When Breath Becomes Air: The Last Days of a Young Doctor

Author Paul Kalanithi · Publisher Heuleum Publishing · Publication Date 2016-08-22 · ISBN 9788965961956

About the Book

If it were clear how many months or years I had left, the path forward would be clear. If it were three months, I'd spend it with my family. If it were a year, I'd write the book I'd always wanted to write. If it were ten years, I'd return to the hospital and treat patients.
My doctor simply said, "I can't tell you how much time you have left. You have to figure out what's most important to you." (from the text)

He realizes that if he doesn't know exactly when he will die, he has no choice but to keep living. He returns to the operating room, takes on an immense workload as a chief resident, and his wife, Lucy, becomes pregnant through in-vitro fertilization. However, with residency completion approaching, his cancer rapidly worsens, forcing him to give up his medical career, and he hovers near death beside his heavily pregnant wife. Ultimately, eight months after his daughter Cady was born, he refused life support and passed away peacefully in the arms of his loving family, with a clear mind. After Paul Kalanithi's death in March 2015, the epilogue of this book, which he painstakingly wrote but could not complete, was penned by his wife, Lucy.
This book became a sensation even before its manuscript was released. As soon as the publishing plan was revealed in New York in December 2014, contracts were secured within a day by Random House in the U.S., as well as publishers in Germany, Italy, and Brazil. Upon its original publication in January 2016, it immediately topped the bestseller lists of Amazon U.S. and The New York Times, maintaining the number one spot on The New York Times bestseller list for 12 consecutive weeks. Translation rights have been sold to 38 countries worldwide, and it became an instant bestseller upon publication in countries like the UK, Germany, Italy, and Canada.

A unique essay that combines experience and contemplation, emotion and intellect,
exploring the meaning of life across literature, philosophy, and medicine

Paul Kalanithi was captivated by literature in his adolescence. He was fascinated by the question of what makes life meaningful, and literature conveyed the meaning of life in the form of stories. He then discovered that the human mind is a function of the brain, leading him to major in English literature and biology at Stanford University. Exploring humans as both physiological and spiritual beings, he ultimately decided to become a doctor. It was "an opportunity to connect with suffering people and to continue contemplating what makes human life meaningful in the face of physical decline and death."
Paul Kalanithi chose his specialty with this sense of calling in mind. "Neurosurgery seemed to offer the most challenging and direct confrontation with meaning, identity, and death." The author's life, from choosing medicine based on humanistic insight to treating patients with fatal brain injuries and constantly wondering what he could do for them, raises the question in our society of what role medicine and science can play in human life, and what it means to be a good doctor.

A neurosurgeon works in the crucible of identity. Every brain surgery inevitably manipulates the brain, the essence of a human being, and when speaking with patients undergoing brain surgery, one inevitably confronts issues of identity. The point is not simply to live or die, but which is worth living. If you could not speak in exchange for a few more months of life, what choice would you make? What if you lost the use of your right hand trying to stop seizures? How much extreme pain would your child have to endure for you to say it would be better to die? (from the text)

And finally, at the age of thirty-six, the author is diagnosed with a terminal illness, finding himself in the same position as his patients. He despairs at the fact that he doesn't know when he will die, just as he didn't know before he got cancer, even after being diagnosed with stage 4 lung cancer. If he doesn't know when he will die, he has no choice but to keep living, intensely aware of death's much closer presence. He echoes Samuel Beckett's line: "I can't go on. I'll go on." Even if I am dying, I am still alive until I actually die. I decided to keep living instead of dying.
Even as his body crumbled towards death, there was a definite hope that his future wouldn't be stolen. Through the pain of cracked fingertips from chemotherapy, Paul Kalanithi laboriously typed a final letter to his daughter:

When the time comes for you to tell me how you lived, what you did, and what meaningful things you accomplished in the world, I hope you won't forget to mention that you filled your dying father's days with abundant joy. It was a joy I had never felt before in my life, and because of it, I am now content and can rest in peace, not wishing for anything more. In this moment, that truly means the world to me. (from the text)

Table of Contents

Prologue
Part 1_ I Started Out Very Healthy
Part 2_ Don't Stop Until Death Comes
Epilogue | Lucy Kalanithi
Foreword | Abraham Verghese
Acknowledgments
Translator's Afterword