In Chapter Ten, Cole realizes what it means to be alive... what does he realize that he needs to do in order to live?

In Chapter Ten, Cole realizes that is order to really live, he needs to find real meaning in his life.

In death there was no control, no anger, no one to blame, no choices, no nothing. To be alive was to have choice. The power to choose was real power, not the fake power of making others afraid. Cole knew he had used that fake power many times. All of his life he had squandered his choices, wallowing in revenge and self-pity, keeping himself down. Now, as he lay near death, those he had hated were safe and warm. Those he had blamed were still alive and well. He had hurt himself most. Life was empty and meaningless unless he found some meaning.