A lesson on life and flow from Roger Ebert

A week before Roger Ebert died, my colleagues and I gathered for a meeting withDr. Karl Ahlswede, a former cardiac surgeon who stepped away from his practice 2 years ago to start something new. Dr. Karl’s practice is now dedicated to advance care planning, or preparing for the end of life. We hired Dr. Ahlswede to offer his program to our entire staff; to help us each be better prepared for dealing with our own health issues, and for issues facing our families and friends.

Advance care planning might seem like an unusual service for a business to offer it’s employees, but we’re finding that thinking about our own mortality (and the mortality of our families and loved ones) gave us unexpected benefits.

Roger Ebert’s cancer diagnosis in 2002 changed much about his life, but some things didn’t change. He lived publicly, choosing to continue his career as a film reviewer even after he lost his ability to speak in 2006. As he told Chris Jones of Esquire in 2010 (via a blue Post-It note): “There is no need to pity me. Look how happy I am. This has lead to an [explosion] of writing.”

Writing is what Ebert did for us, but another quote from his journal that he shared with Jones makes clear that he was writing as much for himself as for his readers:

“When I am writing, my problems become invisible, and I am the same person I always was. All is well. I am as I should be.”

Reading that line reminded me of something Dr. Ahlswede told us last week at the start of our first meeting. His practice focuses on understanding what a patient values – not a set of checkboxes or treatments, but the things in their life that make their lives full. In discussing this with one of his patients, she told him that if she couldn’t live at home with minimal assistance and be able to knit, she didn’t want to live. That’s the kind of thing that doesn’t show up in an electronic health record or even a living will, but it is the kind of information that Dr. Ahlswede uses to help his patients and their families make difficult choices.

For this patient, it was knitting. For Ebert, it was writing, and the way he described it sounds like something else we talk about a lot in our office: flow. Flow is a mental state first described by Mihály Csíkszentmihályi that is characterized by deep engagement in an activity. It is the feeling you get when you are completely focused on a task that challenges you, one that causes the rest of the world to disappear for a while.

Different people achieve flow through different activities, and since it is deeply enjoyable, it is worth figuring out what activities cause it for each of us. It might be walking, or cooking, or travel, but whatever it is, thinking about our own mortality helps focus our minds on what we need and what we can do without. Dr. Ahlswede’s approach helps us think about more than just how we will die, it helps us discover the things we truly value about life.

And the sooner we get clear about what those things are, the better. As we sat around the table in our office, we each talked about the activities that get us into flow, and how valuable that feeling is. That we are (hopefully) decades away from having to put Dr. Ahlswede’s work into practice for ourselves isn’t just prudent. We’ve learned something important we can start right away: making more time for the things that make us feel alive.