Title: When Breath Becomes Air
Author: Paul Kalanithi
Publisher: Random House
Rating: 5 out of 5
How I got it: I borrowed a copy from the library
I used to think that I had a book in me, but lately I’ve become less sure about that. My prose is clear and readable, but not breathtaking. I don’t have any striking new insights into the human condition. Most importantly, I read books like When Breath Becomes Air and become hopelessly discouraged at the protean talents of someone like Paul Kalanithi.
This man did not stop. He hungered for knowledge, he inhaled it until it filled his veins and bubbled in his blood. I mean, look at his biography:
Paul Kalanithi, M.D., was a neurosurgeon and writer. Paul grew up in Kingman, Arizona, before attending Stanford University, from which he graduated in 2000 with a B.A. and M.A. in English Literature and a B.A. in Human Biology. He earned an M.Phil in History and Philosophy of Science and Medicine from the University of Cambridge before attending medical school. In 2007, Paul graduated cum laude from the Yale School of Medicine, winning the Lewis H. Nahum Prize for outstanding research and membership in the Alpha Omega Alpha medical honor society. He returned to Stanford for residency training in Neurological Surgery and a postdoctoral fellowship in neuroscience, during which he authored over twenty scientific publications and received the American Academy of Neurological Surgery’s highest award for research.
Two B.As, an M.A, an M.Phil, a stint at the Yale School of Medicine, and a residency at one of the most prestigious medical schools in the country, where he did amazing neurological research.
All of that before he died in his late 30s from cancer.
I look at people like him, read their glittering prose, and feel that if people like this in the world exist with such gifts, any attempts of mine to compare don’t mean much.
And so we come to When Breath Becomes Air, Kalanithi’s first and only book, a meditation on trying to find the answers to life’s big questions by marrying a love of literature — the purest expression of human thought — with an understanding of the human brain — the mechanism that produces such thought. How do our minds work? Do doctors gain a deeper understanding of humanity by seeing people at their weakest and most vulnerable? Kalanithi tried reconcile these deep questions by combining his literary knowledge with his medical knowledge to study neuroscience, hoping that he could find the key to human identity.
Unfortunately, in the final year of his residency, he was diagnosed a rapidly metastizing form of cancer that left him with only years, if not months, to live. Thus he was suddenly forced to use his own lived experience to answer the questions that he spent his entire academic career investigating, rather than the second-hand experiences and knowledge of others. This dual understanding of being both a doctor and a patient gave him new insights and helped him develop more empathy for the people he treated. It also left him frail and exhausted.
Was writing this book worth it for him? I don’t know if he found an answer that was satisfactory, but I hope he did. But there are so many contributions he could have made to our understanding of the human mind that now remain unfulfilled. Reading over crystal-clear prose like this makes his absence, the loss of that potential, an even bigger wound than it already is:
The enormity of the moral mission of medicine lent my early days of med school a severe gravity. The first day, before we got to the cadavers, was CPR training, my second time doing it. The first time, back in college, had been farcical, unserious, everyone laughing: the terribly acted videos and limbless plastic mannequins couldn’t have been more artificial. But now the lurking possibility that we would have to employ these skills someday animated everything. As I repeatedly slammed my palm into the chest of a tiny plastic child, I couldn’t help but hear, along with fellow students’ jokes, real ribs cracking.
Cadavers reverse the polarity. The mannequins you pretend are real; the cadavers you pretend are fake. But that first day, you just can’t. When I faced my cadaver, slightly blue and bloated, his total deadness and total humanness were undeniable. The knowledge that in four months I would be bisecting this man’s head with a hacksaw seemed unconscionable.
I mean, this man could have seriously been the next Oliver Sacks! It’s cruel that he died so young, that he left a wife and a daughter behind just when he was on the cusp of becoming who he truly wanted to be. And it makes me sad to know such cruelty.
I started reading When Breath Becomes Air on the first anniversary of Kalanithi’s death — a completely unintentional but apropos coincidence. I hope that when the dust surrounding the books’ initial publication settles, it will join the ranks of other respected works of medical non-fiction like The Emperor of All Maladies and The Immortal Life of Henrietta Lacks.