Breath Becomes Air Quotes

You can’t ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving.

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.

There is a moment, a cusp, when the sum of gathered experience is worn down by the details of living. We are never so wise as when we live in this moment.

That message is simple: When you come to one of the many moments in life when you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you 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.

I can’t go on. I’ll go on.

even if I’m dying, until I actually die, I am still living.

Will having a newborn distract from the time we have together?" she asked. "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.

The main message of Jesus, I believed, is that mercy trumps justice every time.

Years ago, it had occurred to me that Darwin and Nietzsche agreed on one thing: the defining characteristic of the organism is striving.

Life wasn’t about avoiding suffering.

When you love someone, they become a part of who you are. They're in everything you do. They're in the air you breathe and the water you drink and the blood in your veins. Their touch stays on your skin and their voice stays in your ears and their thoughts stay in your mind. You know their dreams because their nightmares pierce your heart and their good dreams are your dreams too. And you don't think they're perfect, but you know their flaws, the deep-down truth of them, and the shadows of all their secrets, and they don't frighten you away; in fact you love them more for it, because you don't want perfect. You want them. You want—" He broke off then, as if realizing everyone was looking at him again. "You want what?" said Dru with enormous eyes. "Nothing," Julian said. "I'm just talking.

There are a hundred trillion cells in the human body, and every single one of the cells of my body loves you. We shed cells, and grow new ones, and my new cells love you more than the old ones, which is why I love you more every day than I did the day before. It’s science. And when I die and they burn my body and I become ashes that mix with the air, and part of the ground and the trees and the stars, everyone who breathes that air or sees the flowers that grow out of the ground or looks up at the stars will remember you and love you, because I love you that much.

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.

When Great Trees Fall When great trees fall, rocks on distant hills shudder, lions hunker down in tall grasses, and even elephants lumber after safety. When great trees fall in forests, small things recoil into silence, their senses eroded beyond fear. When great souls die, the air around us becomes light, rare, sterile. We breathe, briefly. Our eyes, briefly, see with a hurtful clarity. Our memory, suddenly sharpened, examines, gnaws on kind words unsaid, promised walks never taken. Great souls die and our reality, bound to them, takes leave of us. Our souls, dependent upon their nurture, now shrink, wizened. Our minds, formed and informed by their radiance, fall away. We are not so much maddened as reduced to the unutterable ignorance of dark, cold caves. And when great souls die, after a period peace blooms, slowly and always irregularly. Spaces fill with a kind of soothing electric vibration. Our senses, restored, never to be the same, whisper to us. They existed. They existed. We can be. Be and be better. For they existed.

What makes life meaningful enough to go on living?

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.

If the unexamined life was not worth living, was the unlived life worth examining?

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. But now I knew it acutely. The problem wasn’t really a scientific one. The fact of death is unsettling. Yet there is no other way to live.

I run because if I didn’t, I’d be sluggish and glum and spend too much time on the couch. I run to breathe the fresh air. I run to explore. I run to escape the ordinary. I run…to savor the trip along the way. Life becomes a little more vibrant, a little more intense. I like that.

I will share your joy and sorrow / Till we’ve seen this journey through.

Literature not only illuminated another’s experience, it provided, I believed, the richest material for moral reflection. My brief forays into the formal ethics of analytic philosophy felt dry as a bone, missing the messiness and weight of real human life.

Those burdens are what make medicine holy and wholly impossible: in taking up another’s cross, one must sometimes get crushed by the weight.

I don’t believe in the wisdom of children, nor in the wisdom of the old. There is a moment, a cusp, when the sum of gathered experience is worn down by the details of living. We are never so wise as when we live in the moment.

Bereavement is not the truncation of married love,” C. S. Lewis wrote, “but one of its regular phases—like the honeymoon.

The tricky part of illness is that, as you go through it, your values are constantly changing. You try to figure out what matters to you, and then you keep figuring it out. It felt like someone had taken away my credit card and I was having to learn how to budget. You may decide you want to spend your time working as a neurosurgeon, but two months later, you may feel differently. Two months after that, you may want to learn to play the saxophone or devote yourself to the church. Death may be a one-time event, but living with terminal illness is a process.

We shall rise insensibly, and reach the tops of the everlasting hills, where the winds are cool and the sight is glorious.

Thermodynamic miracles... events with odds against so astronomical they're effectively impossible, like oxygen spontaneously becoming gold. I long to observe such a thing. And yet, in each human coupling, a thousand million sperm vie for a single egg. Multiply those odds by countless generations, against the odds of your ancestors being alive; meeting; siring this precise son; that exact daughter... Until your mother loves a man she has every reason to hate, and of that union, of the thousand million children competing for fertilization, it was you, only you, that emerged. To distill so specific a form from that chaos of improbability, like turning air to gold... that is the crowning unlikelihood. The thermodynamic miracle. But...if me, my birth, if that's a thermodynamic miracle... I mean, you could say that about anybody in the world!. Yes. Anybody in the world. ..But the world is so full of people, so crowded with these miracles that they become commonplace and we forget... I forget. We gaze continually at the world and it grows dull in our perceptions. Yet seen from the another's vantage point. As if new, it may still take our breath away. Come...dry your eyes. For you are life, rarer than a quark and unpredictable beyond the dreams of Heisenberg; the clay in which the forces that shape all things leave their fingerprints most clearly. Dry your eyes... and let's go home.

Don’t think I ever spent a minute of any day wondering why I did this work, or whether it was worth it. 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. The cost of my dedication to succeed was high, and the ineluctable failures brought me nearly unbearable guilt. Those burdens are what make medicine holy and wholly impossible: in taking up another’s cross, one must sometimes get crushed by the weight.

When there is no place for the scalpel, words are the surgeon’s only tool.

I expected to feel only empty and heartbroken after Paul died. It never occurred to me that you could love someone the same way after he was gone, that I would continue to feel such love and gratitude alongside the terrible sorrow, the grief so heavy that at times I shiver and moan under the weight of it.

Once time is lit, it will burn whether or not you're breathing it in. Even after smoke becomes air, there is the memory of smoke. I am seeing as if by the light of a match, a glimpse of my life and having it feel right.

The adrenaline rush subsides as it becomes harder to catch your breath. You become light headed, then dizzy and confused as the air runs out. Reason and sense evaporate as the darkness claims you. That is how it felt to be a Tunnel Rat.

When you love someone, they become a part of who you are. They’re in everything you do. They’re in the air you breathe and the water you drink and the blood in your veins. Their touch stays on your skin and their voice stays in your ears and their thoughts stay in your mind. You know their dreams because their nightmares pierce your heart and their good dreams are your dreams too. And you don’t think they’re perfect, but you know their flaws, the deep-down truth of them, and the shadows of all their secrets, and they don’t frighten you away; in fact you love them more for it, because you don’t want perfect. You want them.

Any major illness transforms a patient’s—really, an entire family’s—life.

Everyone succumbs to finitude. I suspect I am not the only one who reaches this pluperfect state. Most ambitions are either achieved or abandoned; either way, they belong to the past. The future, instead of the ladder toward the goals of life, flattens out into a perpetual present. Money, status, all the vanities the preacher of Ecclesiastes described, hold so little interest: a chasing after wind, indeed.

I would have to learn to live in a different way, seeing death as an imposing itinerant visitor but knowing that even if I'm dying, until I actually die, I am still living.

Grand illnesses are supposed to be life-clarifying. Instead, I knew I was going to die—but I’d known that before. My state of knowledge was the same, but my ability to make lunch plans had been shot to hell. 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?

Be ready. Be seated. See what courage sounds like. See how brave it is to reveal yourself in this way. But above all, see what it is to still live, to profoundly influence the lives of others after you are gone, by your words.

Words have a longevity I do not.

She had become so thoroughly annealed into his life that she was like the air he breathed--necessary but scarcely noticed.

Death comes for all of us. For us, for our patients: it is our fate as living, breathing, metabolizing organisms. Most lives are lived with passivity toward death -- it's something that happens to you and those around you. But Jeff and I had trained for years to actively engage with death, to grapple with it, like Jacob with the angel, and, in so doing, to confront the meaning of a life. We had assumed an onerous yoke, that of mortal responsibility. Our patients' lives and identities may be in our hands, yet death always wins. Even if you are perfect, the world isn't. The secret is to know that the deck is stacked, that you will lose, that your hands or judgment will slip, and yet still struggle to win for your patients. You can't ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving.

Diseases are molecules misbehaving; the basic requirement of life is metabolism, and death its cessation.

Putting lifestyle first is how you find a job --- not a calling.

A tureen of tragedy was best allotted by the spoonful.

So here's the truth - I love you. I love everything about you – the way you stick up for people even when it costs you. The way you keep trying to do the right thing even when you're not exactly sure what the right thing is. I love how you put words together. You're as skilled with words as any knife fighter with a blade. You can put an enemy down on his back, or you can raise people up so they find what's best in themselves. You've changed my life. You've given me the words I need to become whatever I want. I love how you talk to lytlings. You don't talk down to them. You respect them, and anybody can tell you're actually interested in what they have to say. I love the way you ride a horse – how you stick there like an upland thistle, whooping like a Demonai. I love the way you throw back your head and stomp your feet when you dance. I love how you go after what you want – whether it's kisses or a queendom. I love your skin, like copper dusted over with gold. And your eyes – they're the color of a forest lake shaded by evergreens. One of the secret places that only the Demonai know about. I love the scent of you – when you've been out in the fresh air, and that perfume you put behind your ears sometimes. Believe it or not, I even love your road smell – of sweat and horses and leather and wool. I want to breathe you in for the rest of my life.

(B)rains give rise to our ability to form relationships and make life meaningful. Sometimes, they break.

A story is alive, as you and I are. It is rounded by muscle and sinew. Rushed with blood. Layered with skin, both rough and smooth. At its core lies soft marrow of hard, white bone. A story beats with the heart of every person who has ever strained ears to listen. On the breath of the storyteller, it soars. Until its images and deeds become so real you can see them in the air, shimmering like oases on the horizon line. A story can fly like a bee, so straight and swift you catch only the hum of its passing. Or move so slowly it seems motionless, curled in upon itself like a snake in the sun. It can vanish like smoke before the wind. Linger like perfume in the nose. Change with every telling, yet always remain the same.

Openness to human relationality does not mean revealing grand truths from the apse; it means meeting patients where they are, in the narthex or nave, and bringing them as far as you can.

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.

Moral duty has weight, things that have weight have gravity.

So what tense am I living in now?

Doctors, it turns out, need hope, too.

Suffering can make us callous to the obvious suffering of another.

In taking up another’s cross, one must sometimes get crushed by the weight.

What kind of life exists without language?

Somewhere someone thinks they love someone else exactly like I love you. Somewhere someone shakes from the ripple of a thousand butterflies inside a single stomach. Somewhere someone is packing their bags to see the world with someone else. Somewhere someone is reaching through the most terrifying few feet of space to hold the hand of someone else. Somewhere someone is watching someone else’s chest rise and fall with the breath of slumber. Somewhere someone is pouring ink like blood onto pages fighting to say the truth that has no words. Somewhere someone is waiting patient but exhausted to just be with someone else. Somewhere someone is opening their eyes to a sunrise in someplace they have never seen. Somewhere someone is pulling out the petals twisting the apple stem picking up the heads up penny rubbing the rabbits foot knocking on wood throwing coins into fountains hunting for the only clover with only 4 leaves skipping over the cracks snapping the wishbone crossing their fingers blowing out the candles sending dandelion seeds into the air ushering eyelashes off their thumbs finding the first star and waiting for 11:11 on their clock to spend their wishes on someone else. Somewhere someone is saying goodbye but somewhere someone else is saying hello. Somewhere someone is sharing their first or their last kiss with their or no longer their someone else. Somewhere someone is wondering if how they feel is how the other they feels about them and if both theys could ever become a they together. Somewhere someone is the decoder ring to all of the great mysteries of life for someone else. Somewhere someone is the treasure map. Somewhere someone thinks they love someone else exactly like I love you. Somewhere someone is wrong.

Severe illness wasn’t life-altering, it was life-shattering. It felt less like an epiphany—a piercing burst of light, illuminating What Really Matters—and more like someone had just firebombed the path forward.

Yet the paradox is that scientific methodology is the product of human hands and thus cannot reach some permanent truth. We build scientific theories to organize and manipulate the world, to reduce phenomena into manageable units. Science is based on reproducibility and manufactured objectivity. As strong as that makes its ability to generate claims about matter and energy, it also makes scientific knowledge inapplicable to the existential, visceral nature of human life, which is unique and subjective and unpredictable. 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.

What happened to Paul was tragic, but he was not a tragedy.

We are never so wise as when we live in this moment.

If the weight of mortality does not grow lighter, does it at least get more familiar?

Death may be a one-time event, but living with terminal illness is a process.

Can I tell you a boring science fact?" she whispered. "I bet you didn't learn it in Shadowhunter history class." "If you're trying to distract me from talking about my feelings, you're not being very subtle about it." He touched her face. "You know I make speeches. It's okay. You don't have to make them back. Just tell me you love me," "I'm not trying to distract you." She held up her hand and wiggles the fingers. "There are a hundred trillion cells in the human body," she said. "And every single one of the cells of my body loves you. We shed cells, and grow new ones, and my new cells love you more than the old ones, which is why I love you more every day than I did before. It's science. And when I die and they burn my body and I become ashes that mix with the air, and part of the ground and the trees and the stars, everyone who breathes air of sees the flowers that grow out of the ground or looks up at the stars will remember you and love you, because I love you that much," She smiled. "How was that for a speech?

When you love someone, they become a part of who you are. They’re in everything you do. They’re in the air you breathe and the water you drink and the blood in your veins. Their touch stays on your skin and their voice stays in your ears and their thoughts stay in your mind. You know their dreams because their nightmares pierce your heart and their good dreams are your dreams too. And you don’t think they’re perfect, but you know their flaws, the deep-down truth of them, and the shadows of all their secrets, and they don’t frighten you away; in fact you love them more for it, because you don’t want perfect. You want them. You want-

Maybe, in the absence of any certainty, we should just assume that we’re going to live a long time. Maybe that’s the only way forward.

life’s meaning, its virtue, had something to do with the depth of the relationships we form.

At those critical junctures, the question is not simply whether to live or die but what kind of life is worth living.

Death, so familiar to me in my work, was now paying a personal visit.

all have a notion of what it means to be good, and we can’t live up to it all the time.

Variation on the Word Sleep I would like to watch you sleeping, which may not happen. I would like to watch you, sleeping. I would like to sleep with you, to enter your sleep as its smooth dark wave slides over my head. and walk with you through that lucent wavering forest of bluegreen leaves with its watery sun & three moons towards the cave where you must descend, towards your worst fear I would like to give you the silver branch, the small white flower, the one word that will protect you from the grief at the center of your dream, from the grief at the center. I would like to follow you up the long stairway again & become the boat that would row you back carefully, a flame in two cupped hands to where your body lies beside me, and you enter it as easily as breathing in I would like to be the air that inhabits you for a moment only. I would like to be that unnoticed & that necessary.

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?

You could not help but feel your specklike existence among the immensity of the mountain, the earth, the universe, and yet still feel your own two feet on the talus, reaffirming your presence amid the grandeur.

The word hope first appeared in English about a thousand years ago, denoting some combination of confidence and desire. But what I desired—life—was not what I was confident about—death. When I talked about hope, then, did I really mean “Leave some room for unfounded desire?” No. Medical statistics not only describe numbers such as mean survival, they measure our confidence in our numbers, with tools like confidence levels, confidence intervals, and confidence bounds. So did I mean “Leave some room for a statistically improbable but still plausible outcome—a survival just above the measured 95 percent confidence interval?” Is that what hope was? Could we divide the curve into existential sections, from “defeated” to “pessimistic” to “realistic” to “hopeful” to “delusional”? Weren’t the numbers just the numbers? Had we all just given in to the “hope” that every patient was above average? It occurred to me that my relationship with statistics changed as soon as I became one.

The funny thing about a lie is that once it has been said and believed, it lives and becomes. It can't be taken back. It sucks all the air from you until you give up and it takes over and you forget how to breathe on your own. It is like those parasitic relationships, but not like the shark and the little remora that politely cleans the shark's skin and sometimes attaches itself to its underbelly. No, it is more like a tapeworm eating someone from the inside out.

There was once an invisible man, the monster continued, though Conor kept his eyes firmly on Harry, who had grown tired of being unseen. Conor set himself into a walk. A walk after Harry. It was not that he was actually invisible, the monster said, following Conor, the room volume dropping as they passed. It was that the people had become used to not seeing him. "Hey!" Conor called. Harry didn't turn around. Neither did Sully nor Anton, though thet were still sniggering as Conor picked up his pace. And if no one sees you, the monster said, picking up its pace, too, are you really there at all? "HEY!" Conor called loudly. The dining hall had fallen silent now, as Conor and the monster moved faster after Harry. Harry who had still not turned around. Conor reached him and grabbed him by the shoulder, twisting him round. Harry pretended to question what had happened, looking hard at Sully, acting like he was the one who'd done it. "Quit messing about," Harry said and turned away again. Turned away from Conor. And then one day the invisible man decided, the monster said, its voice ringing in Conor's ears, I will make them see me. "How?" Conor asked, breathing heavily again, not turning back to see the monster standing there, not looking at the reaction of the room to the huge monster now in the midst, though he was aware of nervous murmurs and a strange anticipation in the air. "How did the man do it?" Conor could feel the monster close behind him, knew that it was kneeling, knew that it was putting its face up to his ear to whisper into in, to tell him the rest of the story. He called, it said for a monster.

There’s a place in the ocean, so deep, where not a single point of light penetrates through it. And for so long, I’ve been trapped there, unable to breathe. When I met you, you lifted me out of that darkness, and it was the first time I came up for air. You’ve become my oxygen, bella ladra, and I can no longer breathe without you.

All the idylls of youth: beauty manifest in lakes, mountains, people; richness in experience, conversation, friendships. Nights during a full moon, the light flooded the wilderness, so it was possible to hike without a headlamp. We would hit the trail at two A.M., summiting the nearest peak, Mount Tallac, just before sunrise, the clear, starry night reflected in the flat, still lakes spread below us. Snuggled together in sleeping bags at the peak, nearly ten thousand feet up, we weathered frigid blasts of wind with coffee someone had been thoughtful enough to bring. And then we would sit and watch as the first hint of sunlight, a light tinge of day blue, would leak out of the eastern horizon, slowly erasing the stars. The day sky would spread wide and high, until the first ray of the sun made an appearance. The morning commuters began to animate the distant South Lake Tahoe roads. But craning your head back, you could see the day’s blue darken halfway across the sky, and to the west, the night remained yet unconquered—pitch-black, stars in full glimmer, the full moon still pinned in the sky. To the east, the full light of day beamed toward you; to the west, night reigned with no hint of surrender. No philosopher can explain the sublime better than this, standing between day and night. It was as if this were the moment God said, “Let there be light!” You could not help but feel your specklike existence against the immensity of the mountain, the earth, the universe, and yet still feel your own two feet on the talus, reaffirming your presence amid the grandeur.

When you love someone, they become a part of who you are. They're in everything you do. They're in the air you breathe and the water you drink and the blood in your veins. Their touch stays on your skin and their voice stays in your ears and their thoughts stay in your mind. You know their dreams because their nightmares pierce your heart and their good dreams are your dreams too. And you don't think they're perfect, but you know their flaws, the deep-down truth of them, and the shadows of all their secrets, and they don't frighten you away; in fact you love them more for it, because you don't want perfect. You want them.

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. And Truth comes somewhere above all of them, where,

It is just dawn, daylight: that gray and lonely suspension filled with the peaceful and tentative waking of birds. The air, inbreathed, is like spring water. He breathes deep and slow, feeling with each breath himself diffuse in the natural grayness, becoming one with loneliness and quiet that has never known fury or despair. "That was all I wanted," he thinks, in a quiet and slow amazement. "That was all, for thirty years. That didn't seem to be a whole lot to ask in thirty years.

He knew he would never be alone, never suffer unnecessarily. At home in bed a few weeks before he died, I asked him, “Can you breathe okay with my head on your chest like this?” His answer was “It’s the only way I know how to breathe.” 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.

Relying on his own strength and the support of his family and community, Paul faced each stage of his illness with grace—not with bravado or a misguided faith that he would “overcome” or “beat” cancer but with an authenticity that allowed him to grieve the loss of the future he had planned and forge a new one. He cried on the day he was diagnosed. He cried while looking at a drawing we kept on the bathroom mirror that said, “I want to spend all the rest of my days here with you.” He cried on his last day in the operating room. He let himself be open and vulnerable, let himself be comforted. Even while terminally ill, 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.

Come back to me. Where have you gone? And why so long? I miss the star below your lip, the constellation on your chest. I miss your ways, how you net butter-flying words and release them for others to enjoy. I miss your tenderness, the sweetness of your breath and the song of your voice. I miss how you worship me. Come back to me once more. Why did you go? And whatever for? The heavens plotted against us. The clouds came and pissed on our lives. The smell of charged particles still lingers in the air. What will become of you and I? Come back to us.

I was searching for a vocabulary with which to make sense of death, to find a way to begin defining myself and inching forward again. The privilege of direct experience had led me away from literary and academic work, yet now I felt that to understand my own experiences, I would have to translate them back into language. Hemingway described his process in similar terms: acquiring rich experiences, then retreating to cogitate and write about them. I needed words to go forward.

While all doctors treat diseases, neurosurgeons work in the crucible of identity: every operation on the brain is, by necessity, a manipulation of the substance of our selves, and every conversation with a patient undergoing brain surgery cannot help but confront this fact. In addition, to the patient and family, the brain surgery is usually the most dramatic event they have ever faced and, as such, has the impact of any major life event. At those critical junctures, the question is not simply whether to live or die but what kind of life is worth living. 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 in 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?

Love is like air, babe. It's there all the time, and you don't even think about it,or you take it for granted. Then all of a sudden, you need it, or you can't breathe. You inhale, and for the first time you're aware it's keeping you alive. You feel it brush your skin all the time. Sometimes it's warm and other times it's cool, but it's there surrounding you, feeding you, holding you. When you finally realize it's love, you become vulnerable. With that new fear of not having air, you subconsciously allow someone special to breathe life for you.

If you believe that science provides not basis for God, then you are almost obligated to conclude that science provides no basis for meaning and, there for, life itself doesn't have any. In other words, existential claims have no weight; all knowledge is scientific knowledge. Yet the paradox is that scientific methodology is the product of human hands and thus cannot reach some permanent truth. We build scientific theories to organize and manipulate the world, to reduce phenomena into manageable units. Science is based on reproducibility and manufactured objectivity. As strong as that makes its ability to generate claims about matter and energy, it also makes scientific knowledge inapplicable to the existential, visceral nature or human life, which is unique and subjective and unpredictable. Science may provide the most useful may 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.

The temperature jumped another ninety degrees. Why couldn't anyone see in my life how awesome Noah was? I shoved up my sleeves, welcoming the cold air on my skin. "Echo, stop!" Ashley propelled her self out of the gliter. I froze and then remembered Ashley was damaged. I was going on a date, not to Vegas to elope. Noah's strong hand slipped over my wrist before he entwined his fingers with mine. The sensation of warm flesh against an area I allowed no one to see, much less touch, caused me to shiver. My eyes widened, realizing my mistake. This is what had freaked Ashley out. What had come over me? I never pulled up my sleeves. I spent all my time pulling them down. When had I become...comfortable? He rubbed his thumb over my hand. "I planned on taking her to my house to meet some of my friends." Noah could have told them he was getting me to the ghetto to buy us crack and they wouldn't have heard him. Ashley stood in place, staring at my exposed scars as my father stared at our combined hands. I reached over to pull down my sleeve, but Noah casually placed his hand over my forearm, preventing me fron doing it. My lungs squeezed out all the oxygen in my body. Noah Hutchins, in fact, a human being, was overtly, on purpose, touching my scars. I'd stopped breathing moments ago, as had Ashley. Noah continued as nothing earth-shattering had happened. "What time does Echo need to be home?" Blinking my self back to life, i answered for them, "My curfew is eleven." "Twelve." My father stood and extended his hand. "I didn't have a chance to properly introduce myself earlier. I'm Owen Emerson.

It is a common belief that we breathe with our lungs alone, but in point of fact, the work of breathing is done by the whole body. The lungs play a passive role in the respiratory process. Their expansion is produced by an enlargement, mostly downward, of the thoracic cavity and they collapse when that cavity is reduced. Proper breathing involves the muscles of the head, neck, thorax, and abdomen. It can be shown that chronic tension in any part of the body's musculature interferes with the natural respiratory movements. Breathing is a rhythmic activity. Normally a person at rest makes approximately 16 to 17 respiratory incursions a minute. The rate is higher in infants and in states of excitation. It is lower in sleep and in depressed persons. The depth of the respiratory wave is another factor which varies with emotional states. Breathing becomes shallow when we are frightened or anxious. It deepens with relaxation, pleasure and sleep. But above all, it is the quality of the respiratory movements that determines whether breathing is pleasurable or not. With each breath a wave can be seen to ascend and descend through the body. The inspiratory wave begins deep in the abdomen with a backward movement of the pelvis. This allows the belly to expand outward. The wave then moves upward as the rest of the body expands. The head moves very slightly forward to suck in the air while the nostrils dilate or the mouth opens. The expiratory wave begins in the upper part of the body and moves downward: the head drops back, the chest and abdomen collapse, and the pelvis rocks forward. Breathing easily and fully is one of the basic pleasures of being alive. The pleasure is clearly experienced at the end of expiration when the descending wave fills the pelvis with a delicious sensation. In adults this sensation has a sexual quality, though it does not induce any genital feeling. The slight backward and forward movements of the pelvis, similar to the sexual movements, add to the pleasure. Though the rhythm of breathing is pronounced in the pelvic area, it is at the same time experienced by the total body as a feeling of fluidity, softness, lightness and excitement. The importance of breathing need hardly be stressed. It provides the oxygen for the metabolic processes; literally it supports the fires of life. But breath as "pneuma" is also the spirit or soul. We live in an ocean of air like fish in a body of water. By our breathing we are attuned to our atmosphere. If we inhibit our breathing we isolate ourselves from the medium in which we exist. In all Oriental and mystic philosophies, the breath holds the secret to the highest bliss. That is why breathing is the dominant factor in the practice of Yoga.

When you love someone, they become a part of who you are. They're in everything you do. They're the air you breathe and the water you drink and the blood in your veins. Their touch stays on your skin and their voice stays in your ears and their thoughts stay in your mind. You know their dreams because their nightmares pierce your heart and their good dreams are your dreams too. And they don't think they're perfect, but you know their flaws, the deep-down truths of them, and the shadows of all their secrets, and they don't frighten you away; in fact, you love them more for it, because you don't want perfect. You want them.

Do not miss me, because I will always be with you. In every drop of rain that touches your tongue, in every breath of air you inhale. In the tips of the leaves that you brush with your fingertips as you pass by. I will be there, in every moment. I am not gone, I am only altered, from this state of matter to another. For a moment, for too brief a moment, I was the man that loved you, but now that I am changed, I am the air, the moon, the stars. For we are all made of stars, my beloved. You and I, and all of life, we were all born out of the death of a star, millions of billions of years ago. A star that lived long and then, before its death, burned at its brightest, its fiercest - an enflaming supernova. But when it died, it did not cease to exist; instead everything it was made of became part of the universe once again, and everything that is part of the universe will once more become part of us. So do not miss me, because I do not die; I transform - into the wind in the tops of the trees, the wave on the ocean, the pebbles under your foot, the dust on your bookshelves, the midnight sky. Wherever you look, I will be there.

It seemed to work at first. I tried hard to forget, but there remained inside me a vague knot-of-air kind of thing. And as time went by, the knot began to take on a clear and simple form, a form that I am able to put into words, like this: Death exists, not as the opposite but as a part of life. Translate into words, it's a cliche, but at the time I felt it not as words but as that knot of air inside me. Death exists - in a paperweight, in four red and white balls on a billiard table - and we go on living and breathing it into our lungs like fine dust. Until that time, I had understood death as something entirely separate from and independent of life. The hand of death is bound to take us, I had felt, but until the day it reaches out for us, it leaves us alone. This had seemed to me the simple, logical truth. Life is here, death is over there. I am here, not over there. The night Kizuki died, however, I lost the ability to see death (and life) in such simple terms. Death was not the opposite of life. It was already here, within my being, it had always been here, and no struggle would permit me to forget that... I lived through the following spring...with that kind knot of air in my chest, but I struggled all the while against becoming serious. Becoming serious was not the same thing as approaching truth, I sensed, however vaguely. But death was a fact, a serious fact, no matter how you looked at it. stuck inside this suffocating contradiction, I went on endlessly spinning in circles...In the midst of life, everything revolved around death.

1. WE'VE LEFT SHORE SOMEHOW BECOME THE FRIENDS OF EARLY THEORY CLOSE ENOUGH TO SPEAK DESIRE AND PAIN OF ABSENCE OF MISTAKES WE'D MAKE GIVEN THE CHANCE. EACH SMILE RETURNED MAKES HARDER AVOIDING DREAMS THAT SEE US LYING IN EARLY EVENING CURTAIN SHADOWS, SKIN SAFE AGAINST SKIN. BLOOM OF COMPASSION RESPECT FOR MOMENTS EYES LOCK TURNS FOREVER INTO ONE MORE VEIL THAT FALLS AWAY. 2. THIS AFTER SEEING YOU LAST NIGHT, FIRST TIME SMELLING YOU WITH PERMISSION: SHOULDERS TO WONDER OPENLY AT AS CAREFULLY KISSED AS THOSE ARMS WAITED IMPOSSIBLY ON. THEY'VE HELD ME NOW AND YOUR BREATH DOWN MY BACK SENT AWAY NIGHT AIR THAT HAD ME SHAKING IN THE UNLIT ANGLICAN DOORWAY. 3. ARE WE RUINED FOR FINDING OUR FACES FIT AND WANT TO KNOW MORE ABOUT MORNING? IS FRIENDSHIP CANCELLED IF WE CAN'T CALL EACH OTHER ANYMORE IN AMNESIA, INVITE OURSELVES TO LAST GLANCES UNDER SUSPICIOUS CLOCKS TELLING US WHEN WE'VE HAD ENOUGH? 4. YOUR STEADY HANDS CRADLING MY GRATEFUL SKULL: WERE YOU TAKING IN MY FACE TO SAVE AN IMAGE YOU'VE RARELY ALLOWED YOURSELF AFTER LEAVING THAT COLD ALCOVE? AM I A PHOTOGRAPH YOU GAZE AT IN MOMENTS OF WEAKNESS? YOU ORDERED ME OFF MY KNEES INTO YOUR ARMS. WASN'T TO BEG THAT I KNELT; ONLY TO SEE YOU ONCE FROM BELOW. TRIED TO SAY SOMETHING THAT FILLED MY MOUTH AND LONGED TO REST IN YOUR EAR. DON'T DARE WRITE IT DOWN FOR FEAR IT'LL BECOME WORDS, JUST WORDS.

At those critical junctures, the question is not simply whether to live or die but what kind of life is worth living. 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 in exchange for the small possibility of a fatal brain hemorrhage? Your right hand's function to stop seizures? How much neurological 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?

Amo amas amat amamus amatis amant amavi amavisti amavit amavimus amavistis amaverunt amavero amaveris amaverit… Everything was love. Everything will be love. Everything has been love. Everything would be love. Everything would have been love. Ah, that was it, the truth at last. Everything would have been love. The huge eye, which had become an immense sphere, was gently breathing, only it was not an eye nor a sphere but a great wonderful animal covered in little waving legs like hairs, waving oh so gently as if they were under water. All shall be well and all shall be well said the ocean. So the place of reconciliation existed after all, not like a little knot hole in a cupboard but flowing everywhere and being everything. I had only to will it and it would be, for spirit is omnipotent only I never knew it, like being able to walk on the air. I could forgive. I could be forgiven. I could forgive. Perhaps that was the whole of it after all. Perhaps being forgiven was just forgiving only no one had ever told me. There was nothing else needful. Just to forgive. Forgiving equals being forgiven, the secret of the universe, do not whatever you do forget it. The past was folded up and in the twinkling of an eye everything had been changed and made beautiful and good.

I have heard people suggest that because humans are natural that everything humans do or create is natural. Chainsaws are natural. Nuclear bombs are natural. Our economics is natural. Sex slavery is natural. Asphalt is natural. Cars are natural. Polluted water is natural. A devastated world is natural. A devasted phyche is natural. Unbridled exploitation is natural. Pure objectification is natural. This is, of course, nonsense. We are embedded in the natural world. We evolved as social creatures in this natural world. We require clean water to drink, or we die. We require clean air to breathe, or we die. We require food, or we die. We require love, affection, social contact in order to become our full selves. It is part of our evolutionary legacy as social creatures. Anything that helps us to understand all of this is natural: Any ritual, artifact, process, action is natural, to the degree that it reinforces our understanding of our embeddedness in the natural world, and any ritual, artifact, process, action is unnatural, to the degree that it does not

...we're a people who pollute the very air we breathe. And our rivers. We're destroying the great lakes; Erie is already gone, and now we've begun on the oceans. We filled our atmosphere with radioactive fallout that put poison into our children's bones, and we knew it. We've made bombs that can wipe out humanity in minutes, and they are aimed and ready to fire. We ended polio, and then the United States Army bred new strains of germs that can cause fatal, incurable disease. We had a chance to do justice to our Negroes, and when they asked it, we refused. In Asia we burned people alive, we really did. We allow children to grow up malnourished in the United States. We allow people to make money by using our television channels to pursued our own children to smoke, knowing what it is going to do to them. This is a time when it becomes harder and harder to continue telling yourself that we are still good people. We hate each other. And we're used to it.

Dalinar took one step forward, then drove his Blade point-first into the middle of the blackened glyph on the stone. He took a step back. “For the bridgemen,” he said. Sadeas blinked. Muttering voices fell silent, and the people on the field seemed too stunned, even, to breathe. “What?”Sadeas asked. “The Blade,”Dalinar said, firm voice carrying in the air. “In exchange for your bridgemen. All of them. Every one you have in camp. They become mine, to do with as I please, never to be touched by you again. In exchange, you get the sword.” Sadeas looked down at the Blade, incredulous. “This weapon is worth fortunes. Cities, palaces, kingdoms.” “Do we have a deal?”Dalinar asked. “Father, no!”Adolin Kholin said, his own Blade appearing in his hand. “You—” Dalinar raised a hand, silencing the younger man. He kept his eyes on Sadeas. “Do we have a deal?” he asked, each word sharp. Kaladin stared, unable to move, unable to think. Sadeas looked at the Shardblade, eyes full of lust. He glanced at Kaladin, hesitated just briefly, then reached and grabbed the Blade by the hilt. “Take the storming creatures.” Dalinar nodded curtly, turning away from Sadeas. “Let’s go,”he said to his entourage. “They’re worthless, you know,”Sadeas said. “You’re of the ten fools, Dalinar Kholin! Don’t you see how mad you are? This will be remembered as the most ridiculous decision ever made by an Alethi highprince!” Dalinar didn’t look back. He walked up to Kaladin and the other members of Bridge Four. “Go,” Dalinar said to them, voice kindly. “Gather your things and the men you left behind. I will send troops with you to act as guards. Leave the bridges and come swiftly to my camp. You will be safe there. You have my word of honor on it.” He began to walk away. Kaladin shook off his numbness. He scrambled after the highprince, grabbing his armored arm. “Wait. You—That—What just happened?” Dalinar turned to him. Then, the highprince laid a hand on Kaladin’s shoulder, the gauntlet gleaming blue, mismatched with the rest of his slate-grey armor. “I don’t know what has been done to you. I can only guess what your life has been like. But know this. You will not be bridgemen in my camp, nor will you be slaves.” “But…” “What is a man’s life worth?” Dalinar asked softly. “The slavemasters say one is worth about two emerald broams,” Kaladin said, frowning. “And what do you say?” “A life is priceless,” he said immediately, quoting his father. Dalinar smiled, wrinkle lines extending from the corners of his eyes. “Coincidentally, that is the exact value of a Shardblade. So today, you and your men sacrificed to buy me twenty-six hundred priceless lives. And all I had to repay you with was a single priceless sword. I call that a bargain.” “You really think it was a good trade, don’t you?” Kaladin said, amazed. Dalinar smiled in a way that seemed strikingly paternal.

Cinder." Kai pulled one leg onto the bank, turning his body so they were facing each other. He took her hands between his and her heart began to drum unexpectedly. Not because of his touch, and not even because of his low, serious tone, but because it occurred to Cinder all at once that Kai was nervous. Kai was never nervous. "I asked you once," he said, running his thumbs over her knuckles, "if you thought you would ever be willing to wear a crown again. Not as the queen of Luna, but ... as my empress. And you said that you would consider it, someday." She swallowed a breath of cool night air. "And ... this is that day?" His lips twitched, but didn't quite become a smile. "I love you. I want to be with you for the rest of my life. I want to marry you, and, yes, I want you to be my empress." Cinder gaped at him for a long moment before she whispered, "That's a lot of wanting." "You have no idea." She lowered her lashes. "I might have some idea." Kai released one of her hands and she looked up again to see him reaching into his pocket - the same that had held Wolf's and Scarlet's wedding rings before. His fist was closed when he pulled it out and Kai held it toward her, released a slow breath, and opened his fingers to reveal a stunning ring with a large ruby ringed in diamonds. It didn't take long for her retina scanner to measure the ring, and within seconds it was filling her in on far more information than she needed - inane worlds like carats and clarity scrolled past her vision. But it was the ring's history that snagged her attention. It had been his mother's engagement ring once, and his grandmother's before that. Kai took her hand and slipped the ring onto her finger. Metal clinked against metal, and the priceless gem looked as ridiculous against her cyborg plating as the simple gold band had looked on Wolf's enormous, deformed, slightly hairy hand. Cinder pressed her lips together and swallowed, hard, before daring to meet Kai's gaze again. "Cinder," he said, "will you marry me?" Absurd, she thought. The emperor of the Eastern Commonwealth was proposing to her. It was uncanny. It was hysterical. But it was Kai, and somehow, that also made it exactly right. "Yes," she whispered. "I will marry you." Those simple words hung between them for a breath, and then she grinned and kissed him, amazed that her declaration didn't bring the surge of anxiety she would have expected years ago. He drew her into his arms, laughing between kisses, and she suddenly started to laugh too. She felt strangely delirious. They had stood against all adversity to be together, and now they would forge their own path to love. She would be Kai's wife. She would be the Commonwealth's empress. And she had every intention of being blissfully happy for ever, ever after.

There was music from my neighbor's house through the summer nights. In his blue gardens men and girls came and went like moths among the whisperings and the champagne and the stars. At high tide in the afternoon I watched his guests diving from the tower of his raft, or taking the sun on the hot sand of his beach while his two motor-boats slit the waters of the Sound, drawing aquaplanes over cataracts of foam. On week-ends his Rolls-Royce became an omnibus, bearing parties to and from the city between nine in the morning and long past midnight, while his station wagon scampered like a brisk yellow bug to meet all trains. And on Mondays eight servants, including an extra gardener, toiled all day with mops and scrubbing-brushes and hammers and garden-shears, repairing the ravages of the night before. Every Friday five crates of oranges and lemons arrived from a fruiterer in New York--every Monday these same oranges and lemons left his back door in a pyramid of pulpless halves. There was a machine in the kitchen which could extract the juice of two hundred oranges in half an hour if a little button was pressed two hundred times by a butler's thumb. At least once a fortnight a corps of caterers came down with several hundred feet of canvas and enough colored lights to make a Christmas tree of Gatsby's enormous garden. On buffet tables, garnished with glistening hors-d'oeuvre, spiced baked hams crowded against salads of harlequin designs and pastry pigs and turkeys bewitched to a dark gold. In the main hall a bar with a real brass rail was set up, and stocked with gins and liquors and with cordials so long forgotten that most of his female guests were too young to know one from another. By seven o'clock the orchestra has arrived, no thin five-piece affair, but a whole pitful of oboes and trombones and saxophones and viols and cornets and piccolos, and low and high drums. The last swimmers have come in from the beach now and are dressing up-stairs; the cars from New York are parked five deep in the drive, and already the halls and salons and verandas are gaudy with primary colors, and hair shorn in strange new ways, and shawls beyond the dreams of Castile. The bar is in full swing, and floating rounds of cocktails permeate the garden outside, until the air is alive with chatter and laughter, and casual innuendo and introductions forgotten on the spot, and enthusiastic meetings between women who never knew each other's names. The lights grow brighter as the earth lurches away from the sun, and now the orchestra is playing yellow cocktail music, and the opera of voices pitches a key higher. Laughter is easier minute by minute, spilled with prodigality, tipped out at a cheerful word. The groups change more swiftly, swell with new arrivals, dissolve and form in the same breath; already there are wanderers, confident girls who weave here and there among the stouter and more stable, become for a sharp, joyous moment the centre of a group, and then, excited with triumph, glide on through the sea-change of faces and voices and color under the constantly changing light. Suddenly one of the gypsies, in trembling opal, seizes a cocktail out of the air, dumps it down for courage and, moving her hands like Frisco, dances out alone on the canvas platform. A momentary hush; the orchestra leader varies his rhythm obligingly for her, and there is a burst of chatter as the erroneous news goes around that she is Gilda Gray's understudy from the FOLLIES. The party has begun.