Good Books

When Breath Becomes Air


I just finished reading the book – When Breath Becomes Air written by Paul Kalanithi – a doctor who died of lung cancer shortly before he wrote in his book about his experience in his residency to become a doctor, his understanding of life and death, as well as the battling process with cancer.

“The author confronted death – examined it, wrestled with it, accepted it – as a physician and patient. He wanted to help people understand death and face their mortality.”

There are a lot of wisdom in his book, but I found my heart was exceptionally moved by these 3 parts of his book as shown below. I also wrote about my memory, thought and feeling in this post.

– 1 –

Early on, when I made a long, quick cut through my donor’s diaphragm in order to ease finding the splenic artery, our proctor was both livid and horrified. Not because I had destroyed an important structure or misunderstood a key concept or ruined a future dissection but because I had seemed so cavalier about it. The look on his face, his inability to vocalize his sadness, taught me more about medicine than any lecture I would ever attend. When I explained that another anatomy professor had told me to make the cut, our proctor’s sadness turned to rage, and suddenly red-faced professors were being dragged into the hallway.

Other times, the kinship was much simple. Once, while showing us the ruins of our donor’s pancreatic cancer, the professor asked, “How old is this fellow?”

“Seventy-four,” we replied.

“That’s my age,” he said, set down the probe, and walked away.

– 2 –

Second, it is important to be accurate, but you must always leave some room for hope. Rather than saying, “Median survival is eleven months” or “You have a ninety-five percent chance of being dead in two years,” I’d say, “Most patients live many months to a couple of years.” This was, to me, a more honest description. The problem is that you can’t tell an individual patient where she sits on the curve: Will she die in six months or sixty? I came to believe that it is irresponsible to be more precise than you can be accurate.

– 3 –

The way forward would seem obvious, if only I knew how many months or years I had left. Tell me three months, I’d spend time with family. Tell me one year, I’d write a book. Give me ten years, I’d get back to treating diseases. The truth that you live one day at a time didn’t help; What was I supposed to do with that day?

 

My Old Memory

Reading the book reminds me of my father’s death.

My father was diagnosed with Stage 4 lung cancer when I was in the early year of my study in college. He then lost the ability to walk because the cancer cell has spread over his spinal cord and as a result, he had been through radiotherapy and chemotherapy. In the initial treatment, the tumour started to shrink and we thought it will be continued this way, but later we realised it was just a false hope. The hope turned into despair in just a few months. Eventually the cancer cell became immune to the therapy and we just couldn’t stop the cancer cell growing bigger and bigger each day in my father’s body. It was more than just frustration and could never be described in words.

These painful memories came back when I read the author had been through similar process battling with Stage 4 lung cancer as described in his book, though my father died more than 9 years ago and I couldn’t even remember a lot of the details when he was sick. For instance, I do not remember which side of his lung (either left or right) was largely affected by the tumour. Yet, the feeling of depression and frustration was so strong in my heart and never go away.

There were a few times I dreamed that my father was still alive and healthy as if he had never passed away – was the memory that he died just a dream? But when I woke up finding myself alone in my rented flat (I was living alone for 4 years in Wellington in New Zealand) and remember the fact that father has left me for so many years, I felt extremely lonely.

 

Life and Death

The concept of death never really appears in my mind until I was 20 years old. I have never seen my grandparents as they passed away before I was born. My father wouldn’t let me attend any funeral (or even heard about it) because he was a very conservative Chinese man (and a bit too superstitious), who believed attending the funeral was not good. So, the first funeral that I attended was my beloved father’s funeral when I was 20 years old.

It was sad to see my father’s dead body, and at the same time, I was feeling strange. Because it was the first time I saw once-a-strong-and-healthy-person will eventually die and gone forever. Of course, when I was a kid I learned that a person will die, but I really just ‘feel’ it after living for 20 years. You LEARN something from book or school, but you FEEL something from your actual experience.

 

~ Life is beautiful, but fragile. ~

Life is too short and fragile. At the same time, it is so beautiful and exciting. I want no regrets, so I am doing my best to live my life to the fullest. I hope my life has some sorts of meaning, at least for myself.

Many things happened after the death of my father. Perhaps it was the point when my life truly began because my father’s death awakened my desire to live.

If I was never born, I will never have desire and feeling. But because I am now alive and healthy (as least for the moment), I want more than that. I have something that I want to accomplish, some people that I love and want to protect, some places that I really want to go.

 

~ How I look at Death ~

I fear no death, but I fear of suffering from the pain and disease and disability and causing pain in the people who love me. I also fear of being paralysed one day. What’s more painful than having thought and feeling but will never be able to express them? I am constantly having sleep paralysis and I am afraid. But after all, I am more fearful of the death of my love… just like how I lose my father.

I don’t think death itself is scary because I believe once a person is dead he/she will no longer have thought and feeling (as if sleeping without any dream). And I don’t believe in reincarnation or the ideas about heaven and hell. But perhaps, it is very immature and ignorant to say so because so far I have never hovered between life and death.

I remember my father said “if only I can live a few years more…” after he was diagnosed with lung cancer. If I know I will die soon, perhaps I am willing to do anything to live a bit longer. And I will definitely act differently than now if I know my life is going to the end soon.

Everyone look at death differently, and I have developed my belief too. My thought may change over time, but at least it is what I believe at the moment.

Death terrifies people, but it can also make people brave and pursue something that he/she really likes. We can’t change death, but we can change our perception on how we look at death. Death is neither evil nor kind, it is just the end of the process of life.

Thinking one will die one day, I constantly remind myself to ignore the trivial matters and stop judging people. Isn’t that a good thing?

 

~ Religion is a big influence ~

I think there is a huge connection between the religion and how people look at death. Some people may believe that there is reincarnation, or some may believe that a person will go to heaven or hell after death.

Well, no one really knows what happens after death. So it is the belief that matter the most.

Some people put their hope in the next life (reincarnation) or next generation (their children). For instance, if I cannot get my dream job as a doctor, maybe I would hope my children to become a doctor; or, even if I do not perform well in this life, it doesn’t matter since I will be reborn in a new body when I am dead…

In my opinion, these are very dangerous thoughts.

Your belief does not change how the universe does its work, but it shapes your desired life.

I don’t really believe in religion – it was partly influenced by my sister, but after all, it was my choice. I remember once my friend was shocked and said to me: “how can you not have a religion?!”

But, what is the point of having a religion that you do not have faith in? What is the point of saying myself is a Christian if I do not believe in Jesus Christ, or why claim myself a Buddhist if I do not believe in Buddhism?

In my opinion, humans are too insignificant to affect the universe. Are humans really that powerful? Why are we different from other living creatures and why would we have ‘special treatment’ after death? After all, we are just small tiny little mortals on earth.

Don’t get me wrong. I do not think that having beliefs of reincarnation or religion are wrong. I don’t judge or criticise. Life is too short to pursue something that can never be proven. I just want to emphasise it is the belief that shapes our life.

It is no wrong to put hope in next life or next generation, but it shouldn’t reduce the quality of our current lifestyle. Why give up doing better in our life when we are able to do so?

In fact, having a religion is good when it brings benefit or value to our life. I love the idea of Karma in Buddhism which means the actions of an individual (cause) will influence the future of that individual (effect). This has encouraged people to do more good things, such as helping people and so on.

Nonetheless, everyone is different. Some people feel their life is complete when they believe in God, but the same perception does not apply to me or some other people. It is a decision that we have to make – choose the most beneficial beliefs, and don’t feel bad about it.

 

~ From Life to Death ~

In Paul’s book, he described how he changed from a ‘heartless’ surgeon to someone who really cares for his patient and put himself in patient’s place. But it wasn’t until when he was sick and then realise how painful it was to go through the terminal illness. Yes… You will never feel it until you experience it. Trying to feel something that you haven’t been through is like quenching a thirst with salty water.

From life to death, it is merely a few decades – it is nothing compared to the billions of years of existence of the earth. Yet, it is the entire life for everyone, including me and you. Be humble and passionate, and find true meaning in our short life span. Perhaps, a meaningful life doesn’t mean pursuing something concrete, but instead, it is an attitude and spiritual fulfilment.

I hope that one day when I die, it is when I am ready to die. And I have accomplished everything that I have desired in my life. And, I would not cause anyone to suffer for me. 🙂

 

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