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Medicine

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.