When Breath Becomes Air [Religio Medici]

 I heard about Paul Kalanithi's book, When Breath Becomes Air, long before I actually read it. I knew that Bill Gates and Anne Patchett both raved about it, that it spent 51 weeks on the bestseller list and was a 2017 Pulitzer Prize Finalist, but I was hesitant to read the memoir about a brain surgeon who was diagnosed with lung cancer because I didn't think I could relate to it. Working at the American Lung Association and having talked to many individuals whose lives are impacted by lung cancer, I decided to finally give the book a shot.

Kalanithi was 36 and nearing the end of residency as a neurosurgeon at Stanford University when he was diagnosed with stage 4 lung cancer. As a young boy, Kalanithi devoured books and had ambitions of becoming a writer, but growing up in a family of physicians, he understood medicine's pivotal role in society. In both his undergraduate and graduate studies, he took on double course loads of literature and science, paving his path to be either a writer or a doctor. Kalanithi was fascinated with the moral complexities that come with humanity and realized that as a writer he would only be a casual observer but as a physician he would be on the front lines of life and death. He decided to go to medical school and pursued neurosurgery, one of medicine's most strenuous fields.

Throughout When Breath Becomes Air, Kalanithi describes the emotional turmoil doctors face as caretakers for the sick, and he grapples with his disappointment in his own humanity and not being able to be perfect in the operating room. The distinct narrative of this novel is that of a doctor who understands that his patients, nearing the end of their lives, have put all of their hope and faith into him to pull them out of their illness. He brings the readers into the mind of a doctor and shows that for him, and many of his colleagues, this is not just a job, but a calling he was obligated to answer. Early on, Kalanithi made specific decisions to be present for his patients, to meet them where they are and give them the empathy and attention they needed, even if he had already worked 16 hours that day. It's clear that Kalanithi was a gifted neurosurgeon, who would have likely rose to the top of his field worldwide, but he was also gentle and caring physician, the type of doctor you would want to have if you were having brain surgery.  

Then Kalanithi became sick and his 20-year plan vanished. He was now the patient.

Kalanithi's oncologist refused to discuss survival rates and life expectancy. Instead, she instructed Kalanithi to live the life he wanted, do whatever he enjoyed the most, but these instructions did not give him clarity. Like any of us striving to live our best lives, he was torn on which direction to steer his goals. If he had 20 years to live, he'd go back to medicine. Only five, then he would write. This question plagued him through the initial treatment that was able to stabilize his tumor and allowed him to return to the operating room. He and his wife even decided to undergo in vitro fertilization treatments to grow their family.

His life was progressing, with a child on the way and nearing residency graduation, when a scan revealed another tumor. Despite what everyone else was saying, Kalanithi knew it was the beginning of the end. He left medicine to spend time with his family and write.

Kalanithi's book was published posthumously, 10 months after he passed away, and ends with a tear-inducing passage written by his wife, Lucy. Now a single mother, Lucy describes visiting her husband's grave with their daughter and teaching her about the father she will never know. It was a fitting conclusion to the book, and I loved it so much that I wanted to hear more from Lucy and her experiences with her husband's cancer.

This novel is not a resource for lung cancer (I recommend Lung.org/lung-cancer for more information) and not a book for only those whose lives have been touched by lung cancer. No matter who you are, or what journey you've gone on, you will find something about When Breath Becomes Air that speaks to you. Whether it is the love of the written English language, grappling with how best to spend your time on Earth or accepting life as the finite thing it is, Kalanithi's words resonate with us all.

When Breath Becomes Air is a beautifully written book that shows us that we can't control the matter or timing of our death, but we can choose how we approach it. It took me awhile to get to this book, and given our finite time on this planet, I highly recommend you don't make the same error.

I received this book from a lady friend of my dear son 💙 for Christmas 2017. I enjoy reading it from cover  to cover. Read 📚 In Private 👍 👌 🙆‍♂️ 

WHEN BREATH BECOMES AIR

You that seek what life is in death,

Now find it air that once was breath.

 New names unknown, old names gone:

Till time end bodies, but souls none.

Reader! then make time,

while you be,

But steps to your eternity.

Dāng hūxī biàn chéng kōngqì

 当      呼吸  变       成       空气

nǐmen zài sǐwáng zhōng xúnzhǎo 

 你 们   在   死 亡       中       寻 找

shēngmìng de yìyì,

    生    命     的 意义，

xiàn zài zhǎo dào céng jīng shì

  现  在      找   到      曾    经     是

hūxī de kōngqì.

呼吸 的     空气。

Xīn míng zì wèi zhī,  jiù míng zì xiāo shī :

  新   名 字     未 知，旧    名 字    消 失：

Zhí dào shí jiān zhōng jié le ròu  tǐ,

  直  到     时 间       终     结  了 肉 体，

dàn línghún què méi yǒu.

 但     灵  魂    却    没  有。

Dúz hě! Rán hòu téng chū shí jiān,

 读 者！   然 后      腾      出   时 间，

dāng nǐ zài de shí hòu,

   当   你 在  的   时 候，

dàn mài xiàng nǐ de yǒnghéng.

 但    迈      向   你  的   永     恒。

Dāng hūxī biàn chéng kōngqì

nǐmen zài sǐwáng zhōng xúnzhǎo shēngmìng de yìyì,

xiànzài zhǎodào céngjīng shì hūxī de kōngqì.

 Xīn míngzì wèizhī, jiù míngzì xiāoshī:

Zhídào shíjiān zhōngjiéle ròutǐ, dàn línghún què méiyǒu.

Dúzhě! Ránhòu téng chū shíjiān,

dāng nǐ zài de shíhòu,

dàn mài xiàng nǐ de yǒnghéng.

Religio Medici

Genre(s): Non-fiction

Subgenre(s): Meditation and contemplation

Core issue(s): Charity; faith; nature; salvation; scriptures

Overview

At age thirty, Sir Thomas Browne wrote Religio Medici, an explanation and analysis of his religious belief in relationship to his profession as a medical doctor. Intended as a personal meditation, Religio Medici circulated in manuscript form for several years, spawning various unauthorized texts. When a critical response to it was published, Browne saw to the publication of a new, authorized edition. Both documents, appearing during an era of social and religious upheaval when men could be executed for expressing their religious beliefs, present a tactful, idiosyncratic expression of a spiritual life shaped by Christian doctrine, medieval and classical thinking, and the explosion of knowledge occurring in the seventeenth century.

The work has two parts: The first explores faith and, implicitly, hope; the second, charity. In the preface, Browne disclaims the thoughts contained in the work as connected to the time in which they were written and not necessarily thoughts he would hold at another, more mature stage of his life. He explains that his meditation is not a scholarly work and asks the reader to read with a mind informed by faith and open to accepting his imaginative self-exploration.

Browne affirms that he has had a happy, serene, long connection with and belief in Christianity as handed down to him through the Church of England and the Reformation. He believes in divine providence. Realizing that some aspects of faith cannot be understood, he eagerly delights in the mystery, stating that he is a man capable of living with uncertainties.

Browne accepts the doctrines of his church but allows himself in the meditation to focus on what would be his ideal relation to God. He appreciates, though now rejects, some of the customs of the Catholic religion, and he advocates tolerance. He would like to subscribe to the heresy that all souls are at last saved and prefers not to judge Turks and Jews who are called heretics. He accepts church doctrine as the practical course and does not wish to promote fragmentation within the church. This easy acceptance of differences sets him apart from many religious zealots of his day and places him in the tradition of moderates such as Richard Hooker, who wrote Of the Lawes of Ecclesiasticall Politie (1593, 1597).

In the first part of Religio Medici, Browne contemplates and explores several themes. He expresses, as do John Donne and George Herbert, no fear of death and a belief in the witty paradox expressed by Donne that death dies when a person dies, while human beings continue into eternal life. He praises nature, finding nothing ugly there. God, the creator, the great artist of nature, has created a harmonious whole from many related parts. Browne subscribes to the view of life as a great chain of being in which all parts are connected and each part is connected to what is just above and just below it. Thus he reaffirms humankind’s spiritual and material nature. He accepts both devils—and their manifestation on earth as witches—and angels. As a seventeenth century thinker accustomed to seeing correspondences, he readily recognizes that within a human being is a microcosm of the macrocosm. He sees in each human the same struggles for harmony that exist in the body politic.

Browne finds in all people the spirit of God, believing that his own spirit existed in the...

(This entire section contains 1453 words.)

For by compassion, we make others' misery our own, and so, by relieving them, we relieve ourselves also. When a disease is beyond one's capacity to cure, one professes great shame and is reluctant to charge the patient a fee, calling this "scarce honest gain. " ~ Honest Physicians.

PLOT SUMMARY

Religio Medici

by Sir Thomas Browne

Nonfiction | Book | Adult | Published in 1642

Plot Summary

Religio Medici (1643) is a spiritual memoir by English physician and author Sir Thomas Browne. Translated as "The Religion of a Doctor," Religio Medici expresses Browne's views on a wide range of scientific and religious subjects. Because some of these views were unorthodox at the time and controversial, Browne may not have intended the tract to be published. It was only in 1642 when an unauthorized copy went into circulation that Browne released an official version for consumption the following year. A best-seller across Europe at the time of its publication, the book later went on to influence writers and thinkers for centuries to come, including Thomas de Quincey, Carl Jung, and Virginia Woolf, who maintained that Religio Medici paved the way for all future memoirs. William Osler, who is frequently credited as "the father of modern medicine," considered Religio Medici so influential to his career that he reportedly memorized it by heart.

After completing his medical studies at Leiden University in the Netherlands, Browne set about cataloging his values and belief systems into a comprehensive spiritual tract. One of the key themes of his philosophy concerns the importance of separating one's attitudes on science and religion. For a physician, one of the clearest implications of this belief is that a doctor must not only tolerate but also respect individual patients' religious or philosophical beliefs, even if they conflict with one's own. In seventeenth-century Europe, such religious tolerance was practically unheard of in the professional and peasant classes alike. A citizen was not only expected but also required by law to practice the religion of the state, be it Catholic, Protestant, or Orthodox. In no state was Judaism the official religion, therefore, Jews were ostracized and frequently persecuted for their beliefs. Such beliefs, however, according to Browne, should not preclude the physician from treating patients.

This tolerance stems largely from Browne's own belief that individual churches and sects should not "usurp the gates of heaven, and turn the key against each other; and thus we go to heaven against each others' wills, conceits, and, with as much uncharity as arrogance, do err." For this reason, Browne strongly opposes the religious mandates put forth by most European states at this time, which led to bitter and bloody conflicts like the Thirty Years War, which raged during the period in which Browne wrote Religio Medici.

While Browne expresses deep and unprecedented tolerance for others' belief systems, he is adamant in his own religious beliefs. A Protestant, Browne abides by the notion of sola fide or "faith alone." In short, this means deep and abiding faith in God, Jesus, and the resurrection is sufficient justification for a sinner to be pardoned and her soul saved. This differs from Catholicism, which tends to emphasize "works" or good deeds as part of the grace required to gain admission into heaven. In discussing his beliefs, Browne also attests to the existence of hell and the promise of the last judgment, the eschatological worldview that says the second coming of Jesus Christ will hearken God's final and eternal judgment of every human being on the planet.

While Browne believes that science can illuminate religious truths, he is a strict adherent to the scientific rigors of empiricism and observation pioneered by rationalists like Sir Francis Bacon and which are now associated with what is referred to in the twentieth century and beyond as "the scientific method." Doing so necessitates a clear separation between the spheres of religion and science, at least when conducting medical procedures or formulating diagnoses.

Nevertheless, Browne recognizes a strong moral component to the science of medicine. To him, medicine is more than a trade or profession; it is a moral pursuit built on a foundation of service to others. This moral component also renders one's medical career into a journey of personal fulfillment. "For by compassion," Browne writes, "we make others' misery our own, and so, by relieving them, we relieve ourselves also." When a disease is beyond Browne's capacity to cure, he professes great shame and is reluctant to charge the patient a fee, calling this "scarce honest gain." This conceiving of the physician as a person of great moral character, for whom honesty and compassion are paramount, was unprecedented at the time.

In one of the only surviving contemporary reviews of Religio Medici, the French physician Guy Patin wrote: "A new little volume has arrived from Holland entitled Religio Medici written by an Englishman and translated into Latin by some Dutchman. It is a strange and pleasant book, but very delicate and wholly mystical; the author is not lacking in wit and you will see in him quaint and delightful thoughts. There are hardly any books of this sort. If scholars were permitted to write freely we would learn many novel things, never has there been a newspaper to this; in this way the subtlety of the human spirit could be revealed."