Reflection on being a Doctor with a Terminal Illness
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Reflection on being a Doctor with a Terminal Illness


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Reflection on being a Doctor with a terminal illness. Passionate man who instead of giving up pushed through became a father, continued to work as chief residency as a neurosurgeon, and wrote a book his memoir 'When Breath Becomes Air'.

Paul Kalanithi was born on April 1, 1977 he dedicated his life trying to find out what makes life meaningful. After graduating high school he went to Standford University, where he graduated with a Bachelor of Arts and Master of Arts in English and a Bachelor of Science in Human Biology in 2000. Later Paul decided to go to medical school, he attended the Yale School of Medicine . Graduating 2007 cum laude. At Yale, Kalanithi met his wife Lucy Goddard, who would become his future wife.

After graduating from medical school, Kalanithi attended Standford to complete his residency training in neurosurgery and a postdoctoral fellowship in neuroscience. Close to completing his residency Paul started not feeling well. Symptoms of severe back pain and weight loss. After a CT scan it was confirmed he was diagnosed with metastic stage IV lung cancer.

Paul took some time off to tend to his health, once stabilized it allowed him to go back to work. However, Kalanithi succumbed to his illness and died in March of 2015.

His decision to go to medical school, he writes was an effect 'to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of of death and decay.' Kalanithi writes in great detail about his years of training, and in these parts of his memoir, you might forget for a minute you are reading the words of a dying man. You become drawn in learning about the cases, the patients, the dilemmas. But Kalanithi is also one of those patients (insert reference).

Paul and Lucy decided to freeze his egg before he started Chemotherapy so when it came time to have a baby. His wife Lucy said he was the one who initially had the strong instinct despite his illness… I said to Paul, 'Don't you think that saying goodbye to a child would make your death more painful? And he said, 'Wouldn't it be great if it did?' (Insert Reference).

What makes life worth living in the face of death? What do you do when the future, no longer a ladder toward your goals in life, flattens out into a perpetual present? What does it mean to have a child, to nurture a new life as another fades away? Finding the strength along the journey to death to step over the line between doctor and patient.


The book “When Breath Becomes Air” summarises the experiences of a young, passionate and struggling man who took a tough stand of becoming a father under the influence of lung cancer while continuing his hospital association as a neurosurgeon. Paul Kalanithi was born on April 1, 1977, and dedicated his entire life to exploring the pattern of a meaningful life and associated positive outcomes. Paul attended Stanford University after accomplishing his graduation from high school with the objective of acquiring Bachelor and Master degrees in Arts and English as well as a Bachelor of Science degree in Human Biology in the year 2000. Later in his life, Paul decided to attend medical school at the Yale School of Medicine. Paul met his future wife “Lucy Goddard” at Yale in 2007 while graduating from medical school.


After graduating from medical school, Kalanithi attended Stanford University to accomplish his residency training in neurosurgery and a postdoctoral fellowship in neuroscience. Paul started experiencing health complications and wellness issues at the end of his residency tenure. He experienced the manifestations attributed to severe back pain and weight loss. The sustained experience of these adverse manifestations resulted in the deployment of CT intervention for the evaluation of associated aetiology. CT intervention is the preferred modality requiring deployment with the objective of evaluating suspected cases of lung cancer (Thippeswamy, et al., 2013). In the presented case scenario, the CT modality confirmed the diagnosis of the patient’s metastatic stage IV lung cancer.

The evidence-based research literature reveals an elevated prevalence of the pattern of stage IV lung cancer in the patients affected with weight loss and severe low back and leg pain (Crisp & Pierce, 2011). The attained diagnosis was evidentially retrieved in concordance of the patient’s symptomatology and substantiated by abnormal radiological findings. I think that the emotional inconsistencies experienced by a qualified physician under the influence of a terminal illness are radically different from the psychological experience of patients with a non-medical background. The implementation of advanced directives and configuration of evidence-based decision-making (for the terminally ill patient) requires the active engagement of the treating physicians with the patient as well as his/her family members (Papadimos, Maldonado, Tripathi, Kothari, & Rosenberg, 2011). In the presented case scenario, the cancer patient was himself a qualified neurosurgeon who had attained thorough insight into the symptomatology, aetiology, manifestations, comorbidities and mortalities arising from stage IV lung cancer. Eventually, the healthcare team had to search for a more pragmatic and rational approach warranted for enhancing the healthcare and wellness outcomes in the treated cancer patient.

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