This is probably one of the best-known memoirs to come out in the past decade. It’s written by a neural surgeon who was diagnosed with terminal cancer just as he was preparing to finish his training. So going into it, you know it’s going to be an intense read, and that you should probably make sure you’ve got a box of tissues standing by.
Because Paul Kalanithi was a doctor as well as a patient, this book is a unique combination of the two perspectives. There are plenty of memoirs written by doctors about their training and practical experiences. Likewise there are lots of memoirs written by patients of all kinds – even some by their family members. But this is the first book I have come across that straddles both sets of experiences and carves out its own perspective balancing the two.
The book starts with Paul Kalanithi’s childhood and background, shows us who he is and how he ended up choosing the career path he did. At the beginning of the book he’s within reach of fulfilling his goals, but he and his wife Lucy are having a hard time connecting since they are both doctors with busy schedules and a lot of pulls on their time and energy. Paul’s diagnosis turns everything on its head, and, in a weird way, it actually serves as a catalyst for the two to reconnect and focus on how much they love one another.
By the time his diagnosis happened, I felt like I knew Paul, and of course it was devastating. After his diagnosis there are some ups and downs, different treatments that work to varying degrees, but they also cause a whole range of side effects along with the pain and problems that come with his illness itself. His ability to function is likewise thrown into a rollercoaster-like series of ups and downs. It’s a harrowing journey, particularly because he possesses an ability to capture feelings in words that bring the reader right into it with him.
What I wasn’t prepared for in this book is that it actually is not totally a downer. Yes, it’s hard. It’s sad. It’s a blinding reminder that no one is ever guaranteed tomorrow. But it’s also full of hope and love. Paul captures it perfectly when he says:
“I began to realize that coming in such close contact with my own mortality had changed both nothing and everything. Before my cancer was diagnosed, I knew that someday I would die, but I didn’t know when. After the diagnosis, I knew that someday I would die, but I didn’t know when. But now I knew it acutely. The problem wasn’t really a scientific one. The fact of death is unsettling. Yet there is no other way to live.”
It’s true. I’ve experienced a lesser version of this realization in my own medical issues. Of course mine aren’t imminently terminal, but during some of the terrifying attacks I’ve had where I didn’t know if my lungs were going to recover or if I was just going to stop breathing, and then after it was over not knowing when it would happen again and if that would be the attack that killed me, I came close to that feeling of mortality. And it was unsettling. That’s really the only word for it. It’s one thing to know you could die tomorrow, it’s another thing to come face to face with that reality. It changes something fundamental in your mind, and you can never go back to the time before it happened. It’s like death was invisibly walking beside you the whole time, but suddenly you can see that it’s there. And you can’t ever stop seeing it.
I think this affects people in different ways. Paul seemed to eventually come to terms with that, and decide to just keep living. He and his wife decided to have a baby, even though they knew he may not live long enough to meet or know her. He continued to work towards becoming a doctor, even when it took everything he had, and didn’t guarantee future prospects. The tone of the book was optimistic, even in such difficult circumstances, and that is not an easy thing to pull off. It left me feeling somehow more hopeful than I did when I went into it, and possibly helped me shift my mindset ever so slightly about what it means to live with the imminence of death (something I think we’ve all been touched by in recent years due to the pandemic). I was not sure if it was a good idea to pick this book up now, when things already feel so heavy. But it turned out to be exactly what I needed. I’m so glad I finally decided to read this book, and I definitely think you should, too.
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. – Goodreads
Book Title: When Breath Becomes Air
Author: Paul Kalanithi
Series: No
Edition: Hardback/Audiobook
Published By: Random House
Released: January 12, 2016
Genre: Memoir, Cancer, Medicine, Mortality
Pages: 229
Date Read: August 7-9, 2021
Rating: 9/10
Average Goodreads Rating: 4.36/5 (480,423 ratings)