years ago, I had as a patient a young man who had become separated
from his ski party and spent three days in below-zero weather yet
somehow had managed to survive. He had been hospitalized for
several days in the ski country, and then flown to our center in New
York because of frostbite and progressive gangrene of his
feet. The local surgeons had wanted to amputate and it was
hoped that our world-renowned vascular surgeon team could avoid this
difficult choice. He had some initial surgery and for three
weeks the outcome was not clear. Then his left foot began to
improve and his right became steadily worse. The time for
amputation at hand, the young man flatly refused. He preferred
to keep his foot.
became sicker and sicker as the toxins from his injured foot began
to flood his body. His family and friends were desperate, but
he would not be moved. He would keep his foot. The
situation came to a head late one evening when for the third or
fourth time a group of doctors shared his most recent laboratory
studies and reviewed his worsening condition with him. In the
midst of this discussion his fiancée, overwhelmed by the
possibility of her beloved's death, was driven beyond her
endurance. Weeping, she tore his engagement ring off her
finger and thrust it onto the swollen black little toe of his right
"I hate this damned foot," she sobbed.
"If you want this foot so much, why don't you marry it?
You're going to have to choose, you can't have us both."
We all looked at the small bright diamond, surrounded by the black
and rotting tissues of his foot. Even under the fluorescent
lights, it sparkled with life. The young man said nothing and
closed his eyes with weariness. Weary ourselves, we left to
continue the medical rounds. The next day, he scheduled his
to follow him through the fitting of his artificial foot and his
rehabilitation. At the end of the year, only a slight limp
marked his difficult choice. Two weeks before his wedding I
revisited that final medical conference with him, asking what had
changed his mind. He said that seeing the diamond on his toe
had shocked him. Jenny had been right. He had been
married to his foot. Her dramatic gesture had helped him to
see for the first time that he was more attached to keeping his foot
than he was committed to his life, to their life together. Yet
it had been the promise of that life that he had clung to, that had
enabled him to survive three days alone in the snow.
attachment has its source in the personality, in what the Buddhists
refer to as the "desire nature," commitment comes from the
soul. In relationship to life, just as in human relationships,
attachment closes down options, commitment opens them up.
Modern life has made us people of attachment rather than people of
commitment. Indeed, many people have found that it is
difficult to tell the difference between attachment and commitment
in their own lives. Yet attachment leads farther and farther
into entrapment. Commitment, though it may sometimes feel
constricting, will ultimately lead to greater degrees of
freedom. Both involve in the moment an experience of holding,
sometimes against the flow of events or against temptation.
One can distinguish between the two in most situations by noticing
over time whether one has moved through this activity or this
relationship closer to bondage. Attachment is a reflex, an
automatic response which often may not reflect our deepest
good. Commitment is a conscious choice, to align ourselves
with our most genuine values and our sense of purpose.
Survival in a setting of life-threatening illness may involve a
willingness to let go of everything but life itself.
remarkable collection of
true stories draws on the
concept of "kitchen table
wisdom"--the human tradition
of shared experience that shows us
life in all its power and mystery
and reminds us that the things
we cannot measure may be
the things that ultimately
sustain and enrich our lives.