‘When Breath Becomes Air’ by Paul Kalanithi

Non-fiction – paperback; Vintage; 228 pages; 2017.

What makes life worth living in the face of death? That’s the subtitle of When Breath Becomes Air, a life-affirming memoir — published posthumously — by Paul Kalanithi, a neurosurgeon diagnosed with inoperable lung cancer at the age of 36.

By all accounts, Kalanithi was an extraordinary man. He held several degrees — in English literature, human biology, and the history and philoso­phy of science and medicine — and spent a decade training to be a neurosurgeon. He also had a successful writing career and had pieces published in the New York Times, the Washington Post and the Paris Review Daily.  On top of this, he still managed to find the time to get married and have a child.

His driving force? The quest to answer questions that had plagued him for most of his adult life: what makes human life meaningful? If the unexamined life was not worth living, was the unlived life worth examining?

I felt literature provided the best account of the life of the mind, while neuroscience laid down the most elegant rules of the brain. Meaning, while a slippery concept, seemed inextricable from human relationships and moral values. […] Literature not only illuminated another’s experience, it provided, I believed, the richest material for moral reflection.

The book largely charts Kalanithi’s search for those answers over the course of his short life. It charts his American childhood in small town Arizona, the middle son of Indian immigrants who encouraged him to work hard. It follows his transformation from arts student to medical student, and the joy and meaning he found in his decade-long training as a neurosurgeon.

Later, we see how he rescues a troubled marriage in order to fulfil a long-term plan to become a father. And then, finally, we learn about his difficult switch from doctor to patient when his severe chest pain, back spasms, night sweats and weight loss is diagnosed as terminal cancer.

But through all this hard work, upheaval and illness there is one constant in Kalanithi’s life: books and reading. (The text is dotted with so many references to classics, poetry and modern fiction I felt entirely inadequate, because I haven’t come close to reading a quarter of the titles mentioned and I think I read quite a lot of novels.)

When Breath Becomes Air is written in an engaging, self-aware style. Kalanithi is at much at home explaining complicated medical procedures as he is writing about his own personal life and the things that make him tick. It’s intimate, moving, honest and profound.

As well as an in-depth reflection on mortality and death, it is very much a call to arms about living the best life you can and of making your life meaningful in whatever way makes you happy. It’s a testimony to hard work and dedication, of being curious and committed, of forging your own path when societal norms might suggest another. It’s the kind of memoir you don’t forget in a hurry.