Before I Go

[WillyT]

Before I Go
By Paul Kalanithi
Photography by Gregg Segal
Stanford Medicine
3/4/15

The funny thing about time in the OR, whether you frenetically race or steadily proceed, is that you have no sense of it passing. If boredom is, as Heidegger argued, the awareness of time passing, this is the opposite: The intense focus makes the arms of the clock seem arbitrarily placed. Two hours can feel like a minute. Once the final stitch is placed and the wound is dressed, normal time suddenly restarts. You can almost hear an audible whoosh. Then you start wondering: How long till the patient wakes up? How long till the next case gets started? How many patients do I need to see before then? What time will I get home tonight?

It’s not until the last case finishes that you feel the length of the day, the drag in your step. Those last few administrative tasks before leaving the hospital, however far post-meridian you stood, felt like anvils. Could they wait till tomorrow? No. A sigh, and Earth continued to rotate back toward the sun.



But the years did, as promised, fly by. Six years passed in a flash, but then, heading into chief residency, I developed a classic constellation of symptoms — weight loss, fevers, night sweats, unremitting back pain, cough — indicating a diagnosis quickly confirmed: metastatic lung cancer. The gears of time ground down. While able to limp through the end of residency on treatment, I relapsed, underwent chemo and endured a prolonged hospitalization.

I emerged from the hospital weakened, with thin limbs and thinned hair. Now unable to work, I was left at home to convalesce. Getting up from a chair or lifting a glass of water took concentration and effort. If time dilates when one moves at high speeds, does it contract when one moves barely at all? It must: The day shortened considerably. A full day’s activity might be a medical appointment, or a visit from a friend. The rest of the time was rest.

With little to distinguish one day from the next, time began to feel static. In English, we use the word time in different ways, “the time is 2:45” versus “I’m going through a tough time.” Time began to feel less like the ticking clock, and more like the state of being. Languor settled in. Focused in the OR, the position of the clock’s hands might seem arbitrary, but never meaningless. Now the time of day meant nothing, the day of the week scarcely more so...

And...

Yet there is dynamism in our house. Our daughter was born days after I was released from the hospital. Week to week, she blossoms: a first grasp, a first smile, a first laugh. Her pediatrician regularly records her growth on charts, tick marks of her progress over time. A brightening newness surrounds her. As she sits in my lap smiling, enthralled by my tuneless singing, an incandescence lights the room.

And...

Yet one thing cannot be robbed of her futurity: my daughter, Cady. I hope I’ll live long enough that she has some memory of me. Words have a longevity I do not. I had thought I could leave her a series of letters — but what would they really say? I don’t know what this girl will be like when she is 15; I don’t even know if she’ll take to the nickname we’ve given her. There is perhaps only one thing to say to this infant, who is all future, overlapping briefly with me, whose life, barring the improbable, is all but past.

That message is simple: When you come to one of the many moments in life when you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man’s days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more, but rests, satisfied. In this time, right now, that is an enormous thing.

More: http://stanmed.stanford.edu/2015spring/before-i-go.html

[merrily]

1. Thank you for this.

Once, I sat on a free shuttle from one of Boston's neighborhood health centers to Mass General Hospital. An elderly woman sat next to me and nervously struck up a conversation. (We were both going for medical care.) She told me she was dying soon. (She didn't mean from age, but I have forgotten the illness.) And she had never been married or had any children. And, as she looked back over her life, she felt as though it had all been for nothing because she had accomplished nothing, would leave no mark, etc.

By this time she was weeping and I had all I could do not to break down and cry, too, that is how searing her sense of worthlessness was. Thinking as quickly as I could, I said (in perhaps typical merrily fashion), you don't know what good you have done in the world. You may have done something fantastic for someone without ever knowing how much it meant. You may have smiled at stranger who was about to commit suicide and saved a life, you just have no way of knowing."

At this point, she stopped weeping, straightened up, brightened up and smiled. She said, "You know, that's very true. I always have made it a point to smile at people, even strangers. You could be right." And then, we conversed in small talk until the shuttle reached the doors of the hospital

[WillyT]

2. :( ::::::::::::::::

I've suggested the same type of things...

A simple kindness... a helping hand.. a kind word..

[merrily]

3. Where the hell do you get off, telling people how to behave?

Just kidding.



Good for you. Again, we don't know what impact we have on others. Smiling at strangers was enough to make that poor woman think her entire life had not been for nothing--and she was right!

[Enthusiast]

4. +1! You deserve

a hug, for that day, what you did, the kindness you shared. I knew you were nice. [URL=.html][IMG][/IMG][/URL]

[Enthusiast]

5. So sad.

[michaz]

6. Saw this last night. It is so touching and sure puts things in perspective. nt