When Breath Becomes AirLarge Print - 2016
Waterville, Maine : Thorndike Press, a part of Gale, Cengage Learning, 
From the critics
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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 lot unknown to me in a my prior years, a joy that does not hunger for more and more but rests, satisfied.
"Death may be a one-time event, but living with terminal illness is a process."
"In the end, it cannot be doubted that each of us can see only a part of the picture. The doctor sees one, the patient another, the engineer a third, the economist a fourth, the pearl diver a fifth, the alcoholic a sixth, the cable guy a seventh, the sheep farmer an eighth, the Indian beggar a ninth, the pastor a tenth. Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete."
"A match flickers but does not light. The mother's wailing in room 543, the searing red rims of the father's lower eyelids, tears silently streaking his face: this flip side of joy, the unbearable, unjust, unexpected presence of death... What possible sense could be made, what words were there for comfort?"
"You can't ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving."
"... As a resident [neurosurgeon], my highest ideal was not saving lives - everyone dies eventually - but guiding a patient or family to an understanding of death or illness. ... The families [of the patient] see the past, the ... memories, the freshly felt love, all represented by the body before them. I see the possible futures, the breathing machines connected [to] the neck, the pasty liquid dripping [into] the belly, the possible long, painful, and only partial recovery - or, sometimes more likely, no return at all of the person they remember. In these moments, I acted not, as I most often did, as death's enemy, but as its ambassador. I had to help those families understand that the person they know ... now lived only in the past and that I needed their input to understand what sort of future he or she would want: an easy death or to be strung between bags of fluids ... to persist despite being unable to struggle." (p. 87-88)
...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.
You can't ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving.
I was less driven by achievement than by trying to understand, in earnest: what makes human life meaningful? I still felt literature provided the best account of the life of the mind, while neuroscience laid down the most elegant rules of the brain.
Chemotherapy began on Monday. Lucy, my mother and I went to the infusion center together. I had an IV placed, settled into an easy chair and waited.
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"When Breath Becomes Air" is an autobiography of a doctor who became a patient after being diagnosed with Stage IV lung cancer. At first it starts with Kalanithi in good health and working towards his goals and becoming a neurosurgeon. He is highly motivated and interested in pursuing mortality and what makes a life meaningful. During this period he is the one who guides terminally ill patients and families through the changes in their lives and must help them come to terms with the decisions they need to make. Then suddenly, the roles are reversed upon him and Kalanithi becomes the patient and he is the one being guided through the changes and decisions. The sudden change is shocking, yet he manages to work through it. In the final stages of his life, he begins to reflect his life and wonder what to do with a single day. By the end, it seems he has come to some form of acceptance of his own mortality. Yet throughout the autobiography is the thoughtfulness and the theme of mortality and death.
At first, he wanted to "uncloak death" and stare at it unblinking. But when he faced his own mortality, he found that it seemed very different. Death once so surreal had suddenly become his reality. And he had to navigate through it without any experience. He found himself lost and unsure of what directions to take. During this time, he began to realize what his patients had gone through and the true weight of mortality.
But what really sticks is this quote: "Years ago, it had occurred to me that Darwin and Nietzsche agreed on one thing: that defining characteristic of the organism is striving."
After ten years of medical education, Paul Kalanithi was on the verge of completing his training as a neurosurgeon when he became concerned about his own health. At first he blamed the rigours of residency, but a CT scan soon revealed the worst: cancer in the lungs, spine, and liver. Early in his university career, Kalanithi studied literature, dreaming of a career as a writer, but was driven to medicine by questions about mortality and meaning that he felt could not be answered by literature alone. Suddenly, those questions became urgent and personal, and the only time left to write a book and achieve that dream was now.
This book is one of the best 75 books in the past 75 years and it was just published this year. It will be truly a classic when you consider it’s about a neurosurgeon who discovers he has lung cancer. As the summary on the back of the box says – “One day he was a doctor treating the dying, and the next he was a patient struggling to live.” Only 36 years old Kalanithi had many questions he wanted answers to – “What make 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?” Together with his large, loving family Kalanithi discovers the meaning of life. He was a brilliant writer and surgeon and was transformed as he explored literature in pursuit of what is important in life. I admire that he found what he was looking for and reported in a sensitive, matter-of-fact way without sentimentality.
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