#they constantly question the theme of the difference between machine and man and striving to be the other

[gayemeralds]

creates my own iteration of a franchise and becomes so so so attached. latoya my love im so sorry you’re not real. you are in my head tho and im going to lie here thinking about you.

[sowingseedsandshootinghoops]

When Breath Becomes Air: How to Live a Life of Meaning from the Point of View of a Neurosurgeon Dying from Lung Cancer

Note on the text: I used Paul Kalanithi’s When Breath Becomes Air as published by Random House in 2016. 

Paul Kalanithi was a student of neurosurgery at Stanford who was diagnosed with, and even died from, a severe form of lung cancer. The title of his autobiography come from the first two lines of Caelica 83 by Fulke, as quoted on the introductory page: “You that seek what life is in death;/ now find it air that once was breath” (Introductory page). These lines really helped elucidate the central theme of the book: what makes life meaningful?

When ever since he was a child, Paul was an avid reader of books and had seen scores of authors attempt to answer this question, with varying degrees of success. But he didn’t think about it too deeply, especially in terms of the brain, until he was a student at Stanford, studying English, and encountered a book entitled Satan: His psychotherapy and Cure by the Unfortunate Dr Kassler, J.S.P.S. by Jeremy Levin, a book which he otherwise hated. However he was intrigued by the book’s assertion that what is called mind is just another function of the brain. Kalanithi says that it was 

an idea that struck [him] with force. . . . Of course it must be true- what were our brains doing otherwise? Though we had free will, we were also biological organisms-the brain was an organ, subject to the laws of physics too! Literature provided a rich account of human meaning; the brain, then was the machinery that somehow enabled it. It seemed like magic (30). 

It was then that he decided to started taking classes in neuroscience and biology. Eventually he decided to pursue post graduate studies as a neurosurgeon. However he always saw what he he was doing in the medical field as the practical application of the various philosophies of life that he had encountered. It was only in “practicing medicine that [he] could pursue a serious biological philosophy” and see where it was that “biology, morality, literature, and philosophy intersected” in the creation of a meaningful life (43, 41). 

It’s clear that he sees brain, meaning the organ itself, and mind, the more philosophic “thought center”, as being intricately linked together, and that both serve an important function in the process of creating a meaningful life. He continuously comments on how “the brain mediates our experience of the world” and how any damage to the brain forces people to ask the question “what makes life meaningful enough to go on living?” (71). Yet the brain itself isn’t enough. In order to create a meaningful life, we must move beyond the realm of that physical organ and into the more metaphysical world of mind. In the aftermath of his diagnosis, Paul became very aware of this fact. Despite all the knowledge he had regarding what his body was going through, he needed to dive into the deeper realm of mind in order to be able to really understand, much less much express to others, what he was going through. What it was like to know that you are dying and how that affects you. So he dove back into literature and read “anything written by anyone who had written anything about mortality. [He] was searching for a vocabulary with which [he could] make sense of death, to find a way to begin defining [himself] and [begin] inching forward again” (148). Although it helped for him to understand what his body was going through as a physical organism, it wasn’t enough. He needed the words to describe what he was going through as an individual, not just as a generic man-with-cancer. He thought in a similar way regarding the brain and mind and their ability to help us live a meaningful life. 

We need both our minds and our brains. Brains live in the world of science, of facts, of universal laws that can be understood and that are adhered to by more or less everyone. Minds exist in a world of subjectivity and personal opinion, and even “if a correct answer is possible, verification is certainly impossible” (172). No one really knows why Suzy loves Joey instead of Stevie. It’s a mystery. Ultimately both viewpoints offer valuable insight and neither has the answer all on its own. Science offers us the best way to learn about the physical world, including the brain, and how it works, by giving us 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 life: hope, fear, love, hate, beauty, envy, honor, weakness, striving, suffering, virtue. Between these passions and scientific [theories] there will always be a gap. No system of thought can contain the fullness of human experience” (170). In other words, science’s strength lies in the fact that it can explain tangible, related, and universal facts, which is incredibly important, but in doing so it misses an incredible important part of the human experience which is the subjective experience of the individual: 

The problem however eventually becomes evident: to make science the arbitrator of metaphysics is to banish not only God from the world but also love, hate, [and] meaning. . . a world that is self-evidently not the world we live in. That’s not to say that if you believe in meaning, you must also believe in God. It is to say that if you believe that science provides no basis for God, then you are almost obligated to believe that science provides no basis for meaning and therefore life itself doesn’t have any. In other words, existential claims have no weight” (169). 

So you need to understand both physics and metaphysics, you need both a brain and a mind, in order to figure out how to live a life that is meaningful. 

The truth is that the business of figuring out how to live a life that is meaningful is a tough business to be in precisely because 

your values are constantly changing. You figure out what matters to you and then you keep figuring it out. . . . . You may decide you want to spend your time 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 (160-161). 

Ultimately how do we create meaning for ourselves? We make decisions. We at some point decide what is important to us and how we are going to live our lives, and we do this because we are, underneath it all, meaning-making machines. Kalanithi talks about how the uncertainty regarding how much time he had to live affected the way in which he viewed himself and was blocking him from being able to lead the full and meaningful life that he wanted. He did not know if he had enough time to go back and finish his studies, or if he should just focus on being a good husband and a philanthropic member of community and live as if he were going to die tomorrow. Until one day he made the decision that he was going to live his life as if he was going to life forever, and go back to serving people as a neurosurgeon resident for as long as he could. The way he describes it, somewhat humorously, is that he had gone through all the stages of grief just to arrive at denial: “And now, finally, maybe I had arrived at denial. Maybe total denial. 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” (162). 

So what is it that makes life meaningful? Kalanithi doesn’t provide a definitive answer. After all he can only speak for himself. But there are a few things that he does know about making life meaningful. He knows that the brain is important in this process, as is the mind. But what is perhaps most important is that people can find life-fulfilling meaning in a variety of ways, in whatever they do. So not everyone may find it in neurosurgery like he did, others may find it in teaching, or simply finding ways to love the people around them, and that’s ok. All those ways are equally valid. Sometimes people can have the most impact, and can find that life-defining level of meaning, in ways that, to others, might seem insignificant, even though they really aren’t. Just look at the words he writes to his daughter Caty, who is too young to have any living memory of her father, at the close of the book: 

When you come to one of the many moments in life where you must give an account of yourself, provide a ledger of who you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man’s days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more but rests satisfied. [And] in this time, right now, that is an enormous thing (199). 

Sometimes it will be in the small things that you find the most meaningful way to live your life, sometimes it’ll be in the big ones. Either way it is safe to say that both your brain and your mind will help you on the path to deciding what a meaningful life is to you and how to live it.