Reviews: May/June 2016

View full image

When Breath Becomes Air
Paul Kalanithi ’07MD
Random House, $25
Reviewed by Sylvia Brownrigg ’86

Sylvia Brownrigg ’86 is the author of six books of fiction. Her new novel, Pages for Her, will be published in 2017.

If grief memoirs are painful, then accounts by the dying are surely heartbreaking, as readers come to understand that the wise, sympathetic voice on the page has been extinguished. Yet When Breath Becomes Air by Paul Kalanithi ’07MD, a neurosurgeon who learned in his sixth year of residency that he had stage IV lung cancer, is inspiring rather than devastating. In it, the calm, reflective Kalanithi’s subject is not, What is it to die young? But rather—What is it to lead a meaningful life?

Kalanithi, who died in March of 2015, was a brilliant scientist as well as a highly skilled neurosurgeon. He was still completing his training, at age 36, when he reviewed a set of lung scans showing masses of ominous lesions—with the distinction that these scans were his own. Within days, the young surgeon had traded in his scrubs and crossed the divide between doctor and patient. In some sense this separation interests him more than that between life and death, as, ever learning, he observes and admires the empathic qualities of his own oncologist. Death itself does not frighten Kalanithi: “I had started in this career, in part, to pursue death: to grasp it, uncloak it, and see it eye-to-eye, unblinking.”

It is impossible not to marvel at Kalanithi’s courage and fortitude, qualities celebrated in the book’s moving forward by Abraham Verghese and in its epilogue by Paul’s loving wife, Lucy. Mercifully light on gruesome physical detail, Kalanithi spends his precious words exploring the ways terminal illness helps a person focus on what matters most to him or her. For him, this focus led to two remarkable decisions. After early success with one treatment, Kalanithi chose, with great determination, to return to the OR and complete his degree. Around the same time, he and his wife decided to have a child—a daughter, born eight months before he died, whose precious existence gave him comfort in his last months.

A deep humanism informs Kalanithi’s book, which is laced with quotations from Eliot, Tolstoy, and others. (He received both a BA and an MA in English, having originally planned to be a writer.) There are lines of Beckett’s that this wise soul finds especially resonant, as he weakens yet continues: “I can’t go on. I’ll go on.”