When Breath Becomes Air

by Paul Kalanithi

Books became my closest confidants, finely ground lenses providing new views of the world.

If the unexamined life was not worth living, was the unlived life worth examining?

No philosopher can explain the sublime better than this, standing between day and night. It was as if this were the moment God said, “Let there be light!” You could not help but feel your specklike existence against the immensity of the mountain, the earth, the universe, and yet still feel your own two feet on the talus, reaffirming your presence amid the grandeur.

brains give rise to our ability to form relationships and make life meaningful. Sometimes, they break.

I had come to see language as an almost supernatural force, existing between people, bringing our brains, shielded in centimeter-thick skulls, into communion.

Moral speculation was puny compared to moral action.

here you are, violating society’s most fundamental taboos, and yet formaldehyde is a powerful appetite stimulant, so you also crave a burrito.

Doctors invade the body in every way imaginable. They see people at their most vulnerable, their most scared, their most private. They escort them into the world, and then back out.

every operation on the brain is, by necessity, a manipulation of the substance of our selves,

he who should teach men to die would at the same time teach them to live.

The fact of death is unsettling. Yet there is no other way to live.

Hemingway described his process in similar terms: acquiring rich experiences, then retreating to cogitate and write about them.

Because I would have to learn to live in a different way, seeing death as an imposing itinerant visitor but knowing that even if I’m dying, until I actually die, I am still living.

Death may be a one-time event, but living with terminal illness is a process.

I had learned something, something not found in Hippocrates, Maimonides, or Osler: the physician’s duty is not to stave off death or return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence.

That’s not to say that if you believe in meaning, you must also believe in God. It is to say, though, that if you believe that science provides no basis for God, then you are almost obligated to conclude that science provides no basis for meaning and, therefore, life itself doesn’t have any. In other words, existential claims have no weight; all knowledge is scientific knowledge.

Science may provide the most useful way to organize empirical, reproducible data, but its power to do so is predicated on its inability to grasp the most central aspects of human life: hope, fear, love, hate, beauty, envy, honor, weakness, striving, suffering, virtue.

Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete.

Graham Greene once said that life was lived in the first twenty years and the remainder was just reflection.

Ardbeg