When Breath Becomes Air

by Paul Kalanithi

this is how 99 percent of people select their jobs: pay, work environment, hours. But that’s the point. Putting lifestyle first is how you find a job—not a calling.)

the question is not simply whether to live or die but what kind of life is worth living.

Any major illness transforms a patient’s—really, an entire family’s—life. But brain diseases have the additional strangeness of the esoteric.

I could see that there were two strategies to cutting the time short, perhaps best exemplified by the tortoise and the hare. The hare moves as fast as possible, hands a blur, instruments clattering, falling to the floor; the skin slips open like a curtain, the skull flap is on the tray before the bone dust settles. As a result, the opening might need to be expanded a centimeter here or there because it’s not optimally placed. The tortoise, on the other hand, proceeds deliberately, with no wasted movements, measuring twice, cutting once. No step of the operation needs revisiting; everything moves in a precise, orderly fashion. If the hare makes too many minor missteps and has to keep adjusting, the tortoise wins.

Most lives are lived with passivity toward death—

Yes, all cancer patients are unlucky, but there’s cancer, and then there’s CANCER, and you have to be really unlucky to have the latter.

life wasn’t about avoiding suffering.

even if I’m dying, until I actually die, I am still living.

In medicine, this is known as the WICOS problem: Who Is the Captain Of the Ship?

What happened to Paul was tragic, but he was not a tragedy.