You may not immediately recognize the name Paul Kalanithi, but it's highly likely you've read his work. In January 2014, Paul wrote an op-ed piece for The New York Times titled "How Long Have I Got Left?" that went viral. After being diagnosed with stage IV lung cancer at the age of 36, he very courageously shared how he was processing his diagnosis. His bravery and candor struck a chord with readers all over the world. The piece dominated my Facebook newsfeed for weeks.
During his treatment, Paul began writing a book. He had a lifelong love for literature and the written word. Before his diagnosis, he always thought he would write a book later in life. With an uncertain future, he became determined to make that dream a reality. No matter his condition or strength on any given day, he typed.
It was Paul's dying wish that his draft make it to print. He made his wife Lucy swear to shepherd it over the finish line and shepherd it she did. The book is called "When Breath Becomes Air" and it is brilliant and beautiful. It read it in two sittings.
The book begins with a prologue in which Paul describes learning of his diagnosis. He was in the final year of his neurosurgery residency, graduation on the horizon. He writes:
"At age thirty-six, I had reached the mountaintop; I could see the Promised Land, from Gilead to Jericho to the Mediterranean Sea. I could see a nice catamaran on that sea that Lucy, our hypothetical children, and I would take out on weekends. I could see the tension in my back unwinding as my work schedule eased and life became more manageable. I could see myself finally becoming the husband I'd promised to be."
Moments after the oncologist shares the news he continues:
"And with that, the future I had imagined, the one just about to be realized, the culmination of decades of striving, evaporated."
The prologue moves into Part I of the book (Part I of II). Those initial pages take us back to Paul's childhood, his love of learning and his decision to pursue medicine. He takes us on the journey with him as he puts those scrubs on for the first time and begins his residency. In one particularly poignant passage he pauses on the second day of residency to try and understand how he is expected to become the person who stands between life and death. The page reads:
"In my life, had I ever made a decision harder than choosing between a French Dip and a Reuben? How could I ever learn to make, and live with, such judgment calls? I still had a lot of practical medicine to learn, but would knowledge alone be enough, with life and death hanging in the balance? Surely intelligence wasn't enough; moral clarity was needed as well. Somehow, I had to believe, I would gain not only knowledge, but wisdom, too. After all, when I had walked into the hospital just one day before, birth and death had been merely abstract concepts. Now I had seen them both up close. Maybe Beckett's Pozzo is right. Maybe life is merely an 'instant,' too brief to consider. But my focus would have to be on my imminent role, intimately involved with the when and how of death -- the grave digger with the forceps."
In an equally honest and introspective moment, he shares how he attempted to process his transition from doctor to patient. He explains:
"One chapter of my life seemed to have ended; perhaps the whole book was closing. Instead of being the pastoral figure aiding life transition, I found myself the sheep, lost and confused. Sever illness wasn't life-altering, it was life-shattering. 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."
In Part II, Paul shares the details of his final year. His relationship with his oncologist, the choices he made about his own treatment. The incredibly difficult choice of whether or not to have a child with his wife, Lucy.
The second part of the book ends rather suddenly. As you're reading, you realize that is because Paul was unable to continue. He lost the fight. I can't explain how haunting that felt, realizing the narrative stopped not as a stylistic choice, but because Paul passed away before he could finish.
The book's epilogue is written by Paul's wife, Lucy. How she managed to do this I will never know. I am in awe of her strength and her commitment to honoring his wishes.
Lucy describes the moment in the hospital when Paul turned to her and said, "I'm ready." She shares:
"The family gathered together. During the precious minutes after Paul's decision, we all expressed our love and respect. Tears glistened in Paul's eyes. He expressed gratitude to his parents. He asked us to ensure that his manuscript be published in some form. He told me a last time that he loved me. The attending physician stepped in with strengthening words: 'Paul, after you die, your family will fall apart, but they'll put it back together because of the example of bravery you set.' Jeevan's eyes were trained on Paul as Suman said, 'Go in peace, my brother.' With my heart breaking, I climbed into the last bed we would share."
I was reading the epilogue on a plane and as I turned each page my lip was quivering, then my eyes started to well and then before I knew it, I was wiping away tears that wouldn't stop coming. There are so many parts of this book that are hard to read because as you get to know Paul, you begin to understand his incredible wisdom, talent and potential. The world lost someone exceptional.
This week I got to read about something wonderful that happened for Paul's wife Lucy and their daughter Cady. Lucy is the twin sister of Joanna Goddard, the blogger behind one of the most successful lifestyle sites in the country, A Cup of Jo. Through her relationships, Joanna was able to provide Lucy with a complete makeover for the apartment she shared with Paul. I cannot think of a person more deserving. You will not be abe to read this or see the photos without tearing up.
Though it is a very emotional book, you have to read "When Breath Becomes Air." It will fill you with gratitude for your health and your loved ones and it may even ignite a new fire to really chase your dreams. We should all strive to live our lives with the same passion, strength and bravery as Paul.
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