[this book made me think to powerfully about what I value in life]
"If the unexamined life was not worth living, was the unlived life worth examining?"
"Moral speculation was puny compared to moral action."
"Would you trade your ability - or your mother's - to talk for a few extra months of mute life? The expansion of your visual blind spot the exchange for eliminating the small possibility of a fatal brain hemorrhage? Your right hand's function to stop seizures? How much neurologic suffering would you let your child endure before saying that death is preferable? Because the brain mediates our experience of the world, any neurosurgical problem forces a patient and family, ideally with a doctor as a guide, to answer this question: What makes life meaningful enough to go on living?"
"When a patient comes in with a fatal head bleed, that first conversation with a neurosurgeon may forever color how the family remembers the death, from a peaceful letting go ("Maybe it was his time") to an open sore of regret ("Those doctors didn't listen! They didn't even try to save him!"). When there's no place for the scalpel, words are the surgeon's only tool.
"The call to protect life - and not merely life but another's identity; it is perhaps not too much to say another's soul - was obvious in its sacredness."
"Before operating on a patient's brain, I realized, I must first understand his mind: his identity, his values, what makes his life worth living, and what devastation makes it reasonable to let that life end."
"While most scientists connived to publish in the most prestigious journals and get their names out there, V maintained that our only obligation was to be authentic to the scientific story and to tell it uncompromisingly. I'd never met someone so successful who was also committed to goodness. V was an actual paragon."
"You can't ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving."
"Yes, I thought, and therein was the paradox: like a runner crossing the finish line only to collapse, without that duty to care for the ill pushing me forward, I became an invalid."
"I began to realize that coming in such close contact with my own mortality had changed both nothing and everything. Before my cancer was diagnosed, I knew that someday I would die, but I didn't know when. After the diagnosis, I knew that someday I would die, but I didn't know when."
"If the weight of mortality does not grow lighter, does it at least get more familiar?"
"'Don't you think saying goodbye to your child will make your death more painful?' 'Wouldn't it be great if it did?' I said. Lucy and I both felt that life wasn't about avoiding suffering."
"Because I would have to learn to live in a different way, seeing death as an imposing itinerant visitor but knowing that event if I'm dying, until I actually die, I am still living."
"Moral duty has weight, things that have weight have gravity, and so the duty to bear mortal responsibility pulled me back into the operating room."
"The way forward would seem obvious, if only I knew how many months or years I had left. Tell me three months, I'd spend time with family. Tell me one year, I'd write a book. Give me ten years, I'd get back to treating diseases. The truth that you live one day at a time didn't help: What was I supposed to do with that day?"
"the physician's duty is not to stave off death or return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence."
"Science may provide the most useful way 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."
"In the end, it cannot be doubted that each of us can see only a part of the picture. The doctor sees one, the patient another, the engineer a third, the economist a fourth, the pearl diver a fifth, the alcoholic a sixth, the cable guy a seventh, the sheep farmer an eighth, the Indian beggar a ninth, the pastor a tenth. Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete."
"Suddenly, all of my joys were salted. For breakfast, Lucy made me a bagel with cream cheese; it tasted like a salt lick. I set it aside. Reading was exhausting."
"During lucid moments, I was acutely aware that with this many voices, cacophony results. In medicine, this is known as the WICOS problem: Who Is the Captain Of this Ship? The nephrologist disagreed with the ICU doctors, who disagreed with the endocrinologists, who disagreed with the oncologists, who disagreed with the gastroenterologists."
"There we were, doctor and patient, in a relationship that sometimes carries a magisterial air and other times, like now, was no more, and no less, than two people huddled together, as one faces the abyss."
"Part of the cruelty of cancer, though, is not only that it limits your time; it also limits your energy, vastly reducing the amount you can squeeze into a day."
"Graham Greene once said that life was lived in the first twenty years and the remainder was just reflection. So what tense am I living in now?"
"Most ambitions are either achieved or abandoned; either way, they belong to the past."
"There is perhaps only one thing to say to this infant, who is all future, overlapping briefly with me, whose life, barring the improbable, is all but past."
"... you have 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."
"We each joked to close friends that the secret to saving a relationship is for one person to become terminally ill. Conversely, we knew that one trick to managing a terminal illness is to be deeply in love - to be vulnerable, kind, generous, grateful."
"That Paul and I formed part of the deep meaning of each other's lives is one of the greatest blessings that has ever come to me."
"He let himself be open and vulnerable, let himself be comforted."
"Not fully captured in these pages are Paul's sense of humor - he was wickedly funny - or his sweetness and tenderness, the value he placed on relationships with friends and family. But this is the book he wrote; this was his voice during this time; this was his message during this time; this was what he wrote when he needed to write it."
"For much of his life, Paul wondered about death - and whether he could face it with integrity. in the end, the answer was yes. I was his wife and a witness."
