When Breath Becomes Air - Paul Kalanithi
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.
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 mortality and on the relationship between doctor and patient, from a gifted writer who became both.
I'll be honest, I don't think my review is going to do this book justice, but I'll tell you what, if there was ever a book that kick you in the balls, it would be this one. The book is really three parts for me: Part 1- In Perfect Health I Begin, Part 2- Cease Not till Death and the Epilogue. The Foreward by Abraham Verghese is kind of blah for me and I was a little worried from reading that that I was going to be bored. Also, the Prologue was meh for me as well and written by Paul.
But Part 1 is all about his time debating what to do with his life career wise, why he chose being a doctor and more specifically, a neurosurgeon. What is really fascinating is the frank way he talks about the profession behind the scenes, surgical procedures and becoming automated at it, and then the stories about patients. There was a line on page 102 that reads, "How little do doctors understand the hells through which we put patients." and it really touched me because I know so many people in the middle of chemo and radiation, tests and procedures that doctors don't know how successful they'll be, and then my situation where nobody knows what to really do with me and it's like, how true is this? But what was also touching in this section is how he talks about his mission in life and work was to figure out the meaning of life, how to die with integrity, and how it all comes together to be able to say it was a meaningful existence, which is something I think we can all relate to, I know I certainly can right now.
Part 2 is all about his diagnosis of lung cancer, the journey through treatment and ultimately, death. Once you know death is your last option, everything else has been exhausted, how do you do that the right way? Paul and his wife Lucy debate on having a child- she worries if they don't, will he be disappointed to not have left anything behind? He worries that if they do, she'll be raising their child alone. But together they decide to have a child and their daughter Cady is born in the aftermath of chemo treatments not going as planned.
Paul never got to "finish" his book but I think it's ultimately fitting that the ending paragraph is this:
"When you come to one of the many moments in life where 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."
And that right there punched me in the gut. Because you think about the people you have lost that you wish you could have done more for. It's so easy to forget that the time you did spend with them was meaningful and maybe it was enough. Paul only got eight short months with his daughter but in that time she was able to fill the rest of his life with happiness. I can't think of a better way to go, to be honest.
The last part is the Epilogue, written by Paul's wife, Lucy. She really did such an amazing job closing the book out with the final chapter of Paul's life. She gave a great, personal point of view of what that was like for her, and for him, and touched on other things in their marriage that Paul wrote about. And you just want to hug her, because you feel like you just went through it all with her by the time you get to the epilogue.
I guess after having died twice during the birth of my daughter, I feel a need to figure out why I'm still here. I clearly haven't finished what I was meant to do, but what is it? It's so hard to know, but I'd like to think that if I were dying of cancer I'd have enough in me to write this beautifully. Amazing book.