We’re born into our bodies, and we take that for granted.

Our first job is to take a breath, something we’ll hopefully do many millions of times and never think about.  That first breath changes everything: Our blood starts to flow through our heart and lungs in a different way and for the first time we taste a new world.

Before we’re born, all our needs are met via an artery and a vein.  It’s how we get our oxygen, our nutrients, our means of fighting infection.  When that connection is lost,  we start to depend our own body to notify us when we need something.  If we’re fortunate, there’s someone nearby to respond, to feed us, to clean us.

Sometimes that need is simply to be held, a combination of touch and movement and hearing a larger heart beating, and we learn to assemble those things into love.  Messages from our body, delivered to our brain and becoming the most important emotion we’ll ever experience.  A reassurance that what we need will continue to arrive, that we will be able to grow and thrive and remain.

Anyone who attempts to distill these things down to science, to a cascade of synaptic firing and neurotransmitter release can never have held their own child during the moments of those that first breath, that first cry, after making it through all that pain and fear and blood and  felt the flood of relief carried on that mighty shriek. The first of hundreds of millions of breaths to come.  Much more than physiology and catalytic enzymes.

Our bodies are astoundingly complex assemblies whose chemistry we’ve only begun to understand, physical substance that is driven and maintained by emotions that become so intertwined as our bodies and minds develop, that we cease to understand them as distinct things.  We discourse about the physical self and the emotional self as if they’re separate, but they’re not.  Each is made of the other.  They are undissectable.

When we’re young, our bodies are our deliverance.  Uncontainable energy, flexible and cartilaginous and healable.  Limited only by the height of the countertop and too many syllables.  Sometimes our bodies report pain, but it’s usually the byproduct of growth spurt or exertion.  Sometimes it’s a bone knitting back together or a scar forming.

As we age, we calcify.  Our thoughts and legs less prone to frenzy and sometimes harder to compel.  We creak and pop and sometimes forget.

Sometimes we discover a new character of pain.

I had a patient who was diagnosed with stage IV lung cancer, found when she came to the hospital for weakness in her legs.  It was in her lungs, her bones, her spine, her brain.

The body she had come to trust, to recognize as herself, the place she depended on, now an enemy. Now she was confined in a small space with a fast, destructive thing whose motives were unknowable.  Her cancer all but ignored our medicines, and her back pain and headaches became the landscape on which all other things were placed.  Nothing was just one thing anymore.  Hunger and eating both meant pain.  Eventually her ribs hurt so much that the previously effortless act of taking a breath was restricted as if tied by wire:  the memory of deep lungs unable to be satisfied by her short, stabbing attempts.  Her physical home, invaded and traitorous.  Her mind, however, remained without self-pity or resentment.

My colleagues in palliative care were able to give her the only thing she needed then: A reprieve from the relentless transformation of her physiology into the source of her greatest pain.  She passed away comfortably in her home attended by hospice nurses.

She and others have taught me that there’s a part of us that’s unafflictable.

There’s a thing in us that cannot suffer disease, or degenerate, or know pain.  Objectively, I don’t know what a spirit or a soul truly are, but I can say with some hope that I don’t think our bodies are our limit.  When our physical self transforms into something malevolent, we remain something else: a thing that is capable of dignity and strength even when our ability to raise our head is taken away.   This thing opens our eyes when we first join the world, and squeezes our lungs to project that first high-pitched roar in the delivery room.

It’s the thing that drives our first breath.

It remains after our last.

Kenneth D. Bishop is a hematology-oncology fellow who blogs at Out Living.