Well-being is about the reasons one wishes to be alive
Being mortal is about the struggle to cope with the constraints of our biology, with the limits set by genes and cells and flesh and bone. Medical science has given us remarkable power to push against these limits, and the potential value of this power was a central reason I became a doctor. But again and again, I have seen the damage we in medicine do when we fail to acknowledge that such power is finite and always will be. We’ve been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive. Those reasons matter not just at the end of life, or when debility comes, but all along the way. Whenever serious sickness or injury strikes and your body or mind breaks down, the vital questions are the same: What is your understanding of the situation and its potential outcomes? What are your fears and what are your hopes? What are the trade-offs you are willing to make and not willing to make? And what is the course of action that best serves this understanding?
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It’s saying no.
That’s your first hint that something’s alive. It says no. That’s how you know a baby is starting to turn into a person. They run around saying no all day, throwing their aliveness at everything to see what it’ll stick to. You can’t say no if you don’t have desires and opinions and wants of your own. You wouldn’t even want to.
No is the heart of thinking.