BOOK REVIEW: WHEN BREATH BECOMES AIR

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Staff editor for Book World with a focus on children"s books, memoirs, fiction, parenting, health and fitness
Paul Kalanithi at the Stanford Hospital & Clinics in năm trước. (Norbert von der Groeben/Stanford Hospital và Clinics)

Paul Kalanithi’s memoir, “When Breath Becomes Air,” written as he faced a terminal cancer diagnosis, is inherently sad. But it’s an emotional investment well worth making: a moving và thoughtful memoir of family, medicine & literature. It is, despite its grim undertone, accidentally inspiring.

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In 2013, Kalanithi, a 36-year-old neurosurgeon, was found to have sầu lung cancer. A nonsmoker who enjoyed reading and the outdoors, Kalanithi was rising through the ranks at Stanford University School of Medicine when weight loss & severe baông chồng pain sent hyên hobbling lớn the doctor. Kalanithi knew what was coming even before the CT scan results revealed multiple tumors. In that single moment, he writes, “the future I had imagined, the one just about lớn be realized, the culmination of decades of striving, evaporated.” Now, he’d wear a light xanh hospital gown instead of a surgical one. The diagnosis stole not only his future, but also his identity. “Who would I be, going forward, & for how long?” he asks.


Paul Kalanithi reflects on being a physician và a patient, the human experience of facing death, and the joy he found despite terminal illness. (Stanford/YouTube)

Kalanithi’s diagnosis is both a death sentence & an opportunity — albeit an unwanted one — for the kind of introspection that many of us clayên ổn lớn want but that never seems possible unless forced by tragedy. Raised on a steady diet of literature — Sartre, Twain, Thoreau — assigned by his mother when he was a boy in Arizona, Kalanithi is a deeply philosophical sort (his master’s thesis in literature at Stanford was “Whitman & the Medicalization of Personality”). His book, adapted parts of which appeared in the Thủ đô New York Times và The Washington Post, showcases his learned background, his contemplative sầu disposition & his kindness. His decision khổng lồ go khổng lồ medical school, he writes, was an effort “to lớn forge relationships with the suffering, and to lớn keep following the question of what makes human life meaningful, even in the face of death và decay.”

Kalanithi writes in great detail about his years of training, & in these parts of his memoir, you might forget for a minute that you are reading the words of a dying man. You’re drawn in — as you might be by the work of Atul Gawande, Oliver Sacks or Jerome Groopman — learning about the cases, the patients, the dilemmas.

Watch Kalanithi talk about his life và family


But Kalanithi is also one of those patients, a position that gives hlặng special insight. “It occurred lớn me that my relationship with statistics changed as soon as I became one,” he writes. He ponders the times when “I had pushed discharge over patient worries, ignored patients’ pain when other demands pressed. The people whose suffering I saw, noted, & neatly packaged into lớn various diagnoses, the significance of which I failed to recognize — they all returned, vengeful, angry, & inexorable.”

His words are bracing for their honesty. He also writes beautifully about the philosophical aspect of medicine, neurosurgery in particular: “Every operation on the brain is, by necessity, a ma­nipu­la­tion of the substance of our selves, and every conversation with a patient undergoing brain surgery cannot help but confront this fact.”


(Random House)
Paul Kalanithi, his wife, Lucy, and their daughter, Cady, in năm trước. (Suszi Lurie McFadden)

Kalanithi’s health improved for a while, allowing hyên ổn khổng lồ go bachồng lớn work and to lớn write more. He persevered through chemotherapy treatments, & when typing became painful, he wore “silver-lined gloves that allowed use of a trackpad and keyboard,” his wife, Lucy — also a doctor — writes in the epilogue. In năm ngoái, though, things took a turn, & Kalanithi died before he completed this work. Lucy, with the book’s editor, finished the manuscript, sometimes piecing together emails và other documents inkhổng lồ the narrative sầu. It’s a seamless collaboration — even the hurried, somewhat disjointed final pages feel lượt thích an authentic reflection of Kalanithi’s physical decline. Lucy’s epilogue & a foreword by Abrađắm đuối Verghese add perspective to the first-person trương mục.

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In one of the book’s most poignant moments, Kalanithi lies on a cot in the same hospital room where his wife is giving birth to lớn their daughter, Cady. Holding his child for the first time, he writes, “The possibilities of life emanated before us.” A few pages later, however, he is confronting yet again the certainty of death. “Everyone succumbs to finitude,” he writes. “I suspect I am not the only one who reaches this pluperfect state.” Only memory and words — in his case, those in this very book — “have sầu a longevity I bởi not.”

Read them and, yes, weep.

Nora Krug is a Book World editor.


Read more:

The best books of năm ngoái

Oliver Sacks’s posthumous gift: ‘Gratitude’

How a long-lost manuscript changed one writer’s life


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Nora Krug Nora Krug is an editor & writer in Book World. Before joining The Washington Post, she was an editor at the Thủ đô New York Times, Architectural Digest and Harper"s Magazine. She also worked as an editor at the book publisher Little, Brown. Follow
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