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When Breath Becomes Air

 

By: Paul Kalanithi

ISBN: 9780812988406

Publisher: Random House

Format:  Hardcover 

Publication Date: 1/12/2016

My Rating: 5 Stars ++

Top Books of 2016

Format: Audio

Foreward: Abraham Verghese 

Narrators: Sunil Malhotra, Cassandra Campbell

ASIN: B0191YTT70

Publisher: Random House Audio

For readers of Atul Gawande, Andrew Solomon, and Anne Lamott, a profoundly moving, exquisitely observed memoir by a young neurosurgeon faced with a terminal cancer diagnosis who attempts to answer the question What makes a life worth living?

At the age of thirty-six, on the verge of completing a decade's worth of training as a neurosurgeon, Paul Kalanithi was diagnosed with stage IV lung cancer. One day he was a doctor making a living treating the dying, and the next he was a patient struggling to live. Just like that, the future he and his wife had imagined evaporated. When Breath Becomes Air, which features a Foreword by Dr. Abraham Verghese and an Epilogue by Kalanithi's wife, Lucy, chronicles Kalanithi's transformation from a naïve medical student “possessed,” as he wrote, “by the question of what, given that all organisms die, makes a virtuous and meaningful life” into a young neurosurgeon at Stanford, guiding patients toward a deeper understanding of death and illness, and finally into a patient and a new father to a baby girl, confronting his own mortality.

What makes life worth living in the face of death? What do you do when the future, no longer a ladder toward your goals in life, flattens out into a perpetual present? What does it mean to have a child, to nurture a new life as another fades away? These are some of the questions Kalanithi wrestles with in this profoundly moving, exquisitely observed memoir.

Paul Kalanithi died in March 2015, while working on this book, yet his words live on as a guide and a gift to us all. “I began to realize that coming face to face with my own mortality, in a sense, had changed nothing and everything,” he wrote. “Seven words from Samuel Beckett began to repeat in my head: ‘I can't go on. I'll go on.'” When Breath Becomes Air is an unforgettable, life-affirming reflection on the challenge of facing mortality and on the relationship between doctor and patient, from a gifted writer who became both.

 

 

For readers of Atul Gawande, Andrew Solomon, and Anne Lamott, a profoundly moving, exquisitely observed memoir by a young neurosurgeon faced with a terminal cancer diagnosis who attempts to answer the question What makes a life worth living?

 

 

My Review

 

A special thank you to Random House and NetGalley for granting my wish--an ARC of a remarkable gift in exchange for an honest review. 

WHEN BREATH BECOMES AIR one of the most beautiful, extraordinary and poignant of memoirs -foreward Abraham Verghese. Paul Kalanithi, a wise and gifted storyteller; a remarkable man, physician, surgeon, husband, son, and father. His childhood, desires, loves, hopes, ambitions, career, adulthood, marriage, and lastly- his ultimate joy and short-lived status, of fatherhood. He writes from his heart---from a physician's viewpoint, as well as a patient. 

Awe-in·spir·ing! 

Living, death, fears, mortality, and grief. How will you embrace the end? Will you leave a legacy behind, or influence the lives of others after you are gone? Paul does so. He writes about time, what it means to him, in the context of his illness. A powerful message. An insightful gift-- he has given unselfishly to others. 

Paul’s desire was to write this book. He had a lifelong love of writing and reading. He became a physician instead; yet, always dreamed of coming back to literature, in some form. When he realized this, unfortunately, he had so little time. His end desire was to see the book published. 

Indeed, this work-of-art, reflects his passion, through each and every word, from beginning to end. Breathtaking. There was medical school and neurosurgery. Paul spent time studying literature at Stanford and the history of medicine at Cambridge, in an attempt to better understand the particularities of death, only to come away feeling like they were still unknowable to him. The mysteries, experiential, and biological manifestations.

He had a love and empathy for those who suffered, for what they endured and what he personally would soon come to bear. At age thirty-six his life takes an unexpected turn. 
 

“You that seek what life is in death, now find it air that once was breath. New names unknown, old names gone: Till time end bodies, but souls none. Reader! Then make time, while you be, but steps to your eternity. – Baron Brooke Fulke Greville, “Caelica 83”


Paul’s diagnosis of lung cancer hit hard, however as a brilliant neurosurgeon, he knew well what lay ahead. Although Paul accepted his limited life expectancy, neurologic decline was a new devastation, the prospect of losing meaning was agonizing. 

 

 

“A man who relied on his own strength and support of others. He faced each stage of his illness with grace. Not with bravado, or a misguided faith that he would overcome or beat cancer, but with an authenticity that allowed him to grieve the loss of the future he had planned and forge a new one.”

 


Paul’s voice in WHEN BREATH BECOMES AIR is strong, distinctive, and full of hope— not for an unlikely cure, but for days that were full of purpose and meaning. His death and his daughter’s birth. Writing this book was his chance, to teach us to face death with integrity. 

Paul delivers a strong and bold message for all of us--our fate is to die—whether young or old. We are a "death-avoidant" culture. We cannot deny this fact when it is staring us in the face. Some may not get any warning. The fact that we do not talk about death, does not mean that we do not think about it. 

Many of us are now baby boomers, we are facing our elderly parents' care, and concerns of our own health –the subject of death becomes more apparent. We can face it a number of ways. We do not have to be ninety, to begin thinking about it. It can occur at any age, as reflected herein. 

Through support from his wife, Lucy (an internist), his loving family, faith, and friends----with bounds of courage, they chose to have a baby, and less than a year later he would be gone. There would be difficult choices to make. Chemo, clinical trials, treatments, and end of life decisions. They never knew Paul’s deathbed would be so near. Only twenty-two months ago they received the devastating diagnosis, and only eight months earlier, the joyous birth of their daughter.

When Breath Becomes Air was unfinished, derailed by Paul’s rapid decline; however, he wrote relentlessly, fueled by purpose, motivated by the ticking clock. Despite the unwavering mental focus, sickness, and fatigue, the final book deal came three months before his death. An urgency—a race against time.

 

“Paul confronted death—examined it, wrestled with it, accepted it—as a physician and a patient. He wanted to help people understand death and face their mortality. Dying is one’s fourth decade is unusual now, but dying is not."


His desire - to get the reader into his shoes. "Not the sensationalism of dying; however, here’s what lies up ahead on the road.” He did more than just describe the terrain. He traversed it bravely. The joy and sorrow. The journey. Paul’s strength was defined by ambition and effort, but also by softness, the opposite of bitterness. He spent much of his life wrestling with the question of how to live a meaningful life, and his book explores that essential territory. 

Readers learn of Paul’s childhood, and his mom’s love of literature, his dad’s strength as a cardiologist and his dedication to his patients, community, and family. His lovely, wife Lucy, their marriage struggles, and deep love. His love of reading, books, and literature. All of the subjects are part of their truth, struggles, and redemption – the meaning of Paul’s life and Lucy’s.

They weathered the storm of Paul’s illness and drew strength from one another, family and their own daughter--as his wife Lucy writes the touching and moving Epilogue. Breathtaking! Profound—"a daily act of holding life and death, joy and pain in balance, while exploring new depths of gratitude and love".

Paul’s writing is utterly stunning —lyrical, poetic, spellbinding. The prose is magical – unforgettable. The title is very fitting, serving as a metaphor for the end, we all must face. Kalanithi reminds us that inevitably the breath of life fades, and we merge with the earth and atmosphere. 

With humor, wit, love, honesty, and raw emotion -- his love for life, faith, family, and literature shines through. A powerful tale of living with death. Paul tells his story so eloquently-- his contributions as both a neurosurgeon and neuroscientist, and his legacy--- his book, his story. A way to help others, a contribution, only he personally, could tell. He chose to look death in the eye.

 

“You left me, sweet, two legacies—A legacy of love. A Heavenly Father would content, had He the offer of; You left me boundaries of pain. Capacious as the sea, Between eternity and time, Your consciousness and me.”— Emily Dickinson


Highly recommend print, digital and audio. The audiobook is outstanding narrated by Sunil Malhotra (Paul), Cassandra Campbell (Lucy). Cassandra Campbell’s voice is almost angelic- a perfect match for Lucy- Spellbinding. It will capture your heart, mind, and soul—you will find yourself hitting rewind numerous times! 

 

Top Non-Fiction Book of 2016.  A Must Read! 

 

On a personal note: 
I have put off writing this review, as there seems to be no words to adequately describe the impact and magnitude of this stunning memoir. There are so many beautiful quotes. I pre-ordered the audiobook, prior to receiving approval for the advanced reading digital copy. I was so captured by the lyrical writing, I listened to the audiobook twice, read the book, bookmarking so many passages, and continue to reference. I have told everyone about this remarkable book, and have watched the videos surrounding the life of this extraordinary couple, and am still utterly speechless. 

Astounded by their courage and the way they faced death. They lived every moment to the end. Fully alive, despite his physical collapse---this was the life he was given, and this is what he made of it. I can only hope I can be half as courageous when my time comes, as well as my family members. 

As many of my Goodreads’ book friends are aware, my mom (83) has stage IV colon cancer (for the last two years) and my dad, (84) has leukemia. I read many books surrounding this disease (both fiction and non-fiction), as well as medical, inspirational and spiritual. This is one of the most inspiring memoirs I have ever read! It has a calming peaceful tone, dissolving fears—beauty and comfort remain with you, long after the book ends. This is not a "one-time read". It is thought-provoking. A treasure. A guide. A gift.Kalanithi's love lives on through his brave words.

 

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Advance Praise 

 

“I guarantee that finishing this book and then forgetting about it is simply not an option. . . . Part of this book’s tremendous impact comes from the obvious fact that its author was such a brilliant polymath. And part comes from the way he conveys what happened to him—passionately working and striving, deferring gratification, waiting to live, learning to die—so well. None of it is maudlin. Nothing is exaggerated. As he wrote to a friend: ‘It’s just tragic enough and just imaginable enough.’ And just important enough to be unmissable.”—Janet Maslin, The New York Times
 
“Paul Kalanithi’s memoir, When Breath Becomes Air, written as he faced a terminal cancer diagnosis, is inherently sad. But it’s an emotional investment well worth making: a moving and thoughtful memoir of family, medicine and literature. It is, despite its grim undertone, accidentally inspiring.”—The Washington Post
 
“Paul Kalanithi’s posthumous memoir, When Breath Becomes Air, possesses the gravity and wisdom of an ancient Greek tragedy. . . . [Kalanithi] delivers his chronicle in austere, beautiful prose. The book brims with insightful reflections on mortality that are especially poignant coming from a trained physician familiar with what lies ahead. . . . The narrative voice is so assured and powerful that you almost expect him to survive his own death and carry on describing what happened to his friends and family after he is gone.”—The Boston Globe
 
“Devastating and spectacular . . . [Kalanithi] is so likeable, so relatable, and so humble, that you become immersed in his world and forget where it’s all heading.”—USA Today
 
“It’s [Kalanithi’s] unsentimental approach that makes When Breath Becomes Air so original—and so devastating. . . . Its only fault is that the book, like his life, ends much too early.”—Entertainment Weekly

“[When Breath Becomes Air] split my head open with its beauty.”—Cheryl Strayed

“Rattling, heartbreaking, and ultimately beautiful, the too-young Dr. Kalanithi’s memoir is proof that the dying are the ones who have the most to teach us about life.”—Atul Gawande

“Thanks to When Breath Becomes Air, those of us who never met Paul Kalanithi will both mourn his death and benefit from his life. This is one of a handful of books I consider to be a universal donor—I would recommend it to anyone, everyone.”—Ann Patchett

“Inspiring . . . Kalanithi strives to define his dual role as physician and patient, and he weighs in on such topics as what makes life meaningful and how one determines what is most important when little time is left. . . . This deeply moving memoir reveals how much can be achieved through service and gratitude when a life is courageously and resiliently lived.”—Publishers Weekly
 
“A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity . . . Writing isn’t brain surgery, but it’s rare when someone adept at the latter is also so accomplished at the former.”—Kirkus Reviews (starred review)
 
“[A] moving and penetrating memoir . . . This eloquent, heartfelt meditation on the choices that make live worth living, even as death looms, will prompt readers to contemplate their own values and mortality.”—Booklist
 
“Dr. Kalanithi describes, clearly and simply, and entirely without self-pity, his journey from innocent medical student to professionally detached and all-powerful neurosurgeon to helpless patient, dying from cancer. Every doctor should read this book—written by a member of our own tribe, it helps us understand and overcome the barriers we all erect between ourselves and our patients as soon as we are out of medical school.”—Henry Marsh, author of Do No Harm: Stories of Life, Death, and Brain Surgery

“A tremendous book, crackling with life, animated by wonder and by the question of how we should live. Paul Kalanithi lived and died in the pursuit of excellence, and by this testimonial, he achieved it.”—Gavin Francis, author of Adventures in Human Being

 

 

Media Mentions

 

About the Author

 

 

Paul Kalanithi, M.D., was a neurosurgeon and writer. Paul grew up in Kingman, Arizona, before attending Stanford University, from which he graduated in 2000 with a B.A. and M.A. in English Literature and a B.A. in Human Biology.

 

He earned an M.Phil in History and Philosophy of Science and Medicine from the University of Cambridge before attending medical school. In 2007, Paul graduated cum laude from the Yale School of Medicine, winning the Lewis H. Nahum Prize for outstanding research and membership in the Alpha Omega Alpha medical honor society. He returned to Stanford for residency training in Neurological Surgery and a postdoctoral fellowship in neuroscience, during which he authored over twenty scientific publications and received the American Academy of Neurological Surgery’s highest award for research.

Paul Kalanithi

 

Paul’s reflections on doctoring and illness – he was diagnosed with stage IV lung cancer in 2013, though he never smoked – have been published in The New York Times, The Washington Post and The Paris Review Daily, in addition to interviews in academic settings and media outlets such as MSNBC.

 

Paul completed neurosurgery residency in 2014. Paul died in March, 2015. He is survived by his wife Lucy and their daughter Cady. Read More 

 

New York Times

Brain Pickings 

The Economist

The Guardian

Financial Times

ABC News

 

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