"Because The Brain Mediates Our Experience Of The World, Any Neurosurgical Problem Forces A Patient And Family, Ideally With A Doctor As A Guide, To Answer This Question: What Makes Life Meaningful Enough To Go On Living?"

So as predicted, I did read When Breath Becomes Air in 2 days. And I do agree with the profound praise that the book has received: it is quite a remarkable read.

The book is the memoir of Paul Kalanithi, a young, talented Stanford neurosurgeon who goes from physician to patient when he discovers that he has stage IV lung cancer. But the book certainly isn't just that simple and it isn't just a recounting of his treatments and coping with the disease. It tells of his early studies and of how Paul decided to pursue neurosurgery even though he majored in literature. He explains his assessment that literature provides the rich account of human existence and that it would provide him  with the tools to fully understand the pivotal question: what makes human life meaningful? It is a question/phrase that is used many times throughout the book and is certainly the crux that guided many of Paul's choices in life. And after graduation from undergrad, Paul comes to see that medicine will allow him to have direct experience with "meaning, life, and death," which literature cannot provide.

But it turns out that his diagnosis and facing his own mortality helps him understand these issues better than he ever did by removing a brain tumor or counseling patients and families who were suddenly faced with life and death situations and decisions. While he is clear that death was never something that he disacknowledged and that it was an ever-present topic during his medical studies and practice, knowing that he had a much more limited amount of time than expected put a significant shift in how he viewed his own mortality, and more importantly, his own humanity.

The book ends somewhat abruptly, and the epilogue by Paul's wife Lucy helps to explain the circumstances of his death, pursuing the completion of the book, and sharing her perspective of their relationship and his disease. While I was reading the book and the epilogue, it was strange too because I remember a lot of the stuff that Lucy had posted on Facebook while it was happening. I actually went back to look at posts and stuff from that time. And while the book ended around the time that Lucy and Paul's daughter was born, I knew that Paul had lived for a while after that (around 8 months), recalling that they had been chosen as part of a charity event to attend the Superbowl in Arizona in 2015 (as we all cheered on the Seahawks); Paul passed away about a month afterward. So the abrupt ending to the book probably meant that Paul only managed to write up through his daughter's birth.

The book is definitely cerebral and I think I appreciated the philosophical, biological, and literary examination of existence even more because I am also someone who works in science but is a fanatic lover of literature, and who also has aspirations of being a writer (at least in a different context than what my day job is). So maybe my take away should be a parallel: what am I waiting for? How do I know that I even have enough promised time to make it happen?

I would very much recommend the book and really think that it should be required reading for new medical students. There is so much reflection on understanding one's motivation and calling to be a physician in spite of the extraordinary rigors and life sacrifice it requires (Paul initially talks with a bit of resentment about how his father, a physician, was so often absent in his life, but then goes on to make exactly the same decision). But Paul also makes effective communication and empathy with his patients his focus of paramount importance, even though it was easy to get wrapped up in the other empty formalities of being a physician and lose sight of the patient as priority (a particularly poignant anecdote brings this concept home: a fellow resident was assigned to a 9 hour pancreatic cancer resectioning surgery after being up all night, which ended up being cancelled due to the discovery of metastases, and the resident is relieved about the cancellation, but realizes that her relief means something terrible for the patient).

While I never met Lucy's husband, his evaluation of life and death and its meaning and how he pursued them with aplomb during his too-short life was exceptional. It would have been wonderful to read more from such a talented writer and scholar, but we are certainly fortunate to have this book, which is profound, yet life-affirming.

So. Up next. Dare I do it...is Ulysses. The main reason is that the only other list book that I have in my possession is Macbeth. So it's a toss up at this point. I have 3 other non-list books that I could read, but I figure that since I have the time off, it might be a good beast to just dig into now. So we'll see how this goes. While I don't necessarily like reading 2 books at once, I may have to shift to others if this becomes a struggle (I'm having flashbacks to the agony that was Moby Dick). Wish me luck.