Dy­ing doc­tor driven by pro­fes­sional am­bi­tion

The Weekend Australian - Review - - Books -

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

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