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My friend died the other day.

We weren’t terribly close, but we became friends after working together as nurse’s aides one summer when I was a teenager in Tokyo. Thanks to social media we reconnected 5-6 years ago and then again over the past year or so after she was diagnosed with pancreatic cancer.

“Pancreatic cancer – ooh, that’s a bad one,” is the usual response when people hear this. Like any cancer is a ‘good’ or ‘bad’ one to have.. Pancreatic cancer has been on the rise in the U.S. particularly in younger people and in women. Risk factors include smoking, obesity, diabetes – my friend had none of these. Again, we can do everything right in this life, or everything wrong and still get the short end of the stick. I still maintain though, that taking care of your lifestyle to give yourself your best chance and your best life is worth it.

In one of our conversations, she made an offhand comment “if I only have a year left…” At the time she was NED (no evidence of disease) after surgery, radiation, and chemo, and I asked her why she framed her timeline this way. Well, she said matter-of-factly, because the stats for my situation are – 60% will have a recurrence within 2 years, 40% will get 3-4 years, and 20% of those who make it to 5 years will be considered “healed”.

Admittedly, those stats aren’t great – and I would like to think that I would be the 20% that make it - but how I would I look at time, in her shoes given those odds? I know that she was all about her family and friends. She wanted to see the youngest of her three kids graduate high school, have a fantastic Hawaiian vacation with her family, enjoy her time with friends and not be in a clinical trial where she would potentially suffer unpleasant side effects without any proof of efficacy. She was considering coming to Japan for treatment using our immunotherapy – but with Japan in continued lockdown and as she put it her “rogue cells just can’t take a hint” - her time was cut too short.

I admire how she was able to face the last of her days. She died peacefully in her own home surrounded by friends and family. When it is my time, this too is how I would want my life to end. Her life and death give me pause, to think of how I want to live my every day – because none of us know how long we have on this earth.

Once many years ago I thought I was dying. I was traveling in Amsterdam, when I had this sudden onset, worst headache of my life. I was a resident doctor at the time and thought to myself it’s possible that this is a brain hemorrhage. Were I at home, I’d get myself to the ER and ask for a CT scan and a spinal tap. Being in a foreign country, I instead thought to myself “Well, I’ve had a pretty good life, if this is it and I don’t wake up in the morning, I am ok with this”. Would I feel this way now? I don’t think so - I think my mind would go to my kids and think, “I can’t go yet.” I take this to mean that my life is richer and that I have to live my best life, not just for myself, but also for them.

So it’s essential that I do everything I can to be as healthy as I can be. To love and live my life intentionally and to the best of my ability. So that at the end of it, whenever that may be, I can look back and know that I helped people, I made a difference, I had a good life without regrets.

“Santosha” is the Sanskrit word for “complete contentment”. This embodies how I want to live. It doesn’t mean that I should think everything in life is happy or great. It just means to not let external causes or something that is yet beyond my reach (a different job, more money, better health) in order to feel satisfied. Banish the thought “I will feel better, or I will be happier when…” I want to be happy now – because looking back from the future, this may be our best times.

Gratitude and love go a long way in striving towards this. I make it a point to hug and kiss my kids and my husband every single day and tell them that I love them every single day. I value experiences over things. I try not to sweat the little things; they really are not that important. I choose to believe that no matter what happens in life, somehow it’ll be ok, that we can figure things out. We are doing our best with what we know at every given moment – and that is the best that we can do.

Thank you Mitzi, for your inspiration. Your wicked sense of humor. Your beautiful heart. You brought so much light into this world. Your life makes me want to do better and to strive to feel complete, in the here and now, to uncover a lasting Santosha in my life.

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