It is 11 October, 2014. I am writing this in Kathmandu, capital of Nepal at the foot of the majestic Himalayas. The date is only marginally significant - it is now 2 years and seven months since I was successfully operated on for pancreatic cancer - but the location perhaps is more revealing. Kathmandu is a city of life and laughter and matches perfectly the mood of someone who not only has escaped the usual fate of those struck by the deadliest of all the cancers, but has also shaken off the insidious side-effects of chemotherapy, the "planned poisoning" that represents the world's default treatment for malignant tumors.



There is a saying about how 'What doesn't kill you makes you stronger' that many who are undergoing chemo- and/or radiation therapy often hear, or even use themselves, to make light of the unpleasantness of the process and to remind themselves that there is a flip side to the therapy: it may extend their lives.

But recently a colleague of mine in the world of the Internet, Guy Kawasaki, hit upon a headline - I have yet to check whether it was Guy's own or whether he was passing on something from elsewhere - that, for me, is much more pregnant with meaning and possibility, in terms of viewing cancer in the first place, and chemothererapy/radiation treatment in the second, as a potential inflection point for anyone who survives one or both:

What Doesn't Kill You Makes You Smarter

There, for me, is a much more honest statement. Do I feel stronger, having dodged the bullet - thanks to radical Whipple surgery - of pancreatic cancer? Not really. If I could restore my strength to pre-diagnosis levels I'd be very happy. But do I feel smarter? Most emphatically, yes. The things that adversity teaches you - about yourself, about those who love you and are loved by you, about your professional colleagues both direct and indirect, about total strangers and/or long-lost friends, about nutrition, about the Internet, about the healing power of music and above all of love, about cognitive mysteries such as "chemo brain" and the reassurances increasingly offered by brain science, about physical capacity, about mental agility, about emotion, about faith. In truth there isn't a single aspect of the human condition about which you do not, on being confronted with an early departure from the game of life, end up a tad smarter if on the contrary you have the good fortune to survive.

"Survival" and "survivor" remain the metaphors of choice when dealing with people like me but, speaking here only for myself, I am not sure how useful those words are. We are *all* survivors, after all; we all survive, daily, onslaughts of inconsiderateness or even plain cruelty, of injustice either direct or indirect, of disappointment and/or even despair. We all survive week in, week out the challenges of work and play, of life and love, of learning and of teaching, and of the eternal search for meaning in which we are all, to greater or lesser extents of awareness, engaged.

So the fellow who "survives" cancer, of whatever variety, is no different from one who survives any other of life's curve-balls: bereavement, for example, or financial ruin. There is a commonality, and it is that of the bounceback or comeback. We humans are resilient. We have mastered endurance. We are *all* survivors. Of something. Of life itself, perhaps.

But the Kawasaki headline offers a more nuanced perspective. Just as travel broadens the mind, or university, so pancreatic cancer it turns out is a hugely enriching life-phase that does, no doubt about it, leave you smarter. That it might just as easily have left you dead is not I think the point; many things kill us, from traffic accidents to natural disasters. But how many things actually make us smarter? We learn about humility - that is a given when quite literally your life (in the form of your innards) is for multiple hours in the hands of a surgeon. We learn about the incontestable power of positivity. We learn about the boundaries of medicine and the central role of self-healing. We learn about the perils of certainty, and the corresponding importance of flexibility and agile modification of behavior and/or treatment. We learn about the often neglected importance of hydration. We learn about what truly makes us, and those around us, tick.

Now don't get me wrong. There are other ways to get smarter, all of them less painful, less intrusive, and less detrimental and disruptive to the routine of yourself and your family. But that does not detract from this one, enduring truth: What Doesn't Kill You - really, truly madly, deeply...take it from me - Leaves You Smarter.

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