When Breath Becomes Air- review of the memoir

Dr. Kalanithi faced his diagnosis with the same resolve, fortitude, and determination that served him well through medical school and a grueling neurosurgery residency. After his first round of treatment he was able to return to the operating room as a doctor, not a patient.

woman sitting in a cemetery


When Breath Becomes Air

by Paul Kalanithi, M.D.,

Dr. Paul Kalanithi was a 36-year-old resident physician who had, as he wrote, “reached the mountaintop” of anticipating a promising career as a neurosurgeon and neuroscientist. He had a loving wife, a supportive family and professors who respected his knowledge and skill. He seemed destined to be sought after, well paid, productive, successful, and  famous.

(note: a neurosurgeon treats  brain, spinal cord and nerve  diseases such as brain tumors that can be cured or improved with surgery,)

Unfortunately, “the culmination of decades of striving evaporated” when he was diagnosed with an aggressive form of lung cancer for which the prognosis was bleak, even with treatment. He was admitted to the very hospital where he trained as a neurosurgery resident, now  to learn what it is like to be a patient with a potentially terminal illness.

Dr. Kalanithi faced his diagnosis with the same resolve, fortitude, and determination that served him well through medical school and a grueling neurosurgery residency. After his first round of treatment he was able to return to the operating room as a doctor, not a patient.

Prior to entering medicine, Dr. Kalanithi had studied literature, earning degrees in English literature as well as human biology. He also completed a doctorate in history and philosophy of science and medicine at Cambridge.

Thus, when he realized he was facing his own death, he turned to his first love of writing to chronicle his experience and to explore “what makes human life meaningful?” And as he explored the meaning of what life is all about, he also explored the inevitability of death.

“I began to realize that coming in such close contact with my own mortality had changed both nothing and everything. Before my cancer was diagnosed, I knew that someday I would die, but I didn’t know when. After the diagnosis, I knew that someday I would die, but I didn’t know when.

But now I knew acutely. The problem wasn’t really a scientific one. The fact of death is unsettling. But there is no other way to live.”

Dr. Kalanithi passed away without completing his book, although his wife writes in the epilogue, “When Breath Becomes Air is complete, just as it is.” She and his parents kept their promise to have his book published after his death. She writes, “Paul was proud of this book, which was a culmination of his love for literature.”

Even before I finished reading this book, I felt as if I knew Paul and his wife Lucy. As someone who also enjoys writing, I can understand and appreciate his desire to preserve and share this experience.

This memoir is not so much a diary of what happened to Dr. Kalanithi as what happened within him as he confronted his own mortality and chose not to let it define the remainder of his life.

On the copyright page, “Death and Dying” is included in the list of categories for this book. However, you will not find “how to die” instructions here. Instead, you will learn how one man and his family chose to live despite knowing that he would  soon die.

His wife, Dr.Lucy Kalanithi, spoken publicly about her husband, his illness, his death, and the memories he left her and us through his book. Listen as she reflects on his legacy in this interview .

from the book

“In the end, it cannot be doubted that each of us can see only a part of the picture….Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete. And Truth comes somewhere above all of them, where, as at the end of that Sunday’s (scripture) reading,

“The sowers and reapers can rejoice together. For here the saying is verified that ‘One sows and another reaps.’ I sent you to reap what you have not worked for; others have done the work, and you are sharing the fruits of their work.”

(note: the referenced scripture is from the Bible, John chapter 4, verses 36-38, precise version unidentified)

When Breath Becomes Air  was published by Random House.

Other reviews of his life and writing

exploring the HEART of life and death

Author: Aletha Cress Oglesby, M.D.

As a family physician, I explore the HEART of HEALTH in my work, recreation, community, and through writing. My blog, Watercress Words, informs and inspires us to live in health. I believe we can turn our health challenges into healthy opportunities. When we do, we can share the HEART of health with our families, communities, and the world. Come explore and share with me.

4 thoughts on “When Breath Becomes Air- review of the memoir”

  1. Living with HD (Huntington’s Disease) is hard. I know I’m only 23 years old, but the majority of my life consists of a battle between depression, anxiety, and reality.

    I knew that I was going to test positive. In some ways it was a relief because I had an explanation for my bouts of insanity. In more ways, it was a nightmare. A nightmare that lived and breathed through me and my family.

    My mother is my life, and watching her turn into someone I don’t know causes me to have a mental breakdown at least once a day…on top of an overload of classes at a university that curses me with a financial responsibility I don’t know I will be able to carry through.

    It’s hard to get out of bed. The worst kind of sickness is a disease that consumes your mind. So you might have regular mental illnesses, and then you have mental illnesses caused by HD, and then you have to carry the burden of being a caretaker, finishing school, and becoming sick yourself. Not to mention the fear of never finding a husband who wants to deal with your degradation; and even if you were to find someone, you would have to carry the guilt of handing him the responsibility of taking care of you.

    And what about kids? I’ll be 24 in two weeks, and I was always sure that I’d be married with kids by now. But to ensure that they are healthy costs more money than the debt I’ve surrendered to in exchange for an education. I’m only growing older.

    Time is my greatest enemy. You can’t fight him. There is no winning. And the worst part is, people attempt to provide comfort in the phrase, “It’s all in your head.”
    I can’t imagine feeling worse. I can’t imagine being taken care of. I had a dream that I was in the later stages, and it was horrible. I couldn’t even tell my dad “I love you.” I couldn’t stop moving. There was no rest. And I am petrified.

    The only comfort I find is in my HD community. I find solace in reading other people’s stories and knowing that I’m not alone. I love all of you more than you can imagine because we are the same. We understand each other, and empathy is HD’s greatest reward. It has given me a family.

    So please, share your story. It will give strength and hope to others who are suffering…people like me. I urge you to let your voice be heard. I’m tired of being silent, and I know you are too. Speak for those who are too afraid. We are a family.


    1. Thank you for sharing your experience and insights about Huntington’s Disease. I appreciate you visiting this blog and adding to what Drs. Kalanithi teach us about living with life altering disease. I hope my readers will visit your blog to read more of what you have to say. My prayers to you in your quest for wholeness and healing.


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