When Breath Becomes Air

by Paul Kalanithi

it was a love and empathy for those who suffered, for what they endured and what he might bring to bear.

See what courage sounds like.

After I was caught returning at dawn from one such late-night escapade, my worried mother thoroughly interrogated me regarding every drug teenagers take, never suspecting that the most intoxicating thing I’d experienced, by far, was the volume of romantic poetry she’d handed me the previous week. Books became my closest confidants, finely ground lenses providing new views of the world.

Literature provided a rich account of human meaning; the brain, then, was the machinery that somehow enabled it. It seemed like magic.

Literature not only illuminated another’s experience, it provided, I believed, the richest material for moral reflection.

In other words, I could either study meaning or I could experience it.

I had come to see language as an almost supernatural force, existing between people, bringing our brains, shielded in centimeter-thick skulls, into communion.

Everything teeters between pathos and bathos: here you are, violating society’s most fundamental taboos, and yet formaldehyde is a powerful appetite stimulant, so you also crave a burrito.

Her capacity to love was barely finite, and a lesson to me.

Like a premature lung, I felt unready for the responsibility of sustaining life.

I had met her in a space where she was a person, instead of a problem to be solved. She chose surgery. The operation went smoothly. She went home two days later, and never seized again.

Those burdens are what make medicine holy and wholly impossible: in taking up another’s cross, one must sometimes get crushed by the weight.

We would carry on living, instead of dying.

The truth that you live one day at a time didn’t help: What was I supposed to do with that day?

a transformation that carried the force of religious conversion.

You have to figure out what’s most important to you.

Yet their uncertainties and morbidities, whether emotional or physical, remain to be grappled with.

Emma hadn’t given me back my old identity. She’d protected my ability to forge a new one.

to make science the arbiter of metaphysics is to banish not only God from the world but also love, hate, meaning—to consider a world that is self-evidently not

the world we live in. That’s not to say that if you believe in meaning, you must also believe in God. It is to say, though, that if you believe that science provides no basis for God, then you are almost obligated to conclude that science provides no basis for meaning and, therefore, life itself doesn’t have any. In other words, existential claims have no weight; all knowledge is scientific knowledge.

No system of thought can contain the fullness of human experience.

The only real atheism must be grounded in a world-making vision. The favorite quote of many an atheist, from the Nobel Prize–winning French biologist Jacques Monod, belies this revelatory aspect: “The ancient covenant is in pieces; man at last knows that he is alone in the unfeeling immensity of the universe, out of which he emerged only by chance.”

The main message of Jesus, I believed, is that mercy trumps justice every time.

I hadn’t ever considered that I could release myself from the responsibility of my own medical care. I’d just assumed all patients became experts at their own diseases.

When you come to one of the many moments in life where you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man’s

days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more but rests, satisfied. In this time, right now, that is an enormous thing.

When Breath Becomes Air is, in a sense, unfinished, derailed by Paul’s rapid decline, but that is an essential component of its truth, of the reality Paul faced.

Even while terminally ill, Paul was fully alive; despite physical collapse, he remained vigorous, open, full of hope not for an unlikely cure but for days that were full of purpose and meaning.

he once said that he found poetry more comforting than Scripture—and