!), you begin to truly celebrate the wonder in every day. You don’t put off doing things which might increase your happiness. You learn what is important to you and focus on that. You stop ‘sweating the small stuff’ as the popular saying goes.

And maybe, just maybe, this facing up to the reality of death gives us all the kick in the pants we need to get out of our own way and follow our dreams.