Neil was forty-six when it was discovered that there was a malformation in his brain. Although
this was, on the face of it, terrible news, sometimes terrible news presented
at the right time becomes good news. Sometimes it doesn’t. It wasn’t quite clear yet what this was.
The malformation was discovered after Neil had a seizure while at work. He was a professor of
philosophy at New York University. While teaching his course Pessimism, Despair,
and Hope, suddenly, his head tilted up and to the side, his eyes rolled back,
his mouth opened like it was being pulled by a string, and then he collapsed backwards.
The good news was this didn’t kill him, and it allowed the arteriovenous malformation in his
brain to be discovered before it did. At the hospital, the doctors were able embolize the
brain hemorrhage that had caused the seizure, which occurred because of the malformation. The
embolization filled the abnormal connections between his arteries and veins and prevented
oxygenated blood from circulating throughout his brain. Even better news, the malformation
was located close enough to Neil’s skull where it could be accessed and removed completely.
But there was a big catch. The malformation was located in Neil’s frontal lobe—the area of the
brain responsible for things like the way you think, problem solve, and engage with language.
And so, one of the consequences of removing this piece of his brain was that it would likely affect
his ability to think abstractly—to reason, assess, and comprehend theoretical and complex ideas. Of
course, this was a central requirement for his work as a philosopher and a fundamental part
of his identity. He could, of course, choose to not have the surgery and continue on as he was.
But without the surgery, Neil risked having another brain hemorrhage that could kill him.
Neil had dedicated nearly his whole life to philosophy. Starting as a young boy,
he spent much of his time reading and engaging in philosophical questions. This was, at least
partly, motivated by his circumstances at the time. At just eight years old, he experienced
the intensity of death and loss as he watched his older brother pass away from acute myeloid
leukemia. This left Neil an only child. Not long after, his parents divorced. Some fair-weather
marriages only become apparent when the first, real storm hits. Neil’s father was a hotel
consultant who traveled and moved around a lot, often bringing Neil with him. Between the early
death of his brother, the ending of his parents’ marriage, the isolation inherent to traveling
and moving around as an only child, and the widespread exposure to many different cultures,
places, and aspects of humanity—particularly the problems and suffering that pervade it—all
compelled Neil more and more toward philosophy, toward seeking answers and understandings.
Throughout adolescence, Neil particularly found himself compelled toward philosophical pessimism.
He would study and read the works of philosophers like Fyodor Dostoevsky,
Arthur Schopenhauer, Lev Shestov, Emil Ciroan, Peter Wessel Zapffe, and many others.
In adulthood, he would become a professor of philosophy at several major universities
and author six books, a couple of which became successful both in and outside of the intellectual
community. He quickly became a well-respected writer and philosopher, particularly renowned
for his dark, nihilistic, yet beautiful writing style. Neil’s work often challenged accepted and
acceptable viewpoints of humanity and existence. It viscerally embodied the feelings of alienation,
bleakness, and absurdity, often both destroying and repairing the reader with the same line. It
wasn’t that Neil wanted to be pessimistic. He just wanted and needed to be honest and
well-defined—with himself as well as the world. And in doing so, he simply found himself with
this sort of pessimistic view and sensibility. The desire was truth and honesty at any cost—not
bleakness or pessimism. But truth and honesty at any cost includes bleakness and pessimism.
Now, Neil was left with the following two options: undergo the surgery and likely no longer be able
to meaningfully engage in philosophy, or not undergo the surgery and risk dying from another
brain hemorrhage. It wasn’t quite that simple, of course. The odds of experiencing another
brain hemorrhage that could kill him were around 60%. The odds of the surgery killing him were
around 10%. So there were still some elements of convolutedness just in terms of survival. Also,
it wasn’t as if the surgery was going to make him feel or seem like a dramatically different
person. The doctors believed that because of the location and condition of the malformation,
it would most likely just affect his abstract thinking, reasoning,
and comprehension of complex concepts. For many, this choice would be obvious. For Neil, it wasn’t.
For his girlfriend, Maya, however, it was. “The surgery. You have to get the surgery.
Is this seriously even a question?!” she said to Neil while they sat on the
couch after returning home from the hospital. Neil just sat there, rubbing his chin. His eyes
bounced back and forth to her off the floor. “I don’t know. I have to think,” Neil said.
“Think?! That’s your problem! You intellectualize everything, and now you’re considering letting
yourself die over the prospect of not being able to intellectualize everything? You’ve spent
your whole life asking questions and thinking abstractly about everything. But what has the
gotten you? Are you better off than before you started, or if you never had at all? Have you
found anything other than answers you either can’t know or would have been better off not knowing?”
“Depends on what you mean by better off,” Neil answered.
“See. That’s what I mean. Everything doesn’t need to be so complicated.”
“But everything is,” Neil interjected. “Everything is what you see it as. Maybe having a
chance to see life without it always having to be condensed into precise reasons or abstracted into
some theory won’t be such a bad thing.” Neil sat silently, staring forward,
thinking. Maya began to cry. A couple days went by. One of
Neil’s close friends and colleagues, George, who was also a professor of philosophy at NYU,
stopped by Neil’s house to see how he was doing. Almost to a fault, George was an extremely
straight-forward, no-bullshit kind of guy, much like Neil. At some point in their conversation,
after explaining everything, Neil asked George for his thoughts about the situation.
“Well, wouldn’t you be dead anyway … if you got the surgery, and it took from you what
makes you who you are?” George said. “How could you give up the ability to think and understand
the truth of things the same way you always have, to be able to question things with that
level of granularity you’ve dedicated your life to, to potentially not even care about
contemplating things? It's like returning to the starting point of philosophy and not even
choosing to pick up the first book. It’s like trading everything you’ve worked for,
a deep understanding of existence, for ignorance. Is that what you want?” George concluded.
Neil nodded at George as he exhaled with his lips clenched. That was something he probably would’ve
told someone else in his position, but actually being in a position is a lot different than
telling someone what you would do if you were. Around a week later, Neil’s father came to visit
him—a very stoic, pragmatic individual. At some point in their conversation, after explaining
everything, Neil asked him for his thoughts. “Hmm,” his father said. “I’ve always respected
what you do. You know that. But I’ve never fully understood it, to be honest. I’ve
lived my whole life without asking any of these sorts of, what do you call them,
metaphysical questions. And I’ve been fine. You know what they say right? Ignorance is bliss.”
Neil looked at his father. His eyes seemed to widen a bit as he did.
“But,” his father continued, “at the same time, there are things in my life that I
would sacrifice bliss for, that I wouldn’t want to live without. I guess you have to ask yourself,
what’s that for you? Is philosophy more dangerous than it’s worth here? Or is it worth the risk?”
Neil spent the rest of the week thinking, back and forth, back and forth, back and forth.
The next Monday, he had a follow-up appointment with the neurologist.
He sat across from them in their office, looking down.
“So,” the doctor said, “have we decided? Are we moving forward with the surgery?”
Neil looked up and breathed in deeply. “Yes, I’ve decided,” he said confidently.