You may have seen Kalanithi’s story featured on TV—a brilliant young neurosurgeon is diagnosed with stage IV lung cancer and shares his story with the world. Or you may have read his New York Times op-ed that went viral in which he asked, “How Long Have I Got Left?” It is not until you read his 2016 memoir, “When Breath Becomes Air,” which was published posthumously, that you understand his brilliance and depth and the loss we all share when he died in 2015 at the age of 37.
Kalanithi was raised in Arizona, and as a boy he knew he wanted to write. At Stanford he majored in English literature, which he thought to be “the best account of the human mind,” but added the study of neuroscience in order to understand “the most elegant rules of the brain.” He craved knowledge. After college he did advanced work in literature and philosophy but became fascinated with the science of thought and became a neurological surgeon, one of the most mentally and physically demanding jobs imaginable.
He and his wife Lucy, also a physician, rarely had time for each other, so they put off thoughts of starting a family. But during the final stretch of his residency in which he was doing ground-breaking research, excruciating pain in his back, overwhelming fatigue and weight loss drove him to see a doctor. That appointment led to his diagnosis of terminal lung cancer, though the amount of time he had left was unclear.
The cancer, he said, “wasn’t life-altering, it was life-shattering.” Frustrated by the uncertainty of how much longer he would live, every decision about the direction of his life took on weight.
He was fortunate to have an accomplished and wise specialist treat him, one with whom he could be a partner. Their discussions are wonderful examples of patient-centered care where she would ask him repeatedly, “What do you value? What’s important for you to have in your life?” in order to recommend the best treatment. These questions led Paul and his wife to decide to have a child from sperm that had been frozen before chemotherapy began. He was able to delight in their daughter Cady in the months preceding his death.
Lucy wrote an elegant epilogue. She speaks of their last few years, though “wrenching and difficult,” as the “most beautiful and profound of my life.” Sometimes it is death that teaches us about life.