Gratefully Adapting to a World of Perfect Imperfections

Judy adjusted her oxygen mask and, leaning on her thin arms, tried to sit up in the white hospital bed. "I don't know how to say this, but could I ask..." She took another deep breath and continued, stumbling over her words in an unfamiliar way: "Would you consider singing at my funeral?" For a while, I pretended to busy myself with the stethoscope in my pocket, trying not to reveal the strange emotion I felt. When I noticed the awkward silence, I said, "I would be honored. Do you have a song in mind?"

She adjusted the oxygen mask and tried to sit a little straighter. "Not really. It just shouldn't be a sad song. I want people to wear white and celebrate my life. You could sing something beautiful, like Bach."

A Transformative Power

Judy's cancer story had begun seven years earlier with bowel problems that had been investigated for a long time. I had explained that symptoms of ovarian cancer could resemble those of simpler conditions and easily lead to mistaken diagnoses involving the bowel or bladder.

Months of discomfort, repeated tests, and misdiagnoses eventually caused her to lose faith in the medical profession. But Judy quickly moved from anger to acceptance; her resentment of modern medicine's limitations became a deep love for the world around her—a transformative power that was also an astonishing blessing.

After her aggressive surgery, Judy returned, with difficulty, to yoga . Her monthly chemotherapy admissions were joined by a grateful companion who looked forward to spending a few days with such a loving patient. As the chemotherapy machine began running and the first drop fell, she would point out the window to the beauty of the newly blossoming cherry trees. In remission (after treatment had ended), she spent time caring for other patients exhausted by the burdens of their illnesses or treatments. Through metaphor and philosophy, she retaught those patients and the healthcare staff how precious each day, filled with small and simple joys, truly was.

A Final Task

As her disease returned and worsened, her love for her family, friends, and life grew stronger. At 72, preparing to leave this life, she entrusted me with a responsibility I would struggle to bear: she asked me to sing at her funeral. All I wanted to do was run away.

It was not that I could not sing; I am a classically trained singer who performs regularly. It was not that I would not sing; I recognized the great honor of the request, but thought it would be better if I did not. There was almost nothing I would not do to persuade someone attending the funeral to take this burden off my shoulders. Besides, my schedule was full: I would undoubtedly have to cancel clinic hours or reschedule surgery, inconveniencing patients and staff. Where could I practice beforehand? In the car on the way? In a hospital stairwell? And what about allergy season? Would I sneeze and cough throughout the song? There was also the emotional side. Singing with an enormous lump in your throat would be difficult. The circumstances seemed far from ideal for the role Judy wanted me to play in the farewell she deserved.

I knew that all these possible problems I kept considering were excuses, and I knew the real reason I wanted to escape. There was only one reason: "Why should I celebrate a life I could not save?"

Advanced ovarian cancer is something many patients never fully recover from, and I knew Judy had lived longer than many. With the training and experience to treat so many patients, why could I not save someone I had come to respect deeply and love? It was not for lack of effort: she had undergone optimal surgery and state-of-the-art chemotherapy. My conviction and shame that my efforts had been insufficient overshadowed what Judy had achieved throughout her cancer journey. If I had not cured her, how could I face her family and play the central role in this gathering to celebrate her life and death? Was I not the reason we were here in the first place? I had failed. I did not deserve this honor.

Adapting to an Imperfect World

As I tried to understand and accept my guilt over my imperfections and failure, I could not help asking myself, "Why would Judy choose me for such a task?" The last 7 years of Judy's life testified to adapting to an imperfect world. She had forgiven all the doctors whose misdiagnoses had delayed the diagnosis of her advanced cancer. Despite facing many challenges from surgical scars, chemotherapy-induced baldness, and a colostomy bag , she continued living with all her vulnerabilities. The things she "adored" were beside her: her loving family, especially her grandchildren, her dog, yoga, and the God she believed in—all manifested in splendor and beauty, making every imperfection invisible.

Now it was my turn to learn from her, give up my insistence on being the perfect physician, and rebuild my self-image. I was not that doctor, nor was that someone I could ever be. It was time to forgive myself for being human and recognize that I could see my vulnerabilities and choose to find beauty and harmony within them rather than be consumed by them. Following the poise and grace Judy had shown so often, I let go of the burden of perfection I had imposed on myself and accepted my vulnerable places.

The Beauty of Feeling Whole

I finally decided to sing "If With All Your Hearts You Truly Seek Me" from Mendelssohn's Elijah. Its simple but meaningful message and uplifting, joyful melody reflected Judy's philosophy of life. As expected, the memorial service was scheduled to conflict with an operation I needed to perform. Between seeing patients, I left the operating room, put on a dark suit and white shirt, and went from the hospital changing room to my car, where I began warming up my voice. As I drove to the church that morning, snow dusted the daffodils and forsythia—an oddly imperfect beauty and a wonderful metaphor for all the wisdom Judy had so gently bestowed.

Dozens of people dressed in black gathered in small groups in the corridors leading to the chapel. I spotted an empty room and shut myself inside to prepare for my task, but what I heard outside differed from other funerals. Rather than speaking in hushed tones, people spoke as though they wanted everyone to hear about the beauty Judy had brought to their lives. There was laughter in those conversations.

When I saw Judy's son, I left the dark room to offer condolences to him and his family. He, in turn, expressed heartfelt thanks for my role in keeping his family together over the years—for the seven years Judy had spent with her beloved grandchildren, family, and friends; for helping her remain his mother for another 7 years. Just as I had felt honored when Judy chose to begin her cancer journey with me, I felt honored to bring that journey to a close today. Our journey began with anger and fear and ended with joy and song, as every imperfection became part of a beautiful whole through forgiveness and love...

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Dr. Richard M. Boulay's article, translated above, reminds us that life is precious and fragile and that it matters to keep seeing love and beauty even while facing illness. Judy's cancer story shows how we can adapt to a challenging world and value our loved ones and the world around us in ways that make every moment of life precious.

It also teaches that patients and doctors need to accept failures and imperfections as well as successes, and learn from them. This lesson applies to everyone, not only cancer patients. As we cope with life's difficulties, we should remember that we can find beauty and harmony even within imperfections and limitations.