Written by: Dr. Raymond Cruz
One of the best books I have read on the end of life was given to me by my good friend and boss, Dr. Mae Corvera of The Ruth Foundation. No surprise, for Dr. Mae’s passion for hospice and palliative care makes her an authority on good reads about death and dying. Entitled “When Breath Becomes Air”, it is a memoir of a neurosurgeon who was diagnosed with a terminal illness at the age of thirty-six. Dr. Paul Kalanithi takes us through his residency training program, the long hours, the skipped meals, the joys and pains of saving lives, and finally, the trials and tribulations of discovering one’s mortality.
Dr. Kalanithi died of Stage IV Lung Cancer. From his narrative, you could surmise the possible risk factors for this illness – the stressful hours and poor dietary habits – but surprisingly, no mention of any smoking history. It was also heartbreaking how he slowly discovered his illness, the weight loss associated with it, and of course the denial that comes with it. How would you feel if you were diagnosed with advanced cancer at the threshold of your brilliant career?
You never realize the significance of what you are studying until death stares you right in the face.
The book was well-written, for Kalanithi studied literature at Stanford before entering medical school. His quest for significance led him to science, and as he relates his adventures in the various medical subjects ––the medical student in me came flooding back. It’s not really that difficult to be a student, but being in the hospital taking care of actual patients is a different matter. You never realize the significance of what you are studying until death stares you right in the face.
I appreciated Paul’s effort to empathize with his patients. When you are tired and time is of the essence, you tend to overlook the human being behind the patient. This is when it becomes tempting to avoid communication and to focus on routine technicalities. But when Paul was diagnosed with the illness, it was then that he realized what it was like to be on the other side. For no matter how brilliantly you explain and diagnose a disease, the individual sufferer does not remember any of the doctor’s words. The only thing that one can think about is: why me?
A doctor’s life during training passes by like a blur. You sometimes fail to recognize days and nights. All you tend to focus on is the task at hand and hope you don’t make mistakes. In Paul’s case, he never feels like time is passing when he operates because he is so intensely focused on the task at hand. Being technically precise, he says, is crucial. Sometimes the pressure can be catastrophic, as what happened to one of his medical school friends who committed suicide.
What makes life meaningful for one to go on living? It is the thought that one’s life can save another’s.
What makes life meaningful for one to go on living? It is the thought that one’s life can save another’s. Paul’s hands handled countless surgeries, but in the end, his hands could not save his own body. So what happens with the rush associated with achievements in life? Well, it could amount to nothing, if it is filled with self-fulfilling goals without uplifting the lives of others.
Paul realized that although death comes to everyone, because it is an inevitable fate, there is no other way to live but to strive. In dying, he felt that he still needed to live. His values changed as he went through the process of chemotherapy. Every day became an opportunity. He realized the importance of relationships. What happened to Paul was tragic, but it was no tragedy. For in his experiences, we who are still here have come to learn from his story.