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Paul Kalanithi Books

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“Dying in one’s fourth decade is unusual now, but dying is not. “The thing about lung cancer is that it’s not exotic,” Paul wrote in an email to his best friend, Robin. “The reader can get into these shoes, walk a bit, and say, ‘So that’s what it looks like from here. Sooner or later, I’ll be back here in my own shoes.’ That’s what I’m aiming for, I think. Not the sensationalism of dying and not the exhortations to gather rosebuds but: Here’s what lies up ahead on the road.” Of course, he did more than just describe the terrain. He traversed it bravely.”

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“Will having a newborn distract from the time we have together?' she asked. 'Don't you think saying goodbye to your child will make your death more painful?' 'Wouldn't it be great if it did?' I said. Lucy and I both felt that life wasn't about avoiding suffering. Years ago, it had occurred to me that Darwin and Nietzsche agreed on one thing: the defining characteristic of the organism is striving. Describing life otherwise was like painting a tiger without stripes. After so many years of living with death, I'd come to understand that the easiest death wasn't necessarily the best. We talked it over. Our families gave their blessing. We decided to have a child. We would carry on living, instead of dying.”

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“Before operating on a patient's brain, I realized, I must first understand his mind: his identity, his values, what makes his life worth living, & what devastation makes it reasonable to let that life end. The cost of my dedication to succeed was high, & the ineluctable failures brought me nearly unbearable guilt. Those burdens are what make medicine holy & wholly impossible.”

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“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 but rests, satisfied. In this time, right now, that is an enormous thing.”

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“By the end of medical school, most students tended to focus on "lifestyle" specialities - those with more humane hours, higher salaries, and lower pressures - the idealism of their med school application essays tempered or lost. As graduation neared and we sat down, in a Yale tradition, to re-write our commencement oath - a melding of the words of Hippocrates, Maimonides, Osler, along with a few other great medical forefathers - several students argued for the removal of language insisting that we place our patients' interests above our own. (The rest of us didn't allow this discussion to continue for long. The words stayed. This kind of egotism struck me as antithetical to medicine and, it should be noted, entirely reasonable. Indeed, this is how 99 percent of people select their jobs: pay, work environment, hours. But thats the point. Putting lifestyle first is how you find a job - not a calling).”

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“After I was caught returning at dawn from one such late-night escapade, my worried mother thoroughly interrogated me regarding every drug teenagers take, never suspecting that the most intoxicating thing I’d experienced, by far, was the volume of romantic poetry she’d handed me the previous week. Books became my closest confidants, finely ground lenses providing new views of the world.”

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“I discussed in detail what to expect over the next couple of days: what the surgery entailed; how we'd shave only a small strip of her hair to keep it cosmetically appealing; how her arm would likely get a little weaker afterward but then stronger again; that if all went well, she'd be out of the hospital in three days; that this was just the first step in a marathon; that getting rest was important; and that I didn't expect them to retain anything I had just said and we'd go over everything again.”

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“My fellow resident Jeff and I worked traumas together. When he called me down to the trauma bay because of a concurrent head injury, we were always in sync. He'd assess the abdomen, then ask for my prognosis on a patient's cognitive function. "Well, he could still be a senator," I once replied, "but only from a small state." Jeff laughed, and from that moment on, state population became our barometer for head-injury severity. "Is he a Wyoming or a California?" Jeff would ask, trying to determine how intensive his care plan should be. Or I'd say, "Jeff, I know his blood pressure is labile, but I gotta get him to the OR or he's gonna go from Washington to Idaho---can you get him stabilized?”

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