When he climbed the stage, I was startled at his appearance. Before me, ascending to the speaker's podium, was Irvin Yalom, the celebrated author and psychiatrist. I had been used to seeing his picture in his books as a vigorous man with a dashing Alpine hat and a strong, manly smile. Before me was an older man, almost stooped, age 77.

Publishers and authors have a way of never updating their book jacket photographs. The airbrushed picture is good publicity, no doubt. But the reality of aging and the fragile nature of life were there on full display for those of us seated in that audience.

In fact, that was essentially what Yalom talked about in his lecture.

For Yalom, we are creatures who build our lives around the denial of death. Even the strongest of us resist this ultimate fact.

Perhaps this element of our existence is especially frightening today, when so many live without faith in God or an afterlife and when noisy atheists (Richard Dawkins, Christopher Hitchens, Sam Harris & Co.) write best-selling books condemning religion as obsolete. Many of us can be said to be "post-religious" now.

But Irvin Yalom is not noisy, even if he is a non-believer. He spoke serenely, without rhetorical flourish. Sometimes, after a lifetime of experience, a short, simple book will do. Like his newest one, Staring at the Sun: Overcoming the Terror of Death. It reads like a soulful testament.

When Nietzche wept

Yalom has always been the most literate of psychiatrists. He has written novels, including the wonderfully titled When Nietzsche Wept. He has also written definitive textbooks in his field, including Existential Psychotherapy, published 28 years ago. Now, at a time when psychiatry is largely pill-popping pharmacology, how many shrinks would dare title their textbooks after a philosophic movement?

Like the great Sigmund Freud, Yalom is an atheist, even if he does resemble a wise rabbi. And like the French existentialists, Jean-Paul Sartre and Albert Camus, Yalom believes human beings construct their meanings for themselves. God is not part of the equation.

His is an honourable stance. But the thought of death is terrible even for those who believe in an immortal soul or afterlife. Imagine what it is like for those who believe our lives are like brief shooting stars that light up the sky and then fade into the blackness of nothing?

Death and therapy

The heroes of Yalom's book are his patients who bravely faced death when their time came. For years, he treated cancer patients and his book is filled with their stories. But eventually all us die (please forgive me this truism) and the prospect fills many with an anxiety that can't be dispelled by Prozac or Valium.

But the problem for therapists, says Yalom, is that they are often too terrified to bring up the subject with their patients. Therapists can go for years, discussing the most intimate details of their patients' sex lives. It is not sex that is repressed, but death.

Like many philosophers and artists throughout the ages, Yalom wants to breach this wall of silence, but as gently and firmly as he can.

Yalom's great model is the Greek philosopher Epicurus who was born shortly after the death of Plato, 341 years before Christ. As Yalom notes, Epicurean has come to mean "refined sensuous enjoyment," especially good food and drink. But that is not an accurate reading: Epicurus was more interested in the "attainment of tranquility," which is more the philosopher's way.

Speak memory

Like a good shrink, a philosopher's task is to relieve human suffering. And what is the root cause of human misery, Yalom asks? For Epicurus, calling out from the past, it was our "omnipresent fear of death." That has not changed in millennia.

Epicurus used philosophy to counter this terror of death. But unlike Socrates, who faced his end believing the soul was immortal, Epicurus had no such illusions. Most of us fear a state we will never experience. But when you're dead, Epicurus said, you don't know you're dead. You won't feel a thing.

Harsh, perhaps, but there is another argument with more grace and symmetry that the great expatriate Russian novelist Vladimir Nabokov gave us in his memoir, Speak, Memory. Yalom quotes his beautiful words: "Our existence is but a brief crack of light between two eternities of darkness."

Nabokov, like Epicurus, believed life is wedged between two states of non-being. You do not fear the time before our birth, do you? Of course not. So why be afraid of the time after death either?

Yalom admits he finds this insight personally comforting. For those not convinced by these philosophic sleights of hand, Epicurus supplies one more powerful argument: The idea of "rippling." This is Yalom's favourite and the one I find the most moving.

"Rippling refers to the fact that each us creates — often without conscious intent or knowledge —concentric circles of influence that may affect others for years, even for generations," writes Yalom.

The idea is that we all leave something behind, something we can't quite predict. It is not a matter of leaving your name gilded on a hospital wall or a monument. For Yalom, these vain attempts to preserve personal identity are futile. By all means, write books, endow scholarships. But in the end, the famous are as dead as the nameless.

Still, Yalom says, you can leave behind "something from your life experience, some trait; some piece of wisdom, guidance, virtue, comfort that passes onto others, known or unknown." The key here is human connection, which touches other lives in secret and untold ways.

The fear or nothingness

Yalom has seen this rippling effect at work in the lives of his patients. For years, he has had a patient named Barbara who was plagued by death anxiety. When her mother died, Barbara delivered a talk and a favourite phrase of her mother popped into her head: "Look for her among her friends."

At the funeral, Barbara could feel her mother's presence, her gentleness, her character, "ripple into her friends, who would pass the ripples on to their children and children's children." Barbara discovered the power philosophy can have when it comes alive in the presence of others.

Of course, you can ask yourself, is this just a sentimental ploy? Another sop against the fear of nothingness? What about those whose lives don't noticeably ripple into a loving community? People do die without friends, alone and miserable, in prisons and cyclones.

I have known people who will be missed by absolutely nobody. What rippling effect do they have?

Yalom realizes that the idea of rippling can be abstract. But, in the end, he believes one can gain comfort in thinking that one's atoms can ripple and dissolve into the universe. As scientists tell us, we breathe particles from Shakespeare, as well as from your ill-tempered, dead aunt.

After a lifetime of thoughtfulness, compassionate care and achievement, a good existentialist like Yalom is content to let his books and presence ripple into the universe. But take heart, he says. All of us ripple in ways we are not even aware of.