Memento Mori, Memento Vivare…Remember that you will die. Remember to live.

Nothing lasts, and all of it matters: an essay on facing death and finding joy.

When I was in my twenties, I developed nephrotic syndrome, a disease in which both kidneys forget what to retain and what to eliminate. Protein is lost in massive amounts. The disease can lead to kidney failure, dialysis, transplants, and a foreshortened life.

While my contemporaries planned their lives, I was isolated by illness. My world centered on weekly trips to Mt. Sinai Hospital carrying a container holding twenty-four hours of urine. This was the 1960s, and there were no specialized plastic containers. You made do with whatever you could find. I rode the subway and worried that a sudden lurch of the car would splinter the jar and spill its contents across the subway floor.

While my mind was focused on my illness, my chances, and confusion at this turning of my fate. Caught in a vise, I struggled to find a way to live, and reconcile my circumstances.

Once diagnosed, the nephrologist followed me for a year without medication. When there was no improvement, a “miracle” drug, was prescribed. The idea was to somehow get the kidneys to revert to their original state and go back to doing their job. I took massive doses of prednisone, a cortisone derivative. It disfigured and tormented me, and it did not produce the hoped-for miracle. My face changed from narrow and thin to a moon face, my smooth skin now spattered with acne. My innards ached. I felt I had the afflictions of Job. Friends did not recognize me.

After a year, with no provable improvement and against the advice of my nephrologist, I began weaning myself off the medication.

The suffering forced me to examine my life. The fact that nephrotic syndrome is an autoimmune disease underscored that there was a certain poetic justice in my developing an allergy to myself… lots of willfulness combined with ignorance and mistakes brought me unhappiness. But then again, I was young.

I had a great deal of time to think about my choices, and about how I would want to live, if I got to live. I started with the face I no longer recognized in the mirror: who was I if not my face?

I decided on a course of action. I would set about finding what suited my soul and my life’s work. And I would be happy. How to go about it? I hadn’t a clue.

And then, an unexpected gift. About eighteen months after I finished with the medicine, and four years after the onset of the illness, I had a spontaneous remission, and I never suffered from that disease again.

For the time being, death parted ways with me.

My story is not unique. Many people who have had serious illnesses speak of a similar experience that led them to reorder their priorities and redirect their lives. In my case, the illness instructed me. I developed the willingness and dedication to attempt to live authentically. I had come to understand, profoundly, that nothing I had was guaranteed, not longevity, not health, not even my face. And I suspected that the price of living someone else’s dream, for me, was likely illness and death. I determined to stop pretending.

For a brief period, I had a purely bodily sensation of the gift of life, of vibrant health and vitality.

I’d had no idea what precisely I was looking for or how I would find it. The goals may have been vague and possibly unachievable, but my intention was firm. It’s hard to get support from your family and community when you veer off the main path and can’t even explain what you’re after. The advice of the “wise” was that what you see is what you get, and I should just buckle down.

Nevertheless, I have held fast to that commitment for well over sixty years, to this day. And it has served me well.

Not everyone gets a lesson like that. Some people have been so favored by life’s bounty, and have acquired such wealth that allows them to live seemingly free of consequence; they cannot accept that they—with all their success and untouchability—cannot master death or overcome nature. They are “gods”, after all, as their circumstances seem to demonstrate.

There is a difference between the experience of great wealth, known to a few, and the experience of abundance, available to all.

Longevity and Immortality

The oldest story we have on record of a quest for immortality is the epic of Gilgamesh. Some date it to the second millennium BCE in what is now Iraq, and was rediscovered in the nineteenth century. Gilgamesh, a king, is devastated by the death of his friend Enkidu and sets out on a long journey to find the secret of eternal life. He fails.

Our modern-day kings, influential and staggeringly wealthy, are engaged in a similar pursuit, only now they have powerful technology behind them. Despite the interval of thousands of years, the story remains the same. Our contemporary “betters” behave as if they are exempt from nature’s laws and should never have to suffer.

Will immortality ever arrive? Maybe not, but increases in longevity are likely. As AI works out how to cure many diseases and maybe even slow aging, we may increase our lifespan. But whether we live to 85 or 120, the outcome is the same. At some point, we die. No amount of longevity research, supplement-gobbling, and underground bunkers changes that. No amount of money and “stuff” offers a way out of the natural order.

The suffering that comes from knowing the inevitable but still clinging to futile hopes cannot be overestimated. There is fear, even terror, and then there is the missed opportunity. While clinging to possessions, positions, pleasure, power, something powerful is suppressed—joy.

Joy arises from the opposite of self-protection: the acceptance of impermanence. It brings awe, humility, the cherishing of moments, and the spontaneous appreciation of the beauty that surrounds us.

No One Stands Outside the Wheel

In the Tibetan Wheel of Life, the whole of existence is held in the jaws and claws of Yama, Lord of Death, a personification of impermanence itself. Everyone turns on this wheel, including humans and the “gods”, the beings who enjoy the highest pleasures and never have to think about consequences. Yet even they are not immortal. The tradition says the gods suffer more at death than humans do, because they have known only pleasure. I would add that they suffer because their egos cannot bear that they were never exempt.

Baruch Spinoza (1632–1677), a Dutch philosopher of Portuguese-Jewish descent, reached the same conclusion by another road. He rejected the idea that humans are “a dominion within a dominion” (Ethics, Part III, Preface), as if we dominate nature from within some sort of protective bubble. He believed that our recognizing that fallacy would be the beginning of freedom”.

Joy is hard to define, but needs to be separated from “happiness,” and even “delight”. I myself experience it as a vibration that lives within me and connects me to the greater reality of which I am a part. It is not dislodged by sorrow, which is part and parcel of life, nor by the fragility and transience which are shared by all. Here is another perspective from the contemporary poet Ross Gay: Joy is the “practicing of entanglement, our belonging to one another ….”

Those of us who are not insulated by great wealth have experienced being humbled. This is an advantage. As we age, if we choose to cultivate humility and recognize our place as a droplet in the sea of creation, we experience more joy. Understanding impermanence, the inability to hold on to what we have achieved, we cherish those we love, welcome moments with them, even moments of struggle, even fleeting moments.

Nature Also Gives

To see a World in a Grain of Sand

And a Heaven in a Wild Flower,

Hold Infinity in the palm of your hand

And Eternity in an hour.

— William Blake, “Auguries of Innocence” (c. 1803)

©2026 Shulamit Elson