When Breath Becomes Air

Seven months after returning to surgery, Paul has his last CT scan of the residency and the last one he’ll receive before becoming a father. He doesn’t have time to review the scan before heading back to his work obligations. While reviewing them on his own, later, he recognizes a new tumor has developed.

He returns home to tell Lucy. Together, they map out what appointments they’ll need to make for Paul. He’s not sure he’ll be able to return to neurosurgery after the next round of treatments, but he’s got to go to work tomorrow, as he’s already prepared for the day’s proceedings.

The next morning is business as usual. He spends extra time with Mr. R, a patient who developed Gerstmann’s syndrome after having his brain tumor removed. Despite his cognitive impairments (inability to write or do arithmetic, among other things), Mr. R will likely make a full recovery.

He scrubs for what might be the last time of his career and enters the OR to work on what might be the last patient of his career. In the middle of the procedure his back begins to ache. The attending makes an error, accidentally cutting into the dura, which adds an hour to the surgery time.