Book Review: When Breath Becomes Air

You learn more at a funeral than at a feast—After all, that’s where we’ll end up. We might discoversomething from it.The Message - Ecclesiastes 7:2


“This is a sad, but beautiful book.” This is what my friend said as she loaned me When Breath Becomes Air.

She was right, of course. But she could have used an entire list of words.

Tragic Inspiring Humbling Honest Brutal Engaging

The plot of the book is, unfortunately entirely true.

When Breath Becomes Air is the story of Paul Kalanithi, a neurosurgeon who spent a decade of his life studying medicine only to be diagnosed with terminal lung cancer at age 36. As the book jacket describes:

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?

However sad the story is, Paul’s experience of being on both sides of caregiver and patient is unique and, fortunately for the reader, very easy to read. He never drifts into a place of self pity ("why me?"), but he carefully observes the transition from his role as doctor to that of patient.

"It occurred to me that my relationship with statistics changed as soon as I became one."

I might be quoting that sentence for the rest of my life. Such truth...

Further on I found his language around living with a terminal illness particularly compelling.

“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. You may decide you want to spend your time working as a neurosurgeon, but two months later, you may feel differently. Two months after that, you may want to learn to play the saxophone or devote yourself to the church. Death may be a one-time event, but living with terminal illness is a process.”

In living the "process" what Kalanithi discovers is how to live.

“I began to realize that coming in such close contact with my own mortality had changed both nothing and everything. Before my cancer was diagnosed, I knew that someday I would die, but I didn’t know when. After the diagnosis, I knew that someday I would die, but I didn’t know when. But now I knew it acutely. The problem wasn’t really a scientific one. The fact of death is unsettling. Yet there is no other way to live.”

Paul Kalanithi's story continues until his death, and the book, although technically unfinished, closes perfectly with thoughts from his wife.

“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.... Even while terminally ill, Paul was fully alive; despite physical collapse, he remained vigorous, open, full of hope not for an unlikely cure but for days that were full of purpose and meaning.”

Re-read that last snippet.  In the face of death he found something important..."hope for days that were full of purpose and meaning."

Isn't that everyone's hope? Reading this book made me grateful for Paul Kalanithi and for life itself.

A beautiful read indeed.