Lessons on Facing Death, Unafraid

Paul Kalanithi spent much of his life examining the nature of life itself, and the inevitable death that results. He found his calling as a neurosurgeon until a diagnosis of stage IV lung cancer forced him to reexamine his own mortality. He wrote his memoirs, When Breath Becomes Air, during the final year of his life. These are the twelve passages from the book that I found most meaningful:

1. If the unexamined life was not worth living, was the unlived life worth examining?
2. Indeed, this is how 99 percent of people select their jobs: pay, work environment, hours. But that’s the point. Putting lifestyle first is how you find a job—not a calling.
3. Because the brain mediates our experience of the world, any neurosurgical problem forces a patient and family, ideally with a doctor as a guide, to answer this question: What makes life meaningful enough to go on living?
4. Rushing a patient to the OR to save only enough brain that his heart beats but he can never speak, he eats through a tube, and he is condemned to an existence he would never want…I came to see this as a more egregious failure than the patient dying.
5. I had to help those families understand that the person they knew—the full, vital independent human—now lived only in the past and that I needed their input to understand what sort of future he or she would want: an easy death or to be strung between bags of fluids going in, others coming out, to persist despite being unable to struggle.
6. it is important to be accurate, but you must always leave some room for hope.
7. If both areas are damaged, the patient becomes an isolate, something central to her humanity stolen forever. After someone suffers a head trauma or a stroke, the destruction of these areas often restrains the surgeon’s impulse to save a life: What kind of life exists without language?
8. As a doctor, I knew not to declare “Cancer is a battle I’m going to win!” or ask “Why me?” (Answer: Why not me?)
9. even if I’m dying, until I actually die, I am still living.
10. the physician’s duty is not to stave off death or return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence.
11. 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.
12. When Paul emailed his best friend in May 2013 to inform him that he had terminal cancer, he wrote, “The good news is I’ve already outlived two Brontës, Keats, and Stephen Crane. The bad news is that I haven’t written anything.”

When Breath Becomes Air is beautifully written by a man who truly loved words. The book is unfinished—because the author succumbed to his illness before he could finish it—but in a way, that fact adds to its message. If you found any of these passages inspirational, reading the book in its entirety might change the way you look at life, and death.

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