Monday, March 28, 2016

When Breath Becomes Air by Paul Kalanithi

Hardcover, 228 pages Published January 12th 2016 by Random House

What makes human life meaningful? Kalanithi, a thirty-six year old neurosurgeon, tried to locate the nexus of language between science and philosophy to answer the question. “Literature provide[s] the best account of a life of the mind, illuminates another’s experience, and provides the richest material for moral reflection.” There is messiness and weight in real human life that is not accounted for by science, says Kalanithi. Science and analytics (and atheism) cannot encompass all the mystery of human life. He gives the best argument I have heard for religious faith, suggesting that no one human has any answers because each individual has only piece of the puzzle. It is only in human connection that we can start to put the pieces together, making sense of the world. “Human knowledge grows in the relationships we form between each other and the world.”

Science, created by human hands to make sense of the world, cannot contain the world. It doesn’t account for those things that make literature, and life, so compelling and so meaningful: “hope, fear, love, hate, beauty, envy, honor, weakness, striving, suffering, virtue…sacrifice, redemption, forgiveness…justice...goodness…mercy.” Questions without answers. Pieces of a puzzle.

Kalanithi died of lung cancer shortly after writing these words. But he strove every day, in his work, in his studies, in his family and friends, to find meaning in life. He thought it might reside in words. Language. As a neurosurgeon he was taught, and he believed, that if a person lost the capacity to communicate--to speak or to understand language—their life became no life at all. He was a student of literature besides being a neurosurgeon, and in language was meaning.

This memoir is Kalanithi’s attempt at connection. The Foreword is written by a Dr. Abraham Verghese, author of the unique and unforgettable novel about medicine and Africa, Cutting for Stone. The Epilogue is written by his wife, Lucy Kalanithi, also a doctor. Their words fore and aft add heft and a kind of imprimatur: this man really existed and, yes, he was as thoughtful as he appears. His life had meaning.

Kalanithi changed my mind about something, and showed up a deficit, a smallness in my own thinking. I have always been suspicious of people who spend their lives in school, even though they might be concurrently working, piling up more and more degrees. Anybody can do that, I thought. Kalanithi completed a Bachelor's in English literature and human biology, a Master's in English literature, a degree from Cambridge in the history and philosophy of science and medicine, a medical degree with neuroscience and neurosurgery specializations. He was in his mid-thirties when he finally finished. And then he died. That last year he wrote this book and he managed to show me that, if one is focused and serious and seeks the critical nexus between life and death, one may begin to perceive the outlines of a moral philosophy that might help answer the large questions. We only have a lifetime to find meaning, and sometimes that lifetime is short.

When Kalanithi talks of his 8-month old daughter shortly before his death, how she is all future and he is all past, we see what he sees: that their circles just touch, but don’t significantly overlap. She will never know him. This has the poignancy, truth, messiness, love, and tragedy of literature. Of life.

I listened to the audio of this book, read by Sunil Malhotra and Cassandra Campbell. I have encountered Malhotra before and he is one of the best narrators in my experience. His pacing is perfect and he makes the reading very easy to follow. I ended up buying the hardcover because the book was so meaningful for me and because it is easy to pass around.
“One key to managing a terminal illness is to be deeply in love, vulnerable, kind, generous, grateful.” –Lucy Kalanithi



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