How a Neurosurgeon Faced Terminal Cancer
Dr. Paul Kalanithi worked his whole life to become a neurosurgeon. As his fellowship ended, he had to face the type of fatal tumor he'd treated in countless patients.
Dr. Kalanithi was diagnosed with Stage IV lung cancer as he completed his postdoctoral fellowship in neuroscience. He was a neurosurgeon who had to face the end of his life at the peak of his career. He was 36 when he was diagnosed and had to grapple with the erasure of the planned life ahead of him and his family.
When Breath Becomes Air is a short book. It can be read in an afternoon, maybe an evening. It’s a moving account of how someone who healed patients for so long had suddenly become a terminal patient himself.
What it Means to Be a Patient
About halfway through the book, Dr. Kalanithi recalled the many times that he delivered bad news to patients. Telling patients that they had years or months to live was always difficult, but patients often took the news quietly. In a parenthetical, Dr. Kalanithi wrote one of the book’s most profound lines:
“One of the early meanings of patient, after all, is ‘one who endures hardship without complaint.’”
This isn’t an obvious choice for “one of the most profound quotes” from this book. However, this insight sets up the deeper thoughts he has later in the book — as he begins to die in real life and in the book — about how to handle the loss of his future.
Dr. Kalanithi remembered when he was lying in his hospital bed and understood that he would not return to his hospital as a doctor, but as a patient:
“My life had been building potential, potential that would now go unrealized. I had planned to do so much, and I had come so close. I was physically debilitated, my imagined future and my personal identity collapsed and I faced the same existential quandaries my patients face.”
Surprisingly, he did arrive at an answer to his profound question.
Beckett, Camus, Kalanithi
After Dr. Kalanithi’s lung cancer diagnosis, he found refuge in literature to “[search] for a vocabulary with which to make sense of death, to find a way to begin defining myself and inching forward again.”
“I needed words to go forward. And so it was literature that brought me back to life during this time.”
One of the quotes he found comfort in was seven words from Samuel Beckett: “I can’t go on. I’ll go on.”
It’s a testament to the resilience that life demands even in less dire times. So many events are out of our control. Often the only thing to do is to adapt and rebuild around events both inconvenient and shattering.
Beckett’s seven words mirror Albert Camus’ thoughts in The Myth of Sisyphus. Camus found meaning in the absurd struggle against inevitable death. They include the responsibilities that come with the freedoms to choose and act.
Camus’ title came from imagining Sisyphus walking back down the mountain after rolling his boulder up the hill and experiencing the height of freedom, because he was choosing to confront his absurd eternal punishment and spiting the gods through his choice.
Dr. Kalanithi’s final paragraph before his wife’s epilogue begins is a message to his daughter, who was eight months old at the time of his death:
“When you come to one of 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.”
When death is inevitable, the relationships we build and the meaning we bring to others are among the greatest things we can offer in our limited time. Even an infant can gift wise adults with its joy and accompanying sense of meaning.