Recommendations to read When Breath Becomes Air crossed my path a few times before I finally ordered it. Then I read it in two days. It was a beautiful glimpse into the life and mind of a brilliant neurosurgeon-neuroscientist, literary thinker and writer, and human experiencer.
The book is short and so sweet. It’s a breath of fresh air for the mind.
Paul Kalanithi tells the story of transitioning abruptly from doctor to patient to doctor to, finally, patient. It’s no secret that he dies in the end, and yet I eagerly anticipated each page.
“You take notes on a fun book?” my sister replied when I told her that I like to hold an actual book in my hands so that I can underline passages and write notes.
Of course I do.
Here are the passages I found most striking, in order of appearance. They are only a fraction of the beauty of Kalanithi’s prose.
The insights begin in the Foreward, which was written by Abraham Vergese, Kalanithi’s colleague. He writes about finding time to work when you are a neurosurgeon in contrast to when you are a writer:
“I wanted to tell him that a famous writer, commiserating about this eternal problem, once said to me, ‘If I were a neurosurgeon and I announced that I had to leave my guests to go in for an emergency craniotomy, no one would say a word. But if I said that I needed to leave the guests in the living room to go upstairs to write …’ I wondered if Paul would have found this funny. After all, he could actually say he was going to do a craniotomy! It was plausible! And then he could go write instead.”
Verghese summed up the book eloquently when he said, “In the silences between his words, listen to what you have to say back. Therein lies his message.” Isn’t’ that the goal of any writer?
On friendship, Kalanathi had this to say, “Senior year, my closest friend Leo, our salutatorian and the poorest kid I knew, was advised by the school guidance counselor, ‘You’re smart—you should join the army.”
He told me about it afterward. ‘Fuck that,’ he said. ‘If you’re going to Harvard, or Yale, or Stanford, then I am, too.’
I don’t know if I was happier when I got into Stanford or when Leo got into Yale.”
A literary major, he spent his life contemplating words. On language, he stated, “I had come to see language as an almost supernatural force, existing between people, ringing our brains, shielded in centimeter-thick skulls, into communion. A word meant something only between people.”
Then later, words were not enough. He needed to move beyond literature. “Words began to feel as weightless as the breath that carried them. Stepping back, I realized that I was merely confirming what I already knew: I wanted that direct experience.” He wanted to study medicine. “Moral speculation was puny compared to moral action.”
And yet, his words were like poetry. “The patient died, and Nuland was found by his supervisor covered in blood and failure.”
And insightful. “Diseases are molecules misbehaving.”
And don’t we wish all doctors were like him? “From that point on, I resolved to treat all my paperwork as patients, and not vice versa.”
And, “When there’s no place for the scalpel, words are the surgeon’s only tool.”
There were many references to breath along the way. This one, about the weight of death the doctors encountered: “Normally, you breathed it in, without noticing it. But some days, like a humid muggy day, it had a suffocating weight of its own.”
His life became a paradox, one after the other. “Was this a victory or a defeat?”
And “I had passed from the subject to the direct object of every sentence of my life.”
Despite his book, a masterpiece on the subject, “No system of thought can contain the fullness of human experience.”
And the stark reality, “Some days, I simply persist.”
love, JAMEY