Published in the Sunday Times
When Breath Becomes Air
Paul Kalanithi (The Bodley Head)
*****
We come into the world and the first thing that happens is that we take a breath and, if all is well, we give our first cry. What no one knows is how many breaths of air they will take in a lifetime.
Paul Kalanithi was a young man when he died. He was, by his own account and the accounts of others, an incredible man. He held degrees in English literature, human biology and the philosophy of science from Stanford and Cambridge universities. He went on to study medicine at Yale. He chose neurosurgery and was about to graduate when we meet him at the beginning of this book. He was awarded his degree, but he didn’t get to go to the ceremony.
On a basic level, When Breath Becomes Air is a story about what happens when a doctor becomes a patient, but it’s so much more than that. It is a philosophical and literary exegesis of what a life cut short looks like from the viewpoint of a man who no longer has a long-term plan, because the future is not promised to him.
In his prologue he writes: “I flipped through the CT scan images, the diagnosis obvious: the lungs were matted with innumerable tumours, the spine deformed, full lobe of the liver obliterated.” So with this diagnosis, the doctor on the cusp of a glorious future becomes the patient.
What makes this book extraordinary is that it is not a pity party, but rather the story of an illness and the decisions Kalanithi and his wife Lucy have to make – whether to have a child before he dies, what his future will hold. As his disease progresses he reflects on living with the knowledge of what is killing him. It becomes a rigorous meditation on what death means in our death-averse society. It’s about not knowing how long you are going to live, and how that changes the landscape you thought you were going to navigate.
As Kalanithi discovers, the one thing one wants to know is: how long do I have? His oncologist refuses to answer – a frustration for Kalanithi as he feels this loss of agency.
When Breath Becomes Air is rather like an update on all one’s studies of literature and philosophy in one gulp. Strangely, this is not a morbid book; it is filled with a quiet wisdom. It is, however, a sad book. Particularly poignant is the moment when Kalanithi prepares to scrub in for his last surgery.
But it would be wrong to say that because his life was short – Kalanithi died before he was 40 – it didn’t matter. The message of the book may well be that it mattered very much.
This is not a book people should read, it is a book people have to read.
Follow Jennifer Crocker @Malleson30
Book details
- When Breathe Becomes Air by Paul Kalanithi
EAN: 9781847923677
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