When Breath Becomes Air by Paul Kalanithi
“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.”
When Breath Becomes Air is the bestselling memoir of a neurosurgeon diagnosed with lung cancer. He has a studied death. He has seen it in person, had patients and friends die, saw the agony in the faces of families who have suddenly lost a loved one. He knew cerebrally and philosophically that death is a part of life. But he grapples for understanding now that he knows he will know it personally. This is his search for meaning.
“As a doctor, you have a sense of what it’s like to be sick, but until you’ve gone through it yourself, you don’t really know.”
Kalanithi was an obviously brilliant man. A neurosurgeon and writer, highly educated in not just medicine but in literature and philosophy. A man who considered his role as a doctor to be much more than a talented hand with a scalpel. He saw it his duty to understand his patients beyond the treatments and procedures. Before operating on a patient’s brain, he wanted to know what they held in their minds. What they loved. What they valued.
His memoir is an open and personal wrestling with what we all know at some level—that everything we believe about life is a product of cells and chemicals in our body. But he knows this at a deeper level than most of us. He has seen life at its barest, most literal, yet he contemplates its significance on the highest plane.
Kalanithi is humble, likable, vulnerable. He dives into literature, searching for insights on mortality. “I was searching for a vocabulary with which to make sense of death, to find a way to begin defining myself and inching forward again.” He remains positive while accepting his fate, but there is no ultimate answer, only peace.
This is a heart-wrenching book, particularly as death arrives. Kalanithi and his wife chose to have a child while they could, and the final words he wrote are for her. He had imagined a series of letters that she might read when she was older, but he realizes he has no idea what she will be like when she is fifteen. So he leaves her with a simple message:
When you come to one of the many moments in life where 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 in all my prior years, a joy that does not hunger for more and more but rests, satisfied.
This is an emotionally tolling read, but well worth it. Summed up well in one of the epigraphs, a quote from Michel de Montaigne: “He who should teach men to die would at the same time teach them to live.”