“I flipped through the CT scan images, the diagnosis obvious: the lungs were matted with innumerable tumors, the spine deformed, a full lobe of the liver obliterated. Cancer, widely disseminated. I was a neurosurgical resident entering my final year of training. Over the last six years, I’d examined scores of such scans, on the off chance that some procedure might benefit the patient. But this scan was different: it was my own.”
When Paul Kalanithi, a neurosurgeon, looks at the CT scans and sees the obvious within seconds, panic isn’t his first reaction. Instead his greatest worry is that, as he writes in an email to his best friend, he’s outlived two Brontës, Keats and Stephen Crane, but doesn’t have anything to show for it. So he sets out to write a book.
Following a decade of training, Kalanithi was just months away from qualifying as a neurosurgeon and completing his postdoctoral fellowship at Stanford University, and he was planning to start a family with his wife, Lucy when he was diagnosed with inoperable lung cancer. There was a reversal of roles: The doctor was now the patient and he was facing terminal illness. And he was just 36 years old.
Kalanithi was aware that he had no more than a year to live but writing was important for him not just to come to terms with that fact but also, as his wife said in an interview following the publication of the book, it was his way of communicating with his daughter Cady after his death. When he set out to write a book, he didn’t know if he could actually complete the book to make it publish worthy before the inevitable end.
And he died on March 2015 leaving behind his family, including a two-year-old daughter and an unfinished manuscript. His wife, who by her own admittance was not a writer, wrote a moving epilogue and 10 months later When Breath Becomes Air was published.
There’s not a hint of self pity in the book, if that is what you are afraid of. Instead, it’s an honest account of a man driven by his passions and loves, and a desire to understand what lies beyond life.
For Kalanithi, death isn’t a tragedy but failing to understand it definitely is. Kalanithi had always been interested in death and morality.
“Shouldn’t terminal illness be the perfect gift to the young man who had wanted to understand death?” he asks before admitting that it wasn’t life altering but life shattering. And being able to read his own scans and notes on chemotherapy regime as his illness progressed only reinforced the sadness.
In the beginning of the book, Kalanithi talks about how his life was finally falling into place when it fell apart. “I could see the promised land,” he says. As his future evaporates into nothing, Kalanithi struggles to understand what makes life meaningful even when one confronts death, and teaches us, along the way, that life isn’t about milestones, it’s about moments.
Though his was a life snubbed short, there is a lot of wisdom in the pages of the book as well as a sense of urgency. You can almost feel time slipping from Kalanithi’s hands as he writes certain lines. It’s sad but it’s also, in its own ways, uplifting: You learn to value life a little more.
The book is also a contemplation on his role as a doctor and his dealings with life and death on a daily basis. Kalanithi observes that taking care of his patients, he acted “not as death’s enemy, but as its ambassador.” He talks about how “as a doctor, he was an agent, a cause and as a patient, he was merely something to which things happened.” Confronting his own death, he learns how to be a patient and thus how to fully be a doctor.
Alongside soul searching ponderings and meditations on life, Kalanithi gives us glimpses of life of a hardworking man for whom perfection in the little things is important. After all, he was a neurosurgeon. There’s a lot one can learn from Kalanithi’s book. He scrubs in and goes to surgery when he’s in remission showing his dedication to life even when confronted with a terminal illness.
“Don’t you think saying goodbye to your child will make your death more painful?” his wife asks him when they decide to have a child despite his diagnosis. “Wouldn’t it be great if it did?’ he replies. “Lucy and I both felt that life wasn’t about avoiding suffering,” he adds showing that life isn’t about hiding in the shadows.
Kalanithi has not only left a legacy through his writing but he lives on through his words that are poetic in places and a little rough around the edges. This is one book that deserves to be read over and over again. I sure will be reading this slim volume a few more times this year. Like his wife Lucy writes in the epilogue, his memoir can teach us to face life and death with integrity. And like Kalanithi would have said, “that’s an enormous thing.”
cillakhatry@gmail.com
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