When I saw this book on amazon, I was struck by the short teaser it had. I just ordered it right away. And it was a magnificent journey in traversing bravely the personal, professional, spiritual, philosophical and mortal aspects of human life, death and everything in between.

Explaining his rationale behind penning this book, Paul wrote in an email to his best friend, “It’s just tragic enough and imaginable enough. [ The reader ] can get into these shoes, walk a bit, and say, ‘So that’s what it looks like from here…sooner or later I’ll be back here in my own shoes.’ That’s what I’m aiming for, I think. Not the sensationalism of dying, and not the exhortations to gather rosebuds, but : Here’s what lies up ahead on the road.”

Dr. Paul Kalanithi, son to Indian immigrants in US, did his B. A. in English literature and human biology at Stanford University, California, and then an M. A. in the history and philosophy of science at Cambridge, before graduating summa cum laude from the Yale School of Medicine. He returned to Stanford for a residency in neurological surgery and a postdoctoral fellowship in neuroscience. His training was almost complete when the bad cancer diagnosis hit.

Dr. Kalanithi truly understood the role of doctors in a patient’s life and appreciated the access the patient provides to him, “Doctors invade the body in every way imaginable. They see the people at their most vulnerable,  their most scared, their most private. They escort them into the world and then out.”

Being a neurosurgeon was not merely a job for him. He writes, “People often ask if it is a calling, and my answer is always yes. You can’t see it as a job, because if it’s a job, it’s one of the worst jobs there is.” Putting lifestyle first is how you find a job, not a calling.

He acknowledged his limitations as a surgeon, “As a doctor, you have a sense of what it’s like to be sick,  but until you’ve gone through it yourself , you don’t really know. It’s like falling in love or having a kid.” Simultaneously, he knew his job was not limited to the patient but it encompassed their families too.

“As a resident, my highest ideal was not saving lives – everyone dies eventually – but guiding a patient or family to an understanding of death or illness. When a patient in with a fatal head bleed, that first conversation with a neurosurgeon may forever color how the family remembers the death, from a peacefulletting go to an open sore of regret. When there’s no place for scalpel, words are the surgeon’s only tool.”

Paul Kalanithi with a colleague at the Stanford hospital and clinics, California, in February 2014. He died 13 months later.

When he sent his best friend an email in May 2013 revealing that he had terminal cancer, he wrote: “The good news is that I’ve already outlived two Brontës, Keats and Stephen Crane. The bad news is that I haven’t written anything.” It was a jokey way of dealing with the unthinkable but also an indication of Dr. Kalanithi’s tremendous ambition. He had led a fascinating life and was not about to leave it unchronicled.

“I had began to realise that coming face to face with my own mortality, in a sense had changed nothing and everything.” he wrote. In the epilogue, his wife Lucy writes, “Paul lived each stage of his illness with grace – not with bravado or a misguided faith that he would overcome of beat cancer but with an authenticity  that allows him to grieve the loss of the future he had planned and forego a new one.”

Surgeon Paul Kalanithi with his wife Lucy and daughter Cady. When Kalanithi is diagnosed with terminal cancer, his role is immediately transformed from doctor to patient, and from active to passive

To paraphrase Abraham Verghese’s introduction, to read this book is to feel that Dr. Kalanithi still lives, with enormous power to influence the lives of others even though he is gone. This medical masterpiece explores the perimeter of death as the reality of life, not as a pre-determined force pulling us. It is an unforgettable life-affirming reflection of a brilliant human being.


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