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When Breath Becomes Air – Book Review

“Medical school sharpened my understanding of the relationship between meaning, life, and death. I saw the human relationality I had written about as an undergraduate realized in the doctor-patient relationship.”


I was deep-seated in my choice to take up computer science during my last two years of high school. But an unreserved passion for human biology still occupied a small portion of my mind. I decided to explore it again through some medical drama TV-shows and non-fiction works. There were many futile attempts at choosing a book of my liking –most of them were either too technical or were not rated well on Goodreads. 

I noticed Paul Kalanithi’s ‘When Breath Becomes Air’ while casual browsing at a bookstore and immediately bought it for two reasons- 1) it portrayed a struggle against cancer; and oncology is one of my favorite fields of medicine, 2) it was written by an Indian-American doctor with roots in Tamil Nadu and Andhra Pradesh. This book revolves around the life of a dedicated American neurosurgeon, Paul Kalanithi through his battle, nay, journey with lung cancer and his philosophical observations from his exemplary life.

‘When Breath Becomes Air’ is a 256-page autobiography and a memoir written by Dr Paul Kalanithi about a drastic turn in his life. This book was written towards the close of his life and was published posthumously in 2016 by Lucy Kalanithi, his wife, whom he had met in medical school. He brings about the full force of his impressive literacy skills, courtesy of his undergraduate studies in English literature. The book is interjected with Kalanithi’s recollection of his school years, undergrad and the gruelling medical school. After figuring out that he did not fit in the English department, he had his inner calling to attend medical school at Yale. Paul chose to specialize in neurosurgery because he was compelled by its unforgiving call to perfection.

In the final year of his neurosurgery residency, he started having intense back pains and drastic weight loss. Eventually, he was diagnosed with stage IV metastatic lung cancer. Paul describes in his book that his processing of the news had taken the reverse form of the five stages of grief: first, he accepted his diagnosis and prepared for death. But finally, he was at the stage of denial because he wanted to forget that the disease existed and continue to live his life as he envisioned with Lucy and their unborn child. He quotes denial as the only way to move forward from the stark reality of cancer.

Paul Kalanithi was not able to attend his medical school graduation because he was overcome with debilitating nausea. This feels like an analogy with how he developed cancer during the highest point of his career. Paul gives us a very brutal and honest view of his suffering and shares some profound and interesting encounters with various friends, family, colleagues, and mentors. He acknowledges his impending death, following which his breath had finally ceased to become air. His no-holds-barred conveyance of emotion had a profound impact on me as I read through his struggle.

My favorite part of the book is when Kalanithi perfectly accomplishes the narration of his childhood and tells us about the various elements of his past that greatly influenced him to become a physician. He recounts his childhood incidents with much fervor and enthusiasm. Each paragraph of the book has a deep meaning. His usage of various analogies to describe his journey is simply brilliant and moved me to search for the same in my own life.

The epilogue was penned by Lucy Kalanithi and her words brought me close to tears as she recounts the final days of her beloved husband. His achievements were greatly emphasized by Lucy, which made me ponder about the positive impact he had on others’ lives, though his return to practicing neurosurgery after diagnosis was punctured by bouts of illness and fatigue. Paul realistically conveys this information, and I have never felt more empathy for a person through his writing.

Paul Kalanithi’s remarkable writing got me hooked to his book and left me wanting for more. It is a great book to get started on medical non-fiction. His writing style oozes with a sense of calm and serenity even as he describes his ill-fate. His autobiography is very immersive - the description of the various rotations he went through during his residency transports me to the operation theatre just by reading his magical words. 

I recommend this book to those who seek to start reading non-fiction, as the author used a simple yet profound style of writing that makes the point across with clarity. Every medical student and doctor must read this book to understand the deeper notion of disease and the resulting fallout a patient feels when they are diagnosed.

Tagged in : cancer, tragedy, when breath becomes air, book review, medical, non-fiction, doctor, life, death,