#212 | The Limits of Science in Grasping the Human Condition—a Young Doctor on Facing His Own Mortality

episode SUMMARY:

Douglas Vigliotti discusses the thought-provoking memoir “When Breath Becomes Air” by Paul Kalanithi, a neurosurgeon who powerfully explores the profound questions of meaning, purpose, and mortality that arise when the young doctor faces his own terminal illness. Through Kalanithi's deeply personal and eloquent writing, listeners are confronted with the existential challenges of what it means to be human in the face of life's fragility. This book is a poignant meditation on one of life's most challenging questions: what makes a life worth living?

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Welcome back to “Books for Men”, a podcast to inspire more men to read and bring together men who do. So this week I have a memoir to share with you. It is titled, “When Breath Becomes Air” by Paul Kalanithi, hope I'm pronouncing his last name correctly. It's a shorter memoir around 220 pages or so. It came out in 2016. Before I share more about the book, the author, and some of my big takeaways, I'm also going to share a lot of quotes from this book. Before I do any of that, I did want to remind you that the best way to support this podcast is to subscribe on whatever podcast platform you're listening on. It's the best way to inspire more men to read the more subscribers, the more eyeballs that ears the podcasting gets in front of a one.

(00:57)

A to that would be to rate it or review it. Also, I did want to remind you that there is a companion newsletter for this podcast that goes out once a month and rounds up all of the episodes from that month. It's complete with full book and author information, all the best quotes, episode summaries, and newsletter-only book recommendations. It's packed with life lessons and takeaways, and it's just a gentle monthly nudge to read more or to remind you about some of the past month's episodes. If you're interested in signing up for that, you can at BooksforMen.org. Alright, so that wraps up the preamble. Now let's jump into the extremely touching and emotional book that I am sharing with you today. So who is the author? Well, he was a neurosurgeon. He did his undergrad at Stanford and then earned a history and philosophy degree at Cambridge before going to medical school at Yale.

(02:00)

And then following that, went to Stanford again for his seven-year neurosurgical residency and post-doctoral fellowship. Tragically, he died in his final year at the young age of 37. And this book quite simply is the documentation of the author's time battling stage four lung cancer. And the book ultimately came out 10 months posthumously. So naturally, the setup, the premise, and the content are very deep, but there is a lightness to the way the author writes. I think in someone else's hands, it might not have been executed so skillfully or so. Well, keep in mind, I know I kind of brushed over it. He's writing this book knowing that he's ultimately going to die. He has a wife and a young child, and that alone makes you feel things inside of you that you may put away and not like to feel. But the real strength of this work is in the juxtaposition that the protagonist of the story, right, the author himself is facing.

(03:22)

So I'll explain what I mean by that in literally a moment. But first I should mention that the book came on recommendation to me from a friend who is a neurosurgeon. And she told me, if you haven't read this, you have to read it. So I did around two or three years ago. And man, for the obvious reasons, it hit pretty hard. But peeling it back to something I just said moments ago, that juxtaposition that this main character finds himself in is one that can only be represented by reality. So good fiction can only hope to figure out a premise and a tension that is naturally there in a story like this. And that juxtaposition is simply not that he's young, not that he has a child, not that he has his whole life ahead of them, which are all truths and sad. But I think the opening paragraph actually explains exactly what I'm trying to get at.

(04:28)

So instead of me ruining it, why don't I just read that excerpt to you? “I flip through the CT scan images, the diagnosis obvious the lungs were matted with innumerable tumors. The spine deformed, a full lobe of the liver, obliterated cancer widely disseminated. I was a neurosurgical resident entering my final year of training over the last six years. I'd examined scores of such scans on the off chance that some procedure might benefit the patient, but this scan was different; it was my own.” And so when I read that, my jaw just kind of dropped. I was like, wow, this is going to be a serious book. Because what you have here is somebody who has been on one side of the curtain, suddenly has the situation flipped around on them where they are on the other side of the curtain and having to possess all of the knowledge that they have from the other side.

(05:42)

Now they have to immediately look at it through the patient's lens. And what makes it so challenging is that what you're dealing with a lot of times in these situations are life and death and quality of life decisions. The author says in another passage in the book, “Because the brain mediates our experience of the world, any neurosurgical problem forces a patient and family, ideally with a doctor as a guide to answer this question, what makes life meaningful enough to go on living?” And so we all want to believe that just being alive is a good thing, right? Like you're breathing. But when you're talking about someone who is incapacitated or unable to speak or feel or think, has to be on life support, these existential questions become very interesting to think about what is life if you can't mediate your experience of the world because your brain is not functioning correctly?

(06:58)

And a lot of times, at least in the neurosurgical sense, when there are tumors that are present on the brain, if they are inoperable, or if the patient becomes debilitated in a manner where their quality of life is significantly affected, or perhaps even if you have a successful outcome in surgery, what is left of the patient to move forward? These are the questions that a surgeon has to answer with the loved ones of a family. And when people are quite emotional and rightfully so, this becomes a challenge. And so knowing all of this stuff about the human side of dealing with life-threatening diseases, the author has to face this challenge. Ultimately, it's a terminal challenge and he doesn't make it. But he writes about this so deftly and honestly in the book, and I think his philosophy in writing background really makes this book just so much better.

(08:02)

And the fact that this book even made it into existence coming out after he passed away, I view it as such a gift if you're able to pick it up and read it and experience it because it's that emotionally resonant and that important of a book to understand so many different things, patient surgeon relationship, what it means to answer more existential questions at the end of one's life, to leave behind loved ones. And like he says in the book, “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.” And in that same line of thinking, he has a longer excerpt that seemed to really hit home for me, especially considering the worldview of the person who wrote it, the author says, “The problem, however, eventually became evident. To make science the arbiter of metaphysics is to banish not only God from the world but also love, hate, meaning. To consider a world that is self-evidently not the world we live in.

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That's not to say that if you believe in meaning, you must also believe in God. It is to say though that if you believe that science provides no basis for God, then you are almost obligated to conclude that science provides no basis for meaning, and therefore life itself doesn't have any. In other words, existential claims have no weight; all knowledge is scientific knowledge.” And he goes on to challenge himself even further by saying, “Science may provide 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 human life, hope, fear, love, hate, beauty, envy, honor, weakness, striving, suffering, virtue.” And I think that this all ties really well into how I started this episode around that core juxtaposition and tension that rests at the heart of this story.

(10:41)

Because somebody who has spent a lifetime in the sciences, a short lifetime in the sciences, is now faced with all of these very real, but unexplainable aspects of human life that cannot be explained truly by data or statistics of any kind. This quote that I will end this episode with sums it up perfectly. “In the midst of this endless barrage of head injuries, I began to suspect that being so close to the fiery light of such moments only blinded me to their nature, like trying to learn astronomy by staring directly at the sun. I was not yet with patience in their pivotal moments. I was merely at those pivotal moments. I observed a lot of suffering. Worse, I became inured to it.” All right, now that I've made everybody want to get their tissue boxes out, I hope that you see the brilliance and genius in a work like this.

(11:55)

And there's a reason why I wanted to share it with you, not just to make your heart hurt. It's a book that will make you more empathetic and encourage you to explore the existential and vastitude of life, hopefully helping you to live a more fulfilled one. So again, thank you so much for listening. If you enjoyed this episode, then please remember to subscribe on whatever podcast platform you're listening to this on. Also, if you want to connect with me, you can on Instagram @douglasvigliotti. It's the only social media that I have. Or you can also visit my website and connect with me there, DouglasVigliotti.com. And lastly, if you're interested in listening to my 2021 poem collection, it's titled “mini heartbreaks (or, little poems about life)”. It's raw, it's unorthodox, it's a mini-memoir about writing artistry, women growing up, moving forward. And it's available on the podcast “Slightly Crooked: Good Stories, Told Well”. A link for that will be in the show notes. Again, thanks so much for listening, and for more information on this podcast, you could always visit BooksforMen.org.