after his weight dropped precipitously and he started experiencing unrelenting back pain. One day he was a neurosurgeon making life and death decisions and extirpating brain tumors by intricate surgery, and the next day he was a patient on the other side of the stethoscope struggling to remain alive; his presumed future simply evaporated. A different perspective of a terminally ill patient can be gleaned from Christopher Hitchens, a British-American writer who wrote multiple defiant and honest pieces about his own life and his devastating illness in Vanity Fair and in his final book“ Mortality” that was published posthumously in 2012. After being diagnosed with esophageal cancer that eventually culminated in his death on December 11, 2011, he suddenly found himself,“ being deported from the country of the well across the stark frontier that marks off the land of malady.”
Paul Kalanithi was a non-smoker and was diagnosed in May 2013 with Stage-4 non-small cell EGFR-positive lung cancer with metastases to the spine. His cancer initially responded to chemotherapy and he resumed work as chief resident in neurosurgery, eventually completing his residency, and was in the process of interviewing for a stellar position in an academic center. He and his wife Lucy( whom he had met at Yale), decided to have a child and“ Cady” Kalanithi was born on July 4, 2014. His cancer relapsed in spring 2014. He continued to work on his autobiography, which in realty is an un-finished enterprise because of his premature death. The book is sprinkled with poetry, wonderful nuggets of wisdom from literature and his own reflections as a dual citizen of the worlds of the physician and the patient. The book’ s forward is penned by Dr. Abraham Verghese and is a moving tribute to Paul, whom Verghese met in his office in February 2014 after Paul had written his memorable opinion piece“ How Long Have I Got Left” in The New York Times.
In his Stanford Medicine essay, Paul Kalanithi wrote a moving paragraph for his infant daughter, Cady:“ When you come to one of the many moments in life when you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man’ s days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more, but rests, satisfied. In this time, right now, that is an enormous thing.”
Paul Kalanithi who bridged the chasm between life and death has written an enormously important and devastatingly candid book which provides an exquisitely nuanced, heartfelt and thoughtful narrative with grim and sad undertones of impending death, but at the same time is an amazingly unforgettable and life-affirming perspective while confronting mortality.
M. Saleem Seyal, MD, practices Cardiovascular Diseases with Floyd Memorial Medical Group-River Cities Cardiology.
From Dr. Verghese:“…. In the contest of Paul’ s diagnosis, I became aware of not just his mortality but my own.” He also called his writing“ stunning” and his prose“ unforgettable” and that“ out of his pen he was spinning gold.” After the awful diagnosis and the aftermath of dealing with its consequences in day-to-day living, Paul repeated the seven words of Samuel Beckett,“ I can’ t go on. I’ ll go on,” which kept him going for almost two years after the diagnosis. Throughout his ordeal, he had the abiding support of his extended family, his physicians and their support personnel. But most important was the love and understanding, the immeasurable value of his wife, Lucy. She penned a highly emotional, candid and honest epilogue.“ Paul confronted death- examined it, wrestled with it— accepted it— as a physician and a patient,” she writes. She offers an important guide to managing terminal illness—“ to be vulnerable, kind, generous, grateful.”
MAY 2016 17