Two Guys, One Book
When Breath Becomes Air by Paul Kalanithi
Welcome to Two guys, One book where two friends tackle the reading list one book at a time. Okay, welcome back to two guys one book. I'm Tim join with Brian. Today's book is When Breath Becomes Air by Paul Kalanithi. How do you say his name? Sake Alan? Ithi Colony that yeah well anything and this was Brian's pick. So yes, Brian. Why did you choose this book? Oh, well, this book is about a neurosurgeon who gets cancer and then he unfortunately passes away and a little back story about me is that I had have had Hodgkin's lymphoma. And went through an ordeal of my own and so it was something that I was curious about reading and because I've heard good things about it and I see why. It's a it's a very good book well written and I enjoyed it quite a bit. So, some of the things he wrote about were very applicable to my experience going through Hodgkin's lymphoma, so I was very I consider myself fortunate because I did not have to deal with the level of cancer that he had to deal with. But unfortunately that is something that people have to deal with it from time to time. So that's why I picked it. I liked it a lot. Did you have any preconceived notions coming into this one going into it? Yeah, I mean I knew the subject matter was going to be kind of heavy but I was impressed. I thought it was really good. There's no yeah. Yeah, he's not it's I well I don't think anybody that's a neurosurgeon is it is a typical person like it takes a lot of hard work and determination to become neurosurgeon, but this Paul in particular he started. He said his academic career in English or literature and he was a big so like I feel like starting his academic career in English influenced him to become a good writer. And so I feel like he was kind of the perfect vessel for this experience to happen to so that he could articulate it in such a beautiful way. Yeah, I like hearing about his upbringing to and now his mom would get him to read all these books when he was a kid kind of like adult level books and with kind of heavy themes but it really helped make him well-rounded and get a sense of literature and philosophy and all these different areas. So yeah, I was impressed by his writing for being a neurosurgeon. I mean, I wouldn't say it's like one of the top tier writers, but for how skilled he is at in the medical field to also be this good of a writer. It's. That's pretty cool. Yeah. Oh absolutely and I'm like, yeah, he looked he rattles off the big list of books that he read as a kid as like that's like some of my favorite books and other ones that I've been meaning to read so it's like it was a perfect. I definitely highlighted that section and took notes like those were gonna be some of my books. I'm going. Yeah read eventually but um, but little brief overview, it's it's got a little prologue where he kind of discusses how this all began. And then he goes back. The first section is In perfect health, I begin. Were he talks about his upbringing in Arizona and and how he became a doctor and how he went through school and wanted to do English first because his dad was a doctor and his brother were both his brothers doctors or just one of them. I think they all were all doctors. Yeah. Yeah. And then so he talks about his background and then when he gets diagnosed in the story or in he goes into the second part of the book called cease not till death and then he writes up until he passes away and then there's an epilogue written by his wife which I thought was very touching as well kind of a good way to wrap things up. It wasn't very long. I felt like it was a quick read. I tore through it in no time it helped when I had a flight but um, yeah, his wife's epilogue was impressive. I thought like she came off as very caring and compassionate and just as good of a writer as he was he was I'm sure we'll have some quotes from that later on but just to go back to the cancer real quick. So he had lung cancer right which he never smoked or anything, which is crazy that. For the fair amount of people who never smoked and still develop it and he's only in his like 30s when he got it. Yeah, I think earlier admitted to mid 30s. I think it was. Yeah, but I actually know somebody else, a good acquaintance of my parents who got lung cancer and he was never a smoker either and I hear that that is to get lung cancer and have it not be in a nonsmoker. That's like. Not a very good cancer to have like that is very aggressive and hard to treat and get rid of cancer. So what was that Hodgkin's lymphoma? Like how did that work? I don't really know much about it. Well, it's the cancer of the lymph node system, which is the lymph node is are nothing you really think about in your bodily functions from day to day, but I think the part of the immune system, I even forget it was a while ago, but no like so I I felt a lump in my armpit which is where some lymph nodes are and then I'll when I went in for scan. I had them in my neck, my armpits, and down in my chest and back and abdomen so I kind of had them all over but they were all really small like that's one cool thing about my experience was that the doctors were very open and. To communicate everything with you and I even saw all my scans and what so like because if you're going through something like that, they are not it sometimes when you go to the doctor for a regular checkup, you kind of feel like sometimes they're just going from one person to the next and you know, but in my experience that the oncology doctors are particularly caring and open to address anything that you may have on your mind and willing to give you their best what they can offer. I know one thing about me was I wouldn't I at the end of my cancer treatments. I went into my oncologist with some existential angst and he he did his best to try to help address some of that but. You know that wasn't really his forte. So yeah dressing there's a lot of existential talk in this book as well who could go into but just to talk about the doctors real quick. What struck me in the book was how much uncertainty I guess there was when it came to medical decisions like when he's describing his own residency as a neurosurgeon and then talking about his diagnosis and how different specialists wanted him to be treated. It was like a lot of them ended up disagreeing about what was wrong in the best way to address it things like that. So a lot of it felt very subjective and kind of crazy to me how disorganized it kind of was but it's good that your experience you had a good kind of relationship with your doctor, right? And and and I think that goes to show just how aggressive and nasty his health condition was. Whereas mine was a pretty routine Hodgkin's lymphoma and they have a regimen of chemo drugs that they give that are pretty consistently good with treating that Hodgkin's lymphoma. So and also there's the difference between Hodgkins and Non-Hodgkin's or as Hodgkins is a just the most popular form of lymphoma. So they know how to treat it the Non-Hodgkin's you get in the different variations that are Maybe. More aggressive or not as well studied and I think in the author's case here that lung cancer spreading to all his other organs created problems that I think you're right that were not a one-size-fits-all solution, you know, but different things were happening so different Specialists that deal with immunity Knology or I don't know I can't even. You know, they he was rounding off how many doctors were in that room that one time towards the end and it was pretty substantial like four or five different doctors of different Specialties and they were all wanting slightly different things. And so yeah, I agree that it did seem in this case that it wasn't it was more subjective because there is no cut and dry solution for scenarios that were as bad as what Paul was in. That's what makes this whole these events. So. Frightening and frustrated I think is uncertainty. It's like he never really knew how much time he had left and found out it's a terminal illness, but does that mean he has a few months or a few years? You know, what should he do about his job. He's been training to be resident surgeon for years. He's in a relationship. He talked about some of his like marital issues and whether or not they should have a kid things like that. Oh, yeah that that that is entirely frustrating and I think. But there's nothing you can do about it and doctors are incredibly smart dedicated hard-working people. But yet even they can disagree on how to handle things or they can't give you a straight answer because they just don't know like that's what one part of the book was that he was talking about how he didn't know how much time he had left when it was really bad. And so what was he going to do like give me a month? I'll just. Do nothing. Enjoy life. Give me three years. I’ll write. Give me 10 years. I'll go back to surgery or something like that. I think it was one part was one quote. He said so that is an and and I found interesting in what and when he was going through his treatments and whatnot. He was wanting the doctor to like given the statistics of it or something and she wasn't she wasn't going to and. because. And I and he mentioned how doctors can't really say like when a doctor says, oh he has six months to live. They can't really say that with certainty, you know, so when somebody lives nine months or a year after the six months come and go a person's like, oh those doctors don't know what they're talking about. But when really, you know, they're just making educated guesses, right? He wanted to know a statistical range. Yeah I have. About this much time to this much time, but I don't think she wanted to give him that frame of reference. She just wanted to kind of take things one day at a time and make progress as much as they could. But yeah as far as like meaning and identity and and navigating that whole experience, I just can't imagine because yeah, like I said, he's did this whole surgical residents like he spent like a decade of his life preparing to be neurosurgeon. He has he's like grand plan. And it's just crazy to think about how that can come crashing down and just like, okay, like who am I now like, how do I Define myself who I'd be like me mentioned like existential angst going to a doctor with that. It's like they're training the medical side, but it's probably hard to help you with that as much right, right. Yeah. but yeah as he talks about lot about like philosophy and in the book and his views and. It's that's what makes him such an interesting subject in this case is that he has that background literature philosophy. He went through this experience and well, he was fascinated with death, right which I have meaning and death right because he he felt at first that like literature was you know, the way to people who have written throughout history about life and the experiences that we all. Go through in life can can find Reflections on how to get meaning out of life through literature. And then so that's how he initially went to literature and then you realize well from the biology from the biological point of view. The the brain is where we create the meeting where we process everything. So if he learns everything about the brain, maybe he'll know more about you know, Get more glimpses in the meaning of life through science and medicine through that way. So I found it interesting how his his philosophical approach to life led him down literature first and then down the medicine field later and I know I can appreciate that as going through Hodgkin's lymphoma has shaped my views of life and death and meaning and all that stuff as well. If I had one critique of the book. And I mean no disrespect sure sure, as you know, yeah everything him and his family went through. Yeah, there are times when maybe it fell a little repetitive some of the language used about his vocation. I guess it's calling because he would say like neurosurgeries the worst industry to go into but I was called by a higher. You know what I mean? Right? I think what he said was I think neurosurgery is not good job. It's a calling. Like if they people don't go into that form of stressful medicine because of the money or the hours or this whatever they go into that because they feel called to do that work and and he mentions that yeah, but also people interested in the brain and curious how it works. Then it just seems like it's a very Noble profession and I have a lot of respect for anyone who does this sort of thing, but. At the same time. I think it's hard to distinguish the line between sounding a little self-important and you know, I have to find something to critique. Yes, of course, you do once again, no disrespect right-handed. But like I see so that you feel like him was kind of stroking his own ego saying. Here I am. I am called to do this great work. It's lousy on my body. It stresses me out both body and mind but it's a calling that I am compelled to do and I wouldn't have it any other way. Part of me felt that yeah at the same time. He's must be very intelligent and it worked like those hours and this kind of subject material like I have all the respect in the world for that. So. Just so was that the main critique you had you have any others. Um, I don't know. I think like I said as a writer, I wouldn't say he's one of the best writers I've read but the fact that it's his not main profession or the thing that he was doing I feel like is that some excuse? I thought he was a great writer. I think he's a good writer. Yeah. I mean, he's not like Hunter S Thompson or Virginia Woolf that we’ve read so far. See I would say I would almost. I enjoyed reading him more than Virginia Woolf. All right. I enjoyed this book more than that. I'm just saying. As a so that's it. That's a that's a good question that we stumbled upon. Is it the book itself or is it the writing and how do you differentiate between the two like, you know, yeah, I mean. This could be a philosophical Rabbit Hole to go into but I think the general heuristic I was going by that like old books are always better. I'm sort of starting to rethink that with it because like this is newer. I like it better than a lot of the older books I've read is it just because the book is old doesn't mean it's good just because the book is new doesn't mean it's bad. Right, you know, less. Well good. I'm glad I'm glad you've come to that realization trying to be flexible in my mental habits. But now it's a it's a beautiful book and and yeah, like we've talked about the epilogue with his wife really helped round it out. I think and add more depth and context of the whole thing. Yeah. I wish it was a little longer but you know, I mean he only was writing it for the last. However months or a year, so he wasn't he when he was first diagnosed. He was more motivated to get back into the operating room and getting back to seeing patients and all that stuff. Yeah, so I get I applaud him for doing that. I think a lot of people would have totally understood if he would have just done something else like just be a professor or something like that or I don't know what else he could have done. You know, I have mixed feelings about his decision to go back as a surgeon while he's diagnosed and undergoing treatments because on one hand. It's like. Is it selfish because you could should be spend time with your family doing this and that but other the other on the other hand, it's like this is your identity. This is what you feel important doing. You should do this because it makes because makes you feel good and on the other hand, so many hands. The other other hand. Is it is he doing a disservice to patients who aren't getting a doctor at their best, but he had like residents to back them up during surgeries. But yeah, I didn't I mean. I guess I never realized the how many tiers of people that are in different stages of their medical career because you have like residents and yet Med students and then residence and doctors and attending and like I didn't quite fall. I don't I'm not a craft. Yeah it is I mean. Yeah, but what struck me in general was how intense the OR is like brain surgery. It's like they're sawing people skulls open just kind of like removing tumors and doing all these things and some of the stories he mentioned like there was a kid. They removed a tumor in the front of his brain. And then it sort of like affected as hypothalamus or something. So that's controls. It's like your impulse control part of your brain and then he was fine in the short term but then years later came back and had all these like behavioral issues. So I just it's just seems like so much pressure as a job. You never know what the right decision is for sure. It's not cut and dry like you said and what the consequences would be down the line from the patient their family. And the stress of a medical resident like they work insane hours one of his friends had committed suicide. Yeah, and as I think based on patient or like the sleep deprivation, they go through it just seems kind of insane. It doesn't really make sense. In my opinion. I mean, I guess you want to it's like training for the Army where you go through hell to get hardened so that you can handle anything that comes your way but. Like going through 48 Hours of sleeplessness I just think is unrealistic. Like just have more people on staff. Yeah to handle that. You know, how do you function as a person? I like no idea you help people you can how do you think clearly know that makes sense to me, but I was listening to I think it's like a TED Talk podcast while ago and they were talking about how the person originally during the formation of this program was like on cocaine. He was like doing these hours like one of the first physician residents whatever and. I forget the whole story but basically the person who can work 15 hours shifts was on cocaine. He set the bar and uh, yeah, so just hop Doctors up on cocaine. Not arguing for that. I think their hours should be way Rush order, right but it's just interesting because we yeah, I mean because yeah, he talks about I mean, I know we're not doing quotes but like. Alright, didn't she see that? I always thought that I only had one year left and residency that I loved her and that we were so close to the life together. We've always wanted that's the thing about going through med school and all this other crap is they have to suspend, you know, their their adulthood almost because there is scraping to get by they're working terrible hours and going through all this stress. And for what like. At the other end they'll be doctors and they'll make a lot of money and that's wonderful. But like. in Paul's example, he didn't get that. Nothing in life is guaranteed, you know to put yourself through the hell that doctors have to go through med school and residency and all that stuff. Is it worth it in the end? A lot of them. Most of them probably say, yes, but. I don't think it was for Paul. I mean maybe it was for Paul because he got to at least help people. In the end he got to perform the surgeries in the OR of on brains and spinal issues and whatnot. So maybe it was worth it for him. But like. well, his plan was kind of to do surgery for like 20 years brain surgery and then be it brain research scientist for like 20 years through this very very long-term plan. And he had the idea like you said is all about making short-term sacrifices for that long-term pay off. But it's tough. When something like this comes up out of nowhere. It makes you think like plans were things we’re thinking about doing in the future and just like, well should we focus more on day-to-day stuff because he talks about a friend who had a car crash was in a car crash and just all of a sudden is gone. It's like he's like comparing his cancer to that sort of sudden accident and just saying like, you know, is it different? Like how do we how should we live our lives based on these circumstances and so right? Yeah, I know for me when I was going when I was diagnosed with Hodgkin's lymphoma I had no plan. Because I was already I already had a job. I was surveying full time. You know, like I was the one school. I was my first adult job couple years into that job, and then I get this diagnosis and at that time I didn't really was I I was just two years into my new job. I didn't really was thinking about like. Getting my professional surveyors license or what would I do ten years from now I had no idea, you know, it wasn't even thinking about that and then the diagnosis comes along that I just have to get through the treatments to get better and then it was like a big void of like now what? That was for me. So like I had no plan like this this guy did of letting out his whole career ahead of him, but. What my personal experience did was it made me reassess everything. Yeah, everything that I was doing and shakes your life up. And then yeah, how do you transition right then out of the what other aspects of his experience do you relate to or like oh that you went through that he went through as well like you did chemotherapy. Hmm. I just did chemo. I didn't do any radiation or anything else. But but one thing he writes. In his book, I mean, he literally I think stole it from yeah, this guy literally stole my line in his part. He says as a doctor, I knew not to declare cancer is a battle I'm going to win or ask why me? (Answer: Why not me?) That's kind of what I thought too is like. You know, there's nothing this is what led me down the my path of stoicism. Is because I didn't think about why me like I was journaling at the time when I was going through my treatments for lymphoma. And so that helped me get through it and I was journaling about like why literally I was journaling. Why not me, you know, somebody out there gets cancer every single day. I mean it sucks. But so why was why would I think that I'm above that? Why do I why do you think I'm special that I wouldn’t you know get a cancer diagnosis? I realized that once I did have the cancer diagnosis asking why me did no good because it was completely out of your control and that's what stoics focus on what you can control and what you cannot control and you can't you can't let yourself get emotionally worked up over things that you cannot control. I couldn't control my diagnosis. All I can control was I was going to go to every doctor's appointment. I didn't care. My work schedule. Thankfully I had a good employer that worked with me too. So I could go out on my doctor's appointments. I was going to do everything I could to get better. That's all I could control. I can't control the diagnosis. You know, I didn't deny it. You know, I didn't what are the five stages of grief. Like, I don't know denial anger bargaining acceptance or there's someone other than their depression. Depression for me was last. But anyway, so like yeah this guy, I think anybody who has been diagnosed with cancer, especially I think would glean a lot from this book if anybody even been close to somebody with cancer. I think would would get a lot from this book to especially during the wife's part of the end. But yeah though this there were several things that just rung so true. To me in this book that. Yeah, I mean that's why I liked it so much. Yeah, and I definitely recommend this to people anybody like you said, it's like the whole Why Not Me philosophy is why should we be the exception to these terrible things that happen and could happen to anybody. Most people are going through some kind of struggle, you know, right that we who knows exactly right? Um, but just that experience and what you went through what he went through. How did like your personality change or like your outlook on the world from that? Oh, well for me, I I was already thinking more about death at that time because my grandparents have passed away both of them within the year and while the two that were left of the four that I had and so I was thinking a lot about their death and then I get this diagnosis and I'm thinking about my own death and so it's just. It just made me more. I sought out. Well, first of all, I got through the the treatment chemo treatments and then I was depressed and so I had to get myself better to focus on that. So I had I went to counseling I tried to just get out of that apartment and do things to just I don't know distract myself or just. You know, so I wasn't moping around in my apartment all the time. And then so I had to get myself better first, but then as I was gradually getting better, I was more interested in philosophy and existentialism and stoicism and stuff like that. So I just made me. It increased my appetite for analyzing humanity and death and how do we derive meaning out of our life? So, I mean, I don't know like if that is something that I would have naturally been drawn to as I got older or you know, or would this diagnosis. Or I would I'm not even cared about that. I think I would have a little bit. I don't think I would have swung so sharply to the philosophy section in Barnes & Noble, but but like so I try to enjoy the little things in life. I don't get worked up over things. I can't control like I said earlier. So but then again, you know, I've always been a laid-back guy so I kind of feel like. I felt like I was a young healthy 27 year old when I was diagnosed so I could easily tackle it and and that's what when I went to the waiting room and saw all the old people because I was the youngest person there by far everyone else was because unfortunately, it's just, you know, as people get older they get, you know are more susceptible to I just seemed like most of the cancer patients there were 50 or older. So I was definitely the youngest one that I saw. I did see another young guy there when I was wrapping up my treatments. It was kind of unfortunate but um, but no, so I just. I felt like I could easily handle it that for some strange reason one thing I thought was if me going through Hodgkin's lymphoma prevented somebody else going through it then I can handle it. It was weird. But yeah, it's interesting cuz he I don't know how you know. Would I be different today? If I hadn't gone through that probably but how different I can't really say it's hard to say. Yeah, that's what I was wondering because you are laid-back guy, but I don't know if that was just from having more perspective now and like not letting little things bother you as much because you've gone through this. I think yes, I've always been laid back, but I would I would before I think I was very much more neurotic like I was more concerned about what other people thought. That I was I'm always been an introvert and but before I would obsess over what people thought or oh crap, I said some stupid or you know, things like that where now I kind of don't stress about that stuff as much because if someone thinks I'm stupid, so be it. I think Abraham Lincoln had a quote. It's better to remain quiet and be thought of as a fool than to open your mouth and remove all doubt. Yeah. Yeah. I mean it's kind of cool but it's good justification for being quiet. Yeah, right, right. Just just you know, you don't have to. prove yourself or Justify yourself to anybody if you don't want to. But what you said about not getting worked up about things kind of goes back to the whole stoic approach is not letting your emotions right harness your. Behavior and way of thinking right. I just one quick quote to tie into that. Yeah, because when he got his not when he got his diagnosis, but when he found out he had a really large tumor and towards the end that was really reinforcing the fact that this was terminal he says, He's looking at like the scan. He says: There it was a new tumor large Philly my right middle lobe it looked oddly like a full moon having almost cleared the Horizon going back to the old images. I could make out the faintest trace of it a ghostly Harbinger now brought fully into the world. I was neither angry nor scared. It simply was. It was a fact about the world like the distance from the Sun to the Earth. Yes that resonated with me too, good selection there Tim. Yeah, because he's absolutely right. There's that's completely out of his control. It's it is what it is that that phrase gets a little overused in my opinion nowadays. Many people say it is what it is kind of like sometimes I mean, it depends on the context because sometimes people say that like throwing their hands up saying what can you do it is what it is. Like there's no point in trying or whatever but sometimes it is what it is is appropriate because. You can't change something. Yeah, it sort of has been repeated ad nauseam, but when it's used in a defeatist way, it's sort of annoying. Like he said but when it's used to just acknowledge. Like that's the reality. I'm going to handle the best way that I can I like that approach. You want to go over one just go over more quotes shirt because I think this will I think I think this book is particularly has a lot of quotes that I think will stimulate other conversations. I mean one thing I just like the way he wrote. Because in Arizona he talking about his child in his upbringing and going to college. He didn't really have a well. Anyway, I'll just read the quote. I felt less like someone preparing to climb a career ladder than a buzzing electron about to achieve escape velocity flinging out into a strange and sparkling universe. So that's kind of how he felt leaving Arizona going to school. He didn't really have a plan at that point, but. You don't need one. That's just it you go to school you figure it out. That's my his life path to was interesting because he was in that it's like a small town in Arizona. But his like Mom really wanted him to have the best opportunity opportunity. So he would like go miles and miles and take SATs. He ended up at Stanford. He studied in Cambridge for like a year to where else would he go? Yeah, I think Yale and then back to Stanford grad school. So, you know, it's interesting cause his parents are Indian. Right. Now what I think is Dad his mom's Tibetan or no? I'm sorry. I'm thinking about somebody else. I think there are some sort of different. Anyway from Central southern Asia. They lived in New York with Purdue prestigious. Primary schools and whatnot. So that's that's where he was born in New York. And then they moved Arizona and the middle of nowhere and so his mom was concerned. He didn't have this nice high school. What is he going to do? So she kind of flung herself in the PTA and getting the school up to Snuff. And yeah, he would go miles to study for the SAT and all this. I was impressed by her as Gander. Yeah out how he talked about him. Yeah. Yeah how much he sacrificed or would do. I'll go ahead and read the first quote how the book opens because I think that sets the tone pretty well. So this is from Baron Brooke folk gravel. I don't know but that's who said it. All right Baron. Yeah, that's who said it. Anyway, how do you become a baron? He says, You that seek what life is in death. Now find it air that once was breath. New names unknown old names gone, till time and bodies but souls none. Reader then make time will you be but steps to your eternity. Yes. So it just combining his love of like poetry literature man and his experience right? I think that is a good way and that's where the title comes from. So, huh? Yeah when breath becomes air oh, I just thought this was funny. He was in med school. Cadaver dissection is a medical rite of passage and a trespass on the sacrosanct engendering a legion of feelings. From revulsion exhilaration nausea frustration and awe to as time passes the mere tedium of academic exercise everything teeters between pathos and bathos. Here you are violating society's most fundamental taboos and yet formaldehyde is a powerful appetite stimulant. So you also crave a burrito. Yeah, you can see his sense of humor kind of come. Yes. That's something his wife mentioned in the epilogue is that he's just a really funny person. Yeah, and and I think she's mentioned it in a way that was kind of lamenting that it didn't show up enough in the book, you know, like it showed up in places like that which I appreciated. But she made it sound like he was like, he was very much a jovial person and. Yeah, it's a tricky tone to send with this book like how much humor do I throw in how much philosophy how much this and that I think he did a good job balancing. Oh, yeah, and another thing I appreciated in the epilogue was that she mentioned how he talked about their marital problems like before the diagnosis. I think just because of the stress of med school and things like that then just that ability to be vulnerable and despite what like, you know his family or whatever. It might have been thinking impressive to me. I like this quote. He's talking about brain surgery and as a neurosurgeon, he says To the patient and family the brain surgery is usually the most dramatic event they have ever faced and as such has the impact of any major life event. At those critical junctures, the question is not simply whether to live or die, but what kind of life is worth living? And he goes on to talk about like do you want to sustain your loved one tubes and things right in this vegetative state? Yes, that's where I lost be kind of comes into right? I think I think I had I picked up on the tail end of that because I have a quote here. The possible long painful and only partial recovery or sometimes more likely no return at all the person they remember. In these moments, I acted not as I most often did as death’s enemy, but as its ambassador. Because they have when they're hooked up to machines and and not no sign of Ever Getting function back. You know, is that how that person would really want to live. It's so hard to say. It's like so many personal beliefs come into it and you have to think about what the family wants and what's best for the individual. Right. I don't even know where to start like. Yeah. So, okay. Well, I just had a few one liner quotes. The Angst of facing mortality has no remedy in probability. I like that one because no matter what you're going through like when my Hodgkin's lymphoma had like a 90% survival rate, right? So I knew that you know, I was chances are I was gonna be okay, but that did not help my angst of facing mortality, you know, so I felt like that was spot on regardless of what the statistics are, right? It's still what you're going through another one liner quote that I like is: If the weight of mortality does not grow lighter, does it at least get more familiar? My answer to that is yes because. Death is death. Right the you know, the weight of that. Is the same whether you're nine or 90, but for me at least having gone through Hodgkin's lymphoma. I do feel like it becomes does it get does it least get more familiar? I would say, yeah. But not like not in a bad way. Not like I'm good. I'm not unafraid of death. I'm still afraid to die, but I'm fascinated to think about it and talk about it. And I think that's one thing. that we as a society of not. I don't. You know, yeah, I know. I know you're well, I think I know what you're saying. Yeah, that's what so his wife in the epilogue also said like we had this death avoiding culture, which I think is really a good way to put it because America in particular like the United States I think is so much focused on like what's new fresh future thinking like present. I don't know what I'm trying to say. But basically we tend to suppress death and not think about it as much as I think a lot of other cultures do and we don't respect the elderly probably as much as many other cultures. Like I was watching this one show where this guy goes around the world like various tribes and things like that like a documentary thing and they kept like some courses like way after they died because they have this very prolonged like funeral ritual and they sort of. I don't want to say drag it out, but they like, you know, they really make. It's like paying respects an appreciation of that person's life, right? Yeah, right and whereas we tend to like sweep things under the rug and try to repress a lot of dark times. I think a lot of other cultures have better appreciation of death and how that plays into their perspective in life. I think is important. I think grief is something. Yeah that we don't address enough in America. I think you're right. I think you hit on good point that other societies have coping mechanisms to I don't know if it's lessening the grief or maybe it's helping to confront the grief. So it doesn't fester underneath the surface. Like I think you're absolutely right sweeping under the rug people when just get it over with don't think about it. Don't even talk about it. Don't bring it up. They don't even address it and that's can't be healthy That's not healthy and I mean. Taking a Side Track Manchester by the sea is a film that came out recently in the last couple of years and I feel like that did a wonderful that film’s about grief and I know you haven't seen it. Right but that it is a hundred percent about grief and it was just so well done that everyone handles it differently and that's okay, but to be healthy about it you need to address it and. I feel like this is what another thing that you can take away from this book is that I feel like the Kalanithi family definitely addressed, you know, the impending events that we're going to happen to their family and they decided to have a daughter. Well a child it happened to be a daughter. I think that was that was great and and he wrote Paul wrote that it provided him with so much joy as at the end of his life. And so I mean there's so many I think there's so many life lessons and take away from this book to. It seems like he handled everything with a lot of integrity like his wife said and the family in general. Hmm. But yeah, when if you recommend this book to other people a lot of them are like oh wait he gets cancer and dies. Like I don't want to read that that just sounds depressing right? That's like I said like not really a healthy reaction because you need to like these things happen and the more you internalize that and are aware of it. I think even though it's like tough to hear about the suffering it kind of broadens your perspective of what people go through you have more empathy. In the future you have more compassion. So I think you've found something very very good there that I think people who go through grief address their grief and confront it do have more empathy and compassion for others and again when you know, I think I think I think well, that's just all right, maybe not a hundred percent certainty. But I feel like that could be a benefit is if you address grief and that increases your empathy and compassion and I think that will just make you more in touch with your own feelings and emotions and doesn't everyone benefit when people are more in touch with their feelings and emotions. That's my view. Yeah, it's just healthier. If you acknowledge these things going on and then let them affect you and just mortality in general. Knowing that we all have this finite time limit and sort of accepting it is it changes how you live your life you're less likely to I think to get caught up in some kind of dead-end career or relationship something if you don't feel is right. You're probably more inspired to change once you sort of reflect more on your mentality and stuff. Absolutely. Absolutely. It's like the good place when you just earned points, if you can if you know your if you know your you're out there earning points for Good Deeds, you'll more likely to do you see the last time I got caught up? Yeah. Okay. Well, I saw the one where there they beat all the demons in the bar right was that but that the main thing was the guy who was doing the point thing where he's like, here's the best guy in the world because he lives so selflessly. It just showed how ridiculous it is to a hundred percent sacrifice your life for like everything else. Yeah, that was funny. There's a healthy balance. I think. Oh, absolutely. Yeah. Absolutely. Yeah, it's a good show. Oh, yeah. It is philosophies. All right. Yeah, they were talking about determinism and Free Will in the good place. I loved it. I absolutely love it. on yeah pretty heavy. Yeah. All right. Um, all right, so when he's going through the treatments. This is quote here A pattern developed over the weeks. The malaise would slowly ease, normalcy returning just in time for the next treatment. That was a hundred percent my experience is I got treated every two weeks every other Thursday. So I get treated Thursday feel somewhat. Okay, like Friday, but then Saturday Sunday Monday was just out. And slowly come back the next week Tuesday, Wednesday Thursday. Okay. Go back to work a little bit of you days and the next week and I'll be like, okay. All right, and I work with few more days and then go back and get treated again. I mean it was just up and down up and down up and down. Yeah, so I mean and so I dressed I've addressed a few of the things that resonated with me, but I feel like that's why anybody can read this that has gone through something. They would read something else or resonate with them and I think that's the beauty of literature and books and art in general is that it doesn't resonate with anybody the same way and that's perfectly fine. That's the whole point of art is just to get a reaction just to or if it's if there's even if there's no reaction. That in itself is the reaction is something doesn't resonate with you then. It doesn't. Everybody has some form of suffering right if it's not cancer. You have your own tragic. And then you have like friends and family have gone through maybe cancer. And yeah, I think it gives you more understanding maybe of what they do reading something like this. Like even though it's a different diagnosis than you different part of the body. It's still parallels in how in some of the things you went through. I like this passage because some people might think. When you have a terminal illness just like, you know, go live it up do your bucket list that sort of thing. You know what I mean? Yeah. No, you're absolutely right. Yeah, but this kind of gives the other angle, okay. okay. Time for me is now double-edged every day brings me further from the low of my last relapse but closer to the next recurrence and eventually death. Perhaps later than I think but certainly sooner than I desire. There are, I imagine, two responses to that realization the most obvious might be an Impulse to frantic activity, to live life to its fullest to travel to dine to achieve a host of neglected ambitions. Part of the cruelty of cancer though is not only that it limits your time, it also limits your energy vastly reducing the amount you can squeeze into a day. It is a tired hare who now races and even if I had the energy I prefer a more tortoise like approach. I plod. I Ponder. Some days I simply persist. Yeah, that's a good one. Yeah, because you can't Yeah a hundred percent. It saps your energy. I mean you're not just going through the treatments or whatever that you have to do, but. Just going through the stress of being sick having a life-threatening illness and and that is not you're just not going to want to go skydiving or you know, hike the Appalachian Trail when you have that on your mind, you know, it's just it's a hundred percent right. It's hard for me to imagine like the stress the emotional burden the personal burden sometimes like financial people without insurance things like that. Like so many different factors that kind. How do you imagine having making time to your bucket list when you have all these other things going on. One thing that I was interested in my experience. Well was it came to diet. When I was going through chemo. I especially the day of I didn't know what I would feel like eating but I talk to one person. I was I was in a group saying you know with what I'm going through. I just been eating whatever the hell I want because who cares, you know, I'm going through chemo I'm going to eat a whole package of Oreo cookies if I want to and the other person was like really you'd want to like eat. A hundred percent healthy food to like help your body and like I never even thought of that, you know, where as if different people, you know have different priorities when it comes to that kind of level of stress. So on one hand, I took the approach of eating a bunch of junk food and whatever I wanted whereas other people would want to take the more holistic route of treating their body as well as they can. In the meantime while they're going through all these treatments and I totally see both routes right. Please tell me my Indulgence of of junk food was okay. It's ongoing. I don't think it has stopped. We go out a lot to Shadow don't ya? I think I know what you're saying like everyone has different. And I get from your perspective. I probably do the same thing like you just want to enjoy life. Like I'm going through all this stuff stuff. Like why not just have the extra dessert and I think they even said that somewhere in the booker like some interview I listen to is just. Why pass up on dessert like enjoy your life and these things that go along with its right? That's it for your family moderation why Compounders? All right, so I'm going to read my favorite quote of the book. I forget what part of this book this what of the book it was, but I'll just read it. One chapter of my life seem to have ended, perhaps the whole book was closing. Instead of being the pastoral figure aiding a life transition. I found myself the sheep lost and confused. Severe illness wasn't life-altering. It was life-shattering. It felt less like an epiphany - a piercing burst of light Illuminating what really matters - and more like someone had just firebombed the path forward. Now I would have to work around it. That, favorite quote of the book. That's exactly what it's like it's not life altering its life shattering. You just have to pick up the pieces. It's a great passage. Yeah, I think the last sentence is particularly impactful because now you have to walk around it means when he says like it's empowering, you know, like this is what I'm going through. I have to find a way to deal with it, right? Yeah, someone firebombed the path and he has to work around it. I'm just you just have to find your way like a my I think a Maya Angelou quote. We find our path by walking it. Just drop that on you. Heavy stuff. That is good. I like that. Yeah, he kept quoting like Samuel Beckett. I think yes Mantra that. He would say I can't go on I will go on. Yes, things like that over and over. He quoted like TS Eliot to from the Wasteland or something. Oh, here's one thing I do bring up a good little topic is in the book. He says at her this woman had passed away 82 years old woman passed. At her autopsy. The pathologist would have would be shocked to learn her age. She has the organs of a fifty-year-old. So that's something that I've always been interested about is what if there is something special about you and me that is totally mundane and not that exciting. But wouldn’t you still want to know? Like this 82 year old woman died. And her autopsy. The pathologist says she has great organs organs of 50 year old and that's great for this 82 year old woman. I mean, unfortunately she died like we're all gonna die. What if there was something purely unique about you Tim not just in your body, but also in how you view the world or what you do, you're the best Nintendo switch player in the world and you and there's no way you know that. Would I want to know. Well, of course, you would want to know right but like there's there's got to be something about everybody. That's I guess that is my little nugget that I hold on to when I think about. Every singular person has something special about him. You know, we are all our separate beings on this planet just living trying to live each are our own lives, but deep down there's gotta be something special about everyone. No, I think that's a great like sort of lesson to impart. That might be a little ideal to it is it is totally idealistic. It doesn't it doesn't fit with my existentialism and my stoicism per se but like but there's maybe it no does because everyone can can existentialism is you can choose what is Meaningful in your life. And so everybody can have something special that they choose. That that is their meaning that get make some special. I think that's no I totally agree and to tie back into the book like he the author I think was very special because who else is like training neurosurgeon and as good of a writer as he was with this literature background, he's very unique individual in that sense. And even though he didn't live into his 40s and make those contributions that he could of in the medical field, he's still passed on this book this Legacy and I think that's really impressive. Absolutely. He contributed in this way. Unfortunately that you know, his life is shorter and his wife and daughter now. I hope they can I don't know It's gotta be rough. But I hope they can still find happiness and appreciation for the time they had with him. It sounds like I mean his family is still very supportive. I'm sure of her and she sounded very strong and they made the decision to have a child knowing the circumstances. So I think yeah, I think she'll be all right. Yeah, I can end my quotes with this one from her actually the epilogue so this is his wife saying this is Lucy Kalanithi. Nathie kind of an EP Colony thing. Yeah. Sorry. Sorry. She says Paul’s decision not to avert his eyes from Death epitomizes a fortitude we don't celebrate enough in her death avoiding culture. His strength was defined by ambition and effort but also by softness, the opposite of bitterness. He spent much of his life wrestling with the question of how to live a meaningful life and his book explores that a central territory. Always the seer is a sayer Emerson wrote. Somehow his dream is told somehow he publishes it with solemn Joy. Writing this book was a chance for this courageous seer to be a sayer to teach us to face death with integrity. Amen. Yeah, good stuff. Yeah. Are you ready to face your own death Tim? No. I'm not either but all right. So, what would what rating would you give the book? 4 out of 5, okay. You can say if I'm going to say five. You're biased. So be it. I mean, yes, I don't care. I love this book. I burned through it read it. I mean, I know it's a little shorter, but. I ate it up it was it. Like a pack of Oreos. Yes like a pack of Oreos. Is that all right? I think that's a good way to it's a great book. Yeah, highly recommend. Yes. Yes. So what's our next book Tim the road to unfreedom by Timothy Snyder. Another new one because we establish that old books are bad and new ones are good. Now that's funny you the complete 180 how everything old is crap. The Odyssey, crap. You know, I live in extreme. Yeah, anyway, go to our website two guys one book.com. Feel free to comment on anything you like literally anything because nobody does but that's okay. All memes. Yeah. Yes keep reading keep keep reading