When Breath Becomes Air: A Conversation
There’s a book out right now that has everyone talking on both sides of our counter. Customers can’t get enough of it, and most everyone on our staff has taken a copy home too. As always when this happens, we like to share some of the conversation we’re having in real life with our readers online, so we’re devoting this week’s blog post to When Breath Becomes Air by Paul Kalanithi.
This riveting memoir tells the story of a young man like many others, exceptional only for his intellect and talent. From the many doors open to him, he consistently chooses the ones that lead to the most challenging roads, stacking up accomplishment after accomplishment. He earns multiple degrees in both the sciences and the liberal arts from the most elite colleges in the world, ultimately becoming a top-flight neurosurgical resident. He meets and marries a fellow doctor, weighs job offers in teaching, research, and surgery, contemplates impending fatherhood … the world is his oyster. And then, just midway through his thirties, he’s stricken with the same diagnosis he’s delivered to so many patients: terminal cancer. Kalanithi faces his mortality with the same clear eyes and wide heart that brought him worldly success, and his book triumphantly demonstrates how much life can be packed into a sentence before it ends, as they all must, with a full stop.
We invite you to join the conversation about this remarkable book in whatever way you’d like–comment on our blog, email us your thoughts, or just chat us up in person in the store.
Miriam: I’ll be honest, I didn’t read The Last Lecture by Randy Pausch. In fact, when I see a memoir related to terminal illness I put it aside and instinctively reach for a happier subject. But sometimes, a book I wouldn’t usually choose calls out to me, and in retrospect I can see the events that led me towards Paul Kalanithi’s When Breath Becomes Air.
First, there were the articles in The New York Times. I first became aware of Kalanithi’s writing ability in January 2014, when Paul published “How Long Have I Got Left?”. I was moved by how he expressed his feelings about a terminal diagnosis. Then in January of 2016, I read “My Marriage Didn’t End When I Became a Widow” by his wife, Lucy, which was followed the next day by a book review for WBBA. I remembered Paul’s old article and went back and looked it up. The subject matter pierced me in a way it wouldn’t have a few years ago.
My husband treats cancer patients and these kinds of stories flow constantly through our daily life (his far more than mine). But there is some remove. Far closer to home was the recent passing of one of our most beloved neighbors here on the island. His rapid decline after a terminal diagnosis left us reeling. Although he was a brilliant doctor and raised 7 kids, to us he was the godfather of everyone in the neighborhood. He and his wife hosted the neighborhood Christmas party. We always heard his distinctive baritone laugh floating off his deck and over to ours. In the summer we’d catch a glimpse of him mowing his lawn and I used to jokingly tell my husband that would be him in later years. We both visited him right up till the end and often brought our little ones by to lift his spirit. Our children adored him, as did everyone else lucky enough to cross his path. Although we only knew him for five years, he touched our lives in a special way and we will never forget him.
Our neighbor’s memorial service was packed with hundreds of people; I’ve never seen anything like it. He left such an impression on so many people of all ages. And that experience continues to cross my mind, wondering about the meaning of such a life and all that gets left behind.
So this book arrived at a moment when I was ready for it. I urged James to pick up When Breath Becomes Air, and the rest of the staff has been reading it too. We’re so glad that Lori Robinson is interested enough to join our online discussion too and I can’t wait to hear her thoughts.
On that note, James and Lori, what did you think?
James: Although some of my favorite books are memoirs, I wouldn’t say I’m a fan of the genre as a whole. Memoirs are inherently about the self, and all too many of them never get beyond that. But the pre-publication reports about When Breath Becomes Air suggested that it was much more than an exercise in self-indulgence, and together with Miriam’s gentle prodding, that was enough for me to give it a try. What really cinched the deal and made me sure I wanted to complete it–and I am probably the only person in the world for whom this is true–was the epigraph. Anyone who kicks off his book by dropping a quote from Fulke Greville has my attention. I realize that not everyone is the aficionado of Early Modern English Poesy that I am, but just seeing that obscure name shows that Kalanithi has a frame of reference that’s wider than most.
As I started to read further, that expansive outlook paid exactly the dividends I was hoping for. There’s a passage I particularly liked when the author is describing a formative experience he had in the Sierras:
[W]e would sit and watch as the first hint of sunlight, a light tinge of day blue, would leak out of the eastern horizon, slowly erasing the stars. The day sky would spread wide and high, until the first ray of the sun made an appearance. The morning commuters began to animate the distant South Lake Tahoe roads. But craning your head back, you could see the day’s blue darken halfway across the sky, and to the west, the night remained yet unconquered–pitch-black, stars in full glimmer, the full moon still pinned in the sky. To the east, the full light of day beamed toward you; to the west, night reigned with no hint of surrender. No philosopher can explain the sublime better than this, standing between day and night. It was as if this were the moment God said, “Let there be light!”
Beautifully written, and not the sort of observation you might expect from a neurosurgeon. (Editorial aside: this is exactly the same supernal phenomenon that inspired Alexander Calder to a life in art, as I learned some years ago from my son’s picture book.) WBBA was really growing on me at this point.
The true uniqueness of its author’s voice became apparent to me on page 47 in the middle of a discussion regarding, of all things, the dissection of cadavers. Kalanithi is attempting to explain the complex balance that med students must maintain, boldly exploring every anatomical nook and cranny while also respecting the dignity of the deceased. He hits upon an image that’s almost shocking to a layperson: the discovery of a pair of undigested morphine pills in a man’s stomach. Scalpel still in hand, he takes the time to acknowledge the man’s suffering and recognize the humanity that he possessed even at the moment of his death. No one but a surgeon could employ that detail, and no one but a real writer could deploy it to such effect. It blew me away.
Lori: What I loved the most about WBBA taken as a whole was that Kalanithi is continually exploring the question of meaning. His entire life is a search for an answer or, at least more depth of understanding. From a young age, it is the driving force behind every major choice he makes, from what he studies in college, to choosing between a career-advancing summer job and one that connects him with people, to ultimately becoming a doctor specializing in neurosurgery. Because of this underlying motivation, he was willing to follow a meandering path as things changed and evolved.
Although this is not how I generally observe life to be, there is a prevailing mindset that life is a process of figuring out what we want to do/are meant to do/are good at doing and then doing that. We choose and then stay the course. We usually read stories about people who follow this path. What I appreciated about the way Kalanithi told his particular story is his honesty at every step. He was reaching safe ground after years of striving and then his diagnosis changed everything. The future he planned for himself was gone. So he planned a new, much shorter future with the information he had at the time. And then things changed again. And he chose again. His choices weren’t without struggle and doubt and questions. He grieved each lost possible future, but still had a sense of hope and goodness about what was given him. Instead of being locked into “this and only this,” he was willing to risk for the possibility of meaning.
When he and his wife discuss having a child, she poses some questions:
“Will having a newborn distract from the time we have together?” she asked. “Don’t you think saying goodbye to your child will make your death more painful?”
“Wouldn’t it be great if it did?” I said. Lucy and I both felt that life wasn’t about avoiding suffering.
His willingness to engage suffering in order to deeply feel joy as well says everything about his character.
