“When Breath Becomes Air” by Paul Kalanithi

“When Breath Becomes Air” is a memoir written by American neurosurgeon and writer Paul Sudhir Arul Kalanithi. The book revolves around Paul Kalanithi’s encounter with stage IV metastatic lung cancer and his transformative journey towards the end of his life. Sadly, Paul passed away in March 2015 at the age of 37 while actively working on this book. The book got published posthumously and became The New York Times Non-Fiction Best Seller.

The book portrays the abrupt shift from Paul’s role as a doctor treating terminally ill patients to becoming a patient himself, battling for survival. In an instant, the future he had planned with his wife dissolved into thin air. Throughout the book, we get to know Paul’s evolution from a young, inexperienced medical student to a skilled neurosurgeon at Stanford, specializing in the complexities of the brain.  Ultimately, we accompany him on his emotional journey as a patient and a father, bravely facing his own death.

In his last two years, he continued his medical training, became a father to a baby girl, and wrote intensely about his experience facing terminal illness as both a doctor and a patient.  The irony is harsh that Paul, a talented young doctor was struck by lung cancer just as his career was about to flourish. He wrote in his book, “You can’t ever reach perfection, but you can believe in an asymptote towards which you are ceaselessly striving.” Paul’s quote suggests that we can never be perfect, but we should continuously aim for improvement. He has used the idea of an “asymptote,” which is like a goal we approach but never quite reach. Even if we can’t be perfect, the effort to get closer to our ideals is valuable.

The book is split into two parts. The first part “In Perfect Health I Begin,” focuses on Kalanithi’s life prior to being diagnosed with terminal cancer. Paul grew up in Kingman, Arizona, as the son of a doctor. He studied English and Biology at Stanford and later attended the Yale School of Medicine where he met his future wife Dr. Lucy. After finishing medical school, Paul and Lucy returned to Stanford, where he completed his residency. As a surgeon, Paul learned how to compassionately guide patients through critical illnesses and injuries.

The second part “Cease Not till Death, “explores Paul’s experiences and challenges after the diagnosis. Knowing his approaching death, Kalanithi and his wife Dr. Lucy decided to have a child. Paul also found solace in returning to the religious faith of his upbringing. Paul Kalanithi displayed incredible determination and spirit by continuing to perform surgeries despite battling lung cancer. He maintained his sense of humor, laughed and cherished the presence of loved ones, friends, and colleagues. He found joy in nature, cheered enthusiastically at football games, and actively contributed to raise funds for lung cancer awareness. He has quoted, “Even if I’m dying until I actually die, I’m still living.”

The epilogue penned by his wife Lucy serves as a beautiful conclusion to this sad yet remarkable tale. She writes, “I expected to feel only empty and heartbroken after Paul died. It never occurred to me that you could love someone the same way after he was gone.”

The book can be disturbing to read as it has a tragic story. However, Paul Kalanithi’s writing is appealing and without self-pity. His honest style directly engages, keeping us hooked until the end, despite knowing the expected result.