Synopsis (Goodreads): 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.
I generally find non-fiction books hard to review, a fact I may or may not have mentioned before, but writing a review for a book that I loved reading as much as When Breath Becomes Air somehow feels ten times harder.
A story like this makes you realise how truly fragile life is. As Abraham Verghese writes in his Foreword, “in the context of Paul Kalanithi’s diagnosis, you become aware of not just his mortality, but your own”. Paul had a golden future ahead of him when he was diagnosed with advanced stage lung cancer, but his memoir starts more than 10 years earlier, with him tracing his journey towards becoming a neurosurgeon having started off at Stanford studying English Literature and Biology.
Despite the use of a fair amount of medical technical jargon in describing his experiences as a medical student, intern and resident of Neurosurgery, the author makes the subject accessible to the common reader, and he neither diminishes, nor exaggerates the challenges and difficulties in pursuing his calling to neurosurgery. One of my favourite passages from the book reads:
“Neurosurgery attracted me as much for its intertwining of brain and consciousness as for its intertwining of life and death. I had thought that a life spent in the space between the two would grant me not merely a stage for compassionate action but an elevation of my own being: getting as far away from petty materialism, from self-important trivia, getting right there, to the heart of the matter, to truly life-and-death decisions and struggles…surely a kind of transcendence would be found there?
But in residency, something else was gradually unfolding. In the midst of this endless barrage of head injuries, I began to suspect that being so close to the fiery light of such moments only blinded me to their nature, like trying to learn astronomy by staring directly at the sun. I was not yet with patients in their pivotal moments, I was merely at those pivotal moments. I observed a lot of suffering; worse, I became inured to it. Drowning, even in blood, one adapts, learns to float, to swim, even to enjoy life, bonding with the nurses, doctors, and others who are clinging to the same raft, caught in the same tide.
Following his diagnosis with lung cancer and realising that his time is now a lot more specifically limited, the Paul Kalanithi’s words on his acceptance regarding his impending death, the steps he takes to find his values, and discover the joy of living in the simplest and most human experiences like bringing a child into the world, spending time with family and friends, and having meaningful conversations, are awe-inspiring, beautiful, raw and very, very human.
Early in the book, Paul Kalanithi describes language as an almost supernatural force existing between people and bringing our brains into communion. He says a word means something only between people, and that life’s meaning, and its virtue had something to do with the depths of relationships we form. I have always felt that the best books are the ones that stay with you long after you finish reading them. I was sad when I came to the end of this memoir, and not just because the world has lost a gifted surgeon and writer, but because finishing the book felt like losing a good friend.