When breath becomes air – Paul Kalanithi – Review


A curious title indeed and it pays to understand the meaning before getting to know the depth of it. When breath becomes the central focus of one’s existence and the subject is in the act of dying, it’s termed as breath becomes air. When every human takes breath as an undeniably granted component of their life, the same act had become central point of attention for over 22 months ever since Paul was diagnosed of lung cancer, an aspiring neurosurgeon just in his mid-thirties but a career that he has dedicated himself for over decade.

Any surgery related to brain tumour is bound to be complex not just due the significance of the organ but more so due the life and death related outcomes. When prognosis becomes a function of probabilities added with uncertain elements in the mix, the exercise is a share of not just medical expertise but moral dilemma as well. Would you rather live with the pain of tumour than accept the radical change in personality post-surgery? Is death a preferrable option when confronted with dysfunctional or vegetative state as a result of surgery? Paul had it in him to elucidate the matrix of pain vs gain and death vs delipidating life conditions, eventually navigating towards sensible choices amidst an emotional background for many of his patients.

However, Paul would have least expected himself to be on the receiving end, contracting lung cancer and becoming a patient himself. He goes through a phase of denial, fight, fear and finally acceptance of his impending death. All the effort to forge a successful and high-flying life of a neurosurgeon now gets wiped out while he is left with a heavily truncated life expectancy staring at him. He takes medications, undergoes chemotherapy and a third line of exploratory treatment with the hope of recovery and extend his truncated life expectancy by a decade. But all of them fail to arrest cancer growth beyond limited time period, which leaves him with the only option of facing death with close proximity.

With the expectation of roughly a year of life still left in him, Paul begins to essay his autobiography while the last part of the book is completed by his wife Lucy posthumously. All the while, the emotionally perplexing while also rewarding experience would have been the decision to conceive their first child Cady as Paul was undergoing cancer treatment. He gets to witness the birth of Cady and the first eight months of her life term which would have brought him boundless joy.

On 9th March 2015, Paul took his last breath which brought down the curtains of an exceptional neurosurgeon who would have sadly passed away with the regret of a truncated career. Apparently, he happened to be an incredible writer as well, I felt his expressions right through the book was captivating. Paul tried to find meaning of life at the face of death and his spirit to contribute despite adversities is a commendable attribute. 

An emotionally endearing book and I was left with moist eyes during the closing notes of Lucy. When breath becomes air is strongly recommended for those who are inclined to understand the vulnerable aspect of our life.  

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