When Breath Becomes Air

What turned out to be my favorite book that I read last summer was recommended to me by my lovely college roommate and fellow rad-ish blogger, Snow. It was toward the end of the school year that we began discussing it, amid the chaos that was finals and graduation, so I didn’t pick it up until a few months after she had mentioned it to me, once life had quieted some. I do not hesitate when I say that it is a life-changing story, and a book that I wish every single person on earth would read.

When Breath Becomes Air is an autobiographical memoir by Dr. Paul Kalanithi, in which he grapples with his impending death, shortly after completing his neurosurgical residency. We know from the first pages that this story will not end as we hope it would—it is far too short, and the diagnosis of metastatic lung cancer far too severe—but we cannot help but be reeled in to bear witness to and share in his grief as Dr. Kalanithi begins treatment.

While fighting to hold onto what small pieces of his future remain, Kalanithi does so much more than mourn what might have been: he lives his future, his life distilled down to its most important elements. He repeatedly describes the challenge of living with a terminal illness as finding what is important, and then finding it again as one’s values evolve in light of the progressing illness. In this constant struggle for balance, he attains a stunningly beautiful poignancy in his writing, which I am unsure whether to attribute to his illness or his skill as a writer and thinker (I would hazard a guess at some combination of both).

Whereas most would be overwhelmed when placed in his position, Dr. Kalanithi manages his grief admirably: its presence is acknowledged, and even accepted, but never allowed to take up residency or skulk in the corner. However, he does indulge his obsession with time, the one great unknown in the otherwise well-established equation of his life; but my repeated thought as I read was, can we really blame him? His doctor hat allows him to understand his oncologist’s hesitancy to discuss life expectancy, but it is not until he becomes a patient that he truly understands the intricacies of this question, and the compulsive need that many patients feel to ask: how much time do I have left? It is in these blurred lines between doctor and patient where I found the most comfort, simply from being reminded that we can all relate at the fundamental level of human.

I read this book through the lens of a student aspiring to study medicine in the relatively near future, but even more so as a patient who has been forced to confront the emotional implications of living with a chronic disease. Though my condition is nowhere near what Dr. Kalanithi was forced to face, there were instances as I was reading where I found my eyes close involuntarily and my head tilt back slightly, as I screamed a silent YES in my head: YES, someone else has struggled to find meaning in a sometimes seemingly-meaningless existence. YES, it’s okay to be unsure, and to proceed with caution. YES, you can choose family and ambition simultaneously, if that is what truly makes you happy when you crawl in bed at night. YES. Yes, the answers are never as clear as they would seem, but a ticking clock sure helps move some decisions along.

I doubt many people can say what Dr. Kalanithi was able to: given an acute awareness of his mortality, he chose to carry on with life mostly as it was, because he was already doing what he was meant to do. He comments in regard to his training as a physician, “you can’t ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving.” I believe that ultimately, this was more life philosophy than surgical philosophy, and Kalanithi was well on his way toward that asymptote. I hope that I am lucky enough to say the same as I move forward along my own life curve.


You can read an article by Paul Kalanithi featured in the New York Times here.

Dr. Paul Kalanithi, his wife Dr. Lucy Kalanithi, and their daughter Cady


Image sources here and here.