Wednesday, January 4, 2017

It Wasn't Just a Book: Reflections of Paul Kalanithi's "When Breath Becomes Air"

Paul Kalanithi's printed memoir found me staring at it's cover on a wooden side table belonging to a man I had just given an official time of death on.

Maybe it was the black font surrounding a simple, blue feather that caught my eye, or the large and embellished "breath" and "air." Whichever, I picked it up while finding the space in my hospice practice to be a presence, but not hover. Family loomed around me consoling one another as I read the inside cover.

Ironically, Dr. Kalanithi's book was about death. More so, the journey, a first hand account of facing one's own mortality. I suspect someone purchased it as grief support, maybe the patient (who was also a doctor) or the family themselves. 

The book bumped into me again on a date night with my wife. As I sashayed down the Schuler's Book aisles thumbing paperbacks and hard-bounds, it nearly jumped out and in front of me. "Oh! I saw this book a couple of weeks ago and wanted to read it!" I exclaimed to my wife. As excited as I was about refreshing my memory, the book came home with me and set on my bookshelf for three months. And as always, it came at a perfect time both into my life, and into my hands.

During those three months I found myself entering the beginnings of occupational burn-out. Healthcare professionals are at high risk, certain areas of healthcare, such as hospice workers, are at even higher risk. I could feel myself waning - the knocking of mental and emotional fatigue, a brewing sense of numbness, and heightened impatience. Just weeks prior to the book and I's acquaintance, I spent over 6 hours reviewing the hospice philosophy with a women who cried for two of them straight saying, "I just didn't think we were there yet." They were. Bless them all, they had been there. And it was my responsibility to tell her that. I left, certain, a hundred pieces of my heart laid scattered in their home among children's toys as it broke repeatedly for the patients young life, young wife, and three young children. I cried all the way home that night; I rode silent in my car and sobbed.

That experience weighed so heavy on my heart, I prepared to resign my four plus years in hospice. Instead, job applications went unnoticed, and no move within the company seemed viable for my family. I stayed. Consciously. I hadn't connected the feelings of burn-out with the young family until I sat with my wife on our porch one night after work and confessed my feelings of exhaustion. Emotions poured from my crying heart as I articulated the deep sadness I had been carrying for months. I literally cried for half an hour.

That moment of deep, guttural cleansing buoyed me. I felt as though I came to the surface after a long struggle to stay afloat. I rested, I had the lightness to find my way back to the profession I had always considered an honor to be part of.

Where a book often takes me two to three months to read, I completed When Breath Becomes Air in less than 3 days. It was, by far, one of the best books I've ever read. It exemplified and personalized the necessary grace that comes with imminent mortality. Paul was a seeker along with a writer and neurosurgeon. He waged back and forth between literature and neuroscience his entire life, looking for what gave life meaning. He explored the dying experience with fascination and compassion, and in the end found it "paid a personal visit" at 36, two years after his diagnosis.

This book allowed me to return fully to this work that I love, with grace.