Sunday, April 15, 2018

When Death Comes Knocking




“Life’s under no obligation to give us what we expect”
--Margaret Mitchell

March 20 was my birthday and that was the day i finished book on Death and Dying. On my Birth anniversary I was reading book on Death and ruminating on it. Ironic!


First time i heard of the book "When Breath Becomes Air” was in one of doctor youtube speech. I was skeptical in reading biographies either on doctors or death as i was more into thrillers and other genres. But something compelled me to buy that book. First few pages of book was routine life of author and nothing exciting nor enticing for my soul that always craved paradoxical contrary  elements of Adrenaline rush and Blissful Calmness.

Every birthday reminds me of my own mortality and that’s scary. I think, though not sure, keeping our self very busy with family and profession, not thinking mortal nature of our bodies and magically believing that we live forever and expert fully ignoring that from the moment we are born, no matter what path-profession we choose, ultimately we all share only one destination : Grave!. It’s just another matter whether we joyfully walk or cribbing, but walk we must.  There is no choice.

Coming back to book….




 “Breath becomes Air” is simple autobiography of talented 36 year  Neurosurgeon from Stanford who finds he has lung cancer. Book chronicles his journey battling cancer and eventually dies before he completes his memoir. Author philosophies death and describes vividly the process of cancer gnawing away his life. Paradoxically his wife would be in advanced stage of pregnancy. So as his life ebbs away from this world , another life, his daughter, is entering into the world.

As the author being a Neurosurgeon, book is replete with functioning of mind and its intricacies. Its amazing to know how complex human mind is like he describes a case where 8 year adorable kid turns into monster coz of hypothalamus malfunction. It seems just one “mm” inflammation in his hypothalamus made boy suffer from bursts of anger and excessive appetite. He started eating nonstop, hurting people around, becomes obese and finally ends up in asylum. All because of that one crucial millimeter.(FYI Hypothalamus in brain controls sex, food drive among other important functions.) Some brain malfunctions (Gerstmann syndrome) we read end up human ability to read or see or slurry voice or basic math or even wipe out memories. During one such operation he writes how as little pressure at spot in brain made patient immensely sad. Sad,for no reason.Now this, I wonder if our happiness and sadness we experience in this world is result of inner chemicals or outer events or both?

Author philosophically describes his medical practice as student when he first cuts open a dead body in following way which was quite impactful

"Cadaver dissection epitomizes transformation of respected student into arrogant doctor. You practise CPR on plastic mannequins. The mannequins you pretend are real; the cadavers you pretend are fake. In anatomy lab, we objectified the dead, reducing them to organs, tissues, nerves and muscles. On first day , you cant deny the humanity of corpse. But by time you skinned the limbs, sliced through inconvenient muscles, pulled out the lungs, cut open the heart, remove liver, it was hard to recognise this pile of tissue as  human."

We get to know so many words from medical jargon , understand doctor mindset,  doctor's dilemma when to make some difficult choices that involves life and death , where difference between tragedy and triumph was defined by 1 or 2 millimetres.
 "
Throughout his career, he plays the role of confident doctor and views world from commanding position of doctor but finally ends up as patient in the same hospital he operated his patients.  On his death bed, he gets dealt by medical intensivists, nephrologists, gastroenterologists, endocrinologist, oncologists, thoracic oncologists, and otolaryngologists etc who all humorously disagree with each other in treating him

Fragility of human life! Life can be utterly unfair. Healthy people can fall victim to deadly cancer. Heavy drunkard/ smokers can go on to live healthy life with no complications. Author Kushwant singh drank every day died at 99 with natural causes but BKS.Iyengar Yoga exponent who led healthy lifestyle died due to heartstroke at 98.

 “The tricky part of illness is that, as you go through it, your values are constantly changing. You try to figure out what matters to you, and then you keep figuring it out. It felt like someone had taken away my credit card and I was having to learn how to budget. You may decide you want to spend your time working as a neurosurgeon, but two months later, you may feel differently. Two months after that, you may want to learn to play the saxophone or devote yourself to the church. Death may be a one-time event, but living with terminal illness is a process.”― Paul KalanithiWhen Breath Becomes Air

I connect to book in some matters like, in advanced stage of cancer, his physical strength diminishes to extent he couldnt even lift glass, couldnt even sit without backrest for more than an hour. His physical ambitions like climbing mountains or run a marathon, now reduced to stand on his own with no support, just gain some strength. His own past, being top doctor reduced to weak patient being wheelchaired around by his father and wife brings him painful memory. 

Though i didnt die but i remember when i faced it couple of years ago. Lifting tumbler required both hands and would fall after few minutes. In peak condition i used to jog miles uphill but during my sickness taking 3-4 steps proved great challenge. Facing death realigns our world perspective. All unessential identities we gather on rat race in world will drop like dry leaves. Suddenly simplest things like feeling taste, pangs of hunger, few walking steps, clear vision etc give great happiness and hope. Gone are the days you dream Marathon, Scale mountain, vie for top position, buy new car etc etc. All gone like wisps of mist leaving basic survival a great challenge to scale.  Fear- Frustration- Denial -Anger finally Acceptance and resignation to fate.  

 “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.” 


― Paul KalanithiWhen Breath Becomes Air


Michael Schumacher who lived on super fast lane flirted with death all through his F1 driving career but when was he injured? Crashing into coma while snowboarding!!  Life can be dangerously deceptive lulling you into false sense of security 

Finally in the end of the book, author's wife completes the book after his death when he removes his life support and slips into eternal sleep of death. 

Book leaves you insipid after-taste with mixed feel of sadness and deep introspection. Death gains centre stage as we question basic fundamental laws of life and death. Book definitely made me slow my life and look around questioning what and what not are really important. Life can be utterly fickle and fragile! Isn’t it?

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