Book Review: When Breath Becomes Air (2016)

When Breath Becomes Air is a non-fiction autobiographical book written by Paul Kalanithi. It is a memoir about his life and illness, battling stage IV metastatic lung cancer. It was posthumously published by Random House on January 12, 2016.

This is an overdue review that I’m writing now for many reasons. First of them is that I finally have time. Second is that I need –and I think many other people need— a reminder that doctors are people too.

It occurred to me that my relationship with statistics changed as soon as I became one.

…Doctors, it turns out, need hope, too.


As a book, autobiography, and so on

I don’t rate books in numbers, per se, but if I did this book would have a very high score. When Breath Becomes Air is one of those books that’s very difficult to put down. Unlike other novels that I’d put in the same category —such as mystery thrillers and action-packed dramas— this book relies less on its plot to captivate, and more on the quality of its voice.

When Breath Becomes Air reads as so genuine and so heartfelt that you can’t help but flip to the next page. Going through this book feels less like reading letters on a page and more like listening to someone speak intimately about their life. It makes for the best kind of storytelling. But what would you expect? It is a book written by a dying man.

When Breath Becomes Air

To its merit, this book as an autobiography is a testament that a clever ending is not a prerequisite for a good book. After all, we all know how it ends. He dies. It is the journey to that last, breathtaking page that matters.

It’s about death, but it’s about life and everything before and even after as well. The author is an excellent weaver in that regard. It’s a complex intersection of one man’s dazzling intelligence, his philosophy, and his fears, as well as the audience’s own thoughts and fears about death reflected back and again.

Why I recommend this book

This book came highly recommended to my batch by way of our neurology professor. Our professor was a big fan of the intersections between fictional literature and neurology.

For added context, Paul Kalanithi was a neurosurgeon and neuroscientist, but also a holder of a Master of Arts in English Literature, and a Master of Arts in the History and Philosophy of Science and Medicine.

Paul Kalanithi
Paul Kalanithi, photographed by Norbert von der Groeben, taken from NY Times

I finally got around to reading a hard copy last year, when I bought what seemed like the last copy on the shelf in the Manila International Book Fair. I took it as a sign.

I read it and I fell in love. It’s easy to question –why indeed should you read a book about a man who is slated to die? Spoiler alert. Yet when I think about this book it’s not melancholy that overwhelms. I’m not sad. I don’t feel empty either. I feel breathless, sure, and I feel myself dwarfed by the idea of breath turning seamlessly into air…

Instead, I am incredibly proud of what humanity has to offer, even in its final moments. Any reader will be hard-pressed to remark anything but the author’s dignity, genius, and continuing evaluation of legacy and identity. It is sad at some parts, and I did cry at the finality of the epilogue. But isn’t this book a triumph even after death? We can imagine Paul to be happy.

I have always thought that the best kind of book is the one that never truly ends, never truly leaves you. Please read this book to be inspired, and to feel maybe a little bit fragile.

Quotes and other thoughts

A few pages into the book and I started scrambling for my post-it leaflets. There were simply so many lines that I felt I should either remember as a human being, or search later as a medical student. (I never did get around to searching for the terms).

Paul Kalanithi’s fascination with both the arts and the sciences struck me to the very core. It is also my life’s passion to find something that marries both; though I’m still honest enough to say that I don’t want that to happen by writing a bestselling novel while on my deathbed.

“There must be a way, I thought, that the language of life as experienced –of passion, of hunger, of love– bore some relationship, however convoluted, to the language of neurons, digestive tracts, and heartbeats.” (p. 39)

His thoughts on the medical profession made me smile, and also thoughtful of the future. He put into words the responsibility and privilege of every doctor.

“All of medicine, not just cadaver dissection, trespasses into sacred spheres. Doctors invade the body in every way imaginable. They see people at their most vulnerable, their most sacred, their most private. They escort them into the world, and then back out. Seeing the body as matter and mechanism is the flip side to easing the most profound human suffering.” (p. 49)

“Diseases are molecules misbehaving; the basic requirement of life is metabolism, and death its cessation.” (p. 70)

“The pain of failure had led me to understand that technical excellence was a moral requirement.” (p. 105)

In hindsight, such candid musings may or may not be the reason why my mother (whom I bullied into trying this book) hesitated in reading it.

There’s a clever review at the back of my copy from Ann Patchett. She calls this book “a universal donor –I would recommend it to anyone, everyone”. I agree.

A good book is a balm to the soul.

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