Hope in the Proper Things

I've been telling nearly every patient, colleague, resident, medical student, person-in-the-elevator I come across to read Paul Kalanithi's book When Breath Becomes Air (now that I look, I see that it’s the #1 nonfiction book on the NYT bestseller list, so, I’m probably not the only one doing this). When Paul published his article in the New York Times in 2014, he reminded us of the injustice of a cancer diagnosis, especially for someone still in his youth. With his follow up piece in the Washington Post, he conquers this injustice with his reminder that life is lived now, with the people around us, and it’s not lived in the years we expect we will have, because we might not have them.

I think about dying young more often than I should. My dad's first cancer was diagnosed when he was 44, now just 4 years away for me. To be fair, that one and his next one (at age 53) were cured with surgery, but his lung cancer is the one that took him (age 63) and that’s still a bit too early in my opinion. I frequently consider that this could be a legacy I’ve inherited.

Paul’s death at 37 is a non-sensical tragedy, but the gift he's given us by sharing his story is unmeasurable. Having done a residency and fellowship, I can't even imagine what it must have been like to learn that the mantra we trainees all repeat over and over, (hard work pays off, eventually) might not come true. Yet, not a sliver of resentment shows through in his writing.

Instead, nearly every page in his articles and in his book shines light. Light on the value of today. This day: the one we and our family and friends are in right now. Especially a day during which we're healthy, but also the darker ones. The ones that test us, when the challenges far outweigh the rewards. Paul found light on those days, too.

A most powerful reminder from Paul’s writing is that it doesn’t matter what we’ve done or what we think we deserve based on the sacrifices we’ve made or the awards we’ve received. To quote his Post article,

“Most ambitions are either achieved or abandoned; either way, they belong to the past…Money, status, all the vanities the preacher of Ecclesiastes described, hold so little interest…”

Paul never preaches about what should matter to us, either. He simply shows us what matters to him. The final paragraph of Paul’s Post article (which he included in When Breath Becomes Air as well) is one of the most beautiful string of sentences I’ve ever read. I won’t risk suppressing their impact by including them here, but I am not ashamed to admit that they made me cry more freely than I had in a long time.

I’m away from the hospital this week, on vacation with my wife, kids, and a bunch of grandparents. I’m grateful to Paul for the reminder that the ambitions we carry are not the greatest legacy we will leave behind; even in the absence of tragedy, the beautiful things in our lives are fleeting. The only way to honor them is to live them.