Through this book the author takes you through a journey, tries to answer the life and death question, confronts death, rises above it and leaves behind an energy. Dr. Paul Kalanithi, a neurosurgery resident on the verge of completion of his long residency program, gets diagnosed with stage IV lung cancer and is forced to flip his role from a doctor to a patient. He takes a stroll back through his life, decides to fulfill that one old dream of his - to be a writer and excels in it. Paul Kalanithi died in March 2015 while working on this book which was completed by his wife Dr. Lucy Kalanithi. So we very well know how this is going to end and would doubt if we should really try reading this. However the unsentimental handling of the book, the invisible optimism and the evident courage of the man makes it a positive and uplifting reading experience. And we would all agree to Lucy Kalanithi -
'What happened to Paul was tragic but he was not a tragedy!'.
The book is divided into three parts. A foreword by Dr. Abraham Verghese which he himself says should have been an afterword, the main book written by the author divided into three parts and an Epilogue written beautifully by Dr. Lucy Kalanithi.
Dr. Verghese in his Foreword correctly says he got to know the author in depth only after his death, though he had met him once before.
"I came to know him most intimately when he'd ceased to be"
I bet we all would get to know him intimately by the end of the book. The foreword is a little long but a nice read and adds to the bulk of the book.
The crux of the book starts with a short prologue where the author talks about how he gets diagnosed with lung cancer, and about the marital problems the couple had been facing and how that diagnosis brought them back together. The author then goes to his past, through a section titled 'In perfect health I begin', wherein we live his childhood with him. The section starts off with the author saying that he was certain of not becoming a doctor. Born in to a family of doctors, including his dad, he says he knew medicine from its absence. He studied English Literature, human biology and history instead. He was an avid reader and was influenced T.S. Eliot, Nabokov and Conrad but could not find the perfect answer for his question -what makes life meaningful? At Stanford he was lucky to work under one of the greatest living philosophers of his time Richard Rorty. His thesis, much unorthodox, was on the works of Walt Whitman and his vision of Physiological-Spiritual man. However he realized that it was in the practice of medicine that biology, morality literature and philosophy intersected! So he did follow the voice from inside to set aside the books and practice medicine.
The description of early days of his med school training is intriguing and flows parallel to the basic theme of this book - life and death. From anatomy dissections where he dealt with the cadavers to time when he actually gets to see the patients, the first birth he saw which was also the first death, he shows how life and death are closely intersected. There are no boring case histories with loads of medical information and its light and peaceful journey. Delightful!
Later when he had to specialize he found his friends pick up the lifestyle branches with humane work hours and easy money, he followed his heart to master the surgery of the brain - arguably our most important organ. He proves that he wasn't wrong in following his passion. He then describes a few cases in a way only a skilled surgeon can do and we get to see his dexterous hands. Being a doctor is not all about treating them, it is also about talking to them, his biggest inspiration for this was his dad. He explains the power of mind, constructive and destructive, with the examples of psychogenic syndromes. He brings up the issue of self-doubt, when even his moral exemplar, Mr. V on getting diagnosed with pancreatic cancer had the same questions as him in the face of morality.
Then he describes more about his diagnosis and treatment, initially he responded to a new biological therapy and his cancer was almost cured. At this point he regained his strength and pushed himself to work again as a neurosurgery resident and completed his residency. He donned the scrubs he once thought he would never wear again. But there is always a last! His lungs showed a new growth and his condition worsened forcing him to complete the last purpose of his life- to be a writer and he started working on this book. Towards the end he and his wife plans to have a kid and Cady is born and the brief family time they have is touching, intense and full of love! And one day Paul left us! As Lucy Kalanithi puts it
" Paul's decision not to avert his eyes from death epitomizes a fortitude we don't celebrate enough in our death avoidant culture. "
My (amateurish) Rating - 4.5/5
*** I came to know about this book from a friend who said its a must read for us, Doctors. But the basic theme of this book being philosophical and dealing with life and death, it attracted me. I could correlate a lot with this book probably because I am doing my residency in internal medicine. My eyes were full on completing this book. It was supposed to be a sad book but it isn't sad at all levels. I loved the book and thought I would make this my first post here. Excuse this little frog in a well for the possible mistakes***
