Paul Kalanithi Quotes & Sayings

Putting lifestyle first is how you find a job --- not a calling. — Paul Kalanithi

I had to help those families understand that the person they knew - the full, vital independent human - now lived only in the past and that I needed their input to understand what sort of future he or she would want: an easy death or to be strung between bags of fluids going in, others coming out, — Paul Kalanithi

Death may be a one-time event, but living with terminal illness is a process. — Paul Kalanithi

Medical training is relentlessly future-oriented, all about delayed gratification; you're always thinking about what you'll be doing five years down the line. — Paul Kalanithi

My state of knowledge was the same, but my ability to make lunch plans had been shot to hell. The way forward would seem obvious, if only I knew how many months or years I had left. Tell me three months, I'd spend time with family. Tell me one year, I'd write a book. Give me ten years, I'd get back to treating diseases. The truth that you live one day at a time didn't help: What was I supposed to do with that day? At — Paul Kalanithi

I got out of bed and took a step forward, repeating the phrase over and over: "I can't go on. I'll go on. — Paul Kalanithi

At those critical junctures, the question is not simply whether to live or die but what kind of life is worth living. — Paul Kalanithi

Maybe, in the absence of any certainty, we should just assume that we're going to live a long time. Maybe that's the only way forward. — Paul Kalanithi

And as I sat there, I realized that the questions intersecting life, death, and meaning, questions that all people face at some point, usually arise in a medical context. — Paul Kalanithi

At home in bed a few weeks before he died, I asked him, "Can you breathe okay with my head on your chest like this?" His answer was "It's the only way I know how to breathe. — Paul Kalanithi

And then we would sit and watch as the first hint of sunlight, a light tinge of day blue, would leak out of the eastern horizon, slowly erasing the stars. The day sky would spread wide and high, until the first ray of the sun made an appearance. The morning commuters began to animate the distant South Lake Tahoe roads. But craning your head back, you could see the day's blue darken halfway across the sky, and to the west, the night remained yet unconquered - pitch-black, stars in full glimmer, the full moon still pinned in the sky. To the east, the full light of day beamed toward you; to the west, night reigned with no hint of surrender. No philosopher can explain the sublime better than this, standing between day and night. It was as if this were the moment God said, "Let there be light!" You. — Paul Kalanithi

What happened to Paul was tragic, but he was not a tragedy. — Paul Kalanithi

How little do doctors understand the hells through which we put patients. — Paul Kalanithi

The mind was simply the operation of the brain. — Paul Kalanithi

I could either study meaning or I could experience it. After — Paul Kalanithi

I was leaving this small Arizona town in a few weeks, and I felt less like someone preparing to climb a career ladder than a buzzing electron about to achieve escape velocity, flinging out into a strange and sparkling universe. — Paul Kalanithi

But my focus would have to be on my imminent role, intimately involved with the when and how of death - the grave digger with the forceps. Not — Paul Kalanithi

Will having a newborn distract from the time we have together?" she asked. "Don't you think saying goodbye to your child will make your death more painful?"

"Wouldn't it be great if it did?" I said. Lucy and I both felt that life wasn't about avoiding suffering. — Paul Kalanithi

Openness to human relationality does not mean revealing grand truths from the apse; it means meeting patients where they are, in the narthex or nave, and bringing them as far as you can. — Paul Kalanithi

there's that study that says doctors do a worse job prognosticating for patients they're personally invested in. — Paul Kalanithi

What are you most afraid or sad about?" she asked me one night as we were lying in bed.

"Leaving you," I told her. — Paul Kalanithi

Even while terminally ill, Paul was fully alive; despite physical collapse, he remained vigorous, open, full of hope not for an unlikely cure but for days that were full of purpose and meaning. — Paul Kalanithi

One chapter of my life seemed to have ended; perhaps the whole book was closing. Instead of being the pastoral figure aiding a life transition, I found myself the sheep, lost and confused. Severe illness wasn't life-altering, it was life-shattering. — Paul Kalanithi

As a doctor, you have a sense of what it's like to be sick, but until you've gone through it yourself, you don't really know. — Paul Kalanithi

Frail but never weak. — Paul Kalanithi

Yet the paradox is that scientific methodology is the product of human hands and thus cannot reach some permanent truth. We build scientific theories to organize and manipulate the world, to reduce phenomena into manageable units. Science is based on reproducibility and manufactured objectivity. As strong as that makes its ability to generate claims about matter and energy, it also makes scientific knowledge inapplicable to the existential, visceral nature of human life, which is unique and subjective and unpredictable. 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. Between — Paul Kalanithi

Few books I had read so directly and wholly addressed that fundamental fact of existence: all organisms, whether goldfish or grandchild, die. — Paul Kalanithi

Everything teeters between pathos and bathos: here you are, violating society's most fundamental taboos and yet formaldehyde is a powerful appetite stimulant, so you also crave a burrito. — Paul Kalanithi

At moments, the weight of it all became palpable. It was in the air, the stress and misery. Normally, you breathed it in, without noticing it. But some days, like a humid muggy day, it had a suffocating weight of its own. Some days, this is how it felt when I was in the hospital: trapped in an endless jungle summer, wet with sweat, the rain of tears of the families of the dying pouring down. — Paul Kalanithi

Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete. — Paul Kalanithi

Hemingway described his process in similar terms: acquiring rich experiences, then retreating to cogitate and write about them. I needed words to go forward. And so it was literature that brought. — Paul Kalanithi

Learning to judge whose lives could be saved, whose couldn't be, and whose shouldn't be requires an unattainable prognostic ability. — Paul Kalanithi

As graduation loomed, I had a nagging sense that there was still far too much unresolved for me, that I wasn't done studying. I applied for a master's in English literature at Stanford and was accepted into the program. I had come to see language as an almost supernatural force, existing between people, bringing our brains, shielded in centimeter-thick skulls, into communion. A word meant something only between people, and life's meaning, its virtue, had something to do with the depth of the relationships we form. It was the relational aspect of humans - i.e., "human relationality" - that undergirded meaning. Yet somehow, this process existed in brains and bodies, subject to their own physiologic imperatives, prone to breaking and failing. There must be a way, I thought, that the language of life as experienced - of passion, of hunger, of love - bore some relationship, however convoluted, to the language of neurons, digestive tracts, and heartbeats. At Stanford, I had the good — Paul Kalanithi

Paul faced each stage of his illness with grace - not with bravado or a misguided faith that he would "overcome" or "beat" cancer but with an authenticity that allowed him to grieve the loss of the future he had planned and forge a new one. — Paul Kalanithi

A scan showed that a benign brain tumor was pressing on her right frontal lobe. In terms of operative risk, it was the best kind of tumor to have, and the best place to have it; surgery would almost certainly eliminate her seizures. The alternative was a lifetime on toxic antiseizure medications. — Paul Kalanithi

My life up until my illness could be understood as the linear sum of my choices. As in most modern narratives, a character's fate depended on human actions, his and others. — Paul Kalanithi

What patients seek is not scientific knowledge that doctors hide but existential authenticity each person must find on her own. 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. — Paul Kalanithi

tureen of tragedy was best allotted by the spoonful. — Paul Kalanithi

Neurosurgery requires a commitment to one's own excellence and a commitment to another's identity. The — Paul Kalanithi

There is a moment, a cusp, when the sum of gathered experience is worn down by the details of living. We are never so wise as when we live in this moment. — Paul Kalanithi

the heroic spirit of responsibility amid blood and failure. This struck me as the true image of a doctor. — Paul Kalanithi

I would have to learn to live in a different way, seeing death as an imposing itinerant visitor but knowing that even if I'm dying, until I actually die, I am still living. — Paul Kalanithi

Science is based on reproducibility and manufactured objectivity. As strong as that makes its ability to generate claims about matter and energy, it also makes scientific knowledge inapplicable to the existential, visceral nature of human life, which is unique and subjective and unpredictable. — Paul Kalanithi

mind was simply the operation of the brain, an idea that struck me with force; it startled my naive understanding of the world — Paul Kalanithi

Some days, I simply persist. — Paul Kalanithi

Before my cancer was diagnosed, I knew that someday I would die, but I didn't know when. After the diagnosis, I knew that someday I would die, but I didn't know when. But now I knew it acutely. — Paul Kalanithi

the cruelty of cancer, though, is not only that it limits your time; it also limits your energy, vastly reducing the amount you can squeeze into a day. It is a tired hare who now races. And even if I had the energy, I prefer a more tortoiselike approach. I plod, I ponder. Some days, I simply persist. If time dilates when one moves at high speeds, does it contract when one moves barely at all? It must: the days have shortened considerably. With little to distinguish one day from the next, — Paul Kalanithi

knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete. And — Paul Kalanithi

The root of disaster means a star coming apart. — Paul Kalanithi

With my renewed focus, informed consent - the ritual by which a patient signs a piece of paper, authorizing surgery - became not a juridical exercise in naming all the risks as quickly as possible, like the voiceover in an ad for a new pharmaceutical, but an opportunity to forge a covenant with a suffering compatriot: Here we are together, and here are the ways through - I promise to guide you, as best as I can, to the other side. — Paul Kalanithi

And with that, the future I had imagined, the one just about to be realized, the culmination of decades of striving, evaporated. — Paul Kalanithi

How much neurologic suffering would you let your child endure before saying that death is preferable? — Paul Kalanithi

It's not fair - I've been diluting my drinks with water." A — Paul Kalanithi

As a resident, my highest ideal was not saving lives -- everyone dies eventually -- but guiding a patient or family to an understanding of death or illness. — Paul Kalanithi

Looking out over the expanse ahead I saw not an empty wasteland but something simpler: a blank page on which I would go on. — Paul Kalanithi

my imagined future and my personal identity collapsed, and I faced the same existential quandaries my patients faced. — Paul Kalanithi

I thought back to med school, when a patient had told me that she always wore her most expensive socks to the doctor's office, so that when she was in a patient's gown and shoeless, the doctor would see the socks and know she was a person of substance, to be treated with respect. (Ah, there's the problem - I was wearing hospital-issue socks, which I had been stealing for years! — Paul Kalanithi

Death comes for all of us. For us, for our patients: it is our fate as living, breathing, metabolizing organisms. Most lives are lived with passivity toward death - it's something that happens to you and those around you. — Paul Kalanithi

The pain of failure had led me to understand that technical excellence was a moral requirement. — Paul Kalanithi

Being with patients in these moments certainly had its emotional cost, but it also had its rewards. I don't think I ever spent a minute of any day wondering why I did this work, or whether it was worth it. The call to protect life - and not merely life but another's identity; it is perhaps not too much to say another's soul - was obvious in its sacredness. Before — Paul Kalanithi

To find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay. — Paul Kalanithi

If the weight of mortality does not grow lighter, does it at least get more familiar? — Paul Kalanithi

Mortal duty has weight, things that have weight have gravity, and so the duty to bear mortal responsibility pulled me back. — Paul Kalanithi

Only later would I realize that our trip had added a new dimension to my understanding of the fact that brains give rise to our ability to form relationships and make life meaningful. Sometimes, they break. — Paul Kalanithi

The morning commuters began to animate the distant South Lake Tahoe roads. But craning your head back, you could see the day's blue darken halfway across the sky, and to the west, the night remained yet unconquered - pitch-black, stars in full glimmer, the full moon still pinned in the sky. To the east, the full light of day beamed toward you; to the west, night reigned with no hint of surrender. No philosopher can explain the sublime better than this, standing between day and night. It was as if this were the moment God said, "Let there be light!" You could not help but feel your specklike existence against the immensity of the mountain, the earth, the universe, and yet still feel your own two feet on the talus, reaffirming your presence amid the grandeur. — Paul Kalanithi

When I was a med student, the first patient I met with this sort of problem was a sixty-two-year-old man with a brain tumor. We strolled into his room on morning rounds, and the resident asked him, "Mr. Michaels, how are you feeling today?" "Four six one eight nineteen!" he replied, somewhat affably. The tumor had interrupted his speech circuitry, so he could speak only in streams of numbers, but he still had prosody, he could still emote: smile, scowl, sigh. He recited another series of numbers, this time with urgency. There was something he wanted to tell us, but the digits could communicate nothing other than his fear and fury. The team prepared to leave the room; for some reason, I lingered. "Fourteen one two eight," he pleaded with me, holding my hand. "Fourteen one two eight." "I'm sorry." "Fourteen one two eight," he said mournfully, staring into my eyes. And then I left to catch up to the team. He died a few months later, buried with whatever message he had for the world. — Paul Kalanithi

What makes human life meaningful? I still felt literature provided the best account of the life of the mind, while neuroscience laid down the most elegant rules of the brain. — Paul Kalanithi

(Alexander Pope: "A little learning is a dangerous thing; / Drink deep, or taste not the Pierian spring.") — Paul Kalanithi

My brain was fine, but I did not feel like myself. My body was frail and weak - the person who could run half marathons was a distant memory - and that, too, shapes your identity. Racking back pain can mold an identity; fatigue and nausea can, as well. — Paul Kalanithi

It's easier when the patient is ninety-four, in the last stages of dementia, with a severe brain bleed. But for someone like me - a thirty-six-year-old given a diagnosis of terminal cancer - there aren't really words. — Paul Kalanithi

Years ago, it had occurred to me that Darwin and Nietzsche agreed on one thing: the defining characteristic of the organism is striving. Describing — Paul Kalanithi

remember the moment when my overwhelming unease yielded, when that seemingly impassable sea of uncertainty parted. I woke up in pain, facing another day - no project beyond breakfast seemed tenable. I can't go on, I thought, and immediately, its antiphon responded, completing Samuel Beckett's seven words, words I had learned long ago as an undergraduate: I'll go on. I got out of bed and took a step forward, repeating the phrase over and over: "I can't go on. I'll go on." That — Paul Kalanithi

Yes, I thought, and therein was the paradox: like a runner crossing the finish line only to collapse, without that duty to care for the ill pushing me forward, I became an invalid — Paul Kalanithi

values of Christianity - sacrifice, redemption, forgiveness - because — Paul Kalanithi

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. I — Paul Kalanithi

The word hope first appeared in English about a thousand years ago, denoting some combination of confidence and desire. But — Paul Kalanithi

But in residency, something else was gradually unfolding. 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 patients in their pivotal moments, I was merely at those pivotal moments. I observed a lot of suffering; worse, I became inured to it. Drowning, even in blood, one adapts, learns to float, to swim, even to enjoy life, bonding with the nurses, doctors, and others who are clinging to the same raft, caught in the same tide. My — Paul Kalanithi

Doctors in highly charged fields met patients at inflected moments, the most authentic moments, where life and identity were under threat; their duty included learning what made that particular patient's life worth living, and planning to save those things if possible--or to allow the peace of death if not. Such power required deep responsibility, sharing in guilt and recrimination. — Paul Kalanithi

Even if you are perfect, the world isn't. The secret is to know that the deck is stacked, that you will lose, that your hands or judgment will slip, and yet still struggle to win... — Paul Kalanithi

Existential claims have no weight; all knowledge is scientific knowledge. Yet the paradox is that scientific methodology is the product of human hands and thus cannot reach some permanent truth. — Paul Kalanithi

[H]e found poetry more comforting than Scripture - and his ability to forge from his life a cogent, powerful tale of living with death. — Paul Kalanithi

I had come to see language as an almost supernatural force, existing between people, bringing our brains, shielded in centimeter-thick skulls, into communion. A word meant something only between people, and life's meaning, its virtue, had something to do with the depth of the relationships we form. — Paul Kalanithi

There is a tension in the Bible between justice and mercy, between the Old Testament and the New Testament. And the New Testament says you can never be good enough: goodness is the thing, and you can never live up to it. The main message of Jesus, I believed, is that mercy trumps justice every time. — Paul Kalanithi

We each joked to close friends that the secret to saving a relationship is for one person to become terminally ill. Conversely, we knew that one trick to managing a terminal illness is to be deeply in love - to be vulnerable, kind, generous, grateful. — Paul Kalanithi

Dying in one's fourth decade is unusual now, but dying is not. "The thing about lung cancer is that it's not exotic," Paul wrote in an email to his best friend, Robin. "The reader can get into these shoes, walk a bit, and say, 'So that's what it looks like from here. Sooner or later, I'll be back here in my own shoes.' That's what I'm aiming for, I think. Not the sensationalism of dying and not the exhortations to gather rosebuds but: Here's what lies up ahead on the road." Of course, he did more than just describe the terrain. He traversed it bravely. — Paul Kalanithi

I was making the decision to do this work because this work, to me, was a sacred thing.) Lucy — Paul Kalanithi

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. That — Paul Kalanithi

Indeed, this is how 99 percent of people select their jobs: pay, work environment, hours. But that's the point. Putting lifestyle first is how you find a job - not a calling.) As — Paul Kalanithi

He, uh - he apparently had a difficult complication, and his patient died. Last night he climbed onto the roof of a building and jumped off. I don't really know anything else." I searched for a question to bring understanding. None was forthcoming. I could only imagine the overwhelming guilt, like a tidal wave, that had lifted him up and off that building. — Paul Kalanithi

Do you think my life has meaning? Did I make the right choices? — Paul Kalanithi

I had traversed the line from doctor to patient, from actor to acted upon, from subject to direct object. — Paul Kalanithi

When there is no place for the scalpel, words are the surgeon's only tool. — Paul Kalanithi

You can't ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving. — Paul Kalanithi

The MRI shows a mass in your brain, which is causing your symptoms." Silence. "Do you want to see the MRI?" "Yes." I — Paul Kalanithi

Standing at the crossroads where I should have been able to see and follow the footprints of the countless patients I had treated over the years, I saw instead only a blank, a harsh, vacant, gleaming white desert, as if a sandstorm had erased all trace of familiarity. — Paul Kalanithi

Always the seer is a sayer," Emerson wrote. "Somehow his dream is told; somehow he publishes it with solemn joy. — Paul Kalanithi

He knew he would never be alone, never suffer unnecessarily. At home in bed a few weeks before he died, I asked him, "Can you breathe okay with my head on your chest like this?" His answer was "It's the only way I know how to breathe." That Paul and I formed part of the deep meaning of each other's lives is one of the greatest blessings that has ever come to me. — Paul Kalanithi

This was summer at Sierra Camp, perhaps no different from — Paul Kalanithi

The curse of cancer created a strange and strained existence, challenging me to be neither blind to, nor bound by, death's approach. Even when the cancer was in retreat, it cast long shadows. When — Paul Kalanithi

I don't believe in the wisdom of children, nor in the wisdom of the old. There is a moment, a cusp, when the sum of gathered experience is worn down by the details of the living. We are never so wise as when we live in the moment. — Paul Kalanithi