When Breath Becomes Air

When Breath Becomes Air helps you see what’s really important by diving into Paul Kalanithi’s life of loving neuroscience, literature, meaning, and his family that ended from cancer in his mid-thirties.

Growing up, Paul Kalanithi fell in love with literature. He decided he would study literature, but in the summer before college, he found something else captivated him: human biology. On his way to Stanford, he got a book that explored the idea that the brain is a machine that allows the human mind to exist. His fascination led to him taking neuroscience courses.

Kalanithi liked to ponder big questions like what life’s meaning was, and looked to both neuroscience and literature to find answers. He felt literature, and particularly fiction was a manifestation of the mind’s life. He drew from works that connected meaninglessness and isolation, concluding that true meaning comes from human relationships.

But he understood that literature wouldn’t give him the whole answer. He needed to keep studying neuroscience to understand human meaning. Kalanithi believed that because the brain allows our mind to exist, the ability we have to build relationships comes directly from the brain. He also knew if he wanted to understand life, he needed to understand the most unavoidable part of it all: death. What better way to do this than practice medicine?

During his time in medical school, Kalanithi spent a lot of time with cadavers. Most students covered the faces of the cadavers and didn’t learn their names, but he was moved by their humanity.

His first experience with a birth was also about death. A woman went into premature labor and lost both of her twins. Because of this experience, Kalanithi was left with the image of life one day, death the next.

When he specialized in neurosurgery, he realized how much responsibility he would have in life or death decisions. He struggled with the expectation to be able to judge who could be saved, who couldn’t, and who shouldn’t be saved. If he rushed a patient to the OR to save their life but they were left to live unable to speak and eat, was this really the life they wanted?

He witnessed many deaths, both from patients and even people who worked at the hospital. When he got deeper into his practice, he tells of his regrets that his exhaustion and stress from his responsibility sometimes made him neglect his patients’ humanity.

By the time his residency was ending, he had earned awards and the respect of senior doctors. He even had a great job lined up. But after months of back pain, he found out that he had malignant lung cancer that was spreading across his body. Following…