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When Breath Becomes Air by Paul Kalanithi
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When Breath Becomes Air

by Paul Kalanithi

Other authors: Lucy Kalanithi (Epilogue)

Other authors: See the other authors section.

MembersReviewsPopularityAverage ratingMentions
3,1942262,839 (4.24)252
"For readers of Atul Gawande, Andrew Solomon, and Anne Lamott, a profoundly moving, exquisitely observed memoir by a young neurosurgeon faced with a terminal cancer diagnosis who attempts to answer the question What makes a life worth living? At the age of thirty-six, on the verge of completing a decade's worth of training as a neurosurgeon, Paul Kalanithi was diagnosed with stage IV lung cancer. One day he was a doctor treating the dying, and the next he was a patient struggling to live. And just like that, the future he and his wife had imagined evaporated. When Breath Becomes Air chronicles Kalanithi's transformation from a naïve medical student "possessed," as he wrote, "by the question of what, given that all organisms die, makes a virtuous and meaningful life" into a neurosurgeon at Stanford working in the brain, the most critical place for human identity, and finally into a patient and new father confronting his own mortality. What makes life worth living in the face of death? What do you do when the future, no longer a ladder toward your goals in life, flattens out into a perpetual present? What does it mean to have a child, to nurture a new life as another fades away? These are some of the questions Kalanithi wrestles with in this profoundly moving, exquisitely observed memoir. Paul Kalanithi died in March 2015, while working on this book, yet his words live on as a guide and a gift to us all. "I began to realize that coming face to face with my own mortality, in a sense, had changed nothing and everything," he wrote. "Seven words from Samuel Beckett began to repeat in my head: 'I can't go on. I'll go on.'" When Breath Becomes Air is an unforgettable, life-affirming reflection on the challenge of facing death and on the relationship between doctor and patient, from a brilliant writer who became both. Advance praise for When Breath Becomes Air "Rattling, heartbreaking, and ultimately beautiful, the too-young Dr. Kalanithi's memoir is proof that the dying are the ones who have the most to teach us about life."--Atul Gawande "Thanks to When Breath Becomes Air, those of us who never met Paul Kalanithi will both mourn his death and benefit from his life. This is one of a handful of books I consider to be a universal donor--I would recommend it to anyone, everyone."--Ann Patchett"-- "At the age of 36, on the verge of a completing a decade's worth of training as a neurosurgeon, Paul Kalanithi's health began to falter. He started losing weight and was wracked by waves of excruciating back pain. A CT scan confirmed what Paul, deep down, had suspected: he had stage four lung cancer, widely disseminated. One day, he was a doctor making a living treating the dying, and the next, he was a patient struggling to live. Just like that, the future he and his wife had imagined, the culmination of decades of striving, evaporated. With incredible literary quality, philosophical acuity, and medical authority, When Breath Becomes Air approaches the questions raised by facing mortality from the dual perspective of the neurosurgeon who spent a decade meeting patients in the twilight between life and death, and the terminally ill patient who suddenly found himself living in that liminality. At the base of Paul's inquiry are essential questions, such as: What makes life worth living in the face of death? What happens when the future, instead of being a ladder toward the goals of life, flattens out into a perpetual present? When faced with a terminal diagnosis, what does it mean to have a child, to nuture a new life as another one fades away? As Paul wrote, "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." Paul Kalanithi passed away in March 2015, while working on this book"-- On the verge of completing a decade's worth of training as a neurosurgeon, Kalanithi was diagnosed with stage IV lung cancer. Just like that, the future he and his wife had imagined evaporated. Kalanithi chronicles his transformation from a naïve medical student into a neurosurgeon at Stanford working in the brain, the most critical place for human identity, and finally into a patient and new father confronting his own mortality.… (more)
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» See also 252 mentions

English (225)  Danish (2)  Spanish (1)  French (1)  All languages (229)
Showing 1-5 of 225 (next | show all)
Stunning. ( )
  Chiara_Quinn | Apr 13, 2020 |
Neurosurgery is not for the faint hearted. It demands the highest training and skill for even a couple of millimetres difference can literally mean kill or cure. This profession is the one that Paul Kalanithi chose with the ambitious aim of having a virtuous and meaningful life. He never wanted to become a doctor, having had personal experience of growing up in a family of medical practitioners. But, he ended up choosing this career after studying English literature and human biology followed by a master’s in the history and philosophy of science. It was whilst training as a neurosurgeon that he learnt to talk to patients about their treatments, their hopes and sometimes the stark realities of their prognosis. To deal with the suffering of the patient and their families, he had to become mentally tough and remote, pressures that not all of his colleagues could cope with.

Then one day the tables were turned; he became the patient.

He had dismissed the back pain and the exhaustion as part of the job and never sought advice until it was too late. His diagnosis was metastatic lung cancer. As his hopes and dreams evaporated; he realised he may never become a qualified surgeon. He had spent his career treating dying people every day. When the tables were turned, he faced his own death with dignity. It did make him see how his chosen profession treated those coping with terminal illness.

We shall rise insensibly, and reach the tops of the everlasting hills, where the winds are cool and the sight is glorious

It is an eloquently written book and such a sad story. Towards the end of his life they decide to have a child, knowing that the wider family would support Lucy; the description of him being at the birth but barely able to rise from his bed is very moving. Finally, Lucy’s eulogy to Paul is equally heart breaking and full of love. It is a painfully honest account of a short, but intense life. ( )
  PDCRead | Apr 6, 2020 |
When Paul Kalanithi passed away on March 9, 2015, I was a high school senior, concerned more with my on-again off-again boyfriend than anything remotely close to the meaning of life and death.

Five years later, I found myself sobbing into the pillow of my makeshift bedroom (thanks, quarantine), clinging to the final words of Paul’s book.

When Breath Becomes Air didn’t have me repeatedly tearing up and dabbing my eyes at multiple parts. Rather, the heavy emotion grew and grew inside me as I read, until I knew the tears were inevitable. And when I finished those final words, I ran to that pillow and gasp-sobbed into it, curling myself into a ball and shaking until I had nothing left to cry.

The name Paul Kalanithi hadn’t meant a thing to me three days earlier.

My close friend from college sent me the book in the mail for my birthday, proclaiming it to be a personal favorite and a highly recommended read. Sure, I’d heard of When Breath Becomes Air, although I can’t remember where or when or why.

Not long before, my high school best friend had sent me The Unwinding of the Miracle by Julie Yip-Williams, and When Breath Becomes Air sounded similarly emotional and heavy. While I enjoyed that book, it was easier to return to the comfort of romantic novels and contemporary fiction rather than confront cancer and nonfiction death through literature again so soon.

But I wanted to read the book for my friend, and stuck it in my luggage with me as I packed up for the roadtrip to spend quarantine back East with my family. A quick text to let my friend know that I was starting the book soon meant that I would have to do just that: start the book soon.

So a few afternoons later, I did just that. By the following afternoon, the book was closed and I was sobbing into that pillow.

The name Paul Kalanithi means a lot more to me now.

I’m not sure that his name — or the poetry of his language, the beautiful inner sentiments, his story of letting go — will ever leave me. And if it does, I’ll pick the book up and read it again to remind myself.

I never want to forget the experience of reading this book.

Summary
For those not unlike myself, who haven’t/hadn’t heard of Paul Kalanithi, Paul was an esteemed neurosurgeon and neuroscientist who developed Stage Four lung cancer at 36. As he tells us, that only happens to 0.0012% of 36 year olds.

The book opens with Paul’s realization of his disease. The bad news that he had to deliver to patients time and again, delivered to him. Much sooner than ever anticipated, and at the same time, not anticipated at all.

We are then taken on the journey of Paul’s childhood, a brief summary of his time in Kingman, Arizona and how he wound up becoming a doctor, after saying it would be the one job he wouldn’t do.

In fact, the book opens with the line, “I knew for certainty that I would never be a doctor.”

Right off the bat, we as readers, knowing the premise of the book, understand that certainty is never guaranteed.

Paul’s love of literature and its importance in his life’s journey is emphasized, a testament to how he developed his gorgeous way with words. His mother instilled this in him; after moving her family to the area of the country with the worst performing school district, she forced her kids to read the best literature in hopes of them still being able to realize their potential (spoiler: it worked!).

This is followed by a chronological progression of Paul’s time in medical school and residency. As readers, we become invested in the case of each patient he shares — devastated by the death of premature twins, the recovery of an eight-year old with a brain tumor — whose stories only last a few page turns at most.

In the latter half of the book, we return to Paul’s diagnosis and the time he had left after that. The child that Paul and his wife, Lucy, chose to have amidst the cancer. His treatments, and the time they afforded him. His confusion about whether to spend time with family, return to surgery or write this book.

By the time Paul passes away, before the manuscript for the book in your hands is finished, it’s impossible to not be moved and rendered more or less speechless. At least, it was impossible for me. I’m only two days removed from finishing the book, and tears come back to my eyes as I write this.

Review
When Breath Becomes Air is sandwiched by a foreword from physician Abraham Verghese and an epilogue by Paul’s wife, Lucy Kalanithi.

Abraham is a particularly interesting choice for a prologue, as he had only met Paul once. His introduction describes in depth that although he met Paul in reality, he only truly got to know and understand Paul after reading this book.

“But it was only when I received the pages that you now hold in your hands, two months after Paul died, that I felt I had finally come to know him, to know him better than if I had been blessed to call him a friend.”

That’s high praise for a 225 page book — and I’ll admit that I didn’t buy it at first. I thought the book would be moving, yes. But it’s not often that a book creates that kind of a bond between author and reader. After finishing, I regret ever doubting Abraham. This book does exactly as he says.

In her epilogue, Lucy commented on the style in which Paul wrote this book, noting that she wishes people got to know how incredibly funny he was in real life, amongst other things.

I’ll disagree with Lucy a little bit here — there were a handful of moments that made me laugh out loud. Such visceral emotions across the spectrum because of words on a page is an incredible feat.

The following is one of my favorite funny moments. Paul had just started doing labs with real dead bodies, and was worried about how he would respond to cutting open and inspecting a real human body. This passage is a perfect balance between Paul’s elevated writing and down to earth nature:

“Cadaver dissection is a medical rite of passage and a trespass on the sacrosanct, engendering a legion of feelings: from revulsion, exhilaration, nausea, frustration, and awe to, as time passes, the mere tedium of academic exercise. Everything teeters between pathos and bathos: here you are, violating society’s most fundamental taboos, and yet formaldehyde is a powerful appetite stimulant, so you also crave a burrito.”

I can’t bring myself to spoil any more of the beauty of this book. I could have told you fifty pages in that this was a 5 out of 5, and I wasn’t wrong.

Read, read, read. And, most importantly, let yourself feel all of it.

5 out of 5 stars. ( )
  RedHotReads | Mar 30, 2020 |
Amazing book. Very touching intro to our mortality. ( )
  cploonker | Mar 22, 2020 |
It's wonderful! The best perspective that I ever had ( )
  brunoalano | Mar 22, 2020 |
Showing 1-5 of 225 (next | show all)
“When Breath Becomes Air” is gripping from the start. But it becomes even more so as Dr. Kalanithi tries to reinvent himself in various ways with no idea what will happen.

Part of this book’s tremendous impact comes from the obvious fact that its author was such a brilliant polymath. And part comes from the way he conveys what happened to him — passionately working and striving, deferring gratification, waiting to live, learning to die — so well. None of it is maudlin. Nothing is exaggerated. As he wrote to a friend: “It’s just tragic enough and just imaginable enough.” And just important enough to be unmissable.
 

» Add other authors (17 possible)

Author nameRoleType of authorWork?Status
Paul Kalanithiprimary authorall editionscalculated
Kalanithi, LucyEpiloguesecondary authorall editionsconfirmed
Campbell, CassandraNarratorsecondary authorsome editionsconfirmed
Verghese, AbrahamForewordsecondary authorsome editionsconfirmed
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I knew with certainty that I would never be a doctor.
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I knew with certainty that I would never be a doctor. I stretched out in the sun, relaxing on a desert plateau just above our house. My uncle, a doctor, like so many of my relatives, had asked me earlier that day what I planned on doing for a career, now that I was heading off to college, and the question barely registered. If you had forced me to answer, I suppose I would have said a writer, but frankly, thoughts of any career at this point seemed absurd. I was leaving this small Arizona town in a few weeks, and I felt less like someone preparing to climb a career ladder than a buzzing electron about to achieve escape velocity, flinging out into a strange and sparkling universe.
Though we had free will, we were also biological organisms -- the brain was an organ, subject to all the laws of physics, too! Literature provided a rich account of human meaning; the brain, the, was the machinery that somehow enabled it. It seemed like magic.
Literature provided, I believed, the richest material for moral reflection.
Moral speculation was puny compared moral action.
I had come to see language as an almost supernatural force, existing between people, bringing our brains, shielded in centimeter-thick skulls, into communion.
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