When Breath Becomes Air

When Breath Becomes Air was published earlier this year (2016) by the family of Paul Kalanithi following his death in March 2015. There are so many superlatives to describe this man whose career was cut short by his death from cancer, soon after he completed his residency in neurosurgery at Stanford. A compassionate physician, neurosurgeon, scholar, and writer, the world has lost a man who was surely going to make major contributions. He elegantly described being on both sides of the life-death issue with which he dealt with first as a doctor and then subsequently as a patient. The forward is from the highly respected physician-author (among his books, Cutting for Stone) who knew Dr. Kalanithi at Stanford, and the touching epilogue is written by his wife, an internist.

In addressing his twin loves of English and neuroscience, Kalanithi wrote, “I was driven less by achievement than by trying to understand, in earnest: What makes human life meaningful? I still felt literature provided the best account of the life of the mind, while neuroscience laid down the most elegant rules of the brain.” He added that his “highest ideal was not saving lives – everyone dies eventually – but guiding a patient or family to an understanding of death or illness…. When there’s no place for the scalpel, words are the surgeon’s only tool.”

As his death neared and Kalanithi contemplated the life of his infant daughter, he wrote, “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 where 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 job 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.”

I hope what I’ve written tempts you to read it. Do you think about life and death as often as I do? I’m a psychiatrist and psychoanalyst who discusses such issues on nearly a daily basis. I found Kalanithi’s words to be profound and helpful. Thanks to my friend Mike C. for recommending this book.