The decades 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 died, 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 Clancy wrestles within his profoundly moving, exquisitely observed memoir.
Paul Kalanithi died in March 2015, while working on this book, yet his words live on it as a guide and gifts 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 challenges facing death and on the relationship between doctor and patient, from a brilliant writer who became both.
5/5 stars. Memoir, Cancer, Mortality.
When Breath Becomes Air is a book that I can not imagine anyone being disappointed by. I’ve been fascinated by the questions of mortality since my junior year of high school when this kid in my class passed away from a long struggle with cancer. I remember coming out of that assembly, so many people crying, and getting back into the classroom. My teacher was not about to give us a lesson. She told us to take time, go to counseling if we needed to, write something if we needed to do that, draw, do whatever we needed to be okay. I sat there, with a pen in hand, trying to write something, but the only thought going through my head was that a kid the same age as me had died. A kid who was a basketball star and smart too, before things went downhill. The year he was diagnosed, he told this other kid he was going to try to beat my grade in science (because I always had a really high grade), but he never had a chance because he was undergoing treatment. And then he was gone, three years later. Someone my age was gone. It wasn’t an accident, it was his body fighting against himself. It took me a while to process.
When Breath Becomes Air brought me back to that feeling. Anything can happen. We don’t know when we will be removed from this world. Paul Kalanithi had a plan, for years in the future – but then he developed cancer. Imagine planning on going to school and being in residency for decades, putting the rest of your life on hold until you finish all the schooling to become the doctor you always wanted to be. But you never reach the end, you never get to the after. All that work, essentially wasted. All those loans you took out to cover your schooling never paid.
I was incredibly touched by this book. The writing is phenomenal, Kalanithi was a beautiful person, and it was so incredibly sad to feel him struggling with cancer, his wife, and thoughts of a family. I literally cried while reading this book and I was so frustrated when I got to the end because my family kept interrupting me to do things that I deemed less important, like go out to dinner. I only had like ten pages left! Just let me read in peace and cry about it!
I think the moment that made me cry was when Paul Kalanithi and his wife decided to try for a child together, even though Paul might die before his daughter got to an age to remember him. That killed me. I can’t even imagine what that would be like to realize that my child might never remember me. To think that child wouldn’t know how much I cared, even though my spouse would probably remind her again and again who I was and how much I cared.
Also, this book includes some pretty cool moments Kalanithi had through his science studies, which added to the story. If I remember correctly, Kalanithi was also interested in literature, which might explain why his writing is so beautiful. I had a highlighter with me whenever I read the book, marking it up like crazy.
I believe this one is a message to his daughter:
“That message is simple: 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.”
“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.”
“Will having a newborn distract from the time we have together?” she asked. “Don’t you think saying goodbye to your child will make your death more painful?”
“Wouldn’t it be great if it did?” I said. Lucy and I both felt that life wasn’t about avoiding suffering.
“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.”
“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.”
Purchase When Breath Becomes Air here.