Last year, a book called When Breath Becomes Air was released to the world for reading. It’s the kind of book that, on the surface, you wouldn’t think would end up being discussed on this kind of blog. The book is the memoir and story of Paul Kalanithi, a neurosurgeon ten years in the making who, at the age of 36, was diagnosed with Stage IV lung cancer. Kalanithi invites us into his journey in two parts: Part One, the story of growing into a healthy medical student on the cusp of greatness, “possessed by the question of what…makes a virtuous and meaningful life,” and Part Two, where little did he know, he would work to answer this question through his diagnosis until his death in 2015. The manuscript technically didn’t get finished, but Paul’s wife, Lucy, adds an epilogue of their last season of life together and ties up the bow on Paul’s unfinished work.
I won’t do a full review here, but I do want you to catch a glimpse of how much this book impacted me. I checked the book out from the library a bit on a whim recently, hearing from a couple trusted reader friends online that it was a terrific read. I wasn’t expecting life-changing, but I think I’m ready to call it that. Few books can do that, and I think When Breath Becomes Air did it. Its words are amazingly powerful (being a Christian blog, I will say there is some language here and there, but not a lot). It is a soul-stirrer. This is the kind of book that book clubs should pick, because there’s so much to discuss and wrestle with, and so much to ask ourselves in light of its truths and pondering.
To whet your appetite (until you hopefully read it), here are a few of Kalanithi’s key quotes from the book:
Don’t think I ever spent a minute of any day wondering why I did this work, or whether it was worth it. The call to protect life—and not merely life but another’s identity; it is perhaps not too much to say another’s soul—was obvious in its sacredness. Before operating on a patient’s brain, I realized, I must first understand his mind: his identity, his values, what makes his life worth living, and what devastation makes it reasonable to let that life end. The cost of my dedication to succeed was high, and the ineluctable failures brought me nearly unbearable guilt. Those burdens are what make medicine holy and wholly impossible: in taking up another’s cross, one must sometimes get crushed by the weight.
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.
I can’t go on. I’ll go on.
Openness to human relationality does not mean revealing grand truths from the apse; it means meeting patients where they are, in the narthex or nave, and bringing them as far as you can.
I don’t believe in the wisdom of children, nor in the wisdom of the old. There is a moment, a cusp, when the sum of gathered experience is worn down by the details of the living. We are never so wise as when we live in the moment.
I would have to learn to live in a different way, seeing death as an imposing itinerant visitor but knowing that even if I’m dying, until I actually die, I am still living…Severe illness wasn’t life-altering, it was life-shattering. It felt less like an epiphany—a piercing burst of light, illuminating What Really Matters—and more like someone had just firebombed the path forward.
You can’t ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving.
“Will having a newborn distract from the time we have together?” she asked. “Don’t you think saying goodbye to your child will make your death more painful?”
“Wouldn’t it be great if it did?” I said. Lucy and I both felt that life wasn’t about avoiding suffering.”
Words have a longevity I do not. I had thought I could leave [Cady] a series of letters–but what would they say? I don’t know what this girl will be like when she is fifteen; I don’t even know if she’ll take to the nickname we’ve given her. There is perhaps only one thing to say to this infant, who is all future, overlapping briefly with me, whose life, barring the improbable, is all but past.
That message is simple: When you come to one of the many moments in life when you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man’s days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more, but rests, satisfied. In this time, right now, that is an enormous thing.
This book, above all, is encapsulated in Kalanithi’s probing question: “What makes life meaningful enough to go on living?” That’s what When Breath Becomes Air hopes to answer, and help you answer. It certainly helped me.