Book Review - When Breath Becomes Air - Paul Kalanithi

Warning - Spoilers abound

If you know nothing about the book, stop reading this review now and go read the book instead.

Paul Kalanithi’s poignant memoir has been on my reading list ever since I read a review of the book on NYTimes, then followed that to an article by him. For a day or two, I went down a rabbithole about his life and around his work and his family in that funny way that the internet does to you where one minute of idle research stretches into two hours of obsession. Unfortunately, like most non-fiction on my reading list, it got pushed back to be replaced by whatever disposable mind candy I could pick up (usually Urban Fantasy). With a nasty throat infection striking the whole lot of us, we had a forced family vacation this week, and I used the time to work through my reading list again, disposing of some, bumping others up and so on and I remembered well enough to bump this book to the top.

This book isn’t easy reading, given its subject matter. It is however, far easier than it should be, and that is down to the skill of the author. But I’m getting ahead of myself here.

Paul Kalanithi is a second generation Indian-American neurosurgeon. He is at the top of his profession, getting finished with the grind of residency and the start of a better paced, more remunerative career when he learns he has cancer. In a moment, everything changes for him and his family, and he channels his feelings, thoughts, frustrations and journey into this beautifully written memoir.

This memoir takes us through three phases of his life -  the first covering his formative years, leading up to his decision to take medicine over while chronicling his love for reading and writing and the deeply moral view he takes of his profession and his role. He quotes from writing as diverse as old masters and medical pioneers, from poets and from journalers when he makes a point, and this section, though condensed, offers a good view into his multi-faceted personality as well as his questioning self.

The second phase covers his residency, his life with his wife Lucy, and his growth and maturity as a surgeon. It covers his ambitions to do more - as a neuroscientist and as a writer, and takes us through the bathos and pathos of his job. As a layman, I get a lot of it, both the difficulty as well as the unrelenting grind, but I found myself wishing in parts that I got it as vividly as I did the other parts of this book.

The final part though, is what really makes this book what it is. I cannot put myself in his place with any degree of solidity, but when I try, I know I could never do it with the degree of calm, of focus and pure goodness he does. The frustration and pain does creep in, but he doesn’t sink into it or wallow in it, instead he chooses to focus his life, whatever remains of it into the best options he sees for himself. At every point, he lives his process-  a Plan A, a Plan B, a Plan C for every situation even when life continuously throws him curveballs.

There is an epilogue written by his wife Lucy that deserves as much attention as the book itself. It is starkly honest and well written, and it completes the book.

Paul’s writing is fluid and lyrical. He has a way of drawing you into the story, into every scene and making you live every bit of it. When he travels down a path unfamiliar to you, as with the sections on surgery, he finds a way of making it approachable and identifiable. This is as much a testament to the clarity of his writing as it is to the way he thinks, wrapping a situation into a multitude of perspectives. At the end of it, I wish, selfishly, that he could lived to his eighties; with his skills, I can only imagine how much he could have achieved in a full span of years.

I would strongly recommend this book for everyone. It is both a celebration of Paul’s life and a dirge for his passing. It is the sort of book that can be read in a sitting, and when completed, deserves re-visiting every year.