“I began to realize that coming in such close contact with my own mortality had changed both nothing and everything. Before my cancer was diagnosed, I knew that someday I would die, but I didn’t know when. After the diagnosis, I knew that someday I would die, but I didn’t know when. But now I knew it acutely. The problem wasn’t really a scientific one. The fact of death is unsettling. Yet there is no other way to live.”
― Paul Kalanithi,
Over the last couple months, I’ve gotten really into audiobooks.
Which is unfortunate considering audiobooks tend to be more expensive than regular books, so my meager graduate student budget can only afford one audible credit per month. But I’ve realized this is the only surefire way that I read something that doesn’t start off with an abstract…
Each month, I put a lot of thought into what book I’ll read because I won’t get another pick for 30 more days. I read reviews on various sites, keep track of recommendations on social media or podcasts I follow, annoyingly ask friends and strangers alike what they’re reading if I see them with a book (a habit I’ve developed since childhood, no joke), all in a careful attempt to identify books worthy of my time and most importantly, my $15 monthly credit.
Consequently, my reading list over the last few months has been… well, eclectic. Topics ranging from a real woman’s obsession with the Golden State Killer to a fictional woman’s obsession with half-human/half-zombie children, from a book about a difficult yet fascinating childhood in South Africa to a science book about the importance of sleep that I know was specifically written to convince me graduate school was the worst decision of my life. (Brownie points to anyone able to correctly name all those books!)
This last week, when I discovered my friend’s blog, The Patellar Reflex, I saw that she recommended a book called When Breathe Becomes Air. When I looked into it, the book went immediately to the top of my oh so very selective audible list.
In case you’re too mesmerized with my blog to do a google search of your own, When Breath Becomes Air is a memoir by neurosurgeon Dr. Paul Kalanithi. At 36, at the cusp of enjoying the golden years of his career, Kalanithi is diagnosed with terminal lung cancer. So he set out to write this memoir about what makes life worth living in the face of death.
*Minor spoilers ahead*
It’s a fascinating book. Although, I will add, it’s not the best written book. It’s repetitive, at times hard to follow, and at other times, frankly too lofty and obscure. It feels like an unfinished draft––a man closing in on death, rapidly scribbling down his most important thoughts, imparting his final words of wisdom.
And well, that’s exactly what it is; Kalanithi died halfway through writing it. So then, what are a dying man’s last words worth? What this book lacks in style and clarity, it makes up in its invaluable insights into life, death, and the role of doctors and patients alike in making sense of it all.
In one part of the book, Kalanithi discusses his struggle to figure out what to do with his day-to-day life:
“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?”
Kalanithi battles with this question for a long time, until he eventually decides to just go back to work as a neurosurgeon because he’s not dead yet:
“I was startled to realize that in spite of everything, the last few months had had one area of lightness: not having to bear the tremendous weight of the responsibility neurosurgery demanded—and part of me wanted to be excused from picking up the yoke again. Neurosurgery is really hard work, and no one would have faulted me for not going back. (People often ask if it is a calling, and my answer is always yes. You can’t see it as a job, because if it’s a job, it’s one of the worst jobs there is.) A couple of my professors actively discouraged the idea: “Shouldn’t you be spending time with your family?” (“Shouldn’t you?” I wondered. I was making the decision to do this work because this work, to me, was a sacred thing.)”
That little snippet of dialogue between Kalanithi and his professors really got to me. What caught my attention is two-fold:
First, Kalanithi’s thoughts (“‘shouldn’t you?’ I wondered”) capture his professors’ apparent blind eye to their own mortality. They question Kalanithi’s decision not to spend time with family, seemingly forgetting they don’t have forever either.
And then second, there’s Kalanithi’s decision to return to work despite being acutely aware of his imminent end. Kalanithi valued his life’s work so much that he felt it was important enough to continue doing even if he was going to die soon.
I guess what struck me about his decision is that when people discuss hypothetical situations like “What would you do if you knew you had 6 months to live?” (recommended party ice-breaker for sure), we often get fixated on what we would change about our daily routine. Personally, I’ve never really thought about what would stay the same. What are the things I do now that I would continue doing, knowing my time on this earth is limited?
And it’s that question, my friends, that’s keeping me up on this hot, humid August night.
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