When Breath Becomes Air by Paul Kalanithi

When Breath Becomes Air by Paul Kalanithi
Published by Random House on January 12, 2016
Genres: [Adult] Nonfiction, Autobiography, Memoir
Pages: 208
Format: Hardcover –> eBook
Source: Purchased –> Borrowed

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5 Stars, Completed January 8, 2017

– SPOILER free –

When Breath Becomes Air shares the story of Paul Kalanithi, an exceptional and gifted neurosurgeon that found his life upended while in his last year of residency when signs of illness started to appear. After medical tests, it was discovered that he, in fact, had stage IV metastatic lung cancer. With his life no different from a ticking clock, he began to ask questions that would confront his mortality. What should he do with the remaining time he has left? Should he return to neurosurgery, or should he write? Should he and his wife, Lucy, have children? In this memoir, Kalanithi answers these questions (and provides responses to many more) by taking readers along his trek of leading a life as (some days) a doctor, (most days) a patient, and (everyday) a human desperate to stay alive.

Literature not only illuminated another’s experience, it provided, I believed, the richest material for moral reflection. My brief forays into the formal ethics of analytic philosophy felt dry as a bone, missing the messiness and weight of real human life.

Autobiographies/memoirs can be a bit of a hit or miss for me, owing to the fact that most seem to be written by those that aren’t so adept with writing. Because of Kalanithi’s love and appreciation for literature from an early age and the fact that he’s earned several degrees in English (on top of his academic accomplishments in science and medicine), his writing was not only very good but beautiful and poetic like the writers and poets he quoted so often. Combined with the subject matter and Kalanithi’s interesting life story, the well written prose only made my level of interest peak higher.

I also really liked that readers could feel the imperceptible shift of urgency towards the later half of the book; Kalanithi’s narrative felt even more strong and polished by that stage (even though I imagine he was more physically weak then than when he started drafting the book). Something else that should, in addition, be appreciated and not overlooked is his wife’s simple but touching epilogue that chronicles his transformation pre-diagnosis to his decline and their daughter’s birth and up to his last breath. (I shed the most hot tears with her section.)

Don’t think I ever spent a minute of any day wondering why I did this work, or whether it was worth it. The call to protect life—and not merely life but another’s identity; it is perhaps not too much to say another’s soul—was obvious in its sacredness. 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.

You would think that this book would only appeal to a certain type of audience. Perhaps those that have battled or are battling a terminal illness, those that have experienced death around them, or those that like books pertaining to medicine. But really, this is one that I would recommend for everyone, and I especially believe this should be required reading for all students that plan on becoming future health care professionals.

When Breath Becomes Air is obviously a book on death and dying, but more importantly it’s about preserving life as well. Kalanithi doesn’t withhold sharing the tremendous responsibilities, pressures, struggles, and limitations that doctors face in their line of work from readers. He doesn’t sugarcoat or romanticize being a neurosurgeon, and readers witness this not only through his personal experiences but also the glimpses they get of his colleagues and friends’ lives. And differing from other medical memoirs I’ve read, the rare empathy that Kalanithi possesses by filling the role of both doctor and patient provides extra clarity and makes this memoir particularly insightful and worth reading.

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.

This review can’t get anymore redundant but I’ll say it again. This book will be relatable to all readers on so many levels. As Dr. Kalanithi points out often in this, death is inevitable and it will come for us all at some point. It is morbid to think about but it is the truth. With this book, he relays that among our daily duties and aspirations, it’s also important to question whether we’re leading meaningful lives. Sometimes we’re so caught up with working towards the future, that the in-the-moment present is often neglected. Reading books such as this one definitely makes one put his/her life into perspective.

What patients seek is not scientific knowledge doctors hide, but existential authenticity each must find on her own. Getting too deep into statistics is like trying to quench a thirst with salty water. The angst of facing mortality has no remedy in probability.

I remember the moment when my overwhelming uneasiness yielded. Seven words from Samuel Beckett, a writer I’ve not even read that well, learned long ago as an undergraduate, began to repeat in my head, and the seemingly impassable sea of uncertainty parted: “I can’t go on. I’ll go on.” I took a step forward, repeating the phrase over and over: “I can’t go on. I’ll go on.” And then, at some point, I was through.

Finally to sum this review up, I can’t recall exactly where I saw this but someone once excellently described When Breath Becomes Air as the “universal donor” kind of book. Indeed, it is no doubt a sad, but affecting, memorable, and important memoir that everyone should pick up at least once in their life. The honest and earnest meditations that Kalanithi has left for the world in this unfinished memoir was certainly a gift to us all. As Abraham Verghese mentioned in the foreword, readers do not need to have meet Paul to know that he was an extraordinary, great man.

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As I read When Breath Becomes Air and even after I completed it, I listened and read a lot of interesting interviews and articles. I’ll link a couple below for your perusal.

https://med.stanford.edu/news/all-news/one-to-one/2015/days-are-long-years-are-short-paul-kalanithi.html
http://stanmed.stanford.edu/2015spring/before-i-go.html
http://paulkalanithi.com/tag/interviews/
http://www.npr.org/sections/health-shots/2016/02/12/466189316/inside-a-doctors-mind-at-the-end-of-his-life

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