Tragic.  Sad.  Authentic.  Absorbing. 

How else to describe a book about a brilliant, young neurosurgeon just at the beginning of career and family when struck down by cancer that I read in one sitting?

Revealing.  Insightful.  Discerning. Helpful.

How I’d like to describe a book where the author relates the challenges of medical school, cancer diagnosis, treatment, remission, career restart, reoccurrence, and death.  

But I can’t.  Nor can I recommend the book.

I learned a lot about Paul Kalanithi, yet I didn’t learn much else.  I learned he showed grit, through medical school, through chemo, and simply by writing the book as he endured it all.  He showed talent and determination.  And I’m sorry he died, for his family and for the many sick people he could have made healthy in what he planned to be a long career in medicine.

And while many remark that diagnosis of a fatal disease quickly focuses the mind and clarifies your definition of purpose in life, I read one man’s struggle to either live with positive hope as if he’s got 20 years ahead of him, or assume “the worst”, realize today’s investment in training or work that pays off only in ten year terms is ill-advised, and focus on making a difference with a shorter time frame to realize a return.

Kalanithi pursued both paths.  And while those patients he managed to see while in remission are forever changed due to his efforts, my understanding of his thought process to reach those decisions remains cloudy.

We all face the live-for-today vs invest-in-the-future conundrum, only most of us have much less information that his 2 year likely survival rate.  He had a clinical diagnosis and professional training to comprehend it.  And while ultimately he moved away from academic research and its decade-long returns measurement, he still chose career … all while also deciding to have a child.  I’m not criticizing his decisions or his right to make them … I just wish I better understood how he arrived at them.

And one final remark … the title … “when breath becomes air” … is the best writing in the book.   What I read is a clinically poetic description of death, as if breath includes a soul and air does not.  That’s a superb statement.  That poetry from a surgeon is, dare I say, breathtaking.  Unfortunately, the rest of the book never reaches that level again; in both prose and message, it’s not as good as the title.

When Breath Becomes Air, by Paul Kalanithi