When Breath Becomes Air

In Dr. Paul Kalanithi’s memoir, When Breath Becomes Air, he chronicles his life: as a child, in medical school, and ultimately, of his final days. On the verge of finishing his neurosurgery residency and with a bright future ahead of him, Paul’s life is turned upside down when he is diagnosed with stage IV lung cancer. Paul writes of the way with which he faces his own mortality. This book fully appreciates the immense responsibility of doctors and of the fragility of life.

Kalanithi also manages to convey the fragility that our lives rest on. We may try to ignore it, but there is that tiny amount of uncertainty in our lives. Kalanithi says that when he was diagnosed with cancer, he was ready to die. But when not knowing exactly how long he would live made the right path forward ambiguous. What he could accomplish depended on how much longer he could live, and not knowing how long he could live in turn made the answer of what he could accomplish uncertain. Kalanithi was a talented doctor, and planned much for the future. He writes that his life “had been building potential, potential that would … go unrealized.” He was truly a talented man: he had degrees both in literature, and in biology. Kalanithi says that he had planned to be a doctor first, and to be a writer later in life. Aspirations for the future are good, but many times, we may find ourselves forgetting to actually live: in the here and the now. Kalanithi was diagnosed with cancer, and that would drastically change his life. A story he told particularly illustrated the reality of his grim situation. Awaiting a train, Kalanithi suddenly started to have severe back spasms. He lay down on a bench, trying to endure the terrible pain. A security guard went up to Kalanithi and told him that he couldn’t lie down there. Kalanithi writes that he had wanted to reply “I’m sorry, but I’m dying from cancer.” These words are so matter-of-fact that they make the reader feel his emotions. A man, dying from cancer, pleading for help. When in pain, Kalanithi would often remind himself of the words of Samuel Beckett: “I can’t go on. I’ll go on.” From Kalanithi, we can learn much about our own reality in this world.

Through this book, I have come to respect doctors, especially surgeons. Kalanithi details his life as a resident: working one hundred hours a week, drinking energy drinks at two in the morning, napping in the car before driving home. Kalanithi recalls a time when he asked his resident if a baby being born too early or too late was the worse between the two. “Judgement call,” his resident had told him. He remembers thinking of the profound decisions he would have to make. “I still had a lot of practical medicine to learn, but would knowledge alone be enough, with life and death hanging in the balance?” Kalanithi further explains that neurosurgeons literally work at identity. When an operation is done, it is not enough to know whether a patient will live or die. “What makes life meaningful enough to go on living?” writes Kalanithi. In the end, Kalanithi observes the reality of a doctor’s responsibility: “You can’t ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving.”

From giving us an inside look at a neurosurgeon’s training and teaching us more about meaning in our lives, Dr. Paul Kalanithi’s memoir helps us face our own lives. Kalanithi’s has a wonderful way with words. His writing has that sophisticated eloquence often seen in great writings. Kalanithi’s wise words can make our lives that much better. Poignant yet hopeful, When Breath Becomes Air is the touching memoir of Dr. Paul Kalanithi.