When Breath Becomes Air by Paul Kalanithi.

After maybe a month or so I am finally back with a book review! And what better book review to write then on this book; which may be one of the best books I have read all year.

What makes a virtuous and meaningful life? Paul Kalanithi believed that the answer lay in medicine’s most demanding specialization, neurosurgery. Here are patients at their life’s most critical moment. Here he worked in the most critical place for human identity, the brain. What is it like to do that every day; and what happens when life is catastrophically interrupted?

When Breath Becomes Air is an unforgettable reflection on the practice of medicine and the relationship between doctor and patient, from a gifted writer who became both.

With a foreword by Dr Abraham Verghese and an epilogue by the author’s wife, Lucy. (Goodreads)

I was on Amazon, ordering books on the reading list for my Health Psychology module at university, and when purchasing one book in particular (On Death and Dying by Elisabeth Kübler-Ross), this book came up as a suggested purchase. I had heard of the book previously, as Leena Normington (YouTube: justkissmyfrog) had raved about it, and reading the description I realised that it would take what I was learning in my module on health psychology and provide an intriguing new perspective.

Turns out it did a great deal more than that. This book was a beautiful, raw, heart-breaking book read, and one which exults life and poignant thought.

“Don’t think I ever spent a minute of any day wondering why I did this work, or whether it was worth it. The call to protect life—and not merely life but another’s identity; it is perhaps not too much to say another’s soul—was obvious in its sacredness. Before operating on a patient’s brain, I realized, I must first understand his mind: his identity, his values, what makes his life worth living, and what devastation makes it reasonable to let that life end. The cost of my dedication to succeed was high, and the ineluctable failures brought me nearly unbearable guilt. Those burdens are what make medicine holy and wholly impossible: in taking up another’s cross, one must sometimes get crushed by the weight.”  

Dr Paul Kalanithi was an English literature graduate, embarking on a career in medicine and neurosurgery to see if there was a way that philosophy, emotion and metaphysics intersected with the biological truth and with medicine. This book provides fascinating discussion of religion, death, how to live your life, finding your passion, the unpredictability and the mortality of human life, and more.

“I began to realize that coming in such close contact with my own mortality had changed both nothing and everything. Before my cancer was diagnosed, I knew that someday I would die, but I didn’t know when. After the diagnosis, I knew that someday I would die, but I didn’t know when. But now I knew it acutely. The problem wasn’t really a scientific one. The fact of death is unsettling. Yet there is no other way to live.”  

Expected of someone who studied English literature at Stanford University, Kalanithi’s writing is exquisite and insightful. It is hard to imagine somebody being able to possess both a scientific and a philosophical, lyrical and fluid mindset; as I was always of the mind you had one or the other. However Kalanithi writes wonderfully, and evokes such emotion. This book causes you to feel a vast array of emotions, from anger at the fate Paul was handed, to uplifted through his relentless dedication and spirit.

“Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete.”   

What I found most interesting about this book, is that which relates to what I’m currently studying at university. In our first health psychology class, we discussed the psychological impact that chronic and terminal illness and, inevitably, death can have on a patient, while also discussing the psychological effects on doctors being surrounded by this all of the time, and how they can become desensitised etc. What is so cruel, but so fascinating about Paul’s story is that he gets to see the story from both sides; having been the – at times desensitised- doctor and the observer of death and suffering, to being the patient. Such a contradiction and conflict in roles gives Kalanithi a fascinating perspective on both sides, and it moved me to tears.

I hope this book review conveys in some shape or form how much I adored this book, how different it is and how important it is. It has filled me with a newfound appreciation for life and reaffirmed the idea of it being fleeting and changeable with the drop of a hat. For someone who loves philosophy and discussing causation and religion, this book provided me with new perspective and new food for thought. It was a stunning and emotional book that I feel will stay with me for a long time to come. May Paul rest in peace and may his book continue to touch people’s lives as it has mine.

“All the idylls of youth: beauty manifest in lakes, mountains, people; richness in experience, conversation, friendships. Nights during a full moon, the light flooded the wilderness, so it was possible to hike without a headlamp. We would hit the trail at two A.M., summiting the nearest peak, Mount Tallac, just before sunrise, the clear, starry night reflected in the flat, still lakes spread below us. Snuggled together in sleeping bags at the peak, nearly ten thousand feet up, we weathered frigid blasts of wind with coffee someone had been thoughtful enough to bring. And then we would sit and watch as the first hint of sunlight, a light tinge of day blue, would leak out of the eastern horizon, slowly erasing the stars. The day sky would spread wide and high, until the first ray of the sun made an appearance. The morning commuters began to animate the distant South Lake Tahoe roads. But craning your head back, you could see the day’s blue darken halfway across the sky, and to the west, the night remained yet unconquered—pitch-black, stars in full glimmer, the full moon still pinned in the sky. To the east, the full light of day beamed toward you; to the west, night reigned with no hint of surrender. No philosopher can explain the sublime better than this, standing between day and night. It was as if this were the moment God said, “Let there be light!” You could not help but feel your specklike existence against the immensity of the mountain, the earth, the universe, and yet still feel your own two feet on the talus, reaffirming your presence amid the grandeur.”  

I hope you guys enjoyed this review. And for those of you have followed me for a little while, you’ll know I originally intended to write a book review and have it published every Sunday. However, to alleviate some pressure, I have decided to scrap this idea and write as and when I can.

Take care everybody! Pip pip!

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2 thoughts on “When Breath Becomes Air by Paul Kalanithi.

  1. […] This is a heartbreaking but uplifting memoir of a neurosurgeon who finds out he is dying of cancer as he is about to complete his residency. This book sounds depressing, but it exerts life and brilliance, it is inspiring and wholesome and is absolutely unbelievable. It conveys the difference between being the doctor and being desensitised, to being the patient  from a person who has seen both sides. It discusses death, spirituality, coming to terms with mortality and much more. So beautiful and inspiring. Please read it! See my review here. […]

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