When Breath Becomes Air is the story of Paul Kalanithi, a neurosurgeon going from doctor to patient as he finds out about his incurable cancer.
Paul Kalanithi grew up with the passion for literature. He was particularly motivated by the search for meaning. The meaning of life.
He had decided to study literature in college, but eventually shifted to medicine. Literature was not enough by itself to answer the big question of the meaning of life.
What’s a Life Worth Living?
Kalanithi often reflects about when it makes sense to save lives and when it doesn’t.
He talks for example about saving a patient who lost the ability to speak and eat by himself. And whom would be forced to spend the rest of his life institutionalized.
And he wonders whether saving his life was the right thing to do.
Another major theme across When Breath Becomes Air is that of the human connection that the health industry should be based upon -but that it’s probably lacking-.
Kalanithi says that working one hundred hours a week and under the pressure to excel made him tired and under constant time pressure.
He recalls of rushing through an interaction with a patient who had just found out she had brain cancer. He would later feel guilty about it. After all, he went into medicine with the belief that the connection among people is an important part of the meaning of life.
Skills Are a Moral Obligation
Kalanithi had removed a brain tumor from a young patient. It was a very, very difficult procedure but the surgery seemed a success.
Years later though he found out that the boy was worsening, becoming violent and uncontrollable. Eventually he had to be institutionalized.
That was the moment when it was ever more clear to him: good intentions are not enough. Skills are critical. And being the most skilled surgeon he could be was a moral obligation.
How to Live When You Got Little to Live?
How would you spend the rest of your days if you knew your days on this world were dramatically cut short?
That’s the question Kalanithi had to grapple with when he found out about his terminal illness.
Kalanithi decided to focus on the accomplishment that was most significant for him: literature and writing.
My Note: I find the question of “how would you live if your days were dramatically cut short” a bit misleading.
We all live dramatically short lives anyway. We should all be asking ourselves this question.
Having a Kid or Not?
Kalanithi was also discussing another major issue with his wife Lucy: should they have a child?
Lucy asked him if having to say farewell to a child wasn’t going to make it even harder for him. But that was no reason for Kalanithi to say no.
He says life is not about avoiding suffering.
In the end, they decided for life. They froze his sperm at a sperm bank before he began treatment and Lucy would later be inseminated.
The Last Hours
Eight months after the birth of his daughter, Cady, Kalanithi faced another difficult choice.
With a worsening condition, he had to decide whether to stay on life support. Aware that he might not make it without it, he decided to go off life support.
There was no point in surviving with just a heart beat.
Life without conscience, he thought, would lose its meaning.
With his family by his side and morphine to alleviate the pain, Kalanithi’s breath became air.
Make The Most Of Your Time
Deepen your human connections and don’t wait for anything to do what you really love. When Breath Becomes Air is not about a terminal patient.
It’s about all of us. We’re all terminal patients.
Connect With People
If you’re a surgeon, I hope you can carry the spirit of human connection in the profession a bit more. As a matter of fact, whichever profession we’re in, isn’t it our duty to treat people with empathy and respect? I think it is..
When Breath Becomes Air is a reflection on life and death, the meaning of life, the difficult choices we face.
It reminded me a bit of Man’s Search for Meaning.