I have sometimes been wildly, despairingly, acutely miserable, but through it all I still know quite certainly that just to be alive is a grand thing.

The speaker acknowledges episodes of intense depression—“wildly, despairingly, acutely miserable”—yet asserts a steadier conviction beneath those moods: that existence itself retains value. The force of the line comes from its refusal to romanticize suffering; it admits misery as real and acute, then pivots to a hard-won gratitude that is not dependent on comfort or success. Read as a statement of resilience, it suggests that meaning can persist even when emotions collapse, and that the simple fact of being alive can be experienced as “grand” despite (not because of) pain. The contrast between despair and certainty gives the sentiment its authority.