When breath becomes air

Mike Sarafa

Mike Sarafa

Life and death. Those are big things. The beauty of life and the mystery of death are topics for the ages. These ideas were captured in all their majesty and mercu­rialness in a 2016 book by Paul Kalanithi titled When Breath Becomes Air, which was recom­mended to me by a friend.

In an age where read­ing is undervalued, a good book can range from a simple treat to a life changing event. What’s unusual about this book is that the author was deceased when it was published and that it was never completed. Kalanithi was survived by his wife and newborn baby, the former of which tied the loose ends together in the Epilogue.

Before writing When Breath Be­comes Air, Kalanithi was a resident in neurological surgery. By his early 30’s he was a renowned surgeon, sought after by national and in­ternational hospitals and medical systems. In 2013, he was diagnosed with stage 4 lung cancer.

As Kalanithi under­went treatment, he shared his reflections on illness and medicine in vari­ous essays. Besides being a brilliant doctor, he was a prolific writer and reader. He began work on this book about his experiences as a doctor and a patient facing a termi­nal illness.

It is a remarkable book, which I read in just a few days. When Breath Becomes Air became a New York Times bestseller, spending 68 weeks on the non-fiction bestseller list.

“You can’t ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving,” Kalanithi writes. In his very full yet incomplete life, the book reveals Kalanithi’s struggles with medicine, philosophy, research and ultimately life and death.

What many appeared to think was a fairy tale marriage amongst two rising stars in the medical field was anything but. In the end, through his sickness and treat­ment, Kalanithi and his wife, Lucy, stood by each other. Using artificial means, they conceived a baby, even though both husband and wife knew that it was highly probable that the baby girl would grow up without a father.

In his book, Kalanithi writes this to his few months-old baby. “When you come to one of the many mo­ments in life when you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man’s days with a sated joy, a joy un­known to me in all my prior years, a joy that does not hunger for more and more, but rests, satisfied.”

Ultimately, a brilliant man’s life was cut tragically short. His book provides a rapid paced glance at his meteoric rise in medicine and his battle with cancer. In the end, Paul loses the battle, but only in one sense. In another way, in dying, he came to understand living.

Isn’t that all of what life is?

“Human knowledge is never con­tained in one person. It grows from the relationships we create between each other and the world, and still it is never complete,” Kalanithi wrote.

Living, dying and human knowl­edge and relationships are big things.

A good book is a little thing.

Very often, big things come in little packages.