When Breath Becomes Air, by neurosurgeon Paul Kalanithi, was recommended to me by a good friend. Although I currently have way too much on the go reading wise because of upcoming classes this fall, I found myself drawn to this book so I requested it from the local library. I’m so glad I did. The book is a powerful, sad, yet beautiful memoir of the author’s quest for a meaningful life. It documents his desire to grasp meaning, especially as it relates to life and death, and how that propelled him into the incredibly challenging career path of a neurosurgeon. His desire to be with people is constantly assaulted by the pressure and speed of the job, the need to constantly make decisions of incredible gravity, and the questions that come from contemplating what it means to live with a brain injury. As if that wasn’t enough, in his late 30s he is diagnosed with cancer, moving all of these life and death contemplations from “a patient’s” struggle to “his”.

Kalanithi is an eloquent writer, voicing his own wrestling with how to face the issue of dying, which informs so much of how we face the issue of living. I resonated with this book because issues of meaning and purpose, life and death, peace and struggle are what dominate my thinking on a daily basis as I work as a pastor. He writes of himself, “Had I been more religious in my youth, I might have become a pastor, for it was the pastoral role I’d sought.” (88) I think that we all search for meaning in the overwhelming circumstances of life, but often the “dailyness” of life and the seemingly endless series of difficult situations that we encounter in our lives and in the lives of others can hinder us from actually contemplating life as it really is. He calls this a search for “a kind of transcendence”, an ability to see deeply and grasp fully why we are here and how best to spend our lives.

I had started this career, in part, to pursue death: to grasp it, uncloak it, and see it eye-to-eye, unblinking. Neurosurgery attracted me as much for its intertwining of brain and consciousness as for its intertwining of life and death. I had thought that a life spent in the space between the two would grant me not merely a stage for compassionate action but an elevation of my own being: getting as far away from petty materialism, from self-important trivia, getting right there, to the heart of the matter, to truly life-and-death decisions and struggles…surely a kind of transcendence would be found there?

But in residency, something else was gradually unfolding. In the midst of this endless barrage of head injuries, I began to suspect that being so close to the fiery light of such moments only blinded me to their nature, like trying to learn astronomy by staring directly at the sun. I was not yet with patients in their pivotal moments. I was merely at those pivotal moments. I observed a lot of suffering; worse, I became inured to it. Drowning, even in blood, one adapts, learns to float, to swim, even to enjoy life, bonding with nurses, doctors, and others who are clinging to the same raft, caught in the same tide.
— Paul Kalanithi (p.81-82)

What finally brought clarity was his own diagnosis. It reminded him of what he already knew, that patients were people not merely problems to be solved. As he sat on the other end of all the tests and consultations he began to see ever more deeply the issues with which all humanity grapples. As his cancer progressed he increasingly found peace and joy in the smallest of things. Perhaps the most beautifully written section of the book are the words he wrote to his infant daughter.

There is perhaps only one thing to say to the infant, who is all future, overlapping briefly with me, whose life, barring the improbable, is all but past. That message is simple. 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.
— Kalanithi (p. 199)

There is a great joy that can be found in our relationships with each other. If we can see past the busyness of our day or the incursions of people’s needs into our own desire to control our time and focus we often begin to taste the depth of what it means to be connected to one another. This flows out of a theological idea, that we are all created in the image of God. God, within His very self is a relationship of Father, Son, and Spirit. That means that we are created to be “in relationship”, both with God and others. It is only in the living out of this relational connection that we can truly be human. Kalanithi is on to this throughout his whole life and it is reflected in the entire book. But the clarity comes when he is staring death in the face. As if often the case, when we know our time is limited we have a shift in perspective that allows us to see what is really important. This book helped me to see this a little more clearly, thankfully without the personal experience of a terminal illness. To remember again that the people around me are more than just “around me”. They are actually a part of me. Seeing them that way, as gifts that come from God, uniquely packaged and sometimes paired with a side of frustration and difficulty, is a reminder that I need on a regular basis. So thanks, Pat Daws, for telling me I needed to read this book. You were right.

Jeff KuhnComment