## Metadata - Author: [[Paul Kalanithi]] - Full Title: When Breath Becomes Air - Category: #books ## Highlights - Throughout college, my monastic, scholarly study of human meaning would conflict with my urge to forge and strengthen the human relationships that formed that meaning. If the unexamined life was not worth living, was the unlived life worth examining? ([Location 377](https://readwise.io/to_kindle?action=open&asin=B00XSSYR50&location=377)) - When there’s no place for the scalpel, words are the surgeon’s only tool. ([Location 875](https://readwise.io/to_kindle?action=open&asin=B00XSSYR50&location=875)) - The root of disaster means a star coming apart, and no image expresses better the look in a patient’s eyes when hearing a neurosurgeon’s diagnosis. ([Location 908](https://readwise.io/to_kindle?action=open&asin=B00XSSYR50&location=908)) - A tureen of tragedy was best allotted by the spoonful. Only a few patients demanded the whole at once; most needed time to digest. ([Location 940](https://readwise.io/to_kindle?action=open&asin=B00XSSYR50&location=940)) - Patients, when hearing the news, mostly remain mute. (One of the early meanings of patient, after all, is “one who endures hardship without complaint.”) ([Location 955](https://readwise.io/to_kindle?action=open&asin=B00XSSYR50&location=955)) - 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. ([Location 975](https://readwise.io/to_kindle?action=open&asin=B00XSSYR50&location=975)) - The funny thing about time in the OR, whether you race frenetically or proceed steadily, is that you have no sense of it passing. 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. ([Location 1033](https://readwise.io/to_kindle?action=open&asin=B00XSSYR50&location=1033)) - Neurosurgery requires a commitment to one’s own excellence and a commitment to another’s identity. 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. ([Location 1067](https://readwise.io/to_kindle?action=open&asin=B00XSSYR50&location=1067)) - Most lives are lived with passivity toward death—it’s something that happens to you and those around you. But Jeff and I had trained for years to actively engage with death, to grapple with it, like Jacob with the angel, and, in so doing, to confront the meaning of a life. We had assumed an onerous yoke, that of mortal responsibility. Our patients’ lives and identities may be in our hands, yet death always wins. 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 for your patients. ([Location 1125](https://readwise.io/to_kindle?action=open&asin=B00XSSYR50&location=1125)) - 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. ([Location 1280](https://readwise.io/to_kindle?action=open&asin=B00XSSYR50&location=1280)) - 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. ([Location 1513](https://readwise.io/to_kindle?action=open&asin=B00XSSYR50&location=1513))