It's impressive to me that Jake managed to remain involved and communicative until so near the end. I withdraw into a personal shell when I get so much as a hang nail. Respect.
(He may have discussed it earlier on HN, I haven't gone through his history to check on this.)
Once he began, however, he continued to the bitter end. And yes that is commendable.
If a hang nail is bad enough to make you withdraw then that means you don't have a lot of experience of getting sick to the point where you had to push through as it hasn't happened a lot. Over the course of the 14 years I've had with my partner (started year 15 last month!) I've seen how she's had to adapt to remain involved and communicative - and a lot of days, that's a struggle for her that she puts herself through to stay connected to the people she loves.
tl;dr: It's an adaptation, and I'm glad that you've not had to build that adaptation.
Seinfeld asked something like 'How do you deal with constant annoyances, all the time, when you're president?'
And Obama replied 'I expect it's similar to what you do -- you fall in love with the work. Sure, sometimes it's painful, annoying, backwards, foolish, etc. But in the end you fall in love with the work, and it saves you.'
That defined purpose in a way I'd never thought about it, and probably undergirds every religion.
It also made me try to open my heart more to people dealing with chronic pain or mental health issues, in terms of their subjective effort. Objectively, it may look like they're just doing {normal thing}, but subjectively that may be requiring 10x or 100x effort from them. And that effort (the work) deserves its own respect, independent of outome.