We are never so wise as when we live in this moment.
The book When Breath Becomes Air (1/12/16), by Stanford Neurosurgeon Paul Kalanithi, remInds me of The Last Lecture (4/8/2008) by Randy Pausch. These memoirs are lessons on living while powering through the most devastating medical obstacles life offers. They share profound insights on living fully in the face of death, by virtue of their authors’ words and actions, as they and their families embark upon an unexpected medical odyssey manifesting the essence of human endurance and inner strength.
I fell in love with author Paul Kalanithi early on in the book because of his passion for literature. He received a Bachelor and Master of Arts in English Literature, as well as a Bachelor of Science in Human Biology from Stanford University, later completing a Master of Arts in the History and Philosophy of Science and Medicine at Darwin College (University of Cambridge). By the time he’d completed his Masters, the calling to Medicine emerged the stronger passion, and Paul subsequently received his MD from Yale School of Medicine, returning to Stanford for a neurosurgery residency and postdoctoral fellowship in neuroscience. At Yale he met fellow medical student Lucy Goddard, and they married in 2006. Lucy wrote the book’s epilogue.
Paul described his academic journey, “I was driven less by achievement than by trying to understand in earnest what makes human life meaningful. I still felt literature provided the best account of the life of the mind, while neuroscience laid down the most elegant rules of the brain. Meaning, while a slippery concept, seemed inextricable from human relationships and moral values. Literature not only illuminated another’s experience, it provided, I believed, the richest material for moral reflection...Where did biology, morality, literature, and philosophy intersect?”
While completing his fellowship at Stanford he began to lose weight, and experienced great fatigue. When packing for a stay in the hospital, he decides to take only books of literature with him. He summarizes how his love of literature impacted him, “T. S. Eliot’s The Human Wasteland resonated profoundly relating meaninglessness and isolation, and the desperate quest for connection. I found Eliot’s metaphors leaking into my own language. Other authors resonated as well. Nabokov for his awareness of how our suffering can make us callous to the obvious suffering of another. Conrad for his hyper-tuned sense of how miscommunication between people can so profoundly impact their lives. Literature not only illuminated another’s experience, it provided, I believed, the richest material for moral reflection. My brief forays into the formal ethics of moral philosophy felt dry as a bone, missing the messiness and weight of real human life.”
Paul addresses his transformation from doctor to doctored,“It occurred to me that my relationship with statistics changed as soon as I became one.” As the story continues about the life he and his family create in the context of his cancer diagnosis, I am mindful of the power and poignancy of Paul’s earlier summer camp experience, described in the book. Following his freshman year at Stanford he applied for two different summer jobs, one at the Yerkes Primate Center, the other as prep chef at a summer camp. He receives offers from both, but chooses the summer camp, much to the dismay of his biology advisor. The camp was an immersion in fellowship against a backdrop of expansive, all encompassing breathtaking natural beauty. He describes standing on the peak of California’s Mount Tallac, as dawn brightens one horizon, from the opposite perspective, dark and stars still occupy the sky, “No philosopher can explain the sublime better than this, standing between day and night. It was as if this were the moment God said, ‘Let there be light!’ You could not help but feel your speck-like existence against the immensity of the mountain, the earth, the universe, and yet still feel your own two feet on the talus, reaffirming your presence amid the grandeur.” This image echoes the haunting quote Paul cites about the transitory nature of life from Samuel Beckett’s play Waiting for Godot, “They give birth astride of a grave, the light gleams an instant, then it's night once more.”
The assistant summer camp director, a doctoral student in English, later sends Paul his published short story about the camp. In one beautiful passage he writes, “Suddenly, now, I know what I want. I want the counselors to build a pyre...and let my ashes drop and mingle with the sand. Lose my bones amongst the driftwood, my teeth amongst the sand...I don’t believe in the wisdom of children, nor in the wisdom of the old. There is a moment, a cusp, when the sum of gathered experience is worn down by the details of living. We are never so wise as when we live in this moment.”
As Paul observes, “Life is not about avoiding suffering. It’s about creating meaning.” As his wife Lucy states in a TedMed talk, “We were learning that living fully means accepting suffering...Living means more than just staying alive.” She cites W.S. Merwin’s poem Separation, “Your absence has gone through me like thread through a needle. Everything I do is stitched with it’s color.” Life’s meaning is more than processing experiences, it’s about living richly in the moment, a kind of partaking in life’s communion with fellow travelers along the path, enriching, expanding, and strengthening us during our brief time together upon this planet, and understanding that while loss may separate, it never diminishes us.”
I fell in love with author Paul Kalanithi early on in the book because of his passion for literature. He received a Bachelor and Master of Arts in English Literature, as well as a Bachelor of Science in Human Biology from Stanford University, later completing a Master of Arts in the History and Philosophy of Science and Medicine at Darwin College (University of Cambridge). By the time he’d completed his Masters, the calling to Medicine emerged the stronger passion, and Paul subsequently received his MD from Yale School of Medicine, returning to Stanford for a neurosurgery residency and postdoctoral fellowship in neuroscience. At Yale he met fellow medical student Lucy Goddard, and they married in 2006. Lucy wrote the book’s epilogue.
Paul described his academic journey, “I was driven less by achievement than by trying to understand in earnest what makes human life meaningful. I still felt literature provided the best account of the life of the mind, while neuroscience laid down the most elegant rules of the brain. Meaning, while a slippery concept, seemed inextricable from human relationships and moral values. Literature not only illuminated another’s experience, it provided, I believed, the richest material for moral reflection...Where did biology, morality, literature, and philosophy intersect?”
While completing his fellowship at Stanford he began to lose weight, and experienced great fatigue. When packing for a stay in the hospital, he decides to take only books of literature with him. He summarizes how his love of literature impacted him, “T. S. Eliot’s The Human Wasteland resonated profoundly relating meaninglessness and isolation, and the desperate quest for connection. I found Eliot’s metaphors leaking into my own language. Other authors resonated as well. Nabokov for his awareness of how our suffering can make us callous to the obvious suffering of another. Conrad for his hyper-tuned sense of how miscommunication between people can so profoundly impact their lives. Literature not only illuminated another’s experience, it provided, I believed, the richest material for moral reflection. My brief forays into the formal ethics of moral philosophy felt dry as a bone, missing the messiness and weight of real human life.”
Paul addresses his transformation from doctor to doctored,“It occurred to me that my relationship with statistics changed as soon as I became one.” As the story continues about the life he and his family create in the context of his cancer diagnosis, I am mindful of the power and poignancy of Paul’s earlier summer camp experience, described in the book. Following his freshman year at Stanford he applied for two different summer jobs, one at the Yerkes Primate Center, the other as prep chef at a summer camp. He receives offers from both, but chooses the summer camp, much to the dismay of his biology advisor. The camp was an immersion in fellowship against a backdrop of expansive, all encompassing breathtaking natural beauty. He describes standing on the peak of California’s Mount Tallac, as dawn brightens one horizon, from the opposite perspective, dark and stars still occupy the sky, “No philosopher can explain the sublime better than this, standing between day and night. It was as if this were the moment God said, ‘Let there be light!’ You could not help but feel your speck-like existence against the immensity of the mountain, the earth, the universe, and yet still feel your own two feet on the talus, reaffirming your presence amid the grandeur.” This image echoes the haunting quote Paul cites about the transitory nature of life from Samuel Beckett’s play Waiting for Godot, “They give birth astride of a grave, the light gleams an instant, then it's night once more.”
The assistant summer camp director, a doctoral student in English, later sends Paul his published short story about the camp. In one beautiful passage he writes, “Suddenly, now, I know what I want. I want the counselors to build a pyre...and let my ashes drop and mingle with the sand. Lose my bones amongst the driftwood, my teeth amongst the sand...I don’t believe in the wisdom of children, nor in the wisdom of the old. There is a moment, a cusp, when the sum of gathered experience is worn down by the details of living. We are never so wise as when we live in this moment.”
As Paul observes, “Life is not about avoiding suffering. It’s about creating meaning.” As his wife Lucy states in a TedMed talk, “We were learning that living fully means accepting suffering...Living means more than just staying alive.” She cites W.S. Merwin’s poem Separation, “Your absence has gone through me like thread through a needle. Everything I do is stitched with it’s color.” Life’s meaning is more than processing experiences, it’s about living richly in the moment, a kind of partaking in life’s communion with fellow travelers along the path, enriching, expanding, and strengthening us during our brief time together upon this planet, and understanding that while loss may separate, it never diminishes us.”
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