When Breath Becomes Air: Understanding Mortality

28 Feb 2016

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By Shree Agrawal

Dr. Paul Kalanithi’s memoir, When Breath Becomes Air, as Dr. Abraham Varghese promised in his foreword, confronted me with the truth of mortality.  The kind that lies beyond textbooks, evidence-based medicine, and clinical research.

Prior to reading his work, I perceived statistics about patient populations experiencing difficult diagnoses to exist in a world detached from my reality.  I likened data surrounding diseases to Dr. Kalanithi’s perspective of “country facts”, his term for theoretical old wives’ tales about dangers in his hometown. The probabilities of human vulnerabilities, especially those that could apply to my loved ones and me, are ones I avoided and discreetly hoped to be untrue.

When I read about his evolution from pre-medical years to those as a neurosurgery resident, there is a surprisingly relatable quality.  I am with Dr. Kalanithi in his gross anatomy lab and clinical experiences as a medical student and then resident. My experiences are tangibly similar in the context of his own.

I can only wonder what separates us, any of us—the cadavers we see in medical school, Dr. Kalanithi, patients (past and future), and me? Was their organized chaos of simultaneous life-sustaining and death-promoting cells, electrical synapses, buzzing hormones and chemicals, any different from that of my own?

There are many things I am left with, only midway through his posthumous work; but most indelibly, “When there’s no place for the scalpel, words are the surgeon’s only tool.” He echoes the values in this blog, and more importantly, in the humanities and ethics of medicine: the doctor-patient relationship, taking time to listen and discuss diagnoses, developing responsibility and ownership of mistakes, and guiding the patient-centered decision making processes.   

As I pause away from the gravitas of Dr. Kalanithi’s memoir and see my email ping with a new message, it becomes grossly irrelevant, now miniscule, in recognition of his existence.

Please share your thoughts in the comments below or on Twitter with #AWSFood4Thought for this month’s February Book Club featuring When Breath Becomes Air.  

Shree Agrawal

Shree Agrawal is a second year medical student at Case Western Reserve University and an active member of AWS on the national medical student committee and within her Northeast Ohio region.  She is passionate about patient-centered decision-making, clinical research, and academic medicine.  In her free time, she enjoys practicing yoga, boxing, and cooking.

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author, and are not necessarily the opinion of the Association of Women Surgeons.

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