February 14, 2016

I finished reading one of the most mind-opening, emotionally moving books that I have ever read:  “When Breath Becomes Air” by Paul Kalanithi.  Kalanithi graduated from Stanford University with a B.A. and M.A. in English Literature.  He went on to earn a Master’s Degree in History and Philosophy of Science and Medicine from the University of Cambridge and graduated cum laude from the Yale School of Medicine.

He returned to Stanford to complete his residency training in neurological surgery.  At the age of 36, on the verge of completing a decade’s worth of training as a neurosurgeon, he was diagnosed with Stage IV lung cancer.

This magnificent book tells the story of his practice as a doctor treating the dying which flowed to the story of him as a patient struggling to live.  He died in March 2015 while working on this book.  His wife completed it.

I have never read a book which brings to life in anything so graphic way the incredible intricacy of operating on the human brain and the miracle that the brain represents.

There are too many phrases and thoughts in this book to try to summarize it in any way that could be satisfactory.  Yet, there were many thoughts that I resonated to so closely based on my own experiences that I cannot fail to record them for future reference.

“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’d prefer a more tortoise-like approach.  I plot.  I ponder.  Some days, I simply persist.  Languor settles in.  There is a feeling of openness.  Now the time of day means nothing, the day of the week scarcely more.”

“Doctor and patient, in a relationship that sometimes carries a magisterial air and other times, like now, was no more and no less, than two people huddled together, as one faces the abyss.  Doctors, it turns out, need hope, too.”

Kalanithi’s memoir leaves us staring starkly into the inevitability of death but equally indeed more so that life is precious and miraculous and needs to be lived in the moment.

Kalanithi’s perspectives on faith and religion mirror my own in many ways.  Like many of us, it is clear he had moments, many of them, of deep disbelief.  Moments when, like most scientific types, “(I) came to believe in the possibility of a material conception of reality, an ultimately scientific world view that would grant a complete metaphysics, minus out-moded concepts like souls, God, and bearded white men in robes.”  He acknowledged spending a lot of his 20s working to build a frame for such an endeavor but, as he eloquently writes, “the problem eventually became evident:  to make science the arbiter of metaphysics is to banish not only God from the world but also love, hate, meaning—to consider a world that is self-evidently not the world we live in.

Scientific methodology in the end is the product of human hands and thus cannot reach some permanent truth.”  This makes “scientific knowledge inapplicable to the existential, visceral nature of human life, which is unique and subjunctive and unpredictable.”  It is unable “to grasp the most central aspects of human life:  hope, fear, love, hate, beauty, envy, honor, weakness, striving, suffering, virtue.”

Like myself, Kalanithi returned to the “central values of Christianity—sacrifice, redemption, forgiveness—because I found them so compelling.”  The main message of Jesus, Kalanithi believed, as do I, is that “mercy trumps justice every time.”

Finally, I have resonated to Kalanithi’s rumination that “maybe the basic message of original sin is less an internal ‘feel guilty all the time'; maybe it is more along these lines:  ‘we all have a notion of what it means to be good and we can’t live up to it all the time.’”

So what is the aspiring metaphysician to do?, Kalanithi wonders, “give up?  Almost,” he replies.  But he goes on (we must) “struggle toward the Truth, but recognize that the task is impossible—or that if a correct answer is possible, verification certainly is impossible.  In the end, it cannot be doubted that each of us can see only part of the picture.  The doctor sees one, the patient another, the engineer a third, etc., etc.  Human knowledge is never contained in one person.  It grows from the relationships we create between each other and the world, and still is never complete.  And Truth comes somewhere above all of them where, as at the end of that Sunday’s reading, ‘the sober and reaper can rejoice together.’  For here the saying is verified that ‘one sows and another reaps.  I sent you to reap what you have not worked for; others have done the work and you are sharing the fruits of that work.’”

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