When breath becomes air

I have read the book ‘When breath becomes air’, by Paul Kalanithi. It was very inspiring, especially for someone in my situation. But I’m not wondering as much about the book itself right now as about its title.

The question on my mind is, if I end up being beaten by this cancer, and if it comes down to that last moment when I’m in bed making a few last breaths, what is it going to be like?

I remember in the epilogue written by the author’s wife, she described the scene of him dying. I can’t recall the exact words she wrote and I don’t have the book with me. But she said that he was surrounded by family in a peaceful environment. She saw him take the last breath in, and then he was gone. It was a beautiful depiction of a tragic moment. But it was a depiction of an outsider nonetheless. What was Dr. Kalanithi himself going through? What will I be going through?

Will I feel fear? So far, I can’t say that I’ve felt afraid to die of my cancer. Even when the prognosis about my pneumonia was at the very worst, I didn’t feel frightened. But don’t take me for some sort of brave macho. I’m afraid of lots of things…

For example, I might be afraid of the physical pain of dying. Most patients die of infections, and I survived what could have been a fatal one. So I hope I know what 80-90% of what that road is like. But then again, infections can show up in different parts of the body, and can cause more pain than what I had experienced. On the other hand, doctors say that many patients die by simply starting to get exhausted, sleeping a lot, and then eventually their bodies shut off and they pass away. That doesn’t sound very painful to me. So let’s table physical pain for now.

What’s more interesting for me to imagine is what mental state I will be in, if any. A coma, half-asleep, some sort of trance? Will I able to see and hear my loved ones? Or all I’ll see and hear will be vague shapes and faint sounds. In that case, how will say bye to them? In a more extreme case, what if I’m in such a trance that I’m not even there? Maybe I’ll be cruising in some other world, not aware that I’m in the hospital bed at all. That would make saying bye to everyone even harder.

Then there’s the question so many people talk about: life flashing before your eyes. Wikipedia (yes, the omnipotent Wiki) says the whole thing lasts for less than one second. How can my brain crank up such unworldly powers to show me vast amount of information in so little time? Or will the duration of my death be longer than a few seconds. Maybe I’ll spend a bit more time watching my life before I draw my last breath.

If there’s a soul and it starts flying up after I die, that would be a trippy experience. I can see everything from a third point of view. But then where does the soul go? If there’s a heaven – and I get to go there – what would that trip be like? It would be cool to be able to ride a dragon down to see the gatekeeper, like in Dragon Ball. Or if there’s reincarnation, how does that transition happen? Do I suddenly wake up in a body of a grown-up dog, or do I get to grow up into a dog from a puppy?

I guess you have to be on the other side and stay there to know for sure what and how things happens.

There’s also another possibility that there’s just nothing on the other side. Part of me still believes that when the brain shuts off, darkness follows.

But it surely is more uplifting to imagine about things like life flashing before you and riding a dragon to a heaven gatekeeper. And in any case, my time hasn’t even come yet.