Mortality: When Breath Becomes Air

I finished When Breath Becomes Air by Paul Kalanithi about a week ago, but I needed some time to think before I started writing. I first heard about this book on NPR, and was immediately intrigued by the circumstances surrounding its creation. Kalanithi was a neurosurgeon who was diagnosed with lung cancer in 2013 and wrote this book before his death in 2015.

Around the same time I heard about the book, my best friend's uncle passed away from brain cancer. While I didn't know him well, it was a devastating loss for my friend, and I realized only after his death the extent of his personal and professional impact on countless individuals. He truly made the world a better place, and reading about all of his contributions and accomplishments in his obituary forced me to wonder about my own legacy and question how I might be remembered.

So in the months between hearing about the book and actually reading it, I spent a fair amount of time thinking about death and loss. I expected the book to be about confronting one's own mortality, but was surprised to find that it was really more about life. As it turns out, Kalanithi spent his entire adult life pursuing this great question: how do we make life meaningful?

Like many who have taken on this great question, Kalanithi began with the simple profundity of nature. Here he describes dawn at Lake Tahoe: "No philosopher can explain the sublime better than this, standing between day and night. It was as if this were the moment God said, 'Let there be light!' You could not help but feel your specklike existence against the immensity of the mountain, the earth, the universe, and yet still feel your own two feet on the talus, reaffirming your presence amid the grandeur" (34).

This "specklike existence" hits me every time I think about the vastness of the universe. Sometimes it makes me feel like I am a significant part of something bigger, and other times it makes me feel inconsequential. It is that tension, I think, that drives us forward in our quest for understanding.

The "struggle toward the capital-T Truth," as Kalanithi puts it, often seems impossible. However, he writes, "In the end, it cannot be doubted that each of us can see only a part of the picture. [...] Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete" (172). At the end of his life, it was his family and friends that brought him the most comfort, joy, and peace. Any time I begin to question or explore my own spirituality, I too am always brought back to these personal relationships. Can we all agree that kindness, forgiveness, and love are the universal principles in all religions?

One unexpected detail from the author's life is that his undergraduate and Master's degrees were actually in Literature, which of course I found intriguing. He weaves quotations from classic literature throughout his musings, using great authors and thinkers to justify or add to his own philosophy.

When Kalanithi was first diagnosed, he wrote to a friend, "The good news is I've already outlived two Brontes, Keats, and Stephen Crane. The bad news is that I haven't written anything" (221). It is a good reminder that many great artists and writers lived in times of war, plague, and high infant and maternal mortality rates. Perhaps they wrote as if they were racing the clock, crafting masterpieces before they were thirty. Now, we have the luxury of expecting eighty or more years, and so we take our time, "finding ourselves" in our twenties, growing careers and families in our thirties. We put off our "bucket lists" because we believe we will have more time later. But what if later never comes? Kalanithi was diagnosed just as his residency was ending. The career he worked tirelessly for was never realized. His first child was only eight months old when he passed away.

Despite this harsh reality, his wife writes in the epilogue, "Even while terminally ill, Paul was fully alive; despite physical collapse, he remained vigorous, open, full of hope not for an unlikely cure but for days that were full of purpose and meaning" (219). His dedication to living a purposeful life, even at the very end, is what I found most inspirational.

I don't have any sage words of wisdom to end with, except to say that I think we can carpe diem by making time for things that are truly important: going on a date with your spouse, finding shapes in the clouds with your kids, or asking Mom to teach you how to make her famous lasagna. We can't all be neurosurgeons, we can't all save the world, but we can all seize these moments that make our lives meaningful.