When Breath Becomes Air

March 1, 2016



Imagine your time was a pie. There’d be a slice for the time you spend at work, if you have a job. And a slice for sleep. And a slice for free time. Do you like how your pie is carved up?

When I look at my pie, the “free time” piece usually feels to me like the small sliver that person with amazing self-restraint asks for at a party. But I don’t have self-restraint, I want a bigger piece dammit.

Hearing me whine about this, a friend of mine recommended I read When Breath Becomes Air by Paul Kalanithi, mentioning that the author grapples a lot with the question of how to best spend one’s time. So I took all of that free time pie wedge and allocated it to reading this book for a couple days. In the end, it probably looked like this:

Kalanithi is a brain surgeon who is diagnosed with advanced stage lung cancer. He shares an intimate portrayal of his own process of coming to terms with his mortality. And one aspect of his process is deciding how to spend the precious time he has left… a decision that weighs on him heavily. But he is lacking an important piece of information. The excerpt below is taken from something he wrote for the New York Times, which was also incorporated into his book:

(Excerpt from Kalanithi’s New York Times article found here.)

I always imagined that the one single positive thing that can come from a terminal diagnosis is a radical clarification of one’s priorities. It’s the reason so many spiritual traditions advocate contemplating one’s own mortality—it is seen as one of the surest ways to pull us out of our narrow, self-focused world view and into a big picture view. Most people avoid it since it’s uncomfortable or feels morbid.

If done well, it can help clarify priorities. But the impact is often short-lived because it’s not real to us. Pretty soon we forget and go back to living our lives.

But a terminal diagnosis… you can’t forget about that. It’s constantly staring you in the face. That’s why many who have been dealt that news go on to say that it helped clarify what was truly important to them in life.

Yet here is Kalanithi, who was given the universe’s most clarifying reminder of the preciousness of life, and he found himself wrestling with the same question… I have this one pie, how do I carve it up in the best, truest way possible?

And he struggled with this question for the simple reason that he didn’t know exactly how much time he had left. As he said, if somebody told him he had a couple months to live or a couple years to live, at least he’d have clarity on how to spend his time. I naively assumed getting a terminal diagnosis provides someone with that certainty. It turns out it doesn’t always do that.

We all live with this same uncertainty about how much time we have left. Most of us just don’t pay attention to it. Most of the time I live as though I have decades left. But I might have just a few years. Maybe it’s six months. Maybe it’s a few weeks. Who knows?

I wonder, how would you spend your time if you were continually aware of the reality of your situation? You have decades or you have years or you have months or you have days or you have hours or you have minutes, and you’ll never know for sure. How do you make the most of those possibilities in tandem?