Close your eyes for a moment and allow yourself to feel the reality that one day you will die. What changes should you make to your life, knowing it is finite? Maybe contemplating your mortality serves as a reminder to stop sweating about the small stuff. Maybe it can push you to do the terrifying thing you have wanted to do for too long: quit your job, buy that plane ticket, try for a baby. Maybe it is a reason to pick up your phone to tell someone that you love them, or that you’re sorry, or that you forgive them.
The secret to living life well is that nothing is a secret at all. Most people share similar ideas about what matters in life, but the problem is that we’re not very good at acting on our knowledge. You can read these sentences and resolve to do better at keeping your life in proper perspective, and five minutes later your entire day can be ruined because you spilled soup down your favourite top, or a close friend said something insensitive.
The hope, especially among people in the storytelling business, is that if you can package life wisdom into compelling enough stories, these stories might help people change. As an intensive care doctor, Matt Morgan is witness to many life-changing stories. His is a useful vantage point, because a routine day’s work for him is frequently the most important day of his patients’ lives, a time when many are forced to take stock. In the ICU, patients are so sick that around a fifth will die despite doctors’ best efforts. Some of his patients medically die – their breathing and hearts stop – and yet are resuscitated and given a second chance at life. They sometimes return from death with stories of having seen their life flash before their eyes (the sudden surge in brain activity witnessed in dying patients provides some scientific evidence for the near-death-experience cliché), or report feeling reassured to know that dying feels just like falling asleep. These patients, who have cheated death, are the inspiration for his new book, A Second Act.
“We have two lives,” Morgan writes. “The second begins when you realise you have one.” A Second Act is structured around the stories of ten people who suffered cardiac arrest and survived, among them a teenager struck by lightning, a new father who falls gravely ill with Covid, a mountaineer who freezes to death in the Dolomites, and a young woman who survived a suicide attempt. In each chapter, Morgan promises to share the survivors’ hard-earned life lessons. “Compared with business gurus or social media influencers, it is these patients who survive their unscheduled meeting with death who are the people we really should be listening to,” he writes.
Remarkably, some of his case studies return from death physically unscathed, while others are less lucky. Rhys, a rugby player who received a blow to his chest that caused such extensive heart damage that he was fitted with a temporary artificial heart, has been stuck on the transplant waiting list for years. He went from being a professional athlete to being virtually bedbound. And yet he, like many other survivors in Morgan’s book, says that almost dying changed him so profoundly that he wouldn’t have altered his circumstances for the world. Had he not died, he would not have got sober, he tells Morgan.
A Second Act has a neat narrative structure and covers a resonant subject, and Morgan is a thoughtful and sensitive writer. But given the importance he places on listening to these death-defying patients, it is disappointing we don’t hear more from them directly. In some instances, such as the story of a man who drowns after being swept into the sea while fishing, we barely hear from the survivor at all. In other chapters, the survivors are given such broad-brush treatment that the decisions they make in their second act are not easy to make sense of. Luca, a pharmacist and the new father who survives dying from Covid, tells Morgan that before Covid “he was a passenger on a train of his own life” but now he wants to climb in and inhabit it fully. He determines that “the most important job I have is working on me” and begins reading a lot of self-help books. I wanted to understand better why this man had previously felt so disconnected from his life, a life that on paper, at least, seemed happy and fulfilled. As someone who reads quite a lot of self-help, and also believes around 90 per cent of self-help books could be transmitted just as effectively via a single Post-it note, I can’t shake the feeling that the best way to be present in your life is to get your nose out of the books and just live it. But maybe Luca, had he been given more space, would have put me to rights.
In other chapters, the trajectories of Morgan’s patients’ second lives follow a more familiar, redemptive arc: a man who beats his drug addiction sets up a basketball team at his former rehab centre; the woman who survives suicide becomes a mental health nurse; the lightning-strike survivor who received too little bereavement support trains to support other bereaved young people. If only the reader felt they knew these plucky survivors better, their stories might have had greater power.
The person we get to know best is Morgan, who interweaves his patients’ stories with his own, and shares insights from his career and his own reading. There are many interesting asides on various aspects of medicine: Roald Dahl’s contribution to neurosurgery and stroke rehabilitation, for instance, or how Tetris became a mental health tool. But when it comes to expert advice on living well, Morgan seems to draw from a relatively narrow and extremely male pool of thinkers. The writer Oliver Burkeman appears twice, as does the late Oxford philosopher Derek Parfit. Morgan writes of Parfit’s concept of moral luck, which highlights how much of our identity and moral decisions are shaped by factors beyond our control. The drunk driver who kills someone is treated very differently to the drunk driver who makes it home without incident, for example, which Morgan very sagely argues is a reason to be more compassionate and less judgemental of others, to stop viewing people as their worst mistake.
He also writes of how Parfit viewed psychological continuity as key to selfhood: you are not literally the same person you were ten years ago, but you do retain an unbroken psychological link to that person – past you is a different person and still you. Morgan writes that for some people, grappling with the harm they did to themselves and others in their first life, this can be a helpful reminder that you needn’t let your past define you. This is certainly true, but it’s striking that what happens to some patients in the ICU might challenge Parfit’s views on selfhood. A patient with severe dementia or major brain damage may lose this psychological continuity, but does their selfhood endure? Morgan’s outlook is unfailingly compassionate and humane, but the book would have been richer – perhaps more unexpected and challenging – had he mined a wider variety of sources and been more willing to embrace contradiction and complexity.
In the final chapter, Morgan tries to get as close as he can to his patients’ experience of surviving death, with all the clarity and renewed purpose that can bring, by holding his own funeral. My knee-jerk reaction was that Morgan might have found the only ceremony more narcissistic than self-marriage. But, in fact, he hosts a joint funeral with a group of friends, and the weekend-long ceremony sounds much more an act of friendship than of self-love. Each participant has asked their family members to write a eulogy for them, and the friends read these out to one another, no doubt an incredibly moving and life-affirming experience. Even so, surely the worst part about missing your own funeral isn’t that you miss out on all your friends and family standing around tearfully talking about how great you are (that’s the hope, at least), but that you don’t get to say any nice things to them in return. Were I to hold my own funeral, I’d do so in secret, and it would be an elaborate, multi-day affair that involves meeting those I care about to tell them how much they mean to me.
As I have written about previously in this magazine, my best friend survived dying almost eight years ago when her heart suddenly stopped while she was on a 10k run. Her response to dying was very different to those Morgan interviews. “There’s no point surviving if you’re just going to live your life framed by the fact you nearly died,” she told me, and she said that while in the immediate aftermath she felt she had gained a new sense of perspective, very soon everyday life took over and she was back to stressing about the same things she always had.
Her comment reminded me of a study from the 1970s, that Morgan also refers to, which compared the happiness levels of people who win the lottery and those who are paralysed in accidents. It found that neither affects people’s happiness as much as you’d imagine, as people grow habituated to their new circumstance. It’s a sign, Morgan writes, that our happiness is shaped less by the events of our life than how we respond to them, and evidence that we are more resilient that we think.
The other way to think about these findings is that we are creatures of the everyday, and happiness – a fleeting emotion – is shaped by the small things: the taste of your morning coffee, the song on the radio, that minor victory at work. Sometimes life events force you to confront your mortality, and when they don’t, we should all make time to peer occasionally into the abyss anyway. Reading A Second Act is one way to do that, and it contains a lot of wisdom. But reflecting on this book I wanted to add a complication to its conclusions. Could it be that the mechanisms that make us bad at learning to live well until it’s too late – our myopia and tendency to get distracted from our purpose, the parts of our brain that allow a soup stain to spoil an otherwise blessed day – are the same ones that help us endure life’s inevitable tragedies? What if sometimes sweating the small stuff isn’t just a privilege, but a way to survive?
A Second Act
Matt Morgan
Simon & Schuster, 272pp, £20
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[See also: The truth about the grooming scandal]
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This article appears in the 08 Jan 2025 issue of the New Statesman, The Great Power Gap