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September 26, 2016

When Breath Becomes Air

by Anne Paddock

When there’s no place for the scalpel, words are the surgeon’s only tool.

Paul Kalanithi graduated from Stanford with a BA and an MA in English Literature and a BA in Biology. He also earned a MPhil in history and philosophy of science and medicine from Cambridge before attending and graduating from the Yale School of Medicine. He returned to Stanford to do an 8-year residency in neurosurgery and a postdoctoral fellowship in neuroscience.  In his seventh year of residency in May, 2013, 36-year old Paul Kalanithi was diagnosed with Stage 4 lung cancer – an illness that rarely strikes young men (he notes that only 0.0012 percent of 36-year olds get lung cancer).

Faced with his own mortality and the grim statistics, Kalanithi pursued aggressive treatment and struggled to complete his residency but he also decided to pursue his love of writing.  He wrote an article for the New York Times called “How Long Have I Got Left” which was published on January 24, 2014, eight months after his diagnosis. At the time, his wife, Lucy was pregnant with their daughter, Cady who would be born in June, 2014.  Encouraged by the response to his article, Kalanithi continued to write as he struggled with his illness, the side effects of the treatments, and his desire to pursue the answers to the question “What makes life meaningful enough to go on living?” The answer was to pursue love – love of his family, friends, and co-workers – because these relationships gave his life meaning.

When_Breath-Becomes_AirKalanithi frantically wrote about this stage of his life in a book that was published in 2016, a year after he died in March, 2015 (22 months after his initial diagnosis).  The book – When Breath Becomes Air – is dedicated to his daughter, Cady who was 8 months old when he died.

The author knew his daughter would never remember him and that the book would be his legacy to her.  What he didn’t know was that the book would become a New York Times Bestseller and an inspiration to many because the words tell the story of a man who faced death with courage and dignity by focusing on living (“We are never so wise as when we live in the moment.”).  He knew the odds better than anyone but he didn’t dwell on his sentence; instead, he focused  on the people who gave his life meaning which is why the book is such a fantastic read.

Several years ago (2008), Randy Pausch with Jeffrey Zaslow published The Last Lecture which was written after Pausch delivered his last lecture at Carnegie Mellon after being diagnosed with pancreatic cancer. The “last lecture” was titled  “Achieving Your Childhood Dreams” and the book expanded on those ideas. Although the book was primarily written for his three young children, readers of all ages were inspired by The Last Lecture.

While Pausch focused on how to live in his bookKalanithi zeroed in on how to find meaning in a life cut short in When Breath Becomes Air. Kalanithi doesn’t tell the reader how to die but instead, how he decided to spend the limited amount of time he had left, which included living in the moment with the people – his wife, daughter, parents, brothers, friends, and colleagues – who made his life meaningful.

Kalanithi had planned to do so much, and he had come so close. His biggest regret was that he would never see his daughter grow up and so he wanted to leave her with his words including the following:

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.

What Kalanithi couldn’t know is how moving his words would be for the people who would eventually read When Breath Becomes Air, a book that seems at times to be unfinished. Kalanithi did in fact die before the book was finished but his wife, Lucy along with Abraham Verghese (who wrote the Foreward) pulled his work together to publish this unforgettable story.

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