prolog

Part 1_ I started out very healthy
Part 2_ Don't Stop Until Death Comes

Epilogue | Lucy Kalanithi
Recommended Reading | Abraham Burghese
Acknowledgements
Translator's Note

It brought tears and emotion to readers around the world.
The last record of a thirty-six-year-old young doctor

Thirty-six, final year of neurosurgery residency before becoming a specialist.
Just when it seemed like the life he wanted was within reach after a grueling fourteen-hour day of training, Paul Kalanithi was diagnosed with stage 4 lung cancer, and it completely changed his life.
His last two years as a doctor, treating patients with critical brain injuries and battling death, and then becoming a patient himself, are told in intelligent and eloquent language.


In January 2014, eight months after being first diagnosed with cancer in 2013, his column, "How Long Have I Got Left?", which was published in the New York Times, created a huge stir.
Here he poignantly portrays the dilemma of a terminally ill patient who has been sentenced to death but does not know exactly when.


If you are clear about how many months or years remain, the path forward will be clear.
If it's three months, I'll spend that time with my family.
If I had a year left, I would write the book I always wanted to write.
If it's 10 years, I will return to the hospital and treat patients.

My doctor just says this:
“I can’t tell you how much time is left.
“You have to find out for yourself what is most precious to you.” (From the text)

He realizes that if he can't know exactly when he will die, he has no choice but to continue living.
He returned to the operating room and, as the most senior resident, took on a tremendous workload, and his wife Lucy became pregnant through artificial insemination.
However, just before completing his residency, his cancer rapidly worsens, forcing him to give up his path as a doctor and he struggles between life and death with his pregnant wife by his side.
Finally, eight months after the birth of his daughter, Kady, he refused resuscitation and died in the arms of his loving family, in a clear mind.
After Paul Kalanithi passed away in March 2015, the epilogue to the book, which he had been working on but never finished, was written by his wife Lucy.

This book was a hot topic as soon as the publishing plan was announced in the New York publishing world in December 2014, before the manuscript was even published, and contracts were signed within a day with Random House in the US, as well as Germany, Italy, and Brazil. In January 2016, upon publication of the original book, it rose to the number one spot on the Amazon and New York Times bestseller lists in the US, and maintained the number one spot on the New York Times bestseller list for 12 consecutive weeks.
The book was licensed to 38 countries around the world, and became an immediate bestseller in the UK, Germany, Italy, and Canada, where it had already been published.


Asking about the meaning of life across literature, philosophy, and medicine
A unique essay combining experience and reflection, emotion and intellect.

Paul Kalanithi was fascinated by young adult literature.
He was fascinated by the question of what makes life meaningful, and literature provided a way to convey the meaning of life in the form of stories.
Then, he learned that the human mind is a function of the brain, so he majored in English literature and biology at Stanford University.
As he explored human beings as both physiological and spiritual beings, he eventually decided to become a doctor.
It was “an opportunity to connect with those who suffer and to continue to ponder the question of what makes human life meaningful even in the face of physical decline and death.”

Paul Kalanithi chose his field of expertise precisely because of that sense of calling.
“Neurosurgery seemed to me to be the most challenging and directly confronting of meaning, identity, and death.” The author, who chose the profession of medicine based on humanistic insights, and who has constantly pondered what he could do for patients with catastrophic brain injuries, raises questions for our society about the role medicine and science can play in human lives and what makes a good doctor.


Neurosurgeons work in the harsh furnace of identity.
All brain surgery inevitably involves manipulating the brain, which is the very essence of human beings, and when communicating with patients undergoing brain surgery, we inevitably face the question of identity.
The point is not simply whether to live or die, but which one is worth living for.
What choice would you make if you were forced to lose your voice in exchange for a few more months of life? What if you lost the use of your right hand while trying to stop a seizure? How much pain would your child have to endure before they would say they'd rather die? (Excerpt from the text)

And finally, at the age of thirty-six, the author is sentenced to death and finds himself in the position of his patients.
Just as he didn't know when he would die even before he was diagnosed with cancer, he despairs over the fact that he doesn't know when he will die after being diagnosed with stage 4 lung cancer.
If you don't know when you'll die, you have no choice but to keep living.
With a keen awareness of death, which is much closer than before.
He repeats a line from Samuel Beckett:
“I can’t go on.
Still I can't go on.
I'll go on).
Even if I am dying, I am still alive until I actually die.
“I decided to keep living instead of dying.”

Even as my body crumbled toward death, there was a firm hope that my future would not be taken away.
As he struggled to type on his keyboard, his fingertips cracking from chemotherapy, Paul Kalanithi left this final letter to his daughter:


When the time comes to explain how you lived, what you did, and what meaningful contributions you made to the world, I hope you won't forget that you filled your father's dying days with joy.
It was a joy my father had never felt in his life, and because of it, he was able to rest comfortably, contented, and without wishing for more.
At this moment, it's really a huge deal to me.
(From the text)