How to Live

What does it mean to live well?
Paul Kalanithi, a neurosurgeon at Stanford, addresses this question in his book When Breath Becomes Air both as a doctor and as a patient. A couple of years into his residency, he was diagnosed with stage-four lung cancer and died aged 37, almost two years after diagnosis.
Often we hope to die having accomplished or attained something in this life, whether it is a toned body, esteemed career, successful marriage, or a well-tempered asset column. Kalanithi wanted to make contributions in his field of neurosurgery as a scientist and a doctor. Yet, physical limitations imposed as a result of having had cancer altered his trajectory.
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.
That is true of everyday interactions, isn’t it? Everything has been going swimmingly till an interruption of some sort happens. We may grumble and bemoan these inconveniences, because how dare our ideal schedule, with our ideal work and ideal resources to carry out that work, be dismantled as though meaningless? As though our work wasn’t worth the time and man-hours required?
What we may have failed to understand is that the world isn’t perfect — at least, perfect in our understanding of the term. Independent and irrespective of our work and our best intentions, mistakes happen. There are times when nature has to give us a severe experience of loss, whether it is a loss of a job or a loss of a home because of natural disaster. We are then forced to come to terms with the question: what matters to me?
Kalanithi had always prided himself in his scientific worldview. Models like the Kaplan-Meier curve kept him grounded. However, in his predicament, his views shifted to a more accommodating one consisting not only of scientific enquiries, but enquiries from subjects as diverse as theology and philosophy. Through literature, which had given him resolve in his time of greatest need, he saw that nonscientific endeavours were every bit as critical to living well.
We build scientific theories to organize and manipulate the world, to reduce phenomena into manageable units. Science is based on reproducibility and manufactured objectivity. As strong as that makes its ability to generate claims about matter and energy, it also makes scientific knowledge inapplicable to the existential, visceral nature or human life, which is unique and subjective and unpredictable. Science may provide the most useful may to organize empirical, reproducible data, but its power to do so is predicated on its inability to grasp the most central aspects of human life: hope, fear, love, hate, beauty, envy, honor, weakness, striving, suffering, virtue.
Science, he has learnt, is a well-established way to control one’s environment given dependent variables. It cannot account for independent variables and random, sometimes unexpected events. In other words, it explains how things are, but not why they are. We are quite content with the way things are when everything is under control. However, there will be tests in our lifetime that reveal how content we are really. Life-tests cannot be quantified nor measured by scientific enquiry, but can be reflected and pondered by holistic enquiry.
To live well, then, is not to assume a nonexistent world of perfection nor to reduce all the problems in a box, but to grapple with what is real — the people, events, and lessons learnt. A wise person named Solomon wrote in the book of Ecclesiastes,
It is better to go to the house of mourning than to go to the house of feasting, for this is the end of all mankind, and the living will lay it to heart. Sorrow is better than laughter, for by sadness of face the heart is made glad.
Only when we are true to ourselves and to others, without putting on a facade of success or opting for simple explanations to complex occurrences. Having cancer forced Kalanithi to expose his repressed assumptions and biases and learn to make sense of it. That perhaps he wasn’t in control, that everything he’s had is a gift. That relationships matter more than accolades and recognition.
I shall close with Kalanithi’s last words in this book.
When you come to one of the many moments in life when you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man’s days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more, but rests, satisfied. In this time, right now, that is an enormous thing.
Nothing is meaningless.
