When Breath Becomes Air
What makes life worth living in the face of death
By Paul Kalanithi
If you have ever wondered what it feels like to analyse the spread of cancer in your own CT scan, then this is the book for you. Paul Kalanithi is a professionally-detached, hard-working student neurosurgeon who was diagnosed with inoperable lung cancer at 36 years old, just as he was on the verge of qualifying. The memoir chronicles his transformation from student, through his medical career, to his destiny as a patient in the hospital where he used to work. Kalanithi takes us on his path of discovery about the meaning of life, initially from his perspective as a medic and then from his view of life as a terminally-ill patient.
A significant proportion of the book relates to Kalanithi’s early life before his diagnosis. The main story begins with his early days doing a postgraduate degree in English literature, where the author began his reflections on the meaning of life. Those initial musings are intimately linked with his medical career and life as a patient, but the book is divided into two parts. The diagnosis marks the end of the reflection of death from the medic’s perspective and the start of the cancer story.
The meaning of life and death runs through the book, and Kalanithi does not avert the reader’s eyes from the realities of death, which are narrated with a blend of clinical precision and beautiful prose. After his diagnosis, Kalanithi goes through an identity crisis provoked by the abrupt halt to his ambitious career. He declares frankly that, “Dying in one’s fourth decade is unusual now, but dying is not.” The diagnosis brings Kalanithi and his wife closer together with their one aim being their joint survival and the birth of their daughter.
When Breath Becomes Air illustrates the important role doctors play in the journey towards death, and the differing views they have on prognosis and treatment. Despite his hopes for a successful professional career being “flattened” into a “perpetual present”, Kalanithi’s desire to live long enough for his daughter to remember him shines through.
The epilogue by Lucy Kalanithi is an equally eloquent description of her husband’s final days. She compares how Kalanithi focused on doing all he could for her future life whereas Lucy focused on her late husband’s symptom control in the present. The story is written by both of them from the heart and its profound gift is to enable the reader to walk in Kalanithi’s terminally-ill shoes and then to step back into their own world, potentially with a new perspective on life and death.
What I wanted:
I had not anticipated an entire life story, so I was disappointed that only the second half of the book focuses on life from the patient’s perspective, leaving me wanting more detail about Kalanithi’s personal feelings in his final days and months.
What I loved:
This book highlights how unique our lives are and shows that the answer to how we live cannot be found in any medical textbook.
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