When Breath Becomes Air

by Paul Kalanithi, Abraham Verghese (Foreword by)

Overview

Notes From Your Bookseller

More about living than dying, this compelling and profound memoir chronicles a doctors struggle against the ravages of disease and the peace that follows acceptance.

#1 NEW YORK TIMES BESTSELLER • PULITZER PRIZE FINALIST • This inspiring, exquisitely observed memoir finds hope and beauty in the face of insurmountable odds as an idealistic young neurosurgeon attempts to answer the question What makes a life worth living?

NAMED ONE OF PASTE’S BEST MEMOIRS OF THE DECADE • NAMED ONE OF THE BEST BOOKS OF THE YEAR BY The New York Times Book Review • People • NPR • The Washington Post • Slate • Harper’s Bazaar • Time Out New York • Publishers Weekly • BookPage

Finalist for the PEN Center USA Literary Award in Creative Nonfiction and the Books for a Better Life Award in Inspirational Memoir

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.

Product Details

ISBN-13:	9780812988406
Publisher:	Random House Publishing Group
Publication date:	01/12/2016
Pages:	256
Sales rank:	4,475
Product dimensions:	5.30(w) x 8.20(h) x 1.00(d)

About the Author

Paul Kalanithi was a neurosurgeon and writer. He grew up in Kingman, Arizona, and graduated from Stanford University with a BA and MA in English literature and a BA in human biology. He earned an MPhil in history and philosophy of science and medicine from the University of Cambridge and graduated cum laude from the Yale School of Medicine, where he was inducted into the Alpha Omega Alpha national medical honor society. He returned to Stanford to complete his residency training in neurological surgery and a postdoctoral fellowship in neuroscience, during which he received the American Academy of Neurological Surgery’s highest award for research. He died in March 2015. He is survived by his large, loving family, including his wife, Lucy, and their daughter, Elizabeth Acadia.

Read an Excerpt

Part I
(Continues…)

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Excerpted from "When Breath Becomes Air"
by .
Copyright © 2016 Paul Kalanithi.
Excerpted by permission of Random House Publishing Group.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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Table of Contents

Foreword Abraham Ferghese xi

Prologue 3

Part I In Perfect Health I Begin 17

Part II Cease Not till Death 117

Epilogue Lucy Kalanithi 201

Acknowledgments 227

Reading Group Guide

1. How did you come away feeling, after reading this book? Upset? Inspired? Anxious? Less afraid?

2. What did you think of Paul’s exploration of the relationship between science and faith? As Paul wrote, “Science may provide the most useful way to organize empirical, reproducible 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. Between these core passions and scientific theory, there will always be a gap. No system of thought can contain the fullness of human experience.” Do you agree?

3. How do you think the years Paul spent, tending to patients and training to be a neurosurgeon, affected the outlook he had on his own illness? When Paul wrote that the question he asked himself was not “why me,” but “why not me,” how did that strike you? Could you relate to it?

4. Paul had a strong background in the humanities, and read widely throughout his life. Only after getting a Master’s in English Literature did he decide that medicine was the right path for him. Do you think this made him a better doctor? A different kind of doctor? If so, how? How has reading influenced your life?

5. What did you think of Paul and Lucy’s decision to have a child, in the face of his illness? When Lucy asked him if he worried that having a child would make his death more painful, and Paul responded, “Wouldn’t it be great if it did,” how did that strike you? Do you agree that life should not be about avoiding suffering, but about creating meaning?

6. Were there passages or sentences that struck you as particularly profound or moving?

7. Given that Paul died before the book was finished, what are some of the questions you would have wanted to ask him if he were still here today?

8. Paul was determined to face death with integrity, and through his book, demystify it for people. Do you think he succeeded?

9. In Lucy’s epilogue, she writes that “what happened to Paul was tragic, but he was not a tragedy.” Did you come away feeling the same way?

10.
How did this book impact your thoughts about medical care? The patient-physician relationship? End of life care?

11. Is this a book you will continue thinking about, now that you are done? Do you find it having an impact on the way you go about your days?

12. Lucy also writes that, in some ways, Paul’s illness brought them closer – that she FELL feel even more deeply in love with the “beautiful , focused man” he became in the last year of his life. Did you find yourself seeing how that could happen?

Editorial Reviews

When Breath Becomes Air…has an aura of the best kind of earnest conversation that kept you up all night in your early adulthood—but it transcends that potential callowness with its Keatsian sense of impending mortality. Kalanithi died too soon to recant the insights that come with the gradual discovery of one's own consciousness, and his book is suffused with a proleptic nostalgia for a youth still in its efflorescence. That truncated youth is touched with youth's particular wisdom…[Kalanithi] is a literate, first-rate reporter in the vanguard of a modern battle, and he writes with the urgency of his looming incorporeity.

The New York Times Book Review - Andrew Solomon

…a great, indelible book…that is as intimate and illuminating as Atul Gawande's Being Mortal, to cite only one recent example of a doctor's book that has had exceptionally wide appeal…I guarantee that finishing this book and then forgetting about it is simply not an option. There is so much here that lingers, and not just about matters of life and death…Part of this book's tremendous impact comes from the obvious fact that its author was such a brilliant polymath. And part comes from the way he conveys what happened to him—passionately working and striving, deferring gratification, waiting to live, learning to die—so well. None of it is maudlin. Nothing is exaggerated. As he wrote to a friend: "It's just tragic enough and just imaginable enough." And just important enough to be unmissable.

The New York Times - Janet Maslin

11/02/2015
Author and physician Kalanithi had nearly completed his residency in neurosurgery at Stanford when he was diagnosed with Stage lV lung cancer at the age of 36. Despite the stubborn progression of his disease, Kalanithi was able to write, work, and delve into a number of profound issues before the end of his life, documented here (his wife provides the epilogue). As a youth in Arizona, Kalanithi was unsure whether he wanted to pursue medicine, as his father did, or if literature and writing were his calling. This inspiring memoir makes it clear that he excelled at both. Kalanithi shares his career struggles, bringing readers into his studies at Yale (including cadaver dissection), the relentless demands of neurosurgery, and the life-and-death decisions and medical puzzles that must be solved. After he begins cancer treatment, Kalanithi strives to define his dual role as physician and patient, and he weighs in on such topics as what makes life meaningful and how one determines what is most important when little time is left. He also shares the challenges of colleagues: an oncologist who walks a tightrope between hope and honest reality; a fellow doctor who commits suicide after losing a patient; Kalanithi’s wife, also a doctor, bearing witness to her husband’s decline even as she gives birth to their child. This deeply moving memoir reveals how much can be achieved through service and gratitude when a life is courageously and resiliently lived. (Jan.)

Publishers Weekly

I guarantee that finishing this book and then forgetting about it is simply not an option. . . . Part of this book’s tremendous impact comes from the obvious fact that its author was such a brilliant polymath. And part comes from the way he conveys what happened to him—passionately working and striving, deferring gratification, waiting to live, learning to die—so well. None of it is maudlin. Nothing is exaggerated. As he wrote to a friend: ‘It’s just tragic enough and just imaginable enough.’ And just important enough to be unmissable.”—Janet Maslin, The New York Times

“Paul Kalanithi’s memoir, When Breath Becomes Air, written as he faced a terminal cancer diagnosis, is inherently sad. But it’s an emotional investment well worth making: a moving and thoughtful memoir of family, medicine and literature. It is, despite its grim undertone, accidentally inspiring.”—The Washington Post

“Paul Kalanithi’s posthumous memoir, When Breath Becomes Air, possesses the gravity and wisdom of an ancient Greek tragedy. . . . [Kalanithi] delivers his chronicle in austere, beautiful prose. The book brims with insightful reflections on mortality that are especially poignant coming from a trained physician familiar with what lies ahead. . . . The narrative voice is so assured and powerful that you almost expect him to survive his own death and carry on describing what happened to his friends and family after he is gone.”—The Boston Globe

“Devastating and spectacular . . . [Kalanithi] is so likeable, so relatable, and so humble, that you become immersed in his world and forget where it’s all heading.”—USA Today

“It’s [Kalanithi’s] unsentimental approach that makes When Breath Becomes Air so original—and so devastating. . . . Its only fault is that the book, like his life, ends much too early.”—Entertainment Weekly

“[When Breath Becomes Air] split my head open with its beauty.”—Cheryl Strayed

“Rattling, heartbreaking, and ultimately beautiful, the too-young Dr. Kalanithi’s memoir is proof that the dying are the ones who have the most to teach us about life.”—Atul Gawande

“Thanks to When Breath Becomes Air, those of us who never met Paul Kalanithi will both mourn his death and benefit from his life. This is one of a handful of books I consider to be a universal donor—I would recommend it to anyone, everyone.”—Ann Patchett

“Dr. Kalanithi describes, clearly and simply, and entirely without self-pity, his journey from innocent medical student to professionally detached and all-powerful neurosurgeon to helpless patient, dying from cancer. Every doctor should read this book—written by a member of our own tribe, it helps us understand and overcome the barriers we all erect between ourselves and our patients as soon as we are out of medical school.”—Henry Marsh, author of Do No Harm: Stories of Life, Death, and Brain Surgery

From the Publisher

★ 2015-09-30
A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer. Writing isn't brain surgery, but it's rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn't enter the field of medicine, in which his father and other members of his family excelled. "But I couldn't let go of the question," he writes, after realizing that his goals "didn't quite fit in an English department." "Where did biology, morality, literature and philosophy intersect?" So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which "would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay." The author's empathy undoubtedly made him an exceptional doctor, and the precision of his prose—as well as the moral purpose underscoring it—suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. "The fact of death is unsettling," he understates. "Yet there is no other way to live." A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.

Kirkus Reviews

Narrator Sunil Malhotra is faithful to the straightforward tone of Paul Kalanithi’s memoir about facing Stage IV lung cancer at age 36, just as he is finishing his training in neurosurgery. Kalanithi confronts his situation with an unflinching but literary curiosity. Malhotra adeptly delivers the author’s confusion over finding himself a confident doctor but a meek patient. He also shares Kalanithi’s youthful resistance to becoming a doctor and his contemplations about the meaning of time. What does living one day at a time mean when you don’t know how long you have? Kalanithi struggles to find an immediate way forward—should he continue to do surgery, write a book, have a baby? Cassandra Campbell narrates the epilogue by Kalanithi’s wife, recounting his final moments in a smooth, empathetic voice that is certain to bring tears. WHEN BREATH BECOMES AIR may be unsentimental, but it is profoundly affecting. A.B. © AudioFile 2016, Portland, Maine

MARCH 2016 - AudioFile