Book Review: When Breath Becomes Air

When you read this slim volume, you know that neurosurgeon and scientist Dr. Paul Kalanithi could have been a writer — is, in fact, a writer albeit of this one lone book. For those of us who love words, I wish we could have had more.

Paul Kalanithi was 36 and on the cusp of a stellar career in neurosurgery when he was diagnosed with Stage IV metastatic lung cancer. He died two years later, the cancer having broken through a gene-targeted treatment, then two rounds of chemotherapy with different drugs. Any of the treatments might have worked a little longer, none did.

I took this book with me to Panama, and read it twice. Now I’m recommending it to both of my kids, who are around Dr. Kalanithi’s age when he died. Matt asked if it’s a meditation on death. It isn’t, actually. Rather, it’s a meditation on life.

The core question for Dr. Kalanithi, from the moment of his diagnosis, was “what do you want most?” I find the question relevant at 71. I wish I had focused on it more clearly in the decades of life that I’ve already had. That’s why I’m hoping Sara and Matt will read it. The answer for Dr. Kalanithi evolved during the course of his illness and treatment. Did he want to get back to neurosurgery? Yes, for as long as possible. Did he and his wife want to have a child, knowing that his time might be short and that his wife would be left to raise the child alone? Yes. Elizabeth Acadia, aka Cady, was eight months old when her father died. What were his treatment options, and what was he willing to endure for a chance at a few more weeks, a few more months, even  a wildly optimistic few more years of life?

I didn’t find the book depressing, although the book’s final chapter is written by his wife Lucy, after the cancer left him too debilitated to finish writing. Her part fits seamlessly with his, which I suspect reflects their commitment to walk through his end-stage lung cancer together. I think their daughter will read the book one day, and she will know that she was born out of a deep and abiding love. This is a meditation on life, and it’s a love story — and as such, it leaves me with hope despite Dr. Kalanithi’s untimely death.

I originally got the book on my Kindle, but I’ve bought a hard copy to pass along to Matt and Sara. Some books simply deserve to be read in print form, so that you can feel the weight of the story in your hands. This is a strong book, a beautiful book, written by a strong and beautiful and ultimately vulnerable man. Do take the risk of reading it, even if you normally shy away from sad topics. There’s no miracle ending here, but there is a life well and gracefully lived, a story elegantly and powerfully shared. Don’t miss the experience.

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