Archive for the 'Happiness' Category

“When Breath Becomes Air”: A call to life before death

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“Go, go, go, said the bird: human kind
Cannot bear very much reality.” — T.S. Eliot, Four Quartets

whenbreathbecomesairI picked up When Breath Becomes Air (hardback; ebook; audiobook) at about 10pm on the first day of spring by a recommendation from the inimitable Jesse Kornbluth. From his and other reviews, I roughly knew what the book was about: death. What better time to meditate on death than on the very cusp of Earth’s re-awakening?

In one sitting, it was read. It’s a tonic against the unreality that assaults us in the world today — politics, entertainment, advertising, broken promises, missed meetings — because it’s the most real book I’ve read in recent memory. Paul Kalanithi is 36 years old, and chief neurosurgery resident at Stanford Medical School. Every day, he opens up people’s skulls with a drill and saw, dissecting through the dura and meninges to get to a tiny tumor in the cerebellum. One false move of his scalpel by 2mm, and instead of a productive career and fatherhood, his patient is fully paralyzed for life. This is not about shifting around some spreadsheet numbers or holding meetings with middle management about shareholder value, folks. Kalanithi’s work is at the interface between thriving and withering, life and death, every day.

And then, Kalanithi’s life takes a turn for the even more real: he himself is diagnosed with lung cancer. At that point, he has to decide whether he will be spending the remainder of his time on Earth dying or living — a span of 1 to 10 years, depending on disease progression. He chooses to live: to rehabilitate himself and go back to full-time surgical practice in spite of his exhausting chemotherapy regimen; to repair his marriage; to have a child; and to write this book. I am very glad he made that decision.

It turns out that Kalanithi’s time on earth was much closer to the lower end of the predicted range, which makes his story even more poignant and the creation of this book even more heroic. Between 100hr weeks at the hospital, mind-fogging chemotherapy, and a newborn, when did he write?

This is a book that stays with you. It’s a lucid exposition from a consummate insider on the practice of medicine and work of healing. When can doctors heal? What do they tell patients when they can’t? How do they react when a patient dies? How do they convey that news to the family? Is life always worth living?

Paul’s days were numbered, and he knew the number was small. But so are ours. If you’re 25, that number is 18,000 to 20,000. If you’re 45, it’s closer to 13,000. If your light plane crashes, or you have a mountaineering accident, or have a freak untreated food poisoning, that number could be much smaller, like it was for my three friends who died in the past year, all under the age of 35.

So the bad news is that we’re all going to die, folks. Especially you. The good news is that every moment that you live is a gift. You can have that fact impressed upon you by a terminal diagnosis. Or you can read When Breath Becomes Air. Let that inform your days, and you just may infuse every moment of your existence with greater meaning, purpose, and joy.

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On pain and how to handle it

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On the morning of Saturday, March 15, I woke up to shooting and stabbing pain down the right side of my neck, upper back and right arm. The pain encircled my ribs and was literally breathtaking.

I figured I must have slept with my neck in a funny position and a little massage would relieve it. But there was no part of my neck and back that my visiting friend could touch without eliciting a howl from yours truly. So I called my acupuncturist and bodywork specialist Steve, who was kind enough to accommodate me on short notice. Although the session gave me some relief, I realized that this was a different beast than a simple stiff neck.

Eventually, I found an experienced physical therapist/bodyworker based in San Rafael named Al Chan, whose deep knowledge of anatomy combined with his iron paws (I call his technique “Ow now, wow later”) helped put me on the mend.

This article is not about the clinical course of my ailment, though. This is aboutpain – where it

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Life, Death, Youth, the Red Book, Oprah and Truth: Harvard Commencement and Reunion 2013

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One of the things that I remember best from my 15th college reunion was looking over at the 20th reunion people and noticing how impossibly old they looked. These were some paunchy, bald folks in dad jeans, with crevasses on their faces and the teenage kids responsible for said erosion. That would never happen to us whippersnappers of the Class of 1993.

Well, it did. And I’m glad it did, since the alternative (e.g. death) is neither novel nor exciting.

Like a wedding, a college reunion is an occasion of almost unalloyed joy. You get several days to catch up with long-lost friends on years of stories, all in the midst of an endless banquet. You meet the heretofore mythical spouses (“Oh! Someone actually agreed to commit her life to you — that’s great!”), you hug their impossibly cute kids, have great conversations, remember old times, and drink far too many Cape Cods strong enough to remove paint and half your liver.

Another similarity with weddings is that a reunion is a gathering of victors. If you’re broke, sick, alcoholic, getting a divorce, grossly out of shape, prematurely aged, going bankrupt, tangling with the law or otherwise on the receiving end of a bad fortune cookie, you’re probably not going to show up. At a place like Harvard, the impulse to avoid the scrutiny and comparison of peers is perhaps even stronger. What, you haven’t published your third bestselling novel yet? How many IPOs? Not the head of Neurosurgery? No tenure? Only spoken at TED Mainstage once? No Pulitzer, MacArthur or Nobel? Why are we friends again?

The Class Report

Exacerbating all of this is the Class Report, better known as the Red Book. Every five years, we are encouraged to

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Taoism in Three Easy Pieces

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It must have happened to you hundreds of times.

There you are at a cocktail party, holding a mojito in one hand and holding forth on everything and nothing with the other, eliciting nods and knowing chuckles from your audience. You look good. Life is good. Then someone asks out of the blue, “So what the hell is this whole Taoism thing about?”

Aw man. Not that again. I mean, is it Taoism with a T, or Daoism with a D? And what’s that yin-yang symbol thingie anyway? Not your area of your expertise, not your bowl of porridge, not in your wheelhouse. End of your cocktail party mojo.

This is a pretty common condition, as I recently found out. A friend who was intrigued by Eastern philosophy but hadn’t the occasion to study it yet asked me what Taoism was all about. Mojito in hand, three basic principles came to mind which I thought you would find useful as a quick introduction, so you’re properly armed for next time it comes up:

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Partial Continuous Ecstasy: Can You Reside in Bliss Around the Clock?

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I want you to stop what you’re doing right now and really pay attention to… your breath. Slow down your breath, and make an effort to feel the air as it enters your nose.

Maybe even pinpoint a particular molecule of air, and follow its path as you feel it move along your airways, as you become conscious of every part of your body it touches.

First, feel it slide into your nostril. Then, slowly, it caresses the inside of your nasal passages, up and over into the back of your throat, down into your trachea. Slowly now – become aware of and really feel every little bit of

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Danny Hillis and Robert Thurman in conversation: Science, Religion and Ethics

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I just got back from a talk with Robert Thurman and Danny Hillis at the Skirball Center here in Los Angeles.It was about religion, science and ethics, bringing together Danny’s viewpoint as a scientist and Robert’s viewpoint as a Buddhist scholar. Basically the equivalent of crack cocaine for my brain.

Thurman is the leading Tibetan Buddhist in America, a professor of religion at Columbia and buddy of the Dalai Lama.He’s just one seriously cool guy – take my word for it.

Danny Hillis is a genius.For me, the idea of genius isn’t just about being smart and having the intellectual horsepower. It’s about generativity, about making things.Well, in his spare time, Danny Hillis created the 10,000 year clock to illustrate his concept of ‘the long now’ – the idea that it’s a good idea to lead our lives now as if we’re having impact way beyond our own lives and that of our children. Hence, ‘long now’.

He’s also made a computer out of tinkertoys and been a Disney Imagineer and a zillion other things.I’d never met Danny in person, and the one thing that I noticed is that this guy is massive.He’s got these meaty bear paws, is at least 6’3”, and has the biggest head I’ve seen on a person.In fact, you could easily fit two of my heads inside his.All them neurons need a home, I tell ya.

But enough introduction.The conversation started civilly enough.Thurman talked about the 3 jewels (or refuges, or rattanas) of Buddhism:

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Why you should not go to medical school — a gleefully biased rant

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In the few years since I’ve graduated from medical school, there has been enough time to go back to medical practice in some form, but I haven’t and don’t intend to, so quit yer askin’ already.  But of course, people keep on asking.  Their comments range from the curious — “Why don’t you practice?” — to the idealistic — “But medicine is such a wonderful profession!” — to the almost hostile — “Don’t you like helping people, you heartless ogre you?”

Since it’s certain that folks will continue to pose me this question for the rest of my natural existence, I figured that instead of launching into my 15-minute polemic on the State of Medicine each time and interrupting the flow of my Hefeweizen on a fine Friday eve, I could just write it up and give them the URL.  So that’s what I did.

Now, unfettered by my prior obligations as an unbiased pre-med advisor, here are the myriad reasons why you should not enter the medical profession and the one (count ’em — one) reason you should.  I have assiduously gone through these arguments and expunged any hint of evenhandedness, saving time for all of you who are hunting for balance.  And here are the reasons:

1) You will lose all the friends you had before medicine.
You think I’m kidding here.  No, I’m not: I mean it in the most literal sense possible. I had a friend in UCLA Med School who lived 12min away, and I saw her once — in three years (UPDATE: twice in 4 years). I saw her more often when she lived in Boston and I was in LA, no foolin’.

Here’s the deal: you’ll be so caught up with taking classes, studying for exams, doing ward rotations, taking care of

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