In the opening chapter of Outlive, Attia recounts a reoccurring dream he had while he was a surgical resident at Johns Hopkins Hospital 20 years ago. In the dream, Attia stands on a city sidewalk trying to catch eggs that are falling from the sky in a padded basket. While he does not know who is throwing the eggs or where they are coming from, he will not be able to catch all the eggs. Attia notes, “Emotions well up in my body as I realize that no matter how hard I try, I’ll never catch all the eggs. I feel overwhelmed, and helpless” (1). This dream kept Attia from getting much-needed sleep during his residency.

The dream also symbolized Attia’s “growing concern about cancer detection and care in the US. As a cancer surgeon in training, Attia helped perform dire surgeries, including removing tumors and other cancerous cells, which he likens to catching the eggs in his dream or helping someone live longer. However, many of these cancer patients still died from cancer. Thus, while they lived longer, they did not live better. This situation for Attia was the egg inevitably hitting the ground.