Often books become faded memories soon after having read them. Occasionally, a book comes along that one remembers even after the storyline itself fades away. Once in a rare while, a book comes along which needs to be reread.

Here’s a book that will make you pause and think, put it down, think some more.

When Breath Becomes Air
Paul Kalanithi

Publisher’s summary
A profoundly moving, exquisitely observed memoir by a young neurosurgeon faced with a terminal cancer diagnosis who attempts to answer the question—What makes a life worth living?

At 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. 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. 


From Richard’s Desk…

As I began reading this book, my dislike of it grew with each page. A third of the way through, I called it quits. Too much gore, too much medical detail, too clinical. Definitely not to my liking at all. I set the book aside.

This book was one of our book club assignments and I always feel I have an obligation as a club member and as its secretary, to complete the assignments. The gnawing responsibility became increasingly intolerable as the book club meeting date neared. I picked up the book and resumed reading. I am glad I did.

Kalanithi writes well. He is steady in focus. He remains on task. He makes his point, embellishes it a bit, reinforces it and moves on.

The neurosurgeon’s early career is an examination of his role as a doctor, his role as a purveyor of cures and medical solutions to patients in need. His successes are tempered by some sad failures. But as a doctor, he excels and his ambitious goals spread about before him like the feathers of a colourful peacock. So much to choose from, so many things to consider.

Sadly, in his dynamic mid-stride, his marriage develops serious problems. A separation seems imminent, juxtaposed by surprising professional opportunities. His career is blooming extremely well, his personal life, declining into shambles.

And then, the ace of spades, the death card. Diagnosed with lung cancer, Kalanithi’s variety of plans are all shelved. Termination of all of them seems inescapable, confirmed increasingly by his research into the disease, lung cancer, and the most serious kind, to add insult to injury. Depression arrives at his door, his future seems to have been terminated.

Enter Emma, his doctor for the course of the malady, a calm, collected, and very objective medical professional who almost seems cold in her bedside manner. Where he sees no hope, she prescribes the first mode of treatment, a drug which has had significant success with many others.

The lull before the storm is the result of the drug. Kalanithi seems to recover, his cancer into significant remission. Fate repeats the deal. The cancer returns. The new mode of treatment, chemo. Again, the process repeats itself.

Meanwhile, the marriage dissolution is put on hold by mutual agreement. In fact, the couple plans on having a baby. With clinical assistance, Lucy becomes pregnant. Additional good news, Kalanithi’s condition seems to be on hold.

While the condition pauses its mortal trek, Kalanithi continues his writing and examination. In his academic days, Paul had considered becoming a writer. He would have been a successful one. He reverts to writing to keep his sanity as the world around him continues its decline due to the disease. Good that he picked up the pen again for his introspective questions about the significance of life, its meaning, and a person’s role and responsibilities in it are profound and resonating. His questioned resonated so vibrantly, I set the book aside again to give some thought to his introspective questions.

Unfortunately, the story gets worse, bittersweet. The sweet joy of his daughter, Cady’s birth was embittered by the news that the chemotherapy failed. His cancer returned with a deadly resurgence. His possible years of life with treatment became months to death.

Kalanithi’s gamut of the emotions a person goes through upon received a death sentence stopped at the last stage: disbelief, denial, pain, anger, bargaining, depression, and acceptance. He began cherishing the positive things of each day, the good, the loving. His wife and his daughter, his parents and in-laws, and his colleagues and close friends.

He died in March 2015, just two years after diagnosis.

A worthwhile read?
The book is an enjoyable read if one evaluates it strictly from the angle of being a literary work. It reads well, It is written well. The writer writes with professionalism and class. It’s a good book.

The book’s subject matter, not so much, distasteful to many people averse to thinking about their mortality. People who think about their lives passing by, passing by quickly, passing by faster than they may like, would not likely enjoy this book. This book not only reminds a person about their mortality but it asks profound questions about a person’s reasons for being here. This can be discomforting for many people.

I liked the book because its author demonstrated courage and optimism where one would think no positive emotions could possibly be found. Kalanithi’s book reinforces the idea of a person doing some introspection to find reasons to be grateful and thankful for living and for having lived.



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