Dr. Paul Kalanithi is a brilliant young neurosurgeon in the midst of his residency when he is faced with a terminal cancer diagnosis. When Breath Becomes Air is his memoir, his exploration and examination of what makes life worth living. And indeed, this harrowing yet exquisite account of his life and musings as he shuffles ever closer to his inevitable death is well worth reading.
Educated Americans love nothing more than a doctor who can write and Dr. Kalanithi is one of those rare souls who excelled both in the operating room and on the page. In the first part of his story, we learn about his upbringing and his genius – he has a master’s degree in English literature and one in philosophy and considered being a writer before opting to take the more difficult path of becoming a surgeon. In his own words, “The call to protect life – and not merely life but another’s identity; it is perhaps not too much to say another’s soul – was obvious in its sacredness.”
It was not a decision taken lightly and he throws himself into his training with eyes wide open. As he writes, “The cost of my dedication to succeed was high, and the ineluctable failures brought me nearly unbearable guilt. Those burdens are what make medicine holy and wholly impossible: in taking up another’s cross, one must sometimes get crushed by the weight.”
What is remarkable is that Dr. Kalanithi continues his residency while undergoing harrowing treatments for his cancer. The grueling training required to succeed in one of America’s most prestigious hospitals (Stanford) would be impossible for most high functioning, healthy individuals. Paul has unfathomable grit and tenacity and keeps inching towards his goal even as his body deteriorates and betrays him.
This book is not for the faint-hearted. Tears rolled down my cheeks at many moments, especially as he enters his final days at the tender age of 37, just months after his baby daughter is born.
Dr. Kalanithi passed away before finishing his manuscript (oh and he was also writing this book in addition to everything else) and the last part is pieced together by his wife, Lucy who is also a doctor. In the epilogue she writes, “Although these last few years have been wrenching and difficult – sometimes almost impossible – they have also been the most beautiful and profound of my life, requiring the daily act of holding life and death, joy and pain in balance and exploring new depths of gratitude and love.”
Indeed, one of the most heartfelt aspects of the book is how Dr. Kalanithi navigates the uncertainty of his predicament and how he must recontextualize his life and the way he must now improvise given so much uncertainty. As Janet Maslin writes of the book in the New York Times: “There is so much here that lingers, and not just about matters of life and death: One of the most poignant things about Dr. Kalanithi’s story is that he had postponed learning how to live while pursuing his career in neurosurgery. By the time he was ready to enjoy a life outside the operating room, what he needed to learn was how to die.”
The tragedy of this story is of a brilliant man who is unfairly and senselessly taken far too soon (although is there any other way?), leaving behind a grieving wife and eight month old daughter. The beauty of the story lies in Dr. Kalanithi’s ability to express in words his experience, to take charge of his own narrative even as he has so little control and power in the face of his own death. I, along with millions of others, am eternally grateful to have been able to bear witness to his life and death through his writing.