Thursday, October 6, 2016

When Breath Becomes Air by Paul Kalanithi

Oh, my. I've had When Breath Becomes Air by Paul Kalanithi for some time now, but I was waiting to be in just the right mood to read it. Paul Kalanithi is a neurosurgery resident just at the edge of finishing his training when he discovers that he has lung cancer and that the cancer has already spread. In this book, Paul describes the ways in which cancer changes his life. This autobiography takes the reader back to Paul's childhood and along the path that led him to medicine. Initially, Paul was drawn to literature. He has a B.A and M.A in English Literature from Stanford. Then, as he became interested in medicine, he also earned a B.A in Human Biology from Stanford. He then earned an M.Phil in History and Philosophy of Science and Medicine from the University of Cambridge after which he attended medical school at Yale. After returning to Stanford for his residency, he was involved in several award-winning research projects while also completing rigorous training in neuroscience and neurosurgery. Paul had an incredible career ahead of him and had plans to share his extensive knowledge through teaching. Through it all, this was Paul's purpose:

I was driven less by achievement than by trying to understand, in earnest:
What makes human life meaningful?

I was fascinated with the descriptions of Paul's work as a physician. I find medicine very intriguing and the descriptions of his day-to-day work were so interesting to me. Harder to read, however, were his struggles transitioning from doctor to patient. After his diagnosis, Paul was forced to take some time away from work.

...without that duty to care for the ill pushing me forward, I became an invalid.

After two months [of physical therapy], I could sit for thirty minutes without tiring. I could start having dinner with friends again.

Oh, I can't imagine how difficult that must have been. Terminal illness takes so much away from the patient. After much difficulty, Paul and his wife Lucy decide to have a child. This was not an easy decision. Paul didn't want to burden his wife, nor did he want to miss the experience of being a parent.

Lucy:"Don't you think saying goodbye to your child will make your death more painful"
Paul:"Wouldn't it be great if it did?"
Lucy and I both felt that life wasn't about avoiding suffering.

Of course having a child would add one more person to whom he would have to say goodbye, but it would be one more person to love until that day arrived. He displayed so much strength of character, so much integrity of heart:

...knowing that even if I'm dying, until I actually die, I am still living.

Can we all claim to have such perspective? Paul maintained his sense of humor. At the end of his fifteenth medical school class reunion, he had this experience:

...when old friends called out parting promises-- "We'll see you at the twenty-fifth!" -- it seemed rude to respond with "Probably not!"

In the epilogue, Paul's wife Lucy shares Paul's final days and her experience with his death. It is a touching account of love and loss. She says:

Paul confronted death-- examined it, wrestled with it, accepted it-- as a physician and a patient. He wanted to help people understand death and face their mortality.

Finally, one last quote that is sure to pull at the reader's heart:

At home in bed a few weeks before he died, I asked him, "Can you breathe okay with my head on your chest like this?" His answer was "It's the only way I know how to breathe."

Oh, this book fascinated me and eviscerated me. No one can know the good that Paul might have been able to do as a physician if he had lived a long, healthy life, but the good I expect he has done with this book is immeasurable. He has left a legacy for his daughter and a guide to anyone experiencing a terminal illness as well as family members and friends of those patients. This book is beautiful and heart-rending. Please read it.

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