“I began to realize that coming in such close contact with my own mortality had changed both nothing and everything” (189).
Paul Kalanithi
“Death may be a one-time event, but living with terminal illness is a process” (228).
Paul Kalanithi
Paul Kalanithi wrote When Breath Becomes Air towards the end of his life. He tried to finish as much as he could but he died before it was even published. Death is a part of life. Yet it can come at any point because it is uncertain how and when it would happen. The only certain part of it is that it will happen.
There is a thin line between life and death. When a person is born, one thing is certain, one day they will die. It is the cycle of life; with life comes death.
Life is full of uncertainties. But when one knows that they are going to die soon, it is as if life stands still. “And with that, the future I had imagined, the one just about to be realized, the culmination of decades of striving evaporated” (39). Time stops and everything that was planned changes. Life is unpredictable and not always goes according to plan. Someone can have everything planned out, and then all of a sudden, something happens, and everything changes.
Growing up, Paul never wanted to be a doctor. He had first-hand experience of what life would be like. Yet that goes to show that people change. Nothing is set in stone. People grow and change.
Paul’s loved literature growing up. He looked to literature when he needed answers.
T.S. Eliot’s The Waste Land resonated profoundly, relating meaninglessness and isolation, and the desperate quest for human connection….Nabokov, for his awareness of how our suffering can make us callous to the obvious suffering of another….Conrad, for his hypertuned sense of how miscommunication between people can so profoundly impact their lives. (57)
Literature holds knowledge. The more a person reads, the more they know. It helps provide different perspectives. “Literature not only illuminated another’s experience, it provided, I believed, the richest material for moral reflection” (57-58). Not everyone has the same outlook. But knowing how a person thinks helps you understand them more.
When Paul thought that he could no longer go anywhere with literature, he turned to science. “Medical school sharpened my understanding of the relationship between meaning, life, and death” (84). He always looked for the meaning of life. Medical school was no exception. He was able to find some of his answers there. “I had started in this career, in part, to pursue death: to grasp it, uncloak it, and see it eye-to-eye, unblinking” (124). “Neurosurgery attracted me as much for its intertwining of brain and consciousness as for its intertwining of life and death” (124).
Life is not just about learning but also practicing. “It was becoming clear that learning to be a doctor in practice was going to be a very different education from being a medical student in the classroom” (100-101). Experiencing and learning are two different things. One can learn all they want, but they would not know everything until they put it all into practice.
Paul was a neurosurgeon resident until he was a cancer patient. “It occurred to me that my relationship with statistics changed as soon as I became one” (192). “Once I had been diagnosed with a terminal illness, I began to view the world through two perspectives; I was starting to see death as both doctor and patient” (198). Once the line between doctor and patient is crossed, everything changes. “How little do doctors understand the hells through which we put patients” (152). “As a doctor, you have a sense of what it’s like to be sick, but until you’ve gone through it yourself, you don’t really know” (200). Having the knowledge and actually experiencing it are two completely different things.
Severe illness wasn’t life-altering, it was life-shattering. It felt less like an epiphany—a piercing burst of light, illuminating What Really Matters—and more like someone had just firebombed the path forward. (173)
Paul Kalanithi
When Paul knew that his time was running out, he turned back to literature. He always knew that he wanted to write a book. Although he never was able to see the final product, he finished what he could.
Torn between being a doctor and being a patient, delving into medical science and turning back to literature for answers, I struggled, while facing my own death, to rebuild my old life—or perhaps find a new one. (199)
Knowing that he was running out of time, he did not complete all that he wanted. But he was able to complete as much of his plans as he could.
And so it was literature that brought me back to life during this time. The monolithic uncertainty of my future was deadening; everywhere I turned, the shadow of death obscured the meaning of any action. (212)
Literature was always there for him. When he couldn’t find the answers, he could in literature. Even at the end of his life, he was able to turn to literature.
Time is never certain. Nobody knows how much time they have. “Part of the cruelty of cancer, though, is not only that it limits your time; it also limits your energy, vastly reducing the amount you can squeeze into a day” (276). Paul was never able to finish writing. He did the best he could to finish as much as he could. His wife, Lucy, wrote in the epilogue that “this book carried the urgency of racing against time, of having important things to say” (299). “He wanted to help people understand death and face their morality” (299).
