When Breath Becomes Air(5)

“Oh, what a bummer!”

“Say, do you mind if I put my bags down and rest a bit?”

I had hoped a few days out of the OR, with adequate sleep, rest, and relaxation—in short, a taste of a normal life—would bring my symptoms back into the normal spectrum for back pain and fatigue. But after a day or two, it was clear there would be no reprieve.

I slept through breakfasts and shambled to the lunch table to stare at ample plates of cassoulet and crab legs that I couldn’t bring myself to eat. By dinner, I was exhausted, ready for bed again. Sometimes I read to the kids, but mostly they played on and around me, leaping and yelling. (“Kids, I think Uncle Paul needs a rest. Why don’t you play over there?”) I remembered a day off as a summer camp counselor, fifteen years prior, sitting on the shore of a lake in Northern California, with a bunch of joyous kids using me as an obstacle in a convoluted game of Capture the Flag, while I read a book called Death and Philosophy. I used to laugh at the incongruities of that moment: a twenty-year-old amid the splendor of trees, lake, mountains, the chirping of birds mixed with the squeal of happy four-year-olds, his nose buried in a small black book about death. Only now, in this moment, I felt the parallels: instead of Lake Tahoe, it was the Hudson River; the children were not strangers’, but my friends’; instead of a book on death separating me from the life around me, it was my own body, dying.



On the third night, I spoke to Mike, our host, to tell him I was going to cut the trip short and head home the next day.

“You don’t look so great,” he said. “Everything okay?”

“Why don’t we grab some scotch and have a seat?” I said.

In front of his fireplace, I said, “Mike, I think I have cancer. And not the good kind, either.”

It was the first time I’d said it out loud.

“Okay,” he said. “I take it this is not some elaborate practical joke?”



“No.”

He paused. “I don’t know exactly what to ask.”

“Well, I suppose, first, I should say that I don’t know for a fact that I have cancer. I’m just pretty sure of it—a lot of the symptoms point that way. I’m going to go home tomorrow and sort it out. Hopefully, I’m wrong.”

Mike offered to take my luggage and send it home by mail, so I wouldn’t have to carry it with me. He drove me to the airport early the next morning, and six hours later I landed in San Francisco. My phone rang as I stepped off the plane. It was my primary care doctor, calling with the chest X-ray result: my lungs, instead of being clear, looked blurry, as if the camera aperture had been left open too long. The doctor said she wasn’t sure what that meant.

She likely knew what it meant.

I knew.

Lucy picked me up from the airport, but I waited until we were home to tell her. We sat on the couch, and when I told her, she knew. She leaned her head on my shoulder, and the distance between us vanished.

“I need you,” I whispered.



“I will never leave you,” she said.

We called a close friend, one of the attending neurosurgeons at the hospital, and asked him to admit me.

I received the plastic arm bracelet all patients wear, put on the familiar light blue hospital gown, walked past the nurses I knew by name, and was checked in to a room—the same room where I had seen hundreds of patients over the years. In this room, I had sat with patients and explained terminal diagnoses and complex operations; in this room, I had congratulated patients on being cured of a disease and seen their happiness at being returned to their lives; in this room, I had pronounced patients dead. I had sat in the chairs, washed my hands in the sink, scrawled instructions on the marker board, changed the calendar. I had even, in moments of utter exhaustion, longed to lie down in this bed and sleep. Now I lay there, wide awake.

A young nurse, one I hadn’t met, poked her head in.

“The doctor will be in soon.”

And with that, the future I had imagined, the one just about to be realized, the culmination of decades of striving, evaporated.





PART I


In Perfect Health I Begin





The hand of the LORD was upon me, and carried me out in the spirit of the LORD, and set me down in the midst of the valley which was full of bones,

And caused me to pass by them round about: and, behold, there were very many in the open valley; and, lo, they were very dry.

And he said unto me, Son of man, can these bones live?

—Ezekiel 37:1–3, King James translation



I KNEW WITH CERTAINTY that I would never be a doctor. I stretched out in the sun, relaxing on a desert plateau just above our house. My uncle, a doctor, like so many of my relatives, had asked me earlier that day what I planned on doing for a career, now that I was heading off to college, and the question barely registered. If you had forced me to answer, I suppose I would have said a writer, but frankly, thoughts of any career at this point seemed absurd. I was leaving this small Arizona town in a few weeks, and I felt less like someone preparing to climb a career ladder than a buzzing electron about to achieve escape velocity, flinging out into a strange and sparkling universe.



I lay there in the dirt, awash in sunlight and memory, feeling the shrinking size of this town of fifteen thousand, six hundred miles from my new college dormitory at Stanford and all its promise.