When Air Becomes Breath

 A Personal Essay by Megan Anderson

Who would true valor see/ let him come hither.../ then fancies fly away/ He'll fear not what men say/ He'll labour night and day/ to be a pilgrim

I read the last few words of When Breath Becomes Air slowly, so as to enjoy every last word to the end. Paul Kalanithi’s wife had to finish his book for him; the antagonist of his story killed him. She told us
about how much he loved and how much he lived to the end. I’m fighting back tears like Paul fought cancer. I’m failing, like he did. No. Paul succeeded. He reminded me why I love and live. He did that by greeting me kindly with raw emotion and sleepless nights and failing health. Like Paul, I watched myself waste away, wondering what would come of it. We’ve never met, Paul and I, but we have walked a lonely path together. He struggled, but he was honest with himself. I think it’s time for me to do the same.

Cancer of the brain comes in two varieties: primary cancers, which are born in the brain, and metastases, which emigrate from somewhere else in the body, most commonly from the lungs.
I was in elementary school. My friends and I had a section of grass that we always ran to in our giddy excitement for recess. We toppled in a heap onto the grass laughing and panting from the exertion. We were free! In my excitement, I called out “Watch out, steamroller!” and I rolled over my friends. I giggled at their groans of complaint. One said “Megan, you’re like a boulder! Maybe you shouldn’t eat so much.” The others laughed. “Yeah, Megan!” I frowned. I didn’t want to be a boulder. Boulders were ugly and heavy. I wanted to be dainty like the princesses in movies. I thought about the contents of my lunchbox: sandwich, fruit leather, cheese stick, capri sun, and a cookie. Hmm. Capri Suns do add a lot of weight to my lunch box. I won’t bring one tomorrow. I don’t want to be a boulder, I thought.

When I dressed in the morning, my belt cinched one, then two notches tighter.
I was in high school. Ready to start another day. I was standing in front of the mirror, my head cocked to one side. My eyes roved over my legs, my hips, my jawline. My brain edited them to be thinner, the way I wanted them to be. The way they should be. With a sigh, I headed out the door, hoping my mom didn’t notice that I hadn’t eaten breakfast.

I was too tired to eat when I got home.
I was at a party. The food table was glaring at me, taunting me. I craned my neck to see what was there. Mentally, I made a list of the things I couldn’t eat. Almost everything. There were a few vegetables. I could eat those, and maybe also one cookie. No, I thought, that would be way too much. I survey the room, noticing the size of other girls’ thighs, comparing them to my own. Hers are bigger, hers are bigger, hers are... smaller. My stomach remains empty.

Cancer. I was a neurosurgical resident entering my final year of training. Over the last six years, I’d examined scores of such scans, on the off chance that some procedure might benefit the patient. But this scan was different: it was my own.
I’m gasping over the toilet, shaking. Tears well up in my eyes as I slowly walk back to my room. Guilt swirls around me like the storm clouds in my head. If only I didn’t eat so much. I crawl into my bed and look down at my legs through the covers. They’re taking up way too much space. Why can’t they just disappear? I run my cold hands through my brittle hair and I sigh, hoping that I’ll be able to sleep tonight.

With the cancer having invaded multiple organ systems, the diagnosis was clear.
I’m at track practice. My lungs protest. My legs protest. I can’t seem to get enough air. After running another 400 meters, I collapse onto the ground, rolling onto my back, panting. I was the last one to finish. Everyone else is doing their stretches. Feeling lightheaded, I sit up and reach for my toes. My coach starts barking out orders for us: “Listen up! Tomorrow is the track meet and that means I want you to give yourself fuel! Good fuel, people! I don’t want any of that McDonald’s nonsense, because I’ll have to look at it after you throw up. Tonight, eat some pasta and have a good breakfast!” A few playful groans of complaint follow, but then there is talk of fresh, warm lasagna. But I’m on a no carb diet. I stare at my hands in my lap. I’m so tired of being tired.

That night I look at myself in the mirror. I wanted to do well tomorrow at the meet, but eating bread would slow my progress. I wasn’t to my ideal weight yet. But what if my coach was right? Maybe... maybe if I ate just a little bit more, I wouldn’t be so tired tomorrow.

My mom makes French toast that night. I eat two slices. And... I feel good.

I’m sorry, but I’m dying from cancer. 
I’m standing outside his office. When I enter, he smiles. We exchange formalities. Then it comes out, gushing like a geyser: “I have a problem”. He listens. I tell. I tell him everything. My aversion to food, my game of comparison and my long nights of standing in front of the mirror. I pause, and he looks at me thoughtfully. “You know, your Heavenly Father doesn’t think of you like that.” I sigh. God asks for perfection. Of course He thinks of me like that. Everyone sees how much I need to lose weight, I’m sure. 
“He created you after all,” he said with a knowing look in his eyes. I blink. Well, then, maybe He made a mistake with me. I squirm in my chair. He continues, “And you must also know that He can help you, if you ask Him to.” 

Everyone in our church says that, I think, but my eyes are on him. I think about my primary class, and me, seven years old with legs swinging as I sat on those cold metal chairs. I remember a song that we sang, the one where the teachers sang one verse and we sang the other. There was that sister whose hips didn’t quite fit in the framework of the chair, but she still sang loudly with her high vibrato. Pray, He is there; speak, He is listening. You are His child; His love now surrounds you. I hadn’t thought about those words in so long. Back then, they were just a lilting melody coming from this teacher’s lungs. Today they meant something.

So, God can help me? 

I ask him a few questions, realizing that that primary teacher sang loudly because those words meant something to her, too. He answers my questions with a calm, confident assurance, echoing the melody of the song. I’m beginning to realize that there is a way out, and that way is becoming clear to me. Suddenly I’m peering up at a pinprick of light that is starting to filter into my dark tunnel. I take a deep breath as I realize what I have to do.

We shook hands, my arm entangled in the IV line.
I went home that night, walking right past the mirror. I fell to my knees, and gasped. “Help me, help me, help me, I can’t do it without you.” There were too many things to change. My whole thought process, who I was. This poison inside of my brain invaded everything. I couldn’t possibly get rid of it on my own. It was impossible. “Please. Help me. Help me please... Father.” Peace came. And I slept with hope as a pillow.

He let himself be open and vulnerable, let himself be comforted.
I’m in front of the mirror again, thinking. I’d always imagined the sadness inside of me as a spiraling slide. Some days I would creep towards the edge and allow myself to slide down, descending into darkness. There I would lie as I hated food, hated my body. I thought I deserved it. Now, here I am, eyeing myself in the mirror, fighting the urge to crawl towards the dark chute. I take deep breaths. The slide is so close, compelling. I turn away. Then I say it. I look in the mirror and say those three words: “I am beautiful.” I pause. Then a sob escapes my mouth. Something miraculous had just happened. I had believed those three words.

We’re gonna fight and beat this thing, Doc.
I’m in college. I’ve been working on my relationship with food. I ignore my thighs, taunting me from under the table that they’re too fat for all of that carby spaghetti. But my nutrition class told me this was healthy. I slurp the noodles into my mouth, letting the tomato sauce splatter all over my face. Delicious. Vitamins and minerals that my body wants. Here you go body, I think. Here’s what you’ve been wanting for too long. My thighs’ protests are muffled now. That’s better.

In this time, right now, that is an enormous thing.
Today, I’m chopping my avocados while humming to myself. My hums become my background music as I waltz over to the fridge to grab a tortilla. Tortillas were off limits five years ago, but now they’re a staple. I eat them with almost everything. Dancing around the kitchen, I feel the soreness in my legs from my morning run. I run faster and longer than ever thanks to the fuel that I give my body. Before I blend the avocados, I sprinkle salt over them. Another off-limits food from not too long ago. It took me a few years to realize that salt was okay. I have a right to enjoy my food after all. Guacamole made, I twirl over to the oven to broil the cheese on my tortilla. It’s an orchestra of off limit foods from earlier, but now they make a delicious, healthy meal. Food and I, we’re friends now.

Paul was fully alive; despite physical collapse, he remained vigorous, open, full of hope not for an unlikely cure but for days that were full of purpose and meaning.
I’m better today, thanks to God and the people that helped me see the miracle that my body is. In the end, that primary song was right. I wish I could say the same happy ending for Paul. But the difference between us was that I had a choice; he didn’t. I plucked the killer out of my brain while his devoured him. I stuck my chin out at myself in the mirror and proudly told myself that I was beautiful, thick thighs and all. Paul’s book reminded me of that. He reminded me to stop counting calories and start counting moments. He reminded me of my resolve to live my life as full as it could possibly go. 

And today, today my life is as full as my satisfied stomach.

Image Credits: "Paul Kalanithi Legend", "Avocado Food Vegetable Fruit", "Art Language Mirror Piece" (Public Domain images by Wikimedia Commons)