Paul Kalanithi had his life mapped out: 20 years of medical practice followed by 20 years of writing. Amidst that span, marriage and children, vacations and celebrations—plenty of time to repair the strains in his marriage caused by his tenacious pursuit of medical excellence. Found riddled with cancer late in his surgical residency, already a gifted neurosurgeon at age 36, he soldiered on for a time. While terminal himself, he operated on others.
Finally lacking the endurance for surgery, he concentrated on writing When Breath Becomes Air. In just under two years left to him, he wrote about his cancer treatments, about medicine as a high calling, about his past and ongoing life. He also became a father, nine months before he died, at age 37.
His cancer responded well to initial treatment, but returned. He explains his reaction to seeing those scans, which told him his end was coming fast:
“I was neither angry nor scared. It simply was. It was a fact about the world, like the distance from the sun to the earth. I drove home and told Lucy.”
Few have been more prepared than Kalanithi to make sense of mortality. Growing up in Arizona, the son of a cardiologist, he’d planned to be a writer partly because of how hard his father worked. The price of medicine seemed too high. But then he became a neurosurgeon.
Weaving stories of surgeries he performed or treatments he witnessed with his own experiences as a patient Kalinithi reveals himself not only as intelligent but as deeply empathetic to patients. Like the rest of us, as a patient himself he had fine doctors and fair—and one awful resident who almost killed him, it seemed as much from ego and lack of empathy as from inadequate experience. When Breath Becomes Air might be assigned in medical schools to address what seems a vexing nub: always building technical expertise while blending that skill with one’s humanity