When Breath Becomes Air - Paul Kalanithi


This book was a beautiful read, and I regret not having read it years ago when I discovered it on New York Times's Best Seller list. Its prose is elegant and piercing. Every sentence is eloquently worded and none bereft of value. The author, Paul Kalanithi, had a promising career as a neurosurgeon/neuroscientist ahead of him when he was stricken by cancer - and that in part was the impetus for this book.

I had started in this career, in part, to pursue death: to grasp it, uncloak it, and see it eye-to-eye, unblinking.
The quote above summarizes Kalanithi's motivation to pursue medicine and forms a theme for most of the book. Having already completed a BA and MA in Literature, the decision to enter Medical School would not have come lightly.


by the end of medical school, most students tended to focus on "lifestyle" specialties—those with more humane hours, higher salaries, and lower pressures—the idealism of their med school application essays tempered or lost.
The US Medical training system is undoubtedly very rigorous. It starts off with Medical School and is followed by years of residency. The hours are long and the pressures high. Before reading this book, it had never occurred to me that the medical profession was not just a job but a calling to some. Training to be a neurosurgeon is the toughest. Deciding to add training to become a neuroscientist, in addition, must have been even more challenging. I have a newfound respect for the doctors who pursue the higher rigorous disciplines in medicine.
The twilight existence of unconscious metabolism becomes an unbearable burden, usually left to an institution, where the family, unable to attain closure, visits with increasing rarity, until the inevitable fatal bedsore or pneumonia sets in. Some insist on this life and embrace its possibility, eyes open. But many do not, or cannot, and the neurosurgeon must learn to adjudicate.
I found the above quote very profound. Even though neurosurgeons can save lives, Kalanithi (like most surgeons) was very cognizant of the quality of life awaiting a patient after a surgical procedure. Afflictions affecting the brain can severely impact patients' relationships with their families and friends. The "twilight existence," as described by the author, seems to be the worst because of the loss of human connection. This acute cognizance appears to come full circle when Kalanithi's cancer turns recurrent and spreads to his brain. The book ends with the birth of his daughter. In the prologue (penned by his wife), we learn that Kalanithi's last days though sad and heartbreaking, were spent surrounded by those who loved him.
Relying on his own strength and the support of his family and community, Paul faced each stage of his illness with grace—not with bravado or a misguided faith that he would "overcome" or "beat" cancer but with an authenticity that allowed him to grieve the loss of the future he had planned and forge a new one.
And lastly, a quote that I enjoyed reading and will takeaway -
"You can't ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving."