When Breath Becomes Air by Dr. Paul Kalanithi
Published by Random House in 2016 (Posthumously)
Version: Audible Audio
Narrators: Cassandra Campbell, Sunil Malhotra
Length: 5h 35m
Genres: Non Fiction, Autobiography, Memoir
Verdict: Exquisite. Highly recommended.
“We shall rise insensibly, and reach the tops of the everlasting hills, where the winds are cool and the sight is glorious.”
My brother recommended this book to me, one day while we were sitting at my parents’ dinner table. We’d been talking about what we were reading at the time and he mentioned that this book moved him. Immediately, I bought it on Audible. I was surprised at the length, thinking that this would maybe have less value than I thought. I was so incredibly wrong. Paul Kalanithi writes beautifully, his words gentle and measured, packing a great deal of insight and emotion into such a short book. Sunil Malhotra’s narration is perfect for the writing, his voice is wonderfully inflected and a pleasure to close your eyes and listen to.
Dr. Paul Kalanithi was an accomplished neurosurgeon and scientist who, at the vibrant age of 36, was diagnosed with terminal cancer. From childhood he resisted following in the footsteps of his family to become a doctor, dreaming instead of becoming a writer. He went to University to study English Literature and Human Biology, becoming fascinated with the brain, the soul. It was his curiosity to understand the human psyche that led him to become a neurosurgeon, and he graduated in 2007 from the Yale School of Medicine. He continued with his postdoctoral fellowship and returned to complete his residency training, and it was during this time, during the long hours and hard work, that the symptoms of his terminal cancer began to make themselves known. They worsened steadily and developed into Stage 4 lung cancer.
This book is the memoir he wrote during his treatment and subsequent decline. It is an incredibly uplifting work, this man who understands exactly what is happening to himself comes to terms with his own death in a comfortingly positive manner. At many points he feels frustration, despair, but looks upon these moments as a crossroads, an opportunity to re-evaluate his principles, and never lets that despair overcome him.
“Grand illnesses are supposed to be life-clarifying. Instead, I knew I was going to die—but I’d known that before. My state of knowledge was the same, but my ability to make lunch plans had been shot to hell. The way forward would seem obvious, if only I knew how many months or years I had left. Tell me three months, I’d spend time with family. Tell me one year, I’d write a book. Give me ten years, I’d get back to treating diseases. The truth that you live one day at a time didn’t help: What was I supposed to do with that day?”
A great lesson that is highlighted through this memoir is that, in the face of his impending death, Paul overcame the suspension of life that might affect someone who knows they have limited time left to them. This man became an accomplished neurosurgeon, kept working through his illness for as long as he had the strength to help so many people, became a father, wrote the memoir I hold in my hands. He continued working, he continued fighting and he made peace with his death. This memoir is his account of that short life lived as fully as it could be, and has become a way to help others in death as he did so much in life.
“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. But now I knew it acutely. The problem wasn’t really a scientific one. The fact of death is unsettling. Yet there is no other way to live.”
I got through most of the book in awe, listening to what he wrote during the hardest time in his life. I began wondering, if I were in the same situation, how I would deal with it. How do I feel about death, my own death? It’s inevitable, is it something to be feared?
“Don’t be afraid of death; be afraid of an unlived life. You don’t have to live forever, you just have to live.” ― Natalie Babbitt,
I find it curious that this book came to me now, at the beginning of a new year after a particularly trying one. It helped me find perspective on hardships and how I deal with them, and how to stay positive and motivated even when my circumstances seem bleak. It also opened my eyes to the aspects of medicine and surgery that I had never considered. I had hoped to become a surgeon but due to circumstances out of my control I became an engineer instead. I still think about it and have, numerous times, thought that I would have become a great doctor if given the chance. Paul provides an intimate glimpse into the human aspects of being a doctor, the emotional support that is required by patients and their families in addition to the physical. I’d never considered this aspect of the medical field in any detail, and the knowledge gained is richer for the observation of a doctor himself becoming the patient, heartbreaking though it was to experience.
“The physician’s duty is not to stave off death or return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence.”
The book is ended by Paul’s wife, Dr. Lucy Kalanithi. She explains that Paul was unable to complete the memoir he had devoted so much time through his illness on due to his untimely death. She talks about him as her husband, friend, colleague. She talks about his family, and how they all stood strong in the face of his death. She talked about his death, and the courage they all, Paul included, showed during this incredibly heart-wrenching time, and I felt overcome by emotion for this family, for all they had experienced and everything they were to miss out on. Her incredible strength, patience and understanding moved me in ways I can’t describe. Paul and Lucy’s daughter was 8 months old at the time of his death.
I believe this to be one of those books that give new insights with each reading, and at different stages of life. I’m thankful that this book was written, grateful for the comfort it provides. I see this book adding value to the life of every person who reads it.
“When you come to one of the many moments in life when you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man’s days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more, but rests, satisfied. In this time, right now, that is an enormous thing.”