When Breath Becomes Air

“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 simply:

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.”   Paul Kalanithi, in a letter to his daughter.  Excerpt from When Breath Becomes Air

My brother passed away from pancreatic cancer last fall, and I didn’t feel quite ready for When Breath Becomes Air, a Stanford neurosurgery resident’s memoir about his cancer diagnosis. Also, in my work as a clinical librarian, I’d spent time supporting and rounding with clinical staff in neurology/neurosurgery. I had a special affection and respect for the brilliant, hard-working residents, who were about the same age as my sons. So to read about the death of a young resident from lung cancer….

But if you are a living, breathing person who likes to read memoir and nonfiction, and if you consider yourself an engaged participant in our death-denying culture, I would say When Breath Becomes Air is required reading.

One of my favorite authors, Ann Patchett, who owns a bookstore that practices the art of making personal recommendations to readers based on their interests, says, “This is one of the handful of books I consider to be a universal donor – I would recommend it to anyone, everyone.” 

On publication, When Breath Becomes Air shot to number 1 on the New York Times Nonfiction Bestseller List. So when I saw Paul Kalanithi’s memoir on our library’s “Most Wanted Book” shelf, I decided to grab it.

Paul Kalanithi set out to be a writer and then switched to medicine and neurosurgery, one of the most challenging and consuming of all clinical disciplines. He believed that a person’s brain determines his identity, which is inseparable from his values and sense of life’s meaning.

Finding meaning was all-important to Kalanithi. During his residency, Paul came to see it was his responsibility to do his best to give his patients the quality of life that would allow them to live according to their most precious values.

We need more doctors who have both the time and desire to get to know and serve their patients in this way, wouldn’t you say?

In his memoir, Kalanithi says the twin pursuits of caring for patients with brain illnesses and writing as a way to explore the meaning of life’s joys and traumas was his perfect calling.

It’s just that he hadn’t planned on doing the writing part until much later in his career. Many months after his diagnosis, when he could no longer work as a neurosurgeon, Paul chose to use his remaining time to write a memoir that, among other things, explores living and dying from the unique perspective of someone who is both a patient and healer.

He and his wife decided to have a child, too. Paul writes of becoming a father with great joy. It reminded me of last summer, when my brother (and our extended family) lived with end-of-life illness, even as we celebrated his daughter’s wedding.

As you can see from the memoir excerpt above, Paul was an extraordinary writer. Medical humanities literature, also known as narrative medicine, written by patients, doctors, nurses, and clinicians, is really coming into its own, and I think When Breath Becomes Air will become a classic.

Paul Kalanithi stands right alongside Anthony Verghese, Danielle Ofri, Sherwin B. Nuland, Tilda Shalof, Theresa Brown, Atul Gawande, Oliver Sachs, and others as one of the best. Really, his memoir is not to be missed.

“The fact of death is unsettling. Yet there is no other way to live.”  Paul Kalanithi

Below is the trailer for When Breath Becomes Air.

Have you read When Breath Becomes Air, and what did you think? Have you read another medical humanities or health related memoir, novel, or essay that you have especially liked? Please share your thoughts and recommendations in the comments.