When Breath Becomes Air

by Paul Kalanithi

Hardcover, 2016

Status

Available

Publication

New York : Random House, 2016.

Description

"For readers of Atul Gawande, Andrew Solomon, and Anne Lamott, 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," he wrote. "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. Advance praise for When Breath Becomes Air "Rattling, heartbreaking, and ultimately beautiful, the too-young Dr. Kalanithi's memoir is proof that the dying are the ones who have the most to teach us about life."--Atul Gawande "Thanks to When Breath Becomes Air, those of us who never met Paul Kalanithi will both mourn his death and benefit from his life. This is one of a handful of books I consider to be a universal donor--I would recommend it to anyone, everyone."--Ann Patchett"-- "At the age of 36, on the verge of a completing a decade's worth of training as a neurosurgeon, Paul Kalanithi's health began to falter. He started losing weight and was wracked by waves of excruciating back pain. A CT scan confirmed what Paul, deep down, had suspected: he had stage four lung cancer, widely disseminated. One day, he was a doctor making a living treating the dying, and the next, he was a patient struggling to live. Just like that, the future he and his wife had imagined, the culmination of decades of striving, evaporated. With incredible literary quality, philosophical acuity, and medical authority, When Breath Becomes Air approaches the questions raised by facing mortality from the dual perspective of the neurosurgeon who spent a decade meeting patients in the twilight between life and death, and the terminally ill patient who suddenly found himself living in that liminality. At the base of Paul's inquiry are essential questions, such as: What makes life worth living in the face of death? What happens when the future, instead of being a ladder toward the goals of life, flattens out into a perpetual present? When faced with a terminal diagnosis, what does it mean to have a child, to nuture a new life as another one fades away? As Paul wrote, "Before my cancer was diagnosed, I knew that someday I would die, but I didn't know when. After the diagnosis, I knew that someday I would die, but I didn't know when. But now I knew it acutely. The problem wasn't really a scientific one. The fact of death is unsettling. Yet there is no other way to live." Paul Kalanithi passed away in March 2015, while working on this book"-- On the verge of completing a decade's worth of training as a neurosurgeon, Kalanithi was diagnosed with stage IV lung cancer. Just like that, the future he and his wife had imagined evaporated. Kalanithi chronicles his transformation from a naïve medical student 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.… (more)

Media reviews

“When Breath Becomes Air” is gripping from the start. But it becomes even more so as Dr. Kalanithi tries to reinvent himself in various ways with no idea what will happen. Part of this book’s tremendous impact comes from the obvious fact that its author was such a brilliant polymath. And part comes from the way he conveys what happened to him — passionately working and striving, deferring gratification, waiting to live, learning to die — so well. None of it is maudlin. Nothing is exaggerated. As he wrote to a friend: “It’s just tragic enough and just imaginable enough.” And just important enough to be unmissable.

User reviews

LibraryThing member arubabookwoman
Paul Kalanithi was diagnosed with stage 4 lung cancer at age 36 just as he was finishing his fellowship in neurosurgery. This is a moving memoir as he faces his untimely death. There are lots of literary references, as Paul was also a serious reader, considering a Ph. D. in literature at one time. I was most moved by the message he left for his daughter, who was born during his illness, in the closing paragraphs of the portion of the memoir he wrote. His wife wrote an afterword, which is also very moving, in which she states: "What happened to Paul was tragic, but he was not a tragedy."

Recommended

3 1/2 stars
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LibraryThing member stellarexplorer
When Breath Becomes Air by Paul Kalinithi.

The author was a young neurosurgeon who learned he had metastatic terminal cancer when he was 36, just finishing his training. Throughout his life, Kalinithi sought to understand what it meant to live a meaningful life. This book represents the work he did, in his final year of a life cut tragically short, to convey as much as he could of what he learned. In the process, he shows us the dying that is part of living, not shrinking into the avoidance of death that is so prevalent in our faux-immortal culture that glorifies youth and vitality.

This is a beautiful work, a remarkable accomplishment were he not so ill, and yet no doubt not possible without the felt immediacy of his situation. Kalinithi managed to grieve, to fear, to lose, and still to love, to have courage, and to face reality with open eyes and steadfast clarity. He put a lifetime of thought and struggle with ideas into this book, and it fails him to try to summarize, other than to say that he squeezed every bit of meaning and purpose he could muster into his life and his remaining time. His love for his wife, his friends and his service through doctoring helped to sustain him. And in no small measure so did his infant daughter, conceived after his diagnosis. In his words, and though these are his final thoughts in the book, I think it is worth quoting them here because they will tell you much about him and about whether this is something you may want to read:

"There is perhaps only one thing to say to this infant, who is all future, overlapping briefly with me, whose life, barring the improbable, is all but past.
That message is simple:
When you come to one of the many moments in life where you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man's days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more but rests, satisfied. In this time, right now, that is an enormous thing."

I am much the better for having read this.
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LibraryThing member jwhenderson
I cannot remember reading a more courageous book. The author, a neurosurgeon who was both a reader and a writer, was able to face being diagnosed with stage IV lung cancer and write about his experience of being treated. More than that he writes about a demonstration of transformation through his own example; first from a young student of literature into a Neurosurgeon/ Neuroscientist; and second, from an intelligent thriving man into a seriously ill man facing the imminent nature of his own mortality. How he was able to face both that battle and his own limitations that resulted from the battle comprise this inspirational story.

The demands placed upon a medical student are tremendous. They are described in detail with a beautiful prose style that blends reality with metaphor in a seamless way. These demands are nothing compared to the demands that Paul placed on himself as he traversed the difficult course toward his twin goals of neurosurgeon and neuroscientist. His residency is described as a breathless experience, yet one that allowed him eventually to breathe a little as he observes, "By this point in my residency, I was more experienced. I could finally breathe a little, no longer trying to hold on for my own dear life." (p 88)
He describes the tension when operating on the brain or near the spinal cord; where minuscule movements can make the difference between life and death or, even worse, life without some necessary brain function. The suspense of these moments is palpable for the reader.

After being diagnosed with lung cancer and beginning to undergo treatment that, perhaps, might extend his life enough to provide at least the possibility or part of the life he had originally planned, he underwent periods of pain that made his life incredibly difficult. One thing from his earlier life became a life-saver, however temporary, for him. It is a moment when he shares, "Lost in a featureless wasteland of my own mortality, and finding no traction in the reams of scientific studies, intracellular molecular pathways, and endless curves of survival statistics, I began reading literature again: Solzhenitsyn's Cancer Ward, B. S. Johnson's The Unfortunates, Tolstoy's Ivan Ilyich, Nagel's Mind and Cosmos, Woolf, Kafka, Montaigne, Frost, Greville, memoirs of cancer patients--anything by anyone who had ever written about mortality." (p 148) He was trying to make sense of death and find a way to begin to define himself with a vocabulary that was meaningful and helpful. It was a vocabulary that would help him understand his own experiences. It was a process that worked as he concluded, "And so it was literature that brought me back to life during this time. . . I got out of bed and took a step forward, repeating the phrase over and over: 'I can't go on. I'll go on.' [Beckett]" (p 149)

He was able to return to work for a period of time. Not at the level he had been at when first diagnosed, but at a level that allowed him to contribute and attempt to be the surgeon he once was. But the joy was gone, and eventually the cancer returned. Paul writes eloquently of the final days with his wife and new-born baby. Yet his life did not have the longevity that his words would. His life, his breath, allowed him to share a story of fortitude and courage, becoming an inspiration for his family, friends, and all who have the honor to read his memorable memoir.
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LibraryThing member clamairy
I cried several times while reading When Breath Becomes Air. This one cut a bit close to the bone for me, but not entirely for the reasons one might think. I can only begin to imagine the depth of this man's anger & grief and I'm amazed at how he overcame them to write such a beautiful book with the last of his fading strength. Though part of me wishes it were longer, in actuality I doubt I could have handled it as a 400 pager. Mainly I wish he'd found the time to write other things, since his plan was to be a surgeon for the first part of his life and a writer for the second.

I bought this in hardcover form because I thought I would probably want to read it more than once, and I hope to have my kids each read it at some point. That made it much harder to save my favorite passages, though. I was stuffing little pieces of paper in it to mark pages, but sadly some of them fell out. But here are two short ones. One with some with humor:

"The good news is I've already outlived two Brontës, Keats and Stephen Crane. The bad news is I haven't written anything yet."

And one without:

"It occurred to me that my relationship with statistics changed as soon as I became one."

There is another I loved about hard decisions when one's loved one's quality of life has ebbed, but it is quite long and rather depressing. I might come back and add that later, or I might just keep that one to myself.
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LibraryThing member herzogm
This is one of the most authentic books that I have ever read. It brought me to tears even though I knew from the beginning how it was to end.
LibraryThing member TimBazzett
WHEN BREATH BECOMES AIR already has several thousand reader reviews at Amazon, so what else can I add? Probably not much. It's a hard book to read in the first place, but add to that the fact that I was writing condolences to the families of two old friends, and attended a funeral during the weekend I was reading it, and ... Well, while it is a hard book to read, it also offers some insight and some comfort about the end of life.

Paul Kalinithi was only 36 years old when an aggressive cancer took his life, a promising and talented neurosurgeon-neuroscientist. He somehow accepted his fate with grace and hard-won wisdom. Here are a few of his words -

"Death comes for all of us. For us, for our patients: it is our fate as living, breathing, metabolizing organisms. Most lives are lived with passivity toward death - it's something that happens to you and those around you."

As someone who witnessed death on a regular basis, Kalanithi knew that "death always wins." It's a hard lesson to learn, but I think it's better to learn as much about it as you can. The closer you keep death in front of you during your life, the easier it might be to accept when your own time comes. One of the thing that Paul and his wife, now his widow, learned (and these are Lucy Kalanithi's words) -

"... we knew that one trick to managing a terminal illness is to be deeply in love - to be vulnerable, kind, generous, grateful."

Indeed. Lucy also shared this, in her Epilogue -

"At home in bed a few weeks before he died, I asked him, 'Can you breathe okay with my head on your chest like this?' His answer was, 'It's the only way I know how to breathe.'"

This is, no question, a very sad book, being about a talented young man's bright future cut short. But it's also a very brave book, full of wisdom, yearning, and love. Because Paul Kalanithi loved his wife, his new baby, his family, his work - life. But he left it bravely, and he left us this book, a resonating record of his last journey. Highly recommended.

- Tim Bazzett, author of the memoir, BOOKLOVER
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LibraryThing member asawyer
Once again, I believe the hype of this book affected it for me, I expected much more. I also hate to not have a glowing review when this was a dying man's last effort. Yes, it was beautifully written by, clearly, a very intelligent student of literature who became a neurosurgeon to explore the relationship of life to death. Kalanithi, no longer given the time to do the research and become the neurosurgeon he'd trained to become, he needed to write a book about his experience. This was an interesting window into the life of a smart cancer patient (I have had and do have friends on this same journey), but didn't, for me, achieve the book I believe he was hoping to write. Having read Atul Gawande's medical books, the format and descriptions of operating on the brain seemed very familiar and interesting, but the overshadowing black cloud of terminal lung cancer was the point of this one. Granted, he ran out of time, and perhaps if he'd had the 5 years he'd hoped for, the book would have evolved more fully.… (more)
LibraryThing member booksandbosox
I received this as part of LibraryThing's Early Reviewer program.

Well, this book was not what I expected. First off, I expected it to be a lot sadder. In fact, I didn't cry until the afterword, written by Kalanithi's wife. I also expected to be a bit terrified - frankly, when I read something that makes me think about the fact that one day I will cease to exist, I usually panic and cry and have to literally do everything I can to think about something else. Since this is a book written by a man facing a terminal cancer diagnosis, I expected to feel a lot of that existential terror. But I didn't, mainly because Kalanithi faced his death incredibly bravely and scientifically, which somehow made it less terrifying for me to think about. Obviously, I still don't want to die for a very long time, but now I hope that I could face it just a little bit better. Finally, I think this book makes clear that Kalanithi was a scientist above all else - if you're going into this expecting something about how to live your best life and not take things for granted, I think you'll be surprised. Yes, he does spend some time figuring out what he wants to spend his remaining time focusing on, but mostly, he focuses on the science of everything. A good read, if not quite the emotionally powerful one I expected.… (more)
LibraryThing member realbigcat
I give very few 5 star ratings but this book was so well written that I just could not put it down. When Breath Becomes Air is the true story of a neurosurgeon Paul Kalanithi and his role reversal from doctor to patient. To be specific it's a heart wrenching account of a highly successful young doctor with a fantastic future ahead of him but is given a diagnosis of terminal cancer. Eloquent in his own words Dr Paul tells of all his struggles and emotions while battling this terrible disease. He has a keen interest and education in literature and that shines clearly in his words. While this is an extremely sad book it's also inspirational. You learn the life of a chief resident and all the intricacies of dealing with patients and other medical staff. Being a surgeon is truely a calling. The main takeaway from this book is how gracious Paul accepted his fate. Truely an inspiration for everyone. I would highly recommend this book to anyone.… (more)
LibraryThing member Cariola
This short memoir delivers quite an impact--or at least it did for me. I am not one that usually reads memoirs, particularly if they are promoted as "inspirational." But I had seen a piece on television about Paul Kalanithi and the experiences detailed in his book, and several LTers whose opinions I respect also recommended it. I'm glad that I went out on a limb and borrowed this book from my library. It wasn't at all what I might have expected from some of the blurbs and reviews that I had read, which led me to believe that it would be some sort of "finding spirituality in the face of death" memoir. Yes, in part it is about Kalanithi's experience, as a neurosurgeon/neuroscientist, dealing with a cancer diagnosis at the age of 36, and how he comes to terms with the inevitability of death. But it's so much more. He tells us how, after earning BAs in English literature and human biology, an MA in English literature, and an M.Phil in history of science and medicine, he found his calling as a neurosurgeon and returned to medical school. He explains to us the other side of the doctor-patient relationship and how his own philosophy of dealing with patients and their families evolved. And in his journey through cancer and its treatment, he learns how to be a patient, how to rejoice in and rely upon the love of family and friends, and how important it is not just to accept death but to know that the life you have lived a life has been worthwhile. This is NOT a touch-feely memoir that ends up relying on some higher power to see one through, so if that's what you're looking for, seek elsewhere. It's not a boo-hoo story about a man dying young, nor is it the story of such a man becoming strong in the face of death. Kalanithi asks himself tough questions and doesn't shy away from the tough answers. But what comes through, even in his last weeks, is his intelligence, his sensitivity, and his amazing spirit. I can't praise it enough.… (more)
LibraryThing member brendajanefrank
If you have read and liked works by Verghese or Gawandi, you will find “When Breath Becomes Air,” by Paul Kalanithi, equally rewarding. Kalanithi, age 36, was a talented neurosurgeon in a residency at Stanford when he was diagnosed with stage IV lung cancer (no, he did not smoke). A year later, he was dead.

During his final year, Kalanithi completed his residency, had a baby with his wife Lucy, also a physician, spent long days in the OR performing complicated surgeries, and wrote this memoir. He learned to balance living and dying. Knowing that he did not have the time to pursue a career in research, yet pursuing his practice of neurosurgery while he was able.

Kalanithi’s first calling was writing. He graduated from Stanford with a B.A. and M.A. in English Literature and a B.A. in Human Biology, then earned an M. Phil in History and Philosophy of Science and Medicine from the University of Cambridge. In 2007, Kalanithi graduated cum laude from the Yale School of Medicine.

Kalanithi had the courage to enjoy the pleasure of time spent with his wife and baby daughter while knowing that his days were numbered and their future would be without him.

A sample of his wisdom and bravery is his advice to his infant daughter:

“When you come to one of the many moments in life when you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man's days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more, but rests, satisfied. In this time, right now, that is an enormous thing.”
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LibraryThing member jennyo
Full disclosure-I received this book as part of the early reviewers program. I believe I would have bought a copy anyway (and probably still will at some point so I have a copy to share). I thought the book was marvelous. Well written and easy to read, I plowed through it in a matter of a couple of days. I think there are sections I'd like to go back and reread at some point, especially when the author was discussing his feelings about what it was like to work with cadavers. I found that fascinating. And the part where he talked about his faith. That section in particular resonated with me. I will definitely be going back to that section of the book to reread.

I think the world lost a good man when the author died, but I am very glad he took the time to share his story with us.
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LibraryThing member lit_chick
Paul Kalinithi, a brilliant thirty-six year old neurosurgeon is diagnosed with stage IV lung cancer. And like that – in that instant – the future he and his wife, Lucy, have planned evaporates. When Breath Becomes Air is his story as he navigates terminal cancer, becomes a new father, and confronts his mortality. Well-written and well worth the read: poignant, sad, but also celebratory. Kalinithi died March 2015, less than two years after his diagnosis.

Memorable Quotes:
On time:
"Time for me is now double-edged: every day brings me further from the low of my last relapse but closer to the next recurrence – and, eventually, death. Perhaps later than I think, but certainly sooner than I desire. There are, I imagine, two responses to that realization. The most obvious might be an impulse to frantic activity: to “live life to its fullest,” to travel, to dine, to achieve a host of neglected ambitions. Part of the cruelty of cancer, though, is not only that it limits your time; it also limits your energy, vastly reducing the amount you can squeeze into a day. It is a tired hare who now races. And even if I had the energy, I prefer a more tortoiselike approach. I plod, I ponder. Some days, I simply persist."

To his infant daughter:
"When you come to one of the many moments in life where you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man’s days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more but rests, satisfied. In this time, right now, that is an enormous thing."
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LibraryThing member klburnside
When Breath Becomes Air is a memoir by Paul Kalanithi, a neurosurgeon who is diagnosed with terminal cancer at the age of thirty-six. He wrote the books in the final months of his life, and it is his reflection on his experiences as a doctor, his views on what it means to be human, and his coming to terms with his own mortality.

In the first half of the book, Kalanithi discusses his life before being diagnosed with cancer. From a young age, Kalanithi had a deep love for reading and literature. He found that literature contained powerful messages about human life, and did so in a way that was profoundly meaningful. In this quest for meaning, Kalanithi became fascinated with the brain and its role in the complexities of thought and emotion that makes us who we are. This led him to pursue degrees in both human biology and English literature and later go on to medical school.

Kalanithi writes a lot about the type of doctor he wants to be. As a doctor, he often encountered his patients in extremely vulnerable and private situations, and he felt a strong need to recognize the sacred in each individual. He recognizes the importance of being present and understanding what is important to his patients so he can be with them as they contemplate the unfathomable questions of what life becomes when a tumor or removal of a tumor alters the brain. Who do we become when the brain is changed in such a profound way that it affects personality, language, or impulse control? Is a life with a completely altered identity and limited function worth saving?

The book is incredibly well written and very moving. Kalanithi touches on a lot of very heartbreaking issues that are hard to think about. Patients confronted with losing their language abilities, parents watching their children diagnosed with brain cancer, parents losing their babies only days after birth. His own joys in holding his infant daughter, and the pain of knowing he would not be there to see her grow up. There is no shortage of tragic stories in this book and it is an extremely emotional read, but worth it for me. The book is probably not for everyone, it packs quite the emotional punch, so proceed with caution.
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LibraryThing member mjspear
Heart-wrenching and beautiful recounting of a brilliant neurosurgeon (and philosopher) who dies at 38 of lung cancer. His description of the frenzied life of a surgeon's residency is countered by the musings of a man facing his own mortality. There are other dualities in the book: doctor/patient, faith/science, powerful/powerless, ego/humility. This book will make you think --and feel.… (more)
LibraryThing member kremsa
The best book I've read in a long time. Extremely well written and meaningful. What an amazing man Dr Kalanithi was!
LibraryThing member bragan
Paul Kalanithi was in his thirties and just at the start of what was promising to be a successful and fulfilling career as a neurosurgeon when he was diagnosed with terminal lung cancer. Suddenly, he found himself living a life whose future was very, very different from the one he'd worked and planned for.

In this memoir, he shares his thoughts about life, death, and suffering, both from a doctor's and a patient's perspective, and searches for meaning in his work, in literature, and in human relationships. It's deeply thoughtful, beautifully written, and poignant without ever being despairing. Looking mortality in the face is hard, but we all have to do it sometime, and I find I am rather grateful to Dr. Kalanithi for holding my hand for a moment and helping me take a good, long stare at it.… (more)
LibraryThing member strandbooks
This is one of the few books that I will recommend to everyone. Kalanthi spent years on the search for what creates a meaningful life, first through studying literature and then as a neurosurgeon. Right before he finished his residency he was diagnosed with lung cancer. Such a rare person that is brilliant at literature and science. He left the world with a look into a life being cut short. It's hard to imagine how he wrote this while being so ill.

"As a doctor, I had had some sense of what patients with life-changing illnesses faced--and it was exactly these moments I had wanted to explore with them. 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? But I'd had no idea how hard it would be, how much terrain I would have to explore, map, settle. I'd always imagine the doctor's work as something like connecting two pieces of railroad track, allowing a smooth journey for the patient. I hadn't expected the prospect of facing my own mortality to be so disorienting, so dislocating.
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LibraryThing member writemoves
I read this story in one sitting. It was not a very easy book to read in the sense that one new that the ending was going to be sad. That being said, this is a very inspirational book – – full of life lessons. Paul Kalanithi was a young neurosurgeon, husband and father. He was not only very conscientious about the care for his patients but he also was very philosophical – – thinking about the big questions regarding life-and-death. In his mid-30s, getting ready to move on to the next stage of his career and future, he was diagnosed with stage IV – lung cancer. As I said this was not a very easy book to read because he details his struggles and pains while trying to combat the cancer – – physical and mental. Shortly before his death, he and his wife have a daughter. His daughter Cade provided Paul solace and joy as he was dying. Kalanithi was an excellent writer who wish to leave a lesson or legacy for others. He succeeded.… (more)
LibraryThing member nbmars
Neurosurgeon Paul Kalanithi died of metastatic lung cancer at age 37. When he was diagnosed with the disease in 2013, he set out to write a memoir, with his wife Lucy adding an Epilogue after his March, 2015 death. Because of his life and this book, his legacy will be ongoing, and it is our privilege, as readers, to share his final thoughts.

The story of Kalanithi’s life pulls you in right away. He begins with his diagnosis, and then backtracks to his childhood. All the while, he meditates on the meaning of life and death, particularly when he starts practicing medicine, and especially, when he is diagnosed with cancer:

“'I began to realize that coming face to face with my own mortality, in a sense, had changed nothing and everything,'” he wrote. “Seven words from Samuel Beckett began to repeat in my head: ‘I can’t go on. I’ll go on.'”

His writing is so intimate, so devoid of pretense and social distancing, that by the end, you will feel the devastation of having lost a very close friend, beyond regretting the loss to the world of a genuinely good person.

Evaluation: How do we manage to look death in the eye and face death with integrity? Kalanithi not only tells us, but shows us through the way he lived his final two years after receiving his diagnosis. Many reviews laud this book as life-affirming, and it is. In addition, it is replete with thought-provoking meditations on the meaning of life that have the immediacy and poignancy of one who must answer that question right then, at that moment. The author riffs on literature, shows his sense of humor, and shares many moments of joy. I laughed a lot, but cried more; this book filled me with a profound sadness. Nevertheless, I consider this book to be a must-read, and highly recommend it.
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LibraryThing member lgura
When Breath Becomes Air is simultaneously heartbreaking and uplifting. Paul Kalanithi was a physician in his final year of residency in neurosurgery at Stanford when he learned he had advanced lung cancer. His book was his fulfillment of his desire to write of his life, find meaning in what happened, and leave a legacy for his daughter. Moving from the present to his youth in Arizona, we learn of his vow to never become a physician after observing the toll the profession took on his family. Encouraged to read by his mother, who sought to give her children every advantage Kalanithi becomes captivated by literature, philosophy, and immerses himself in reading. Humorously, his mother worries about average teenage temptations such as drugs, but he is intoxicated only by reading.

Friendships and relationships are important to Paul, but he also does let his work interfere with them as he finds himself drawn to the profession of medicine in spite of his youthful vow. Before entering medical school, as an undergraduate he studies literature, philosophy, neuroscience and biology. He earns a masters in literature from Stanford, but realizes that literature as a profession doesn't fit for him. He ponders "...where did biology, morality, literature, and philosophy intersect?" While waiting for the medical school acceptance process he travels to England, earning another masters degree in the history and philosophy of science.

At Yale, he meets his future wife Lucy, another med student, and upon finishing, they travel back to Stanford, both immersed in residency, but his extends longer and their marriage suffers. A key turning point is when Lucy learns he is worried about his health, yet not confiding in her. She plans to move out to ponder their future.

Frustratingly, it seems to take Paul too long to aggressively pursue a diagnosis for his symptoms. When he finally makes an appointment, he does not see his usual attentive physician, but a brisk, businesslike substitute who discourages him from getting the MRI that would have revealed his cancer. She dismisses this as too expensive, and recommends an X-Ray for his back pain, something that won't reveal cancer. Paul almost meekly accepts this, and that was difficult to understand. By the time he does get the required tests, his body is riddled with cancer.

The diagnosis of metastatic lung cancer brings Paul and Lucy back together as they discuss whether to have a child (they do). Various treatments allow a return to neurosurgery, but the pace of this work is grueling and physically difficult. His excellent oncologist works with him to enable continuation toward completion of is residency. He does complete residency, but by then he knows he will never practice, the hoped for professorship at Stanford will not be his.

Paul's final days are full of reflection and life with his family including his new daughter. After his death, Lucy completes the book. In the forward, Abraham Verghese says he did not really know Paul Kalanithi until he read the book. As a reader, one does get the sense of truly knowing Paul, his gifts and flaws, and how much we lost.
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LibraryThing member -Cee-
The choices of living, facing death, taking charge, letting go, what is important, experiencing the unexpected, and caring relationships all raise questions and emotions that are embedded in our humanity. Even though there are not always clear answers, Dr Kalanithi is brave enough to ask the hard questions and bold enough to share his journey. This is an amazing book. I wish this gifted man was still with us - he had so very much to offer. At least we have his book which leaves pointers to examine our own lives. Well worth reading.… (more)
LibraryThing member dalaimomma
When Breath Becomes Air by Paul Kalanithi...several days later I am still thinking about this beautiful book. Expect to cry..expect to cry several times. Expect to know how this book ends early on and still cry at the end knowing...it's a beautiful read. Raw in details and thoughts..real in every possible way. My only issue with this book is that it was too short..and that's not really an issue, I just wanted more. Paul certainly had a talent with his mind and his hands that went beyond neurosurgery. A gripping, haunting, thought provoking book that teaches a lesson about life and how we should embrace living it but not so much where it is too cliche or fake in it's positivity. Mr. Kalanithi does not sugar-coat anything for his readers. I highly recommend this book and want to go further into my review when I have had more time to truly sit and think about it even further. I kinda wanna stew on these thoughts just a little more because they gripped me..they really gripped me(so, revised, thorough review coming soon via my blog).

In the meantime I will say this, I am glad that I read this book...and again I recommend this book to anyone that enjoys a beautiful completely truthful memoir..and def for someone who isn't afraid to shed a few tears.

Thanks to the peeps at LibraryThing and publishers of this book for giving me the opportunity to win this fantastic read FREE in exchange for an honest review to which I gladly and voluntarily gave.
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LibraryThing member EllenCam
I received an early edition of this book through the Librarything Early Reviewers Program. This book grabbed onto me from the first sentence. This is not a in category of books that I generally read, but this book transcends all categories. The author is a highly educated young neurosurgeon, married to another doctor, planning their hopefully successful and happy lives when this young doctor gets the worst news anyone can get. He has terminal cancer. He can tell that himself by looking at the scans. How shocking that must have been at that time in his life. Not only did this intelligent man study medicine in college, he also had a huge interest in literature, which shines through in this book. It is beautifully written, flows easily and is very insightful into his changing thoughts as the next couple of years before his death proceed. He has to make the difficult transition from doctor-in-charge to a patient. I particularly liked his oncologist, who refused to talk statistics and kept him going through even the worst times. As his death approaches, he begins to question his rather detached attitude toward his patients, focusing more on the success of his treatment than on the feelings of the patient. He now realizes that listening is one of the most important things a doctor can do. He and his wife decide to have a child, and this child is an adorable 8 month old when he dies. Paul did not actually have time to fully complete the book, but he left off at a part that easily transitions into the beautiful epilogue written by his wife Lucy. I an so sad that this man will not be able to read the accolades that this book is sure to get, but he certainly packed a lot of life into his 36 years. This book is fantastic, one of my favorites.… (more)
LibraryThing member Dianekeenoy
I won this book as a Early Review copy from Librarything. Part of me was a little frightened about reading and then reviewing a book written by a young neurosurgeon who is diagnosed with stage IV lung cancer. I did read this book straight through after picking it up. Paul Kalanithi died in March of 2015 while still working on this book.

He wanted to leave this book for his wife and daughter. The strength it took for him to accomplish this is amazing. Everything about this book, from the forward by Abraham Verghese to the epilogue by his wife, Lucy Kalanithi will move you to tears. However, this book isn't depressing, it's a testament to living a fulfilling life.
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