By Paul Kalanithi
Paul Kalanithi forged a remarkable path to neurosurgery. Kalanithi initially started school with a plan to study literature while looking for answers to that great question: how to make meaning out of life? When literature fell short of providing these answers, he turned to philosophy, focusing on doctor-patient relationships and the morality of working with people facing mortality. This ultimately led him to the fields of neurosurgery and neuroscience, where he quickly rocketed to the top of his class, continuing to explore and refine his understanding of a meaningful life as mediated through the doctor-patient relationship. With graduation nearing and the world as his oyster, Kalanithi suddenly started to live the philosophy he had been searching for when the doctor became a patient diagnosed with terminal cancer. With his deep understanding of medicine, Kalanithi can make sense of the scans, tests, treatment options, and existing information about his illness. More foreign and difficult for him is releasing the role of doctor and allowing himself to become a patient following doctor’s orders. With the support of his wife and family, Kalanithi navigates the tumultuous waters of an unknown but significantly foreshortened lifespan while trying to live with that elusive and ever-changing sense of meaning.
“When Breath Becomes Air” by Paul Kalanithi is a story told in two parts: searching for morality and philosophy related to making meaning out of life, and enacting that morality and philosophy while facing an uncertain and swiftly approaching death. Kalanithi’s studies have certainly been thorough, and the first half of the book is laden with philosophical musings. Kalanithi strives constantly to put theory into practice, and weaves in stories from his colleagues, his patients, and his own reflections to illuminate the ways in which the doctor-patient relationship can contribute to making meaning out of life. As a patient, the second half of the book focuses on the new awareness he gains from living the other side of the doctor-patient relationship. He continues to illuminate the lessons he learns as a patient with personal reflections, stories from his interactions with others, and an intimate knowledge of how the body responds to sudden and unpredictable changes. The overarching tone of the story is one of grace, inquisitiveness, and calm acceptance. Though Kalanithi continually searches for answers, there is some measure of peace in knowing the answers can’t be nailed down.
I highly recommend this book. It almost feels gratuitous to read this book because he shares so many insights into the medical world, both as one who tries to relieve suffering and as one who succumbs to suffering. However, he offers his story freely and with the hope that others will learn from it, so that makes it OK to feel like I’m snooping a bit, doesn’t it? The inclusion of personal and patient stories and the reminder that all of us are grappling with death makes this book highly engrossing. Kalanithi’s perspective is realistic without being overly sentimental or overly callous. Certainly worth reading, and if you can manage it, worth reading in one (or two) sittings.