When Breath Becomes Air by Paul Kalanithi

Review: When Breath Becomes Air by Paul Kalanithi

By Phoebe Breed

When Breath Becomes Air by Paul Kalanithi landed on my bookshelf long after first hearing about the book from a co-worker of mine in the operating room. Jeannie specialized in neurosurgery, scrubbing in alongside our surgeons, and was captivated by Kalanithi’s experience and his writing. At the time I was in graduate school to be a nurse practitioner and my boyfriend of many years was in his general surgery residency. That being said, I didn’t think it was a good time to read a heartbreaking memoir about a neurosurgery resident who was diagnosed with stage IV lung cancer.

Now that I am gearing up to start my first job as a nurse practitioner, I have been pondering how much I am able to elicit from patients what makes their lives worth living. This is especially important as I will be working in geriatrics and palliative care: with people reflecting on their lives, and making decisions about what quality of life means to them. Given this stage of my life, I thought it was finally time for me to dig into Kalanithi’s dying work. I was not disappointed.

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 naive 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 I Liked

Paul Kalanithi is a gifted writer. This makes complete sense, given that he has both a bachelor’s and a master’s degree in English literature, from Stanford no less! Reading his words was a fluid experience. His writing is easy to follow, but it was not simple. I walked away from this book marveling at the vocabulary Kalanithi demonstrated. I certainly learned several new words, but did not feel foolish for not knowing them because of the ease with which he slid them into his sentences.

The story. I’m not sure if this story would be quite as moving if I was not closely tied to both medicine (through my career as a nurse, and now a nurse practitioner) and the surgical training process (through my foolish decision to start dating a young surgeon during his first of five years of general surgery residency!). However, I think everyone can relate to the questions that Kalanithi raises about the meaning of life.

His unapologetic tone. Kalanithi and his wife make a big decision after his diagnosis to have a child together. This is just one example of a decision that Kalanithi and his family made during his illness that one could judge him for, but he never lets you. His tone sheds light on the importance of individuals’ choices to the individual, not to the world. This was his life, and it was up to him how to live it. Yes. Just, yes.

The epilogue. Kalanithi’s wife, Lucy, wrote the ending to his book, and it was refreshing to have her experience shared, as well as important to know how Kalanithi’s story ended.

What Wasn’t My Favorite

The epilogue. I loved Lucy’s ending to the book, but is also the part that broke me the most. The description of Kalanithi’s last days was difficult, and I found myself in Lucy, which made reading her writing all the more difficult.

Favorite Quotes

“I received the plastic arm bracelet all patients wear, put on the familiar light blue hospital gown, walked past the nurses I knew by name, and was checked into a room – the same room where I had seen hundreds of patients over the years. In this room, I had sat with patients and explained terminal diagnoses and complex operations; in this room, I had congratulated patient on being cured of a disease and seen their happiness at being returned to their lives; in this room, I had pronounced patients dead. I had sat in the chairs, washed my hands in the sink, scrawled instructions on the marker board, changed the calendar. I had even, in moments of utter exhaustion, longed to lie down in this bed and sleep. Now I lay there, wide awake.
A young nurse, one I hadn’t met, poked her head in.
‘The doctor will be in soon.’
And with that, the future I had imagine, the one just about to be realized, the culmination of decades of striving, evaporated.”

“Neurosurgery is really hard work, and no one would have faulted me for not going back. (People often ask if it is a calling, and my answer is always yes. You can’t see it as a job, because if it’s a job, it’s one of the worst jobs there is.)”

Rating