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My life up until my illness could be understood as the linear sum of my choices. As in most modern narratives, a character's fate depended on human actions, his and others. -- Paul Kalanithi
[H]e found poetry more comforting than Scripture - and his ability to forge from his life a cogent, powerful tale of living with death. -- Paul Kalanithi
And with that, the future I had imagined, the one just about to be realized, the culmination of decades of striving, evaporated. -- Paul Kalanithi
What happened to Paul was tragic, but he was not a tragedy. -- Paul Kalanithi
Time for me is now double-edged: every day brings me further from the low of my last relapse but closer to the next recurrence - and, eventually, death. Perhaps later than I think, but certainly sooner than I desire. -- Paul Kalanithi
Neurosurgery seemed to present the most challenging and direct confrontation with meaning, identity, and death. -- Paul Kalanithi
Cadaver dissection epitomizes, for many, the transformation of the somber, respectful student into the callous, arrogant doctor. -- Paul Kalanithi
Openness to human relationality does not mean revealing grand truths from the apse; it means meeting patients where they are, in the narthex or nave, and bringing them as far as you can. -- Paul Kalanithi
Humans are organisms, subject to physical laws, including, alas, the one that says entropy always increases. -- Paul Kalanithi
Even while terminally ill, Paul was fully alive; despite physical collapse, he remained vigorous, open, full of hope not for an unlikely cure but for days that were full of purpose and meaning. -- Paul Kalanithi
The MRI shows a mass in your brain, which is causing your symptoms." Silence. "Do you want to see the MRI?" "Yes." I -- Paul Kalanithi
Learning to judge whose lives could be saved, whose couldn't be, and whose shouldn't be requires an unattainable prognostic ability. -- Paul Kalanithi
The mind was simply the operation of the brain. -- Paul Kalanithi
Always the seer is a sayer," Emerson wrote. "Somehow his dream is told; somehow he publishes it with solemn joy. -- Paul Kalanithi
I was leaving this small Arizona town in a few weeks, and I felt less like someone preparing to climb a career ladder than a buzzing electron about to achieve escape velocity, flinging out into a strange and sparkling universe. -- Paul Kalanithi
Hemingway described his process in similar terms: acquiring rich experiences, then retreating to cogitate and write about them. I needed words to go forward. And so it was literature that brought. -- Paul Kalanithi
A scan showed that a benign brain tumor was pressing on her right frontal lobe. In terms of operative risk, it was the best kind of tumor to have, and the best place to have it; surgery would almost certainly eliminate her seizures. The alternative was a lifetime on toxic antiseizure medications. -- Paul Kalanithi
I had come to see language as an almost supernatural force, existing between people, bringing our brains, shielded in centimeter-thick skulls, into communion. A word meant something only between people, and life's meaning, its virtue, had something to do with the depth of the relationships we form. -- Paul Kalanithi
Standing at the crossroads where I should have been able to see and follow the footprints of the countless patients I had treated over the years, I saw instead only a blank, a harsh, vacant, gleaming white desert, as if a sandstorm had erased all trace of familiarity. -- Paul Kalanithi
And even though I no longer really knew what it was, I felt it: a drop of hope. The fog surrounding my life rolled back another inch, and a sliver of blue sky peeked through. -- Paul Kalanithi
One chapter of my life seemed to have ended; perhaps the whole book was closing. Instead of being the pastoral figure aiding a life transition, I found myself the sheep, lost and confused. Severe illness wasn't life-altering, it was life-shattering. -- Paul Kalanithi
A tureen of tragedy was best allotted by the spoonful. Only a few patients demanded the whole at once; most needed time to digest. -- Paul Kalanithi
Anatomy lab, in the end, becomes less a violation of the sacred and more something that interferes with happy hour, and that realization discomfits. In our rare reflective moments, we were all silently apologizing to our cadavers, not because we sensed the transgression but because we did not. -- Paul Kalanithi
The call to protect life - and not merely life but another's identity; it is perhaps not too much to say another's soul - was obvious in its sacredness. -- Paul Kalanithi
As a resident, my highest ideal was not saving lives -- everyone dies eventually -- but guiding a patient or family to an understanding of death or illness. -- Paul Kalanithi
We each joked to close friends that the secret to saving a relationship is for one person to become terminally ill. Conversely, we knew that one trick to managing a terminal illness is to be deeply in love - to be vulnerable, kind, generous, grateful. -- Paul Kalanithi
Science, I had come to learn, is as political, competitive, and fierce a career as you can find, full of the temptation to find easy paths -- Paul Kalanithi
there's that study that says doctors do a worse job prognosticating for patients they're personally invested in. -- Paul Kalanithi
Paul," he said, "do you think my life has meaning? Did I make the right choices?"
It was stunning: even someone I considered a moral examplar had these questions in the face of mortality. -- Paul Kalanithi
Will having a newborn distract from the time we have together?" she asked. "Don't you think saying goodbye to your child will make your death more painful?"
"Wouldn't it be great if it did?" I said. Lucy and I both felt that life wasn't about avoiding suffering. -- Paul Kalanithi
tureen of tragedy was best allotted by the spoonful. -- Paul Kalanithi
Science is based on reproducibility and manufactured objectivity. As strong as that makes its ability to generate claims about matter and energy, it also makes scientific knowledge inapplicable to the existential, visceral nature of human life, which is unique and subjective and unpredictable. -- Paul Kalanithi
Paul faced each stage of his illness with grace - not with bravado or a misguided faith that he would "overcome" or "beat" cancer but with an authenticity that allowed him to grieve the loss of the future he had planned and forge a new one. -- Paul Kalanithi
In taking up another's cross, one must sometimes get crushed by the weight. -- Paul Kalanithi
a family will visit constantly, daily or even twice a day. Then maybe every other day. Then just weekends. After months or years, the visits taper off, until it's just, say, birthdays and Christmas. Eventually, most families move away, as far as they can get. -- Paul Kalanithi
If time dilates when one moves at high speeds, does it contract when one moves barely at all? It must: the days have shortened considerably. -- Paul Kalanithi
If the unexamined life was not worth living, was the unlived life worth examining? -- Paul Kalanithi
What are you most afraid or sad about?" she asked me one night as we were lying in bed.
"Leaving you," I told her. -- Paul Kalanithi
I was making the decision to do this work because this work, to me, was a sacred thing.) Lucy -- Paul Kalanithi
There is a tension in the Bible between justice and mercy, between the Old Testament and the New Testament. And the New Testament says you can never be good enough: goodness is the thing, and you can never live up to it. The main message of Jesus, I believed, is that mercy trumps justice every time. -- Paul Kalanithi
I would have to learn to live in a different way, seeing death as an imposing itinerant visitor but knowing that even if I'm dying, until I actually die, I am still living. -- Paul Kalanithi
This book carries the urgency of racing against time, of having important things to say. Paul confronted death - examined it, wrestled with it, accepted it - as a physician and a patient. He wanted to help people understand death and face their mortality. -- Paul Kalanithi
The physician's duty is not to stave off death or return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence. -- Paul Kalanithi
The fact of death is unsettling. Yet there is no other way to live. - -- Paul Kalanithi
Moral duty has weight, things that have weight have gravity, and so the duty to bear mortal responsibility pulled me back into the operating room. Lucy was fully supportive. -- Paul Kalanithi
Medical training is relentlessly future-oriented, all about delayed gratification; you're always thinking about what you'll be doing five years down the line. -- Paul Kalanithi
How much neurologic suffering would you let your child endure before saying that death is preferable? -- Paul Kalanithi
Existential claims have no weight; all knowledge is scientific knowledge. Yet the paradox is that scientific methodology is the product of human hands and thus cannot reach some permanent truth. -- Paul Kalanithi
Neurosurgery requires a commitment to one's own excellence and a commitment to another's identity. The -- Paul Kalanithi
As a doctor, you have a sense of what it's like to be sick, but until you've gone through it yourself, you don't really know. -- Paul Kalanithi
Few books I had read so directly and wholly addressed that fundamental fact of existence: all organisms, whether goldfish or grandchild, die. -- Paul Kalanithi
A word meant something only between people, and life's meaning, its virtue, had something to do with the depth of the relationships we form. It was the relational aspect of humans that undergirded meaning. -- Paul Kalanithi
My brain was fine, but I did not feel like myself. My body was frail and weak - the person who could run half marathons was a distant memory - and that, too, shapes your identity. Racking back pain can mold an identity; fatigue and nausea can, as well. -- Paul Kalanithi
the heroic spirit of responsibility amid blood and failure. This struck me as the true image of a doctor. -- Paul Kalanithi
Part of the cruelty of cancer, though, is not only that it limits your time; it also limits your energy, vastly reducing the amount you can squeeze into one day. -- Paul Kalanithi
Over the last six years, I'd examined scores of such scans, on the off chance that some procedure might benefit the patient. But this scan was different: it was my own. I -- Paul Kalanithi
The word hope first appeared in English about a thousand years ago, denoting some combination of confidence and desire. But -- Paul Kalanithi
But my focus would have to be on my imminent role, intimately involved with the when and how of death - the grave digger with the forceps. Not -- Paul Kalanithi
Graham Greene once said that life was lived in the first twenty years and the remainder was just reflection. So -- Paul Kalanithi
You can't ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving. -- Paul Kalanithi
mind was simply the operation of the brain, an idea that struck me with force; it startled my naive understanding of the world -- Paul Kalanithi
It's very easy to be number one; find the guy who is number one, and score one point higher than he does. -- Paul Kalanithi
Everything teeters between pathos and bathos: here you are, violating society's most fundamental taboos and yet formaldehyde is a powerful appetite stimulant, so you also crave a burrito. -- Paul Kalanithi
Diseases are molecules misbehaving; the basic requirement of life is metabolism, and death its cessation. -- Paul Kalanithi
I don't believe in the wisdom of children, nor in the wisdom of the old. There is a moment, a cusp, when the sum of gathered experience is worn down by the details of the living. We are never so wise as when we live in the moment. -- Paul Kalanithi
There is a moment, a cusp, when the sum of gathered experience is worn down by the details of living. We are never so wise as when we live in this moment. -- Paul Kalanithi
This was summer at Sierra Camp, perhaps no different from -- Paul Kalanithi
values of Christianity - sacrifice, redemption, forgiveness - because -- Paul Kalanithi
Sometimes the news so shocks the mind that the brain suffers an electrical short. This phenomenon is known as a "psychogenic" syndrome, a severe version of the swoon some experience after hearing bad news. -- Paul Kalanithi
Out of his pen he was spinning gold. -- Paul Kalanithi
(Alexander Pope: "A little learning is a dangerous thing; / Drink deep, or taste not the Pierian spring.") -- Paul Kalanithi
Do you think my life has meaning? Did I make the right choices? -- Paul Kalanithi
Words have a longevity I do not. -- Paul Kalanithi
When there is no place for the scalpel, words are the surgeon's only tool. -- Paul Kalanithi
Death comes for all of us. For us, for our patients: it is our fate as living, breathing, metabolizing organisms. Most lives are lived with passivity toward death - it's something that happens to you and those around you. -- Paul Kalanithi
If the hare makes too many missteps and has to keep adjusting, the tortoise wins. If the tortoise spends too much time planning each step, the hare wins. -- Paul Kalanithi
People often ask if it is a calling, and my answer is always yes. You can;t see it as a job, because if it's a job, it's one of the worst jobs there is. -- Paul Kalanithi
If the weight of mortality does not grow lighter, does it at least get more familiar? -- Paul Kalanithi
like the ancient Greek concept arete, I thought, virtue required moral, emotional, mental, and physical excellence. Neurosurgery seemed to present the most challenging and -- Paul Kalanithi
It's easier when the patient is ninety-four, in the last stages of dementia, with a severe brain bleed. But for someone like me - a thirty-six-year-old given a diagnosis of terminal cancer - there aren't really words. -- Paul Kalanithi
knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete. And -- Paul Kalanithi
You could not help but feel your specklike existence among the immensity of the mountain, the earth, the universe, and yet still feel your own two feet on the talus, reaffirming your presence amid the grandeur.
Page 54 -- Paul Kalanithi
Severe illness wasn't life-altering, it was life-shattering. It felt less like an epiphany - a piercing burst of light, illuminating What Really Matters - and more like someone had just firebombed the path forward. -- Paul Kalanithi
The root of disaster means a star coming apart. -- Paul Kalanithi
What kind of life exists without language? -- Paul Kalanithi
Mortal duty has weight, things that have weight have gravity, and so the duty to bear mortal responsibility pulled me back. -- Paul Kalanithi
I had traversed the line from doctor to patient, from actor to acted upon, from subject to direct object. -- Paul Kalanithi
The pain of failure had led me to understand that technical excellence was a moral requirement. -- Paul Kalanithi
I had to help those families understand that the person they knew - the full, vital independent human - now lived only in the past and that I needed their input to understand what sort of future he or she would want: an easy death or to be strung between bags of fluids going in, others coming out, -- Paul Kalanithi
my imagined future and my personal identity collapsed, and I faced the same existential quandaries my patients faced. -- Paul Kalanithi
In fourteenth-century philosophy, the word patient simply meant "the object of an action, -- Paul Kalanithi
What patients seek is not scientific knowledge that doctors hide but existential authenticity each person must find on her own. Getting too deeply into statistics is like trying to quench a thirst with salty water. The angst of facing mortality has no remedy in probability. -- Paul Kalanithi
What makes human life meaningful? I still felt literature provided the best account of the life of the mind, while neuroscience laid down the most elegant rules of the brain. -- Paul Kalanithi
And as I sat there, I realized that the questions intersecting life, death, and meaning, questions that all people face at some point, usually arise in a medical context. -- Paul Kalanithi
Where did biology, morality, literature, and philosophy intersect? -- Paul Kalanithi
At those critical junctures, the question is not simply whether to live or die but what kind of life is worth living. -- Paul Kalanithi
Only later would I realize that our trip had added a new dimension to my understanding of the fact that brains give rise to our ability to form relationships and make life meaningful. Sometimes, they break. -- Paul Kalanithi
It's not fair - I've been diluting my drinks with water." A -- Paul Kalanithi
Years ago, it had occurred to me that Darwin and Nietzsche agreed on one thing: the defining characteristic of the organism is striving. Describing -- Paul Kalanithi
Literature not only illuminated another's experience, it provided, I believed, the richest material for moral reflection. -- Paul Kalanithi
If I were a writer of books, I would compile a register, with a comment, of the various deaths of men: he who should teach men to die would at the same time teach them to live. - Michel de Montaigne, "That to Study Philosophy Is to Learn to Die -- Paul Kalanithi
To find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay. -- Paul Kalanithi
Indeed, this is how 99 percent of people select their jobs: pay, work environment, hours. But that's the point. Putting lifestyle first is how you find a job - not a calling.) As -- Paul Kalanithi
The curse of cancer created a strange and strained existence, challenging me to be neither blind to, nor bound by, death's approach. Even when the cancer was in retreat, it cast long shadows. When -- Paul Kalanithi
At home in bed a few weeks before he died, I asked him, "Can you breathe okay with my head on your chest like this?" His answer was "It's the only way I know how to breathe. -- Paul Kalanithi
Doctors, it turns out, need hope, too. -- Paul Kalanithi
Death may be a one-time event, but living with terminal illness is a process. -- Paul Kalanithi
The decision to operate at all involves an appraisal of one's own abilities, as well as a deep sense of who the patient is and what she holds dear. -- Paul Kalanithi
Frail but never weak. -- Paul Kalanithi
Some days, I simply persist. -- Paul Kalanithi
Putting lifestyle first is how you find a job --- not a calling. -- Paul Kalanithi
Before my cancer was diagnosed, I knew that someday I would die, but I didn't know when. After the diagnosis, I knew that someday I would die, but I didn't know when. But now I knew it acutely. -- Paul Kalanithi
Suffering can make us callous to the obvious suffering of another. -- Paul Kalanithi
I got out of bed and took a step forward, repeating the phrase over and over: "I can't go on. I'll go on. -- Paul Kalanithi
I could either study meaning or I could experience it. After -- Paul Kalanithi
Before operating on a patient's brain, I realized, I must first understand his mind: his identity, his values, what makes his life worth living, and what devastation makes it reasonable to let that life end. -- Paul Kalanithi
Looking out over the expanse ahead I saw not an empty wasteland but something simpler: a blank page on which I would go on. -- Paul Kalanithi
The truth that you live one day at a time didn't help: What was I supposed to do with that day? -- Paul Kalanithi
How little do doctors understand the hells through which we put patients. -- Paul Kalanithi
to make science the arbiter of metaphysics is to banish not only God from the world but also love, hate, meaning - to consider a world that is self-evidently not the world we live in. That -- Paul Kalanithi
Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete. -- Paul Kalanithi
Yes, I thought, and therein was the paradox: like a runner crossing the finish line only to collapse, without that duty to care for the ill pushing me forward, I became an invalid -- Paul Kalanithi
Even if you are perfect, the world isn't. The secret is to know that the deck is stacked, that you will lose, that your hands or judgment will slip, and yet still struggle to win... -- Paul Kalanithi
Nobody has it coming. -- Paul Kalanithi
Even in having children in this new life, death played its part. -- Paul Kalanithi
Maybe, in the absence of any certainty, we should just assume that we're going to live a long time. Maybe that's the only way forward. -- Paul Kalanithi
If boredom is, as Heidegger argued, the awareness of time passing, then surgery felt like the opposite: the intense focus made the arms of the clock seem arbitrarily placed. Two hours could feel like a minute. -- Paul Kalanithi
all have a notion of what it means to be good, and we can't live up to it all the time. -- Paul Kalanithi