When Breath Becomes Air by Paul Kalanithi

“As I gradually restore Words Like Silver to its archive of reviews written between 2011 and 2024, I'll aim to first and foremost make my reading history explorable by publishing the blurbs and short reflections as books cross my mind, with the goal of eventually transferring and fleshing out the original WLS content. For now, please enjoy this brief spotlight.”

For readers of Atul Gawande, Andrew Solomon, and Anne Lamott, a profoundly moving, exquisitely observed memoir by a young neurosurgeon faced with a terminal cancer diagnosis who attempts to answer the question 'What makes a life worth living?'

At the age of thirty-six, on the verge of completing a decade's worth of training as a neurosurgeon, Paul Kalanithi was diagnosed with stage IV lung cancer. One day he was a doctor treating the dying, and the next he was a patient struggling to live. And just like that, the future he and his wife had imagined evaporated.

When Breath Becomes Air chronicles Kalanithi's transformation from a naïve medical student "possessed," as he wrote, "by the question of what, given that all organisms die, makes a virtuous and meaningful life" into a neurosurgeon at Stanford working in the brain, the most critical place for human identity, and finally into a patient and new father confronting his own mortality.

What makes 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? These are some of the questions Kalanithi wrestles with in this profoundly moving, exquisitely observed memoir.

Paul Kalanithi died in March 2015, while working on this book, yet his words live on as a guide and a gift to us all. "I began to realize that coming face to face with my own mortality, in a sense, had changed nothing and everything," he wrote. "Seven words from Samuel Beckett began to repeat in my head: 'I can't go on. I'll go on.'"

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When Breath Becomes Air is an unforgettable, life-affirming reflection on the challenge of facing death and on the relationship between doctor and patient, from a brilliant writer who became both.

I would love to get better about picking up memoirs, and reflective books of this nature. They don't necessarily have to be about mortality—although that's definitely a subject in which I'm interested—but I'm always looking to expand my repertoire. Anyone who follows me on Twitter knows that I practically worship the blog Brain Pickings (now called The Marginalian), a collection of writings on philosophical and scientific subjects. While this book is undeniably different, it captures the same meditative and academic tone that I adore so much.

Paul Kalanithi was, no doubt, a talented writer. He balances his genuine questions about the meaning of life with a clear-minded logic that makes for an equalizing, powerful read. It could be sparse, but it also carried a simple beauty in the prose.

When it drifted into metaphysical musings, it tied it into his day-to-day actions and experiences so it didn't feel too abstract. It could be plainspoken, but never in a way that was dull for me.

It's not explosive, or earth-shattering. It wasn't heartbreaking for me. But it was sad, moving, and lovely. As much as I love passionate books that absolutely destroy me, another part of me is always looking for quiet books that make me sit and think for a while. If that's not your cup of tea, I can see why it might not feel like the most beneficial book in the world. But I feel better for having read it, and I'll carry it with me for a while.

For fans of:

The Year of Magical Thinking by Joan Didion; The Long Goodbye by Meghan O'Rourke; On Love by Alain de Botton; Grey's Anatomy (TV); etc,.