You can’t ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving. Paul Kalanithi
Paul Kalanithi went to Stanford University then Yale School of Medicine to become an Indian-American neurosurgeon.
He wrote “When Breath Becomes Air” while receiving treatment for a rare type of lung cancer.
I find myself constantly returning to reread bits of the book because his vivid description of his rise to the pinnacle of residency — having mastered the core operations and garnered the highest awards —then reached a point where he ought to endure (a disorienting and “life-shattering”, as he puts in) terminal illness continues to deeply inspire me today because I find them so compelling.
It provides a stark reminder that: I am an abled-body being who has the time, and energy under my arsenal— a chance — to seize the day.
It’s effect on me: my lack of motivation and persistent idleness will thus not be tolerated. So I thought I might share his work:
- Science, I had come to learn, is as political, competitive, and fierce a career as you can find, full of the temptation to find easy paths.
- By the end of medical school, most students tended to focus on “lifestyle” specialties — those with more humane hours, higher salaries, and lower pressures — the idealism of their med school application essays tempered or lost.
- I was driven less by achievement than by trying to understand, in earnest: What makes human life meaningful?
- Life wasn’t about avoiding suffering. Years ago, it had occurred to me that Darwin and Nietzsche agreed on one thing: the defining characteristic of the organism is striving.
- I had thought that a life spent in the space between the two would grant me not merely a stage for compassionate action but an elevation of my own being: getting as far away from petty materialism, from self- important trivia, getting right there, to the heart of the matter, to truly life-and -death decision and struggles … surely a kind of transcendence would be found there?
(As an adolescent) Reading this was an eye-opening moment for me: there is no need to engage with petty materialism (i.e. purchasing the trendiest clothes, etc) because ultimately, in the future, whether or not people view you as a fashion icon, it would not matter.
6. Everyone succumbs to finitude. I suspect that I am not the only one who reaches this pluperfect state. Most ambitions are either achieved or abandoned; either way, they belong to the past. The future, instead of the ladder toward the goals of life, flattens out into a perpetual present. Money, status, all the vanities the preacher of Ecclesiastes described hold so little interest: a chasing after wind, indeed.
7. My life up until my illness could be understood as the linear sum of my choices.
This ties neatly with the concept of habits: habits are the compound interest of self-improvement.
Success is the product of daily habits — not once-in-a-lifetime transformation. The choices that we make everyday (a “linear sum”) are what helps us become the type of person who we wish to be; to strive to the trajectory to the person we want to be.
For Paul, everyday he chose to ceaselessly strive. It is in this pursuit he graduated from Stanford then to Yale to become a highly-awarded neurosurgeon-neuroscientist and writer all at once.
8. That morning, I made a decision: I would push myself to return to the OR [operating room]. Why? Because I could. Because that’s who I was. Because 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.
9. At those critical junctures, the question is not simply whether to live or die but what kind of life is worth living … Because the brain mediates our experience of the world, any neurosurgical problem forces a patient and family, ideally with a doctor as a guide, to answer this question: What makes life meaningful enough to go on living?
10. I had reached the pinnacle of residency. I had mastered the core operations. My research had garnered the highest awards … severe illness wasn’t life-altering, it was life-shattering.
“The man who loved hiking, camping, and running, who expressed his love through gigantic hugs, who threw his giggling niece high in the air — that was a man I no longer was. At best, I could aim to be him again … to reclaim the ambitions I had single-mindedly pursued for so long, but without the surety of the time to complete them.”
Being diagnosed with a terminal illness is no easy feat to encounter. It is perplexing to realise that the person you once were, the identity you had, and the trajectory that was once yours, to be no longer fills the mind with a whole slew of questions, as Paul has demonstrated.
However, despite death slowly lurking through his doorstep, Paul chose to aim to be “him” again — to pursue the ambitions he single-mindedly once had.
This propelled him to endure painful hours of physiotherapy to be able to walk into the operating room again.
And without the surety of time, he continued to ceaselessly strive.
We all have the surety of time, and the energy under our disposable — the very things that Paul did not have yet he triumphed through the tragedy — so, exactly, what are we waiting for?