When Breath Becomes Air

When Breath Becomes Air by Paul Kalanithi

Length: 208 Pages

Recommended reader age: Adult

Publisher: Random House, 2016

Genre: Memoir


About the author:

Paul Kalanithi was an American neurosurgeon and writer, born to Indian parents in the USA 

His book “When Breath Becomes Air” is a memoir about his life and illness battling stage IV metastatic lung cancer and was posthumously published by Random House in January 2016. It was on The New York Times Non-Fiction Best Sellers list for multiple weeks.

He has also published 4 essays on the subject of being both a patient and a physician, as well as the joy that can be found even when facing death. He is also the author of multiple scientific papers.

Read more about him here.

For readers of Atul Gawande, Andrew Solomon, and Anne Lamott, a profoundly moving, exquisitely observed memoir by a young neurosurgeon faced with a terminal cancer diagnosis who attempts to answer the question ‘What makes a life worth living?’

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 treating the dying, and the next he was a patient struggling to live. And just like that, the future he and his wife had imagined evaporated. When Breath Becomes Air 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 neurosurgeon at Stanford working in the brain, the most critical place for human identity, and finally into a patient and new father 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.

Paul Kalanithi died in March 2015, while working on this book, yet his words live on as a guide and a gift to us all. “I began to realize that coming face to face with my own mortality, in a sense, had changed nothing and everything,” he wrote. “Seven words from Samuel Beckett began to repeat in my head: ‘I can’t go on. I’ll go on.'” When Breath Becomes Air is an unforgettable, life-affirming reflection on the challenge of facing death and on the relationship between doctor and patient, from a brilliant writer who became both. “

My Thoughts:

This book was somewhat of a surprise favourite for me, it was a random pick up from a service station on my way to Manchester for university and it’s cover and blurb did not prepare me for how hard it was going to hit – very clear as to why it was shortlisted for the Welcome Book Prize in 2017. In language, provided you have watched some form of Casualty episode in your life, there is nothing that either isn’t explained, or is difficult to pick up through context (however, coming from a medical-ish background I may be wrong), making it an easy read, but due to the content of the book, it is well worth taking your time reading it despite being a relatively short book. 

It is a first-person account of Paul Kalanithi’s journey from being diagnosed with terminal cancer and the ensuing change from being a doctor to becoming a patient. He lets you see a window into his decision making, his inner turmoil and his regrets and excitement as he tries to carry on with life knowing he is nearing his death. Paul’s introspection in trying to find what matters to him in life combined with his background in writing has the book take on a philosophical quality that means, for me, this book is best enjoyed by myself in a quiet nook.   Paul’s final message is applicable to everyone, lending itself very well to being read out loud, where it becomes almost poetry. 

 Whereas in most books, I would tend to skip the foreword (by Abraham Verghese – Publisher) and epilogue (by Lucy Kalanithi – Paul’s wife), in this book I would say they add more context and make the book more impactful as it is bookended by people involved in the story and lets you glimpse the wider effect of Paul’s death and decision making. Without these additions, the book appears unfinished, as a result of Paul’s death. 

Tissues are a requirement for this book. 

For me, this book excelled as I read it in a time of personal turmoil just after my father’s death when I was struggling with my mental health and finding the joy in life (something I am still trying to work out as you can see in Graduation Blues). While the circumstances of the book and my life are drastically different, something of Paul’s writing seems to transcend the “cancer” tale, allowing you the gift of learning from his life and the lessons he has learnt. His final message in particular is something that I will pick up and read when I feel I am losing myself to a black hole of misery. The joy that he manages to feel on his death bed is inspiring, and the huge loss that his wife evidently feels when he dies resonated with me in that moment. 

If you were a fan of This is going to hurt by Adam Kay or The Prison Doctor by Amanda Brown, this book is definitely for you. 

Favourite quote:

“Even if you are perfect, the world isn’t.”

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