When Breath Becomes Air by Paul Kalanithi

I bought this book shortly after it was published and must confess that it has taken me almost a year to have the courage to actually read it.  It is the first-person memoir of a brilliant young neurosurgeon who, shortly before completing his residency at the age of 36, was diagnosed with stage IV lung cancer.

The book terrified me because my sister had been a brilliant oncologist who, at the height of her professional accomplishments, died of cancer less than a week after her 51^st birthday.  Although I was with her throughout her journey, it has still remained a puzzle to me how a physician—someone who has spent her career either curing cancer or easing the suffering of those who would not survive—could face her own terminal diagnosis.  My sister and I didn’t talk much about her mental or spiritual state, but she would answer any medical questions with a clinical precision that eventually left me unwilling to ask too much. I have always felt that maybe I failed her.  How could I comfort and care for her if I never dared probe the fears and doubts she left unspoken under her mask of professional detachment?

So I hoped this book would provide me with an opportunity to peak behind that mask. It did not.  Dr. Kalanithi’s experience was very different than my sister’s.  He was diagnosed with stage IV cancer  so knew that it was probably terminal from the beginning.  My sister’s cancer crept up on her, proving to be resistant to surgery and chemo before it became apparent that it would be terminal.

That being said this is an enormously powerful memoir. Part one of the book describes his early life, the influences that led him to a career in medicine and his training.  Much of this section talks about his interest in mind, neuroscience and identity, and how he learned to manage the enormous responsibility of making life and death decisions as well as his strategies for coping when nothing could save his patients. Part two describes his life and actions after his diagnosis. 

Throughout he addresses issues of mortality not just from the perspective of a physician, but also from that of a philosopher and a student of literature who had spend much of his far too brief life struggling to understand the meaning of individual existence.

Three and a half smileys out of five. 😀😀😀😶