"My view is that if there is no evidence for it, then forget about it...
An agnostic is somebody who doesn't believe in something until there is evidence for
it, so I'm agnostic."
"The idea that God is an oversized white male with a
flowing beard, who sits in the sky and tallies the fall of every sparrow is ludicrous.
But if by 'God,' one means the set of physical laws that govern the universe, then
clearly there is such a God. This God is emotionally unsatisfying... it does not
make much sense to pray to the law of gravity."
In the Valley of the
by Carl Sagan
Four times now I have looked Death in the
face. And four times Death has averted his gaze and let me pass.
Eventually, of course, Death will claim me–as he does each of us. It’s
only a question of when. And how.
I’ve learned much from our
confrontations—especially about the beauty and sweet poignancy of life,
about the preciousness of friends and family, about the transforming power
of love. In fact, almost dying is such a positive, character-building
experience that I’d recommend it to everybody—except, of course, for the
irreducible and essential element of risk.
I would love to believe that when I die I
will live again, that some thinking, feeling, remembering part of me will
continue. But as much as I want to believe that, and despite the ancient
and worldwide cultural traditions that assert and afterlife, I know of
nothing to suggest that it is more than wishful thinking.
I want to grow really old with my wife,
Annie, whom I dearly love. I want to see my younger children grow up and
play a role in their character and intellectual development. I want to
meet still unconceived grandchildren. There are scientific problems whose
outcomes I long to witness—such as the exploration of many of the worlds
in our solar system and the search for life elsewhere. I want to learn how
major trends in human history, both hopeful and worrisome, work themselves
out: the dangers and promise of our technology, say; the emancipation of
women; the growing political, economic and technological ascendancy of
China; interstellar flight.
If there were life after death, I might, no
matter when I die, satisfy most of these deep curiosities and longings.
But if death is nothing more than an endless, dreamless sleep, this is a
forlorn hope. Maybe this perspective has given me a little extra
motivation to stay alive.
The world is so exquisite, with so much love
and moral depth, that there is no reason to deceive ourselves with pretty
stories for which there’s little good evidence. Far better, it seems to
me, in our vulnerability, is to look death in the eye and to be grateful
every day for the brief but magnificent opportunity that life
Near my shaving mirror, so I see it every
morning, is a framed postcard. On the back is a penciled message to a Mr.
James Day in Swansea Valley, Wales. It reads:
Just a line to show that I am alive &
kicking and going grand. It’s a treat.
It’s signed with the almost-indecipherable
initials of one William John Rogers. On the front is a color photo of a
sleek, four-funneled steamer captioned "White Star Liner Titanic." The
postmark was imprinted the day before the great ship went down, losing
more than 1500 lives, including Mr. Rogers’. Annie and I display the
postcard for a reason. We know that "going grand" can be the most
temporary and illusory state. So it was with us.
We were in apparently good heath, our
children thriving. We were writing books, embarking on ambitious new
television and motion-picture projects, lecturing, and I continued to be
engaged in the most exciting scientific research.
Standing by the framed postcard one morning
late in 1994, Annie noticed an ugly black-and-blue mark on my arm that had
been there for many weeks. "Why hasn’t it gone away?" she asked. At her
insistence, I somewhat reluctantly (black-and-blue marks can’t be serious,
can they?) went to the doctor to have some routine blood tests.
We heard from him a few days later when we
were in Austin, Tex. He was troubled. There clearly was some lab mix-up.
The analysis showed the blood of a very sick person. "Please," he urged,
"get retested right away." I did. There had been no mistake.
My red cells, which carry oxygen all over the
body, and my white cells, which fight disease, were both severely
depleted. The most likely explanation: that there was a problem with the
stem cells, the common ancestors of both white and red blood cells, which
are generated in the bone marrow. The diagnosis was confirmed by experts
in the field. I had a disease I had never heard of before: myelodysplasia.
Its origin is unknown. If I did nothing, I was astonished to learn, my
chances were zero. I’d be dead in six months. I was still feeling
fine—perhaps a little lightheaded from time to time. I was active and
productive. The notion that I was on death’s doorstep seemed a grotesque
There was only one known means of treatment
that might generate a cure: a bone-marrow transplant. But that would only
work if I could find a compatible donor. Even then, my immune system would
have to be entirely suppressed so the donor’s bone marrow wouldn’t be
rejected by my body. However, a severely suppressed immune system might
kill me in several other ways—for example,. By so limiting my resistance
to disease that I might fall prey to any passing microbe. Briefly I
thought about doing nothing and waiting for advanced in medical research
to find a new cure. But that was the slimmest of hopes.
All our lines of research as to where to go
converged on the Fred Hutchinson Cancer Research Center in Seattle, one of
the premier institutions for bone-marrow transplants in the world. It is
where many experts in the field hang their hats—among them E. Donnall
Thomas, the winner of the 1990 Nobel Prize in Physiology or Medicine for
perfecting the present techniques of bone-marrow transplantation. The high
competence of the doctors and nurses, the excellence of their care, fully
justified the advice we were given to be treated at "the Hutch."
The first step was to see if a compatible
donor could be found. Some people never find one. Annie and I called my
only sibling—my younger sister, Cari. I found myself allusive and
indirect. Cari didn’t even know I was ill. Before I could get to the
point, she said, "You got it. Whatever it is…liver…lung…It’s yours." I
still get a lump in my throat every time I think of Cari’s
But there was of course no guarantee that her
bone marrow would be compatible with mine. She underwent a series of
tests, and one after another, all six compatibility factors matched mine.
She was a perfect match. I was incredibly lucky.
But "lucky" is a comparative term. Even with
the perfect compatibility, my over all chances of a cure were something
like 30 percent. That’s like playing Russian Roulette with four cartridges
instead of one in the cylinder. But it was by far the best chance that I
had, and I had faced longer odds in the past.
Our whole family moved to Seattle, including
Annie’s parents. We enjoyed a constant flow of visitors—grown-up children,
my grandson, other relatives and friends—both when I was in the hospital
and when I was an outpatient. I’m sure that the support and love I
received, especially from Annie, tilted the odds in my favor.
There were, as you might guess, many scary
aspects. I remember one night, on medical instructions, getting up at 2
a.m. and opening the first of 12 plastic containers of busulfan tablets, a
potent chemotherapeutic agent. The bag read:
Dispose of as BIOHAZARD
One after another, I popped 72 of these
pills. It was a lethal amount. If I was not to have a bone-marrow
transplant soon after, this immune-suppression therapy by itself would
have killed me. It was like taking a fatal dose of arsenic or cyanide,
hoping that the right antidote would be supplied in time.
The drugs to suppress my immune system had a
few direct effects. I was in a continuous state of moderate nausea, but it
was controlled by other drugs and not so bad that I couldn’t get some work
done. I lost almost all of my hair—which, along with a later weight loss,
gave me a somewhat cadaverous appearance. But I was much buoyed when our
4-year-old son, Sam, looked me over and said, "Nice haircut, Dad." And
then, "I don’t know anything about you being sick. All I know is, you’re
gonna get better."
I had expected the transplant itself to be
enormously painful. It was nothing of the sort. It was just like a blood
transfusion, with my sister’s bone marrow cells on their own finding their
way to my own bone marrow. Some aspects of the treatment were extremely
painful, but there’s a kind of traumatic amnesia that happens, so that
when it’s all over you’ve almost forgotten the pain. The Hutch has an
enlightened policy of self-administered anti-pain drugs, including
morphine derivatives, so that I could immediately deal with severe pain.
It made the whole experience much more bearable.
At the end of the treatment, my red and white
cells were mainly Cari’s. Their sex chromosomes were XX, instead of the
rest of my body’s XY. I had female red and white blood cells and platelets
circulating through my body. I kept waiting for some of Cari’s interests
to assert themselves—a passion for riding horses, say, or for seeing half
a dozen Broadway plays at one clip—but it never happened.
Annie and Cari saved my life. I’ll always be
grateful to them for their love and compassion. After being released from
the hospital, I needed all sorts of medical attention, including drugs
administered several times a day through a porthole in my vena cava. Annie
was my "designated caregiver"—administrating medication day and night,
changing dressings, checking my vital signs and providing essential
support. People who arrives at the hospital alone are said,
understandably, to have much poorer chances.
I was, for the moment, spared because of
medical research. Some of it was applied research, designed to help cure
or mitigate killer diseases directly. Some of it was basic research,
designed only to understand how living things work—but with ultimately
unpredictable practical benefits, serendipitious results.
I was spared also by the medical insurance
provided by Cornell University and (As a spousal benefit via Annie) by the
Writers Guild of America—the organization of writers for movies,
television, etc. There are tens of missions in America without such
medical insurance. What would we have done in their shoes?
In my writings, I have tired to show how
closely related we are to other animals, how cruel it is to gratuitously
inflict pain on them, and how morally bankrupt it is to slaughter them,
say, to manufacture lipstick. But still, as Dr. Thomas put it in his Nobel
Prize lecture, "The marrow grafting could not have reached clinical
application without animal research, first in in-bred rodents and then in
out-bred species, particularly the dog." I remain very conflicted in this
issue. I would not be alive today if not for the research on
So life returned to normal. Annie and our
family returned to Ithaca, N.Y., where we live. I completed several
research projects and did the final proofing of my book The Demon Haunted
World: Science as a Candle in the Dark. We met with Bob Zemeckis, the new
director of the Warner Brothers movie Contact, based on my novel, which we
are co-producing. We began negotiating on some new television and movie
projects. I participated in the early stages of the encounter with Jupiter
of the Galileo spacecraft.
But if there was one lesson I keenly learned,
it is that the future is unpredictable. As William John Rogers, cheerfully
penciling his postcard in the brisk air of the North Atlantic, ruefully
discovered, there is no telling what even the immediate future holds. And
so, after being home for months—my hair growing back, my weight back to
normal, my white and red cells counts in the normal range and me feeling
absolutely splendid—another routine blood test took the wind out of my
"I’m afraid I have some bad news for you,"
the physician said. My bone marrow had revealed the presence of a new
population of dangerous rapidly reproducing cells. In two days, the whole
family was back in Seattle. I’m writing this article from my hospital bed
at the Hutch. Through a new experimental procedure, it was determined that
these anomalous cells lack an enzyme that would protect them from two
standard chemotherapeutic agents—chemicals I hadn’t been given before.
After one round with these agents, no anomalous cells—not one—could be
found in my marrow. To mop up and stragglers (they can be a few but very
fast growing), I’m in the midst of two more rounds of
chemotherapy—probably to be topped off with some more cells from my
sister. Once more, I have a real shot at a complete cure.
We all have a tendency to succumb to a state
of despair about the destructiveness and shortsightiveness of the human
species. I’ve certainly done my share (and on grounds I still consider
well-based). But one of my discoveries during my illness is the
extraordinary community of goodness to which people in my situation own
There are more than 2 million Americans in
the National Marrow Donor Program’s volunteer registry, all willing to
submit to a somewhat uncomfortable marrow extraction to benefit some
unrelated perfect stranger. Millions more contribute blood to the American
Red Cross for no financial reward, not even a $5 bill, to save an
Scientists and technicians work for
years—against long odds, often for low salaries and never with a guarantee
of success. They have many motivations, but one of them is the hope of
helping others, of curing diseases, of staving off death. When too much
cynicism threatens to engulf us, it is buoying to remember how pervasive
Five thousand people prayed for me at an
Easter service at the Cathedral of St. John the Divine in New York City,
the largest church in Christendom. A Hindu priest described a large prayer
vigil for me held on banks of the Ganges. The Imam of North America told
be about his prayers for my recovery. Many Christians and Jews wrote me to
tell about theirs. While I do not think that, if there is a god, his plan
for me will be altered by prayer, I’m more grateful than I can say to
those—including so many whom I’ve never met—who have pulled for me during
Many of them have asked me how it is possible
to face death without the certainty of an afterlife. I can only say that
it hasn’t been a problem. With reservations about "feeble souls," I hare
the view of a hero of mine, Albert Einstein: "I cannot conceive of a god
who rewards and punishes his creatures or has a will of the kind that we
experience in ourselves. Neither can I—nor would I want to—conceive of an
individual that survives his physical death. Let feeble souls, from fear
for absurd egotism, cherish such thoughts. I am satisfied with the mystery
of the eternity of life and a glimpse of the marvelous structure of the
existing world, together with the devoting striving to comprehend a
portion, be it ever so tiny, of the Reason that manifests itself in