When Breath Becomes Air

4.5 starsAt age 36, in the last year of his neurosurgery residency, Paul Kalanithi discovered he had stage IV lung cancer. For the next 22 months, he and his wife Lucy, an internal medicine physician, awoke each day focused on living, not “living until...” When Breath Becomes Air was written largely because Dr. Kalanithi had the soul of a poet and turning to words to express any experience in life was as instinctive to him as breathing itself. His intent was that his story could aid in the healing of others and that one day his own daughter would read it and get a sense of the father she would never remember.The book’s format, like the author’s writing style, is simple, straightforward, eloquent, and unflinchingly honest – Prologue, Part I and Part II. In the prologue, Paul describes the first step in his diagnosis, getting x-rays for his recurring severe chest pain. It was 15 months prior to the end of his residency. He could see the light at the end of the long 10-year tunnel of preparation for his work in neurosurgery. There would be wonderful opportunities to practice as well as conduct research, offer of a professorship, a huge increase in income, a new home and starting a family with Lucy. The x-rays were fine, he was told. But he had lost weight and the pain was not letting up in severity. He began researching incidence of cancer in his age group. Things with Lucy were strained at that time, partly because he was not sharing his concerns about his condition. She decided against going with him on a vacation with old friends in order to sort out her own feelings about their relationship. He came home in severe pain after just a couple of days. She picked him up from the airport. After he told her about his symptoms and his self-diagnosis, she took him to the hospital that night where a neurosurgeon friend admitted him.Most of Part 1, In Perfect Health I Begin, describes life prior to the diagnosis, obviously back to his childhood. Both of his parents were immigrants from India, his father a Christian and his mother Hindu. Both families disowned them for many years. They moved their own family of three sons from Bronxville, New York to Kingman so Paul’s father could establish a cardiology practice, which he did very successfully. Paul’s mother had been trained as a physiologist in India before eloping with Paul’s father when she was 23. Her own father had defied the traditions of 1960s rural India and insisted that his daughter be educated and trained for a profession. She was horrified to discover that Kingman’s school district was among the lowest performing in the entire country. Her eldest son had been educated in Westchester County, New York schools, where graduates were assured of admission to the nation’s most prestigious universities. He had been accepted at Stanford before the move to Kingman. What would happen to 10-year-old Paul and his 6-year-old brother Jeevan? Instead of wringing her hands, Mrs. Kalanithi threw herself into supplementing her sons’ educations and improving that of all the children in the area. She gave Paul a reading list intended for college prep students and at age ten he read 1984, followed by many other modern and traditional classics. He discovered a love for words as an expression of the human spirit. His mom got elected to the school board and worked with teachers and others to transform the school district. After a few years their 30+% dropout rate was greatly reduced and graduates were getting accepted at universities of their choice.No doubt Paul was born with that poetic soul, but it was his mother’s guidance that led him to read the literary giants who nourished that soul. It was his parents’ examples of excellence in their own lives, their faith, and service to their community, in this strange land that they made their own, that formed Paul’s desire and need to serve.In When Breath Becomes Air, he writes of vocation, a term you rarely hear people use these days. A thousand years ago when I was growing up, vocation was ubiquitous. We were told time and again that discerning our vocation was one of our prime responsibilities as human beings. It was our reason for being here, what we were called to do in service to humankind. Teaching, medicine, religious ministry, musicianship, military, etc. By knowing our natural talents we could know our vocation.Paul had many talents and interests, complicating his vocation decision. He studied both English literature and human biology in college. “I still felt literature provided the best account of the life of the mind, while neuroscience laid down the most elegant rules of the brain.” Also a man of deep spirituality, Paul reflected, “Literature not only illuminated another’s experience, it provided, I believed, the richest material for moral reflection. My brief forays into the formal ethics of analytic philosophy felt dry as a bone, missing the messiness and weight of real human life.” The intersection of science and morality was of prime interest to Paul.The rest of Part I describes how Paul came to see medicine and then neurosurgery as his vocation. He forthrightly deals with the idealism of medical students and residents and how that idealism is dimmed or completely snuffed out by the realities of giving medical care to other human beings. His explanation of cadaver dissection and why physicians and their families do not donate their own bodies to medical science is eye opening. “Cadaver dissection epitomizes, for many, the transformation of the somber, respectful student into the callous, arrogant doctor.” This is the kind of honesty displayed throughout the entire book. He writes of his own loss of idealism and how the recognition of that affected his own self-image as well as his job performance. “I wondered if, in my brief time as a physician, I had made more moral slides than strides.”That earlier mentioned phrase, “the messiness and weight of real human life” describes this book. The author has given the world not a mere recollection of events or achievements, but has laid bare his soul, exposing the very marrow of his being. This book should be read by every premed student in the world before they commit to a decade or more of study and relentless hard work.In Part II , Cease Not till Death, the author details the diagnosis, the immediate aftermath, the determination to emphasize living not dying, the quest to conceive a child, and the agony involved in treatment. I think Part II should be experienced by each reader. Most readers will find it extremely compelling and very personal. It is the nitty gritty of this man’s inner being. Lucy, his wife, wrote an eloquent epilogue further detailing Paul’s experience while writing this book, the support they received from colleagues, friends, family, and others after his death on March 9, 2015.I found this book soul wrenching, but also witty, uplifting and hopeful. Without preaching, he reveals some deep flaws in the way we do health care and the price that not just patients but the care providers sometimes pay. In our war with cancer, it won a battle here by taking this remarkable man so early. He would have touched hundreds of students and thousands of patients with the professorship that would have been his. But When Breath Becomes Air is sure to touch millions of us. Cady Kalanithi will one day be able to read for herself just who her father really was.Rating: 4.50/5.0.

The book is very well written, you get caught by Paul's story. The process of becoming a great neurosurgeon and the process of dying are told in an intense and interesting way.

I have a bachelors in English and was reading this as part of a Masters class.Long story short: this is not an uplifting read and is laudable only in that it made me literally cry. Unfortunately, most people will most likely remember this book solely for its emotional strength and less for the arguments with which Kalanithi struggled to answer.I would not recommend this book to any causal reader on its own. Perhaps as part of a course of study or other such intentional read, Otherwise I can only assume this book has received such high accolades on the strength of the emotional impact alone. To be fair, this is the first book I have ever read that made me literally cry, and I do not say this as hyperbole. I literally cried for nearly an hour, despite foreknowledge of the ending, as I slogged through the epilogue.Kalanithi is a troubling author and the book is troubled for it. Though it isn't patently obvious, and no one would set forth to write themselves as the villain in their own memoir, I would not call Kalanithi a good person. So before I explicate that thought let me say that he is evidently, and demonstrably, intelligent as his various degrees and awards would attest. Yet his writing is of merely good quality for most of the book, though it is not by far the worst I have ever read. This results in a somewhat conversational retelling of his life, interspersed with the occasional medical jargon, that centers around an obsession with death and the meaning of life. All of this combined with some genuinely interesting philosophical examinations drove me to read the whole book in two sittings (though were it not for life circumstances it could easily have been one).The real issue begins with the fact that the narrative follows a pattern in which he will tell of something ostensibly happy followed by something dramatically more depressing or horrifying. At one point he speaks of the life of a surgeon as being "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" (pg 44 Kindle edition near location 508). I suspect his writing pattern was an attempt to emulate this feeling within readers, though perhaps that is going a step too far. What this functionally results in is that often he does not, or perhaps will not, account for nor explain certain statements that, given the philosophical nature of his work, require explication. He speaks of moral implications but then never explores said issues; he has none of the contemplative introspection I would expect but rather only entangles his recollections with rhetoric. Not only that, but there are a few small instances wherein he either implies or does something morally dubious that then taint his arguments.A friend of mine said, " I feel enriched but also much emptier. This was by far the most profoundly troubling work I've read yet". Not only do I agree with that sentiment generally, but I also can't say I'm any better for having read it. Ultimately, I fear that the visceral emotional impact will far outweigh any of the more interesting arguments of this book. That for me, at least, is the real tragedy of this book.

Livro com reflexões valiosas sobre a vida. Para refletirmos sobre a nossa finitude. Vale a pena ler essa historia inspiradora de um medico que inverte seu papel para de um paciente terminal.

As I’ve been trying to face my own fear of death and dying, I stumbled upon this book. In 4 hours, I’ve read the entire thing without being able to put it down. My only regret, I bought the Kindle version instead of hardcover (however I now have a hardcover on order to permanently live on my book shelf).This book is important because it’s not so much a memoir as it is an in-the-moment account of a cruel fate that is gracefully accepted. Many of us wonder how we will react when we face our certain death, this book gives you a slight taste of the rollercoaster ride I can only assume we all will face if we are fortunate/unfortunate enough to be able to know our fate.As someone who recently had their first child, this book is heartbreaking. However, this is one (likely the only) book I’ve ever read which has allowed me to ponder what type of legacy I would like to leave. Paul’s thought process is spilled onto the page in a raw format which outlines his attempts to answer this question and with a final chapter written by his wife, I believe he achieved as much as one can.This book is an absolute must have for anyone looking to see one man’s (valiant) attempt at finding meaning in a sometimes unfair world. Reading up to 100 books per year and never leaving a single review prior to this should resonate just how important this text is for any human to read.Great work Paul and Lucy, this is an amazing piece of literature. Thank you for the humour, reality, and tears.

Libro bien escrito, del principio hasta el final. Sorprendente la última parte ya que toca la fibra y es muy emotivo.

"When Breath Becomes Air" is a profoundly moving exploration of life, death, and the human spirit that left an indelible impact on me. Written by the late Dr. Paul Kalanithi, a neurosurgeon diagnosed with terminal cancer, the book offers a poignant reflection on mortality and the pursuit of meaning.Kalanithi's eloquent prose beautifully captures the essence of his journey, navigating the realms of medicine, philosophy, and literature. The narrative weaves between his experiences as a doctor and a patient, creating a powerful narrative that is both intellectually stimulating and emotionally resonant.As he grapples with his own mortality, Kalanithi invites readers to contemplate the universal questions of existence. The book delves into the fragility of life, the significance of our choices, and the search for purpose in the face of inevitable death.The raw honesty and vulnerability displayed by the author make "When Breath Becomes Air" a profoundly human story. It transcends the confines of a traditional memoir, touching on themes that resonate universally. Kalanithi's introspective exploration of love, identity, and the meaning of a life well-lived leaves an enduring impact, prompting readers to reflect on their own lives and values.In essence, "When Breath Becomes Air" is not just a book; it's a testament to the beauty and fragility of the human experience. It is a poignant reminder that in confronting mortality, we find the essence of what it truly means to live

As expected.