This doctor's memoir impacts this reader
I wept a little as I finished reading When Breath Becomes Air, written by Dr. Paul Kalanithi as he was dying. At the tender age of 36, he was diagnosed with Stage IV lung cancer - just as he was qualifying as a neurosurgeon. Living only 22 more months, Paul’s very first book was a finalist for the Pulitzer Prize.
After reading the trajectory of his life on the flyleaf (BA and MA in English at Stanford, BA in Human Biology at Stanford, MPhil in History and Philosophy at Cambridge, Medicine at Stanford, and then cancer), I found myself being a little skeptical. In our society, it’s usually people who abuse their bodies with drugs or alcohol that die so young – not healthy-habited folk like Paul.
To further embed his goodness into my psyche, I am writing to capture my reaction to this tragic arc. This young man’s wisdom in the face of death is worth holding on to.
Every person ever born will die: we only vary in the length of time we live, and our cause of death. Ours is a death-averse society and each of us should actively contemplate our mortality and then inform our families of our wishes and priorities.
When Paul was ten, his family moved to tiny Kingman, Arizona. Its education system was the poorest in the state, so his mother encouraged his reading everything on a college preparatory list, which instilled his love of words.
He was torn between becoming a writer or a doctor. Cancer struck as he was finishing his gruelling neurosurgery residency.
Viktor Frankl, an Austrian psychiatrist who survived Auschwitz, wrote Man’s Search for Meaning. Its principal message: when you can’t change a situation that life presents, the only thing you can change is your attitude to that situation. That is exactly what Paul did.
When facing premature death, he reached back into his literary education and poured out his current experiences in excruciating detail. His legacy is a handbook to help ordinary people, who lack his extensive medical expertise, face a life-ending disease. Any terminally ill patient will identify with his struggles.
This practicing Christian author refers to science as the basis of medical knowledge, yet “scientific methodology is the product of human hands and thus cannot reach some permanent truth.” Belief in God and Jesus helped him understand love, emotions, and the meaning of life.
Paul describes being transformed from a naïve medical student “possessed by the question of what, given that all organisms die, makes a virtuous and meaningful life,” into a neurosurgeon. Then he becomes a cancer patient and new father facing his own mortality.
I suggest that medical schools assign this book to their students to help them focus on the humane side of medicine. He recounts conversations with patients in detail, that student doctors could internalize.
For example, when preparing to operate, Paul consulted gently with the patient and family. “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.”
His writing style gives the impression that he held nothing back. In the epilogue, his wife writes that his laptop became his treasured companion once he’d stopped working, giving him purpose whether waiting to see a specialist, or enduring chemotherapy. How heartbreaking that he could not witness the book’s completion and wide public acclaim.
There is much to be learned from the dying about how to keep your priorities straight. Speaking personally, this book helps squelch my ridiculous complaints about minor challenges life throws my way.
Every day is a gift.