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'When Breath Becomes Air' and the uncertainty of death

staff note

In the last year, the Duke community has lost a few of its own. The news of a death reaches every student, even those who didn’t know the deceased personally. Their absence is felt by their loved ones and their presence lives on in people’s memories. 

As young college students in good health, with ambitions and a bright futures, we rarely think about death — unless we have to. When confronted with the inevitability of our mortality, few of us know what to feel, think or do. What is right in a situation where death is involved?

Paul Kalanithi, a neurosurgeon who died of lung cancer at 37, asked this question in his book, “When Breath Becomes Air”: “If the weight of mortality does not grow lighter, does it at least get more familiar?”

The weight of mortality was foreign to me until my mom told me my grandfather had cancer. At the time, I wasn't fully aware of how seriously ill he was. I had a naive sense of optimism that he would be okay and somehow get through it. When I visited him in the hospital, he seemed to be doing well. He was planning ways the doctors could cut out more of the cancer in his stomach. I believed in his steadfast hope until I came home from school one day to the news of his death.

My first reaction was utter disbelief. My mom must be playing a practical joke, trying to test me somehow. Now I realize how ridiculous my denial was. I was blindsided by the strangeness and newness of death.

Today death feels a little bit less unfamiliar. After having to confront its reality multiple times in the last year, I am almost curious about it. I have an urge to get to know it more intimately in the perhaps futile hope that the more I find out about mortality, the less terrifying it will be. Yesterday, I finished reading Kalanithi’s memoir,  which chronicles his last months working as a neurosurgeon.

Kalanithi was in his last year of residency when he found out he was dying. He had his entire career ahead of him. His diagnosis changed his trajectory. He decided that he wanted to write a book that chronicled his relationship with cancer, death, his patients and his wife — and eventually with his newborn daughter Cady. 

Kalanithi had no clear idea of exactly how much time he had. The phrase “live one day at a time” didn't clarify what he was supposed to do in the days he had left. Living with cancer, Kalanithi realized that he had gone through the five stages of grief in reverse: from acceptance to depression to bargaining to anger and finally to denial — total denial that he had cancer. 

“Maybe, in the absence of any certainty, we should just assume that we’re going to live a long time,” he writes. “Maybe that’s the only way forward.”

My friend asked me if I would rather know when I would die or not know at all. I think I would prefer to live not knowing. Maybe because that way I can hold death at arm’s length. That way I can live under the safe assumption that I will live to see my grandchildren go to school. I can dream of sitting on my front porch in a rocking chair and watch the events of a lazy Sunday afternoon unfold. 

The uncertainty of not knowing justifies my tendency to procrastinate and my aversion to planning for the future. The truth is I don’t know death very well. A part of me doesn’t ever want to be in the company of death. But more and more, I’m beginning to realize that I don’t really have a say in the matter. Whether I’m ready for it or not, one day death will get to know me.

Keyin Lu is a Trinity sophomore and Recess staff writer.


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