Each breath we take signifies our presence in this world. Each breath we exhale carries our burdens and accomplishments, our joy and our pain. When we cease to be, breath simply becomes air, a mere collection of molecules that further imposes our absence. This then begs the question, did every breath that I have taken mean something in this vast world? This is a story about life, death, and everything in between. When Breath Becomes Air is a raw and unparalleled story about a successful, young neurosurgeon’s struggle with life and meaning and his sudden confrontation with death.
Paul Kalanithi was a successful, young neurosurgeon with months left in his residency. He was receiving a lot of lucrative job offers and was finally realizing the fruits of long years of studying when he was suddenly diagnosed with lung cancer. He started a memoir of his life experiences during the last year of his life, and in it, he weaves in and out of specific life experiences and inner thoughts. The novel was not perfect, but it was real and natural. It was refreshing to read about his uncensored thoughts; he courageously talks about even his worst ones, such as how he sometimes could be guilty of being apathetic towards his patient’s concerns.
The first part of the novel — “In Perfect Health I Begin” — delves into Paul’s formative years. He narrates why he chose to major in English literature in college and his journey to realizing his calling as a neurosurgeon. Even though he writes in a direct way, it is evident that he is skilled in prose, as seen in one of my favorite lines in which he talks about going to college: “I felt less like someone preparing to climb a career ladder than a buzzing electron about to achieve escape velocity, flinging out into a strange and sparkling universe.” He struggled to choose between science and English to explore two different facets of the same question: what makes human life meaningful. I enjoyed how the author’s ideas about each field developed and how he tried different experiences and ultimately realized his calling. He chronicled his experiences throughout his years at Yale Medical School, from the early years of dissecting cadavers to doing rounds at the hospital. He wrote about his experiences in such a way that technical situations unique to doctors are explained easily through analogies to real-life, everyday situations, therefore still allowing for readers to connect without prior knowledge of medical jargon. This first half was a bit rushed and sudden; however, it is understandable since it was written in retrospect to his current life situation.
Kalanithi then spends the next half of the book struggling to deal with being diagnosed with lung cancer. He starts off with acceptance that he will never be a neurosurgeon again, an obsession with prognosis and survival curves, and hopelessness, among others. He was amazed by how different seeing death from the outside as a doctor was from directly experiencing it himself. However, as time goes by, his view of the situation becomes a bit more positive. As he reflects in one line of the book, “The fact of death is unsettling. Yet there is no other way to live.” It was very humbling and realistic to see this successful, sure man have the humility to admit that he has no idea what to do, but the most important part is that he persists through the confusion to find meaning in life again. He turns back to literature to translate his experiences to words in the hopes of sharing it with others. He and his wife make the decision to have a child, which Paul accepts as something that would enrich his life rather than add another unnecessary suffering. After months of being cancer-free, he relapses and the disease comes back more aggressively than before. He persists and lives a life that is filled with small joys such as writing, his family, and, most especially, his daughter. His story ends with a dedication to his daughter about the joy she brought to a dying man’s life.
When Breath Becomes Air is a must-read that offers innumerable lessons. It is not a perfect story; it is flawed and does not give a clear conclusion. It’s a tragic story about how to live and how to face death. Yet, how the author describes each of his life experiences — in painstaking and raw detail — makes this book unparalleled to any other that I have read. Urgency and truthfulness ring with every word and the way each sentence is written makes a connection with the reader that lasts until the last page. However, if you are looking for a guide on how to come to terms with eventual death, this book is not for you. This book simply narrates a dying man’s thoughts and realizations in life, and you as the reader go through the journey with him, often asking yourself the same questions that he asks in the face of death. This narrative may affect different people in different ways; it is paradoxically specific and universal at the same time.