Death is the reality

Image used with permission from my son Dr. Kevin Sudevan (a screenshot grabbed from a video of him performing a craniotomy)

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. - Paul Kalanithi in his book When breath becomes air.

This is one of the books I have read this year and has made a deep impact on me. It touched my soul and the words of the author continues to vibrate deep within. Often times when I speak about death to anyone I find that the person immediately tries to change the subject in an effort to make the conversation lighter.

Death is a concept that does scare many of us, even those of us who boast that death doesn't scare us are shaken to the core when death stares us in the face or stretches its hands to snatch a loved one. Death is a part of life, easy to say that right? All of us know that we will die someday, but the problem is when the sentence hangs like an albatross on our shoulders but still remains a mystery in terms of how much time is left.

I was speaking about death to my son last week and he immediately said, "Mom can we speak about happier things?' This is a young man who stares death in the face everyday. He is himself a Neurosurgery resident nearing his final year of residency. Every surgery he does right now is a trauma case, mainly an accident where some one fell off from a height, or a road accident. Yet, there is this hesitation to talk about death, death of his loved one.

PaulKalanithi Random House publishing Group

This book 'When Breath Becomes Air" is a memoir written by a brilliant neurosurgeon and neuroscientist, Paul Kalanithi. Dr.Paul faces a death sentence - fourth stage liver cancer. One would assume that it is tragic book about suffering and death, which it looks like on the outset, but to be honest it is a book about life, time, choices, values and identity. I intentionally added time to the list as Paul writes about time as he sees it from the point of view while he faces life after "the diagnosis".

“Time for me is now double-edged: every day brings me further from the low of my last relapse but closer to the next recurrence – and, eventually, death. Perhaps later than I think, but certainly sooner than I desire.”

After ten years of training to be a neurosurgeon just as he stands at the pinnacle of success the scan he sees rattles the very foundation of his dreams, his liver and spine are ridden with tumors. Paul the chief resident who has always had to make the decision on what he could do to save a patients life while ensuring that the patient/s is still able to live a life of quality is now faced with the same dilemma about his life. The roles have changed he is now a patient under the care of the best oncologist but still at the mercy of the doctors and an sterile, clinical system. There he writes about the patient doctor equation which every doctor should read.

“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.”.- Paul Kalanithi, When Breath Becomes Air

Paul poignantly talks about how most of us lose sight of our mortality and pursue the things that really don't matter in the final equation. Cherishing what matters is what living life is all about. Paul chooses to spend the time he has left on this earth by doing what he loves the most. He decides to write his memoir and leave a legacy behind for those of us who still alive wondering about the purpose of life.

Take life as it comes, you are entitled to nothing. Asking why me doesn't help, it only serves to make the challenge more difficult and the heart more bitter, so embrace the life you have is the message I got from this book. I find this approach so honest, and practical. There is no point in running away from the package called life, we cannot just take the best things and refuse to accept the difficult parts about life.

Values make us who we are, nonetheless when faced with the prospect of death in the near future our values change, actually they get redefined by the time that is left to us. As we face the inevitable all other pursuits in life lose their significance and only what is most important takes center space.

Paul writes about how his illness has changed everything about his life.

“Verb conjugation has become muddled, as well. Which is correct: “I am a neurosurgeon,” “I was a neurosurgeon,” or “I had been a neurosurgeon before and will be again”?..
So what tense am I living in now? Have I proceeded beyond the present tense and into the past perfect? The future tense seems vacant and, on others’ lips, jarring.” sums up his dilemma.

Just as his life hangs in the balance he and his wife Lucy decide to have a child. Lucy asks him if having a child would make it more painful to say goodbye when the time comes and Paul answers, "Well wouldn't it be great if it did". The meaning of life, the value of one's existence and the nature of life and death is conveyed in this one short sentence.

The letter he writes to his daughter is so poignant that it made me cry.

When you come to one of the many moments in life when you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man’s days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more, but rests, satisfied. In this time, right now, that is an enormous thing. - Paul Kalanithi

"I am ready" Paul expresses his readiness to die, to have the support systems removed and face death staring it squarely in the face. He embraces death just as he embraced life. How many of us would be ready to face death bravely I've wonder so many times? Forget about the readiness to die, most of us don't even have the courage to speak about death.

This book is so intense, gripping and brutally honest in its approach. It wrenches my heart, made me cry a few times and made me smile at so many other places. Paul's humor even as he faces death is amazing. He writes an email to his friend telling him about his illness

“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.” - Paul Kalanithi In his book When breath becomes air.

This is the book I've wanted to discus with family and friends since the time I read it, but they are worried that I am talking about my death and want to put this off. So what If I want to talk about my death? Death is inevitable, no one can stop it, I am more vulnerable than most others (because of my heart condition) but that doesn't mean I may not outlive others. On the other hand maybe I'll die tomorrow, death doesn't warn anyone about its arrival, nor does death wait for anyone.

I am glad to have shared my take on this incredible book. Dr. Paul Kalanithi has given me a new understanding of death. I have not really feared death but to accept death and embrace it as a part of living became so real as I read this book.

Thank you for giving me this opportunity to share my thoughts on this book. This is my attempt to answer @irenenavarroart 's secon question for the 132 challenge of the #ladiesofhive community contest. I know I am writing this at the last minute, but I just noticed this challenge a couple of hours ago.

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