What if you die in 22 months..
Paul Kalanithi died 22 months after getting diagnosed with stage IV lung cancer. He was only 36 years old...
22 months from today is Wednesday, March 4, 2026.
Paul Kalanithi died 22 months after getting diagnosed with stage IV lung cancer. His book, “When Breath Becomes Air”, was published posthumously.
He was 36 years old, a respected neurosurgeon and neuroscientist at Standford University.
But one phone evaporated his forty-year plan in an instant.
As he writes:
“My life had been building potential, potential that would now go unrealized. I had planned to do so much, and I had come so close. I was physically debilitated, my imagined future and my personal identity collapsed, and I faced the same existential quandaries my patients faced. The lung cancer diagnosis was confirmed. My carefully planned and hard-won future no longer existed.”
You see Paul never thought he’d die young. Like many of us, he spent hours, weeks, and years planning his whole life. In his grand master plan, there wasn’t room for lung cancer or death for that matter.
Paul spent many years studying the perennial questions of life. He completed his MA in English literature. Then chose to pursue medicine because he felt medicine brought him closer to death and to answering the question of meaning.
Despite his continual contact with life and death on the operating table, he didn’t face his mortality until after his terminal diagnosis. This is most evident in this section:
Death, so familiar to me in my work, was now paying a personal visit. Here we were, finally face-to-face, and yet nothing about it seemed recognizable. Standing at the crossroads where I should have been able to see and follow the footprints of the countless patience I had treated over the years, I saw instead only a blank, a harsh vacant, gleaming white desert, as if a sandstorm had erased all trace of familiarity.
This is a slice of what it feels like when you first attempt to confront your mortality. What Paul’s terminal illness did was make him honest.
You quickly realize that abstractly talking about death vs. standing face-to-face with death are two different things.

“Like my own patients, I had to face my mortality and try to understand what made my life worth living… torn between being a doctor and being a patient, delving into medical science and turning back to literature for answers, I struggled, while facing my own death, to rebuild my old life—or perhaps find a new one.”
You can feel his anxiety and frustration. What should he do now? Does his life have meaning? Did he do the right thing? These questions haunted him as they did to his mentor/friend V when V was diagnosed with pancreatic cancer.
Here were two men: one at the height of his career and the other full of potential. Each respectively was gaining enormous prestige. Ready to take on the world. But… the possibility of death interrupted their master plans.
V recovered from his cancer and continued executing his gameplan. But Paul did not recover.
Death doesn’t discriminate between old or young, rich or poor, celebrity or beggar, teeming with potential or lacking any.
Death goes where it pleases without asking permission.
Near the end of the book, Paul concludes with this:
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.
We’re all like Paul in many ways we don’t think death is coming any time soon. How could it? We’ve got plans to execute, places to visit, things to accomplish, medals to win!
We’re caught up in the vanities.
But we know death will make us honest so instead we distract ourselves with noise and busyness. We delude ourselves into believing that death is something that happens to others but not us!
Yet, there’s a small voice inside us continually reminding us of our finiteness…
So we do everything possible to prevent death.
We become obsessed with staying young forever. We spend thousands of dollars on supplements and gadgets to help us heal faster, stay leaner, and become stronger. Just to slow down ageing in hopes that it will delay death from knocking…
But Paul's story is a reminder for us that all of us have a terminal diagnosis: our inevitable death. The only difference is that Paul knew he had a few months to live, while we, on the other hand, don’t have a clue…
Don’t wait to be thrown into chaos to reflect on your mortality.
Plan for the future knowing well that death is a once-in-a-lifetime event. Contemplate your death, so that you live a life worthy of all the moments you experience from now onwards.
Plan for the future knowing this moment is the only certainty.
Seek truth, and live honestly.
Philosophy itself is nothing but a meditation upon death: we must think about it often to do it well but once.
— Baltasar Gracián
Till next week,
Peace!