A scattering of thoughts…that’s just how it is sometimes.
Like with tattoos, you can quickly learn a lot about someone from their favorite book. Some choose theirs for pure aesthetic, others for pure meaning. In rare cases, they’ve found one that somehow satisfies their unique definition of both beauty and meaning.
I think your answer changes depending on the context — where you’re caught in the web of life in that moment. What’s coloring your experience? Nostalgia or longing? Wonder or whimsiness?
I find that regardless of circumstance When Breath Becomes Air is an answer I turn to time and time again. Without my knowing, it—or should I say Paul—found me at the precise moment when I was ready to receive the wisdom from his life.
In many ways, I saw Paul’s story as my own — one that transcends the finer details that keep us distinct. One that beautifully captures what it means to be fully human.
Paul, a neurosurgeon on the brink of completing residency, finds out he has metastatic stage IV lung cancer. On the precipice of life beginning, only to find himself at the finish line.
At the time I was reading, I was in a similar position. I’d just graduated from college and moved to New York City to start my “prestigious” job. Finally announcing to life “I’ve arrived!” at 22.
I felt like I had my entire life ahead of me, my potential as endless as the Manhattan streets themselves. But as I neared the back cover of the book, the intuitive sense a character won’t make it kicking in, I had to reflect on what it’d be like for life to end.
To hold life and death in each hand.
//
Books are a way to communicate something to someone without you saying anything. They may not be open to what you have to say because of some mental gymnastics in your relationship, or perhaps you struggle to express yourself truthfully through words.
I’ve gifted When Breath Becomes Air to numerous people at this point. Most recently, I gave my dog-eared and margin-scribbled copy to Mom as she headed out the door for her trip to South Africa. Since she’s a physician, I thought she’d appreciate it even more.
Truthfully, I wasn’t certain if she’d read it or not — it was 50-50 in my eyes. But the morning after she came back, she told me she was deeply touched by the book. Painting an image of her nearing the end and breaking down in tears just as the plane touched down in Johannesburg.
It meant a lot to me that she read it — that we’d deepened our connection without saying a word. It was a nice moment, one I left in the past as I got on with my day.
I had a newsletter to write.
It’s only in hindsight we realize the significance of moments, seeing how they were perfectly placed by the hand of mystery.
Shortly after, Dad would peek in and ask:
“Are you busy?…We need to have a family meeting.”
My heart sank. My mind immediately thought:
“Oh my god did Nai Nai pass overnight? I was just talking to her yesterday.”
Sitting on the couch, life felt slowed down as I awaited the news. Limbo. That’s what it felt like. You know your life is about to get shaken up, it’s only a matter of how.
It’s conflicting to say I’m thankful my initial thought was disproved. Because instead was news I, nor anyone, ever thinks they’ll hear during their lifetime.
“Mom has cancer.”
//
Is there any word in the English language as terrifying as “cancer?” I don’t think there is. We fear it more than “death.” Because while death is certain, cancer can go either way. You can fight the good fight and live on as a symbol of strength and perseverance. Or succumb to illness and become a memory to those you love. Another faceless statistic and sad story to everyone else.
Fate determined by no more than the flip of a coin.
Your family holds their breath, thanking Whatever Noun for the coin continuing to flip their way. But will it continue to? No one knows. Until their loved one (hopefully) rings the bell in the cancer ward, their lives are also colored by the unexpected guest who entered their lives. Perhaps not the same color, but a shade derived from it. Darker or lighter? It’s hard to say. It really depends on the day.
In my darker moments, it hits me like a truck how unprepared I am to live in a world without Mom — my mind literally can’t compute the possibility. What do you mean she may not live to meet my partner? Spoil my kids? Watch me do the work I’m called to in this lifetime?
Her not being around was never part of the plan.
While her diagnosis isn’t terminal, I’m forced to confront how real death is in this moment. And yeah, it brings every emotion to the surface. Dunking me under waves of sadness and confusion, the weight of it all an iron on my chest.
In my lighter moments, I’m intensely aware of my immense love and gratitude for her. Despite the ebbs and flows of our relationship over the years, it’s at a place now I couldn’t have imagined. How did life unfold a path of healing at my age? Why me instead of K? Why not the countless other kids estranged from their parents?
It makes no sense.
Neither does cancer. It’s a weird glitch in the human code — one we hope is anything but intentional. Why write a script that leads to genetic mutations that eat us alive from the inside?
You can try to explain it away, but after a certain point, science breaks down. Notions of “blessing” and “tragedy” break down. “Good” and “bad” break down. “Darker” and “lighter.”
There’s nothing to explain, life just is. Happening. You’re just here to experience it for the time being.
All that matters is what’s real for you right now. The pain in your heart. A steady stream of tears down your face. Moments you want to hold onto, but know won’t last.
//
The sacred texts caution you against holding on—attachment breeds suffering—but I’m not ready to lose Mom. I’m not ready to be asked about my parents and say “My mom passed away of cancer.” The words feel foreign coming out of my mouth.
I hope they remain that way. I’m only human.
The truth is, she may pass, and she may not. To deny the possibility would be to deny the laws of nature, the universe, Whatever Noun.
Life and death are held in each hand.
To resist what is is an inclination of the mind. Nothing more, nothing less.
It’s this resistance that leads to suffering. Denying the fact that your parent has cancer and could die earlier than you thought just leads to repressing your feelings. In the process, mixing some cocktail of unexpressed emotions that will eat you alive from the inside as much as cancer does.
These days, I surrender to the waves as they arrive. I encourage the tears to flow as I slam the keys in between stilted breaths. I meet the pain in my chest as I look at childhood photos when everything felt just right. I smile to myself as my parents and I search for my “lost” phone. I try to capture the seemingly mundaneness of it all. Because in that moment, cancer doesn’t exist. Only laughter. Only love.
A moment I want to hold onto, but know won’t last.
In the past, I would’ve resisted the feelings. And at times, I still save them for later. I cry a bit in the bathroom before coming to dinner. I bite my lip to keep from breaking down while driving back from the hospital. I know at some point, they’ll come through, and I’ll welcome them when they do. Because if I don’t feel them now, they’ll rip me apart later.
I’m realizing this is something of a growth edge for me — to allow myself to break down in front of others. I guess the question is “Can I lose control and still be held in love?”
When my head is buried in the warmth of Mom’s chest while she rubs my back, I have my answer.
//
In darkness, it’s hard to see the light that’s always there — to believe everything is unfolding perfectly. Can cancer really be an act of God? Part of some grand tapestry woven in a way I’m too human to see? How do you tell that to a 25-year-old whose mom has cancer? Yes, I hope as much as you do it’ll pass. But it also may not. This whole fiasco may lead to some transformation or whatever, but at what cost? A life without Mom?
There is the relative reality of her humanness. And I love her humanness. I love my humanness. I love being human. My heart aches at how much I love all of this.
She may pass, but in absolute reality, will “she” ever really be gone?
If the essence of being human is our capacity to love, then I don’t think we ever lose anyone. Our hearts will break a million times, aching for what was, but when we look at an old photo or think of a precious memory, our smile reminds us of what lives on.
These days, smiles come with tears.
I’m starting to understand the other end of the saying “love hurts.” When I was younger, love hurt because of how little love I felt. Now, it’s because of how much love there is.
I haven’t hurt this much in a long time. A long long time. The thought of Nai Nai passing sure, but that hasn’t felt as viscerally real as this. Yet they’re both real. Always are — regardless of age or if you have cancer.
In every moment, in each breath, is life and death. A beginning and ending. Nothing more, nothing less.
And right now, I realize I’m helpless. Utterly fucking helpless.
We are, in all our majesty, the most fragile beings on this planet. The gift of a conscious mind allows us to muse on our own death in a way other beings are unable to. And so we grasp for control when life is just water slipping through our fingertips.
Perhaps this is a call to you, to me, to live well. Beautifully. Without fear. But instead to welcome and surrender to whatever washes up on your shores.
Cancer. Love. Everything.
//
It’s an awkward conversation to have these days when people ask “How are you?” Do I just blurt out “My mom has cancer”?
I feel awkward saying it — it’s like telling a crush you like them. You want to say it, but the words don’t want to come out. They feel scary to say. Perhaps if you keep them in, your fears aren’t real for the time being. You can just be friends catching up or hanging out. Not friends trying to figure out what to say next.
All this makes me understand why people don’t want sympathy. They don’t need an “I’m sorry” or “She’ll get through it.” It’s a kind gesture, but doesn’t consider whose right in front of you.
Instead, ask how I am.
“What’s rubbing you raw in this moment? What terrors keep you up at night?”
Because as much as my mind forgets Mom has cancer at times, I’m never totally “fine.”
The cloud is there even if it’s not raining.
You don’t need to do or say anything. Just be and listen. Let’s watch the cloud. Hold the umbrella if it rains.
That’s more than enough.
//
I’ve come to realize that life is a divine comedy. Or mystery. Same thing. Carefully (or not at all) placing moments to remind us that our minds can’t explain or rationalize the immensity of what’s unfolding.
How could I have known the significance of the moment I handed Mom When Breath Becomes Air that morning? I couldn’t have. But something else did.
Mom tells me how much the book means to her, especially after the news of her diagnosis. It’s given her clarity, inspiration, and strength for the journey ahead.
As unbelievable as it may be to say, these moments make it clear to me that even in the most difficult of times, there’s a gift in every moment.
It won’t last, but why not enjoy it for the time being?
Oh, Dennis. My heart breaks for you and your family. I love the beautiful take you have on your unfortunate situation. The ability to see that experiencing life in its wholeness is a gift and not a curse is a really great thing to be aware of. I'm not going to tell you that I'm sending love or that I feel your pain, because that's really not going to do anything. Just know that there are so so many people who've been exactly where you are and have grown through it 💓 Stay close to people who will be there for you. Much love.