When Breath Becomes Air By Paul Kalanithi,Abraham Verghese

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#1 NEW YORK TIMES BESTSELLER • PULITZER PRIZE FINALIST • This inspiring, exquisitely observed memoir finds hope and beauty in the face of insurmountable odds as an idealistic young neurosurgeon attempts to answer the question What makes a life worth living? NAMED ONE OF PASTE’S BEST MEMOIRS OF THE DECADE • NAMED ONE OF THE BEST BOOKS OF THE YEAR BY The New York Times Book Review • People • NPR • The Washington Post • Slate • Harper’s Bazaar • Time Out New York • Publishers Weekly • BookPage Finalist for the PEN Center USA Literary Award in Creative Nonfiction and the Books for a Better Life Award in Inspirational MemoirAt 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.

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When Breath Becomes Air (2016) made a huge splash, becoming a NYT bestseller, etc. Even Bill Gates read (and reviewed, and loved) it. In it, Dr. Paul Kalanithi basically tells his life’s story in two main threads: how he came to choose, learn, and practice medicine, and how he’s fighting late-stage lung cancer in only his mid-30s. The situation has (had…) all the makings of a kind of hero’s journey, and no wonder it grabbed people’s attention. A superstar young doctor dying of lung cancer right after bringing home a new baby, imagine that.But as far as I can tell, the Paul Kalanthi described in the book would want me to write an honest critique of his work, and I can’t be 100% positive. I have no problem with the lofty philosophical bits, but many other prospective readers will. Kalanithi seems to think that his decision to study medicine is deeply interesting (he studied literature first, and first bristled at the thought since there were doctors in the family). But I didn’t care so much – who among us hasn’t changed their college major or master’s program once or thrice? Depending on your existing worldview, you’ll either find Kalanithi’s ultimate choice of neurosurgery as either inspired or eye-rollingly hubristic.Kalanthi is interested in the mind-body problem, and I know that he would have studied it specifically. But, disappointingly, he can’t muster much more to say about it than platitudinous rhetorical questions (“There must be a way, I thought, that the language of life as experienced – of passion, of hunger, of love – bore some relationship, however convoluted, to the language of neurons, digestive tracts, and heartbeats.”)For someone who decided (years ago, as a student) that “human relationality” “undergirds meaning,” it’s a little rich that Kalanithi had become estranged from his wife prior to his diagnosis and then barely mentions her pregnancy in passing. I do believe it’s noble that Kalanithi tried to relate to his patients on a human level, especially seeing as how he operates on what he takes to be the seat of their souls. But readers are just as likely to feel alienated by Kalanithi’s focus on strangers to the detriment of those close by. It’s like an overdone character in a book: doctor too busy caring for patients to care for his own wife, oops! The very last paragraphs Paul wrote are about his infant daughter Cady, and the joy she brought him as he died. But that’s why those bits seem a little surprising. Perhaps, due to Kalanithi’s increasing frailty, the part of the journey that turned him from arrogant doctor into sated family man simply went mostly unwritten.To be clear, producing a single book that encapsulates everything someone with a full professional and personal life might want to say is a totally Herculean task (especially to undertake while already critically/terminally ill). It’s certainly no surprise that When Breath Becomes Air isn’t completely satisfactory in that regard. You don’t have to be a perfect person to write a good book, either. But since this is a book review…The highlight reel of Kalanithi’s life doesn’t make you feel especially connected to him, but you feel obligated to preemptively develop some empathy because you know what’s coming next. His experiences training as a doctor are sort of depressing and cliched: start ambitious, end desensitized. His experiences as a student shouldn’t have to be that significant. But because his life is turning out to be rather short and he was a student for most of it, they become forced into significance. I don’t know exactly what I’d want anyone, dying or not, to say about “human relationality” vis a vis meaning in life (personally, I don’t think there’s any such meaning to be had, but the question comes up often enough that there has to be something to say).Throughout, Kalanithi’s writing is alternately beautiful and cringe-worthily heavy-handed (“in taking up another’s cross, one must sometimes get crushed by the weight”). It’s clear that he’s trying to find a comfortable writing voice (while also grappling with the weightiest possible subject matter), and under such pressure. What a shame that he got only an ill-fated Titanic crack at writing a book. If this material had spanned a few decades instead, who knows how it could have come out.I did especially enjoy (???) the section on glioblastoma, from a neurosurgeon’s point of view. It helped me to more fully envision the events that unfolded around my family member’s recent diagnosis. The epilogue, by Paul’s widow Lucy Kalanithi, is quite beautiful (a number of Amazon reviewers like it better than the rest of the book). It helps to drive home that Paul is gone, his life’s previous work (doctoring), new work (writing), and would-have-been-future-work (parenting) all left unfinished. She too must find her voice for this task under immense pressure, kudos for that. I have only begun to dip a toe into the mental fog of grief and it’s enough to make you forget how to brush your teeth, let alone how to write something huge numbers of strangers would want to read.All of the above notwithstanding, I read the book very quickly and definitely cried at the end.Read this book if you’re interested in how a doctor thinks about his own death and if you don’t mind stories without silver linings.Don’t read this book if you’re very put off by arrogance or intellectualism.

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