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A Journey of Pain and Suffering in The Book When Breath Becomes Air

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We often lose ourselves in books as reading is the sole means by which we slip, inadvertently, often impotently, into another’s life. One of these books is When Breath Becomes Air written by the hands of Paul Kalanithi and published in 2016. It is a memoir about the author’s life and illness, battling lung cancer. One day he was a doctor treating the dying, and in the blink of an eye, a patient struggling to live. This book includes various philosophical, medical and social issues the author encountered, lived through and hoped to share with the readers. Among the issues mentioned in the book are two medical issues that will be discussed in this report, which include lung cancer and its diagnosis, and Parkinson’s tremor and its causes.

To begin with, the first medical issue is about stage IV lung cancer. Paul Kalanithi, the book’s author, was a 36-year-old neurosurgeon by profession and passion standing at the threshold of seeing his dream come true and on the verge of making big contributions to the world. Unfortunately, he witnessed a cruel twist of destiny; he was rising through the ranks as a neurosurgeon when weight loss and ferocious back pain sent him hobbling to the doctor. The X-rays appeared fine, so he ignored the symptoms. A few weeks later, bouts of severe chest pain and a persistent cough developed, with a more rapid weight loss, causing him to visit the doctor again. This time, Kalanithi knew what was coming even before the CT scan results were revealed. The diagnosis was obvious: the lungs were matted with inestimable tumors, the spine deformed, a full lobe of the liver obliterated. The cancer was widely disseminated. From leading a normal life with the eventuality of death at the back of his head to a life where that eventuality is in the foreground of everything he does, Kalanithi decided to confront death with words as cancer invaded his life as a neurosurgeon.

Cancer is known as a disease in which body cells grow out of control. Lung cancer begins in the lung and may spread to lymph nodes or other organs in the body. It is usually grouped into two main types: small cell and non-small cell. These types grow differently and are treated differently. As there are very few nerve endings in the lungs, a tumor could grow without causing pain or discomfort. When symptoms are present, they are different in each person, but may include a cough that doesn’t go away, hoarseness and constant chest pain. Some symptoms do not appear until the cancer has spread to other parts of the body, which include: weight loss, loss of appetite and headache. In the book, Kalanithi suffered from symptoms that developed gradually over time, from being mild to becoming major, and was advised by the oncologist to start chemotherapy.

In addition to the lung cancer, another medical issue mentioned in the book is the Parkinson’s tremor. Kalanithi once had to treat a Parkinson’s tremor in a patient by placing an electrode nine centimeters deep in his brain. The target was a tiny almond-shaped structure, the subthalamic nucleus. Its different parts subserve different functions : movement, cognition, emotion. He concluded that the tremor looked better after turning on the current to asses the tremor and looking at the patient’s left hand. The patient, however, voiced that he felt overwhelmingly sad and that his feeling had started to go away. Kalanithi had to pull the electrode out and reinsert it again, this time two millimeters to the right and, fortunately, the tremor went away.

Tremors are unintentional trembling or shaky movements in one or more parts of the body. Tremors are common in middle-aged and older people, but anyone can have them. The cause of tremors is a problem in the parts of the brain that controls muscles in the body, such as the hands. In many cases, medicines and sometimes surgical procedures can reduce or stop tremors. With classic Parkinson tremor, there appears to be a dysfunction of the basal ganglia network and the cerebello-thalamo-cortical network. There is evidence that the basal ganglia network triggers the onset of tremor and the cerebellar network is responsible for the amplitude.

In conclusion, the book When Breath Becomes Air is a reminder of the transience of life, yet an even louder reminder of longevity of deeds and memories. This book provides readers with an opportunity to delve into a journey of pain and suffering, as well as experiencing life from the perspective of a dying person. Both of the medical issues described in the book involved dealing with severe and terminal illnesses and how they affected the patients. Kalanithi, diagnosed with stage IV lung cancer, describes, clearly and simply, and entirely without self-pity, his journey from a medical student to an all-powerful neurosurgeon to a helpless patient. He became a person who could literally, as a doctor, put himself in his patient’s shoes, battling with a terminal illness. As for the patient with the Parkinson’s tremor, he experienced the feeling of sadness, followed by numbness and lack of emotions. Luckily, Kalanithi and his colleagues were able to fix the problem.

All in all, though the book is inherently sad, it’s an emotional investment well worth making: a moving and thoughtful memoir that is, despite its grim undertone, accidentally inspiring. Kalanithi touches on everything and draws you in to the whirlwind that was his life growing up and now as it accelerates approaching death.

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