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Noted songwriters Jerry Leiber and Mike Stoller wrote a song in the 1960s that has captivated me ever since. Although several singers recorded "Is That All There Is?" before her, Peggy Lee's recording in 1969 made the song famous, and that is the version that hooked me.

JOSEPH V. SIMONE, MD... - Click to enlarge in new windowJOSEPH V. SIMONE, MD, has had leadership roles at St. Jude Children's Research Hospital, Huntsman Cancer Institute, Memorial Sloan-Kettering Cancer Center, the University of Florida Shands Cancer Center, the National Comprehensive Cancer Network, and the National Cancer Policy Board, and has served on the NCI's Board of Scientific Advisors. He welcomes comments and suggestions for future topics for his column. E-mail him

I learned recently that many of the lyrics were taken verbatim from a story written by Thomas Mann in 1896 entitled "Disillusionment" (Enttauschung). A major difference between the story and the song is that the narrator in Mann's story finally has a sense of hope when he sees the sea for the first time. The story and the lyrics are existentialist. Simply put (maybe too simply), bad things happen for no good reason; ultimately we are alone in our joy and sadness, in life and in death; accept that and quit whining.


So why does an old pediatrician remain hooked by a song of disillusionment for over 40 years? I have had a successful career; I cared for children with cancer for over 30 years and loved it; I have a happy, healthy, and loving family; I have had the privilege of being a leader in prestigious institutions; and I am happily semi-retired. So I am not sure I know why such a song and message has stayed with me. But I suspect it has something to do with my medical career, so let me give it a try.


The lyrics are too lengthy to reproduce for this column, so here is a summary gathered from several sources, followed by selected lyrics.


The lyrics are written from the point of view of a person who is disillusioned with events in life that are supposedly unique experiences. The singer tells of witnessing her family's house on fire when she was a little girl, seeing the circus, and falling in love for the first time. After each recital she expresses her disappointment in the experience. She suggests that we "break out the booze and have a ball-if that's all there is," instead of worrying about life. At the end she explains that she'll never kill herself either, because she knows that death will be a disappointment as well.


I remember when I was a very little girl, our house caught on fire.


I'll never forget the look on my father's face as he gathered me up


in his arms and raced through the burning building out to the pavement.


I stood there shivering in my pajamas and watched the whole world go up in flames.


And when it was all over I said to myself, "Is that all there is to a fire?"


Is that all there is, is that all there is


If that's all there is my friends, then let's keep dancing


Let's break out the booze and have a ball


If that's all there is


Then I fell in love, with the most wonderful boy in the world.


We would take long walks by the river or just sit for hours gazing into each other's eyes.


We were so very much in love.


Then one day, he went away. And I thought I'd die - but I didn't.


And when I didn't I said to myself, "Is that all there is to love?"


Is that all there is, is that all there is


If that's all there is my friends, then let's keep dancing


I know what you must be saying to yourselves.


If that's the way she feels about it why doesn't she just end it all?


Oh, no. Not me. I'm in no hurry for that final disappointment.


For I know just as well as I'm standing here talking to you,


when that final moment comes and I'm breathing my last breath, I'll be saying to myself,


Listening to Peggy Lee sing it is quite a different experience than reading the lyrics. She plays her role well: her demeanor is not self-pitying or morose, but rather, nakedly direct with the sad, hard facts of her life and her attempts to understand and deal with it.

Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

The person in Mann's story found hope against the odds, despite a long trail of sorrow and disappointment. The song, and Lee's exposition of it, leaves no room for hope, not even the hope for death to end her misery. This is not just hopelessness; it is despair.


I first heard the song in my early years at St. Jude, the '60s and '70s. At first it puzzled me because it was so extremely different from the popular songs of that day, which was a transition period from crooners to Elvis and Rock and Roll. Even the most whiskey-soaked country song did not go so deep into dark philosophy. I asked my self, "What does she mean? Why is she so negative and sad? Is she just clinically depressed?" And, the key question, "Am I missing something?"


It was years later that I began to have some insight into the song and why it affected me. I had started taking care of children with cancer in 1963 when I began my fellowship. The mortality among my patients over the next decade was extremely high. Like many of us, I was searching for meaning in this carnage. I read many books about death and dying written by psychologists, physicians, philosophers, and theologians. It didn't help much (in retrospect, that should not have been surprising).


And at some point I thought, maybe she is right. Seeing all the families suffer and their beloved children suffer and die doesn't make sense; maybe our hope is in vain. In those days many pediatric oncologists left the specialty and became radiologists, radiotherapists, and dermatologists, and one of my colleagues even became a neonatologist. But for those of us deeply involved in searching for better treatment, it would be almost impossible to do the work without at least some hope.


Then, in the early- and mid-'70s we struck gold, we had developed some fairly effective therapy for childhood leukemia. Fellows were beating down the door to work with us because the optimism was contagious and exciting. And the progress has continued until this day.


I learned several things from this 40+-year experience: Without hope, life can seem meaningless, which is why despair is viewed as a sin, an offense against God, in some religions. For most who practice medicine, there is a steady growth of hope balanced with science, and humility balanced with confidence. And most important, an unusual artistic work can make a deep and lasting impression, as Peggy Lee's recording has for me, by becoming a mirror to look inside and examine oneself.