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When Breath Becomes Air

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For readers of Atul Gawande, Andrew Solomon, and Anne Lamott, a profoundly moving, exquisitely observed memoir by a young neurosurgeon faced with a terminal cancer diagnosis who attempts to answer the question 'What makes a life worth living?'

At the age of thirty-six, on the verge of completing a decade's worth of training as a neurosurgeon, Paul Kalanithi was diagnosed with stage IV lung cancer. One day he was a doctor treating the dying, and the next he was a patient struggling to live. And just like that, the future he and his wife had imagined evaporated. When Breath Becomes Air chronicles Kalanithi's transformation from a naïve medical student "possessed," as he wrote, "by the question of what, given that all organisms die, makes a virtuous and meaningful life" into a neurosurgeon at Stanford working in the brain, the most critical place for human identity, and finally into a patient and new father confronting his own mortality.

What makes life worth living in the face of death? What do you do when the future, no longer a ladder toward your goals in life, flattens out into a perpetual present? What does it mean to have a child, to nurture a new life as another fades away? These are some of the questions Kalanithi wrestles with in this profoundly moving, exquisitely observed memoir.

Paul Kalanithi died in March 2015, while working on this book, yet his words live on as a guide and a gift to us all. "I began to realize that coming face to face with my own mortality, in a sense, had changed nothing and everything," he wrote. "Seven words from Samuel Beckett began to repeat in my head: 'I can't go on. I'll go on.'" When Breath Becomes Air is an unforgettable, life-affirming reflection on the challenge of facing death and on the relationship between doctor and patient, from a brilliant writer who became both.

208 pages, Kindle Edition

First published January 12, 2016

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About the author

Paul Kalanithi

13 books1,745 followers
Paul Kalanithi, M.D., was a neurosurgeon and writer. Paul grew up in Kingman, Arizona, before attending Stanford University, from which he graduated in 2000 with a B.A. and M.A. in English Literature and a B.A. in Human Biology. He earned an M.Phil in History and Philosophy of Science and Medicine from the University of Cambridge before attending medical school. In 2007, Paul graduated cum-laude from the Yale School of Medicine, winning the Lewis H. Nahum Prize for outstanding research and membership in the Alpha Omega Alpha medical honor society. He returned to Stanford for residency training in Neurological Surgery and a postdoctoral fellowship in neuroscience, during which he authored over twenty scientific publications and received the American Academy of Neurological Surgery’s highest award for research.

Paul’s reflections on doctoring and illness – he was diagnosed with stage IV lung cancer in 2013, though he never smoked – have been published in The New York Times, The Washington Post and The Paris Review Daily, in addition to interviews in academic settings and media outlets such as MSNBC. Paul completed neurosurgery residency in 2014. Paul died in March, 2015, while working on When Breath Becomes Air, an unforgettable, life-affirming reflection on the challenge of facing mortality and on the relationship between doctor and patient, from a gifted writer who became both.. He is survived by his wife Lucy and their daughter Cady.

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5 stars
354,153 (57%)
4 stars
184,135 (29%)
3 stars
62,087 (10%)
2 stars
13,333 (2%)
1 star
6,953 (1%)
Displaying 1 - 30 of 43,823 reviews
Profile Image for Petra on hiatus, really unwell.
2,457 reviews34.4k followers
April 8, 2023
I finished the book and I'm glad that I perservered with it. It's quite an odd book and an overall rating might be the sum of the parts, but is not going to reflect the writing or content of those parts. Ratings, part I, 1 star, part II, 3 stars and part III, 5 stars.

The first part, the foreword, by Abraham Verghese, was verbose, hagiographic and contradictory . He said he didn't know the author at all until after his death. Then he says well he did meet him and they had a long email correspondence. And so it goes. He says it's the foreword but should be the afterword. Verghese must have sat there with a thesaurus composing endless sentences of praise for the author, who had, like most of us, never accomplished anything much out of the ordinary. I dnf'd this part and give it a whole, rounded-up 1 star.

The second part, I feel churlish writing this, I really do. The author had an interesting career in his short life, mostly as a student. He had a MA in English Literature, another MA in History and Philosophy of Science and Medicine, a BSc in Human Biology and finally an MD from Yale, before going on to be a neurosurgeon.

It was in his brief career as a neurosurgeon and scientist he was diagnosed with cancer. He tried his best to be introspective and give guidance through the exponentially-increasing awfulness that is the journey through this dread disease. The problem was, he wasn't a natural writer although he'd wanted to be one all his life. His prose might have been just the stuff of essays at his Ivy League universities, but to me it was reminiscent of a writers' group where each attempt to outdo the other with portent-laden phrases and lots of deep literary references. It was tedious in parts. But... he did his best and he was a good doctor, husband and father, and this was only his debut book. Five stars for the man, but three stars, just, for this central section of the book.

The long afterword was written by his widow. She is a doctor too, but could easily be a writer. She just has 'it' and her late husband, who wanted it so much, didn't. She rounds out the story he told, and continued on at length in the most interesting and well-written part of the book. Her ability to convey emotion without getting either lyrical or sappy was excellent. Five stars. Dr. Lucy Kalanithi should have been credited as co-author. I hope she goes on writing.

It won't make sense to read the last part without the second, but you can easily skip the foreword, all it adds is unnecessary verbiage and lots of pages to make it look more than just the thin tome it really is.

An example of the really rather awful writing that got me down. You may disagree, you may feel that the three words I suggest - dawn came up, are no substitute for the 150 poetic, lyrical, descriptive ones the author wrote instead. I'm too hard, right?
Profile Image for Diane S ☔.
4,783 reviews14.2k followers
January 31, 2016
As I finished this book with tears running down my face I asked myself, "Why did you read this book? You know it was going to be sad, how could a man dying of lung cancer before the age of forty be anything but." Yet to just classify this memoir, to classify this novel as such is to devalue the man he was. He was a lover of literature, a neurosurgeon, a scientist, a son and brother, a husband and father. He tried to live each day to the best of his ability, he helped many and he acknowledged the doctor patient relationship had a big disconnect with the reality of life, how their lives would change after being diagnosed with a serious illness. He was not a saint, he cried when given a death sentence, but his thoughts were not always for him, he always wanted to make sure his wife had a life after he was gone. So in many ways this was a profoundly beautiful read by a remarkable man.

His wife says it best, "What happened to Paul was tragic, but he was not a tragedy."
Profile Image for Maxwell.
1,174 reviews8,401 followers
August 1, 2017
I don't think you should read this book because the story of an incredibly gifted man who had his life taken away at such a young age might give you the motivation to live life more fully. I think you should read this book because that talented, inspiring man has incredibly important things to say derived from his own experiences, and it's important to listen and learn from them.

Read this book with the knowledge that you might not always be able to understand everything someone goes through, but you can set aside the time to listen to their story and hopefully give them the dignity and respect they deserve as a human being, in life or death.

“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.” -Paul Kalanithi
Profile Image for Aisling.
Author 3 books104 followers
August 2, 2017
Oh dear. I was always told not to speak ill of the dead. It feels awful to give a three star rating to a nice guy (by all accounts) who is now dead. But I simply did not find this book compelling or insightful enough. It is mildly interesting to learn about neurosurgery as a specialty and to read the author's thoughts as he faced diagnosis, illness and then death. I always felt that the author was holding back; that it was too clinical, too calm, just not passionate enough. The first time I felt that I was reading something worthwhile was in the 26 page epilogue by the author's wife. I guess the best way to say it is this; this is a quick read. And of course it should not be.
Profile Image for Emily (Books with Emily Fox).
554 reviews60.5k followers
April 19, 2018
Do yourself a favour and don't listened to the ending of this book while doing your makeup...

Theres no way to review a book where the author died too young from cancer leaving his wife and 8 months old baby behind without feeling like an asshole for not giving it 5 stars.

That’s why more often than not, I don’t give a rating to the autobiographies I read. I just don’t feel comfortable rating someone’s life.

Cancer and the death of a close one is something most of us unfortunately can relate to and I think it’s why this book got so popular.
I’m glad the author was able to write this book since it was his dream but in my opinion the best part of it was the epilogue from his wife. I’m sure it’s where most of us ended up ugly crying.
Profile Image for Tharindu Dissanayake.
288 reviews560 followers
April 17, 2021
"Death comes for all of us. For us, for our patients: it is our fate as living, breathing, metabolizing organisms."

Though 'When Breath Becomes Air' had been on my shelf for a while now, I've been going back and forth, unable to decide whether I should read this, as I was somewhat fearful of the impact this memoir might have on me. One must always brace himself/ herself when reading a book like this, for, you dive in knowing well about the inevitable heartbreaking ending. But, now that I'm finished, the only thing I regret is not reading the book sooner. Dr. Paul Kalanithi's insightful, beautiful and emotional memoir is something that everyone must read.

"What makes life meaningful enough to go on living?"

The first half of the story is not what I had expected at all. Dr. Kalanithi starts from his childhood, little briefing about the family background and the turning points which directed him towards becoming a doctor, followed by the years in medical school. But what he focuses on most during the first half of the book is, the difficulties faced by a Resident, prior to graduation. The exhausting journey a Resident has to make is explained in a very captivating manner, allowing the reader to empathize with all medical professionals. This part of the book has been an eye-opener for me, for, never had I imagined it to be this much demanding. But it's not only that. He also goes on to describing moral/ ethical dilemmas one had to face, and the different ways each person deals with critical situations.

"At those critical junctures, the question is not simply whether to live or die but what kind of life is worth living."

With the starting of second half, Dr. Kalanithi moves on to challenges he had to encounter after his diagnosis. The personal experiences are sometime quite overwhelming, navigating through an alternating curve where we continuously switch between hope and despair. Even with knowing the ending, it's difficult not to become hopeful that everything might get better and then stay that way. In my opinion, this latter half of the book is therapeutic for any reader, because, if one had already experienced a similar situation, they'll be able to relate and ease their pain at least a little, while others will understand the anguish and pain suffered by the patients and their families. The way you view people - not just the terminal patients, but any hardships faced by fellow human beings - will change profoundly.

"I feared I was on the way to becoming Tolstoy's stereotype of a doctor, preoccupied with empty formalism, focused on the rote treatment of disease - and utterly missing the larger human significance."

Another thing that is going to surprise the readers is the beautiful use of language where Dr. Kalanithi's skills in literature and language really shines through. The narrative is not something one would expect from a doctor. Two main chapters are followed by the epilogue by Lucy Kalanithi, which is even more heartbreaking. But it is commendable how well she completes memoir, and delivering us this remarkable book. Reading preferences notwithstanding, I urge every reader to go through this book, at least once. It won't take you more than a couple of hours, but this book will profoundly change the way you see the world. Thank you, Dr. Paul Kalanithi, for your last, but most exceptional contribution to posterity.

"Science may provide the most useful way to organize empirical, reproductible data, but its power to do so is predicated on its inability to grasp the most central aspects of human life: hope, fear, love, hate, beauty, envy, honor, weakness, striving, suffering, virtue."

"Yeah. Yeah, I like happy endings."

Profile Image for Iris P.
171 reviews206 followers
April 6, 2019
Sharing this interesting New York Times interview with Dr. Lucy Kalanithi.
She sounds like a very special person too:
Upgrading this to 5 stars, not sure why I didn't before

After finishing this profound, emotional memoir I feel like I lost a good friend.
Thank you Paul Kalanithi for this beautiful gift you left for us, wherever you are...

 photo 556069_1280x720_zpsbfrek8oe.jpg
Paul Kalanithi & Baby Cady during his last days of life

 photo IMG_00468_zps504xcdb8.jpg
Kalanithi with wife Lucy and Baby Cady

I was going to try to write a longer review but my mind is not into it these days.
All I can say this book will stay with me for a long time and everything good you've heard about how amazing it is it's more than well deserved.

Sad, poignant, raw, beautiful...
Profile Image for Cindy.
407 reviews116k followers
November 9, 2021
I enjoy memoirs, but this one didn't grip me as much as others have, which is a shame considering how beloved this book seems to be. I admire Paul's resilience and passion for the world and his relationships, and I felt most compelled by his wife's conclusion towards the end when he couldn't complete his book. I think what kept me from being emotionally engrossed in this book was the writing. I would have appreciated more descriptions and storytelling about his experiences and relationships, rather than being told these things. There's lots of talk about finding the value in life, and I would have liked to read more scenes, examples, etc. to support those notions.
Profile Image for Philipp.
632 reviews189 followers
January 24, 2016
alternative title: "How the upper class dies"

Autobiographical book by a guy who's trained and studied all his life, nearly became a writer, then chose to become a doctor instead (that's what happens when you come from a family of medical doctors), and is diagnosed with cancer at the end of his training. Torschlusspanik [1] sets in and he has to write that one book he always wanted to write. It's partially an autobiography of his training, a hymn to his wife, and a bit on patient-doctor relationship.

Sometimes it's way too pretentious for its own good, lots of classical lit, lots of poetry quotes, lots of namedropping - who on earth reads Wittgenstein to a newborn?? - and sometimes it's too sentimental and just straight-up walks into Tuesdays with Morrie territory. It is not an ugly death - for that the family is too well-trained in medicine to "fight" ultimately senseless fights, too well-acquainted with death to cause a fuss, too rich to die in a dump, too well-connected to suffer bad doctors.

The last chapter written by the wife after his death is probably the best - still, I wouldn't recommend it, not much new, not that interesting [2]. Would make a good book for Oprah's Book Club.

I can guarantee you that yours and my death will be much worse than what is described here. Here there is no constant vomiting, no blood, no mucus, no week-long screaming from the pain. Death is too clean, like the book itself.

[1] One of the best words we have in German - literally "gate closing panic", it usually denotes a woman who starts to behave unusual once she realises that her child-bearing age window is closing, but it can be used to describe everyone who starts to behave unusual once time starts to run out

[2] It feels extremely mean to write that about a guy's work who has just died
Profile Image for Elyse Walters.
4,010 reviews627 followers
November 3, 2019
1/12/16: Update: Just wanted to mention that this book goes on sale today. Its an amazing story!

Paul Kalanithi studied literature at Stanford University. For his thesis, he studied
the work of Walt Whitman, a poet , who a century before, was possessed by the same questions that haunted him. Kalanithi wanted to find a way to understand and describe what he termed "the Physiological-Spiritual Man."

Kalanithi had a passion for literature. He began to see language as an almost supernatural force, existing between people, bringing our brains, shielded in
centimeter-thick skulls, into communion.
"There must be a way, I thought, that the language of life as experienced – – of passion, hunger, of love – – bore some relationship, however convoluted, to the language of neurons, digestive tracks, and heartbeats."

Paul Kalanithi's thesis was well-received -- but neuroscience as literary criticism didn't quite fit in the English Department. ( nor did he). There was a question he couldn't let go of. "Where did Biology, morality, literature, and philosophy intersect?".

Kalanithi consulted a premed advisor - set aside his passion for literature - and figured out the logistics to get ready for medical school. He was still searching for answers to the question "what makes human life meaningful, even in the face of death and decay?"

When he was in his fourth year medical school, he watched many classmates choose to specialize in less demanding areas, (radiology or dermatology for example). It puzzled him that many students focused on lifestyle specialities--those with more humane hours, higher salaries, and lower pressures. For himself, he chose neurosurgery as a specialty.

Kalanithi was diagnosed with Cancer. ( he actually was almost certain he had cancer many months before getting an X-Ray or MRI). Once it was clear that the cancer had invaded multiple organ systems--( "severe illness wasn' life altering--it was life shattering"), decisions needed to be made. His wife Lucy, father, siblings, doctors were all involved - and chemo would start soon.
Clarifying the rest of his life ( only age 36 at the time), was going to be a process.
He and Lucy went to visit a sperm bank to preserve gametes and options. They had planned on having kids at the end of his residency.
To think. Paul Kalanithi wrote this book - relentlessly- fueled with purpose during the last year of his life -- never got to finish his life's plan..( yet he still worked that last year).... But he was racing against time. With this book - he was hoping to confront death - examine it- accept it-- as a physician and a patient. He wanted to help other people understand death and face their mortality. "It's not exotic..but tragic enough and imaginable enough he says".

There is a beautiful - but so sad- Epilogue by Lucy - from Paul's wife at the end of the book. Their baby had been born eight months before Paul died - March 9th, 2015.

Lucy reports that Paul let himself be vulnerable and comforted by family and friends.. and even when terminally ill, he remained fully alive!

Thank You Random House, Netgalley, and Paul ( and Lucy), Kalanithi
Profile Image for Justin.
285 reviews2,304 followers
October 24, 2016
I read this almost two months ago and realized I never reviewed it. When I finished the book, I just couldn't review it. It's a small book, but it's powerful. I didn't shed any tears at the end of it, but I remember sitting there physically shaking and feeling really numb and tingly. A book has never impacted me that way before, and I'm not even sure why I read the book in the first place since I knew what I was getting myself into.

Wait, I know why I wanted to read it. It was very therapeutic for me. I don't want to pull back the curtain too far on my life, but I've seen the havoc cancer causes out of nowhere in people's lives. People very close to me. I've held my grandmother's hand as she took her last breath after battling pancreatic cancer. My grandfather wasn't far behind her thanks to cancer in his lungs and throat. My dad has been battling colon cancer for the last two years. He's up and down. I think chemo does more bad than good. It's definitely taken its toll on him, but he's fighting.

All this cancer and death hitting so close to home left me in this weird phase two years ago where I got to learn what a panic attack feels like. It's like having a heart attack, but not really, but close. It's scary. I think cancer blasting through my family while I was in the process of trying to move across the country just really shook me up. I still deal with the effects of it sometimes.

I think God was just trying to show me there are some things in life I can't control. I can pick my job, my house, what to watch on Netflix, but I have no power over death or cancer or a heart attack or a car crash or any of it.


So this book was helpful. I felt like I really connected with it and it was something I needed to read. You might not have quite the same reaction, but I still highly recommend reading it. Fiction is always great to escape the dark realities of the world we live in, but sometimes confronting those realities head on is extremely beneficial.
Profile Image for Dr. Appu Sasidharan (Dasfill).
1,275 reviews2,444 followers
February 18, 2023

This is one of the best medical memoirs I have read. This book tells us about cancer both from a Doctor's perspective and a patient's perspective. Kalanithi's journey from a medical student into a Stanford Neurosurgeon will be an inspiring one for many. But it is the latter half of the book that tells you how to deal with a terminal illness that inspires you the most.
“There is a moment, a cusp, when the sum of gathered experience is worn down by the details of living. We are never so wise as when we live in this moment.”
Profile Image for Joseph.
224 reviews42 followers
May 19, 2019
Okay, I so wanted to like this very absorbing book more than I did. I am not going to recap it other than to say that Paul came from a privileged background, a very supportive family and an Indian (Asian Tiger) mom. He succumbed to an aggressive form of lung cancer. My own wife died of lung disease (idiopathic pulmonary fibrosis). Outside of the hospital I was her caregiver for a year and a half. I was the one who made sure she had oxygen, got to her appointments, watched this once vital woman deteriorate, and held her hand in icu when she passed. Unlike Paul and Lucy, we did not stay together out of a sense of obligation because one of us was sick. Unlike Paul and Lucy we did not have an extended family to support us. Unlike Paul and Lucy we adopted. I went through this with her because I loved her. I never thought of another option even though she tried to persuade me once or twice that there might be other options.

The book is very well written and Paul had a gift for including just the right amount of medical detail and jargon. He explains things precisely when explication as needed. The book flows smoothly from his childhood through Stanford and then Yale medical school. Paul according to himself is just about the best at whatever he undertakes and again according to himself he always takes care to score one more point than his closest competitor. He catalogues a list of the books he has read -- exclusively Western -- and drops a few favorite quotations from some. Strangely he makes no mention of Indian writing or writers or of the great Kiowa author Scott Momaday who matriculated at Stanford. Kinda too bad Paul did not read Momaday. If he had he might have understood the power and use of words better than he did.

He becomes according to himself a wonderful neurosurgeon, probably the best ever although he does not reduce it to that exact description. He is decisive, fast, innovative and just an all around wonderful doctor.

If you are getting the impression that he comes across as extremely self centered you broke the code. If you are getting the impression that he comes across as lacking real depth you not only broke the code you read between the lines.

The book is very well written and at times absorbing, but it left me wondering, was that all there was to Paul and Lucy?
Profile Image for Sabaa Tahir.
Author 22 books32.2k followers
July 17, 2016
Never has a book turned me into a sad sobbing mess so quickly. Philosophical, beautiful, moving, difficult, heartbreaking. Highly, HIGHLY recommend.
Profile Image for jessica.
2,555 reviews35.7k followers
November 15, 2020
‘even if im dying, until i actually die, i am still living.’

this memoir offers a very unique perspective on life and death, science and philosophy.

as someone who also studied both literature and neuropsychology, i appreciate and completely relate to pauls outlook on how both are connected forces which drive life.

his insights to what makes a life meaningful, the importance of purpose, and seeing humanity in people are good lessons to be taught. while not necessarily groundbreaking ideas at the core, its how he exemplifies these ideas in the context of his life and diagnosis that will serve as a good reminders to others to live life to the fullest.

4 stars
60 reviews293 followers
April 20, 2019

This is the story of the perception and management of life and death (both separately and together) of a 36 year old doctor nearing the completion of his neurosurgery training when he got diagnosed with a stage 4 cancer.

Being a person on the path of being a surgeon, having a love for books, philosophy, literature, writing and a thirst to know deeper meaning for life, I felt I could understand the author very well, somehow!
The parts regarding a surgeon's hectic schedule, the heavy burden of patients' wellness and care and the thorough explanation of surgical procedures proved to be like my own normal routine and consequently made me feel more at home with this man's philosophies and researches for whatever he was looking for out there in this whole wide universe!

Paul had a passion to fully grab the meaning and purpose of life, death and human existence and this love took him on an adventurous journey first through literature, then through medicine and finally both!

“Years ago, it had occurred to me that Darwin and Nietzsche agreed on one thing: the defining characteristic of the organism is striving.”

He found that no matter how much close to a patient a doctor was during his illness, he could never grasp the true meaning of his suffering since he could never be in his shoes!

This book shows how fragile life is to spoil the long hours of hard work and fail you in achieving your goals, how unpredictable it can be to divert you from the path that so definitely was leading you towards your dreams just in the previous moment.

This book shows how life is to be lived, how death is to be welcomed and how much effort it takes to have the integrity to look them both in the eye, fight with dignity and come out a winner, despite losing your breaths in the battle!

Tears welled up in my eyes while reading the part when despite having a weakening body, this man invested enough energy to gain unlimited happiness during the moments of delivery of his daughter.

He taught us that vulnerability is not weakness. It takes real strength to reveal your vulnerable side. It is in the weakest moments that a man can be the strongest, never knowing he could endure all that pain.

This book opens our eyes to our mortality. That our time in this universe is limited. That love and knowledge are immortal tools that we can use to our aid to make our stay on this planet infinite.

Finally this book teaches us how the pain and suffering could be reduced by the undying love, affection and care of one's family. That life is not lived in years. Even in the smallest amount of time, we can create valuable and immortal memories.

“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.”

The book is written in simple and honest language yet it touches the deepest parts of heart and mind. Being written by a man who had a limited time frame and a vast knowledge and understanding of the human miseries and their connections with the beginning, mid and end of the story called life, I would not like to judge it harshly. Just having the courage enough to write a book with such influence on readers is a feat worth praising!

The sadness I felt, after knowing that we have lost one of the best neurosurgeons and a visionary, affectionate human being who could do so much with his talent and compassion to reduce the sufferings of the world, was immense!

"Only 0.0012% of 36-year-olds get lung cancer. "

The dilemma???
He had to be the one!

5 starts!
Highly recommended!
Profile Image for Ali Goodwin.
172 reviews17.4k followers
November 28, 2022
Ahh SUCH A GOOD BOOK. I cried so hard at the end. This story is so heartbreaking yet took me on such a range of emotions from hope to appreciation to anger to sadness. I truly think everyone should read this book.
Profile Image for Jen CAN.
506 reviews1,489 followers
May 21, 2017
Unforgettable is what Verghese says in his foreword. I agree and am fighting for my own breath to write my thoughts about this stunning memoir that has left me gasping for air. The writing. The emotion. The beauty in the darkness of dying.
I mourn the death of this writer, a surgeon of great potential. A doctor of great compassion. But the message he has left us is quite eloquently simple: make life as meaningful as you can in the time you have. Be grateful.
The touching epilogue his wife Lucy wrote.
My tears runneth over. 5⭐️ - have upped this. This one will stay with me for a long while.
Profile Image for NickReads.
461 reviews1,194 followers
March 16, 2020
I can't express enough my admiration for this book, for Paul Kalanithi himself.

Thank you Paul, thank you for showing us what is life really about.

I hope you found the meaning of life and death, the one you searched endlessly.

Sir, you will be remembered.
Profile Image for Matthew Dinda.
72 reviews16 followers
March 15, 2017
I'm sorry Paul Kalanithi died. I'm sorry he had to struggle through something so horrible. I'm sorry that the world lost a clearly brilliant, passionate neurosurgeon. But just once, I'd like to read a cancer memoir from someone without privilege. Without education, without wealth, without the best treatment in the world at their fingertips. I want to hear of the person who is NOT going to leave a legacy behind, whose ego is not so ballooned that the foreword describes their mediocre prose as "spun gold." I have learned nothing, except that some people's stories get told, and many times those are not the stories I want to hear.
Profile Image for Always Pouting.
575 reviews760 followers
February 14, 2020
Paul Kalanithi is thirty six and so close to finishing his training as a neurosurgeon when he finds out he has stage IV lung cancer. As an undergraduate Kalanithi studied English literature and his love of reading and writing had been a constant through out his life. He had always felt that when he was older he would like to write and had decided to focus on neurosurgery for now, where he could make a bigger difference by saving people's lives. All his hopes and dreams for the future were suddenly unrealistic as an upper limit of a handful of years was put onto his life. Kalanithi pens this memoir, dealing with the struggles of facing death and having to go from being able to save others lives to now be the one staring down mortality.

The writing was excellent but reading this memoir was so depressing. Just the fact that someone so brilliant was going to die and not be able to keep contributing when they clearly had so much to offer. I was disappointed by where the book left off but then I read the afterword to find out that he had died before he could even finish the memoir which just made it twenty times worse. Death is inevitable but like Kalanithi acknowledges we don't really think about it as being imminent and so it's not the same as when you're terminal and trying to make peace with dying. I just found it so hard to read him struggling to make sense of how to best use the rest of his time especially since there was no way for him to know how limited it really was. Also the fact that he didn't get to see more of his daughter and watch her grow up. It was just depressing honestly, well written but I just felt sad and I don't know what else to say. It just feels unfair because I wish I was even a fraction as smart or eloquent but I'm not but I get to live and he doesnt.
Profile Image for Warda.
1,210 reviews19.7k followers
June 23, 2017
“Thank you for loving me.”

My heart is full! I was not expecting for this book to have the impact on me that it did. What a beautiful account of a man who truly lived his life to the fullest, despite dying quite young. He gave an incredible and resilient narrative on dealing and living with lung cancer and it unexpectedly shortening your life, but fighting through it despite all odds. Creating a new life, a new dream in that present moment and not letting the prospect of death stop you from living a life full of passion and hope. This is a story we can all learn from.

An all-time favourite.
Profile Image for Larry H.
2,514 reviews29.5k followers
September 17, 2016
Wow. I had to wait a little bit to pull myself together before writing a review of this exquisite book, even though I am tremendously late to the party on this one.

"...See what it is to still live, to profoundly influence the lives of others after you are gone, by your words. In a world of asynchronous communication, where we are so often buried in our screens, our gaze rooted to the rectangular objects buzzing in our hands, our attention consumed by ephemera, stop and experience this dialogue with my young departed colleague, now ageless and extant in memory. Listen to Paul."

Paul Kalanithi was, by all accounts, an excellent neurosurgeon, with the potential of being a true guiding force in medicine and science. He spent most of his early adult life seeking knowledge on multiple fronts, from literature and science to philosophy and ethics. When he finally decided to pursue a career in neurology, he wasn't just content to be a doctor—he wanted to understand and identify with his patients fully, to help them and their families adjust to whatever their new reality would be following a diagnosis, an accident, a surgery.

"I was pursuing medicine to bear witness to the twinned mysteries of death, its experiential and biological manifestations: at once deeply personal and utterly impersonal."

At the age of 36, Paul was diagnosed with Stage IV lung cancer. Suddenly his life has transformed him from doctor to patient, not an easy transition for anyone, especially someone as hands-on with patient care as Paul had been. While he and his internist wife Lucy are prepared for the worst, Paul's oncologist has hope, and doesn't allow him to wallow in his diagnosis. If he wants to stop being a neurologist, she tells him, it has to be because he doesn't want to continue or wants to pursue something else—his cancer won't stop him.

As he struggles with thoughts of his future, however long that might be, he ponders how to fill that time. Should he continue working in a field that has so richly given back to him, and given him the chance to touch so many lives? What gives a life value, and how can that value be measured? What obligations does he owe his family, his friends, his wife, his infant daughter?

"At those critical junctures, the question is not simply whether to live or die but what kind of life is worth living."

When Breath Becomes Air is an intellectual and deeply emotional memoir, written by a young man with so much promise, so much heart, so much empathy. It is both a reflection on coming face-to-face with one's own mortality and a commentary on the responsibility doctors have to help their patients and their families through that same reflection, whether it happens with some warning or suddenly. It is also a love story, of a man and his wife, a man and the child he will never truly know, and a man and his career.

You know from the very start of Abraham Verghese's introduction to the book that Paul lost his battle with cancer, yet the end of his life, and the epilogue written by Paul's wife still feel like sucker punches. You mourn a man you probably never knew, but you feel truly blessed he chose as one of his final acts to share his life, his death, and his thoughts with the world, because we are all better for them.

"'The thing about lung cancer is that it's not exotic,' Paul wrote in an email to his best friend, Robin. 'It's just tragic enough and just imaginable enough. [The reader] can get into these shoes, walk a bit and say, 'So that's what it looks like from here...sooner or later I'll be back here in my own shoes.' That's what I'm aiming for, I think. Not the sensationalism of dying, and not exhortations to gather rosebuds, but: Here's what lies up ahead on the road.' Of course, he did more than just describe the terrain. He traversed it bravely."

This is a beautiful book, truly a work of art that I won't soon forget. Easily one of the finest books I've read in some time. My thanks to the Kalanithi family, and Paul himself, for this opportunity to view such an exceptional man at such a critical juncture in his life.

See all of my reviews at http://itseithersadnessoreuphoria.blo....
Profile Image for Janet Gould.
2 reviews
April 13, 2016
I expect the author was actually a much nicer guy than he comes across as being in this book. However throughout the book he tells us again and again that he was the smartest kid in school, that he got into Stanford AND Yale and was the best med student and the best med students become surgeons and the best surgeons become neurosurgeons, so of course he became a neurosurgeon. And then... became the BEST neurosurgeon - chief resident at a top hospital. And wait there's more: he's also well- read and illustrates this by throwing in frequent quotes from literature.
It is unfortunate the author spent so much time cataloging his accomplishments when actually he had an interesting story: a young man thought he had most of his life ahead of him and was suddenly faced with a mortal illness. A more introspective story might have explored how this sudden reversal of fortune affected his inner life, relationships, and values. But this is not an introspective story and only touches on such things in a very superficial way.
Perhaps the most interesting question here arises from the backstory. Why does a young man when faced with a deadly disease remain narcissistically focussed on his own accomplishments? Is this the price to be paid for an upbringing that reminds us of the "the Namesake" and the "Tiger Mother?"
But none of these ideas are explored and unfortunately the book becomes a not very interesting story about a promising career cut short and a too-early death.
Profile Image for Linda.
1,291 reviews1,331 followers
March 9, 2016
"To begin with -- or, maybe, to end with --I got to know Paul only after his death. I came to know him most intimately when he'd ceased to be." (Abraham Verghese)

And we, for the most part, can actually say the same thing about Paul Kalanithi. We've come to know of him only after he had left this world of ours. Ironically, I write this on March 9th, the one-year anniversary of his passing.

Paul Kalanithi: son, husband, father, brilliant surgeon. He was a healer whose very existence gave hope to so many. How can this be? In my humble opinion, I believe that we are here on this earth for the appointed time of our being. We draw no more breath than what is pre-determined by a Higher Being....be it the last, raspy breaths of the elderly or the sole breath of a dying newborn. Paul was here for his personal alloted time.

This book is divided into two sections: before cancer diagnosis and after cancer diagnosis. Many have expressed a disconnect after having read this story. Many were looking for the gentle words of the dying in philosophical terms. The little nuggets were indeed there. But the perspective was all Paul's.

The beginning of the book was both clinical and procedural. That was Paul revealing his sense of "being"......what it took to become this focused man of medicine and of science. His steps were measured in the direction of his accomplishments and towards the light of a future that was never meant to be.

The second part of the book concentrated on the shifting of his identity from directing physician to the role of dependent patient. His profound knowledge of medicine served him in a limited capacity as he fought against the aggression of the disease. "But I'd had no idea how hard it would be, how much terrain I would have to explore, map, settle." Much like the rest of us in our stilted human experience.

The Epilogue is beautifully written by his wife, Lucy. She writes: "his transformation, from life to death, the ultimate transformation that awaits us all."

When Breath Becomes Air should not be taken as a maudlin reading, but one of hope and one of living a life well, no matter what the promise of longevity reveals.

Profile Image for Michelle.
147 reviews240 followers
October 13, 2019
“When Breath Becomes Air” is not only poignant, touching, and painful -- it is also full of love, insight, courage and humility. I’m thankful Paul Kalanithi found a way to share his love of writing and prodigious talents with the world, especially under such harrowing circumstances. The world is a richer place because of it… And at heart, this is a life-affirming book. It was for me, anyway.

Paul expresses, lived, and has shared how meaning can transform tragedy into a deep transcendence of being that shimmers. With meaning and eloquence, he was able to step outside of himself, trapped in his disease for sustained periods of time, and create the side of humanity we can't know. He does so with balance and personal reflection on the value of life and our relationships with others. His realization of patients as people, and about quality of life was profound to me. Though sad, the story never felt manipulative or self-pitying.

I couldn’t help but reflect on my life while I was reading this, and I think this is the book's greatest strength. From a distance, it might seem that Paul’s life would be hard to relate to -- Stanford, Yale, Christian dad, Hindu mom, neurosurgery etc.-- but his empathy and insight cut through all that and make him all the more human. This is a memoir that anyone "ceaselessly striving" to live with grace, dignity, and accountability will benefit from -- a testimony of the impact of such a life.

Paul’ s life-long love and study of literature is evident in the way he uses words to express his thoughts and concepts. His lyricism is in the choice of his words, making it for a very direct, honest, objective narration, yet deep and captivating. As I see his message: we will die, but we can live a meaningful life by giving ourselves to make an impact on others -- by trying to improve those around us by doing good deeds, and by art such as writing. In this way, we may live on, as Paul has managed through this sublime memoir. I found his wife's epilogue particularly touching in describing the last couple of weeks when he could write no more, and his monumental endeavor to write his story.

Thinking back as I write this review, I felt the loss of this man. Just like in my own life, there was an impact that required a little time before I could look back and see the gifts of wisdom shared from a unique human being:

“With what strife and pains we come into the world we know not, but ’tis commonly no easy matter to get out of it.”
Profile Image for Thomas.
1,521 reviews9,014 followers
January 7, 2022
I enjoyed this memoir and can see why so many people applauded it when it first came out. Paul Kalanithi’s writing is straightforward and evocative at the same time. For a man approaching his own death, he crafted this memoir in a way that doesn’t feel overly sentimental yet still captures the love he has for his profession, his family, and for literature and writing. I felt immersed in several parts of When Breath Becomes Air, ranging from Kalanithi’s journey to discovering neurosurgery as his true passion as well as the raw details he included both about his practice of neurosurgery and his own illness. I feel like contemporary society in the United States can be averse to openly naming, processing, and honoring death, so I appreciated this book for encouraging us to reflect on what actually matters in life beyond everyday stressors or more insignificant worries. When reading When Breath Becomes Air, I thought about my best friends and my own passion for healing work and art.

My main critique of this memoir is that at times it felt like Kalanithi was participating in glorifying or giving a pass to toxic work cultures within the field of medicine? For example, at one point he wrote about how he noticed some of his colleagues opting for careers in less stressful medical disciplines like dermatology or radiology. The tone he used in this section of the book felt a bit condescending – I think it’s totally fair for people to want a career where they can live healthy lives physically and mentally, spend time with their friends and families, devote time to hobbies, etc. At one point he wrote about how the difference between a job/career and a calling, and how because he perceived neurosurgery as his calling, he was willing to endure overwork even to the detriment of his health and the quality of his marriage. I felt turned off by this language because I feel like something should be able to be your calling *and* you should be able to live a healthy life outside of that calling too.

Overall, a quick and impactful read. While I respect that Kalanithi wrote what felt most authentic for him, I wish he had avoided glorifying overwork in medicine, especially given the worrying rates of mental health problems and deaths by suicide by doctors, including one of Kalanithi’s own former colleagues who he wrote about in this book.
Profile Image for Paul Bryant.
2,219 reviews9,926 followers
January 31, 2018
Paul Kalanithi tells us about a 62 year old man with a brain tumor.

We strolled into his room on morning rounds and the resident asked him “Mr Michaels, how are you feeling?”
“Four six one eight nineteen!” he replied, somewhat affably.
The tumor had interrupted his speech circuitry, so he could speak only in streams of numbers, but he still had prosody, he could still emote : smile, scowl, sigh. He recited another series of numbers, this time with urgency. There was something he wanted to tell us, but the digits could communicate nothing other than his fear and fury.
“Fourteen one two eight,” he pleaded with me, holding my hand. “Fourteen one two eight.”
“I’m sorry.”
“Fourteen one two eight,” he said mournfully, staring into my eyes.
And then I left to catch up with the team.

I have seen another example of this kind of language affliction myself. My own mother had vascular dementia and lost the power of language in her last three or four months. And yet she still conversed with us. So she would speak in streams of jumbled syllables which made no sense at all, but they would sound exactly like normal speech – some streams of gibberish sounded just like amusing anecdotes and questions would have a rising inflection – you could tell when she was recounting a wistful ancient memory. In fact you could tell all the emotions of what she was saying, you just couldn’t understand a single word, because she was no longer speaking in words. I think that in her own mind she was making perfect sense. Whether she could understand what we said to her is anyone’s guess.

Her final infirmity taught me a valuable lesson – not all dementia is cruel. Her version was quite kind. She seemed very contented. She never seemed to notice anything was amiss.

Quite the opposite happened to the author of this remarkable memoir. He was a neurosurgeon, he was in his late 30s, just about to be launched into the very peak of a glittering career. He knew exactly what he was looking at when he saw his own CT scans.

I was going through some books cluttering up my to-read shelf and I picked up this one today; I can’t even remember how it got there. From somebody else I think. Not really my kind of thing – a bit morbid, a bit melodramatic, a bit obvious – but once I started I was hooked all the way to the bitter end. He has a beautiful style.

I pulled away the fat until the fascia appeared and I could feel the tips of his vertebrae. I opened the fascia and smoothly dissected the muscle away, until only the wide, glistening vertebrae showed up through the wound, clean and bloodless.

There’s quite a lot of that. He is as unembarrassed about his own surgical skill as he is about his own cancer and its terrible progression. Some people, I guess, are just fantastic.

I agree with everybody else : 5 stars.
Profile Image for Kelsey (munnyreads).
77 reviews5,739 followers
August 1, 2021
I read this on my 3-hour plane ride today. The last paragraph and epilogue broke me. Ugly cried into the sleeve of my sweatshirt.
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