When Breath Becomes Air

I can’t go on. I’ll go on.

One of my friends was the first person to introduce me to this book. We go through these things often. Finding the next book to read is my least favourite part of reading. So stuck in a classroom, waiting for a professor to show up, I asked her – “Have you read anything good lately?” And she said, without a moment’s thought- read this book, ‘When breath becomes air’. The title itself intrigued me. When I came home a few months later, I found one of my grandfather’s friends had said almost the exact same thing to him, and lent him the book to boot. So when I found it around the house, I leaped on the chance to finally read it.

When Breath Becomes Air is a memoir of sorts, by Paul Kalanithi, published posthumously. It’s the story of this neurosurgery resident, 1 year away from graduation. He’s one year away from this thing he’s worked so hard for, for so long. In one year, he can finally unpause his life, get a six figure salary, take it at a slower pace, ease his strained marriage, have kids. Then one fine day he wakes up with excruciating back pain. At age 36, his diagnosis is Stage IV lung cancer.

This book is not another cancer story. Or a doctor’s story. It’s this man’s story. It’s a story of life and death, and what is more universal than that? It’s his very fascination with this concept that’s the backbone of this book, and in fact, his life and his career in neuroscience and medicine.

He talks about his experiences, the slow transformation from civilian to medical student, student to doctor, doctor to scientist. As a medical student, with much of the same existential questions, his fascination with these concepts was especially resonant.

In our rare reflective moments, we were all silently apologizing to our cadavers, not because we sensed the transgression but because we did not.

He talks about fortunately or unfortunately, slowly losing the human touch, realising that, and trying to make amends. He talks about the incredible science behind what he does.

He talks of being a surgeon, of handling people’s brains, their very identity. He describes his first birth, his first death, these experiences so profound, you’d think anyone wouldn’t have words to describe them. He finds the words. He talks about panicking on handling his first patient by himself in an emergency, and it slowly becoming routine to the point that he was able to rescue his ice cream sandwich and finish eating it after a trauma call. The life of doctors indeed.

Those burdens are what make medicine holy and wholly impossible: in taking up another’s cross, one must sometimes get crushed by the weight.

He also talks about his own life after his diagnosis, his further fascination with the concept of death, his understanding of what his life meant to him, his methods to deal with his sudden disability.

I began to realize that coming in such close contact with my own mortality had changed both nothing and everything. Before my cancer was diagnosed, I knew that someday I would die, but I didn’t know when. After the diagnosis, I knew that someday I would die, but I didn’t know when. The fact of death is unsettling. Yet there is no other way to live. Death may be a one-time event, but living with terminal illness is a process.

We see him changing from doctor to patient to human being and all the way back again. We see him as he grapples with major life decisions, talks about relationships that he forged that pulled him through this time, and things he gained because of this time.

“Will having a newborn distract from the time we have together?” she asked. “Don’t you think saying goodbye to your child will make your death more painful?”

“Wouldn’t it be great if it did?” I said. Lucy and I both felt that life wasn’t about avoiding suffering.”

This book is an intelligent, touching, telling of the story of a man. Several times, you have to stop to think about something you never thought about just that way before. Often, you have to pause to identify with the same things he’s feeling.

Strangely extremely relevant to me, as a medical student, and as a person interested in all the same things this man was interested in, this book was a must read for me. It will be for you too. Even if you don’t share these interests. This book is one of those you carry with you long after you put it down. So go pick it up as soon as you can.


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