When Breath Becomes Air ~ by Paul Kalanithi

This has been read and reviewed highly rated and ranked for so long I just finally caved in.   It’s the memoir of a young brilliant neurosurgeon who discovered in 2013,  while still in his mid-thirties, that he had cancer and it was terminal – he had about a year to live.  So he wrote, a first love,  his memoirs.  


When Breath Becomes AIr
by Paul Kalanithi
2015 / 256 pages
read by  Sunil Malhotra, Cassandra Campbell / 5h 35m
rating:  10 / memoir

I think maybe the hype messed me up at first and I was expecting more than what was apparent in the first couple of chapters.  But then I got caught up in it and yes,  I got teary and yes it was also thoughtful and illuminating.

The book opens with the author having symptoms and finally talking about them and then getting a diagnosis.   Then the reader is taken into a kind of sweet memoir of his childhood and studies up to age about 35 or so – 2013.

Kalanithi describes his childhood and educational  experiences but that’s as far as he gets because due to an aborted attempt at studies in literature he was still in residency at Stanford when he died.

I’m not all that big on reading about medicine –  Cutting for Stone by Abraham Verghese is one of the few books which describes surgical procedures I have ever been able to read.   Verghese wrote the Foreward to Kalanithi’s book – nice.

So we get to walk with Kalanithi as he studies and survives the births and deaths of patients.  And wonders if knowledge is enough – he knows he also needs moral clarity – wisdom.   “The grave digger with the forceps.”

He also marries a young woman named Lucy and she sticks it right out with him.  That’s the background – we get to know Paul as a human being and as a doctor.  The next part deals with Paul as a patient  –  a dying patient.

He took to reading literature again and having a child with his wife.  And then he realizes that he’s not dead yet, Paul gets back to life as much as he can just going through the changes while he prepares for death.   He goes through the stages of grief and goes on anyway – through shock and magical thinking and denial – each in its own time.

The thing is Paul knew intellectually what was going on up to the end – he’d seen it in his own patients  – but on a personal level he searched for meaning – this is that story.

Kalanithi has a gift for words so the narrative is clear and informative but also quite literary in some ways – many ways.  Yes,  Paul declined as had been foretold.    To me this is a tale of rare courage and a willingness to live for meaning as long as was possible. Once again in the hospital, it became harder to breathe and Paul Kalanithi  finally died surrounded by family in March 2015.

It’s a beautiful book – more than I expected as it turns out,  and more than most memoirs.     The Epilogue says the book was not entirely finished,  but it is,  in all ways,  complete because he lived with his cancer and he lived until he died.