When Breath Becomes Air
Paul Kalanithi’s When Breath Becomes Air (2016) is a beautiful, and at times heartbreaking, ode to the meaning of life. At the age of 36 and as the final year of his neurosurgical residency began, Kalanithi faced a terminal cancer diagnosis. His response, as embodied by this book, is both brave and thoughtful. In today’s world, death is something that we, the privileged ones with access to modern medical care, don’t tend to face as young and middle-aged folks, certainly not for ourselves. Kalanithi’s book reminds us that death comes for us all, and we never know when it will come.
In recalling his college-days wish to study that which got at human meaning (he studied literature), Kalanithi explores that desire to pinpoint human meaning. Like others (myself included), he tended to find the most apt descriptions in the works of writers like T.S. Eliot, Nabokov, Conrad, and Joyce. Yet, with time he came to appreciate not only human literature, but also human physiology. In particular, neuroscience fascinated Kalanithi: “Literature provided a rich account of human meaning; the brain, then, was the machinery that somehow enabled it” (30). When Breath Becomes Air offers Kalanithi’s account of how one can get at the meaning of life through study, family and contemplation.
This is a book that has haunted me since I read it a few months ago (in November). It has taken me some time to grapple with its subject, and attempt to articulate what it is that I find so moving about its prose. Kalanithi ruminates on life as a thinker and a surgeon, a son, a husband and ultimately a father, but beyond all else he is mortal and must face the limitations of his personal biology. He does so bravely and eloquently, and I think we all have something to learn from his end-of-life journey as documented in this book. Abraham Verghese (author of Cutting for Stone) writes a moving foreword, and Paul’s widow, Lucy writes a tear-jerking, life-affirming epilogue, making When Breath Becomes Air all the more meaningful.
This is not a long book; in fact, some people read it in one sitting. I, however, found that I needed to set it down, walk away and allow myself the time to consider his words and experiences. Whether you choose to read the book in a day or a month or a year, I encourage you to find your way to its pages and sit with the mortality common to us all.
A Few Great Passages:
“Though we had free will, we were also biological organisms—the brain was an organ, subject to all the laws of physics too! Literature provided a rich account of human meaning; the brain, then, was the machinery that somehow enabled it. It seemed like magic” (30).
“I still felt literature provided the best account of the life of the mind, while neuroscience laid down the most elegant rules of the brain. Meaning, while a slippery concept, seemed inextricable from human relationships and moral values” (31).
“I studied literature and philosophy to understand what makes life meaningful, studied neuroscience and worked in an fMRI lab to understand how the brain could give rise to an organism capable of finding meaning in the world, and enriched my relationships with a circle of dear friends through various escapades” (35).
“Patients, when hearing the [bad] news, mostly remain mute. (One of the early meanings of patient, after all, is ‘one who endures hardship without complaint.’) Whether out of dignity or shock, silence usually reigns, and so holding a patient’s hand becomes the mode of communication” (96).
“Yet the paradox is that scientific methodology is the product of human hands and thus cannot reach some permanent truth. We build scientific theories to organize and manipulate the world, to reduce phenomena into manageable units. Science is based on reproducibility and manufactured objectivity. As strong as that makes its ability to generate claims about matter and energy, it also makes scientific knowledge inapplicable to the existential, visceral nature of human life, which is unique and subjective and unpredictable. 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” (169-170).
“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 reading, ‘the sower and reaper can rejoice together’” (172-173).
Bibliography:
Kalanithi, Paul. When Breath Becomes Air. Random House: New York, 2016.
