Dying doctor driven by professional ambition
glass to his lips. He will witness from a wheelchair the birth in July 2014 of his only child — a daughter, Cady, conceived in a lab. Among the first things Paul and Lucy do after his diagnosis is visit a sperm bank. The medication he’ll be taking will likely kill off any possibility of becoming a father the natural way.
Cancer has put paid to Lucy’s trial separation. “In truth, cancer helped save our marriage,” her husband writes. Kalanithi had always refused to go to couples therapy — now his doctor-wife finally gets her way under a grotesque new set of circumstances. Their counsellor specialises in cancer.
All the while Kalanithi is grappling for meaning. He had planned a 40-year career: 20 years a neurosurgeon, the next 20 an author. Writing a memoir seems to fit with his prognosis. "If the unexamined life was not worth living,” Kalanithi wants to know, “was the unlived life worth examining?”
He’s put on a drug called Tarceva, developing the severe acne that correlates with a good response. Pockmarked and bleeding, “I was happier being uglier and alive.” His doctor’s life becomes that of a patient: now he has an account with a mail order pharmacy, a bed rail, an ergonomic mattress and a new financial plan for Lucy. He weighs up the pros and cons of different treatment plans and their toxic sideeffects: “If I lose my hands, I can find another job,” he says with a doctor’s pragmatism. “We can beat this thing,” his cardiologist father tells him — how many times has Kalanithi heard that one before?
Sick as he is, he makes a startling decision, “to push myself”. Why? “Because I could. Because that’s who I was.” Soon — tanked up on painkillers — he is operating deep into the night again, fixated on becoming a fully qualified neurosurgeon. He writes: A couple of my professors actively discouraged the idea: ‘‘Shouldn’t you be spending time with your family?’’ ‘‘Shouldn’t you?’’ I wondered. I was making the decision to do this work because this work, to me, was a sacred thing. One wonders what Lucy thinks. Work is doubly exhausting. At times he sleeps for 40 hours, “but I was calling the shots”. It’s a comeback. “I had gone from being unable to believe I could be a surgeon to being one, a