When Breath Becomes Air

dr paulDr. Paul Kalanithi is a brilliant young neurosurgeon in the midst of his residency when he is faced with a terminal cancer diagnosis. When Breath Becomes Air is his memoir, his exploration and examination of what makes life worth living. And indeed, this harrowing yet exquisite account of his life and musings as he shuffles ever closer to his inevitable death is well worth reading.

Educated Americans love nothing more than a doctor who can write and Dr. Kalanithi is one of those rare souls who excelled both in the operating room and on the page. In the first part of his story, we learn about his upbringing and his genius – he has a master’s degree in English literature and one in philosophy and considered being a writer before opting to take the more difficult path of becoming a surgeon. In his own words, “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.”

It was not a decision taken lightly and he throws himself into his training with eyes wide open. As he writes, “The cost of my dedication to succeed was high, and the ineluctable failures brought me nearly unbearable guilt. Those burdens are what make medicine holy and wholly impossible: in taking up another’s cross, one must sometimes get crushed by the weight.”

What is remarkable is that Dr. Kalanithi continues his residency while undergoing harrowing treatments for his cancer. The grueling training required to succeed in one of America’s most prestigious hospitals (Stanford) would be impossible for most high functioning, healthy individuals. Paul has unfathomable grit and tenacity and keeps inching towards his goal even as his body deteriorates and betrays him.

This book is not for the faint-hearted. Tears rolled down my cheeks at many moments, especially as he enters his final days at the tender age of 37, just months after his baby daughter is born.

Dr. Kalanithi passed away before finishing his manuscript (oh and he was also writing this book in addition to everything else) and the last part is pieced together by his wife, Lucy who is also a doctor. In the epilogue she writes, “Although these last few years have been wrenching and difficult – sometimes almost impossible – they have also been the most beautiful and profound of my life, requiring the daily act of holding life and death, joy and pain in balance and exploring new depths of gratitude and love.”

Indeed, one of the most heartfelt aspects of the book is how Dr. Kalanithi navigates the uncertainty of his predicament and how he must recontextualize his life and the way he must now improvise given so much uncertainty. As Janet Maslin writes of the book in the New York Times: “There is so much here that lingers, and not just about matters of life and death: One of the most poignant things about Dr. Kalanithi’s story is that he had postponed learning how to live while pursuing his career in neurosurgery. By the time he was ready to enjoy a life outside the operating room, what he needed to learn was how to die.”

The tragedy of this story is of a brilliant man who is unfairly and senselessly taken far too soon (although is there any other way?), leaving behind a grieving wife and eight month old daughter. The beauty of the story lies in Dr. Kalanithi’s ability to express in words his experience, to take charge of his own narrative even as he has so little control and power in the face of his own death. I, along with millions of others, am eternally grateful to have been able to bear witness to his life and death through his writing.

 

Off to the healer we go

tjok-rai-bwI was happy to tag along with my friend here in Bali when she suggested that we hire a driver and go on a day trip, checking off all those clichéd Bali things that I didn’t get a chance to do last time (healer, Holy Water temple, rice fields, traditional dance performance).

And so we headed off on a rainy, humid day, our first stop to visit a traditional Balinese healer. You’ve heard all about Elizabeth Gilbert and Ketut Liyer which I suppose has caused something of a resurgence of interest amongst tourists for such figures. Our Balinese driver, Putu, planned out our whole day and took us to see a healer that he had personally seen when he was a child and who had apparently cured him of a black magic spell. “I was sick when I was a child. I had bad stomach pains. Went to the doctor four times. He couldn’t help. Then my father took me to see the healer and I was better,” he told us.

While I believe there are probably some gifted healers in the world, those of the shamanic variety who have healing powers us average joes don’t have access too, I had low expectations of visiting this man.

We pulled up to his compound, a beautiful, well-kept maze of rooms, statues and shrines in typical Balinese style. The man himself, whom I later would find out is named Cokorda Rai, was working humbly with a patient (client? customer? seeker?) in the porch area where the people come and wait their turn. My friend and I gleaned that the woman and her friend who was waiting were Russian. We waited our turn patiently as Mr. Rai told the girl in broken English how to help herself, although we could only hear the occasional snippet. After waiting about twenty minutes my brave, recently broken-hearted friend took her place on the ground at his feet as he sat behind her in a chair. He wore traditional Balinese dress, complete with white cotton shirt, patterned sarong and traditional hat.

I watched as he felt my friend’s head and face as if he were blind (he’s not) and then pushed his fingers into her ears and felt around her throat and neck. She then lay down on a bamboo mat and he proceeded to poke her toes and feet with a small stick. I guess what he told her resonated as she walked towards us wiping a tear or two from her eye.

Then it was my turn. I get the full head-feeling treatment – and indeed I can attest to the fact that it feels weird when a stranger pokes their long gnarly fingers into one’s ears. He felt around my head and told me that I was strong minded, ‘like a lawyer.’ Unsure if that was a compliment or insult, I kept calm and let him continue feeling around. He asked what my profession was and didn’t seem surprised when I told him. He shouted out across to my friend and Putu that they should ask me for advice because I think I always know what’s best for others.

Then came the painful part.

I lay down on the mat and he proceeded to prod my toes with his evil little stick. It was painful. Like really painful. Like being stabbed. After some minutes of this torturous exercise, the healer comes to the conclusion that I have low blood pressure, that I shouldn’t do anything strenuous at night (it’s true I’m a ‘morning person’), that I need to eat more meat and take Omega-3 supplements. I wouldn’t disagree with analysis. However, I didn’t put much faith in the whole thing to begin with and before I knew it, I’d made my ‘offering’ of $30 and we were on our way to our next attraction. We said a polite goodbye to Mr. Rai and the German expat who was waiting patiently after us. I didn’t give the experience a second thought.

Cut to a few days later and I am forced to fly to Singapore to renew my visa due to some monumental fuckup on an immigration official’s part. I’m in the airport bookstore in the departures lounge (like a moth to a flame!) and a book about Balinese healing catches my eye.

I look at the photo on the back, and to my surprise, it has a picture of the healer whose fingers were in my ears just a few days before. It turns out this Cokorda Rai is quite the famous, revered figure with a lot of mana, both among expats, seekers and local Balinese alike.

More interesting perhaps is what I read about his life between the covers of that book. Encased within the first chapter was a hurried account of a swashbuckling life – a teen runaway, life as a thug on the mean streets of Jakarta, a series of failed business, marriages and some nine children born along the way. But this  regal man (he comes from Balinese royalty) returns home and answers the call and fulfills his destiny…so today, here he is, this elegant man in his 80’s, sitting joyfully on his porch, waiting for those in need for what ails them.