Before operating on a patient's brain... I must first understand his mind: his identity, his values, what makes his life worth living, and what devastation makes it reasonable to let that life end.
I had spent so much time studying literature at Stanford and the history of medicine at Cambridge in an attempt to better understand the particularities of death, only to come away feeling like they were still unknowable to me.
The tricky part of illness is that, as you go through it, your values are constantly changing... You may decide you want to spend your time working as a neurosurgeon, but two months later, you may want to learn to play the saxophone or devote yourself to the church. Death may be a one-time event, but living with terminal illness is a process.
A resident's surgical skill is judged by their technique and speed. You can't be sloppy, and you can't be slow.
What patients seek is not scientific knowledge that doctors hide, but existential authenticity each person must find on her own... the angst of facing mortality has no remedy in probability.
Science is based on reproducibility and manufactured objectivity. As strong as that makes its ability to generate claims about matter and energy, it also makes scientific knowledge inapplicable to the existential, visceral nature of human life, which is unique and subjective and unpredictable.
