In a coffee shop, a philosopher diagnosed with brain cancer and a scientist who researches brain infections engage in a deep conversation about life's significance.

The day begins for Adam Hayden and his wife Whitney as they prepare their three young sons for the day. Their morning routines involve breakfast and scheduling activities, aiming to provide a semblance of normalcy for their children. However, this normalcy is overshadowed by a stark reality: Adam must undergo a brain scan every two months to track a malignant tumor that was removed three years prior. The looming threat of recurrence casts a shadow over their lives.

Each year, over 1.7 million Americans receive a cancer diagnosis, a chilling reminder of human mortality. For Adam, this confrontation with death came unexpectedly. He reflects on the lines of wisdom etched on Death's face, contemplating the lessons they may hold.

In pursuit of understanding his condition and its psychological implications, Adam reaches out to various medical experts. His friend Bill, who specializes in brain infections, joins him in a discussion that blends their unique insights on brain cancer, its effects on identity, and the quest for meaning in life.

“A Strange Occurrence”

On December 26, 2014, Adam, a healthy thirty-two-year-old, notices something amiss while enjoying the holidays with his family. A peculiar shaking in his left foot and a tingling sensation in his leg signal the beginning of a series of alarming symptoms. After experiencing further episodes, he ultimately seeks medical help. Although initial examinations yield no significant concerns, a troubling incident during a drive prompts him to undergo an MRI.

An hour later, following the MRI, Adam is met with silence from the technicians, who guide him back to the waiting room. Three days later, a neurosurgeon reveals the shocking truth: a 7cm tumor resides in Adam's brain, a fact that leaves him grappling with the implications for his identity and agency.

The Impact on Selfhood

The diagnosis of cancer is terrifying, but Adam's situation is particularly alarming due to the tumor's location in a part of the brain that governs self-perception and motor skills. The historical context of brain injuries reveals how they can fundamentally alter personality and memory, further complicating Adam's understanding of himself.

As Adam prepares for surgery to remove the tumor, he grapples with the philosophical implications of altering the very organ that shapes his thoughts and identity. Descartes' famous assertion, “I think, therefore I am,” echoes in his mind as he contemplates the potential changes to his selfhood post-surgery.

Awake During Surgery: “I Felt Like a Puppet”

Surprisingly, Adam learns that his surgery will be performed while he remains conscious. This approach allows him to provide feedback to the surgeons, ensuring minimal damage to critical brain functions. During the procedure, he experiences a surreal sensation as the surgeon stimulates different areas of his brain, making him feel like a puppet controlled by external forces.

Ultimately, the decision is made to leave some of the tumor intact to preserve Adam's quality of life as a father, a choice that weighs heavily on him. Despite the successful removal of part of the tumor, the prognosis remains grim, with a high likelihood of recurrence.

The Genetics of Cancer

Cancer arises from genetic mutations that disrupt normal cellular division, leading to uncontrolled growth. Adam's glioblastoma, a particularly aggressive form of brain cancer, is traced back to a random mutation in one of his glial cells. While this mutation is unfortunate, it carries a “positive prognostic indicator” that may enhance his response to treatment.

However, Adam understands that glioblastoma is notoriously difficult to treat, and despite aggressive therapies, the survival rates remain disheartening.

Finding Meaning in the Face of Illness

Adam reflects on how facing mortality can dramatically shift one's perspective on life. He acknowledges the difficulty of finding psychological support amidst physical challenges and contemplates the essence of meaning in the wake of a terminal illness.

Rejecting the notion that everything happens for a cosmic reason, Adam embraces a naturalistic view of his condition. He reframes his thoughts from “Why me?” to “Why not me?” This shift liberates him from feelings of guilt or cosmic punishment.

The Role of Science and Relationships

Adam finds solace in the idea that meaning can be derived from our interactions and contributions within the material world rather than seeking answers in the supernatural. His experience with brain cancer has not only reinforced his commitment to his relationships but also driven him to advocate for medical research and patient support.

As he navigates his survivorship journey, Adam emphasizes the importance of living with intention and maintaining meaningful connections with others. He acknowledges that, although life is fleeting, it is also filled with opportunities for love, empathy, and understanding.

Confronting Mortality and Seeking Understanding

Adam's unexpected confrontation with death has reshaped his life, prompting him to live more fully and appreciate each moment. He encourages others to embrace life’s uncertainties and seek understanding rather than succumb to despair.

With each new day, Adam remains committed to advocating for those affected by brain cancer and contributing to the ongoing dialogue about meaning in a material world. His journey serves as a reminder that life, despite its challenges, can be rich with purpose and connection.

About the Authors

Adam Hayden is a philosopher and writer deeply involved in the brain tumor community. Diagnosed with brain cancer in 2016, he has contributed to various discussions on medical education and the philosophy of illness.

Bill Sullivan is an author and professor at Indiana University, specializing in genetics and infectious disease. He actively communicates scientific knowledge to the public, aiming to bridge the gap between complex research and everyday understanding.