When Breath Becomes Air – Paul Kalanithi

This book has popped up all over the place for me this year. People’s recommendations, best seller lists, and I finally got around to picking it up for myself last night. When Breath Becomes Air details Kalanithi’s journey from successful neurosurgeon on the cusp of finishing his residency to his role reversal as a patient with inoperable lung cancer. The book is divided into a touching foreword that prepares you for the journey, a prologue and two parts: his healthy life pre-cancer and living post-diagnosis and a touching epilogue written by his wife. This book ended up a little more personal than I realised and left a strong impression that is unlikely to fade.


I was especially stuck by Kalanithi’s account in part one: In Perfect Heath I Begin. What a striking, unique individual he was. His interests in both literature and biology searching in pursuit of understanding and experiencing all that life and death has to offer. For someone to have such strong and dare I say equal respect and love for both literature and psychology and biology and medicine is incredibly rare and impressive. His character and substance continued surprising me through his career with his dedication to keeping his humanity while working with his patients, striving to not letting them become purely a case to be dealt with and solved. Working in the field of healthcare I feel I can take some lessons from his practices. While I am not a doctor and do not work often with terminally ill patients I still think it is important to keep the humanity and remember that the people you work with are no merely patients but unique individuals with tier own story. The world is truly a poorer place without Kalanithi in it and I can only begin to imagine the differences, the breakthroughs he could have made in neurosurgery had he been given a long life to work with. Instead, as his wife Lucy details, he has left his legacy in this beautiful piece of prose.


The prose of this book is reminiscent of the poetry he clearly loved in his lifetime. As Abraham Verghese writes in his foreword if you do read this book ensure you read Paul’s final passage aloud and revel in the poetry and meter of his words. The writing will take your breath away. Paul’s words are incredibly honest and he has truly left a gift for those walking down their own paths of terminal illness, be it their own or someone in their life who is walking this difficult road. I found his unique experiences of transitioning from doctor to patient incredibly enlightening. Most honest of it all is the reality that Paul’s writing was left unfinished. He was unable to finish all he had to give before his passing, truly reflecting the tragedy and beauty of life.


This book draws several parallels with another favourite of mine, The Last Lecture by Randy Pausch (another I would highly recommend) and I know When Breath Becomes Air will join it in the category of most loved books that have so many lessons embedded in them. Books that we should all read at least once, if only to be reminded that we are all lucky for what time we have, to continuously strive for making the most of what we have and to discover what is most important in our own lives and to focus on that which makes us happy. My heart goes out to his wife, Lucy and daughter, Cady. The gift he has left her is truly beautiful and my heart breaks for his time cut short, though it is clear he gave it everything he had.


I would highly recommend this book to anyone. This is the type of book we should all read at least once. For the lessons to be learned. For the perspectives to be gained. For the poetry in the prose. When Breath Becomes Air is a truly memorable book and I give it five microscopic lenses, pivotal for neurosurgery, the passion of Paul’s life.


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