Review: When Breath Becomes Air by Paul Kalanithi

When Breath Becomes Air

Title: When Breath Becomes Air
Author: Paul Kalanithi
Genre: Memoir
Publisher: Random House
Date published: January 19th 2016
Format: Paperback
Page Count: 208

Rating: 4.5/5

Trigger warnings: cancer, death

At the age of thirty-six, on the verge of completing a decade’s worth of training as a neurosurgeon, Paul Kalanithi was diagnosed with stage IV lung cancer. One day he was a doctor treating the dying, and the next he was a patient struggling to live. And just like that, the future he and his wife had imagined evaporated. When Breath Becomes Air chronicles Kalanithi’s transformation from a naïve medical student “possessed,” as he wrote, “by the question of what, given that all organisms die, makes a virtuous and meaningful life” into a neurosurgeon at Stanford working in the brain, the most critical place for human identity, and finally into a patient and new father confronting his own mortality.

What makes life worth living in the face of death? What do you do when the future, no longer a ladder toward your goals in life, flattens out into a perpetual present? What does it mean to have a child, to nurture a new life as another fades away? These are some of the questions Kalanithi wrestles with in this profoundly moving, exquisitely observed memoir.

Paul Kalanithi died in March 2015, while working on this book, yet his words live on as a guide and a gift to us all. “I began to realize that coming face to face with my own mortality, in a sense, had changed nothing and everything,” he wrote. “Seven words from Samuel Beckett began to repeat in my head: ‘I can’t go on. I’ll go on.'” When Breath Becomes Air is an unforgettable, life-affirming reflection on the challenge of facing death and on the relationship between doctor and patient, from a brilliant writer who became both.


Death is a sensitive topic, but Paul’s memoir is filled with details and stories and feelings about it throughout. Initially, as a doctor in residence, he sees it in cadavers. Later he discovers it in the OR as a doctor treating patients. Finally, he comes face to face with it personally, when he transitions from being the doctor to the patient being treated on.

Something that this book started in me was a new renewed sense of understanding if not acknowledgement for doctors. Whether it’s the commitment and sacrifices they give to choose the decade long path to residency for 88 hours long work weeks or the responsibility placed on their shoulders when they’re trying to save patients at their most pivotal moments, it altered my view on what a doctor was. After reading this book, I wanted to find my premed friends and give them a hug and say, “I’m sorry for misjudging you.”

But this book was more than a narrative telling readers what a life of a doctor was like. It was Paul’s method of release and freely opening up to the burdens he’s felt as well as the reflections that he’s made over the course of his career.

I wondered if, in my brief time as a physician, I had made more moral slides than strides.

It’s humbling to watch him tell the uncensored truth; not only the triumph and miracles when a life is saved but also the difficulties and morale of being constantly faced with death.

The memoir isn’t like any I’ve read before. But then again, when are memoirs ever the same. When Breath Becomes Air is a refreshing and enlightening read that I’m very glad I picked up with the helpful nudges of a few friends.

Amid the tragedies and failures, I feared I was losing sight of the singular importance of human relationships, not between patient and their families, but between doctor and patient. Technical excellence was not enough. As a resident, my 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.


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