Paul Kalanithi’s “When Breath Becomes Air”

Synopsis: At the age of thirty-six, on the verge of completing a decade’s worth of training as a neurosurgeon, Paul Kalanithi was diagnosed with stage IV lung cancer. One day he was a doctor making a living treating the dying, and the next he was a patient struggling to live. Just like that, the future he and his wife had imagined evaporated. When Breath Becomes Air, which features a Foreword by Dr. Abraham Verghese and an Epilogue by Kalanithi’s wife, Lucy, chronicles Kalanithi’s transformation from a naïve medical student “possessed,” as he wrote, “by the question of what, given that all organisms die, makes a virtuous and meaningful life” into a young neurosurgeon at Stanford, guiding patients toward a deeper understanding of death and illness, and finally into a patient and a new father to a baby girl, confronting his own mortality.

What makes life worth living in the face of death? What do you do when the future, no longer a ladder toward your goals in life, flattens out into a perpetual present? What does it mean to have a child, to nurture a new life as another fades away? These are some of the questions Kalanithi wrestles with in this profoundly moving, exquisitely observed memoir.

Outlook: I admit, I had a personal investment in this book.  When I say I have a personal investment, it is because I had the honour and privilege of being by my father’s death-bed as he passed from leukemia.  Seeing the things I had seen, I wanted to know how Paul and his family dealt with the same thing.  A killing blow from cancer.  I wanted to see in the mind of someone who was not only a patient, but a doctor.  How would someone with terminal cancer react, when knowing the science behind their disease? What I found out through reading Paul’s book, is that like you and I, they are human.

When Breath Becomes Air summarizes Paul’s entire life.  From early child hood, to university, to interning, to his wife Lucy, and finally diagnosis and death.  I found it odd, but powerful, to hold once again someones entire life in my hand.  Moreover, the life of a neurosurgeon and one that was no longer with us.

Before becoming an MD, Paul received his Masters in English Literature from Stanford.  But deep in the back of his mind, he couldn’t stop thinking about death.  He was fascinated by it, almost becoming obsessed.  It was during this realization he decided to go back to school, to become a doctor.  While attending medical school, it was neurology that pulled him in.  What better way to learn about life and death, than immersing yourself into the human psyche.

Paul’s book was unfinished at the time of his death, but through his writing you can see that he simply had said everything that needed to be said, and the time he had left was going to be spent with his family.  Specifically, spending the last bit of strength he had, holding his newborn daughter, Cady.

It’s interesting how doctors always say “think positive” as being strong-willed goes against everything science says.  If the tests say it’s time, then it should be time.  Why do people who say “Nope, not today!” live longer? Could Paul have gotten more time if he didn’t spend his whole life being fascinated by death? Subconsciously, maybe he felt this was the best way he could experience it.  To truly know death, one must die.  I believe this is only part of it.  When Paul looked at his scans, it is clear to see that he would not survive.  No matter how positive you think.  When cancer has spread to the whole body and brain, it all comes down to time. 

Eventually, Paul was so weak and his fingers so exposed from the medications and chemo, that he wore gloves to keep writing.  He got his English Lit degree to become a writer, and in the final year of his life that is exactly what he became.

The memoir finishes with an epilogue from Lucy.  A doctor herself, and also a fantastic writer.  She has a marvellous way with words, painting a sharp picture in your mind of her love for Paul, and Paul’s love for his family.

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2 thoughts on “Paul Kalanithi’s “When Breath Becomes Air”

  1. Lisa Ralph, Cries from an unkempt garden says:

    Wow, Powerful a little teary eyed here. You sharing your personal investment in the book was inspiring, yet sad. What an incredible look inside the mind of the doctor himself, and his own diagnosis. Getting to read of his own personal struggles, what a great find! I have had many a friend like you sit at their parents bedside as they too were in wait for their release from the pains of cancer. Sorry for your loss Mark. Thank you for sharing a great read with us. Very well written review. I love to read, I read all the time. I read these that you write, and am not so sure I could put words together in such a way that would do justice to any book. Have a great day!

    Liked by 1 person

  2. Jade says:

    Witnessing the pains of a loved one is never easy, and I’m sorry that you had to go through that. Excellent review of a powerful memoir, Mark. Thanks for introducing me to this book. 🙂

    Liked by 1 person

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