When Breath Becomes Air

by Paul Kalanithi

When I was a med student, the first patient I met with this sort of problem was a sixty-two-year-old man with a brain tumor. We strolled into his room on morning rounds, and the resident asked him, “Mr. Michaels, how are you feeling today?” “Four six one eight nineteen!” he replied, somewhat affably. The tumor had interrupted his speech circuitry, so he could speak only in streams of numbers, but he still had prosody, he could still emote: smile, scowl, sigh. He recited another series of numbers, this time with urgency. There was something he wanted to tell us, but the digits could communicate nothing other than his fear and fury. The team prepared to leave the room; for some reason, I lingered. “Fourteen one two eight,” he pleaded with me, holding my hand. “Fourteen one two eight.” “I’m sorry.” “Fourteen one two eight,” he said mournfully, staring into my eyes. And then I left to catch up to the team. He died a few months later, buried with whatever message he had for the world.