When Breath Becomes Air

Completed:

April 26, 2016

I feel trepidatious writing about this book.  The author, Paul Kalanithi, died just one year ago and there is the sensation of walking on still broken earth; a sort of holiness still hovering around his story.  It is a beautiful book.  Dr. Kalanithi was a neurosurgeon / neuroscientist diagnosed with terminal lung cancer a couple years ago and this is what his aims for the book were, in his own words:

“It’s just tragic enough and just imaginable.  [The reader] can get into these shoes, walk a bit, and say ‘So that’s what it looks like from here… sooner or later I’ll be back here in my own shoes.’  That’s what I’m aiming for, I think.  Not the sensationalism of dying, and not exhortations to gather rosebuds, but: Here’s what lies up ahead on the road.”

He did a remarkable job meeting the mark.  His book had just that quality to it.  It wasn’t sensational or overly dramatic.  It wasn’t all “hey, be sure to hug your babies extra close” or anything even close to cliche.  It was his story; his experience, his thoughts, his processing as he went.  It was gripping.

One of the things that his oncologists pressed on him was the need to “figure out what matters to you.”  When he was diagnosed, there was no way to know if he had 3 months or 3 years or maybe even a decade to live.  Kalanithi struggled to know what to do with his time, not knowing how much of it he had left.  And his oncologist just kept saying, “I can’t answer your questions.  I don’t know how much time you have.  You just need to figure out what matters and do that.”   Sitting in bed reading late at night, the same age that Kalanithi was when he wrote the book, I was gripped by the urgency he must have felt.  And of course I wondered what I would choose to do with my time were it me.

Toward the end of the book I was completely surprised to read that he was a Christian.  He was raised in the Church, became an atheist in his 20’s and then came back to his Christian faith.  I wasn’t expecting to read his thoughts on faith.  Most of the book to that point had been Kalanithi grappling with what makes life meaningful, what it looked like to be a good doctor, and the how he had arrived at Stanford as a resident in neurosurgery.

He noted that (I’m paraphrasing here — I’m not a neurosurgeon!) God cannot be scientifically proven.  We will never be able to verify the existence of God with the scientific method.  And so much is left to mysticism and the human experience.

“Yet I returned to the central values of Christianity– sacrifice, redemption, forgiveness — because I found them so compelling.”

I have struggled with my own faith over the years; doubting, wrestling, struggling.  And I always come back to the same thing as Kalanithi.  I am overwhelmingly compelled by the upside-down, everybody’s in, mercy-trumping-judgement teachings of Jesus.  And Kalanithi grasped onto something that I easily and often forget; that one cannot be a Christian in isolation.  We need each other.

In the end, it cannot be doubted that each of us can see only a part of the picture.  The doctor sees one, the patient another, the engineer a third, the economist a fourth, the pearl diver a fifth, the alcoholic a sixth, the cable guy a seventh, the sheep farmer an eighth, the Indian beggar a ninth, the pastor a tenth.  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.

And the sections about his daughter, Cady, were the most poignant; the most piercing of all.   I almost couldn’t bear to read the sections where he wrote of his baby girl, who was just eight months when he died last March.

“Will having a newborn distract you from the time we have together?” she (his wife, Lucy) asked.  “Don’t you think saying goodbye to your child will make your death more painful?”

“Wouldn’t it be great if it did?” I said.

It is said that Kalanithi technically did not finish the book.  He died before it was complete.  But it ends with this message to Cady and I cannot imagine a more apt way for him to sign off.  I read and re-read it in the dark with a headlamp two nights ago and it took my breath away.

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.