When Breath Becomes Air

I was about one third of the way into Paul Kalanithi's end-of-life memoir When Breath Becomes Air: What Makes Life Worth Living in the Face of Death when my husband and I learned about another death in our family. Another death of someone that we didn't consider old. A sudden death of a contemporary. When I picked up the book, I figured it would be a difficult read. Full of suffering and end-of life decisions. I didn't think we'd be facing the end-of-life of a person very dear to our family.

Thankfully, the memoir wasn't like that much at all. I pushed myself to finish it more quickly than I might ordinarily. Because I wanted to be done with death for now. I pushed myself so that I'd be able to pick up something lighter to read.

The book is broken into three parts. Kalanithi starts by telling us a little bit his upbringing and his windy path to becoming a neurosurgeon/neuroscientist. He was always a thoughtful guy. He was an English lit major in college and went on to get a masters in English literature as well.  He was philosophical and got a second masters in the history and philosophy of science and medicine. So even before he had his own life in the balance, he was thinking about the questions of life - mind and body.

The second section of the book is about his life after his diagnosis of lung cancer. Lots of it was technical medical talk so not particularly gut wrenching. Here is where we learn about his decision to go ahead and have a baby with his wife, Lucy. He reflects on giving up operating, giving up on his medical career, on the importance of getting something written before he dies. It includes some end-of-life issues but it was all pretty matter-of-fact. I don't think that I've become so hardened experiencing all the deaths in my own life in the past few years. And I made no comparisons to the end-of-life conversations I had with my cousin once she was diagnosed with osteosarcoma. That wouldn't have made sense. In retrospect, I'm very glad that what seemed to be Kalanithi's biggest issue was, within the context of his own illness, when was it time to move from being doctor to doctor/patient to patient/doctor to simply patient. I wasn't able to personally connect with that and in that way the book was easier for me to get through than I thought it would be.

My favorite passage in the memoir was:

The tricky part of illness is that, as you go through it, your values are constantly changing. You try to figure out what matters to you, and then you keep figuring it out. It felt like someone had taken away my credit card and I was having to learn how to budget. You may decide you want to spend your time working as a neurosurgeon, but two months later, you may feel differently. Two months after that, you may want to learn to playthe saxophone or devote yourself to the church. Death may be a one-time event, but living with a terminal illness is a process.

The book ends with an Epilogue by Lucy Kalanithi, the wife that he met and married in medical school. Her writing gave me a better sense of Kalanithi than his writing gave me of himself. That makes me wonder if others are able to view us more deeply than we can view ourselves? I don't think it was a case of him holding back. I just don't know.

When Breath Becomes Air is the October title for my community book club. I think the discussion of the book should be interesting even though I didn't love the book.