Other Books

When Breath Becomes Air

Kalanithi, Paul - Finished Feb 15, 2017

Run-on Sentence Summary

A successful neurosurgeon’s short memoir exploring what gives life meaning, written desperately in his final years after being diagnosed with terminal lung cancer at age 40.


As you’d imagine with such a topic, this memoir is a punch in the gut. What gives life meaning in the face of death? Paul Kalanithi doesn’t seem to have any more answers than the rest of us.

On paper, he was incredibly successful in life. He received a ridiculous amount of education, including 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. On top of it all he went on to become a neurosurgeon.

Tragically, just when he was about to finish his residency and actualize his meteoric career, he is diagnosed and realizes that all the things he thinks he will one day achieve have gone out the window. With an unknown amount of time left, he has to grapple with exactly what he wants to do.

One of the central themes of the book is the dichotomy between learning and living:

"If the unexamined life was not worth living, was the unlived life worth examining?”

In his younger years, he pursued literature to try to find a philosophical answer for his ethical dilemmas surrounding death, and ultimately turned to medicine so that he confront death head on. As a doctor, death was everywhere, and it was his job to provide philosophical guidance to terminal patients who needed answers as much as he did.

Ironically, after his diagnosis he must turn away from medicine, and returns to literature to write this book in his last days. You can feel his desperation drip off the page as he races to complete his memoir. In the end it is left unfinished- He died in 2015.

Given all of this, it seems that I’ve found a book that is uniquely hard to criticize, but here I go anyway. The writing is poetic and beautiful at times, but also often feels overwrought and scholarly. I couldn’t help but feel that lines such as “Years ago, it had occurred to me that Darwin and Nietzsche agreed on one thing: the defining characteristic of the organism is striving”, while insightful, detracted from what could be achieved more powerfully with a more plainspoken and direct tone. Same goes for the quote below.

As with some other books, I found myself mistrusting my own judgment: did I only dislike this book because of the uncomfortable reality it was confronting me with? Its hard to pin down. Still, the book was powerful and poignant as you would expect, and I’m glad I read it.

Final Thoughts

I’m left with more questions than answers.

Favorite Quote

To his daughter:

“That message is simple: When you come to one of the many moments in life when 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.”