52. When Breath Becomes Air
Rating: ☆☆☆☆☆
Recommended by:
Author: Paul Kalanithi
Genre: Non Fiction, Memoir
208 pages, published January 19, 2016
Reading Format: Audio Book
Summary
At the age of thirty-six, on the verge of completing a decade’s worth of training as a neurosurgeon, Paul Kalanithi was diagnosed with stage IV lung cancer. One day he was a doctor making a living treating the dying, and the next he was a patient struggling to live. Overnight, his imagined future was gone. When Breath Becomes Air, which includes a Foreword by Dr. Abraham Verghese and an Epilogue by Kalanithi’s wife Lucy, tells the story of Kalanithi’s transformation from a naïve medical student into a young neurosurgeon at Stanford, guiding patients toward a deeper understanding of death and illness, and finally into a patient and a new father to a baby girl, confronting his own mortality. Paul Kalanithi died in March 2015, while working on this book, yet his words live on as a guide and a gift to us all.
Quotes
“I began to realize that coming face to face with my own mortality, in a sense, had changed nothing and everything.”
“Will having a newborn distract from the time we have together?” she asked. “Don’t you think saying goodbye to your child will make your death more painful?” “Wouldn’t it be great if it did?” I said. Lucy and I both felt that life wasn’t about avoiding suffering.”
“Seven words from Samuel Beckett began to repeat in my head: ‘I can’t go on. I’ll go on.’”
“Years ago, it had occurred to me that Darwin and Nietzsche agreed on one thing: the defining characteristic of the organism is striving.”
“Yet the paradox is that scientific methodology is the product of human hands and thus cannot reach some permanent truth. We build scientific theories to organize and manipulate the world, to reduce phenomena into manageable units. Science is based on reproducibility and manufactured objectivity. As strong as that makes its ability to generate claims about matter and energy, it also makes scientific knowledge inapplicable to the existential, visceral nature of human life, which is unique and subjective and unpredictable. Science may provide the most useful way to organize empirical, reproducible data, but its power to do so is predicated on its inability to grasp the most central aspects of human life: hope, fear, love, hate, beauty, envy, honor, weakness, striving, suffering, virtue.”
“Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete.”
“Grand illnesses are supposed to be life-clarifying. Instead, I knew I was going to die—but I’d known that before. My state of knowledge was the same, but my ability to make lunch plans had been shot to hell. The way forward would seem obvious, if only I knew how many months or years I had left. Tell me three months, I’d spend time with family. Tell me one year, I’d write a book. Give me ten years, I’d get back to treating diseases. The truth that you live one day at a time didn’t help: What was I supposed to do with that day?”
“Everyone succumbs to finitude. I suspect I am not the only one who reaches this pluperfect state. Most ambitions are either achieved or abandoned; either way, they belong to the past. The future, instead of the ladder toward the goals of life, flattens out into a perpetual present. Money, status, all the vanities the preacher of Ecclesiastes described, hold so little interest: a chasing after wind, indeed.”
“The main message of Jesus, I believed, is that mercy trumps justice every time.”
“The physician’s duty is not to stave off death or return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence.”
“Don’t think I ever spent a minute of any day wondering why I did this work, or whether it was worth it. The call to protect life—and not merely life but another’s identity; it is perhaps not too much to say another’s soul—was obvious in its sacredness. Before operating on a patient’s brain, I realized, I must first understand his mind: his identity, his values, what makes his life worth living, and what devastation makes it reasonable to let that life end. The cost of my dedication to succeed was high, and the ineluctable failures brought me nearly unbearable guilt. Those burdens are what make medicine holy and wholly impossible: in taking up another’s cross, one must sometimes get crushed by the weight.”
“The tricky part of illness is that, as you go through it, your values are constantly changing. You try to figure out what matters to you, and then you keep figuring it out. It felt like someone had taken away my credit card and I was having to learn how to budget. You may decide you want to spend your time working as a neurosurgeon, but two months later, you may feel differently. Two months after that, you may want to learn to play the saxophone or devote yourself to the church. Death may be a one-time event, but living with terminal illness is a process.”
My Take
When Breath Becomes Air, a profoundly moving memoir, is one of only two books to receive five stars from me this year. While the first part, which details Kalanithi’s journey to become a neurosurgeon is fascinating, the second part, when he confronts his mortality, is heartbreakingly beautiful. Kalanithi explores the existential questions that we all must face. When Breath Becomes Air is an unforgettable, life-affirming reflection on the challenge of facing mortality and on the relationship between doctor and patient, from a gifted writer who became both.
