In Memoriam

Saudade is a word in Portugese and Galician with no direct English translation. It conjures a state of intense nostalgic or profound longing for an absent something or someone. There is a repressed knowledge that the object of longing may never return.

I've been holding off on writing this blog, to allow some space, some distance. It is about a physician and writer, who I knew, if only in crossed paths, who died recently of cancer. When I read his writings, I feel saudade. It is a window into his heart and mind that is intensely meaningful and strange because we've probably only shared a handful of words, all work, nothing personal.

Paul Kalanithi was a neurosurgery resident when I was an anesthesia resident, and he was courteous and smart and helpful and professional. Like the vast majority of all the other residents, medical students, fellows, and attendings I encounter, our paths diverged, I thought nothing more of him, and he was merely a blip in my professional life. Earlier this year, I encountered his writing, and I was shocked. He had, at the end of his residency, been diagnosed with metastatic cancer. In his brief and brilliant essay Before I Go and his opinion piece How Long Have I Got Left?, he speaks with such clarity about this time in his life: learning about the diagnosis, deciding to finish his training despite hospitalization and chemotherapy, reflecting on death and dying. He wields his words like a surgeon in the operating room: no wasted movement, each phrase stunning and precise and deliberate. The last paragraph of Before I Go, where he addresses his daughter cannot elicit anything but saudade. How many of us could express such love in so many words, and then put it out into the open? He was thirty seven when he died, and I am awed by his courage, his brilliance, and his humanity.

I think many of us - residents, fellows, young physicians - were struck because of his age, his unexpected cancer, and his untimely death. He was similar to all of us. But I personally am less struck by that than by the admiration for someone who accomplished so much in the life he had, who skirted the technical demands of neurosurgery and wrote with such compassion and beauty.