Reading Paul Kalanithi’s book was like taking in one long breath, and heaving the longest sigh afterwards. It’s the memoir of a brilliant dying man, who spent his years engrossed in a study of how the mind works, first delving into literature and deeper, into neurosurgery. The book was a brief read, but along the way I learned a lot about the body, the mind, the importance of moral virtues and ultimately, the weight of our brief, fleeting lives.
The first part of When Breath Becomes Air involves Paul recalling his childhood in Arizona, as he explored the desert, awed by the sublime. In the foreword by Abraham Verghese, he writes that it wasn’t until he read the book that he truly came to know him. The author revels in the details of life in the desert, as it reveals the surprising pleasures he wouldn’t have known if their family stayed in New York City.
The young Paul had an admirable curiosity and a propensity to search for the deeper truths of one’s existence. These traits were even indulged by his mother, who supplied him with a “college reading prep list” instilling a passion for literature.
After I was caught returning at dawn from one such late-night escapade, my worried mother thoroughly interrogated me regarding every drug teenagers are taking, never suspecting that the most intoxicating thing I’d experienced, by far, was the volume of romantic poetry she’d handed me the previous week. Books became my closest confidants, finely ground lenses providing new views of the world.
Paul read the classics, absorbed in the work of writers like Vladimir Nabokov, Albert Camus, T.S. Eliot. He believed in the power of literature, that it not only provided illumination about universal experiences, but also fertile ground for moral reflection.
At one point, his then-girlfriend lent him a book that was not “high-culture crap,” something “lowbrow” for once. I had to chuckle at this for a second, as Paul discovered yet another truth: that the mind was simply an operation of the brain, an idea that struck him “with force.”
This discovery led him to look into biology and neuroscience, along with English at Stanford University.
Neurosurgery attracted me as much for its intertwining of brain and consciousness as for its intertwining of life and death. I had thought that a life spent in the space between the two would grant me not merely a stage for compassionate action but an elevation of my own being: getting as far away from petty materialism, from self-important trivia, getting right there, to the heart of the matter, to truly life-and-death decisions and struggles…surely a kind of transcendence would be found there?
It was here that his path to neurosurgery started — at Stanford, in the residency program, along with the long hours, the numerous operations. And then came the back pains and the sudden weight loss. He was working 12-16 hour days, surviving on energy drinks and ice cream sandwiches.
After frequent pains, a CT scan revealed his condition: his lungs had several tumors.
Shouldn’t terminal illness, then, be the perfect gift to that young man who had wanted to understand death? What better way to understand it than to live it? But I’d had no idea how hard it would be, how much terrain I would have to explore, map, settle.
The second half of the book was dedicated to living his life as a cancer patient. I’ve never read a book which dealt with the human body so much, as I’ve mostly been buried in books that focused on the metaphysical. I know myself to be scientifically-illiterate, unless it was political science. I’m not made for the hard science stuff, but the details of his operations, as he described his own OR techniques reveal the intricacies the human body.
Paul’s experience revealed that that both physical and metaphysical can co-exist, as he continued to operate, his mind the vessel and his hands as vehicles. He continued to operate for as long as he could. There were times when I choked up reading as I leafed through the pages, his mortality becoming more and more apparent.
It is these moments that remind me of the precariousness of life. To live by virtue, according to Paul, requires moral, emotional, mental and physical excellence. How do we live each day then, with the same zest that Paul saw in life? How do we strive to live by our virtues? The path he chose as a neurosurgeon required grit in the face of highly stressful clinical situations, while writing required the courage to go inwards. I don’t know how he did both.
It is Paul’s attitude — his capacity to forge ahead with conviction is what makes him memorable. At some point, he and Lucy decided to have a child in spite of his impending death. His writing ends with a message to her daughter Cady, of what he felt with his short time with her: a joy that does not hunger for more.
This, I believe, was Paul’s consistent message: