"Throughout college, my monastic, scholarly study of human meaning would conflict with my urge to forge and strengthen the human relationships that formed that meaning. If the unexamined life was not worth living, was the unlived life worth examining?"

"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."

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

“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.”

“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.”

"You would think that the first time you cut up a dead person, you'd feel a bit funny about it. Strangely, though, everything feels normal. The bright lights, stainless steel tables, and bow-tied professors lead an air of propriety. Even so, the first cut, running from the nape of the neck down to the small of the back, is unforgettable."

"For amid that unique suffering invoked by severe brain damage, the suffering often felt more by families than by patients, it is not merely the physicians who do not see the full significance. The families who gather around their beloved—their beloved whose sheared heads contained battered brains—do not usually recognize the full significance, either."

"The root of disaster means a star coming apart, and no image expresses better the look in a patient's eye when hearing a neurosurgeon's diagnosis. Sometimes the news so shocks the mind that the brain suffers an electrical short."

"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."

"Flush in the face of mortality, many decisions become compressed, urgent and unreceding. Foremost among them for us: Should Lucy and I have a child?"

"My own hubris as a surgeon stood naked to me now: as much as I focused on my responsibility and power over patients' lives, it was at best a temporary responsibility, a fleeting power. Once an acute crisis has been resolved, the patient awakened, extubated, and then discharged, the patient and family go on living—and things are never quite the same."