Memoir Review: When Breath Becomes Air

I rarely read a book the same year it is released (just too many waiting on my shelves already!), but when I saw the best-selling memoir When Breath Becomes Air by Paul Kalanithi at our favorite bookstore, I impulsively picked up a copy. I’m so glad I did – I was deeply moved by this stirring memoir written by a young doctor dying of cancer.

No spoilers here: you know from the Foreword and the Prologue that the author was diagnosed with cancer at a young age and died before the book was published. In some ways, that makes his words even more poignant, because he knew he was dying and his remaining time was short when he was writing them. He used those last months of his life to write about life and death, topics that had interested him intensely long before he became ill. He starts from his childhood and the beginning of his college career.

Paul Kalanithi knew with certainty as he started college that he did not want to be a doctor. His father and his uncle were doctors, and Paul was more attracted to literature and writing. He went to Stanford to study English Literature, but while he was there, he became interested in the physical workings of the mind and added Human Biology as a double major. He explains this unusual pairing:

“I studied literature and philosophy to understand what makes life meaningful, studied neuroscience and worked in an fMRI lab to understand how the brain could give rise to an organism capable of finding meaning in the world, and enriched my relationships with a circle of dear friends through various escapades.”

A perennial student, Kalanithi earned an MA in English Literature and a BA in Human Biology from Stanford, then moved to Cambridge and earned an MPhil in History and the Philosophy of Medicine. He finally settled on becoming a doctor and got his medical degree from Yale, then returned back to Stanford to complete his residency. Along the way, he met his wife, Lucy, who is also a doctor, and they got married.

Kalanithi was only 36-years old, months away from becoming a neurosurgeon himself, when he was diagnosed with Stage IV lung cancer. Ironically, he had been on the other side of this for years, treating patients with serious cancers, talking to them, and supporting them. Although he’d suspected cancer for a while (and interestingly, as a doctor with plenty of experience, denied it for a while), in that moment, looking at his own scans with his wife and his doctor, his life changed instantly. Suddenly, instead of struggling through the grueling days of residency and making plans for the next decades of his career, he was unable to work at all and focusing in on the next days and months with his family.

The author’s early instincts to become a writer were right on. His love of literature comes through clearly, and he has a beautiful way of describing the world and his experiences with a sense of clarity. His early fascinations with death and the meaning of life are also put to good use here, as he considers these topics from his suddenly shortened life and impending death. Although I do not have a terminal illness, I found much here to relate to, from his thoughts on how illness changes your life (applicable to chronic illness as well as terminal illness) to his experiences with late-stage cancer, as I just lost my father to melanoma last year, to his reflections on life and death.

Kalanithi died before he finished the book, so his wife wrote the last chapter. Have a box of tissues nearby for that – it is a rough one! He left behind his wife and 9-month old daughter, as well as the rest of his family and friends. Before he left, though, he gave the world a gift – a thoughtful, moving memoir that tells the story of an interesting but too-short life, while musing on the meaning of life. This is a special book.

225 pages, Random House