Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

A tribute to Paul Kalanithi

Tom Peteet, MD
Physician
February 19, 2016
Share
Tweet
Share

There are few aphorisms in medicine that stand up to reality. Here are two: Physicians get the patients they deserve, and we tend to die like we live.

Paul Kalanithi’s posthumous memoir proves both: As a neurosurgery resident at Stanford, he took on the most challenging cases, and when diagnosed with terminal lung cancer, he lived and died pursuing excellence and truth. I read When Breath Becomes Air on a blistering cold day in Boston, flanked by two homeless men taking respite in Barnes & Noble.

I imagined myself a less driven and humble version of Paul, acutely aware of the tension of reading a book of medicine, while a man slowly detoxed a few feet from me. My connection to Paul felt more than ethereal; a colleague from medical school went into neurosurgery and posted in May of 2015 of his death, reaffirming that he, indeed, was an amazing person.

Like Paul before his death, I too am in my mid-thirties, finishing residency, with the whole world ahead of me. What struck me the most was not the prose (yes, stunning, especially given the labors of neurosurgical training), but Paul’s constant pursuit of an inner life within the immanent frame of medicine. He dissected stanzas as he did flesh: calmly and meticulously. But there are so many hours in a day, and Paul could not choose both. As he contemplated what to do with his remaining time on earth, he reflected that if he had ten years, he would operate, but if he had two, he would write. How does a mind hungry for literature and poetry make meaning in a medical world of algorithms, technology, and efficiency?

The role of medical humanities in training is a perennial debate; whether to include reflexive writing as part of evaluations, or to teach seminars on writing. Paul would not care for such debates: Literature lived within him. He may respond that there is both technical and philosophical excellence. On technical excellence, “good intentions were not enough, not when so much depended on my skills, when the difference between tragedy and triumph was defined by one or two millimeters.”

And of the philosophical, “in our rare reflective moments, we were all silently apologizing to our cadavers, not because we sensed the transgression but because did not.” What are the stakes of physicians’ not reflecting on their practice? He does cite one example, a surgeon who refused to take responsibility for mistakes. After an hour of coaching, Paul remarked, “he was doomed.”

Paul shows fortitude in the face of death that feels different from the trope of battle: I will go back to work, and write, and start a family. He’s not fighting to win, but to live out what’s important. Walking across the snowy sidewalks of Boston, I grieved for his wife, daughter, and the world he left behind. In a year, I will be walking in the same snow, and may seize upon a line or quote that renews my work in medicine. For today, it’s his quote of Montaigne:

If I were a writer of books, I would compile a register, with a comment, of the various deaths of men: He who should teach men to die would at the same time teach them to live.

Tom Peteet is an internal medicine resident.

Image credit: MSNBC

Prev

I was unprepared to deal with a homeless patient today. I won’t be tomorrow.

February 19, 2016 Kevin 3
…
Next

Patients and physicians must advocate for a transformed primary care system

February 19, 2016 Kevin 19
…

Tagged as: Surgery

Post navigation

< Previous Post
I was unprepared to deal with a homeless patient today. I won’t be tomorrow.
Next Post >
Patients and physicians must advocate for a transformed primary care system

ADVERTISEMENT

More by Tom Peteet, MD

  • a desk with keyboard and ipad with the kevinmd logo

    Searching for the holy grail of clinical reasoning

    Tom Peteet, MD
  • The price of certainty in the ICU

    Tom Peteet, MD
  • Are preoperative consultations worthless?

    Tom Peteet, MD

Related Posts

  • A physician’s addiction to social media

    Amanda Xi, MD
  • Why this physician teaches first-year medical students 

    Mark Kelley, MD
  • The pandemic has only further strengthened my passion to become a physician

    Karan Patel
  • How a physician keynote can highlight your conference

    Kevin Pho, MD
  • Chasing numbers contributes to physician burnout

    DrizzleMD
  • Hormone replacement therapy is still linked to cancer

    Martha Rosenberg

More in Physician

  • Why Canada is losing its skilled immigrant doctors

    Olumuyiwa Bamgbade, MD
  • Why doctors are reclaiming control from burnout culture

    Maureen Gibbons, MD
  • Why screening for diseases you might have can backfire

    Andy Lazris, MD and Alan Roth, DO
  • Why “do no harm” might be harming modern medicine

    Sabooh S. Mubbashar, MD
  • International doctors blocked by visa delays as U.S. faces physician shortage

    Arthur Lazarus, MD, MBA
  • How I redesigned my life as a physician without abandoning medicine

    Ben Reinking, MD
  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

      Gabe Jones, MBA | Tech
    • Why medicine must stop worshipping burnout and start valuing humanity

      Sarah White, APRN | Conditions
    • Why screening for diseases you might have can backfire

      Andy Lazris, MD and Alan Roth, DO | Physician
    • How organizational culture drives top talent away [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

      Gabe Jones, MBA | Tech
    • Why medicine must stop worshipping burnout and start valuing humanity

      Sarah White, APRN | Conditions
    • Why screening for diseases you might have can backfire

      Andy Lazris, MD and Alan Roth, DO | Physician
    • How organizational culture drives top talent away [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

A tribute to Paul Kalanithi
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...