Neurosurgeon Paul Kalanithi, MD, passed away Monday after bouts with metastatic lung cancer. He was an instructor in the Stanford's department of neurosurgery and a fellow at the Stanford Neurosciences Institute.
Dr. Kalanithi, rose to national prominence in the days before his death when an article he authored reflecting on his time in medicine, fighting cancer and coming to terms with imminent death, was published in Stanford Magazine.
In the article, Dr. Kalanithi talks about how his experience of time changed after undergoing cancer treatment, from the frantic pace in the operating room, always watching the clock, to cherishing the present moments he spent with his young daughter.
His goals for the future also changed, drastically. Instead of looking forward to a successful practice and long career with a growing family, Dr. Kalanithi found himself hoping he'd live long enough for his young daughter to remember him.
For any high-achieving individuals, goals and ambitions are an important driving force for building a successful career and legacy. But when time and energy are cut short, when the goal is to just live a few more days, there is less emphasis on achievement for the future. Instead, as Dr. Kalanithi wrote, the future "flattens out into a perpetual present."
One piece of advice offered at the beginning of the letter comes from a chief resident advising a junior: "Learn to be fast now — you can learn to be good later."
Speed is crucial for delivering surgical care — whether to keep patients from being under anesthesia too long, losing too much blood or absorbing too many resources — but what happens when you don't have enough time to be "good"? What happens when "later" never comes?
Even when he had the energy, Dr. Kalanithi wrote in the letter, he preferred a slower pace to ponder and plan each move deliberately, with no wasted movements.
Here are five key thoughts from Dr. Kalanithi, eloquently put:
1. "Focused in the OR, the position of the clock's hands might seem arbitrary, but never meaningless. Now the time of day meant nothing, the day of the week scarcely more or so."
2. "If time dilates when one moves at high speeds, does it contract when one moves barely at all? It must: The day [returning home after prolonged hospitalization] shortened considerably."
3. "Most ambitions are either achieved or abandoned; either way, they belong to the past."
4. "Money status, all vanities the preacher of Ecclesiastes described, hold so little interest: a chasing after wind, indeed."
5. To his infant daughter, Dr. Kalanithi wrote, "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."