When Breath becomes Air
Paul Kalanithi
April 17,2023
last update: 2024-11-19
Paul Kalanithi’s heart touching story about his struggle to search for a life with meaning, across literature and medicine, finally having a calling in neuroscience only for it to slip away too soon in the form of lung cancer.
This book let me see behind the veil of being a doctor. As kalanithi says, “it is a calling because if you consider it a job, it is pretty crappy job”. Having to work 90 hour weeks, making decisions on life and death. Pushing oneself to the absolute limits.
Paul recounts how their mother made it her mission to reform their school (which was located in the worst literacy district) and making sure her children had a fighting chance at the best educational institute and how they worked through a list of sophisticated literature books since their childhood.
His memories of having worked 18 hours continuously, sleeping in the car because he was unable to completing the 15-minute drive home. and then going home, having 4-hour sleep and then getting ready to work again was inspirational. Here is a man, who made it his life to reduce misery from the lives of people and accepted the pains that came with it. Him, going to work even after his diagnosis, so that he could get his mind off was incredible. A situation which would break any man down and give up on doing anything, made him help people because that is what his natural penchant was.
He had dilemma in college over going to intern at a hospital vs being a chef at a resort. And he chose to become a chef and acknowledging how it was one of his best decisions.
“Don’t you think saying goodbye to your child will make your death more painful?”
“Wouldn’t it be great if it did?” I said.
I was heartbroken, in the pages where he realizes he won’t be graduate after 6 years of residency. Having an unfulfilled dream in one’s deathbed, especially when a person has worked as much as kalanithi has is just unacceptable in my mind. Even though Paul found meaning for his life through his daughter and watching her grow up.
I’ve never pondered over how a doctor is pressured into making decisions with competing priorities. Is it better to not cut the cancer too deep and be a 25-year old with 5 years of healthy life before it recurs or is it better to cut a bit deeper at the risk of not being able to use the legs but live 10 years. The difference could only be 5 mm wide. Being able to objectively would require a great deal of detachment while also trying to do right by the patients. Paul’s story on how he was having an ice cream sandwich and being paged to save a patient, leaving the icecream sandwich behind a table, being unable to save the patient and then wondering what happened to the ice cream sandwich was an incredible realization of the type of environment doctors are demanded to lead their lives.
I felt a huge weight off my chest, when Paul’s cancer stabilised and started retreating. and crestfallen when it came back to ultimately take him away.
I loved the book. And am sad that the world is missing a great person.