How to Live With Dying

Before I could accept mortality, I had to stop running from it

Josiah Mackenzie (Flickr/josiahmackenzie)
Josiah Mackenzie (Flickr/josiahmackenzie)

What exactly is the difference between walking and running? For most of my life, I thought I knew.

The 19th-century explorer Alexandra David Neel recounts the story of encountering, on one of her many Himalayan treks, a lung-gom-pa. At first, the lung-gom-pa just appeared as a black speck on a remote plateau but soon showed itself as a man, traveling at impossibly high speeds across the craggy ground. Neel’s guide informed her that this was a Tibetian mystic, deep in a spiritual trance, whose mind and body had run away from him. She should not speak to the lung-gom-pa for fear that, upon breaking his trance, he would immediately die of exertion. The mystic passed them in a flash, his face serene, and left them in the dust.

Matt—my older, cross-country­–running brother—told me this story when I was a kid. This was running: an effortless blur, divine or at least superhuman. Somehow Matt managed this. He was not particularly athletic, but high school running slowly transformed him into something akin to the lung-gom-pa. One year, my mother and I went to the state championship to watch him race the other lungs-on-legs. There he was: in a trance, face expressionless, deep in an ecstatic state. This was running. What I did in my junior high gym class wasn’t.

Don’t feel bad for me. I just wasn’t a runner. I was, I thought, naturally big boned and therefore never fleet of foot. I did better in water, where I didn’t have to carry my own weight. I could swim for a long time, and relatively quickly, but as I hit the road and reached what I considered a proper speed, my guts started to hurt, and I’d have to stop after a few minutes. My brother assured me that this would go away eventually: “Keep at it, Bear,” he’d say. I gave up almost immediately. I was a walker.

My stomach never stopped hurting, but I did eventually become a runner. It was in college when my shuffle overcame itself and became a run. I was studying philosophy at the time and learned that the ancient Greeks had regarded foot races as a sort of spiritual and intellectual competition. There was even a science behind it called the “tetra,” a four-stage process of preparation, exertion, rest, and moderate activity. Day by day, I followed the tetra and I became faster. At some point in my early 20s, I decided that only the hard day actually mattered. Aristotle warned against overtraining, about not omitting the necessary downtime to recover, but I never liked Aristotle or his call for moderation. Instead, I remembered the lung-gom-pa, and ran (hard) every day—for 20 years. The golden mean was for Sunday strollers, or worse, the old shufflers who used to run.

In snow and sleet, in wind and heat, I ran. I prioritized my training regimen above all else—my professional life, my relationships, and ultimately myself. “Can you take a day off?” my first wife used to ask. No. “Can I run with you?” she’d ask. No. “Can you slow down?” No. My obsession was masked under the cover of “good health,” but most of my friends saw through the thin veneer. What lies beneath the surface of the lung-gom-pa? Narcissism, masochism, perfectionism? I began to schedule my weeks around my runs. When I finished a run, I immediately began to plan for the next one. When I got up in the middle of the night—one of the byproducts of overtraining is sleeplessness—I’d think about how to fit in extra miles.

I’m not blaming running for my first divorce, but it didn’t help. I got remarried. I got another divorce. I kept running. As it turned out, I wasn’t big boned at all. Quite the opposite. I trained for, and won, several triathlons. My four-year-old daughter, Becca, cried when I ran past her on the course, because I wouldn’t stop long enough to give her a hug. When I passed out after competitions, it was a sign that I’d actually been moving. On bad days, I’d drive myself to the emergency room to ask for an IV—so that I could run or swim the next day. The pain in my abdomen, a dull yet crushing force that would shadow my races for days, continued, but I managed to chalk it up as irritable bowel syndrome that I was sure plagued many lung-gom-pas.

The last time I ran, really ran, was February 16, 2020. I was 40. It was sleeting, so I took to the treadmill at the gym at the University of Massachusetts Lowell, where I’d taught philosophy for a decade. I dialed the machine in to a respectable pace—7:09—and took off. I’d just go for six miles today and then shower, shave, and teach my class. If I felt good enough after that, I’d try to have a bite of lunch. That was the last thing I thought before my mind slowly switched off as my legs picked up speed. Forty minutes later, I hopped off the whirring belt. “Bank it,” my running partner Rich used to say. “Running in place kind of sucks,” he’d continue, “but it’s better than nothing.”

In truth, it had sucked more than usual. My stomach pain moved lower into my groin. A foul, ammonia-smelling fluid drenched my back and shorts. I had to stop before reaching six miles. A chatty student, running at a more than respectable pace, had joined me on a nearby machine. He’d wanted to talk about class—something about Aristotle—so I obliged and accelerated to match his stride. I wish he’d waited until I was finished. I wish he hadn’t interrupted my concentration. I wish I didn’t feel like dying.

I stretched out on the gym floor and set my legs up on the wall. If I could get the blood in my toes to go to my brain, I’d be alright. Breathe, breathe, breathe. If I passed out, I might choke on my vomit. I turned on my side and tried to take my pulse. I couldn’t find it but did notice an unearthly vibration where it should have been.

In hindsight, I ought to have listened to Aristotle: all virtues, intellectual or physical, are realized by aiming for a particular goal or mark, like taking aim at the center of a distant target. The bull’s-eye is obviously in the perfect midpoint, equidistant from all of the target’s edges. To hit this specific mark, to become virtuous, one must find a compromise between radical opposites. Aristotle argues that this is the essence of all virtuous behavior—determining the golden mean or midpoint between two degenerate extremes.

Take a principal virtue in Western ethical theory, that of honesty. What are honesty’s degenerate extremes? Is it possible to be not honest enough? Of course—that makes you a liar. But it is also possible to be too honest, a thing called “brutal honesty.” It is frequently immoral to be as honest as you can be. Think about the lies we frequently tell our loved ones, our children, our coworkers, ourselves for the sake of genuine happiness. Are these lies morally problematic? Aristotle would argue that, in many cases, such half-truths are not only permissible but required in the living of a virtuous life. The trick is to find the exact mean between being an immoral liar and a brutal truth-teller. In short, virtue can be understood as a mean between too little and too much.

If you run too little you become a walker. If you run too much, you become injured. And basically intolerable. At a certain point, going the extra mile does not make you a better athlete. It just makes you an idiot. Aristotle advises that the golden mean is context-specific, meaning that there is no general formula for all individuals to determine what is most virtuous. Instead, each person has to measure themselves and the unique situation in order to determine what is appropriate. The Greek word for person is soma, which means body. Each body has its own golden sweet spot, at which point it flourishes, and its own limits, at which point it breaks. Twenty miles a week might be enough for some people and too little for others. A 7:09 mile might be comfortable for a 20-something and kill a man at the age of 40.

Aristotle lived in the immediate aftermath of the Greco-Persian Wars. The turning point of the conflict, the moment when the Greeks set a larger Persian army on their heels was at the battle of Marathon in September of 490 CE. Famously, after the Greeks triumphed, the soldier-messenger Philippides set off at a run toward Athens to announce the good news, covering the roughly 25 miles without a break. When he arrived at the Greek assembly, he burst into the chamber, exclaimed, “We have won!,” and died on the spot. I always thought this was an amazing and inspiring story. Now, in the pale light of recent events, I think it’s misguided. Philippides’s exertion did not alter the outcome of the battle at Marathon, and the assembly could have waited another hour for the news. Writing in the shadow of this event, Aristotle seems to caution us not to kill ourselves in the name of victory.

In the Nicomachean Ethics, Aristotle explains why the golden mean is so very difficult to learn. He suggests that children (and immature adults), those who might benefit the most from the lesson about virtue, who still have time to adjust their lives on the basis of its vital insight regarding moderation, are stubbornly immoderate. Kids, to their credit, are largely unbreakable. This means they are resilient but also notoriously stupid. Aristotle claims that they do not “have ears” for ethical education. As we grow older—and more fragile—our ears become more attuned to the teaching of the golden mean, but we run out of time to adjust our lives on its basis. Usually, the wisdom of moderation is recognized only in hindsight, only when it is too late, when you find yourself prostrate on a gym floor in a pool of sweat.

I’m no longer sure if there is a difference between walking and running, but I know that there is a difference between a heart attack and sudden cardiac arrest. A heart attack occurs when the blood flow to the heart is blocked. The attack can occur slowly or in stages over a period of weeks or months, as the arteries that supply the heart are gradually obstructed. By contrast, cardiac arrest occurs suddenly and often without warning. It’s triggered by an electrical malfunction in the heart that causes an arrhythmia, or irregular heart beat. Most arrhythmias are basically harmless. They can be caused by a lack of sleep, or drinking too much, or eating too little, or stress. Most of them go away after a week or two when a person regains a sense of moderation.

Some arrhythmias, however, come on suddenly and only cease when your heart stops beating. In the cardiothoracic wards, this is called ventricular tachycardia, or the “death beat”—a distinct set of pulses that spikes in excess of 150 beats per minute. Whether we know it or not, our lives are governed by moderation. A heart that beats too slowly or not at all is basically as effective as one that operates in hyperdrive. In both cases, blood fails to enter the chambers of the heart with any regularity. With its pumping action disrupted, the heart cannot pump blood to the brain, lungs, and other organs. Seconds later, a person loses consciousness and has no pulse. Death occurs within minutes if the victim does not receive treatment.

I don’t remember the shock. I still don’t know who administered it.

The device looks like a yellow plastic purse with two wires sticking out the bottom, affixed to what always struck me as wimpy little pads. But I can assure you that the pads to an AED, or automated external defibrillator, are decidedly not wimpy. They administer a 3,000-volt charge in a little less than a thousandth of a second—just enough power to light up every room in our house for five seconds, or enough to save a person’s life.

When I came to, I was still on the gym floor, now surrounded by a crowd of EMTs and police officers.

“Can you hear me, John? Can you tell me where you are?”

I could hear him, like he was calling me from the end of a very long tunnel. I just couldn’t say anything. There was, for a moment, some relief in being totally incapacitated. I didn’t have anything to do, anybody to satisfy, anywhere to run. No one was going anywhere without me. For once, I lay perfectly still.

“Take your time,” he said.

I already was. I was, for the first time in years, not thinking about running. This situation was utterly absurd. The word “absurd” has a number of standard connotations: outlandish, crazy, amazing, freakish. It comes from the Latin absurdum, meaning “out of tune,” extraordinary. This, however, is not the way that Albert Camus meant the term when he coined l’absurd as a philosophical concept in 1942. To Camus, the absurd was strangely normal, a state of affairs that describes the human condition—in a nutshell, the utter dissonance between the human quest for meaning in life and the silent indifference of the universe. Existing in the face of impossible odds lies at the heart of the absurd. When Camus coined the term in the midst of World War II, he explained that the human condition was best exemplified by the myth of Sisyphus, the Homeric tale of man who is punished for his hubris by being forced to roll a boulder up a hill, and to repeat this pointless act for all eternity. Gravity, like the rest of the natural world, has no concern for Sisyphus and his rock.

I’d been running from this stark reality for a long time. Indeed, my obsessive running regime was the principal way in which I fled the absurd. It was my distraction, my escape, my solution—the way that I tried to order a chaotic universe. It’s ironic, but true, that running eventually forced me to face up to the very reality it was meant to hold at bay. I teach Camus every semester, but I didn’t understand him—not even close—until I nearly killed myself on that winter day.

“John, you with me?”

I think I nodded. It was a lie. In truth, I was a thousand miles away. I just needed a little more time. I’d think things through for a few minutes, catch my breath, and I’d be fine. The mat beneath me was frigid, like the temperature in the far north—on another day when I had nearly run into the absurd.

As a boy, my family would summer in Chaffey’s Locks in southern Ontario, on the Rideau Canal. Matt and I loved “going to Canada” and imagined the entire country as a balmy paradise of fishing, canoeing, and shuffleboard. My second ex-wife, Carol, came from Canada, but not exactly the world of shuffleboard and fishing. If you go due north from Billings, Montana, on highway 87, you will, after an hour or so, hit route 191. Go another hundred miles, and you will cross the Canadian border at the small village of Morgan. Go another hundred miles, toward the North Pole, to Swift Current, and you are almost there: just a last stretch beyond any semblance of civilization, another 150 miles to Saskatoon, Saskatchewan. We arrived on the 8th of January. This was the day that I got to experience the uncanny point where Celsius and Fahrenheit meet: 40 below, when mercury, along with everything else, freezes. Camus had warned me, but I hadn’t grasped the severity of the situation: the universe isn’t fit for human life. Instead of recognizing this reality, I’d planned my running route for the following day.

The next morning, it was only 30 below and the air felt brisk but not unbearable. Thin and frictionless, it felt almost inviting, and there was a certain lightness in my step as I jogged out of town. I ran for three miles, and then I turned around. The wind had been at my back and the thermometer hadn’t been measuring wind-chill. “There is but one serious philosophical question,” Camus writes, “and that is suicide.” When confronted with the absurdity of life, he suggests there are three responses and that suicide, while not the most admirable, is certainly not the worst of them. Cold doesn’t describe the sensation. It’s more searing and numb. I wanted to curl up on the side of the road and take a nap. But on some lizard-brain level, I knew that I should just put one foot in front of the next, and I headed for home.

“Ok, let’s get him on the stretcher. He’s not responding.”

I felt four sets of hands slide under my body and lift it onto a bed that was, I thought, the same impossibly icy temperature as the ground. I wasn’t going to escape the absurd this time.

The common experience of being cold is a singular one. No one else can share in the existential expression, “I am cold.” There isn’t room. There comes a point when it is impossible to say that your arms and legs, or any discrete body part, is especially icy. Everything feels the same, bone-deep, and none of it feels good. Escape is perfectly impossible. It drives down on all sides, beating, indifferent, searing, like the sun. Exposure to the absurd makes one tender. In 1942, Camus published The Stranger, the literary complement to his manifesto, The Myth of Sisyphus, written the same year. At the end of the novel, his absurd hero, Meursault, lies on the floor of a jail cell awaiting the call from his executioner. Looking out the window, up at the sky “spangled with signs and stars,” Meursault reflects that, “for the first time I laid myself open to the benign indifference of the universe.” Benign is not the right word. La tendre indifference: the tender indifference. Tender, like a piece of meat, soft and supple. Tender, like an open brush burn, sensitive and raw. Tender, like a heart, careful and vulnerable.

Camus suggests that the comfortable habits of modern life are, at best, mixed blessings. They allow us to mask the absurd, and therefore to mask what is most basic about our nature: that we are fragile, that life is the futile process of not dying. Ignoring these facts of life amounts to what Camus calls “philosophical suicide,” a state in which individuals—in a giant act of self-deception—pretend that the universe is well-fitted to human purposes. Many runners are upbeat optimists, intent on capturing the next “flow state,” which proves that they can get into tune with the cosmos. And that is all well and good. God knows I was constantly on a quest for runner’s high, but Camus might suggest that I was fooling myself. And he might remind me that we are all very good at committing philosophical suicide.

Modernity has no shortage of ways to distract us from our Sisyphean situation: small talk, politics, marriage, religion, entertainment, consumerism, the news, education, the compulsive regimen of exercise. The clockwork efficiency of our practices depends on our ability to believe that they possess some sort of magical, transcendent meaning, the sort of meaning that allows us to escape the absurd. If I can just bank the right number of miles, if I can just get the right grades, if I can just marry the right person—my world will not go to pieces. Camus, however, asks his reader to dwell with the cold reality that our lives are directed to tragic ends—that when we die, nothing but the indifference of nature remains.

“Let’s put the pads back on him—just in case.”

These were the words that actually brought me back.

No thank you. “I’m okay,” I said as loudly as I could, opening my eyes.

I was in an ambulance. Two burly EMTs flanked my cot. A vast array of wires and tubes sprouted out of my arms and chest. I asked for a blanket. And then another. I assured them that I was actually feeling pretty good, that I didn’t need to go to the hospital, that I needed to teach my class and go for my run the next day. They assured me that I was going to Tufts Medical Center in Boston, that it wouldn’t take long, that it was really fast with the sirens and lights. I protested. I didn’t hear any sirens or see any lights. They just laughed. One of them pointed out that I was strapped down to the bed.

I was still unbelievably cold. There is a certain exuberance, so I hear, about summers in the Arctic. When the earth finally thaws out on the prairies, the standing water invites swarms of gnats, but citizens still seize these warm days with a zest that makes little sense to those living in more hospitable cities. Every livable moment seems a bit more precious when total apocalypse is imminent. “There is no love of life,” Camus informs his reader, “without despair of life.” This is one way—a distinctly American way—of understanding Camus’ revolt against the absurd: that each individual has the ability to refuse, again and again, to go gently into that good night. There is, however, another way to run against the absurd—and that is to never run alone.

Thinking back on my one and only run in Saskatchewan, it now strikes me that I didn’t actually make it home. At least not on my own two legs. I was standing still, on the side of the road, looking out at a hundred miles of whiteness, speckled with black thicket. Just waiting. An old woman in a maroon minivan pulled up behind me a mile from town and told me to get in before, in her words, “I caught my death.” She was visibly upset, like she had just stayed a sentence or prevented someone from falling off a bridge. Tears—probably from the cold—streamed down my face. I could not thank her enough for stopping.

The EMTs were calling to me now—again, at the end of a long tunnel.

I went into the “death beat” again and passed out. I stopped breathing. The EMTs brought me back again. There was no running away from this, or anything else for that matter. I wanted to go back, to be more moderate and mindful, to dial in a 7:45 (even a 8:15) instead of my maniacal 7:09. I wanted to call my third and (I’m resolved) last wife, Kathy. I wanted to see Becca and her brother Henry, to say I’m sorry and that I love her. I wanted to do it all again the right way.

I get it now: the appropriate response to the absurd is not to run and is not necessarily total despair, but an existential urgency that has all but vanished in our modern day. I had to stop running and to be totally still in order to realize what I was missing in the rush. In contrast to philosophical suicide, Camus recommends that we maintain a unique orientation to the absurd, which he calls “revolt.” This is not resignation, and it’s certainly not denial. It is the refusal to run away. It’s the willingness to push the boulder of life with full knowledge that one is going to eventually fail. In the end, most of us end up on a gurney, kept alive by the kindness of strangers, running in the face of the absurd. And in the end, most of us wish we’d spent less time on the treadmill, whatever form it might take.

“Good luck, buddy,” one of the EMTs said as he wheeled me through the snow and passed me off to the nurses at the hospital. I wanted to hug him, but my arms were still strapped down.

Instead, I tried to smile and remembered what are perhaps Camus’ most famous words: “In the depth of winter I learned that there lay within me an invincible summer.” It would remain cold for many months. I would have bypass surgery the following week in order to fix a congenital condition called “abnormal right coronary artery,” an innocuous sounding term for the leading cause of sudden death in young athletes. I was no longer young. I was old, and, as my surgeon suggested, unspeakably lucky. I had no right to it, but I would probably see another summer—if not an invincible one.

Permission required for reprinting, reproducing, or other uses.

John Kaag is author of Hiking with Nietzsche. His new book, American Bloods: The Untamed Dynasty That Shaped a Nation, will be published in May.


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