When Breath Becomes Air
by Paul Kalanithi
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- When Breath Becomes Air
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- Paul Kalanithi
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- Random House, Kindle Edition, 208 pages
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"For readers of Atul Gawande, Andrew Solomon, and Anne Lamott, a profoundly moving, exquisitely observed memoir by a young neurosurgeon faced with a terminal cancer diagnosis who attempts to answer the question What makes a life worth living? 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 treating the dying, and the next he was a patient struggling to live. show more And just like that, the future he and his wife had imagined evaporated. When Breath Becomes Air chronicles Kalanithi's transformation from a naïve medical student "possessed," as he wrote, "by the question of what, given that all organisms die, makes a virtuous and meaningful life" into a neurosurgeon at Stanford working in the brain, the most critical place for human identity, and finally into a patient and new father confronting his own mortality. What makes life worth living in the face of death? What do you do when the future, no longer a ladder toward your goals in life, flattens out into a perpetual present? What does it mean to have a child, to nurture a new life as another fades away? These are some of the questions Kalanithi wrestles with in this profoundly moving, exquisitely observed memoir. 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. "I began to realize that coming face to face with my own mortality, in a sense, had changed nothing and everything," he wrote. "Seven words from Samuel Beckett began to repeat in my head: 'I can't go on. I'll go on.'" When Breath Becomes Air is an unforgettable, life-affirming reflection on the challenge of facing death and on the relationship between doctor and patient, from a brilliant writer who became both. Advance praise for When Breath Becomes Air "Rattling, heartbreaking, and ultimately beautiful, the too-young Dr. Kalanithi's memoir is proof that the dying are the ones who have the most to teach us about life."--Atul Gawande "Thanks to When Breath Becomes Air, those of us who never met Paul Kalanithi will both mourn his death and benefit from his life. This is one of a handful of books I consider to be a universal donor--I would recommend it to anyone, everyone."--Ann Patchett"-- "At the age of 36, on the verge of a completing a decade's worth of training as a neurosurgeon, Paul Kalanithi's health began to falter. He started losing weight and was wracked by waves of excruciating back pain. A CT scan confirmed what Paul, deep down, had suspected: he had stage four lung cancer, widely disseminated. One day, he was a doctor making a living treating the dying, and the next, he was a patient struggling to live. Just like that, the future he and his wife had imagined, the culmination of decades of striving, evaporated. With incredible literary quality, philosophical acuity, and medical authority, When Breath Becomes Air approaches the questions raised by facing mortality from the dual perspective of the neurosurgeon who spent a decade meeting patients in the twilight between life and death, and the terminally ill patient who suddenly found himself living in that liminality. At the base of Paul's inquiry are essential questions, such as: What makes life worth living in the face of death? What happens when the future, instead of being a ladder toward the goals of life, flattens out into a perpetual present? When faced with a terminal diagnosis, what does it mean to have a child, to nuture a new life as another one fades away? As Paul wrote, "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 passed away in March 2015, while working on this book"-- On the verge of completing a decade's worth of training as a neurosurgeon, Kalanithi was diagnosed with stage IV lung cancer. Just like that, the future he and his wife had imagined evaporated. Kalanithi chronicles his transformation from a naïve medical student into a neurosurgeon at Stanford working in the brain, the most critical place for human identity, and finally into a patient and new father confronting his own mortality. show lessTags
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WildMaggie Thoughts on death and dying by brilliant young men as they come to terms with their own imminent show more deaths show less
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LibraryThing Early Reviewer copy
Just before completing a neurosurgery residency and launching a promising career as scientist/surgeon, Paul Kalanithi is diagnosed with advanced lung cancer.
This is an amazing book. Imagine Hemingway as a Yale PhD, transitioning from Dr/expert to patient at the mercy of the merciless.
A few sentences, but really the entire work rings like a temple bell.
'Humans are organisms, subject to physical laws, including, alas, the one that says entropy always increases. Diseases are molecules misbehaving; the basic requirement of life is metabolism, and death is its cessation.'
'Before my cancer was diagnosed, I knew that someday I would die, but I didn't know when. After the diagnoses, I knew that someday I would show more 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.'
Describing his feelings, after years of distilling probabilities and odds to patients and families: 'It occurred to me that my relationship with statistics changed as soon as I became one.'
The afterward, written by his wife describing his final days, is equally significant. His end was heroic. I can't recommend this book enough. show less
Just before completing a neurosurgery residency and launching a promising career as scientist/surgeon, Paul Kalanithi is diagnosed with advanced lung cancer.
This is an amazing book. Imagine Hemingway as a Yale PhD, transitioning from Dr/expert to patient at the mercy of the merciless.
A few sentences, but really the entire work rings like a temple bell.
'Humans are organisms, subject to physical laws, including, alas, the one that says entropy always increases. Diseases are molecules misbehaving; the basic requirement of life is metabolism, and death is its cessation.'
'Before my cancer was diagnosed, I knew that someday I would die, but I didn't know when. After the diagnoses, I knew that someday I would show more 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.'
Describing his feelings, after years of distilling probabilities and odds to patients and families: 'It occurred to me that my relationship with statistics changed as soon as I became one.'
The afterward, written by his wife describing his final days, is equally significant. His end was heroic. I can't recommend this book enough. show less
This review was written for LibraryThing Early Reviewers.But if I did not know what I wanted, I had learned something, something not found in Hippocrates, Maimonides, or Osler: 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.
Paul Kalanithi was in his last year of neurosurgery residency when he was diagnosed with Stage IV lung cancer. Before medical school Kalanithi had studied English literature and the History of Medicine in his attempt to discover 'what makes life meaningful". After his cancer diagnosis he also set out to understand death better. He explores both these ideas and the show more relationship between doctors and patients in this memoir. Kalanithi is a skilled writer, his prose is beautiful; it's obvious that he studied literature. As someone who has worked as part of a health care team in a large university research hospital for nearly 30 years I found many truths in Kalanithi's passages about the doctor-patient relationship and the bonds that are forged between all members of the patient care team. I particularly liked the above quote (from pg 166) and the passage on pg 81-82 that describes bonding between members of the care team who can be "clinging to the same raft, caught in the same tide".
Kalanithi died before he could finish the book. The epilogue is written by his wife, Lucy Kalanithi. (warning: you will need tissues handy when you read this part)
Recommended. show less
Paul Kalanithi was in his last year of neurosurgery residency when he was diagnosed with Stage IV lung cancer. Before medical school Kalanithi had studied English literature and the History of Medicine in his attempt to discover 'what makes life meaningful". After his cancer diagnosis he also set out to understand death better. He explores both these ideas and the show more relationship between doctors and patients in this memoir. Kalanithi is a skilled writer, his prose is beautiful; it's obvious that he studied literature. As someone who has worked as part of a health care team in a large university research hospital for nearly 30 years I found many truths in Kalanithi's passages about the doctor-patient relationship and the bonds that are forged between all members of the patient care team. I particularly liked the above quote (from pg 166) and the passage on pg 81-82 that describes bonding between members of the care team who can be "clinging to the same raft, caught in the same tide".
Kalanithi died before he could finish the book. The epilogue is written by his wife, Lucy Kalanithi. (warning: you will need tissues handy when you read this part)
Recommended. show less
I cried several times while reading When Breath Becomes Air. This one cut a bit close to the bone for me, but not entirely for the reasons one might think. I can only begin to imagine the depth of this man's anger & grief and I'm amazed at how he overcame them to write such a beautiful book with the last of his fading strength. Though part of me wishes it were longer, in actuality I doubt I could have handled it as a 400 pager. Mainly I wish he'd found the time to write other things, since his plan was to be a surgeon for the first part of his life and a writer for the second.
I bought this in hardcover form because I thought I would probably want to read it more than once, and I hope to have my kids each read it at some point. That made show more it much harder to save my favorite passages, though. I was stuffing little pieces of paper in it to mark pages, but sadly some of them fell out. But here are two short ones. One with some with humor:
"The good news is I've already outlived two Brontës, Keats and Stephen Crane. The bad news is I haven't written anything yet."
And one without:
"It occurred to me that my relationship with statistics changed as soon as I became one."
There is another I loved about hard decisions when one's loved one's quality of life has ebbed, but it is quite long and rather depressing. I might come back and add that later, or I might just keep that one to myself. show less
I bought this in hardcover form because I thought I would probably want to read it more than once, and I hope to have my kids each read it at some point. That made show more it much harder to save my favorite passages, though. I was stuffing little pieces of paper in it to mark pages, but sadly some of them fell out. But here are two short ones. One with some with humor:
"The good news is I've already outlived two Brontës, Keats and Stephen Crane. The bad news is I haven't written anything yet."
And one without:
"It occurred to me that my relationship with statistics changed as soon as I became one."
There is another I loved about hard decisions when one's loved one's quality of life has ebbed, but it is quite long and rather depressing. I might come back and add that later, or I might just keep that one to myself. show less
When Breath Becomes Air by Paul Kalinithi.
The author was a young neurosurgeon who learned he had metastatic terminal cancer when he was 36, just finishing his training. Throughout his life, Kalinithi sought to understand what it meant to live a meaningful life. This book represents the work he did, in his final year of a life cut tragically short, to convey as much as he could of what he learned. In the process, he shows us the dying that is part of living, not shrinking into the avoidance of death that is so prevalent in our faux-immortal culture that glorifies youth and vitality.
This is a beautiful work, a remarkable accomplishment were he not so ill, and yet no doubt not possible without the felt immediacy of his situation. show more Kalinithi managed to grieve, to fear, to lose, and still to love, to have courage, and to face reality with open eyes and steadfast clarity. He put a lifetime of thought and struggle with ideas into this book, and it fails him to try to summarize, other than to say that he squeezed every bit of meaning and purpose he could muster into his life and his remaining time. His love for his wife, his friends and his service through doctoring helped to sustain him. And in no small measure so did his infant daughter, conceived after his diagnosis. In his words, and though these are his final thoughts in the book, I think it is worth quoting them here because they will tell you much about him and about whether this is something you may want to read:
"There is perhaps only one thing to say to this infant, who is all future, overlapping briefly with me, whose life, barring the improbable, is all but past.
That message is simple:
When you come to one of the many moments in life where you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man's days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more but rests, satisfied. In this time, right now, that is an enormous thing."
I am much the better for having read this. show less
The author was a young neurosurgeon who learned he had metastatic terminal cancer when he was 36, just finishing his training. Throughout his life, Kalinithi sought to understand what it meant to live a meaningful life. This book represents the work he did, in his final year of a life cut tragically short, to convey as much as he could of what he learned. In the process, he shows us the dying that is part of living, not shrinking into the avoidance of death that is so prevalent in our faux-immortal culture that glorifies youth and vitality.
This is a beautiful work, a remarkable accomplishment were he not so ill, and yet no doubt not possible without the felt immediacy of his situation. show more Kalinithi managed to grieve, to fear, to lose, and still to love, to have courage, and to face reality with open eyes and steadfast clarity. He put a lifetime of thought and struggle with ideas into this book, and it fails him to try to summarize, other than to say that he squeezed every bit of meaning and purpose he could muster into his life and his remaining time. His love for his wife, his friends and his service through doctoring helped to sustain him. And in no small measure so did his infant daughter, conceived after his diagnosis. In his words, and though these are his final thoughts in the book, I think it is worth quoting them here because they will tell you much about him and about whether this is something you may want to read:
"There is perhaps only one thing to say to this infant, who is all future, overlapping briefly with me, whose life, barring the improbable, is all but past.
That message is simple:
When you come to one of the many moments in life where you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man's days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more but rests, satisfied. In this time, right now, that is an enormous thing."
I am much the better for having read this. show less
This memoir is poignant in itself but even more so with the handful of intersections between Paul's life and my own. His daughter was born in the same hospital where I birthed mine nine years before, and we both worked at Stanford Sierra Camp around the same time, although I worked a fall conference season while he, as a Stanford student, worked the summer camp. His story would be significant anyway, but being able to see the places he describes makes the story feel even closer. He writes about his mortality with emotion but without melodrama or trite sentiments. It's a beautiful and devastating story.
I cannot remember reading a more courageous book. The author, a neurosurgeon who was both a reader and a writer, was able to face being diagnosed with stage IV lung cancer and write about his experience of being treated. More than that he writes about a demonstration of transformation through his own example; first from a young student of literature into a Neurosurgeon/ Neuroscientist; and second, from an intelligent thriving man into a seriously ill man facing the imminent nature of his own mortality. How he was able to face both that battle and his own limitations that resulted from the battle comprise this inspirational story.
The demands placed upon a medical student are tremendous. They are described in detail with a beautiful show more prose style that blends reality with metaphor in a seamless way. These demands are nothing compared to the demands that Paul placed on himself as he traversed the difficult course toward his twin goals of neurosurgeon and neuroscientist. His residency is described as a breathless experience, yet one that allowed him eventually to breathe a little as he observes, "By this point in my residency, I was more experienced. I could finally breathe a little, no longer trying to hold on for my own dear life." (p 88)
He describes the tension when operating on the brain or near the spinal cord; where minuscule movements can make the difference between life and death or, even worse, life without some necessary brain function. The suspense of these moments is palpable for the reader.
After being diagnosed with lung cancer and beginning to undergo treatment that, perhaps, might extend his life enough to provide at least the possibility or part of the life he had originally planned, he underwent periods of pain that made his life incredibly difficult. One thing from his earlier life became a life-saver, however temporary, for him. It is a moment when he shares, "Lost in a featureless wasteland of my own mortality, and finding no traction in the reams of scientific studies, intracellular molecular pathways, and endless curves of survival statistics, I began reading literature again: Solzhenitsyn's Cancer Ward, B. S. Johnson's The Unfortunates, Tolstoy's Ivan Ilyich, Nagel's Mind and Cosmos, Woolf, Kafka, Montaigne, Frost, Greville, memoirs of cancer patients--anything by anyone who had ever written about mortality." (p 148) He was trying to make sense of death and find a way to begin to define himself with a vocabulary that was meaningful and helpful. It was a vocabulary that would help him understand his own experiences. It was a process that worked as he concluded, "And so it was literature that brought me back to life during this time. . . I got out of bed and took a step forward, repeating the phrase over and over: 'I can't go on. I'll go on.' [Beckett]" (p 149)
He was able to return to work for a period of time. Not at the level he had been at when first diagnosed, but at a level that allowed him to contribute and attempt to be the surgeon he once was. But the joy was gone, and eventually the cancer returned. Paul writes eloquently of the final days with his wife and new-born baby. Yet his life did not have the longevity that his words would. His life, his breath, allowed him to share a story of fortitude and courage, becoming an inspiration for his family, friends, and all who have the honor to read his memorable memoir. show less
The demands placed upon a medical student are tremendous. They are described in detail with a beautiful show more prose style that blends reality with metaphor in a seamless way. These demands are nothing compared to the demands that Paul placed on himself as he traversed the difficult course toward his twin goals of neurosurgeon and neuroscientist. His residency is described as a breathless experience, yet one that allowed him eventually to breathe a little as he observes, "By this point in my residency, I was more experienced. I could finally breathe a little, no longer trying to hold on for my own dear life." (p 88)
He describes the tension when operating on the brain or near the spinal cord; where minuscule movements can make the difference between life and death or, even worse, life without some necessary brain function. The suspense of these moments is palpable for the reader.
After being diagnosed with lung cancer and beginning to undergo treatment that, perhaps, might extend his life enough to provide at least the possibility or part of the life he had originally planned, he underwent periods of pain that made his life incredibly difficult. One thing from his earlier life became a life-saver, however temporary, for him. It is a moment when he shares, "Lost in a featureless wasteland of my own mortality, and finding no traction in the reams of scientific studies, intracellular molecular pathways, and endless curves of survival statistics, I began reading literature again: Solzhenitsyn's Cancer Ward, B. S. Johnson's The Unfortunates, Tolstoy's Ivan Ilyich, Nagel's Mind and Cosmos, Woolf, Kafka, Montaigne, Frost, Greville, memoirs of cancer patients--anything by anyone who had ever written about mortality." (p 148) He was trying to make sense of death and find a way to begin to define himself with a vocabulary that was meaningful and helpful. It was a vocabulary that would help him understand his own experiences. It was a process that worked as he concluded, "And so it was literature that brought me back to life during this time. . . I got out of bed and took a step forward, repeating the phrase over and over: 'I can't go on. I'll go on.' [Beckett]" (p 149)
He was able to return to work for a period of time. Not at the level he had been at when first diagnosed, but at a level that allowed him to contribute and attempt to be the surgeon he once was. But the joy was gone, and eventually the cancer returned. Paul writes eloquently of the final days with his wife and new-born baby. Yet his life did not have the longevity that his words would. His life, his breath, allowed him to share a story of fortitude and courage, becoming an inspiration for his family, friends, and all who have the honor to read his memorable memoir. show less
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“When Breath Becomes Air” is gripping from the start. But it becomes even more so as Dr. Kalanithi tries to reinvent himself in various ways with no idea what will happen.
Part of this book’s tremendous impact comes from the obvious fact that its author was such a brilliant polymath. And part comes from the way he conveys what happened to him — passionately working and striving, show more deferring gratification, waiting to live, learning to die — so well. None of it is maudlin. Nothing is exaggerated. As he wrote to a friend: “It’s just tragic enough and just imaginable enough.” And just important enough to be unmissable. show less
Part of this book’s tremendous impact comes from the obvious fact that its author was such a brilliant polymath. And part comes from the way he conveys what happened to him — passionately working and striving, show more deferring gratification, waiting to live, learning to die — so well. None of it is maudlin. Nothing is exaggerated. As he wrote to a friend: “It’s just tragic enough and just imaginable enough.” And just important enough to be unmissable. show less
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- Canonical title
- When Breath Becomes Air
- Original title
- When Breath Becomes Air
- Original publication date
- 2016-01-12
- Important places
- Kingman, Arizona, USA; New Haven, Connecticut, USA; Palo Alto, California, USA
- Epigraph
- You that seek what life is in death,
Now find it air that once was breath.
New names unknown, old names gone:
Till time end bodies, but souls none.
Reader! then make time, while you be,
But steps t... (show all)o your eternity.
— Baron Brooke Fulke Greville, “Caelica 83” - Dedication
- For Cady
- First words
- I knew with certainty that I would never be a doctor.
— Part One
I flipped through the CT scan images, the diagnosis obvious: the lungs were matted with innumerable tumours, the spine deformed, a full lobe of the liver obliterated.
— Prologue - Quotations
- I knew with certainty that I would never be a doctor. I stretched out in the sun, relaxing on a desert plateau just above our house. My uncle, a doctor, like so many of my relatives, had asked me earlier that day what I plann... (show all)ed on doing for a career, now that I was heading off to college, and the question barely registered. If you had forced me to answer, I suppose I would have said a writer, but frankly, thoughts of any career at this point seemed absurd. I was leaving this small Arizona town in a few weeks, and I felt less like someone preparing to climb a career ladder than a buzzing electron about to achieve escape velocity, flinging out into a strange and sparkling universe.
Though we had free will, we were also biological organisms -- the brain was an organ, subject to all the laws of physics, too! Literature provided a rich account of human meaning; the brain, the, was the machinery that someho... (show all)w enabled it. It seemed like magic.
Literature provided, I believed, the richest material for moral reflection.
Moral speculation was puny compared moral action.
I had come to see language as an almost supernatural force, existing between people, bringing our brains, shielded in centimeter-thick skulls, into communion.
In anatomy lab, we objectified the dead, literally reducing them to organs, tissues, nerves, muscles. On that first day, you simply could not deny the humanity of the corpse. But by the time you'd skinned the limbs, sliced th... (show all)rough inconvenient muscles, pulled out the lung, cut open the heart, and removed a lobe of the liver, it was hard to recognize this pile of tissue as human. Anatomy lab, in the end, becomes less a violation of the sacred and more something that interferes with happy hour, and that realization discomfits. In our rare reflective moments, we were all silently apologizing to our cadavers, not because we sensed the transgression but because we did not.
It was not a simple evil, however. All of medicine, not just cadaver dissection, trespasses into sacred spheres. Doctors invade the the body in every way imaginable. They see people at their most vulnerable, their most scared... (show all), their most private. They escoret them into the world, and then back out. Seeing the body as matter and mechanism is th eflip side to easing the most profound human suffering. By the same token, the most profound human suffering becomes a mere pedagogical tool.
Neurosurgery seemed to present the most challenging and direct confrontation with meaning, identity, and death. Concomitant with the enormous responsibilities they shouldered, neurosurgeons were also masters of many fields: n... (show all)eurosurgery, ICU medicine, neurology, radiology. Not only would I have to train my mind and hands, I realized; I'd have to train my eyes, and perhaps other organs as well. The idea was overwhelming and intoxicating; perhaps I, too, could join the ranks of these polymaths who strode into the densest thicket of emotional, scientific, and spiritual problems and found, or carved, ways out.
I wondered if, in my brief time as a physician, I had made more moral slides than strides.
I feared I was on the way to becoming Tolstoy's stereotype of a doctor, preoccupied with empty formalism, focused on rote treatment of disease -- and utterly missing the larger human significance.
As a resident, my highest ideal was not saving lives -- everyone dies eventually -- but guiding a patient or family to an understanding of death or illness.
Any major illness transforms a patient's -- really, an entire family's -- life.
The root of disaster means a star coming apart, and no image expresses better the look in a patient's eyes when hearing a neurosurgeon's diagnosis.
A tureen of tragedy was best alloted by the spoonful.
Second, it is important to be accurate, but you must always leave some room for hope . . . I came to believe that it is irresponsible to be more precise than accurate. Those apocryphal doctors who gave specific numbers ("The ... (show all)doctor told me I had six months to live"): Who were they, I wondered, and who taught them statistics.
Openness to human relationality does not mean revealing grand truths from the apse; it means meeting patients where they are, in the narthex or nave, and bringing them as far as you can.
Being with these patients in these moments certainly had its emotional cost, but it also had its rewards. I 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 p... (show all)rotect life -- and not merely life but an 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 de... (show all)dication to succeed was high, and the ineluctable failures brought me nearly unbearable guilt. Those burderns are what make medicine holy and wholly impossible: in taking up another's cross, one must sometimes get crushed by the weight.
Perhaps unique in medicine, the ethos of neurosurgery -- of excellence in all things -- maintains that excellence in neurosurgery alone is not enough. In order to carry the field, neurosurgeons must venture forth and excel in... (show all) other fields as well.
Certain brain areas are considered near--inviolable, like the primary motor cortex, damage to which results in paralysis of affected body parts. But the most sacrosanct regions of the cortex are those that control language . ... (show all). . What kind of life exists withouth language?
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,... (show all) I knew that someday I would die, but I didn't know when. But now I knew it acutely. The problem wasn't a scientific one. The fact of death is unsettling. Yet there is no other way to live.
It occurred to me that my relationship with statistics changed as soon as I became one.
What patients seek is not scientific knowledge that doctors hide but existential authenticity each person must find on her own. Getting too deeply into statistics is like trying to quench a thirst with salty water. The angst ... (show all)of facing morality has no remedy in probability.
I had passed from the subject to the direct object of every sentence of my life.
"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... (show all) life wasn't about avoiding suffering. Years ago, it had occurred to me that Darwin and Nietzshe agreed on one thing: the defining characteristic of the organism is striving. Describing life otherwise was like painting a tiger without stripes. After so many years of living with death, I'd come to understand that the easiest death wasn't necessarily the best. We talked it over. Our families gave their blessing. We decided to have a child. We would carry on living, instead of dying.
I was searching for a vocabulary with which to make sense of death, to find a way to begin defining myself and inching forward again. The privilege of direct experience had led me away from literary and academic work, yet now... (show all) I felt that to understand my own direct experiences, I would have to translate them back into language. Hemingway described his process in similar terms: acquiring rich experiences, then retreating to cogitate and write about them. I needed words to go forward. And so it was literature that brought me back to life during this time.
Even working on the dead, with their faces covered, their names a mystery, you fund that their humanity pops up at you—in opening my cadaver’s stomach, I found two indigested morphine pills, meaning that he had died in pa... (show all)in, perhaps alone and fumbling with the cap of a pill bottle.
Because I would have to learn to live in a different way, seeing death as an imposing itinerant visitor but knowing that even if I’m dyung, until I actually die, I am still living.
I had learned something, something not found in Hippocrates, Maimonides, or Osler: 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 l... (show all)ives have disintegrated and work until they can stand back up and face, and make sense of, their own existence. - Last words
- (Click to show. Warning: May contain spoilers.)There is perhaps only one thing to say to this infant, who is all future, overlapping briefly with me, whose life, barring the improbable, is all but past. That message is simple: When you come to one of the many moments in life where you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man's days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more but rests, satisfied. In this time, right now, that is an enormous thing.
- Blurbers
- Gawande, Atul; Patchett, Ann
- Original language
- English
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