Saturday 2 April 2016

When Breath Becomes Air (not an A to Z post)

'When Breath Becomes Air' by Paul Kalanithi was yet another recommendation from Brainpickings; sometimes I think I should stop following it because I can't keep up with all the interesting stuff, but it does extend my reading into non-fiction that I didn't use to read much of.

This book is the life and death of a neurosurgeon who seems to have spent his life contemplating the nature of death and what it means to be alive, so while it is his own story it is also a recounting of some things he has learned along the way. He blends the story of his own illness with the story of his academic pursuits and interests that eventually led him to leave literature and study medicine. It is very much about becoming a doctor, and how he learned to treat his patients as people rather than illnesses. As he writes you can but wish for every medical person you might encounter to be so dedicated to caring and single minded in their pursuit of excellence. As a brain surgeon he seems intensely aware of how his work has the ability to not only save, but to irrevocably change, his patients lives. 

"While all doctors treat diseases, neurosurgeons work in the crucible of identity: every operation on the brain is, by necessity, a manipulation of the substance of our selves, and every conversation with a patient undergoing brain surgery cannot help but confront this fact. In addition, to the patient and the family, the brain surgery is usually the most dramatic event they have ever faced, and, as such, has the impact of any major life event. At those critical junctures, the question is not simply whether to live or die but what kind of life is worth living. Would you trade your ability - or your mother's - to talk for a few extra months of mute life? The expansion of your visual blind spot in exchange for eliminating the small possibility of a fatal brain haemorrhage? Your right hand's function to stop seizures? How much neurologic suffering would you let your child endure before saying that death is preferable? Because the brain mediates our experience of the world, any neurological problem forces the patient and family, ideally with a doctor as a guide, to answer this question: What makes life meaningful enough to go on living?" (p.71)

His cancer forces him into the position of patient and so his own existence thus becomes an extension of his search to understand what makes us human and what makes life meaningful; in having to readjust his view of what he could achieve in his life he is forced to evaluate what is really valuable to him:

"One chapter of my life seemed to have ended; perhaps the whole book was closing. Instead of being the pastoral figure aiding a life transition, I found myself the sheep, lost and confused. 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.
The lung cancer diagnosis was confirmed. My carefully planned and hard-won future no longer existed. Death, so familiar to me in my work, was now paying a personal visit. Here we were, finally face-to-face, and yet nothing about it seemed recognisable. Standing at the crossroads where I should have been able to see and follow the footprints of the countless patients I had treated over the years, I saw instead only a blank, a harsh, vacant, gleaming white desert, as if a sandstorm had erased all trace of familiarity." (p.120-1)

Paul finds his own answer to the meaningful life question; the answer is not *the* answer, it is just his answer. He is not trying to tell anyone what they should do, just that they should find it for themselves, which is what makes this book so thought provoking. The urgency of terminal illness must focus the mind, where the rest of us flounder around with all the time in the world to consider the endless possibilities of life. Happy floundering. 


  1. You sound like me when it comes to reading. I love the breadth but time is a commodity. I stack books in order on one bookshelf. I haven't touched it in a month. I'm working on reading Kindle and doing the A to Z challenge.
    This looks like an incredible, reflective book.

  2. Sounds like a powerful story.

    I have so many books I want to read. I know people who can read a book a day, not me. I am so slow!


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