I am so at home in Dublin, more than any other city, that I feel it has always been familiar to me. It took me years to see through its soft charm to its bitter prickly kernel - which I quite like too.

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Dum Spiro Spero

When Breath Becomes Air, by Paul Kalanithi, Bodley Head, 225 pp. £12.99. ISBN 978-1847923677 Paul Kalanithi was nearing the end of his training as a neurosurgeon when, aged thirty-six, he was diagnosed with stage IV lung cancer. He had never smoked. Even by the exalted standards of American academic medicine, Kalanithi was a high-flier. The son of mixed-faith Indian immigrants (his father a Christian doctor, mother a Hindu physiologist), he grew up in a remote part of Arizona. The Kalanithis had moved there from New York, reasoning that it would be cheaper and that they might thus be able to afford to send their three sons to good universities. Paul, the middle boy, was tutored by his fiercely ambitious mother: “She made me read 1984 when I was ten years old; I was scandalized by the sex, but it also instilled in me a deep love of, and care for, language.” He won a place at Stanford, where he planned to study English literature. Just before he started his course, his girlfriend gave him a copy of a novel by Jeremy Leven called Satan: His Psychotherapy and Cure by the Unfortunate Dr. Kassler, J.S.P.S. Although he found the book “neither cultured nor funny”, it made an impression: “ … it did make the throwaway assumption that the mind was simply the operation of the brain, an idea that struck me with force; it startled my naive understanding of the world.” He decided there and then to study neuroscience as well as English literature. Kalanithi thrived at Stanford: I studied literature and philosophy to understand what makes life meaningful, studied neuroscience and worked in a fMRI lab to understand how the brain could give rise to an organism capable of finding meaning in the world, and enriched my relationships with a circle of dear friends … Studying under the supervision of the great philosopher Richard Rorty, professor of comparative literature at Stanford, he wrote a thesis on Walt Whitman called “Whitman and the Medicalization of Personality”. Kalanithi began to realise, however, that his future would not be as an English professor: “My thesis … was well-received, but it was unorthodox, including as much history of psychiatry and neuroscience as literary criticism.” Asking himself the question “Where did biology, morality, literature and philosophy intersect?” Kalanithi’s inner voice commanded: “Set aside the books and practice medicine.” Despite the fact that his father, uncle and elder brother…



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