When Breath Becomes Air

It was on my Facebook newsfeed that I saw a friend recommending everyone to read When Breath Becomes Air. The book went straight to number one on the New York Times bestseller list and stayed there for 12 weeks.

When Breath Becomes Air is written by Dr. Paul Kalanithi, a 36-year-old neurosurgeon. After having trained for almost a decade, Paul finds out that he’s been diagnosed with stage IV lung cancer. It is at this moment that his life takes a massive turn: from being a doctor treating patients to becoming a patient himself under going treatment for cancer.

It is this very twist of events that Paul chronicles in his book, which is less a memoir and more of an insight into his life experiencing this unforeseen circumstance.

In the foreword by Abraham Verghese, with reference to Dr. Paul Kalanithi’s book, he invites the reader to “see what courage looks like. See how brave it is to reveal yourself in this way. But above all, see what it is to still live, to profoundly influence the lives of others after you are gone, by your words.”

In the first part of the book, Paul brilliantly details the early part of his life and how he came to do medicine. Paul’s childhood experiences are at its best when he shares about his parents (who are south Indian, one is Christian, other is Hindu) and their life in the United States. He along with his brother had a somewhat of that seemingly perfect childhood growing up. Paul also shares his love for literature—Dickens, Twain, Austen – so much so he eventually attaining a degree in English Literature. As he says in the book, “books became my closest confidants, finely ground lenses providing new views of the world.”

He leads us through his college years with a constant thought that would bug his conscience: What makes human life meaningful? Paul felt that literature would provide him the answer, and it did to a large extent. However, he was driven less by achievement and more by asking this pertinent question.

With two degrees under his belt, English Literature and Human Biology- Paul decides to pursue his career in medicine, which proved to be quite beneficial as Paul says in the  book, “medical school sharpened my understanding of the relationship between meaning, life and death.”

In some of the more interesting parts of the book, Paul shares his experiences of going through medical school: his first birth, his first death and his first time cutting up a cadaver. Life becomes challenging for him as he still continues to explore one thing: what makes life meaningful? He shares his experience of dealing with a family who just had a new born baby, only for that baby to die later. He deals with a family whose love one was about to undergo surgery with no clear indication of the outcome. Moments like forced Paul to take decision which he says requires experience, knowledge and most importantly moral clarity.

In the second part of the book, Paul shares with us how his world changes when he finds out he is diagnosed with lung cancer. Now, he is not the doctor anymore but a patient, and a very unique patient because he has all the knowledge of a doctor. However, his thought process changes as he now thinks like a patient who needs to fight for survival. He doesn’t think like a doctor, who needs to come up with techniques to handle the medical diagnosis and subsequent treatments to the patient.

Because Paul is doctor, he works alongside his doctors to seek out the best treatment and can read his medical reports. These were some of the more difficult parts of the book to read as I would recall my own experience with my father’s cancer- treatment, surgeries, doctor visit, scans and all.

In the midst of this all, Paul and his wife contemplate having a child and this becomes a deep moral issue for them- should you plan on having a child when you know that the husband will die eventually? (They eventually do have a daughter and the book is dedicated to her!)

Paul, who now has a death sentence above his head, tries to understand what life is all about in the short amount of time he has left. Again, literature comes to his rescue and he restarts reading books. As he says, “I had to face mortality to understand what made my life worth living.”

When Breath Becomes Air is one of those rare books that becomes very difficult to forget once you finish reading it. The book is filled with joyful, life-affirming moments that you cannot help but be sucked into the infectious optimism. There is so much strength and hope that it uplifts you. It also serves as a reminder that we all have a limited time on earth, and so we should start living our lives meaningfully. Would we change our priorities in life if we knew we had a year to live?


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