WHEN BREATH BECOMES AIR

By Paul Kalanithi

Released : 10/10/2020

Reviewed : 26/09/2020

Reviewed by: Meesha Luwang

This book was published posthumously almost a year after the death of Dr. Paul Kalanithi, a neurosurgeon, who died of lung cancer in his 30s. The foreward, which was beautifully written by Abraham Verghese (of Cutting for Stone-fame) gave a glimpse into the beauty of this book. Kalanithi’s love for language and literature made him pursue a BA and MA in English Literature from Stanford University, from where he also received a B.Sc. in Human Biology. He also received an MA in History and Philosophy of Science and Medicine from Cambridge Univeristy. Not satisfied with where he was heading in life, and arguing that direct experience of life-and-death question was essential to generating substantial moral opinions about them, he enrolled in Yale School of Medicine to become a doctor and a neurosurgeon. Towards the end of his residency he was diagnosed with lung cancer and had to battle against all odds to save his life and his identity. The man who chose to become a neurosurgeon to pursue death: to grasp it, uncloak it, and see it eye-to-eye faced his death the same way- unblinking. Somewhere in the book he wrote “Shouldn’t terminal illness, then, be the perfect gift to that young man who had wanted to understand death? What better way to understand it than to live it?” Throughout the book I felt a sense of urgency; that time was running out. That theme ran throughout the book. While I liked what he had written about his life and training days and residency there were some moments in the book that tore my heart apart::

When his co-resident killed himself after he lost a patient. A man who had trained for years to actively engage with death and grapple with it ultimately let death win. It brought up the important but often hushed up topic of physician suicides. It touched upon the guilt felt by doctors when things go wrong even when they had done all they could.

When he sat in his car and cried after he had performed the last surgery of his life, a decision he was forced to take after his cancer spread too rapidly to be contained.

When he had to miss his own graduation, an event for which he had given his whole life (literally) and which almost cost him his marriage.

Some people had mentioned howsloppy his writing was and how much better the epilogue (written after his death by his wife) was. But remember, he had written this book in his dying days when he couldn’t stand or sit without support, when his mind was foggy because of the illness and the drugs and when he was fighting against time. The book ended abruptly but in a way the incompleteness completed his story because that’s how life often is and so few of us get to plan the chapters of our lives. This book is no literary masterpiece but it’ll make you question your mortality, your worth, and your place in the world. It will break and mend your heart at once and it’ll shatter and soothe your soul at once.