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Dacian

Book: When Breath Becomes Air

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Many times, I wondered what is left of us after we pass away. What do we actually leave behind? It’s always an impossible list as I always know that something might happen that will be definitory to my life up until that point. What we need to make that list is a clear sign that our demise is near and that we will not be able to amount to much else than we already have – but even then, are we really incapable of something great that will remain as our most valuable lesson? Is the idea of death an influence when it is imperceptible or when it is all-encompassing?

Paul Kalanithi emigrated to the US along with his parents and initially followed academic studies in English literature, ultimately to follow in his father’s footsteps and become a doctor. He chose the hardest medical profession, neurosurgery, in which he became one of the most respectable and acclaimed fellows. His residency training was assimilated quickly and he became chief resident. Offers of academic research were pouring in – a remarkable career lay ahead with certain voices calling him one of the best neurosurgeons and doctors of his generation.

After experiencing night sweats, unrelenting back pain and a cough he chose to have a medical check-up that delivered the fatal news: lung cancer. A non-smoker, recently married with everything pointing to a fulminating career was drawn in the tragic story of untimely death.

The story does not end here – this is not the story of the brilliant neurosurgeon that dies of cancer and the world will never know what might have happened. The story begins here – the recollection of his childhood, the love for literature and his family and the last stand in the face of death. Treatment begins and all the ups and downs that come along with it. Hard choices are being made – he and his wife decide to have a daughter, he continues to practice his trade and decides to write a memoir.

When Breath Becomes Air is a memoir that will become a classic – it is pure and straightforward, it paints the image of a life that was lived as all lives are lived and was extraordinary in its unspectacularly dullness. A family that emigrated, a son that became a neurosurgeon and married and after a swift illness had passed away. But there is more, much more – between every line of text there is this feeling that lingers on, like tasting salt. It is simple, but it masks an incredible thirst for knowledge, a love for mankind and the art it is capable of. To study, to practice, to love, to write – each with its difficulties and rewards.

Paul Kalanithi takes us on the journey of his life, we see him as he has saw the world around him. We learn of the hardships and the joys of his life. The struggle of becoming a neurosurgeon, the passion for helping people and developing his craft, the illness and the decisions that have come alongside it, his family and the last day as a doctor. It is intense and it is real and there is nothing more to say other than that – it is a life between two covers, a real life.

To the world When Breath Becomes Air is what we will have left of Paul Kalanithi – we will remember him as a writer and only a handful of his patients that he operated on during his residency will remember him as a doctor. The illness reshaped his life and with that his destiny – he might have become the greatest neurosurgeon in the world, but today he is known as the man that documented his life and his illness, his family and his trade, in one amazing memoir that will remain his testament upon this earth. The incurable disease has stolen the son, the husband and the father from a family and the man who could have made a real difference for some patients, but it has given the world an insight to the nature of man.

Book: Being Mortal: Medicine and What Matters in the End

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One of the topics most avoided when talking about medicine is death. Sure, we are all informed about what causes premature death – like overdose of prescription pills and bad habits that will severely impact our lifespan – but never about regular end of life, when the decrepit body simply breaks down and fades away. It’s like this should never be mentioned – we will do everything in our power to save your life and get you through this – but the problem is that this battle is never won, we die and can do very little about it.

If we are to look back, like a century or so, we see that death was a norm, a tax that needed to be paid. People expected to die and didn’t make much fuss about it – the numbers of people dying at home, in their bed, surrounded by their loved ones were much higher than today. In our time we die mostly in the hospital, connected to machines and kept away from our loved ones in clear rooms in order to prolong our lives even minutes more – even though by then we are either in agony or unconscious.

Truth is that modern medicine, vaccines and hi-tech imaging machines have prolonged our lives considerably – we have moved from an average span of approximately 50 year just a few decades ago to over 70 – that is a huge increase and has brought along with it the idea that one day we might be immortal – even as we are dying today we cannot but hope that in the last minute they will find a cure and we will carry on.

Atul Gawande looks at death through multiple lenses – from hospice care to elderly homes and geriatrics. The strengths and weaknesses of modern medicine and how doctors and the population can prepare themselves for what is about to come. He calmly and rigorously goes through all the fields and stages of death in the modern world – where we should fight and where we should give up. In a small book he tackles a monumental task, that of admitting medicine is not prepared or ready to resolve the problem, and that of the patient who should know when it’s time to give up – rather than run around and try every experimental procedure it would be better to cherish the small time you have left.

In Ancient Greece it was perceived tat the gods were jealous of mortals specifically for the fact that they are so – that they are finite and can cherish each moment as it would be their last, giving them emotions and a meaning that could not be felt in any other way. This is the takeaway from the book – enjoy your life and loved ones, be aware of what our modern culture can give you and try to be at peace with yourself as you might not walk the same road twice.

The patient that nearly drove me out of medicine

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Can’t say I am big fan of literature that you find on certain forums such as reddit, but every now and then I find something that really catches my attention. This is definitely the case with The patient that nearly drove me out of medicine.

The first thing that struck me about the story is that it makes very good use of meta – especially when dealing with the writer and main character. As you go along it becomes more obvious and it covers other areas as well – it is very rare that you find such techniques in amateur authors but, alas, you can find it here.

The language is rather simple although it uses a decent vocabulary and tries not to repeat itself – the story is gripping and you can find yourself drawn by the plot – even if at some point it is rather predictable.

The story itself is a bit disappointing, mostly at the end – such a nice constructed plot deserved a better ending – one that might have begged the author to know more, an open ending perhaps.

All in all the story is gripping and enjoyable – some parts are rather outlandish and it hurts the overall feel of the story, but overall it is just a fun short read.

Book: Without Sanctuary

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In certain aspects the human mind works in a rather simplistic way: we forget the wrong we did and we remember the wrong others have done to us. It’s evolutionary in a way, one starves depression and the other keeps us on our toes regarding the danger we might be in.

We also tend to forget pages of our history simply because we are ashamed of them. We’d rather not have the world, and new generations especially, be aware  of the mistake we have made in the past. We want to save face, even in the darkest of times and rather hide than face our errors and learn from them.

However, there are times when we have caused abominable deeds against fellow man, and while we can blame the region or the age we must also make a point of the fact that it was those exact regions and times that have started a movement in eradicating the horrendous acts altogether. We must open our eyes and see the damage people like us have caused and that we need to make adjustments, that we need to learn of our past and make sure the future never has to face the same tragedy again.

For many of us the end of slavery was the emancipation of African-Americans, but that is not the case as this book shows in dramatic footage what life was in the years after the thirteenth amendment was passed. Lynchings of innocent men and women without any trial – brute force taking lives in the night and killing them in grotesque fashion. People lined up by the thousands, paying small fees so they can discharge their guns into the corpses of the condemned. Journalists and photographers recording the scenes only to justify the act or make a profit out of the images taken at the scene. Law enforcement and politicians that do not object and let the mob’s animalistic behaviour take course in fear of losing jobs and seats.

This book is a part of history – one that we might want to forget or others might want us to not know about. A part of history that is very rarely taught at the full length that it requires. No review will do it justice as it offers an experience that is so traumatic and personal it will linger on with you for a very long time.

Book: War against war

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Not an easy book to read, but although uncomfortable it is one necessary read and experience for someone who has never seen a war. While most anti-war books will speak mostly about the valiance of the winners and the atrocities of the losing side, this book spares no one. The message is clear and simple: war is hell and we must do everything in our power to never allow this to happen.

I first heard about the book while reading  Regarding the pain of others – Susan Sontag writes about the major impact this book had at the time and the fact that although it is quite brutal it seemed to have little impact during the time of its publication. Moreover, even the vivid description of what war causes  did nothing to change the views of its readership regarding war – the most brutal war of our existence, World war II, was just a few years away.

Having pictures of dead soldiers alongside captions of war propaganda, praising the valiance of soldiers, send chills down your body. The mutilations and horrid deaths do cause soul wrenching feelings for its readers and cause viewing war in another light. Even during the foreword the voice of the author send an outstanding message: men should not seek the glory of war and women and mothers should teach their children that war does not cause anything but pain and suffering. The page that instructs mothers not to buy their children toy soldiers for they cause a false feeling of justice and protection.

Today there is a museum that praises the pioneering of the author and truly sees the genius of the artwork he created – at the time of its publication the author was send to a mental asylum as his views were considered anti patriotic – yet one more example of how we see reason too late.

Book: Regarding the pain of others

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Pain has always been a lonely experience – something that cannot be shared with anyone. No one really understands what you are going through. Sure, we have come up with a range of words and some medical tests that can give an indication of how that pain is felt and how severe – maybe come to some reasonable conclusions based on these depictions – but the true feeling of pain is left only to ourselves.
This is not a new topic – people have long discovered that other people cannot relate to their pain and have tried a large number of methods in demonstrating their anguish. Most artistic forms come from pain – it’s easy to understand that some of the worlds most famous paintings and sculptures describe someone in great torment. However, only the very great have made it possible that their afflictions cross centuries and, with them, generations.
Susan Sontag goes in depth about how we perceive pain through art – looking at war photos and other forms of illustrations regarding people in suffering. A remarkable essay on how the mind in agony tries the same methods of exposing itself. From sketches of Francisco Goya to the photos of Ernst Friedrich the only thing that is different is the technology, the device that records – a fancy camera versus the almighty pen.
Allusions to a series of books, photos, movies and other media are given, mostly all with the basic subject of how far we have come in describing our pain and how little we absorb from the pain of people around us. Also, to be fair to accuracy, she also exposes a series of artistic views that are only that – artistic. A great range of photos have been scripted and do not show that ever alluding shot of true feeling – however, this does not impact our reception of the pain the medium shows us, it only makes us feel closer and receptive.

Between confusion and misinformation

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People took to the streets in the last few days in Romania to protest against an executive order that decriminalizes small time corruption – thus making an important number of dignitaries from the ruling party escape trial and a jail sentence. A law passed by corrupt politicians to help corrupt politicians escape the hand of the law. And they say there is no honor among thieves.

Quite unexpectedly, a portion of the Romanian people decided to start a small and peaceful protest against the idea of the bill before it was passed but, after the law was passed anyway, took to higher than ever numbers as the days kept mounting and the bill was not repealed. As it happens when more than half a million people start chanting and spend their evenings in public squares there started to appear a number of channels of communication from both sides that ranged from confusion to misinformation.

Confusion

People in the streets are leaderless and, to a certain degree, unsure of things work at a government level. Which things happen overnight and which things need a bit more time to develop. But this is not the biggest case of confusion – that comes when asking people of what they actually want. They want the law repealed, that is obvious, but apart from that there doesn’t seem to be a lot of consensus. Some want the government to resign, which makes sense in a way since they passed a bill that is specifically designed to keep corrupt dignitaries free. On the other hand, some want the government to stay in place and go through the promises they made in the campaign – somehow planning their fall as they have overpromised and would never deliver what they committed to. There is also a side that only wants the leader of the party to resign as he seems to be the driver of the law since he will be one of the people that benefit from the new law. On the extreme side you have the people that want to abolish the entire party – thinking that this type of premeditated plan is damaging to the country itself and they have lost all legitimacy of legal existence.

Confusion is a normal state during protests – they happen spontaneously and need a bit of time to get their bearings. People are overzealous and have the tendency of throwing their frustrations all around. What is the best solution? There probably isn’t an all-encompassing one to begin with, as with everything the middle ground is usually the best approach.

As the protests lose their steam after the law has been repealed we are left with most of the confusion. Maybe a spark will come from some place – people are already sending lists around trying to get the most of this unique situation. If some of their points will happen it will be a success, but there is always the fear that everything will die down and that would be a loss – the situation would become as it was before the protests thus making the entire scope of the challenge just a somewhat futile experiment of the ancient agora. Busy lives and the hardships of everyday duties make for lousy voters. The continuous effort of informing yourself and public discourse is what will keep the flame alive, not to mention it will dissipate most of the confusion. How it will play out is a mystery, but one that will reveal itself soon enough.

Misinformation

From a political viewpoint all countries are monstrosities when it comes to governing them – if we are to add a mottled population like the one of Romania things get pretty heavy. Balancing a vast audience of pensioners that are living hand to mouth to the uneducated and rural middle-aged people that society seems to have left behind to the overly educated and technological savvy millennials that make their bread in multinational enterprises is a task of leviathan proportions. On top of all this you have a regulated and deeply rooted culture of corruption – balancing political cycles with thieving sprees in order to maintain power and be kept out of jail. Even when just scratching the surface you get a problem that has so many ramifications it is nearly impossible trying to untangle yourself.

The best course of action from this type of political establishment is, and always will be, misinformation. Going from the other political parties to known business men that might or might not have any role in the uprising to blaming the multinational companies themselves for promoting such protests. It works to some degree as it puts multiple sides of the Romanian society against one another. Grandparents vs Parents vs Children. The only thing that comes out of this is a bit of time to try and correct the balance, but with every passing year it gets harder and harder. People are informing themselves, and while some are plugged in to the political bought media outlets that promote a certain doctrine or another the numbers are getting smaller and smaller as informed youngsters have acknowledged where the biggest threat is and have started informing their seniors on where the issues are and how they need their help in overcoming them.

The road to fighting corruption and having a clean and powerful political establishment is long and arduous, but glimpses of it appear every now and then. When the system is shaken it doesn’t stand and what is beyond it appears in the frame. The only weapons that are needed are patience and information – trying to discern one fact from another and arming ourselves with strength and civic valor – not budging based on our misconceptions, but acknowledging the array of multiple lines of thought and action.

The only thing that matters is that the flame that is alight not consume itself gratuitously and real power derives from it – only then will we be on the true path of redemption and be able to stand tall and proud of the choices we have made. It seems like it will never happen, but that is only the misinformation that engulfs us and while we are adamant in seeing disruptive change right away, a side effect of the confusion that comes with enlightenment, we most hold the fort and await the ever churning wheel of time.

Fire

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Fire. So simple and elegant. So fragile and yet so strong. It has molded our lives in such a way that you cannot imagine our civilization without it.
From art to religion and science, it has engulfed our thoughts and shaped our minds.
A moment in the muzzle of a gun, a cry in the consummation of a pyre, the amazement that a Bunsen burner brings, the vivid imagination fire creates while it helps propel a spaceship to new horizons by devouring its fuel, the light it creates is the constant that has reshaped our knowledge and its speed is our biggest discovery yet, the feeling of peace while a big ball of fire crosses the sky day after day.
For me fire always represented the inferno, the place of anguish where our thoughts run like rivers, condemned to flow into eternity.

“Of four infernal rivers that disgorge into the burning lake their baleful streams;
abhorred Styx the flood of deadly hate,
sad Acheron of sorrow, black and deep;
Cocytus, nam’d of lamentation loud heard on the rueful stream;
fierce Phlegethon whose waves of torrent fire inflame with rage.
Far off from these a slow and silent stream,
lethe the River of Oblivion rolls her wat’ry Labyrinth whereof who drinks,
for with his former state and being forgets,
forgets both joy and grief, pleasure and pain.”
(John Milton – Paradise Lost)

Mourning is a time where we reflect on the lives that were lost and the ones we have yet to pursue. As a remembrance we light a candle, for nothing lasts more in our memory than a flickering light, making sure it will never let us forget.

Different

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It comes and goes. Finally! For some it would be a small hell, for me it’s an improvement. Able to focus again, to give time and thought to things that are important. Less frustration, less anger, less fear. There still is pain, there still is uncertainty; but it is fading. Slowly. Going through things one step at a time, not rushing anything – my version of purgatory. It comes fast, it goes slow – always trying to remember that. It will take time.

Going after things in the checklist, trying to regain some control of what’s going on around me. More involved at work, more attentive to friends, more action on things that have been left unattended, but not forgotten. Things are progressing, but not at the speed I would like them to – but I cannot think about that now, I have to give time and space, less control and more acceptance. I keep on wondering if it will stick, who will I be once this is over?

Not everything is improving, not everything shows signs of healing. She still hasn’t come back, she is still in her world – but, again, I must not react; I must wait and try to let things come by themselves. It’s not easy, not when you know how great life once was – how there was hope; and love! She took that away; she says she didn’t mean it – but I am not so sure. There is a rift, a gap I cannot close, and I just can’t seem to let it shut off itself. Fear takes over once more. The itch, the twitch, and everything comes rushing again. It’s not the same, but it’s only a distinction without a difference – a different course of the same meal. I cannot let go, I cannot let things remain the same, I cannot get more involved. Stuck. Keep telling myself: leave it be! You will figure it out at a certain point, but not know. Now you must wait and face it, everyday. Let it consume itself and wait to see what is left. Regroup after the battle, not know.

I was not made for this, probably the reason I have it. People that are ready for it don’t it. It was bad and then it was worse, now it’s bad again. Going on better. Still so much to fix, still so much to go through. I will wait. Not that I have much choice. Curious to see where this will take me.

 

Out of the blue

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It was scary. But they all are. It came out of nowhere, which was somewhat new. It usually tells me it’s coming. Not now. It just came. It was short, at least. Just in the beginning. I stopped it too fast and it didn’t have a chance to consume itself. No problem, it came back later. It took it’s time the second time. But I was in good hands. She did a good job, she let me have it in front of her for the exact time it was needed. Kept the session open for half an hour more after, just to make sure. The recovery was easier too, it lasted a lot less. Is that good news? Would have been better if it didn’t come again at all, but at least I handled it a bit better this time. Maybe that is progress.
I start worrying. Why is it still here? Why will it not go away? I know it will be a while, but every time it comes I feel like I am back at the beginning. But that’s not true. I handle them better. I got used to it and I know how to react. It’s still far from being fixed, but at least I know what it is. I know it by name and feeling and that helps.