Before my flight to Vancouver a couple days ago, I stopped by Barnes and Noble to pick up a copy of Paul Kalanithi’s When Breath Becomes Air. I’ve been really bad about reading (and actually finishing) books lately, and this is one I’d been meaning to read for a while, so I thought it would be nice to bring along on my trip.
I started reading the novel—a posthumously published autobiographic work about a neurosurgeon who is completing his residency at Stanford when he is diagnosed with stage IV lung cancer—on my second flight of the trip, after a short layover in Toronto. Three hours later, I had gotten through not only all 225 pages of the memoir, but half a travel-sized pack of Kleenex, as well.
Needless to say, the work really moved me. On its surface, it’s a tragic tale about a young man with a bright future ahead of him, who could have helped countless more people and changed the world in unimaginable ways, but whose life instead was cut short. There are beautifully written scenes that juxtapose Kalanithi’s objective, scientific knowledge of disease with the emotional and spiritual sides to illness that he experiences throughout his treatment. Who, after all, understands pain better than a dying doctor? The physician-writer also talks a lot about hope and values—about living a meaningful life despite fear and uncertainty. He’s surrounded by family until his very last day and the final paragraph of the novel, addressed to his six-month-old daughter, is a testament to the importance of the loved ones who stood by him through the long years of residency and the tumultuous sessions of chemo.
More than any of these poignant reflections, though, the novel moved me so much because it reminded me, in the most bold and human way possible, just why investing in a liberal arts education is so important.
Before becoming a neurosurgeon, Kalanithi actually studied English in college. He was also fascinated by the intersection of philosophy and neuroscience, however, and took as many biology courses as he did literature classes. It was a quest to better understand the human mind, from both humanist and scientific perspectives, that eventually led Kalanithi to medical school. Becoming a doctor, he wrote, “would allow me a chance to find answers that are not in books, 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” (42).
Kalanithi was able to succeed in such a demanding and rigorous profession as neurosurgery because he viewed medicine as a natural continuation to his education in the humanities. After exhausting theoretical thought, he determined that “it was only in practicing medicine that [he] could pursue a serious biological philosophy” because “moral speculation was puny compared to” the “moral action” of saving lives and easing suffering (43). He took his career seriously, referring to it not as a job but as a “calling.” As a neurosurgeon, he was tasked with protecting an individual’s identity—including all the biological and spiritual components that this nebulous aspect of humanity entails.
Kalanithi’s background in the humanities helped him connect with his patients better. He wrote a lot about informed consent, for instance, and how he would vary his approach to describing a complicated surgical procedure based on the patient. This wasn’t something all doctors did. It would sometimes require spending more time with each patient than simply rattling off all the side-effects of a surgery would, but it was something he found important to do morally. No doubt, it was Kalanithi’s experience studying literature in college and then pursuing a masters in the history and philosophy of science that instilled in him a more profound understanding of the doctor-patient relationship. A liberal arts education helped him learn to value the moral dimension of care-giving as much as the scientific.
“She would likely refuse surgery if I launched into a detached spiel detailing all the risks and possible complications. I could do so, document her refusal in my chart, consider my duty discharged, and move on to the next task. Instead, with her permission, I gathered her family with her, and together we calmly talked through her options. As we talked, I could see the enormousness of the choice she faced dwindle into a difficult but understandable decision. I had met her in a space where she was a person, instead of a problem to be solved” (90).
We see Kalanithi’s interdisciplinary education even in his writing style. “You can’t ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving” is one of the most oft-quoted lines from the memoir. It’s also one of my personal favorite quotes because of how smoothly Kalanithi manages to weave together scientific ideas—asymptotes being primarily a mathematical concept, after all—with philosophical life advice. This quote sits in contrast with a scene later in the novel in which, faced with his recent diagnosis, Kalanithi insists that his oncologist go over the Kaplan-Meier Survival Curves for his particular disease. His oncologist refuses, claiming that it’s more important for Kalanithi to plan his remaining life around personal values than around survival statistics (122). Science and mathematics, we learn from these two passages, give us a useful vocabulary for making sense of the world. Alone, without the morals that literature, philosophy and history teach us however, they are almost meaningless.
It’s easy to forget why college, and a liberal arts education in particular, is so important. Especially when your primary academic focus is pre-professional—whether premed or prelaw or pre-business—and filled with countless required, field-specific courses, you start to lose sight of why you’re taking a Spanish class on the role of inanimate objects in Latin American literature or a gen ed anthropology course on pre-Columbian Mexico. Phrases like “transformative education” and “the quest for knowledge” become clichés that only college deans and admissions pamphlets truly seem to believe in.
Having just completed five semesters of college, I’d be lying if I didn’t admit that I’ve become a bit jaded by the idea of a liberal arts education. I’m excited to go to med school and I’m excited to start working already; jobs I hold on campus such as CrimsonEMS and Writing Center tutoring make me want to finally apply the knowledge I have to help others, instead of spending years more acquiring additional knowledge in fields I may never directly work in again. Yet, When Breath Becomes Air is a powerful reminder that the skills I’m cultivating in college are meaningful and valuable, even if their meaning and value are indirect. Paul Kalanithi wouldn’t have been the physician he was if he hadn’t spent his childhood through his undergraduate years reading every novel he could get his hands on. He wouldn’t have been the physician he was if he hadn’t pursued rigorous scientific research in neuromodulation, either. And I won’t be the doctor I want to be if I don’t take advantage of the opportunity—because it really is an opportunity and not a tedious obstacle to graduate school—to immerse myself in as many different fields that interest me as I can, while I can.
I could continue to go on about how much I loved When Breath Becomes Air. After all, I still haven’t even touched on my favorite scene, in which Kalanithi decides to spend his first summer of undergrad volunteering as a chef at a summer camp instead of pursuing neuroscience research. I could rave some more about how much I love that Kalanithi was both a physician and a writer—how in his short life, he managed to do both very well, and how I now have no excuse not to try to follow through on all of my own passions beyond med school. Instead, however, I’ll leave off with a particularly insightful quote from the memoir:
“Science may provide the most useful way to organize empirical, reproducible data, but its power to do so is predicated on its inability to grasp the most central aspects of human life: hope, fear, love, hate, beauty, envy, honor, weakness, striving, suffering, virtue” (170).
Happy end of fall semester and happy holidays! Here’s to a restful winter break, one that reinvigorates us all to pursue with a new fervor the myriad passions and aspirations, academic or otherwise, that make up the central aspects of our own human lives.
On Ariel's Mind 