From the Editors

Commentary on the Freedom of Chronic Illness
Brian Eckert
Union Spring
02/11/2026

A critical illness is like a great permission, an authorization or absolving.
It’s all right for a threatened man to be romantic, even crazy, if he feels like it.
All your life you think you have to hold back your craziness,
but when you’re sick you can let it out in all its garish colors.
–Anatole Broyard, Intoxicated By My Illness (23)

It seems to me that every seriously ill person needs to develop a style for his illness.
 –Anatole Broyard, Intoxicated By My Illness (25)

I died.
 -D. W. Winnicott
(British psychoanalyst, from an unfinished autobiography) (29)

Chronic illness comes in many forms and affects many people, likely people close to you, and there’s a good chance that you don’t know about it in some of them. This is not a condemnation, but rather, a call to awareness, and reflection on my own experiences with chronic illnesses, including recurring leukemia, mental health problems, and a wide variety of lingering sports injuries. Chronic or even terminal illnesses do not have to be sad, depressing, quiet times. As Dr. Oliver Sacks points out in the Introduction to Intoxicated By My Illness, Broyard seemed to gain energy as he got closer and closer to death—he wrote in his journals up until his last two days (xii). While Broyard’s writings and this essay focus on chronic illness and ways to live with and overcome the challenges it provides, it can be applied to healthy lives. In my brief windows of health, I often think back to my time in the hospital, and the intimate time I’ve spent with death, and it makes me appreciate even the most mundane things—fresh air and sunshine, the autonomy to move around without an IV, real food and good coffee, and I’m content.

There’s also a great deal of seemingly additional freedom and permission that comes along with chronic illness. It certainly helps that I was ‘crazy’ before being diagnosed with cancer, but I certainly resonate with what Broyard wrote. Chronic illness is the ultimate inhibition-inhibitor because it can work in so many capacities. I often think of cancer as a “Get Out of Jail Free” card (although I wouldn’t try it with a real jail) because it’s an unquestionable excuse. “Want to hang out tonight?” “No, I’m not feeling great from chemo.” “Did you finish that assignment?” “No, I had some bad side effects over the weekend.” “Can you help me move?” “No, I have cancer.” But chronic illness can work as a positive excuse in many instances too.

The freedom and inhibitions are in part, and in my experience, an extension of this ultimate, trump-card in the back pocket feeling because the lack of consequences encourages more experimentation, more willingness to fail, because failure is a much less impactful blow when death sits waiting around the corner. A major factor in the growth of AI chatbots is our very human fear of or aversion to failure. Why would I want to sit and struggle with homework when ChatGPT will do it for me in 30 seconds? Why risk failure? When that fear of failure and aversion to struggle disappear, we can become our most uninhibited selves.

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There’s a country song by Tim McGraw titled “Live Like You Were Dying” and he talks about “skydiving / Rocky Mountain climbing” as well as bull riding on “a bull named Fu Manchu” and fishing—“I went three times that year I lost my dad.” This line is an echo of Broyard’s message: don’t wait until death has come and gone to start to “live like you were dying,” to “let [life] out in all its garish colors.” Broyard references an unfinished autobiography by a British psychoanalyst, D. W. Winnicott, that begins “I died” and it works up and out from there. Within this autobiography, Winnicott is writing about his death in the past tense, considering the events to take place upon or after the occasion of his death. This exercise, if you can call it that, catalyzes the development of the uninhibitedness that Broyard talks about. Out-living your own death provides that permission to “live like you were dying,” that typically only comes when you’re actually dying. This is one inherent problem with Broyard’s arguments and my own—is it possible to achieve this sort of uninhibitedness without a near death experience, or out-living your own death, or being diagnosed with a chronic/terminal illness?

My biggest fear about this whole problem, or situation, or phenomenon, is that I don’t know if it’s achievable second-hand. I remember hearing Tim McGraw’s song and many other similar refrains while growing up, but I don’t think I ever fully lived and felt their meaning until after I beat cancer the first time. Leading up to my first cancer diagnosis in June 2019 at age 22, I spent the second half of May driving around Utah and Colorado hiking and camping with my best friend. We had an incredible trip that we still talk about frequently, but I’m not sure if I had the same kind of uninhibited attitude that I’ve developed post-cancer. The goal of the trip was to take advantage of our unique, and fleeting, collegiate freedom of little-to no responsibilities in May aside from moving our stuff into a new apartment, which we were able to do early. And we achieved that goal—we visited most of the major National Parks in those two states, as well as countless other unique geologic features. At this point, I’ve had too much chemo and smoked way too much weed to remember exactly how I felt during those two weeks, but I definitely experienced a lot of anxiety on that trip. And I certainly wasn’t “living like I was dying,” although that was loosely the ethos behind the trip.

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In the years after my first battle with cancer, I did make a lot of changes. I started exercising more and trying to eat better. I worked on developing healthier lifestyle habits and building better, healthier relationships. This wasn’t necessarily for longevity, but for the present. I had effectively outlived my own death as Broyard recommends, and here I was with a second chance, or as I like to think of it: a Dionysian rebirth. Coming out of chemotherapy around the same time that Covid restrictions were loosening made me feel like an entirely new person, and that’s the feeling I don’t remember having out in Utah. I certainly felt a sense of freedom and adventure, but the significant difference was the lack of relief, the exhale of overcoming, the smooth come down from a tumultuous high. Surviving my own death was a relief more than anything, and I believe this is the distinction Broyard is making, and potentially experienced second-hand when his father died while Broyard was still in his 20s.

“You don’t really know you’re ill until the doctor tells you so. When he tells you you’re ill, this is not the same as giving you permission to be ill. You eke out your illness. You’ll always be an amateur in your illness. Only you will love it. The knowledge that you’re ill is one of the momentous experiences in life. You expect that you’re going to go on forever, that you’re immortal. Freud said that every man is convinced of his own immortality. I certainly was. I had dawdled through life up to that point, and when the doctor told me I was ill it was like an immense electric shock. I felt galvanized. I was a new person. All of my old trivial selves fell away, and I was reduced to essence. I began to look around me with new eyes, and the first thing I looked at was my doctor.”

Broyard continues on to make a point about the patient-doctor relationship, and his ideal doctor, but this section provides an example of how Broyard wants his readers to be in and observe the world. The phenomenon and awareness of illness catalyzes the performance of illness. In one sense, illness provides the permission for the individual to be sick, but the doctor provides the diagnosis to instruct the patient on how to perform their ‘sick’ role. The diagnosis and awareness of the illness should be “an immense electric shock,” to wake the patient into a new world of sensation and experience.

The experience of illness, especially chronic illnesses, can be similar to Edmund Husserl’s repeated description of his writing table. Illness may seem to be the same thing every single day, painfully monotonous, the epitome of mundane, but perspective can change everything, as Husserl shows through his example of the writing desk. A renewed focus, or even just an intentionally tightened focus, can make the world seem like an entirely new place. This can be the “electric shock” of death that Broyard talks about, although I don’t think the shock must be a near death experience, but I also can’t think of many examples that aren’t near death experiences that would have the metaphysical force to change a person’s perspective.

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In the weeks leading up to my bone marrow transplant, which requires at least three months away from my apartment, and one month in a quarantine ward at the hospital, I started to pay more and more attention to my surroundings. I used to take the same walk in the same park almost every day, sometimes twice a day. Both of my classes meet in the same room, at the same time, on Monday and Tuesday respectively, so I was repeating the same activities pretty much every day, or multiple times each week. But in my last week before the transplant, I started watching the sunrise and sunset every day, and Spring was starting to pick up (as of writing this on February 28th), so I got to see a few daffodils and leaf-buds on the trees before my month-long hospital stay. Yet, all I’ve thought about since I’ve been in the hospital is whether or not I would have noticed those things if I didn’t have such a high chance of death. I think about the fact that those could be the last daffodils that I ever see, the last pink clouds at sunset, my last breath of unfiltered, fresh Ozark air. Would I have even noticed if I wasn’t dying?

In a sense, living with recurring leukemia has been a blessing because every few years, for the last few years at least, I get the news that I’m sick, “the Big C” is back again. But each time I have out-lived my own death again, and I get that surge of awareness that Broyard writes about, that “galvanization” and “an immense electric shock” that makes me appreciate life and all the overlooked, seemingly mundane details. I still have as many questions as answers when it comes to death, dying, and near-death experiences, but I know that proximity to death is the only guaranteed way to turn up the perceptual volume of experience. So hurry up and outlive your own death, if you want to finally start living.

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BRIAN ECKERT is a PhD candidate in English at the University of Arkansas at Fayetteville. He has been a bartender, farm hand, fry cook, landscaper, and substitute teacher. Brian was born and raised in rural Indiana before attending Case Western Reserve University in Cleveland, Ohio. In 2019, Brian was diagnosed with leukemia and spent several years undergoing intensive chemotherapy treatments, while also completing undergrad, and then starting and finishing a Master’s of Liberal Arts degree at Johns Hopkins University in May of 2022. He lives in Fayetteville and enjoys driving through the mountains and visiting every used bookstore.