Monday, February 15, 2016

When breath becomes air by Paul Kalanithi

This book was a very difficult one for me to read, but I could not put it down once I started. Kalanithi was a neurosurgeon who died in his late 30s from lung cancer. This book is a record of his illness. This book is not for the faint of heart, and if you have a chronic illness yourself, you should be ready to face your own fears if you read this book.

Instead of talking about the book, I will just quote some of the passages from the book that gave me pause.

I began to realize that coming in such close contact with my own mortality had changed both nothing and everything. Before my cancer was diagnosed, I knew that someday I would die, but I didn't know when. After the diagnosis, I knew that someday I would die, but I didn't know when. But now I knew it acutely. The problem wasn't really a scientific one. The fact of death is unsettling. Yet there is no other way to live.

"Leave some room for a statistically improbable but still plausible outcome---a survival just above the measured 95 percent confidence interval". Is that what hope was? ... It occurred to me that my relationship with statistics changed as soon as I became one.... Getting too deeply into statistics is like trying to quench a thirst with salty water. The angst of facing mortality has no remedy in probability. 

That morning, I made a decision: I would push myself to return to the OR. Why? Because I could. Because that's who I was. Because I would have to learn to live in a different way, seeing death as an imposing itinerant visitor but knowing that even if I'm dying, until I actually die, I am still living. 

The tricky part of illness is that, as you go through it, your values are constantly changing. You try to figure out what matters to you, and then you keep figuring it out. It felt like someone had taken away my credit card and I having to learn how to budget. 

The most obvious might be an impulse to frantic activity: to "live life to the fullest,"  to travel, to dine, to achieve a host of neglected ambitions. 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. It is a tired hare who now races. And even if I had the energy, I prefer a more tortoiselike approach. I plod, I ponder. Some days, I simply persist.

His wife reports that Kalanithi made a huge effort to write this book as he slowly deteriorated.  This is the most important work I have read in many years. Everyone should read it. Healthy people who take their lives for granted, and sick people who are trying to find direction in their truncated lives.