Elise

“Out of my thoughts! You are part of my existence, part of myself. You have been in every line I have ever read since I first [met you]. You have been in every prospect I have ever seen since,—on the river, on the sails of the ships, on the marshes, in the clouds, in the light, in the darkness, in the wind, in the woods, in the sea, in the streets. You have been the embodiment of every graceful fancy that my mind has ever become acquainted with. The stones of which the strongest London buildings are made are not more real, or more impossible to be displaced by your hands, than your presence and influence have been to me, there and everywhere, and will be. Estella, to the last hour of my life, you cannot choose but remain part of my character, part of the little good in me, part of the evil. But, in this separation, I associate you only with the good; and I will faithfully hold you to that always, for you must have done me far more good than harm, let me feel now what sharp distress I may.”
― Charles Dickens, Great Expectations

“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?”
― Paul Kalanithi, When Breath Becomes Air

“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.”
― Paul Kalanithi, When Breath Becomes Air

“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.”
― Paul Kalanithi, When Breath Becomes Air