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Experiencing Life while Facing Death “When Breath Becomes Air” by Paul Kalanithi

Anxiety and depression have been a part of my life for so long that they have become a part of who I am. If you spend any time with me at all you will for sure hear me talk about them as they are a part of my daily life and routine. I’m used to them — I manage them. Last year, in 2017, I experienced the biggest loss of my adult life; and I’ve experienced a fair amount of loss. So this loss was a doozy.

Usually when my anxiety and depression flare up I manage them by sticking to my routine, not deviating from my normal activities, and forcing myself to do all the things I don’t want to do. This loss was different. It impacted every part of my life and no matter how I stuck to my routine I couldn't shake the feelings of loss I was experiencing. So I tried something different. I leaned into it. I let the loss wash over me. I bathed in it. I held it out to people who tried to talk to me and when they saw it, most of them ran away in fear. I was glad they did. I had no tolerance for happy people who were not in the throw of grief.

I found comradery with other people who had experienced extreme loss. I started listening to podcasts and reading books about people who had depression or were in recovery. The Hilarious World of Depression ( is probably the first dark podcast I started listening to.

Often they interview someone who has been through clinical depression or is in recovery following something terrible that happened to them. While listening to The Hilarious World of Depression I heard an advertisement for Terrible, Thanks for Asking (

This podcast is put on by a woman who in one year experienced the death of her father, her husband and lost a pregnancy. She's my kind of people. Ravaged by loss. I love her. It is dark and real. Did I mention I was bathing in my loss? I also read books about people that experienced traumatic loss. One that changed my life is “When Breath Becomes Air” by Paul Kalanithi.

Paul was 36 years old and in his sixth year of residency for neurosurgery when he got sick. Until he got sick, his life had been going according to his plan. He planned to spend the first 20 years of his life being a neurosurgeon and the second 20 years being a writer. In his last year of residency he was well on his way to becoming a neurosurgeon before he was 40. He was married to Lucy who is also a doctor and they completed medical school and their residencies together, and got married during this time. Reading about his experiences as a doctor in the first section of the book, one can tell Paul wasn’t an average doctor. He desired to master neurosurgery. He wanted to be the best. Not to simply be the best, but because he had a deep and genuine care and compassion for his patients. Finding compassion in a doctor with so much education is rare.

Paul says he knew right away when he got sick that it was cancer. He dropped weight and had terrible back pain. Even being a doctor himself, it took a year to get a diagnosis of cancer. Once he did get the diagnosis, he learned quickly it was “the bad kind” of cancer. First he was treated with a pill, then chemotherapy--which nearly killed him. Finally he was treated with experimental medicine. All treatments ultimately failed.

Sometimes cancer wins. Sometimes it even wins when it’s fighting someone who is extraordinary.

While Paul was fighting cancer he realized his plan of 20 years of neurosurgery and 20 years of writing would have to change. During his entire illness he tried to determine how long he had to live, but he was always unsuccessful. Fortunately and unfortunately our expiration dates are not stamped on our feet. Knowing death was an acute consideration he had to decide what was important to him and spend his time doing that. He did finish his last year of residency and he did become a neurosurgeon. He even went back to surgery.

He was never himself, but he was still exceptional. He and Lucy discussed having a child, something they always wanted. During their discussions about having a child, Lucy asked Paul if he thought having a child would make death more painful. His answer was “Wouldn’t it be great if it did?” The most impactful statement for me in the book was “Lucy and I both felt that life wasn’t about avoiding suffering.” And so while he battled cancer they created a child. A girl, who was born July 4th, 2014, with her mother laboring in one hospital bed and her father wrapped in blankets and heating pads in a bed next to her. Paul hoped that their child would have memories of him, but he died in March 2015 before her first birthday.

I walked away from “When Breath Becomes Air” with a desire to live. Paul faced a terminal illness and knew he was going to die. He knew it would be soon. In those moments we so often hear people say “I don’t want to die.” What Paul shows us through his life and his writing is that he didn’t just not want to die, but he wanted to live. He wanted to experience life. Somehow he managed to look death square in the eye and not be shaken to his core by fear. He seemed to be motivated by coming face to face with his mortality. How many of us could do that? Even while he faced his mortality, he continued to live a full life.

Paul and Lucy also demonstrated that life isn't about avoiding suffering. What a concept. To love fully means to risk heart break. Loving fully almost guarantees heart break. Loved ones die, they leave, they change and they disappoint. A brave person loves fully anyway. Until I read “When Breath Becomes Air” I never believed the quote by Alfred Lord Tennyson “‘Tis better to have loved and lost than never to have loved at all.” Seeing Paul experience life and death made me a believer. It also made my loss seem like it was worth it. It helped me to move forward from my own loss and to continue to have my heart open to experiencing life.

Written by We Are Kathy editor Heather Fenner

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