Well, then of course, came the disaster in 1975, when my wife and my youngest daughter were flying into the Nepal hills where I was building a hospital and their plane crashed and they were killed. And this certainly, for me, was an absolute disaster, really because the two people that meant most to me in life had been killed in one fell swoop. It did take me quite a number of years to get over it. I found the only way to deal with it was to carry on very energetically, doing the things that we had all been doing together, which was largely building schools and things for the mountain people. Although, people used to say to me, “Time is the great healer,” certainly for the first two years I simply didn’t accept this. But, time was a great healer and after the years passed, the memories still remain. But, I think quite a lot of the pain tends to fade a little bit, and life did become a little bit easier.

everyone saw me as a victim of a terrible illness. But what happened to my body was far less frightening than what happened to my soul. The stroke wiped out my faith. It took me so far from my guru that I felt my oxygen cord had been cut. ... I couldn't put the two together. Then I thought, maybe the stroke is a form of grace, and I hunted for that: how could the stroke be seen as grace? ... The stroke was giving me lessons, advanced lessons. ... It brought me into my soul, and that's grace.

To so many people, I am no longer just myself. I am a reminder of a thought that is difficult for the rational brain to accept: that the elements that constitute our bodies might fail at any moment. When I originally got my diagnosis at age 35, all I could think to say was, “But I have a son.” It was the best argument I had. I can’t end. This world can’t end. It had just begun. A tragedy is like a fault line. A life is split into a before and an after, and most of the time, the before was better.

I had two options. One was to remain silent and wait to be killed. And the second was to speak up and then be killed. I chose the second one. I decided to speak up.

So maybe I don’t try to figure it out. Maybe I just aim to get the couch right: strong bones, high-quality leather, something earthy and animal and real. A surface that knows something of what it was to be alive, that warms to our touch and cools in our absence. Also: an expansive bench that fits all of us. Something that will hold us through everything that lies ahead — the loving, collapsing and nuzzling. The dying, the grieving.

But in the weeks after I learned that the breast cancer I have been in treatment for over the past year had spread to my bones — breaking my spine and becoming incurable and most likely fatal — finding the perfect living-room couch has begun to feel like the most important thing I’ve ever done.

None of this was supposed to happen. At 38, I wasn’t supposed to lie on my back in the E.R. on a late December morning and be told by a teary radiation oncology resident that the pain I’d been having for two months — that I’d been assured was from having a weak core after months of chemo — was actually from a tumor that had devoured my L2 vertebra. John wasn’t supposed to have to hold me up on the toilet. Put my pants on for me. Do Christmas Eve for the children without me. I’m not supposed to be thinking about where he will sit and hold my hand as I take my last breath.