This memoir by a promising neurosurgical post doctorate
fellow who died of lung cancer at age 37 is filled with lyrical language that
soars, beautiful metaphors and inspiring quotes from literature throughout the
ages. This New York Times bestseller is
rare for the fact that the author scientist was also an accomplished and schooled
author. Most scientists have difficulty
writing and difficulty communicating especially when it comes to their subject
of expertise. Not so in the case of Paul
Kalanithe.
The Last Lecture by
Randy Pauche, a memoir by another man stricken with cancer in the middle of his
career does not compare to When Breath Becomes Air. The Last Lecture was a Chevy whereas this
tome is a Mercedes. The loss of a much loved computer science professor at a
good but not great university cannot compare to the loss of a talented
neurosurgeon and author who had the promise of lifesaving and life enhancing
discoveries in his future. Kalanithe’s memoir is really divided into two
halves. The first half deals with his
upbringing as the son of Indian immigrants in Kingman, Arizona where there were
few Indian families. When Paul was ten, the family moved from Bronxville in
Westchester County N.Y to Kingman, Arizona. Bronxville was an upper middle
class suburb of N.Y.C. His father was a hardworking and much respected cardiologist
in Kingman. A graduate of Harvard
University medical school he expected and demanded high scholastic
accomplishments from his three sons.
However, he tempered high standards with love. His mother realizing the
dearth of opportunity for educational excellence in their small town, obtained
a long list of recommended reading for young people headed for college and read
by successful college graduates. She insisted her three sons work their way
through the lists. Before endless hours
of cable T.V. and the ubiquitous ipads, books were one of the Kalanithe
children’s main sources of escape. Paul’s regular quotes from great works of
literature as well as his love of literature were the result. Further, when the SAT tests were not offered
in Kingman, Mrs. Kalanithe drove four hours away to Las Vegas to make sure they
had access to this college application requirement. Although his father is a Harvard man, Dr.
Kalanithe graduates from Stanford with a B.A. in English, a B.A. in biology and
an M.A. in English. He receives an M. of
Philosophy in the history and philosophy of science and medicine from
Cambridge. He then earns a medical
degree cum laude from Yale where he also meets his wife Lucy. They both head to Stanford where he begins a
promising career as a neurosurgical resident and she studies internal
medicine. He received the highest award
given for resident research by the American Academy of Neurological
Surgery. His education and career
reflect his fascination with the tension between objective medicine and
compassionate humanity. When was it time
to give up was a regular refrain in his treatment plans. Little did he know that he would soon answer
that question as a patient.
Dr. Kalanithe worked 100 hour weeks and immersed himself in
his field leaving little time for his wife or social obligations. Still he was a dedicated practitioner
performing lifesaving and life enhancing surgeries on many grateful patients as
well as engaging in groundbreaking research that he hoped would one day provide
the compassionate humanity that he wanted to see in the practice of
medicine. He and his wife, Lucy were
scheduled for a reunion of sorts with some of their east coast classmates. Paul went alone. Even before his trip he was feeling ill. He thought he was coming down with a virus
for weeks and had begun to suffer back pain some of it becoming extreme. He chalked it up to too many long days and
too much time on his feet in the operating room. He was really ignoring his symptoms at this
point and hoping they would disappear.
In this way he is not so different from the typical patient. Believing he would benefit by the trip where
he could rest and relax, he left for the east coast. Once there and exhausted from his travels, he
plopped down in bed and never left it.
He slept the whole of the next day.
On the second day feeling something more than a virus and backache were
the cause of his malaise, he left the reunion early and headed home where he
drove immediately to the hospital where he worked. After an exam by a physician there, he was
admitted. The admitting doctor told him
he was very ill and would need to stay.
Suddenly, the lifesaving doctor became the patient needing lifesaving
treatment. His wife Lucy read the X-Rays
and knew the moment she saw them that her husband, Paul, was dying. Then the two of them viewed the X-Rays
together. The oncologist confirmed their
fears. Paul was on the cusp of a stellar
trajectory when he was diagnosed at the age of 36 with metastatic lung cancer. They marveled at the tiny percentage of 36
year old lung cancer patients there were in the statistics. But Dr. Kalanithe also acknowledged the fact
that when you the patient are the statistic, statistics don’t matter. Realizing he had little time remaining, he
tried to squeeze as much life out of the year and a half left to him. His compassionate oncologist asked him about
those parts of his life that were most important to him, and she strove to save
as much of them as she could. Paul
underwent arduous chemotherapy etc. to delay the inevitable. For a while he was bedridden and the pain in
his back was disabling. Gradually, the
chemo worked and he was able to return to his surgery and research but not at
the same super human pace as before. He
and Lucy were amazed at how the chemo shrunk the tumors. His X-Rays were a marvel. He felt so much better even daring to hope he
had a future. He was hurt when Stanford
offered the prestigious teaching and research position he had expected to come
his way to another resident in his program. Stanford knew he was dying. Still a
Medical school in Wisconsin offered him such a post even agreeing to foot the
bill for monthly visits with his oncologist at Stanford. He felt well enough
that he even flew out to Wisconsin to talk them. He was that good that even
though the medical school believed he had at most five more years of life, they
wanted him anyway. However, it was not to be. Even earlier the Kalanithe’s
decided to have a child so Paul could experience fatherhood, one of his main
goals in life. They succeeded and Lucy
bore a little girl named Elizabeth. His
family in Arizona rallied around him regularly visiting to offer support and
love. After his brief reprieve, his cancer returned with a vengeance as it so
often does. He was unable to complete
his memoir as he would have liked.
However, the book is not lacking because he left the composition sooner
than he would have liked. An epilogue by
his wife, Lucy, ends the book. We can
only hope that the sales from the book will be enough to financially support
his child, Elizabeth so that Lucy and Elizabeth have the same standard of
living they would have had had Paul lived.
This book is a must read.
It is inspirational not only for telling us how to live. It is inspirational
too for telling us how to die gracefully. (248 pages)
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