How to come to terms with death? This is the sort of question that many of us, for understandable reasons, avoid confronting. But a book with this as the central question has risen to the #1 spot on the New York Times bestseller list, Paul Kalanithi’s autobiography, When Breath Becomes Air.
Paul Kalanithi was a star sixth-year neurosurgery resident at Stanford when he was diagnosed with terminal metastatic lung cancer. He was able to return to work just long enough to complete his residency. He and his wife Lucy, also a doctor, focused on strengthening marriage, which had been strained by the demands of their residencies. They had a child, their daughter Cady. Dr. Kalanithi died twenty-two months after his diagnosis. The anniversary of his death is next week, March 9.
The poignant story of the death of a young man of such great promise accounts for much of the draw of Dr. Kalanithi’s autobiography. Another aspect of the book’s draw is the sketches of medical histories of Dr. Kalanithi’s neurosurgery patients, each of which tells of the mysteries of the brain: One patient became inconsolably sad when an electrode to control his Parkinson’s tremors was inserted deep into his brain, while another patient became euphorically happy after the removal of his brain tumor.
But another deeply moving part of his story is how Dr. Kalanithi’s engagement with great literature bore him up in his confrontation with mortality.
Dr. Kalanithi introduced to literature by his mother, who was determined to compensate for their public school district’s deficiencies by seeing that her sons read the books listed on a “college prep reading list” she had tracked down—a list that included many classics. Later, Kalanithi’s high school girlfriend handed him a fantasy novel, Satan: His Psychotherapy and Cure by the Unfortunate Dr. Kassler, J.S.P.S., that sparked his interest in biology and neuroscience. He went on to earn both an undergraduate and a master’s degree in English literature at Stanford before taking up medicine.
When Dr. Kalanithi was diagnosed with terminal cancer, literature—not his medical knowledge—provided the intellectual resources to come to terms with death:
Lost in a featureless wasteland of my own mortality, and finding no traction in the reams of scientific studies, intercellular molecular pathways, and endless curves of survival statistics, I began reading literature again: Solzhenitsyn’s Cancer Ward, B. S. Johnson’s The Unfortunates, Tolstoy’s Ivan Ilyich, Nagel’s Mind and Cosmos, Woolf, Kafka, Montaigne, Frost, Greville, memoirs of cancer patients—anything by anyone who had ever written about mortality. I was searching for a vocabulary with which to make sense of death…
For Dr. Kalanithi, he was able to begin “reading literature again” because he had read so much literature in earlier years—he knew how to read a great book, and he had enough acquaintance with great literature to know how to pick out the books that would speak to him then. But someone who had not already read a lot of literature would not know where to look, or how to read a great book.
Death at such a young age comes by chance. But the resources of literature Dr. Kalanithi’s was able to draw on to face up to his early death came to him not through chance, but through the determination of his mother, the interest of a girlfriend, and dedicated teachers he met at college. Not everyone is so fortunate to have such a determined mother or to attend such a fine college. But we can try to insist that our schools introduce students to great literature so that it will be there, in the back of their minds, to be a resource when today’s young people grow up and face crises of their own.