When Breath Becomes Air By Dr. Paul Kalanithi

“She pronounced it, but without the authoritative tone of an oracle, without the confidence of a true believer. She said it, like a plea. Like that patient who could speak only in numbers. Like she was not so much speaking to me as pleading, a mere human, with whatever forces and fate truly control these things. There we were, doctor and patient, in a relationship that sometimes carries a magisterial air and other times like now, was no more, and no less, than two people huddled together, as one faces the abyss. Doctors, it turns out, need hope, too.” (Page 193)

The day I picked up this book I pretty much abandoned all my responsibilities and finished the 256 pages in one sitting. Blame it on the Kindle Cloud Reader that also let’s you look up unfamiliar vocabulary (medical jargon for me). I was suppose to be prepping for an upcoming project, and I still had yet to finish Virgina Wofle’s To the Light House. However, something told me you need to read this book.

By the time I was done I still had a hard time taking in the fact that the book was published posthumously. Not only was Dr. Paul Kalanithi a brilliant resident doctor, but also a literary connoisseur whose love for literature inspired me to keep turning the pages. He often alludes to writers such as T.S. Elliot throughout his narrative, intertwining both his love for both science and literature.

You grow a deep admiration for him as a doctor, a writer, and most importantly a human being who sets the bar high in terms of emotional intelligence at all times.

As a neurosurgeon-neurologist, in his final residency years that he learns has stage 4 Metastatic Lung Cancer. However, despite an uncertain timeline for his life ahead, he still performs surgery on his patients, and continues to be the loving husband he is.

In this hazy time period he isn’t told from the get-go how much time he has to live. There is initially small tension in his marriage that does fades away, but the questions such as will he ultimately graduate his residency and see a child of his own, linger.

Regardless if you’re in the medical field or not, this twenty-two month roller coaster ride of a book is filled with such rich life moments (his recollections of childhood, obtaining a master’s in English, and ultimately his reason for becoming a doctor) that you feel you are truly riding this journey with Dr. Kalanithi.

We become attached to Dr. Kalanithi’s quest to discover what ultimately makes human life meaningful?

We learn that where there are the boundaries of science that place limitations on a doctor’s emotional being, there are also existentialist questions that prevent a doctor from treating all his patients as simply items on a check list.

“The tricky part of illness is that, as you go through it, your values are constantly changing. You try to figure out what matters to you, and then you keep figuring it out. It felt like someone had taken away my credit card and I was having to learn how to budget.” (Page 158)

I think strength was defined in various ways throughout Dr. Kalanithi’s narrative.

As Dr. Kalanithi faces his own diagnoses he learns that a former medical colleague of his commits suicide. As someone who will never know the emotional toll a surgeon may feel after seeing patients pass away, I can only imagine what Dr. Kalanithi may have felt hearing this news and trying to balance it against his own impeding fate.

We also witness his strength as he endures the different stages of denial and acceptance that accompany his final months. He is given prestigious job offers and accolades, his wife is even pregnant with their daughter, and while life seems to be going forward it’s ultimately his realization to face death honestly that allows the reader to say good-bye to Dr. Kalanithi.

He faces his approaching death with integrity.

If you thought the above was emotional in any way, forget that. By the time you finish the first few pages of the Foreward you’ll be in tears.

I recommend this book to everyone regardless of your career background. This auto-biography serves as a wake-up call to deeply cherish every day in your life as it is your last.

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