I hope this article disturbs you. Thinking about bad outcomes is disturbing and we tend to avoid or deny dealing with the negative. Julia came in angry and depressed because her husband died of a heart attack. He’d had all the classic symptoms: Shortness of breath, chest pains and severe fatigue. Julia repeatedly insisted he see a doctor, and he refused, thinking it would pass. I empathized with him, because a year previously Marilyn, my wife, repeatedly said she didn’t like the way I looked and I refused to check it out. Finally, when I couldn’t walk up our stairs, I told her to drive me to the emergency room where I had a severe heart attack on the examining table. Dr. Peter Viccellio, the emergency room chief and a friend, later told me he was stunned that I fully recovered. I asked other men in the cardiac unit how they got there and, with one exception, they were all in denial. My roommate said he agreed to come to the hospital only “to show my wife how stupid she was.” Julia had to deal with the reality that it was tragically common that we avoid worse-case scenarios.

There are unpleasant realities of life. The biggest is that our life and the lives of people we love are finite. We all hang by a thin thread and as we get older or ill, the thread gets thinner. We have to deal with mortality. Recently, Dolores’ husband, who owned a business, went into a diabetic coma after denying classic symptoms. After talking about her feelings and those of the family, I asked if there was a worse-case plan if her husband was disabled or died. Was there a plan in the family for succession? Who would run the business? How would the assets be handled? I expected her to be stunned by these practical questions, but Dolores recognized the fragility of life and that issues can get significantly worse if ignored. Stories of bitter family disputes over undefined assets are unfortunately common. Just as engineers must build a building to tolerate hurricanes and torrential rains that may not occur, we should plan for negative events.

We have to consider the mortality of people around us. As a kid, I was terribly uncomfortable when my parents spoke of their mortality. My mother picked a prospective wife for my father if she died. I didn’t want to hear of it and my father laughed and said as I grew older I would be more accepting of death. He was right. (After he died, I told the woman, now in her 80s, the story. She was flattered.)

How many of us smoke, overeat, drink too much and/or drive recklessly, giving little or no thought to the fact that we are stretching that thin thread that holds our very lives? I watched my mother and brother die of lung cancer after years of smoking. I asked both why, given they knew the risks, they continued. Because of the effort required to quit, they distorted and enlarged their exemption from the risk. My sister-in-law, even after my brother died, continued to smoke until she was diagnosed with terminal lung cancer. Worse-case planning might have made the real effort of quitting worthwhile.

In my worse-case planning, I think of my death and that of people around me. I do not look at the reality of mortality as negative. In fact, to me, it gives urgency to life. It makes me reflect about what I want to get in while I can. It compels me to call ‘em the way I see ‘em, to be more open to both people and experiences. It prevents my postponing things I want to do. It makes the everyday chickenshit look like everyday chickenshit rather than big catastrophes. Knowing that life is finite makes me more cautious about stupid risks and more open to valuable experiences. The biggest tragedy is never living because we think we have infinite time.